Image: Print and online media coverage of ICR research during the ASCO 2019 cancer conference
Over the past week, the best and brightest minds in cancer research once again flocked to Chicago for the Annual Meeting of the American Society of Clinical Oncology (ASCO). More than 30,000 cancer researchers and clinicians gathered to hear about the latest developments and discuss the newest, most exciting treatments.
The theme of this year’s ASCO conference was ‘Caring for every patient, learning from every patient’. Many of our scientists travelled to the ASCO Annual Meeting for five days of learning, networking and presenting. So how will all the buzz translate to patients? And what were the biggest stories and themes coming out of the conference?
As ever, a large part of ASCO was dedicated to updates on the latest data from clinical trials. Several major trials made waves at this year’s conference, including some led by researchers at the ICR and our hospital partner, The Royal Marsden NHS Foundation Trust.
Targeted drug promise in prostate cancer
On Friday, researchers presented data from a phase II trial led at the ICR and The Royal Marsden of the targeted drug olaparib in men with advanced prostate cancer. The men who received the drug had tumours with faults in various DNA repair genes, including the BRCA genes, best known for their link with breast cancer.
Olaparib was first approved for use in women with ovarian cancer who had inherited faults in their BRCA genes, and is now also licensed for use in BRCA-mutant breast cancer.
The new trial examined whether the drug’s use could be widened out to prostate cancer, and not only to men with inherited mutations but also those who had mutations in DNA repair genes within their tumours. The findings were positive, especially for men whose tumours had mutations in their BRCA genes.
The trial, led by Professor Johann de Bono, Director of the Drug Development Unit at the ICR and The Royal Marsden, found that an incredible 80 per cent of men with BRCA gene faults responded to olaparib.
A phase III trial of olaparib in prostate cancer has already begun, and the ICR researchers are hopeful that the drug will reach patients in the next couple of years.
Immunotherapy as the first treatment of choice
Results from another important clinical trial were also presented on Friday – assessing immunotherapy in patients with cancers of the head and neck.
Following the new results, the immunotherapy pembrolizumab, either on its own or with chemotherapy, looks set to replace an aggressive chemotherapy combination as the first-line treatment for people with recurrent head and neck cancer.
Professor Kevin Harrington, Professor of Biological Therapies at the ICR and a consultant at The Royal Marsden, led the only UK site of the large international trial.
The study found that people given pembrolizumab in combination with platinum chemotherapy lived longer, and those given the immunotherapy on its own experienced fewer serious side-effects, than those treated with the standard, ‘extreme’ combination of two chemotherapy drugs and a targeted antibody treatment.
Innovative treatments are normally tested in patients with advanced disease – who have no other options left. But at the ICR we are also keen to see exciting new treatments assessed earlier in the course of disease, at a stage when patients are more likely to benefit.
It’s really exciting to see an immunotherapy like pembrolizumab assessed as a first-line treatment for people with recurrent head and neck cancer.
NICE is currently reviewing pembrolizumab as a first-line option for head and neck cancer that has come back or spread, and is expected to announce its decision in February 2020.
Here at the ICR we’ll be eagerly anticipating NICE’s decision. We would hope to see immunotherapy soon approved for use on the NHS for these patients, so it can continue to transform treatment for head and neck cancer in the same way it has done for many people with melanoma.
Staying on top of cancer evolution
Research led by Professor Nick Turner, Professor of Molecular Oncology at the ICR and Consultant Medical Oncologist at The Royal Marsden, was presented at ASCO on Saturday. This looked at blood tests to pick out women with advanced breast cancer who were most at risk of early relapse.
The team analysed so-called ‘liquid biopsies’, taken right at the start of treatment with the targeted drug, palbociclib and a hormone therapy. Women whose tumour DNA in the blood contained certain genetic changes were more likely to quickly stop responding to treatment than those without the changes.
The blood test needs to be further validated before it can be rolled out in the clinic, but in future it could help pick out women who are likely to stop responding to therapy quickly. Based on the test results, doctors could then adapt women’s treatment plans – offering to enrol them in other clinical trials or to switch them to an alternative therapy.
Cancer’s ability to evolve and become drug resistant is the greatest challenge facing cancer research. Here at the ICR, we recently launched a revolutionary ‘Darwinian’ drug discovery programme to tackle cancer’s ability to evolve resistance to treatment.
We are fundraising for the last £15 million of a £75 million investment in a new Centre for Cancer Drug Discovery, which will house the new research programme.
Blood tests such as the one developed by Professor Turner’s team offer important clues about the changing genetic make-up of people’s tumours.
This type of information will be invaluable for the researchers in the Centre for Cancer Drug Discovery, who will be combining mathematical modelling, evolutionary theory and AI approaches to stay one step ahead of cancer.
Many scientists from The Institute of Cancer Research, London attended the 2019 ASCO conference in Chicago. See all of our news, blog and video content from the event.
See all ASCO updates
Fresh ideas for research
These are just three of the many exciting studies presented by ICR researchers at the conference. Much was made too of an exciting new form of targeted nuclear medicine for prostate cancer, dubbed ‘search-and-destroy’ treatment by the media.
The therapy is made up of a radioactive particle stuck to a ‘homing signal’ that targets an antibody called PSMA, which is specifically found on prostate cancer cells.
Professor de Bono explained:
“Targeted intravenous radioactive drugs that home in to the tumour are an exciting new wave of treatments coming through for advanced prostate cancer.
“These new therapies have already shown promise in patients whose cancers have stopped responding to other established treatments such as hormone therapy and targeted drugs – but not everyone responds.
“Our new study found that prostate tumours with faults in DNA repair genes had the highest levels of the ‘homing signal’ for this targeted nuclear medicine, a protein called PSMA. In future, testing for faults in DNA repair could pick out those patients most likely to benefit from PSMA-targeted treatments.”
And another study led by researchers in the Drug Development Unit at the ICR and The Royal Marsden looked at the possible benefit of using electronic activity monitors such as Fitbits in a clinical trial setting.
They found that patients with a higher average daily step count were likely to live longer – with mortality falling by about one third for each extra 1,000 steps.
It’s fantastic to see so many advances being made to improve cancer treatment. As ever, the ASCO Annual Meeting offered cancer researchers a unique opportunity to share their work and ideas with colleagues from around the globe – all under the close eye of the world’s media.
At the end of yet another jam-packed conference, the ICR’s scientists are sure to return to London inspired, updated and full of fresh ideas for their own research – I can’t wait to see what’s next.
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