The theme of the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting held in Chicago May 29-June 2 was “Illumination and Innovation: Transforming Data into Information.” One of the largest scientific conferences focused on oncology, with a reported 37,000 cancer experts in attendance from around the globe, the Annual Meeting lived up to the theme by showcasing the field’s latest discoveries and efforts to revolutionize cancer clinical care through the implementation of new information. Of all the areas represented at the conference, tumor immunotherapy and the value and economics of cancer care were emerging areas of focus that again received considerable attention from the oncology community.
Work from dozens of University of Chicago Medicine Comprehensive Cancer Center faculty was presented at the meeting, and selection of many of our physicians and scientists to lead the scientific sessions, or present their perspective on their colleagues’ research or provide a state-of-the-field overview, reinforces the leadership that our investigators provide to the cancer research community. Oral presentations are highlighted here; space limitations preclude us from summarizing the many outstanding poster presentations from our faculty and trainees.
Oral Abstract Sessions
In a presentation that garnered considerable press attention, Tanguy Seiwert, MD, assistant professor of medicine, described compelling early antitumor and safety data of the immune checkpoint inhibitor pembrolizumab in patients with advanced squamous cell carcinoma of the head and neck. The outcome data his study demonstrated is impressive, including overall response rate and tumor shrinkage. In related poster presentations, his group shared the identification of putative biomarkers for the T cell-inflamed phenotype, including the interferon gamma signature, in head and neck cancers and malignant mesothelioma, in an effort to identify those tumors that may be particularly responsive to immunotherapeutic approaches.
In a session on “Developmental Therapeutics – Immunotherapy,” Thomas Gajewski, MD, PhD, professor of pathology and medicine, described his group’s characterization of the T cell-inflamed and non-T cell-inflamed phenotype in metastatic melanoma and demonstration that both subsets show comparable expression of cancer-testis, differentiation, and mutational antigens. He suggested that identification of specific antigens in non-T cell-inflamed tumors may lead to the development of strategies to improve spontaneous T-cell infiltration and responsiveness to immunotherapies.
Todd Zimmerman, MD, associate professor of medicine, shared exciting results from a phase II study involving Andrzej Jakubowiak, MD, PhD, professor of medicine, and Sandeep Gurbuxani, MBBS, PhD, assistant professor of pathology, showing that adding autologous stem cell transplantation to extended treatment with carfilzomib, lenolidomide, and dexamethasone in newly diagnosed multiple myeloma was beneficial. Jakubowiak was also an author on a poster discussed in an oral session on interim analysis of the phase II ASPIRE study assessing effect of carfilzomib, lenalidomide and dexamethasone (KRd) vs. lenalidomide and dexamethasone (Rd) in patients with relapsed multiple myeloma.
In a session on leukemia, myelodysplasia, and transplantation, Wendy Stock, MD, professor of medicine, discussed the findings and implications of the talks in the session focused on new biomarkers and gene expression profiles that may be clinically useful as prognostic indicators in leukemia and myelodysplastic syndrome.
Also providing his perspective on the data presented in this session was Michael Bishop, MD, professor of medicine. Specifically, he discussed hematopoietic cell transplantation for myelofibrosis and grade 3 follicular lymphoma and long-term follow up of AML patients treated with autologous telomerase-based dendritic cell vaccine.
Daniel Catenacci, MD, assistant professor of medicine, was an investigator on a study examining comprehensive genomic profiling of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma and gallbladder carcinomas to assess whether the genomic landscape might direct targeted therapies for these tumors. Catenacci was also involved in a pembrolizumab trial for advanced gastric cancer showing that PD-L1 expression may be helpful in enriching the patient population that may benefit from this therapy.
Hedy Kindler, MD, professor of medicine, was an author on initial results from the multi-institutional Alliance Trials A021101 showing that preoperative modified FOLFIRINOX chemotherapy followed by chemoradiation for borderline resectable pancreatic cancer was associated with manageable toxicity and promising data suggesting efficacy.
Peter O’Donnell, MD, assistant professor of medicine, was senior author on a presentation of the updated promising results and biomarker analysis from KEYNOTE-012 pembrolizumab trial cohort of advanced urothelial cancer showing durable antitumor activity and higher response rate in patients with PD-L1 expression. O’Donnell also chaired a poster discussion session on genitourinary cancer, excluding prostate, in which novel targeted approaches and immunotherapies were presented, as well as predictors of chemotherapeutic response.
In a session on tumor biology, Mark Ratain, MD, Leon O. Jacobson Professor of Medicine, was senior author on a talk describing a novel dicer-substrate small interfering RNA inhibitor of the MYC transcription factor, called DCR-MYC, that was well tolerated and showed promising initial clinical and metabolic responses.
