What we learned from ASCO 2017
Former Vice President Joe Biden’s cancer moonshot may have to wait, due to proposed cuts in the National Institutes of Health (NIH) budget. But for the more than 30,000 cancer researchers, biopharma executives, investors, and public health officials who gathered at the annual meeting of The American Society of Clinical Oncologists (ASCO) recently, there’s still plenty of reason for optimism in cancer treatment. Here’s what caught our attention at ASCO 2017:
Drug combinations may seem random now, but more are embracing it as a treatment model
If one is good, two or three seem to be better. While immunotherapy holds great promise, what looks even more promising is combining therapies, whether it’s two immunotherapy medications together or putting them together with more conventional treatments like chemotherapy and radiation. However, there’s a level of randomness to the combinations put forward that bears further scrutiny. The combinations haven’t been shown to be effective in a majority of patients, and the approaches, according to some, “are a bit like throwing spaghetti at the wall to see what sticks.” Most researchers agree the combination approach, while still in need of greater refinement, is a worthwhile pursuit for cancer treatment.
Medicaid expansion states saw earlier diagnosis of colorectal cancer (CRC)
CRC is often asymptomatic in its earliest and most treatable stages. Screening is critical for bringing down the mortality rate of one of the country’s deadliest cancers. In states where Medicaid expanded, thus expanding the number of people eligible for having their CRC screening covered by the Affordable Care Act, there were earlier diagnosis rates for CRC. While the ACA is headed for an overhaul, cancer researchers were encouraged by the trend.
“Financial toxicity” plagues patients and their families
Cost is a bigger issue than ever – it even has a new term: financial toxicity. Duke University’s Yousuf Zofar, MD, MHS, an associate professor of medicine, has studied the financial effects of cancer care on patients and their families, and finds that they can be just as damaging as the cancer itself. According to the American Journal of Managed Care, results of a panel discussion moderated by Dr. Zofar emphasize the need for the cancer treatment community to come up with a single solution for financial toxicity.
Precision medicine is a promise not yet delivered
Pierian Biosciences is uniquely focused on developing treatment-directing assays that help clinicians target exactly which chemotherapeutic, targeted agent, biologic, or immunotherapeutic agents kill a specific patient’s cancer cells. These assays offer the hope of truly individual, personalized cancer treatment plans. But at ASCO, there was a lot of discussion about how “precise” precision medicine actually is at this time. Larotrectinib, as pointed out by Health News Review, received a lot of attention at ASCO. The new drug showed that “76 percent of patients had tumor shrinkage across 17 different types of tumors. Of those with tumor shrinkage, nearly 80 percent did not have the original tumors rebound — or any new tumors grow — after a year of therapy.” The drug has received Breakthrough Therapy Designation from the Food and Drug Administration (FDA). But tumor shrinkage is only one of many data points to capture in determining the drug’s overall effectiveness. Benchmarks such as median progression-free survival, median overall survival, or duration of response still need to be determined.
There’s reason for optimism
Siddhartha Mukherjee, author of “The Emperor of All Maladies” and “The Gene,” encouraged the ASCO audience to see the silver lining in some of the uncertainty surrounding the future of cancer treatment. From an article in the Washington Post, Mukherjee spoke with hope for the future: “Cancer treatment is entering a promising, if challenging, adolescence…and his fellow oncologists, after years of being hamstrung by a lack of technological tools and treatments, now have therapies to deploy in a thoughtful, reasoned and compassionate way. ‘Always keep in mind, Mukherjee urged the physicians, what it feels like to be a patient in this world.’” We at Pierian Bioscience are dedicated to developing very accurate and reproducible treatment-directing assays that will fulfill the promise of personalized medicine: the right drug for the right patient at the right time. We are focused on helping clinicians target exactly which chemotherapeutic, targeted agent, biologic or immunotherapeutic agent(s) will be most effective against a specific patient’s tumor to allow the physician to truly individualize or personalize each patient’s cancer treatment plan.