REPORT BY PATIENT ADVOCATE SALLY PAYNE ON HER ATTENDANCE AT THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING, CHICAGO, 30 MAY – 3 JUNE 2008.


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On behalf of the International Brain Tumour Alliance (www.theibta.org), I recently attended the American Society of Clinical Oncology (ASCO) meeting in Chicago where, with Eileen and Seamus Feely (a brain tumour caregiver and patient) I manned the IBTA’s exhibition booth in the patient advocacy section.  I have made a brief summary below (from a layperson’s point of view) of some of the noteworthy topics.

 

The link to all of the CNS abstracts presented at ASCO is: http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_category_abstracts_view&confID=55&subCatID=5

 

The abstract numbers are indicated in brackets next to the points mentioned to facilitate further review.

Many of the new studies are looking at current standard of care (concomitant radiation and temozolomideTemodal/Temodar -  followed by six months of adjuvant temozolomide) plus possible additional therapy/therapies in newly diagnosed patients. Research is being focused on improving the standard of care in this way to determine if this helps prolong time to progression (2055) (2077) (13008) (2039)

 

There are a number of single agent therapies being tested in Phase II trials with promising results. (2017) (2018)

There were a number of Phase II studies looking at various vaccines plus standard of care.  Study investigators report that the results have been positive and Phase III trials are planned  ( 2011 and 2042)

Bevacizumab (Avastin) was discussed frequently at ASCO and this antiangiogenic therapy was the subject of a number of presentations.  According to studies, in recurrent tumours Avastin trials show positive results particularly when used in combination with chemotherapy.

 

Avastin plus CPT11 was shown in a number of ASCO-reported studies to be effective. Avastin plus various other chemotherapy options have also had positive study results. (2010b) (2021) (2022) 

 

A lot of interest was shown in combining temozolomide (Temodar in the US and Temodal in the rest of the world) and Avastin at recurrence and in first line treatment. (2074)

 

There were a number of discussions about the difficulties doctors have in reading MRIs after Avastin use. (2085)

 

With regard to temozolomide, varying schedules were discussed. (2010) (2078) (2084) (2044 )  Re-challenge using temozolomide was also a dominant topic. A study that looked at re-challenge with a prolonged temozolomide schedule after recurrence showed positive results. (2078)

 

The role of MGMT status was also mentioned frequently. Debate continues as how best to use this information. (2044)

 

Presentations and discussions at ASCO also focused on anaplastic astrocytoma, with some clinicians indicating that this type of tumour should be separated out in clinical trials as prognosis for this tumour type is more favourable.

 

In addition a study has shown that for anaplastic astrocytoma it doesn’t matter in which order radiation and chemotherapy are administered because there is the same overall survival and little difference in progression-free survival (PFS) (LBA2007).

Of further note was a study with positive results on recurrent /refractory anaplastic astrocytoma which is moving into a Phase III trial (2076).

Of importance to brain tumour patients is the question of access to drugs outside of clinical trials. Discussions were held on this topic and one viewpoint that was expressed was that off-label use could possibly disadvantage patients as enrolment numbers for clinical trials could be affected so overall research might not progress so quickly. This was discussed at an educational seminarAccess to Investigational Drugs Off-Protocol: What Do We Owe Patients?”

 

The issue of pseudo progression was widely addressed.  Pseudo progression was considered most likely to occur up to three months after radiation but can occur up to six months post-radiation . One study showed that pseudo-progression occurred in around 23% of the cases (2025). See also IBTA background paper at: http://www.theibta.org/PseudoProgression.pdf

 

There was an interesting study showing a correlation between the mechanisms of GBM and melanoma. (2082)

 

Although still in its relatively early stages, it was evident at ASCO that stem cell research is being investigated by many institutions.  

 

Note: The IBTA is sponsored by a number of companies in the form of undirected grants. These are acknowledged on the IBTA website at: http://www.theibta.org/sponsorship.html 

 

Every effort has been made to be accurate regarding the information contained in this report and which is for educational purposes only.  However, the IBTA accepts no liability for any errors, inaccuracies or omissions.  For individual patient medical care and advice, consult your doctor.