From bringing care benchside to bedside, from prevention to pharmacogenetics, an unprecedented fusion of all aspects of cancer care guarantees something for everybody when a record-breaking 25,000-plus oncologists, other health care professionals, patient advocates, and patients are expected to descend upon the Big Easy early next month for the 40th anniversary of the world's largest cancer meeting.
More than 37,000 abstracts have been accepted for the four-day meeting, being held June 5 through June 8, at the Ernest N. Morial Convention Center.
The theme, “Forty Years of Quality Cancer Care,” reflects the Society's commitment to caring for patients, said ASCO President Margaret A. Tempero, MD, Professor and Chief of Medical Oncology at the University of California, San Francisco School of Medicine (UCSF) and Director of Clinical Sciences at the UCSF Comprehensive Cancer Center.
“Looking back at the history of ASCO, amazingly our mission has not changed in 40 years,” Dr. Tempero said in an interview, a mission of “bettering the care of the cancer patient through multidisciplinary care.”
“This is a big milestone for ASCO, and we are excited to share the celebration of our history with all the attendees at the Annual Meeting,” added ASCO Executive Vice President and CEO Charles M. Balch, MD.
Attendees can look forward to hearing new data on targeted therapies being used in combinations with conventional chemotherapeutic agents, Dr. Tempero said. “It's becoming more and more apparent that the new targeted drugs work best in combination with traditional drugs,” she explained.
Featured research in that area includes a large-scale study looking at the impact of adjuvant chemotherapy and erlotinib for non-small cell lung cancer as well as a Phase III study evaluating radiation therapy and cetuximab for advanced head and neck cancer, Dr. Tempero said.
Molecular Markers as Predictors of Outcome
To keep up with the rapid changes in diagnosis and treatment that have accompanied the genetics revolution, other studies will examine the use of molecular markers to predict clinical outcomes in cancer patients, said ASCO Scientific Program Co-Chairman Eric J. Small, MD, Clinical Professor of Medicine and Urology at UCSF.
“The program will have an increased focus on bringing care from the benchside to bedside. A number of abstracts will be looking at how genetic markers impact on patient's lives. It's pretty amazing.”
In a “Best Science of Oncology” lecture, Nobel laureate Leland H. Hartwell, PhD, President and Director of Fred Hutchinson Cancer Research Center, will speak about how studies in the lab can predict the start of cancer, specifically biomarkers for the early detection of cancer.
Other hot topics at the plenary session, Dr. Small noted, include a large study looking at the relationship between genetic markers and quality of life (presented by Jeff A. Sloan, PhD, of the Mayo Clinic, with Robert Diasio, MD, of the University of Alabama at Birmingham as the Discussant); and a large study looking at whether the use of statins—3-hydroxy-3-methyl-glutaryl coenzyme A reductase (HMG CoA) inhibitors—can lower the risk of colon cancer.
The statin study will be Abstract 1, and will be presented by Jenny N. Poynter, MPH, of the University of Michigan, with Scott Lippman, MD, of the University of Texas M. D. Anderson Cancer Center as the discussant.
Other plenary papers will examine new treatments for brain tumors and prostate cancer:
* The use of concomitant and adjuvant temozolomide and radiotherapy for newly diagnosed glioblastoma multiforme, the “conclusive” results of a randomized Phase III trial by the European Organization for Research and Treatment of Cancer Brain & Radiation Therapy Groups and the National Cancer Institute of Canada Clinical Trials Group, with the data presented by Roger Stupp, MD, of University Hospital in Lausanne, Switzerland, and Michael Prados, MD, of UCSF as the discussant.
* A randomized Phase III trial of docetaxel/estramustine vs mitoxantrone/prednisone in men with androgen-independent prostate cancer. Daniel P. Petrylak, MD, will present the results of this Southwest Oncology Group trial (#99).
* A multicenter Phase III comparison of docetaxel plus prednisone and mitoxantrone plus prednisone in patients with hormone-refractory prostate cancer. Mario A. Eisenberger, MD, of Johns Hopkins University will present the results, and Bruce J. Roth, MD, of Vanderbilt University will be the discussant for both prostate cancer plenary papers, which are Abstracts 3 and 4, respectively.
“These are randomized trials that will change the practice of cancer in a positive fashion,” Dr. Small predicted.
New This Year: ‘Highlights of the Day’
New to the meeting this year is a “Highlights of the Day” feature. Every morning, five experts in the field will present the best of the research from the day before.
Also, the “best of the best” from smaller annual meetings such as the San Antonio Breast Cancer Symposium, the American Urological Association, the American Association for Cancer Research, and the American Society for Therapeutic Radiology and Oncology will be presented, Dr. Small said.
“If you look at the breadth of everything we're highlighting, it's clear it's going to be a great meeting.”
Some other top research will be highlighted at press conferences, Dr. Tempero added. Among the work to be discussed:
* A Phase II trial of bevacizumab and erlotinib for the treatment of patients with metastatic renal carcinoma, presented by John D. Hainsworth, MD.
* Longer-term data and the potential for raloxifene to reduce breast cancer risk, results from the Continuing Outcomes Relevant to Evista (CORE) trial.
