Looping across different types of analyses can yield intriguing and unexpected results
Not in Chicago – It still feels surreal not to have been to windy city and back for the annual meeting at ASCO this year, such was the ongoing effect of the pandemic in the oncology world.
That said, the virtual meeting has produced some gems this year, including some very important findings many may have missed.
In our latest post meeting report we focus on both biomarkers and clinical findings.
We look at how there are various elements may interplay in unexpected ways, whether signatures from one trial are helpful in another, are there likely to be changes in treatment patterns as a result of data presented and where some emerging early signals might be useful.
One other aspect which crossed my mind was how a deep scientific approach used in one particular cancer might have potential applications in other tumour types with few somatic mutations present such as TNBC, prostate cancer or soft tissue sarcomas.
The results might produce quite different results, yet the process itself might be rather useful to consider…
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In the third part of our ASCO GU coverage from San Francisco, which includes previews and post-match commentary, it’s time to turn our attention to renal cancer. This isn’t one disease, but a broad tumour type with multiple subtypes, some based on histology, with perhaps others to emerge down the road as we learn more about the disease and immune profiling.
There’s quite a bit to discuss this year, some of it quite complex and nuanced.
In the old days, much of the focus was on sequencing single agent TKIs in clear cell carcinoma, now it’s getting much more complex as scientists and researchers figure out combinations and regimen approaches, never mind what to do with the various histologies.
We walk readers through the latest information as we await the data presentations coming out tomorrow…
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Part 3 of our series on Gems from the Poster Halls at ESMO continues with a look at another four important combination studies that may be of keen interest to readers.
These include both targeted therapies as well as immunotherapies.
Some of the posters I was originally keen to write about turned out a little unexpectedly with some issues to address i.e. lack of efficacy or unwanted toxicities based on the dosing schedule used and may require tweaking of the dosing, schedule or trial design. Others will unfortunately be destined for dog drug heaven unless a new tumour type offers more promise. Such is the R&D roller coaster that is oncology – sometimes we forget that more compounds fail than make it market.
The good news is that there were plenty of promising approaches that are worthy of writing up and discussing. In the third part of our poster mini-series, we take another deeper dive with a careful look at some new data in Copenhagen.
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At the last count, the renal cell carcinoma (RCC) space is quite competitive with five VEGF inhibitors (sunitinib, sorafenib, axitinib, pazopanib and bevacizumab), two mTOR blockers (temsirolimus and everolimus) and not forgetting IL–2, all approved by the FDA for the treatment of advanced disease.
Much of the recent focus has been on sequencing, exploring combinations (generally too toxic with little added benefit), and evaluating the potential for novel immunotherapies in development such as checkpoint inhibitors. Biomarkers are few and far between, making it hard to rationally decide which therapy each patient should get and in which sequence.
The key question is, why is this tumour type so challenging from a clinical and scientific perspective?
Recently, new data has begun to emerge that may help inform or enable us to switch to new approaches. While the urologists are eagerly watching the live surgery on the EAU cam, we highlight research data presented at the European Association of Urology (EAU) in Madrid and take a look at how the underlying biology of RCC can elevate our knowledge about where the potential future strategies and blueprint might lie, if we want to facilitate exciting new developments in this field.
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