40th Annual CFS® Highlights New Frontiers in Cancer Care

Benjamin P. Levy, MD

The Chemotherapy Foundation Symposium^® (CFS^®) returns to New York City for its 40th annual meeting with a 3-day program that will deliver the latest updates across the gamut of oncology care. Internationally renowned authorities will offer evidence-based insights and disseminate data from conferences, published research, and guideline updates, offering attendees the opportunity to learn how novel approaches fit into existing practices to optimize clinical care for patients.

Exciting new developments continue to take place in the management of solid and hematologic malignancies. “At CFS^®, leading experts will discuss practice-changing innovations in diagnosis, treatment, and supportive care that occurred over the past year across the spectrum of cancer types,” Benjamin P. Levy, MD, cochair of the meeting, said in an interview with OncLive^®. “The goal here is to cover as much relevant content and, in the process, distill the complexity that has occurred as a consequence of multiple drug approvals and shifting therapeutic options. The international faculty have always done a great job giving both the current perspective as well as what is coming down the pike.” Levy is clinical director of Medical Oncology at Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital and an associate professor of oncology at Johns Hopkins School of Medicine in Baltimore, Maryland.

“We are in a renaissance period in oncology as reflected by innovative treatment strategies as well as new diagnostic paradigms,” Levy added. “This is evidenced by novel therapeutic approaches involving both immunotherapies and targeted therapies as well as the integration of platforms like liquid biopsies that may help diagnose and genotype patients. This meeting will bring together international leaders in the field to take a closer look at these strategies in both solid tumor and hematological malignancies.”

Levy also noted that a great deal of thought went into creating an agenda that would provide a “360-degree perspective on how to deliver optimal comprehensive oncology care.”

Ajai Chari, MD

The format of the sessions, which are limited to 15 minutes each, is meant to optimize the learning experience. “Research has shown that 15 minutes is the optimal amount of time for focusing on new material,” Ajai Chari, MD, cochair of the meeting, told OncLive^® in an interview. “That means listeners pack in a lot of information in a short time, and we select the most significant advances in cancer and hematology—the updates that are most practice-changing.” Chari is a professor and the director of clinical research in the Multiple Myeloma Program at the Icahn School of Medicine at Mount Sinai, in New York City.

Specialized Tracks Return

As in previous years, the meeting will feature sessions dedicated to a variety of topics by tumor type and tracks on nursing insights and practical clinical applications: the Nursing and How I Do It tracks.

“The implementation of the nursing track over the past few years has been a huge success, as these providers are an integral part of the health care team,” Levy said. “They are [not only] managing drug toxicities but also taking the lead on coordination of patient care. Important topics in the nursing track include drug management and patient navigation and timely issues such as health equity and stress management.” The Nursing track will be held this afternoon at 1:10 pm.

Tomorrow at 1:10 pm, the How I Do It track will feature discussions on the administration of various therapies, including bispecific drugs, and the management of older patients. Created 4 years ago, this track “has…met with significant enthusiasm from junior faculty and fellows and allows them to directly interface with a disease expert who tackles the everyday therapeutic management decisions for oncology patients,” Levy said.

During the special sessions on tumor types, Medical Crossfire^® debates will feature key opinion leaders talking about a variety of hot topics in clinical decision-making. “The Medical Crossfire^® is always entertaining, as it showcases different perspectives from leading experts that will hopefully reassure the audience that there may not be just one way to treat a patient,” Levy said.

Topics up for debate at this year’s meeting include:

CAR T: Now or Later (Lines of Therapy)?
Today at 11:30 am
Moderator: Ajai Chari, MD

Actionable Germline and Somatic Genetic Mutations in Breast Cancers
Thursday at 2:30 pm
Moderator: Nina D’Abreo, MD

Management of Oligometastatic Disease in the Context of Competing Immuno-oncology Strategies
Friday at 9:25 am
Moderator: Benjamin P. Levy, MD

What Is the Optimal Therapeutic Regimen for Hormone-Sensitive Prostate Cancer?
Friday at 5:00 pm
Moderator: Daniel P. Petrylak, MD

“One of our strengths is that we are inclusive and reach a wide audience with CFS^®,” Chari said. “As a practicing oncologist, I know how important all our team members are to providing the complex, interdisciplinary care our patients need.”

Tumor-Specific Sessions Highlight Treatment Evolution

The rest of the agenda will feature in-depth discussions arranged by specialty. Today, the hematology track will include sessions on the nuances of managing patients across malignancies, led by experts in leukemia, myeloma, lymphoma, myelodysplastic syndromes, and more.

