May 17-21, 2002
Reporter's Notebook – Dana-Farber researchers present latest findings at ASCO
As many as 25,000 cancer specialists from around the world have converged on Orlando this weekend for the annual meeting of the American Society of Clinical Oncology (ASCO) to discuss the latest developments in cancer treatment and research. Dana-Farber Senior Science Writer Richard Saltus is in Orlando providing regular reports from the four-day conference.
Tuesday, May 21, 2002
Endostatin trial results presented at ASCO meeting
The tumor-starving drug Endostatin has halted some advanced cancers and shrunk them in two cases, according to the latest results of the Phase I clinical trial coordinated by Dana-Farber/Partners Cancer Care and Beth Israel Deaconness Medical Center. The drug, an angiogenesis inhibitor, has proven extremely safe and nontoxic even at high doses.
Paul Eder, MD, clinical director of the Experimental Therapeutics Program, reported the findings Tuesday, the final day of the American Society of Clinical Oncology, attended by an estimated 25,000 cancer specialists.
The report involved 28 patients with advanced cancer who had been receiving continuous Endostatin via an infusion pump of self-injected doses. "We have seen prolonged periods of stable disease of up to 21 months in four patients and sustained small increases in tumor size in two others," said Eder. Two of the 28 patients are still on the trial and taking Endostatin, he said.
Endostatin, a natural compound discovered in the Children's Hospital Boston laboratory of Judah Folkman, MD, has raised hopes because of its potent tumor-shrinking activity in mice. It has moved into Phase II trials coordinated by Dana-Farber/Partners Cancer Care, using doses deemed the most effective in the Phase I trials.
In a poster report on Tuesday, Dana-Farber researchers presented a first-ever assessment of how a child's terminal battle with cancer can severely strain the finances of the family. The research was carried out by John A. Heath, MD, PhD, and Joanne Wolfe, MD, MPH, both pediatric oncologists. When 103 parents of children who had died of cancer were surveyed, 58 percent said they had suffered moderate to great economic hardship. More than half of the families said they relied on public fundraising efforts to help meet expenses.
Endostatin Shows No Toxicity and Some Clinical Activity in Latest Report on Phase I Trial
Care for Child with Terminal Cancer Strains Family Finances
Monday, May 20, 2002
Cancer drug advances reported at ASCO
Drugs that are attacking new targets in cancer cells with encouraging results were spotlighted Monday at the 38th annual meeting of the American Society of Clinical Oncology (ASCO), along with reports on a wide range of other cancer research.
Some results, mainly early findings, of novel "targeted" drugs are being released at the ASCO meeting, which this year has brought about 25,000 cancer specialists here to exchange results and discuss the latest work in the field.
Not all the new designer cancer drugs are working as well as hoped, but some of them are showing encouraging results against stubborn, hard-to-treat cancers. On Monday, Kenneth Anderson, MD, director of Dana-Farber's Jerome Lipper Multiple Myeloma Center gave a poster presentation of results using PS-341, a drug developed by researchers at Dana-Farber and Millennium Pharmaceuticals. The drug is aimed at an enzyme group called the proteasome, which cancer cells use to grow. In the first 78 of 202 patients treated with PS-341, Anderson reported that 77 percent had their disease regress or stop progressing, with few serious side effects. Anderson, who along with Paul Richardson, MD, of Dana-Farber is heading the trial, said more complete data will be released later this year.
Another drug demonstrating the potential of new targeted agents is Gleevec, which jams an abnormal growth signal that operates in certain cancers. Gleevec, originally tested with striking results in a form of leukemia, was moved rapidly into tests in patients with the rare, fatal Gastrointestinal Stromal Tumor (GIST) by George Demetri, MD, director of the Center for Sarcoma and Bone Oncology. In a poster session on Monday he described results of a large trial quickly organized in 2001 that included 746 patients with GIST. The great majority of patients, 88 percent, remain on the trial, which means their disease did not progress, and serious side effects have been relatively few, said Demetri. It's still too early to know whether the drug enables patients to live longer.
Matthew Kulke, MD, responds to a question during an educational session.
Dana-Farber scientists continued to be among those leading educational sessions and clinical discussions on Monday. In one session on neuroendocrine tumors, Matthew Kulke, MD, answered questions from the physicians in the audience about what might be done in complex cases involving these tumors, which are often challenging to treat.
