Highlighting the latest in cancer research

Each June, over 40,000 oncology professionals, including physicians, researchers, patient advocates, and pharmaceutical representatives attend the American Society of Clinical Oncology (ASCO) meeting in Chicago, IL. This meeting is considered the premiere forum for the presentation of the most recent scientific progress made in the fight against cancer.

This year, our Chief Scientist and Senior Vice President of Research, Eva Gordon, PhD and members of our Personal Care Teams of research scientists and advanced practice clinicians attended dozens of presentations to learn the latest clinical data and emerging technologies. They also connected with oncologists, patient advocates, and technology leaders in the cancer community. Here’s some of the most exciting developments at ASCO 2023.

A new option for women with early breast cancer
Ribociclib (Kisqali) is a cell cycle inhibitor that is currently used to treat patients with certain types of metastatic breast cancer. Initial data was presented from a clinical trial called NATALEE, which studied whether patients with earlier breast cancer who had a high risk of recurrence could benefit from adding ribociclib to their hormone therapy.

Patients in this study had stage II or III hormone receptor-positive, HER2-negative early breast cancer and had a high risk of recurrence. Remarkably, the results showed that the addition of ribociclib to hormone therapy decreased the risk of the cancer recurring by 25% versus hormone therapy alone.¹

This study suggests that ribociclib may be an effective treatment for these patients, providing them with a new option for reducing their risk of cancer recurrence.²

“This presentation was incredibly meaningful to me because we guided a PHM client to this trial a couple of years ago, and she remains cancer free and is doing great.”

Eva Gordon, PhD, Senior Vice President, Research and Chief Scientist

Using blood-based tests to guide colorectal cancer treatment

Tumor cells shed small pieces of their DNA into the bloodstream, called circulating tumor DNA (ctDNA). Analysis of ctDNA in a blood sample, or “liquid biopsy,” can measure the amount of ctDNA and identify specific mutations present in the ctDNA.⁶ This can help determine what treatments might work best and can predict the risk of recurrence. In a session at ASCO 2023, a panel of oncologists from institutions around the globe discussed the current uses of ctDNA in managing early colorectal cancer.

The experts reviewed patient cases, debated the best uses of ctDNA testing to monitor disease recurrence, and discussed the most effective, personalized treatment options for each patient, based specifically on their individual ctDNA tests. The panel also provided an overview of five clinical trials studying the use of ctDNA in colorectal cancer that have the potential to change how the disease is managed in the future.

The exciting advances in using ctDNA to manage early colorectal cancer are beginning to improve decision-making for clinicians and patients as they develop treatment plans that optimize effectiveness and limit side effects.

“Hearing the discussion from a case-based panel on using ctDNA in managing early colorectal cancer reminded me how far ahead we are at PHM regarding using ctDNA to guide decision-making.”

Lee Gibbs, PhD, Research Director

A promising treatment for ovarian cancer patients with limited options
Women with a type of ovarian cancer called high folate receptor-α (FRα) platinum-resistant ovarian cancer have limited treatment options and often have poor outcomes. The MIRASOL trial examined whether drug called mirvetuximab soravtansine (Elahere) could benefit women with this type of ovarian cancer. Elahere is a type of drug called an antibody drug conjugate, which combines the targeting aspect of an antibody and the cancer-killing power of a chemotherapy.³

The results presented at ASCO 2023 showed that Elahere treatment resulted a 33-35% increase in survival rates compared to chemotherapy, and a response rate for the Elahere group that was more than double that of chemotherapy group (42% vs. 16%).⁴

Treatment with Elahere also resulted in fewer side effects than treatment with chemotherapy. This study demonstrates that progress is being made in treating this type of cancer for which there are otherwise limited treatment options.

“This treatment offers hope for these patients to get a break from the toxicities of chemotherapy and build strength for the next step in their journey.”

Amber McDonald, MS, PA-C, Managing Clinical Director, Physician Assistant, ClearCancer Solutions

Preventing cervical cancer recurrence with less invasive surgery
The standard of care for low risk, early-stage cervical cancer has been a surgery called a radical hysterectomy. This procedure is quite invasive and requires removal of some tissue around the uterus, as well as the top portion of the vagina. Women who undergo this procedure often endure significant negative effects on their quality of life. There is a less radical surgical option called a simple hysterectomy, which requires only the removal of the uterus.⁵

In a study presented at ASCO 2023, investigators compared the rates of cancer recurrence in patients who underwent radical hysterectomies with those who got simple hysterectomies. They found that there was no difference in the rates of cancer recurrence for 3 years after surgery. Patients who had simple hysterectomies also had fewer surgical complications and better quality of life.⁵

“This study suggests that simple hysterectomy can be an effective alternative that spares women from the detrimental effects of radical surgery while providing similar protection from cancer recurrence.”

