(Vienna, 9th June 2011) The Annual Meeting of the American Society of Clinical Oncology (ASCO) took place in Chicago from 3rd to 7th June 2011. Just like every year, the meeting constituted the highpoint of the oncological congress season, and was visited by around 30,000 participants. Significant study findings with “practice-changing” implications were presented and the Comprehensive Cancer Center Vienna (CCC) was represented with its own strong original contributions.
As the highlight of this year’s plenary P. Chapman presented the findings of the phase III study of the BRAFV600 inhibitor vemurafenib in patients with metastasised melanoma with BRAFV600 mutation. Compared with dacarbazine, vemurafenib had a hazard ratio for overall survival of 0.37 (95% CI 0.26-0.55; p<0.001) and thereby a new era has been introduced to the treatment of patients with BRAFV600 mutation. The corresponding original article has already been made available online via the homepage of the New England Journal of Medicine.
A further contribution of the plenary by J. Wolchok was dedicated to unresectable melanoma in stage III or IV. In the context of a phase III study the advantage of combined therapy with the anti-CTLA 4 antibody iplilimumab and dacarbazine was shown in comparison to the administration of dacarbazine alone with a hazard ratio for overall survival of 0.72 (p=0.0009).
In the paediatric oncological section of the plenary session Dr. Ruth Ladenstein from the St. Anna Kinderspital (St. Anna’s Children Hospital) presented the results of the HR-NBL1/SIOPEN in high-risk neuroblastoma. With a 3-year overall survival of 60 percent in the busulfan-melphalan group in comparison with the CEM (carboplatin, etoposide, malphalan) with 48 percent (p=0.004), the busulfan-melphalan therapy is now recommended as the standard therapy. In the second paediatric study the comparison of high-dose methotrexate therapy with Capizzi methotrexate plus asparaginase in acute high-risk lymphoblastic leukaemia was presented by E.C. Larsen. A benefit of the event-free survival (5 year EFS 82% vs. 75.4%; p=0.006) for the high-dose methotrexate therapy was shown.
In the fifth contribution of the plenary H. Joensuu presented the final results of the SSGXVIII/AIO study which compared the administration of imatinib over 36 months with imatinib over 12 months in operable GIST with a high risk of recurrence. In a population of 400 patients an improvement was shown of the overall survival for the 36-month therapy with imatinib (hazard ratio 0.45; 95% CI 0.22-0.89; p=0.019).
Prof. Dr. Michael Gnant from the University Department of Surgery of the Medical University of Vienna presented the follow-up data of the internationally well-respected ABCSG-12 study which had been published in the New England Journal of Medicine in 2009. It showed that after 76 months there is still the benefit of the administration of the bisphosphonate zoledronic acid in addition to hormone therapy in pre-menopausal women with early-stage hormone-receptor positive breast cancer. The follow-up data can be found in this year’s June edition of Lancet Oncology.
Ass. Prof. Dr. Georg Pfeiler from the University Department of Gynaecology of the MedUni Vienna showed in the population of the ABCSG-12 study that patients under anti-hormonal therapy presented an increase in the Body Mass Index, however this increase did not negatively affect the progression-free survival or the overall survival.
The team of the Austrian Brain Tumor Registry (ABTR) and the Brain Tumour Unit of the CCC (www.ccc.ac.at/cns) presented the findings of an Austria-wide statistical investigation of the survival times of all of the patients with first diagnosis of primary glioblastoma in 2005 which had been carried out by Dr. Adelheid Wöhrer from the Clinical Institute of Neurology of the MedUni Vienna. It was shown that the survival times on the population level have improved significantly in comparison with historical data. The contribution was met with wide interest and received very positive comments.
Berghoff et al. from the University Department of Internal Medicine I of the MedUni Vienna presented a study on the subject of targeted therapy in HER2 positive metastasised breast cancer. In a “real-life” population, which included all patients who were treated with trastuzumab at the University Department of Internal Medicine I between 1999 and 2009 it is shown that the influence of trastuzumab on the overall survival is significantly greater than had previously been acknowledged.
Dr. Rupert Bartsch from the University Department of Internal Medicine I at the Medical University of Vienna presented new results with regard to the systemic therapy in HER2 positive patients with cerebral metastases. After the positive affect of systemic therapy with trastuzumab could be shown in previous work (Bartsch et al. J. Neurooncol. 2007), it was now shown that there are even more promising results for the addition of lapatinib (average survival after 24 months not achieved; p=0.002).
The Central European Cooperative Oncology Group (CECOG) with its headquarters in Vienna presented, with T. Ciuleanu as the lead author, for the first time, the findings of the equivalence of cetuximab in weekly vs. two-weekly intervals in an adapted dose in combination with chemotherapy in metastasised colon carcinoma.
This new strategy has opened the path to a new application method of the antibody cetuximab.
The CCC has also awarded three travel grants for this important congress to young, committed junior researchers who have presented a contribution in Chicago.
The following works were presented by MedUni Vienna Young Scientists at the Annual Meeting of the American Society of Clinical Oncology 2011:
Dr. Judith Maresch
Ärztin in Facharztausbildung am Klinischen Insititut für Pathologie
» Pathologic indicators of chemotherapy response in colorectal liver metastases: A comparative study.
» Influence of KRAS status of colorectal cancer liver metastases in patients receiving neoadjuvant chemotherapy including bevacizumab prior liver resection.
Ing. Dr. Birgit Flechl
PhD der Klinik für Innere Medizin I
» Clinical outcome of GBM long-term survivors.
Dr. Christoph Grimm
Arzt in Facharztausbildung der Univ.-Klinik für Frauenheilkunde
» Treatment of cervical intraepithelial neoplasia with topical imiquimod.