Obligatory—This is not medical advice
Every year, thousands of oncologists gather at McCormick Place in Chicago during the first week of June for the American Society of Clinical Oncology Meeting (ASCO). This event serves as a unique gathering for doctors and industry professionals, providing an opportunity to stay informed about the latest advancements in cancer treatment. Downtown Chicago is adorned with advertisements promoting cutting-edge immunotherapies, replacing the usual Brian Urlacher hair loss prevention posters. Although the primary purpose is to learn about the forefront of oncology, the meeting also offers a valuable chance for me and my colleagues to reconnect, discuss ongoing research, and enjoy the city during its finest season. Here are some notable highlights.
Impact of Pregnancy in women with desmoid fibromatosis: An international retrospective observational study
A significant portion of the patients under my care who have desmoid tumors is young women. These individuals understandably have numerous inquiries regarding how pregnancy can impact their desmoid tumors. Although we still require more longitudinal data from patients, an abstract by Fiore et al. (#11513) provides us with a better understanding.
Results:
There was a risk of progression of 5% during pregnancy
Risk of progression was 9% in the postpartum window
Treatment was needed in only 6% of patients
Efficacy and safety of nivolumab and trabectedin in pretreated patients with advanced soft tissue sarcaomas (GISG-15, NitraSarc)
First Author: Peter Reichardt, Abstract: 11500
This study was a non-randomized, exploratory phase II trial that involved two groups of patients with sarcomas. Group A consisted of patients with leiomyosarcomas and liposarcomas (L-type sarcomas), while Group B included patients with non-L sarcomas (sarcomas other than leiomyosarcoma or liposarcoma). The treatment regimen involved patients receiving three cycles of trabectedin, followed by a combination of trabectedin and nivolumab for a maximum of 16 cycles. The study protocol was later amended to include nivolumab starting from cycle 2. The primary endpoint assessed was the progression-free rate at 6 months based on the RECIST criteria.
Results
92 patients were enrolled
43 in Group A
49 in Group B
The Progression Free Rate at 6 months was 47.6% for patients in group A, which was higher than historical controls
Interpretation: Given this met its primary endpoint as deemed by this trial, randomized controlled trials of trabectedin vs trabectedin + nivolumab should be considered
Single-arm, open-label phase 2 trial of doxorubicin plus zalifrelimab (anti-CTLA-4), with balstilimab (anti-PD-1) for advanced STS
This trial was done for patients in the 1st/2nd lines of treatment without prior immunotherapy or doxorubicin. It utilized Simon minimax 2-stage design with a primary endpoint of progression free rate at 6 months. Improvement sought was 20% over baseline (of 43%).
Results:
35 patients were recuirted
Progression free rate is estaimted to be 52% (but still maturing)
Response rate was 35%
Interpretation: While data are still maturing, statistically speaking, this trial has not yet met its primary endpoint. While I have no doubt that randomized trials of doxorubicin and immunotherapy will be conducted, perhaps this isn’t the right combination for most patients.