2019 Clinical Cancer Advances
The work of nine researchers who previously received early-career funding from Conquer Cancer are featured in Clinical Cancer Advances 2019: ASCO's Annual Report on Progress Against Cancer. This independent review of the field, now in its 14th year, showcases major breakthroughs in clinical cancer research and care, as well as emerging trends in oncology.
Advance of the Year – Rare Cancers
At Memorial Sloan Kettering Cancer Center in New York City, Mrinal M. Gounder, MD, led the first randomized, global trial for patients with desmoid tumors - a rare type of sarcoma.
The trial: Patients with unresectable progressive desmoid tumors randomly received either treatment, a drug called sorafenib, or a placebo.
The results: Tumors did not grow for one year in twice as many patients who received treatment compared to those who received a placebo.
The impact: This study is particularly important because it is the first of its kind and there is little information available on desmoid tumors. Because there are so few patients with desmoid tumors, which sometimes shrink even without systemic treatment, managing a trial at all has been a challenge for doctors. Before this trial, patients with desmoid tumors were often given off-label treatments.
Dr. Gounder received a Conquer Cancer Career Development Award (CDA) in 2012, supported by the Sarcoma Foundation of America.
Immunotherapy Treatment – Lung
At New York University Perlmutter Cancer Center in New York City, Leena Gandhi, MD, PhD, led a large clinical trial of patients with metastatic non–small-cell lung cancer (NSCLC).
The trial: Patients received either standard chemotherapy or chemotherapy and an immunotherapy drug called pembrolizumab.
The results: Patients given immunotherapy in addition to chemotherapy lived significantly longer (and without tumor growth) than patients who only received chemotherapy.
The impact: Lung cancer is the number one killing cancer of men and women in the United States. These trials dramatically increase the population that can be considered for the use of immunotherapy as the first line of treatment to essentially all non-squamous NSCLC patients.
Dr. Leena Gandhi received a Conquer Cancer Young Investigator Award (YIA) in 2008.
Immunotherapy Treatment – Head & Neck
At the University of California Moores Cancer Center at UC San Diego Health in La Jolla, Ezra E. Cohen, MD, led a large clinical trial of patients with head and neck cancer that had either returned from a previous diagnosis or spread to other parts of their body.
The trial: The research team compared the efficacy and safety of pembrolizumab versus standard-of-care therapy for the treatment of head-and-neck squamous cell carcinoma.
The results: The results demonstrated clinically meaningful prolongation of overall survival and favorable safety profile of pembrolizumab in patients with recurrent or metastatic head and neck squamous cell carcinoma.
The impact: This is the first phase III trial to demonstrate the impact of PD-L1 expression on the efficacy of pembrolizumab in head and neck cancer.
Dr. Ezra Cohen speaks at the 2018 ASCO-SITC Clinical Immuno-Oncology Symposium. He received a Conquer Cancer YIA in 2003 supported by MGI Pharma, Inc. and a 2005 CDA supported by Sanofi-aventis.
Immunotherapy Treatment – Lymphoma
At The University of Texas MD Anderson Cancer Center in Houston, Sattva S. Neelapu, MD, led a multi-center study of patients with refractory large B-cell lymphoma who received CAR T-cell immunotherapy.
The trial: Patients received CAR T-cell immunotherapy.
The results: Patients receiving this therapy had high levels of durable response with some side effects.
The impact: These therapies represent a promising new option for patients. Prior to the discovery, the survival for these lymphoma patients could be measured in months.
Dr. Neelapu received a Conquer Cancer CDA in 2006 supported by Eli Lilly & Company.
Targeted Therapies – Lung
In two separate trials, Conquer Cancer researchers joined forces to improve treatment for patients with non-small cell lung cancer (NSCLC). Suresh S. Ramalingam, MD, led the trial at Winship Cancer Institute at Emory University in Atlanta. Pasi A. Jänne, MD, PhD, led the group at the Dana-Farber Cancer Institute in Boston.
The trials: Patients received either standard epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) or a third-generation EGFR-TKI, osimertinib.
The results: Taken together, the trials showed that the treatment almost doubled the time to disease progression achieved with older medicines and quality of life improved for patients. Based on these data, osimertinib has become the new initial treatment of choice in NSCLC patients with certain mutations, including those not responsive to older therapies.
The impact: A new drug was approved by the FDA in 2018.
Dr. Suresh Ramalingam (left) received a Conquer Cancer CDA in 2006 supported by AstraZeneca. Dr. Pasi Janne (right) received a YIA in 2001 supported by Eli Lilly & Company.
Surgery and New Approaches – Leukemia
In two separate trials, Conquer Cancer researchers joined forces to improve treatment for older patients with acute myeloid leukemia. Courtney D. DiNardo, MD, led the study at The University of Texas MD Anderson Cancer Center in Houston. Daniel A. Pollyea, MD, headed up efforts at the University of Colorado School of Medicine in Aurora.
The trials: Patients were given two drugs (one which affects the DNA methylation process and one which provokes cancer cell death) to determine if the combination could boost remission of acute myeloid leukemia in older people.
The results: Of the patients initially enrolled, 60 percent went into complete remission (or achieved complete remission but bone marrow function was not completely restored).
The impact: This study demonstrated unprecedented overall response and complete response rates for this patient group. The treatment is poised to become a new standard of care for these patients whose needs were previously unmet.
Dr. Courtney D. DiNardo received a Conquer Cancer YIA in 2012. Dr Daniel A. Pollyea received a Conquer Cancer YIA in 2009 and a CDA in 2013.
Patient Care – Palliative Care
At Massachusetts General Hospital in Boston, Jennifer S. Temel, MD, led a study of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation.
The trial: Patients who received inpatient palliative care along with standard transplant care were tested against those who did not receive palliative care.
The results: Based on this study, incorporating in-patient palliative care into routine transplant could reduce depression and lead to decreased psychological distress that typically persists six months beyond the transplant.
The impact: This work builds on the growing body of literature supporting the integration of palliative care in advanced cancer care. However, this expands the work to patients with hematologic malignancies undergoing hematopoietic stem cell transplantation, and for some, potentially curable therapy.
Dr. Jennifer Temel receives the Walther Cancer Foundation Palliative and Supportive Care in Oncology Endowed Award and Lecture from Walther Cancer Foundation representatives, Greg Pemberton and Dr. Craig Brater at the 2018 Palliative Care in Oncology Symposium. In 2005, she received a Conquer Cancer CDA supported by Amgen.
A panel of experts in different oncology subspecialties, as well as cancer prevention, quality of care, and health disparities develop Clinical Cancer Advances. New in this year's report, ASCO debuts a set of priorities for cancer research to accelerate progress against cancer. The research priorities identified by ASCO address vital, unmet needs and help fill knowledge gaps in areas critical to improving patient care.
Conquer Cancer grants funded these researchers at various stages of their careers. Unless noted in the published study, the projects highlighted in this report do not reflect direct funding from Conquer Cancer or the donors who supported the grants.
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