To commemorate the organization's 40th anniversary, ASCO is planning a variety of special events, publications, and displays that will look back at the history of the Society over the past four decades, Dr. Tempero said
A museum featuring highlights of the Society—from decade-by-decade overviews of major ASCO events and leaders to scientific advances—will be centrally located in the exhibit area.
And throughout the convention center, timeline banners will feature milestones in the cancer community, while interactive kiosks will offer attendees an opportunity to learn more about ASCO's history.
Dr. Tempero said she is particularly proud that all attendees will receive a 50-plus page color monograph that captures the history of ASCO, as well as progress in oncology over the past four decades.
Additionally, attendees will receive a commemorative video on the history of ASCO, which includes interviews with founding members and other leaders in the field of oncology. Excerpts from the film will be shown at the ASCO museum and at history kiosks throughout the convention center.
Among the Special Sessions will be:
* High-Priority Cooperative Group Phase III Trials for Community Practitioners, co-chaired by Jeffrey S. Abrams, MD, of the NCI, and Norman Wolmark, MD, of the NSABP and Allegheny General Hospital and another member of OT's Editorial Board.
* An International Symposium on Lymphoproliferative Diseases, chaired by Heinz Ludwig, MD.
* Measuring Quality in an Office-Based Practice: The ASCO Quality Oncology Practice Initiative, chaired by OT Editorial Board member and columnist Joseph V. Simone, MD.
“This is a physician-initiated, practice-based quality-improvement program run largely by volunteers at the practices' own expense,” he explained in response to an e-mail inquiry.
“It promises to be a relatively simple, painless, and inexpensive way for oncology practices to develop a culture of self-examination and continuous improvement. An Alpha Group of seven community oncology practices has built and tested the system, and the program is now being tested by a Beta Group of nine different practices to verify the model. If all goes well, it will be opened up to any practice willing to participate.”
* NCI/FDA Collaborative Initiatives in Cancer Clinical Research, co-chaired by Dr. Tempero and NCI Director Andrew von Eschenbach, MD.
* Recognizing and Treating Distress in Clinic Patients: Rapid Screening and Impact on Quality of Life of Patients, chaired by Jimmie Holland, MD.
* Special Topics in Geriatric Oncology, including a tribute to B.J. Kennedy, MD, and Paul Calabresi, MD, to be chaired by Joanne E. Mortimer, MD, and moderated by Donna Regenstreif, PhD.
* Updated data from the National Initiative on Cancer Care Quality, which will be chaired by Joseph S. Bailes, MD, a member of OT's Editorial Board, who started the project during his term as ASCO President (1999–2000). The final report is expected this summer.
New this year will be a “technology pavilion” in the Exhibit Hall, described as featuring the latest in advanced technologies for health care professionals, such as database management, electronic communications, PDA-based solutions, and other electronic products that relate to the clinical and practice setting.
Larry Norton: Karnofsky Lecture
Larry Norton, MD, has been selected to deliver this year's David A. Karnofsky Memorial Lecture. Dr. Norton has given his talk the intriguing title of “Ignorato Motu, Ignoratur Natura (Being Ignorant of Motion is Being Ignorant of Nature).”
PET Scanning Promising in Diagnosing Cancer-Related Neurological Disorders
PET imaging appears to aid in the diagnosis of particular neurological syndromes associated with cancer, according to data presented at the American Academy of Neurology Annual Meeting, held last month in San Francisco.
As explained in a news release, before cancer is even diagnosed, patients can develop problems with the brain, spinal cord, or nerves, although the cancer has not spread to the nervous system. These paraneoplastic neurological disorders are uncommon, difficult to diagnose, and usually appear in patients whose primary cancer is extremely difficult to find.
Abnormal antibodies in the blood or spinal fluid are often associated with these disorders, though they cannot help identify the primary tumor.
PET imaging has been shown to improve detection of a variety of cancers, and earlier tests have suggested this technique may be useful in identifying small tumors in patients with paraneoplastic neurological disorders. But PET imaging is not yet widely available, and clear indicators of clinically meaningful outcomes using PET are essential to warrant use with this patient population.
“Accurately defining the role of this technique for these patients is critical,” said Steven Allder, MD, of the Department of Neurology at Royal Hallamshire Hospital in Sheffield, UK.
He and his colleagues studied the use of PET imaging in 32 patients with suspected paraneoplastic neurological disorders who had not yet been diagnosed with cancer.
With each patient, all relevant investigations had been performed prior to PET imaging resulting in no diagnostic conclusions. Each patient then underwent PET imaging from the neck to the pelvis.
All patients were then prospectively followed-up, with the results of all further investigation collected. Final diagnosis was determined, and the sensitivity and specificity of the results of the initial PET scan were calculated.
“This particular PET scanning in our patient population successfully yielded a high proportion of relevant lesions that were undetectable by alternative diagnostic means,” Dr. Allder reported.
The results indicate, he said, that PET is an appropriate, promising tool for patients with undiagnosed paraneoplastic neurological disorders.
His coauthors for the study were Basil Sharrack, Marios Hadjivassiliou, Wendy Tindall, Edwin Vanbeek, and Mike Hanney.