Takeaways from ASCO 2021
The American Society of Clinical Oncology (ASCO) holds a conference each year in the Spring. For 2021, similar to many annual conferences, ASCO held a virtual conference again. Additionally, they offered free patient advocate access, which only expanded patient access to important information. Just a note, there is a European counterpart to the American Society, which also holds regular conferences.
It is important to note that GRASP, which stands for Guiding Researchers and Advocates to Scientific Partnerships, conducted poster reviews and discussion virtually. GRASP, which debuted at the San Antonio Breast Cancer Symposium (SABCS) in December of 2019 grew to over 300 participants over a period of two weeks during ASCO and included scientists and advocates from all over the world with all different kinds of cancer. Kudos to Christine Hodgdon and Julie Maues, both superb and dedicated patient advocates, for a job well done, yet again!
ASCO, in contrast to SABCS, includes reports and updates from all different kinds of cancer and is one of the largest gatherings of clinical oncologists in the world, if not the largest. As a breast cancer patient, I find this conference a little harder to navigate and so I'm particularly thankful for the medical oncologists who participate regularly in the Twitter chat #bcsm (breast cancer social media) each Monday evening at 9 pm eastern and the oncologists who regularly interpret the information for us.
Here are my key takeaways from the conference:
First of all, in the phase three (3) clinical trial Olympia, women and men with HER2-negative early breast cancer who had a BRCA1 or BRCA2 mutation were randomly assigned to take the medication Lynparza a/k/a olaparib, a PARP inhibitor. This phase lasted for one year and had an arm of patients receiving the medication and a placebo arm. Lynparza is already used in the metastatic setting, showing good results, so I'm not surprised that this study showed a reduction in risk of reoccurrence by 7%. Yet another good example that focusing on treating metastatic disease ends up helping those people who have early-stage breast cancer as well.
Secondly, there was a very very small study (ten people) that demonstrated it would be possible to determine whether or not someone would develop brain metastases by looking at changes in the cerebrospinal fluid. There was quite a bit of chatter about this very small study with 90%+ efficacy rate and I'm hopeful that we will see more about this in the future.
Third, results of several studies were presented that looked at genomic assays, which are tests that look at the genes of the tumor itself. Each study looked at how much hormonal medication would be needed after patients underwent the "traditional" treatment of surgery, chemo, radiation, etc., for early-stage disease. The results of these studies demonstrate an incremental shift towards prescribing the least amount of medication possible and more personalized treatment utilizing hormonal therapy.
Fourth, since the approval of the first CDK4/6 inhibitor in 2015, this class of medication has become the go-to first line of treatment for most individuals diagnosed with stage IV metastatic breast cancer. At ASCO, the results from several longitudinal follow-up studies of two of the three CDK4/6 inhibitors confirmed these medicines improve survival for persons with metastatic hormone receptor-positive (HR+) breast cancer. Since we have known this anecdotally for some time, it is good to see those results in black and white.
Fifth (and my favorite), a study led by patient advocates explored how patients feel about reducing their doses and/or modifying their doses, even when limited information is available about the changes. Not surprisingly, the results demonstrated that patients are extremely open to adjusting their doses when it meant that both efficacy and their individual quality of life was maintained. It's always good to see patients teaching as much as they are learning at these conferences!
Why attend conferences?
Why attend these conferences? I attend them to stay current on the information we all need in order to participate fully in our treatment, to meet other doctors and researchers, and to connect with other patient advocates. It has been much easier to do these things virtually as each of the conferences has gotten better at delivering the best content through a virtual platform. That being said, I'm looking forward to SABCS21, which I intend to attend in person in December.
Internal radiation therapy is the most common type of radiation used to treat breast cancer.