Christina Celestino, MSN, RN, FNP-BC, Clinical Director, Nurse Practitioner

Update on a unique cancer treatment: tumor treating fields
Cancer treatments like radiation, chemotherapy, and other medications often come with challenging side effects that impact quality of life. Tumor Treating Fields (TTFields) are a type of non-invasive cancer treatment that uses low intensity, alternating electric fields to disrupt cell division and tumor growth. TTFields are delivered by transducer arrays placed on the skin, close to the tumor, to inhibit growth. This type of treatment is quite tolerable, with skin irritation as the most common side effect.^7,

TTFields are currently approved by the US FDA for the treatment of glioblastoma multiforme (an aggressive type of brain cancer) and for malignant pleural mesothelioma (a cancer of the lining of the lungs). There are many clinical trials investigating TTFields in a variety of cancers and seven studies involving TTFields were presented at ASCO 2023.

One interesting study that was presented, the LUNAR study, involved patients with non-small cell lung cancer who had worsening disease after platinum-based chemotherapy. The results showed a significant increase in overall survival (of about 3 months) in patients who had TTFields treatment added to standard of care therapy versus those who received standard of care treatment alone.⁹

While these benefits were modest, the use of non-invasive TTFields continues to be a promising treatment option that may prove beneficial for a variety of cancers in the future.

“As a big supporter of TTField devices, I was excited to hear about the results of the LUNAR phase 3 trial results in NSCLC following platinum failure reported at ASCO2023.”

Irina Sagalovskiy, PhD, Research Director

References

1. Slamon, D. J. et al. Ribociclib and endocrine therapy as adjuvant treatment in patients with HR+/HER2- early breast cancer: Primary results from the phase III NATALEE trial. JCO 41, LBA500–LBA500 (2023).
2. Interim NATALEE Data Support Ribociclib Plus Endocrine Therapy for Stage II/III HR-Positive/HER2-Negative Early Breast Cancer. ASCO Daily News https://dailynews.ascopubs.org/do/10.1200/ADN.23.201439/full.
3. Mirvetuximab Soravtansine Improves Survival in Patients With Recurrent Ovarian Cancer – The ASCO Post. https://ascopost.com/news/june-2023/mirvetuximab-soravtansine-improves-survival-in-patients-with-recurrent-ovarian-cancer/.
4. Phase III MIRASOL (GOG 3045/ENGOT-ov55) study: Initial report of mirvetuximab soravtansine vs. investigator’s choice of chemotherapy in platinum-resistant, advanced high-grade epithelial ovarian, primary peritoneal, or fallopian tube cancers with high folate receptor-alpha expression. | Journal of Clinical Oncology. https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA5507.
5. Plante, M. et al. An international randomized phase III trial comparing radical hysterectomy and pelvic node dissection (RH) vs simple hysterectomy and pelvic node dissection (SH) in patients with low-risk early-stage cervical cancer (LRESCC): A Gynecologic Cancer Intergroup study led by the Canadian Cancer Trials Group (CCTG CX.5-SHAPE). JCO 41, LBA5511–LBA5511 (2023).
6. Malone, E. R., Oliva, M., Sabatini, P. J. B., Stockley, T. L. & Siu, L. L. Molecular profiling for precision cancer therapies. Genome Med 12, 8 (2020).
7. Arvind, R. et al. Tumor-Treating Fields: A fourth modality in cancer treatment, new practice updates. Critical Reviews in Oncology/Hematology 168, 103535 (2021).
8. Wenger, C. et al. A Review on Tumor-Treating Fields (TTFields): Clinical Implications Inferred From Computational Modeling. IEEE Rev Biomed Eng 11, 195–207 (2018).
9. Leal, T. et al. Tumor Treating Field (TTFields) therapy with standard of care (SOC) in metastatic non-small cell lung cancer (mNSCLC) following platinum failure: Randomized, phase 3 LUNAR study. JCO 41, LBA9005–LBA9005 (2023).