This year marks the fifth anniversary of the first approved chimeric antigen receptor (CAR) T-cell therapy, tisagenlecleucel (Kymriah), for patients with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or later relapse.1 Since its approval, 6 additional CAR T-cell products have become available, and educational efforts have ramped up to deliver quality information on the availability of and access to these revolutionary therapies. “Front and center for me is the CAR T story that is unfolding in hematological malignancies,” Levy said. “I truly believe this will be the future of all of oncology once we (1) iron out the science and (2) make it affordable for everyone.”

Optimized testing and treatments of early and advanced disease, including chemotherapeutics, targeted therapies, immunotherapies—alone and in combination—and multimodal strategies continue to improve clinical outcomes, and a large portion of the programming across breast, lung, genitourinary, and gastrointestinal cancers will focus on sequencing questions and the shifting treatment landscape.

In gynecologic cancers, the latest news is about the role of maintenance PARP inhibitors and the removal of select indications, including niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca), that were voluntarily withdrawn due to safety concerns for heavily pretreated patients with BRCA-mutated ovarian cancer.² Eirwen M. Miller, MD, will examine the “Evolving Landscape of Frontline Maintenance Therapy for Advanced Ovarian Cancer” tomorrow, November 10, at 7:15 am.

HER2 status has been a hot topic in the breast cancer space, as new has called for greater communication across disciplines, with the approval of fam-trastuzumab deruxtecan-nxki (Enhertu) for patients with HER2-low disease.3 Presenters Shanu Modi, MD, and Neelima Vidula, MD, will focus on the role that antibody-drug conjugates (ADCs) have played in the space and the ever-changing sequencing of treatments. Modi, a medical oncologist at Memorial Sloan Kettering Cancer Center, will present “How to Sequence HER2-Directed Therapies in MBC” tomorrow, November 10, at 2:15 pm, and Vidula, a breast medical oncologist at Massachusetts General Hospital, in Boston, will discuss “Current and Emerging Antibody-Drug Conjugates (ADCs)” at 4:05 pm, as part of the breast cancer afternoon sessions.

“The treatment landscape for patients with resectable non–small cell lung cancer (NSCLC), has shifted dramatically,” Levy said. This targeted therapy revolution, which has taken place during the past 12 months, will drive discussion topics on Friday morning, November 11.

“The approval of neoadjuvant chemotherapy with immunotherapy in early-stage disease is shedding new light on ways to improve outcomes and cures. I look forward to hearing Jamie E. Chaft’s perspective on this topic given her leadership role in this strategy.” Dr Chaft, an associate attending physician at Memorial Sloan Kettering Cancer Center, will focus on the “Role of Immuno-Oncology (IO) and Targeted Therapies in Early-Stage Lung Cancer” at 8:45 am on Friday, November 11.

In terms of nondriver NSCLC, ADCs have gained significant traction for patients with advanced stage NSCLC, Levy said. “Melissa L. Johnson, MD, has been at the forefront and has led many of these ADC trials [and] I very much look forward to hearing her insights on where we are heading in this field.” Johnson, program director of lung cancer research at Sarah Cannon in Nashville, Tennessee, will deliver a talk on “Antibody-Drug Conjugates (ADCs) for Non-Driver NSCLC” on Friday, November 11 at 7:30 am.

With molecular targeting dominating discussions across tracks, Charu Aggarwal, MD, MPH, will discuss liquid biopsy and next-generation sequencing in diagnostics. “This area is fascinating, as we’re just beginning to scratch the surface on how to leverage liquid technologies into our clinics,” Levy said. Although “the utility of liquid biopsies is now established for accurate genotyping of patients with advanced stage lung cancer, new ways of using circulating tumor DNA [ctDNA] technology are being developed.”

“One is longitudinal assessment, looking at changes in ctDNA when patients are on a targeted therapy or immunotherapy as an early indicator of response or lack of response. The other…is looking…[at] minimal residual disease…in patients who are cured and are being surveilled by scan. The question is, can you use ctDNA to detect recurrences earlier than a CT scan that then can inform treatment decisions? That’s really very, very exciting moving forward, and I know Dr Aggarwal, who is an international expert in this area, will do a great job covering this topic.” Aggarwal will present “Optimizing Testing Strategies: How to Leverage Liquid Biopsy in the Diagnostic Algorithm” on Friday, November 11, at 7:45 am.

References

1. FDA approval brings first gene therapy to the United States. News release. FDA. August 30, 2017. Accessed November 4, 2022. bit.ly/3S18a9u
2. Harris J. Physicians lose access to 3 PARP inhibitors for heavily pretreated, BRCA-mutated advanced ovarian cancer. OncLive. September 23, 2022. Accessed November 4, 2022. bit.ly/3Uss1Qk
3. FDA approves first targeted therapy for HER2-low breast cancer. News release. FDA. August 5, 2022. Accessed November 4, 2022. bit.ly/3d4X2JQ