Walter Stadler, MD, Fred C. Buffett Professor of Medicine and Surgery, was an author on the presentation of the Prostate Working Group 3’s consensus criteria for guiding trials in castration-resistant prostate cancer, considering biomarkers, eligibility interventions, and outcomes. Additionally, Habibul Ahsan, MBBS, Louis Block Professor of Public Health Sciences, co-chaired a session on cancer prevention, genetics and epidemiology.
Clinical Science Symposia
William Dale, MD, PhD, associate professor of medicine, provided his insight on a session of predicting and improving adverse outcomes in older patients, including the inclusion of geriatric assessment elements to help predict short-term mortality.
Everett Vokes, MD, John E. Ultmann Professor of Medicine, was an author of a phase III study showing that nivolumab, an anti-PD-1 checkpoint inhibitor, demonstrated superior outcomes compared to docetaxel in previously treated advanced or metastatic squamous cell non-small cell lung cancer.
Hematology/oncology fellow Randy Sweis, MD, presented work from the Gajewski laboratory describing the molecular drivers of the non-T cell-inflamed tumor microenvironment in urothelial bladder cancer and showed that activation of the beta-catenin, PPARgamma and FGFR pathways are strongly correlated with T cell exclusion in these tumors.
Stadler presented his perspective on work presented in a session on “Molecular Drivers and Genomic Biomarkers in Genitourinary Cancers” and suggested careful evaluation of molecular predictors of response in renal cancer.
Catenacci was senior author on phase III trial showing that a MET inhibitor, rilotumumab, did not improve outcomes when added to epirubicin, cisplatin and capecitabine (ECX) as first-line therapy in patients with advanced MET-positive gastric or gastroesophageal junction cancer.
Education, Highlights of the Day, and Meet the Professor Sessions
Rena Conti, PhD, assistant professor of pediatrics, and Blase Polite, MD, associate professor of medicine and chair of the government affairs committee for ASCO, are among the thought leaders in cancer economics and policy and participated in one of several sessions on payment reform in oncology care. Conti addressed problems with “buy and bill” (the process of physicians purchasing drugs, maintaining inventory and then billing after administration to patients) from an economist’s perspective. Polite, who also spoke on the topic in a Special Session, discussed the Medicare ASP (average sale price)-plus-six (percent) reimbursement rate for outpatient drugs. Additionally, Polite summarized the top presentations of the meeting in health services and quality of care in a Highlights of the Day Session.
Ratain discussed the ethical challenges faced by oncologists regarding their financial relationships with industry and the implications of the Sunshine Act for oncologists and researchers. This legislation requires manufacturers of drugs, devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value to physicians and teaching hospitals, with the goal of increasing transparency.
Olatoyosi Odenike, MD, associate professor of medicine, described the risk-stratified approach to frontline therapy in myelodysplastic syndromes (MDS) in a session on therapeutic progress in MDS. She discussed the evolving role of molecular genetics on risk prediction and the importance of individualized therapy based on risk stratification.
Wendy Stock, MD, highlighted the improving treatment outcomes for young adults with acute lymphoblastic leukemia (ALL), including use of a holistic approach and multidisciplinary team to treat these patients as well as improved disease-free survival rates when treated with pediatric-based protocols.
In addition, Seiwert summarized the top presentations from the American Association for Cancer Research Annual Meeting on head and neck cancer, and Richard Larson, MD, professor of medicine, presented the Highlights of the Day Session on leukemia, myelodysplasia, and transplantation.
John Renz, MD, PhD, professor of surgery and director of the liver transplant program, presented on “Hepatobiliary Carcinoma Tumor Board: Making Sense of the Technologies,” and hematology/oncology fellow Jesse Soodalter, MD, presented a case study and discussion in an Education Session on the targeted therapy and immunotherapy of chronic lymphocytic leukemia. Lastly, Gini Fleming, MD, professor of medicine, discussed adjuvant therapy for corpus-confined endometrial cancer in a Meet the Professor Session.
Of special note, fellow Mark Applebaum, MD, was a 2015 Brigid Leventhal Merit Award Recipient for his work “Second malignancies in neuroblastoma patients: a report for the International Neuroblastoma Risk Group” with Drs. Cohn, Tara Henderson, Navin Pinto and Samuel Volchenboum, and fellow Steven Maron, MD, was a 2015 Merit Award Recipient for his work “ARQ 197 in patients with previously-treated malignant mesothelioma (MM): A phase II trial from the University of Chicago Phase II Consortium” in collaboration with Drs. Kindler, Salgia and Theodore Karrison.
As always, the ASCO annual meeting generated a great deal of coverage in mainstream media and trade publications. A sampling of stories featuring our researchers:
- Tanguy Seiwert’s research on pembrolizumab was covered by Reuters, OncLive, MedPage Today, Medical News Today and the ASCO Post.
- Scott Eggener was interviewed in another piece in the ASCO Post about prostate cancer screenings.
- Todd Zimmerman was quoted by Frontline Medical News about stem cell transplants for multiple myeloma patients.
- Michael Bishop was quoted by Cancer Network in a piece about an acute myeloid leukemia vaccine.