By Erik J. MacLaren, PhD
This year’s annual meeting of the American Society of Clinical Oncology (ASCO) is taking place June 3–7 in Chicago. The theme of the meeting this year is Collective Wisdom: The Future of Patient-Centered Care and Research, which helps to stress the need for collaborative efforts across disciplines to advance the field of oncology. More than 5,200 abstracts have been accepted for the 5-day program, and the 7 sessions previewed here are of particular interest to the thoracic cancer community.
Kicking off Friday afternoon, Julie R. Brahmer, MD, from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, Maryland, will be participating in a meet-the-professor session titled “Prescribing and Managing Immunotherapy.” Dr. Brahmer is an international leader in the field of immunotherapy for lung cancer and is known for her work on nivolumab, among other contributions to the field. Her presentation will focus on identifying and managing side effects in patients treated with immunotherapeutic agents.
On the morning of Saturday, June 4, Graham Warren, MD, PhD, from the Medical University of South Carolina in Charleston, South Carolina, will speak at the education session “Lung Cancer Screening and Prevention.” Dr. Warren investigates the clinical effects of tobacco on the biology of cancer cells and cancer treatment outcomes, and his presentation will urge clinicians to promote smoking cessation in patients with cancer. “The most important take-home from my session will be that addressing tobacco use prior to, during, and following a cancer diagnosis is critical,” said Dr. Warren. “There are very clear relationships between smoking and adverse cancer treatment outcomes, and providing evidence-based cessation support for all cancer patients who use tobacco will allow us to realize the clinical benefits of cessation both in our screening populations as well as in our patients undergoing cancer treatment.”
Monday has a trio of lung cancerrelevant presentations, beginning with “What’s Next in Cancer Immunotherapy?” an education session on Monday morning that will focus on the current status of immunotherapy trials, as well as targets and biomarkers in development. “Immunotherapy holds a lot of potential for improving outcomes in difficult-totreat thoracic cancers,” according to Charles M. Rudin, MD, PhD, from the Memorial Sloan Kettering Cancer Center in New York City, who is not presenting at the session, but spoke to IASLC about the topic. Dr. Rudin is excited by the progress in immunotherapies, especially their potential to treat small cell lung cancer (SCLC). “SCLC is often remarkably responsive to initial chemotherapy, but upon recurrence is really quite resistant,” he said. “Immunotherapies are likely to have a central role in the treatment of SCLC, and there are already exciting emerging data with combination PD-1 and CTLA-4 directed therapy.” Looking to the future of treatment in SCLC, Dr. Rudin predicts immunotherapies— with a twist. “The immune microenvironment of small cell is different from other solid tumors, and there may be alternative immune regulators, beyond PD-1 and CTLA-4, that may be of particular relevance for SCLC.”
Minimally invasive surgeries are reducing recovery times and morbidities for patients with stage I NSCLC, and the rapid adoption of SBRT in place of conventionally fractionated radiotherapy is increasing overall survival for our early stage patients.
The meet-the-professor session “Stereotactic Body Radiation Therapy or Surgery for Early-Stage Non-Small Cell Lung Cancer” is also scheduled for the morning of June 6. The speakers will discuss and compare the current uses of SBRT and surgery in patients, as well as optimal adjuvant therapy for these treatments. IASLC Lung Cancer News spoke about this session with Charles B. Simone, II, MD, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. Although he is not presenting himself, Dr. Simone, who investigates the use of SBRT in medically operable and medically inoperable patients with stage I NSCLC, expressed his enthusiasm for the subject. “With numerous trials comparing the two modalities now open or about to open, including the SABRTooTH trial (United Kingdom), POSTLIV trial (China), STABLEMATES trial (United States), and VALOR trial (Veterans Administration Hospitals), the debate on surgery vs SBRT for stage I NSCLC is only beginning, and the upcoming session at ASCO on SBRT and surgery will be of great interest to all providers caring for patients with lung cancer,” he said. “Minimally invasive surgeries are reducing recovery times and morbidities for patients with stage I NSCLC, and the rapid adoption of SBRT in place of conventionally fractionated radiotherapy is increasing overall survival for our early stage patients.”
Monday afternoon, Jessica S. Donington, MD, of the New York University School of Medicine will join two other speakers in the education session “Local Therapies in the Management of Oligometastatic and Metastatic Non- Small Cell Lung Cancer.” Dr. Donington, a thoracic surgeon, will discuss the indications for surgical intervention in NSCLC. On the final day of ASCO 2016, the education session “Small Cell Lung Cancer: On the Move (Again?)” will be chaired by Walter John Curran, MD, FACR, from the Winship Cancer Institute of Emory University in Atlanta, Georgia, and the group chairman and principal investigator of NRG Oncology. Dr. Curran has led seminal clinical trials in locally advanced lung cancer and is an international authority on the disease. His presentation is titled “The Role of Radiation Therapy in Extensive Small Cell Lung Cancer: Prophylactic Cranial Irradiation, Thoracic Radiation, or Not?”
Another session taking place Tuesday morning, “Immunotherapy: Beyond Anti-PD-1 and Anti-PDL1,” will feature a presentation by Edmund Moon, MD, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. Dr. Moon’s research, as well as his talk, is focused on augmenting adoptive T cell therapy for solid cancers like lung cancer and malignant pleural mesothelioma. “This session will outline some of the major hurdles to treatment using single-agent checkpoint blockade and will cover promising complementary avenues of immunotherapy that have the potential to make an impact in nonresponders,” he said. While Dr. Moon anticipates progress in using biomarkers to guide anti-PD-1 therapy, he also predicts new breakthroughs on the horizon for NSCLC including, “…the idea of personalized immunotherapy, or analyzing tumor infiltrating lymphocytes to determine which combination of checkpoint antibodies should be used to treat an individual patient.” ✦