Dr. Shea's Takeaways from ASCO 2016

Posted by John Shea, M.D., Ph.D. on 6/6/16 2:37 PM

CLD's Medical Director, Dr. John Shea, recently attended the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. The Annual Meeting brings together 30,000 oncology professionals from around the world and features educational sessions that present state-of-the-art treatment modalities, new therapies, and the latest groundbreaking research. 

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The theme for this year's meeting was Collective Wisdom: The Future of Patient-Centered Care and Research. Collective wisdom allows for transformative advances in cancer research and treatment. Evidence of this impact can clearly been seen in the area of immunotherapy.

Progress in the field of immunotherapy (using the patient’s own immune system to fight cancerous cells) is undoubtedly one of the most exciting developments in cancer treatment to emerge in a while. “No recent advance has been more transformative than the rise of immunotherapy, particularly over this past year, making immunotherapy the American Society of Clinical Oncology’s (ASCO’s) Advance of the Year”, proclaimed ASCO President Julie M. Vose, MD, in ASCO’s Clinical Cancer Advances 2016. Immunotherapy has even made it to the mainstream: TIME Magazine made the potentials of immunotherapy their March 2016 cover story.

And so at the ASCO 2016 Annual Meeting, it’s with no surprise and with a lot of excitement that we see a major focus on new emerging immunotherapies and new combination therapies for existing immunotherapies. For example, Bristol-Myers Squibb Company [which promotes immunotherapy agents Yervoy (ipilimumab) and Opdivo (nivolumab)] is scheduled to give 36 presentations in Chicago this June focusing on immunotherapies. Recently approved monoclonal antibodies Darzalez (daratumumab, Janssen Biotech, Inc.) and Empliciti (elotuzumab, Bristol-Myers Squibb Company), the first in their classes for the treatment of multiple myeloma, will also be presenting additional efficacy data this conference. In total, ASCO is dedicating 3 separate clinical science symposia tracks to the advances in immunotherapy, in addition to more than 50 oral and poster presentation populating individual disease tracks.

Yes, this is an exciting time for an exciting field. But while we should be hopeful, we should also hold a bit of healthy skepticism for immunotherapies’ true future for cancer therapy. Transformative therapies have come before, with broad spectrum of activity and durable response (eg, chemotherapies like aminopterin or cisplatin, the B-cell-targeting rituximab, among many others). These therapies inarguably had substantial impact on patients’ lives with certain types of cancer, but the overall impact that these drugs and their derivatives had in our War on Cancer fell short of expectations.

There’s a potentially overwhelming number of ongoing studies involving immunotherapies (over 400 registered at according at ClinicalTrials.gov); overwhelming because a large volume of data does not always lead to a great depth of knowledge. Some of these emerging immunotherapies target the same mechanisms as established immunotherapies, and they are being studied in the same indications (non-small cell lung cancer, melanoma, renal cell carcinoma, bladder cancer) that approved immunotherapies have already been shown to be efficacious. Emerging agents with the same mechanism of actions indicated for the same tumor types are not in line with the spirit of ASCO’s Advance of the Year. Indeed, patients for clinical trials are a precious, finite resource; a patient recruited to a one of these >400 immunotherapy clinical studies is one less patient available for another study…perhaps one supporting 2020’s Advance of the Year. Too many resources focused on immunotherapies has the real potential to hinder future advances.

Immunotherapy rightly deserves the spotlight during ASCO’s 2016 Annual Meeting, and we look forward to the potentially game-changing data that will be discussed this June. But we should interpret that data with the context of game-changing therapies that had come before and anticipate the Advances of the Year yet to come.

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Topics: oncology asco immunotherapy