Each year, the American Society of Clinical Oncology (ASCO) independently reviews advances in clinical cancer research and identifies those that have had the greatest impact on patient care. The report for 2009 highlights 51 of the most significant studies, including 15 that the editors consider are major advances that have the potential to lead to a reduction in mortality from cancer.
The following therapeutic advances were addressed:
• First targeted treatment for gastric cancer: large clinical trial found that adding trastuzumab to standard chemotherapy for advanced gastric cancer increased survival by 26% in patients whose tumours expressed high levels of the HER2 protein, compared with chemotherapy alone.
• First effective immunotherapy for neuroblastoma: chimeric anti-GD2 antibody ch.14.18 was found to reduce risk of relapse and improve survival by 20% for high-risk neuroblastoma.
• First RCT in more than 30 years to demonstrate an improvement in overall survival in advanced head and neck cancer: adding cetuximab to initial chemotherapy increased overall survival by 20% and increased progression free survival by 46%, compared with chemotherapy alone.
• Study provides new insight into the most effective use of gefitinib: large clinical trial found that first-line gefitinib treatment slows progression of NSCLC in Asian nonsmokers or light smokers whose tumours have EGFR gene mutations but not in those without mutations. Furthermore, patients without EGFR mutations responded better to standard chemotherapy.
• FDA approved bevacizumab as a single agent for previously treated glioblastoma- the first drug in a decade to be approved to treat the disease. Bevacizumab also approved to treat metastatic renal cell carcinoma (RCC) in combination with interferon, based on research demonstrating that this regimen increased progression-free survival and overall survival. FDA approved everolimus for patients with RCC whose disease has progressed despite treatment with other targeted drugs.
• Results from the largest-ever trial of advanced biliary cancer confirmed that combination treatment with gemcitabine and cisplatin is the most effective treatment approach, both increasing survival and reducing disease progression by nearly one third, compared with gemcitabine treatment alone.
• Maintenance therapy with pemetrexed improves survival for advanced lung cancer: results from a large, international trial established maintenance therapy with pemetrexed as a new standard of care for patients with advanced non-squamous NSCLC.
• Radiation after surgery improves survival for early-stage prostate cancer, according to results from a large trial that observed patients for a median of 13 years. This finding establishes a new standard of care for men who choose to undergo surgery for early-stage prostate cancer.
• Human papillomavirus (HPV) vaccine is effective in older women: researchers reported that Gardasil reduces the risk of HPV infection, cervical cancer, and other HPV-related disease among women age 25 to 45 years who have not been previously infected with the HPV strains targeted by the vaccine. These findings suggest that vaccination may be beneficial for a larger population of women than previously thought.
• Adjuvant treatment with bevacizumab does not prevent recurrences of colon cancer in individuals who have undergone surgery for colon cancer.
• Standard three-drug chemotherapy is superior to single-drug therapy in older women with breast cancer: a major study comparing the two approaches found that the three-drug combination regimen is considerably more effective for these patients and is associated with fewer adverse effects than single drug therapy.