The Bionest Oncology team spent a jam packed and exciting five days at ASCO 2016 earlier this month in Chicago. More than 30,000 oncology professionals gathered from all around the world to discuss the latest data and innovations in oncology, and it did not disappoint. The theme of ASCO this year was Collective Wisdom, which was echoed by Joe Biden’s speech about data sharing and facilitating collaboration to improve cancer research and care. Harnessing and sharing this wisdom is critical in oncology, and there was certainly a lot of discussion about how to gather and what to do with clinical data.
We spoke about some of the topics on our radar pre-ASCO here, so let’s see how these fared.
Immuno-Oncology: Immuno-Oncology was named ASCO’s Advance of the Year and the annual meeting was a buzz with immuno-oncology updates. Overall, a significant portion of the data releases were focused on updated data sets for front-runner PD-1 / PD-L1 therapies. However, there was certainly no shortage of early stage data for new and upcoming targets and approaches.
- Merck’s KEYNOTE studies with Keytruda reported promising long-term data in melanoma, with OS rates of 50% and 40% at 2 and 3 years: “For the first time, we are hearing the word “cure” in regard to some patients with metastatic melanoma” – ASCO.
- BMS’ Opdivo also showed some highly promising data in NSCLC, particularly in the 1L setting in combination with Yervoy — where one year OS rates reached 90% in PD-L1+ patients with the Q12W Yervoy dosing.
- Not surprisingly, there was a high level of focus on biomarkers to predict responses, including a dedicated Clinical Science Symposium to explore the topic in more detail. Presenters discussed the value of biomarkers such as mismatch repair (MMR) deficiency in CRC, and mutational load and TCGA subtype in urothelial cancer, and presented data for new signatures and biomarker panels that could expand our knowledge of who will respond to treatment. The consensus seems to be that while PD-L1 provides valuable information in some cases, there is most certainly a need for multiple biomarkers given that immune responses are dynamic and constantly evolving.
Patient Centricity and Quality of Care: The topic of “Patient Centricity” was front and center this year at ASCO. We heard information on several unique initiatives and projects designed to empower patients and improve on all aspects of care. For example, the “Moovcare” app for lung cancer created a lot of buzz this year at ASCO, showing that it could improve survival and improve patient’s quality of life. Moovcare is a web-based follow-up app where patients self-assess symptoms on a weekly basis, and the data is sent directly to the oncologist. Based on the data, the app analyzes for specific symptom changes or alerts, and the oncologist can adapt/change treatment as needed. The study reported that at one year, 75% of patients in the Moovcare group were alive versus 49% of those not in the Moovcare group. For a disease like lung cancer, which is often treated in the community, such a tool provides close interactions between the patient and oncologist without adding extra burden or time for an appointment.
Biomarkers and Personalized Approaches: The Precision Medicine topic has seen a lot of buzz in the past few years, and this ASCO was no different. We heard about three large-scale initiatives designed to better understand the utility for targeted therapy in less-studied tumors:
- Targeted treatment in Pediatric Oncology through the AcSé program in France, which provides secured access to innovative therapies for patients in a clinical trial,
- The MyPathway basket-and-umbrella study in the United States which enrolled patients with HER2 alterations, BRAF mutations, Hedgehog pathway mutations, and EGFR mutations, who subsequently received treatment based on their biomarker status, and
- Ongoing work from the Lung Cancer Mutation Consortium (LCMC) which aims to further explore driver mutations and response to targeted therapy in its latest study in lung adenocarcinoma.
Managing the Wisdom: True to its theme of Collective Wisdom, we heard a lot of discussion around big data and the power of harnessing this data into something actionable. Of course, there was lots of talk around ASCO’s CancerLinQ™, a big data initiative to help improve the quality and value of cancer care by analyzing de-identified patient records. So far, more than 50 oncology practices in the US have started to implement the tool, uploading data from electronic medical records into the CancerLinQ system. Joe Biden also spoke about the Genomic Data Commons, a public database funded by the National Cancer Institute. The goal of the database is to facilitate data sharing and collate data on tumor sequencing and treatment responses, in order to build our knowledge and create a centralized location for the data.
All in all, ASCO 2016 delivered on some major topics and highlighted the progress we’ve made in some key areas of immuno-oncology, precision medicine and big data. The voice of the patient is growing stronger each day in oncology, prompting us and others to brainstorm on how to create strategies aimed at patients themselves, in addition to the traditional physician “customers.”
Next up for the team is ESMO in Copenhagen – look for us there in October!