ESMO Congress News site
2cureX is following ESMO from the perspective of Functional Precision Medicine; to Predict tumor resistance and sensitivity to cancer treatment. You can find some of the highlights here.
Prof. Clare Turnbull, Division of Genetics and Epidemiology, Institute of Cancer Research, London, presents a study that shows that delays in cancer treatment due to
For example COVID-19 is a concern, it is reported that a 6 months delay in surgery leads to 10000 death a year in England.
Delays in diagnosis and surgery cause exponential burden of attributable mortality.
The paper states that the he COVID-19 pandemic has placed unprecedented strain on health care provision.
To avoid a deferred public health crisis of unnecessary cancer deaths, urgent ringfencing of substantial resources is required.
Dr. Anna D. Wagner discussed the importance of recognizing the importance of sex and gender as modifiers of health and disease. One presentation (Abstract 1041P) had assembled eight randomized trials in non-small cell lung cancer (NSCLC) including 5199 patients where immune check point inhibitors (ICIs) vs standard chemotherapy showed a significant benefit when analyzing overall survival (OS) for both men and women. When looking at progression-free-survival (PFS) however, only men obtained a benefit.
This stressed the need for reliable Precision Medicine tools. 2cureX is well under way in developing a immune-oncology IndiTreat test together with University Medical Center Hamburg-Eppendorf (UKE) in Hamburg.
A large Ovarian cancer trial (1,566 patients), ICON8 could not see a significant difference in progression-free-survival (PFS) between dose-dense and conventional carboplatin/paclitaxel treatment regiments (Abstract 805O).
Dose-dense chemotherapy is a treatment regimen where the chemotherapy is providing more frequent to the patients as compared to the conventional, weekly dosing. The hypothesis in the present study was that dose-dense approach would improve patient outcome. However, neither PFS nor Overall survival (OS) differed between the two treatment modalities. This supports the notion that it is not the way in which the treatments are provided to these patients that is important; but it is picking the right drugs for the individual patient. A good example at ESMO is the SOLO-1 trial presented on the 18. September (see above) – where the PARP inhibitor Olaparib provides a significant improvement in five-year survival.
The IndiTreat test is not distinguishing between such two dosing regimens; but providing treatment guidance with regard which drug or drug combination that will identify the most effective treatment for the individual patient.
One presentation by Villafuerte et al. (1587MO) and two by Vokinger et al. (1593P and 1586MO) investigated whether there is a correlation between the cost of new drugs for cancer treatment and their benefit. The analysis included all FDA and EMA approved drugs in the period 2005 to 2018 for the treatment of solid cancers. It was concluded that no relation exists between the drug price and benefit to society and patients.
In other words, new expensive drugs do not necessary filter into improved patient outcome and a positive health economic benefit.
The PARP inhibitor Olaparib significantly improves the five-year survival of patients with newly diagnosed advanced ovarian cancer.
Results from the first double-blinded randomized phase III-trial (SOLO-1) between the PARP inhibitor Olaparib and standard chemotherapy showed a clear benefit of PARP inhibition (presentation ID 811MO by Dr. S. Banerjee et al.). The median progression free survival was thus 56 months for PARP treated patients as compared to 14 months for the placebo group. This and other studies open for a new era in the management of recurrent ovarian cancer (download abstract (pdf)).
This highly encouraging result opens for a number of questions: How do the other PARP inhibitors compare to Olaparib; Is there a need to individualizing PARP treatment using a Functional Precision Medicine tool like IndiTreat.
On September 14th , Prof. Emile Voest (Netherlands Cancer Institute, Amsterdam, NL) gave a presentation in the ESMO Virtual Congress 2020 Industry Satellite Symposium entitled “Putting personalised healthcare at the heart of clinical practice”.
The title of his presentation was “Looking at where personalised healthcare has become reality”. In his presentation he made reference to a study on Pan-cancer whole-genome analyses of metastatic solid tumours that was published in Nature in 2019 (https://rdcu.be/b7u2p ).
It showed that on average genomic approaches identify actionable targets in 31% of the cases. It seems that other tools such as functional precision medicine tests based on patient-derived microtumors would aid in identifying effective drug therapies for the large fraction of patients that do not benefit from genomics guided medicine.
“On. September ESMO Daily Reporter interviewed Dr. Rodrigo Dienstmann (Oncoclinicas Precision Medicine, Sao Paulo, Brazil and Vall d’Hebron Institute of Oncology, Barcelona, Spain) who expressed skepticism of whether genetic profiling is capable of guiding cancer therapy in daily clinical practice. Dientmann said: for most tumor types, at the individual patient level, we should calibrate the expectations given the rarity of actionable genetic alterations that have proven clinical impact”. On the 17. October a Symposia named “Precision medicine: Hopes and hypes” on this topic is to be held. 2cureX will follow the symposium, and provide a News update at this page.