An Expert’s Guide to ASCO 2018: A Preview of the Top Abstracts

Tanios Bekaii-Saab
Tanios Bekaii-Saab, MD, FACP

Mayo Clinic College of Medicine and Science
Leader, GI Cancer Program
Mayo Clinic Center
Mayo Clinic in Arizona
Phoenix, Arizona

Tanios Bekaii-Saab, MD, FACP, has no real or apparent conflicts of interest to report.

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John M. Burke, MD

Associate Chair
US Oncology Hematology Research Program
Rocky Mountain Cancer Centers
Aurora, Colorado

John M. Burke, MD, has disclosed that he has received consulting fees from AbbVie, Celgene, Gilead, and Genentech and funds for research support from Janssen.

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Elias Jabbour, MD

Associate Professor
Department of Leukemia
The University of Texas MD Anderson Cancer Center
Houston, Texas

Elias Jabbour, MD, has disclosed that he has received consulting fees from Amgen, Bristol-Myers Squibb, Pfizer, and Takeda and funds for research support from Amgen, Novartis, Pfizer, and Takeda.

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Shaji K. Kumar, MD

Mark and Judy Mullins Professor of Hematological Malignancies
Myeloma Amyloidosis Dysproteinemia Group
Consultant, Division of Hematology
Mayo Clinic
Rochester, Minnesota

Shaji Kumar, MD, has disclosed that he has consulted with no personal compensation for AbbVie, Celgene, Janssen, Merck, and Takeda and has received funds for research support of clinical trials to his institution from AbbVie, Celgene, Janssen, Merck, Roche, sanofi‐aventis, KITE, and Takeda.

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Daniel P. Petrylak, MD

Professor of Medicine (Medical Oncology) and of Urology
Director, Prostate and GU Medical Oncology
Co-Director, Cancer Signaling Network Program 
Yale Cancer Center
New Haven, Connecticut

Daniel P. Petrylak, MD, has disclosed that he has received consulting fees from AstraZeneca, Bayer, Bellicum, Dendreon, Exelixis, Ferring, Johnson & Johnson, Lilly, Medivation, Millennium, Pfizer, Roche Laboratories, and sanofi-aventis; has received funds for research support from Agensys, AstraZeneca, Bayer, Clovis, Dendreon, Endocyte, Genentech, Innocrin, Johnson & Johnson, Lilly, MedImmune, Medivation, Merck, Millennium, Novartis, Pfizer, Progenics, Roche Laboratories, sanofi-aventis, and Sotio; has provided expert testimony for Celgene and sanofi-aventis; and has ownership interest in Bellicum and Tyme Pharmaceuticals.

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Elizabeth R. Plimack, MD, MS

Chief, Division of Genitourinary Medical Oncology
Director, Genitourinary Clinical Research
Professor, Department of Hematology/Oncology
Fox Chase Cancer Center
Temple Health
Philadelphia, Pennsylvania

Elizabeth R. Plimack, MD, MS, has disclosed that she has received consulting fees from AstraZeneca, Bristol-Myers Squibb, Clovis, Eli Lilly and Company, Exelixis, Genentech, Horizon Pharma, Inovio, Novartis, and Pfizer and funds for research support from Astellas, AstraZeneca, Bristol-Myers Squibb, Genentech, Merck, Peloton, and Pfizer.

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Thomas Stinchcombe, MD

Medical Oncologist
Thoracic Oncology Program
Duke University Medical Center
Durham, North Carolina

Thomas Stinchcombe, MD, has disclosed that he has received consulting fees from AstraZeneca, Norvatis, and Takeda.

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Anne S. Tsao, MD

Division of Cancer Medicine
Department of Thoracic/Head and Neck Medical Oncology
Department of Mesothelioma Program
The University of Texas MD Anderson Cancer Center
Houston, Texas

Anne S. Tsao, MD, has disclosed that she has served on advisory boards for Ariad, AstraZeneca, Bristol-Myers Squibb, Boehringer-Ingelheim, Eli Lilly, EMD Serono, Epizyme, Genentech, Merck, Novartis, Roche, Seattle Genetics, Sellas Life Sciences, and Takeda and received funds for research support from Ariad, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Epizyme, Genentech, Merck, Millennium, Polaris, and Seattle Genetics.

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Released: May 31, 2018

At the 2018 ASCO annual meeting, important results from many clinical trials are being reported. Below, experts in lung cancer, gastrointestinal and genitourinary cancers, and hematologic malignancies have highlighted their most anticipated abstracts. CCO will cover each of these studies and dozens more as a part of their Independent Conference Coverage of ASCO 2018. As the ASCO annual meeting unfolds, remember to check the CCO Web site often for downloadable slidesets summarizing the presented data and then again after the meeting has adjourned for CME-certified online activities, featuring expert analyses and perspectives on the clinical implications of the data.