ASCO named two Dana-Farber researchers to receive its Young Investigator Awards, which are given to physicians entering their final year of an oncology training program who intend to pursue investigative careers in clinical oncology. The two, each awarded $35,000 to begin their investigative studies, are Karl Hsu, MD, for a project titled "Zebrafish Model of FLT3-Mediated Leukemogenesis" and William Y. Kim, MD, for "The Role of Integrins in Platinum-Resistant Ovarian Cancer."
The meeting concludes on Tuesday.
Early Findings Suggest New Type of Drug Shows Promise in Treating Multiple Myeloma
Sunday, May 19, 2002
ASCO issues breast cancer treatment guidelines
Dana-Farber's Eric Winer, MD, leads expert panel
In a long-awaited report, an expert panel has advised post-menopausal breast cancer patients not to switch from the standard treatment, tamoxifen, to a newer class of drugs called aromatase inhibitors for reducing the risks of a recurrence.
Eric Winer, MD, responds to a reporter's question.
The chair of the panel, Eric Winer, MD, director of Dana-Farber's Breast Oncology Center, announced the recommendation on Sunday at a press conference during the annual meeting of the American Society of Clinical Oncology (ASCO).
Tamoxifen, an estrogen-blocking drug, is routinely prescribed for women following surgery for early breast cancer and whose tumors have estrogen receptors on their surface. It's been shown that tamoxifen lowers the chances of a recurrence and also prolongs survival. However, newer drugs known as aromatase inhibitors have shown promise in a recent clinical trial of being equally or more effective and possibly having fewer serious side effects.
The panel headed by Winer was convened by ASCO to weigh whether the aromatase inhibitors, in particular anastazole (Arimidex), should be substituted for tamoxifen.
"We would not recommend that doctors and patients start using this [anastazole] as standard treatment in post-menopausal women," Winer said at the news conference, attended by national and international media. While the clinical trial showed that Arimidex was slightly more effective in reducing cancer recurrence, Winer said that the long-term effectiveness and side effects are not well-enough known to make it clearly superior to tamoxifen. But the answers, he added, should come within a few years.
Another Dana-Farber adult oncologist, Harold Burstein, MD, PhD, also served on the 18-member expert panel.
Philip Febbo, MD, answers questions following his presentation.
The four-day conference has brought an estimated 25,000 cancer specialists to Orlando to hear research findings reported and attend educational sessions on the state-of-the-art in cancer treatment. Sunday's presentations included a number by Dana-Farber scientists both in the research and educational forums.
Phillip Febbo, MD, shared results of efforts to find distinctive gene "signatures" in prostate tumors that could indicate whether they are at a high or low risk of recurring, and could be treated accordingly. Febbo, a genitourinary oncologist, also briefed reporters on the high-tech methods being used to find genetic differences between tumors to aid in improved diagnosis and treatment.
Monika Krzyzanowska, MD, presents the findings from her team's study.
Another Dana-Farber researcher, Monika Krzyzanowska, MD, reported on her analysis of hundreds of short research reports, or abstracts, given at previous ASCO meetings. Krzyzanowska, who is in Dana-Farber's center for outcomes research, found that abstracts with positive results - showing that an experimental drug was an improvement, for example - were more likely to go on to publication than were abstracts that had negative findings.
A study by Timothy Gilligan, MD, showed that African-American men with advanced prostate cancer actually lived slightly longer than white men when all were treated similarly, contradicting a common belief that African-Americans tend to do more poorly.
Annick Van den Abbeele, MD, outlines the use of imaging technologies to measure the effectiveness of Gleevec in treating GIST.
Other Dana-Farber investigators giving reports or leading discussions on Sunday included Annick Van den Abbeele, MD; Patrick Y. Wen, MD; Matthew Kulke, MD; Judy Garber, MD, MPH; Steven Joffe, MD, MPH; Kenneth Anderson, MD; John V. Heymach, MD, PhD.
Saturday, May 18, 2002
Dana-Farber research featured as ASCO meeting begins
The largest annual cancer research conference opened Saturday in a hopeful mood, with scientists delivering the first of some 3,000 reports to be presented at the American Society of Clinical Oncology's 38th annual meeting.
The ASCO meeting brings together researchers and oncologists from across the United States and many foreign countries to discuss the latest findings from clinical trials and laboratory experiments. About 25,000 cancer specialists are expected to attend.
Larry Norton, MD, the president of ASCO, told a large audience of media representatives, "We have more at this meeting that is going to influence patient care more than at any meeting in the past." He noted that of the five major plenary talks, three would involve screening and cancer prevention rather than treatment - a significant change of focus.
