If it’s the end of May it must be time for ASCO! What’s ASCO, you ask? It is the American Association of Clinical Oncology annual meeting that is held in Chicago around this time of the year. Although the association is a professional organization based in the U.S., their annual meeting, which attracts more than 30,000 people, includes cancer docs hailing from more than 100 countries across the world. Also in attendance are representatives from most, if not all, pharmaceutical and biotech companies as well as a significant number of cancer patients and advocates.
Last year there was a lot of new research about breast cancer presented at ASCO. This year there were fewer developments.
There were a few good presentations that reported findings from studies looking at treatments for metastatic disease. One of these was the MARIANNE trial, which randomly assigned 1095 patients with advanced or previously untreated metastatic HER2-positive breast cancer to one of three treatments: T-DM1 (Kadcyla) plus pertuzumab (Perejta); T-DM1 (Kadcyla) plus placebo; or trastuzumab (Herceptin) plus a taxane (docetaxel or paclitaxel). The third arm of Herceptin plus chemo, was the standard of care when the study began.
The end result: Combining two HER2-targeted therapies or using Kadcyla alone was not better than Herceptin plus chemo. It’s also important to note that after the MARIANNE trial started other study results led to the standard of care for first-line treatment for HER2+ metastatic breast cancer to become a taxane, Perjeta, and Herceptin. Until we see a better combination, that will not change.
Findings also were presented from the PALOMA trial, which compared fulvestrant (Faslodex) alone to Faslodex and palbociclib (Ibrance) in pre- and post-menopausal women with ER+, HER2- metastatic breast cancer that had progressed on prior hormone therapy. Ibrance is a new type of drug called a CDK inhibitor, and the study showed that using it along with Faslodex was better than Faslodex alone. There are currently other CDK inhibitors in clinical trials, and it is good to see this new approach working for patients with ER+ metastatic disease.
Bigger news to me was the inclusion of patients and advocates as equal partners in the conference. Pharmaceutical companies and ASCO itself hosted many events especially geared to advocates. And there were multiple opportunities for advocacy groups to interact at all levels. There also was evidence that our cry for more attention to the collateral damage of treatment is being taken seriously. One presentation was titled “The Cost of the Cure”, the exact phrase we used three years ago to launch the Collateral Damage project! This shift since I entered the field 25 years ago is remarkable–and was past time. It is only with everyone at the table that we will make real progress in solving cancer once and for all!