Top Picks: Lung Cancer
Thomas Stinchcombe, MD, and Anne S. Tsao, MD: Several phase III studies with new findings on frontline immune checkpoint inhibitor therapy are anticipated to change practice in advanced NSCLC. The results of the late-breaking plenary abstract on KEYNOTE-042 trial will establish whether the survival benefit of frontline pembrolizumab monotherapy that led to its indication for patients with advanced NSCLC and PD-L1 tumor expression ≥ 50% can be expanded to include NSCLC patients with PD-L1 tumor expression ≥ 1%. Regarding combination chemoimmunotherapy, the primary PFS and safety analysis for the IMpower 131 trial of carboplatin/nab-paclitaxel alone and with atezolizumab and the OS analysis for the IMpower150 trial of carboplatin/paclitaxel/bevacizumab alone and with atezolizumab will illuminate the role of first-line atezolizumab/chemotherapy combinations for advanced squamous and nonsquamous NSCLC, respectively. Also anticipated are the results of the CCGA study evaluating a highly specific blood test for the detection of early-stage lung cancer via genomewide sequencing of plasma cell–free DNA.

Top Picks: Hematologic Malignancies
Numerous interesting and potentially practice-changing studies in hematologic malignancies are being reported at ASCO 2018. According to Shaji Kumar, MD, there will be promising data on new agents of interest in relapsed/refractory multiple myeloma, including phase II data on the BCL-2 inhibitor venetoclax in combination with carfilzomib/dexamethasone and updated results on bb2121 anti-BCMA CAR T-cell therapy, which forecast potential new treatment options on the horizon for this hard-to-treat patient population. In addition, the preplanned interim analysis of the randomized phase III A.R.R.O.W. study will determine if the more convenient once-weekly dosing of carfilzomib plus dexamethasone can be used in place of the approved twice-weekly dosing for this patient population. Next, the final PFS and safety analyses of the phase III OPTIMISMM trial comparing pomalidomide/bortezomib/low-dose dexamethasone triplet therapy vs bortezomib/low-dose dexamethasone therapy and a subgroup analysis of the phase Ib MMY1001 study evaluating daratumumab in combination with carfilzomib/dexamethasone will clarify options for lenalidomide-exposed or lenalidomide-refractory patients.

In the setting of leukemia, Elias Jabbour, MD, anticipates that the data on long-term outcomes of 2 phase II trials of blinatumomab followed by HSCT for B-cell precursor ALL and early-phase results for 2 investigational agents, the mutant IDH1 inhibitor ivosidenib in high-risk relapsed/refractory AML and the novel recombinant immunotoxin moxetumomab pasudotox in relapsed/refractory hairy cell leukemia, should be promising.

In lymphoma, John M. Burke, MD, highlights 3 of the most clinically relevant studies reporting at ASCO 2018: the phase III RELEVANCE study comparing the chemotherapy-free regimen of lenalidomide plus rituximab vs rituximab plus chemotherapy in patients with previously untreated grade 1-3a follicular lymphoma, as well as 2 studies with the potential to have an impact on the treatment of patients with Waldenström macroglobulinemia, a phase II study of the BTK inhibitor acalabrutinib and a preplanned interim analysis of a phase III study of ibrutinib/rituximab vs placebo/rituximab.  

Top Picks: Genitourinary Cancers
Daniel P. Petrylak, MD, and Elizabeth R. Plimack, MD, MS, have identified several genitourinary cancer studies of interest reporting at ASCO 2018. Again, immune checkpoint inhibitor therapy remains at the forefront of new findings. With the report of efficacy and safety data from cohort A of the phase II KEYNOTE-427 trial, we will see pembrolizumab potentially move into the first-line setting for advanced clear-cell renal cell carcinoma. Data from 2 phase II studies will inform the use of immune checkpoint inhibitors in the preoperative, neoadjuvant setting for operable, muscle-invasive urothelial cancer prior to cystectomy, including safety and efficacy results from the ABACUS trial of neoadjuvant atezolizumab and interim clinical and biomarker findings from the PURE-01 study of preoperative pembrolizumab. In metastatic urothelial cancer, we will see early-phase efficacy and safety results from studies of novel therapies, including updated phase I results for enfortumab vedotin, an antibody–drug conjugate to Nectin-4, and the first phase II results for erdafitinib, an FGFR inhibitor, in an advanced urothelial carcinoma population selected for FGFR alterations.

Top Picks: Gastrointestinal Cancers
Tanios Bekaii-Saab, MD, FACP: There are 2 late-breaking abstracts in pancreatic cancers, including the randomized phase III GI PRODIGE 24/CCTG PA and PREOPANC-1 trials, the results of which promise to illuminate the role of adjuvant mFOLFIRINOX vs gemcitabine in patients with resected pancreatic ductal adenocarcinomas and preoperative chemoradiotherapy vs immediate surgery for resectable and borderline resectable pancreatic cancer, respectively. Meanwhile, the phase III KEYNOTE-061 trial will clarify the role of pembrolizumab vs paclitaxel in previously treated advanced gastric or gastroesophageal junction cancer, and we will also see the results of a phase III study in patients with stage III gastric cancer asking whether intraperitoneal/intravenous or intravenous adjuvant chemotherapy is more efficacious.

Remember to check the CCO Web site often during and after ASCO!
These are just a few of the interesting and important abstracts selected by our expert faculty from ASCO 2018. Downloadable slideset summaries of these studies and dozens more will be available on our Web site as the data are presented at ASCO. After the meeting, comprehensive analyses by our expert faculty members will explore the clinical implications of the data in CME-certified text-based modules.

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