Dozens of Dana-Farber physicians and researchers have come to ASCO to talk about new findings, lead educational sessions, or sum up and discuss other scientists' presentations.
Some of the talks are in cavernous halls as big as airplane hangars, with thousands in attendance. In an afternoon Presidential Symposium on breast cancer treatment, Judy Garber, MD, MPH, director of the Friends of Dana-Farber Cancer Institute Risk and Prevention Clinic, reviewed the most recent knowledge about breast and ovarian cancer genes, and about radical preventive measures like prophylactic mastectomy.
In an afternoon poster session, Harold Burstein, MD, PhD, gave the results of a clinical trial testing the drugs Herceptin and Navelbine in women with metastatic breast cancer and an overactive Her2 gene. He reported that, as in an earlier study, the drug combination caused tumors to shrink in many women without the severe hair loss and nausea of standard drugs.
Gregory Videtic, MD
ASCO selects a number of investigators to present their work at press conferences. On Saturday, Gregory M. Videtic, MD, of the radiation oncology department described his study comparing patients with small cell lung cancer who continued to smoke during radiation treatment with those who quit. He found that those who kept smoking tended to do significantly more poorly.
In other sessions, Kenneth Anderson, MD, talked about research that is aiding patients with multiple myeloma, a blood cancer, and referred to new findings involving a drug called PS-341 that will be reported later in the meeting. He also showed slides of quarterback Tom Brady and the New England Patriots Super Bowl champions, saying that with teamwork like that, he and his colleagues vow to cure the disease.
Steven Joffe, MD, MPH, a Dana-Farber bioethics specialist, reported on a study that found a significant number of oncologists incorrectly believed that clinical trials are intended to benefit the people who volunteer to be in them. Their actual purpose is to create new knowledge to benefit future patients.
Margaret Shipp, MD
Other Dana-Farber presentations included Charles Fuchs, MD, on a study of two colon cancer drug regimens; Margaret Shipp, MD, commenting on the use of DNA "gene chips" to probe different types of cancer; and George Demetri, MD, and Janet Lee Abrahm, MD, discussed pain and symptom control in cancer patients.
The ASCO meeting continues through Tuesday.
American Cancer Specialists Disagree about the Purpose of Clinical Trials
Friday, May 17, 2002
Largest cancer meeting of the year draws many from Dana-Farber
If he hadn't suffered a recent knee injury, Robert Mayer, MD, would be on his way to the annual meeting of the American Society for Clinical Oncology (ASCO) for the 38th consecutive year. And even though he won't be there, he'll participate in a session by videoconference.
Dozens of other Dana-Farber physicians and researchers will spend all or part of the next four days in Orlando, where this year's ASCO meeting is expected to attract some 24,000 cancer specialists to exchange the latest information in cancer research. Investigators from the Institute will present more than 80 research reports on everything from the new cancer drug Gleevec to the ethics of clinical trials. The meeting begins Saturday and ends on Tuesday.
It's far from the only cancer meeting of the year, but it's the largest. Some 3,200 research summaries, or abstracts, have been accepted by the ASCO reviewers. Some of the reports are presented in plenary talks, others in smaller sessions, and many are detailed in posters tacked up in huge halls where people can walk by and browse.
"This could be called the World Oncology Convention," says Mayer, noting that half or more of the attendees are from other countries. Mayer, director of the Center for Gastrointestinal Oncology, says that Dana-Farber participation has always been a key part of ASCO. Three DFCI physicians have served as ASCO presidents - Mayer; Emil (Tom) Frei III, MD; and George P. Canellos, MD - and many from the Institute staff have served on important ASCO committees.
ASCO provides an opportunity for both senior and junior staff "to see and hear about the clinical research that is going on elsewhere in the country," says Canellos, medical director for network development. In addition, he says, the best in European cancer research has customarily been presented at ASCO, "and hopefully, despite Sept. 11, this will continue," Canellos adds.
Many pharmaceutical company representatives attend the meeting as well, and there's an enormous exhibit hall where drug and device and textbook companies display their wares.
Timothy Gilligan, MD, of Dana-Farber's Department of Adult Oncology, who will be attending for only his second time, says, "It's useful for people like me who are very junior to meet people and to make sure you're up to date on what the breakthroughs are in areas outside of your specialty." And in "meet-the-professor" sessions, he notes, "you can meet national experts in every field."
