ASCO 2017: Oncology Leaders Pick Their Top Abstracts

Gina Columbus @ginacolumbusonc
Published Online: Tuesday, May 30, 2017

The final OS results from this pivotal trial—which led to the accelerated FDA approval of palbociclib as a frontline treatment for postmenopausal women with ER-positive, HER2-negative metastatic breast cancer—will be presented.

“Palbociclib added to endocrine therapy has been integrated in the management of patients with ER/PR-positive, HER2-negative metastatic breast cancer, based on significant improvements in PFS rates compared with endocrine therapy alone. A trend towards an improvement in OS in the original PALOMA-1 trial is promising. OS data for the larger randomized trials (PALOMA-2, PALOMA-3) are highly awaited.”

A randomized, double-blind, phase III study comparing SB3 (trastuzumab biosimilar) with originator trastuzumab in patients treated by neoadjuvant therapy for HER2-positive early breast cancer; Double-blind, randomized phase III study to compare the efficacy and safety of CT-P6, trastuzumab biosimilar candidate, versus trastuzumab as neoadjuvant treatment in HER2-positive early breast cancer (Abstracts 509, 510)

Both clinical trials explore the efficacy of trastuzumab biosimilars as neoadjuvant therapy for patients with HER2-positive breast cancer.  

“These studies showed that SB3 and CT-P6 are similar in safety and efficacy to the originator trastuzumab. The neoadjuvant setting offers the opportunity to test novel biosimilars in early-stage breast cancer. Both studies [that will be] presented at ASCO showed pathologic response rates within the prespecified range to show biosimilarity. In my opinion, pathologic complete response is an acceptable surrogate endpoint for efficacy of HER2-targeted antibodies. The development of high-quality clinical data is critical for approval of therapeutic monoclonal antibodies in breast cancer, especially in early stages of the disease.  The availability of trastuzumab biosimilars is expected to expand access to this life-saving therapy across the globe.” 

BREAST CANCER, SURVIVORSHIP

Deanna Attai, MD, assistant clinical professor of surgery at the David Geffen School of Medicine at the University of California Los Angeles

Axillary management in early breast cancer: surgeon attitudes in a population-based study (Abstract 561)

 
Deanna Attai, MD

Deanna Attai, MD

Researchers surveyed physicians regarding their attitudes toward axillary lymph node dissection in patients with 1 to 2 positive sentinel nodes since the publication of the landmark study Z0011. Among the surgeons surveyed, 49% endorsed axillary node dissection for Z0011-eligible patients with 1 sentinel node macrometastasis, and 63% endorsed axillary node dissection for Z0011-eligible patients with 2 sentinel node macrometastases.

“As the bulk of cancer care is delivered in community settings, this study stresses the need for continuing physician education, especially for surgeons who may not treat a large number of breast cancer patients. Patients should also be encouraged to ask questions of their surgeon including case volume, whether or not there has been multidisciplinary input, and rational for axillary dissection if that procedure is recommended.”

Self-reported financial stress among patients evaluated at a community cancer program (Abstract 6553)

These are the findings of patient-reported financial stress, quality of life, and quality of health at an outreach cancer program located in a federally qualified health center. Just over 50% of patients reported some degree of financial stress, and 12% of patients reported extreme financial stress. (See comment below abstract 6512 summary.)

How costs get discussed (or not) in routine oncology practice (Abstract 6512)

Researchers reviewed audio recordings of a cross-section of medical oncology conversations to determine frequency, patterns, and attitudes of patients and providers on cost. Of 151 audio-recorded consultations between patients and oncologists, only 28% contained any mention of cost, and the average length of any cost discussion was less than 2 minutes. Patients usually initiated cost discussions.

On both abstracts 6553 and 6512: “As physicians, we can no longer ignore the financial impact that our recommended treatments have on our patients. These studies should serve as a call to physicians to educate themselves about the costs of various treatments, and the financial burdens that impact our patients.”

Survivorship care plans: recommended versus delivered care (Abstract 10076)

The American College of Surgeons Commission on Cancer and the National Accreditation Program for Breast Centers call for survivorship care plans to be distributed to patients upon completion of therapy. Survivorship care plans, Attai explains, are important for patients to summarize their treatment and to inform them of recommended follow-up as well as potential treatment side effects and signs and symptoms of recurrence. In addition, these plans can be helpful for the patient’s primary care physician.

“The authors of abstract 10076 noted that despite the delivery of survivorship care plans to patients, primary care physicians were often not notified, and many patients underwent redundant and unnecessary testing due to lack of care coordination and communication.”

What do social media-savvy cancer survivors tell us about the completeness of survivorship care plans? (Abstract 10063)

After surveying an online breast cancer community, the investigators found that only a small percentage of patients received a survivorship care plan, and none received a complete one.

“Care coordination remains important, even after active cancer treatment ends. Oncology team members need to do a better job communicating with primary care physicians during and after treatment, and patients need to be better informed regarding posttreatment surveillance guidelines and side effect management.”
 



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