ASCO wrap-up

One advantage to attending the annual meeting of the American Society of Clinical Oncology is being able to ascertain the "buzz" among oncologists. What developments excite them? What findings will they implement upon returning to their practices? The answer to the first question is simple: Nearly every oncologist I spoke to mentioned T-DM1, the first of a new class of "precision" drugs that has been compared to a "smart bomb," because it uses an antibody to deliver a toxin directly to the cancer cell, leaving healthy cells untouched. In a large study, it delayed the time of disease progression in women with advanced breast cancer, and it seemed to improve overall survival by at least a year (additional research is needed to confirm).Oncologists were also buzzing about new immunotherapies, although the idea of manipulating the immune system to deal with cancer is anything but new. More than 100 years ago, Dr. William Coley conceived the idea, but it has only recently become possible because of advances in technology. In a small, early study, a new immune therapy called anti-PD1 shrank tumors in 18 percent of patients with lung cancer, 27 percent in patients with kidney cancer and 28 percent in patients with melanoma. "The PD-1 story is maturing," says Mike Wong, MD, PhD, of the University of Southern California. "There's still the question of durability." If researchers can coax this type of therapy, which has been referred to as a "magic bullet," to endure, it will create a new paradigm in cancer care.The theme of this year's conference, "Collaborating to Conquer Cancer," was clearly demonstrated through sessions presented by oncologists and experts from other fields, such as nuclear medicine, hematology, immunology and genetics. An educational session about things busy oncologists should know focused on the futility of some treatments in certain situations, staging of low-risk prostate and breast cancers, post-therapy surveillance of patients with breast cancer, and management of neutropenia.