2017 ASCO Annual Meeting Presscast

Today-

Highlights from a presscast held ahead of the 2017 ASCO Annual Meeting.

Welcome to OncLive News Network! I’m Gina Columbus.

Phase III results showed that adjuvant gefitinib reduced the risk of disease recurrence by 40% versus standard chemotherapy in patients with EGFR-positive non—small cell lung cancer.

The findings were from the phase IIII ADJUVANT trial, in which, at a median follow-up of 36.5 months, the median disease-free survival was 28.7 months with gefitinib versus 18.0 months with a regimen of vinorelbine plus cisplatin.

The 3-year DFS rates were 34.0% versus 27.0%, respectively. At the time of the analysis, 76 overall survival events had occurred.

Previously reported trials in unselected NSCLC populations have fallen short when attempting to demonstrate a benefit for anti-EGFR tyrosine kinase inhibitors in the adjuvant setting.

*****************************************

For patients with macroscopically resected biliary tract cancer, treatment with adjuvant capecitabine improved overall survival by 15 months compared with observation alone.

These findings, also presented during the ASCO presscast, were from the phase III BILCAP study. Here, the median overall survival with capecitabine was 51.1 months compared with 36.4 months for observation in the intent-to-treat analysis, which did not pass the bar for statistical significance. However, in sensitivity analyses that adjusted for nodal status, gender, and stage of disease, capecitabine did show a statistically significant 30% reduction in the risk of death versus observation.

Moreover, the median relapse-free survival was 25 months in the capecitabine arm versus 18 months for observation. Overall, there were no deaths attributed to treatment. In the per-protocol assessment, which included 430 patients, the median OS was 53 months with capecitabine versus 36 months for observation.

**************************************

Prospective findings of another study from the presscast emphasized the mounting evidence of the importance of a healthier lifestyle for cancer survivors. One such intervention—eating tree nuts like almonds, walnuts, and pecans—can improve overall survival and reduce the risk of recurrence in colon cancer survivors.

Researchers performed a prospective observational study of a subset of 826 patients participating in the randomized CALGB 89803 trial examining adjuvant combination chemotherapy in patients with stage III colon cancer.

Among the 19% of patients in the subset who reported consuming 2 or more ounces of nuts per week, risk of disease recurrence was 42% lower and the risk of death was 57% lower.

Nut intake was chosen for examination in this observational study, not only because of their known association with lower cardiovascular mortality, but also their link to a lower incidence of obesity, type 2 diabetes, metabolic syndrome, and insulin resistance—all conditions that are associated with a higher risk of recurrence and death from colon cancer.

It was reported that the benefits of tree nuts held even after adjusting for several factors associated with colon cancer recurrence, such as patients' total calorie intake, age, sex, number of lymph nodes, baseline performance status, BMI, physical activity, aspirin use, and glycemic load.

*****************************************

According to findings from another study presented during the presscast, more Stage I cancers were diagnosed after the passage of the Affordable Care Act within five screenable disease types—colorectal cancer, female breast cancer, cervical cancer, lung cancer and prostate cancer—than were diagnosed before ACA implementation.

There is extensive evidence to suggest that a lack of health insurance or poor health insurance coverage can result in cancer being diagnosed at a later stage. The implementation of the ACA brought with it Medicaid expansion and the Marketplace exchange in 2014. These measures substantially increased the number of Americans 18 to 64 years old who have insurance coverage. With more patients on health insurance, there is more access to cancer screening and physicians, leading to earlier diagnosis of cancers that can be found via screening.

The percentage of cancers diagnosed at Stage I increased by 1% across four of the cancer types, but decreased by 1% in prostate cancer. According to the adjusted prevalence ratios, the increase in Stage I diagnoses from 2013 to 2014 was statistically significant for colorectal cancer, female breast cancer and lung cancer, but not for cervical cancer.

*****************************************

Patients with stage III colorectal cancer who maintained a healthy body weight, engaged in regular physical activity, and adopted other healthy lifestyle behaviors experienced a 42% lower chance of death and a trend toward reduced cancer recurrence than those who followed less healthy lifestyles.

Results from the study of 992 patients were presented in the ASCO presscast, showing that patients with colorectal cancer who followed lifestyle recommendations made by the American Cancer Society experienced longer disease-free survival and overall survival.

The 91 survivors who logged the highest healthy lifestyle scores experienced a 42% lower risk of death, as well as a 31% trend toward reduced chance of recurrence, compared with the 262 survivors who logged the lowest lifestyle scores. When alcohol consumption was included in the score, the 162 survivors with the highest scores for a healthy lifestyle had a 51% lower chance of death and a 36% lower chance of cancer recurrence than did the 187 survivors with the lowest healthy lifestyle scores. It wasn’t 1 healthy lifestyle factor that drove these associations; rather, body weight, regular physical activity, and a healthy diet were all found to be important.

The researchers noted that maintaining a healthy lifestyle can do more than improve colon cancer-specific outcomes; it can also help patients to improve their overall health, which is important because some have other ongoing health problems, such as diabetes or heart disease.

*****************************************

The efficacy of the human papillomavirus vaccine continues to be impressive, with newly reported findings showing that it reduced the prevalence of high-risk oral HPV infections by 88% in young adults who had at least 1 dose of the vaccine; however, low vaccine uptake remains a concern.

Results from one of the first large studies to explore the impact of HPV vaccination on oral infections show that their prevalence among vaccinated young adults was 0.11% for HPV types 16, 18, 6, and 11, compared with 1.61% for unvaccinated individuals.

Prevalence of the 4 HPV types covered by the vaccine was eliminated in men who had been vaccinated compared with those who had not been vaccinated. Prevalence of the 33 nonvaccine HPV types was similar between the 2 groups.

HPV vaccination is currently indicated for the prevention of cervical, vulvar, and vaginal cancers in women, and anal cancers in both women and men. It has not been clear, however, whether the vaccines could reduce incidence of oral cancers related to oral HPV infection.

This week, we also sat down with Dr Aditya Bardia of Massachusetts General Hospital to discuss the evolution of CDK4/6 inhibiton in breast cancer.

That’s all for today.

Thank you for watching OncLive News Network! I’m Gina Columbus.