Showing posts with label immunotherapy. Show all posts
Showing posts with label immunotherapy. Show all posts

Thursday, June 9, 2022

News from #ASCO22 - Part 2, Gyn Cancer Oral Abstract Session

 The #ASCO22 Oral Abstract session for Gynecologic Cancers was held on June 6, 2022. 

ATHENA–MONO (GOG-3020/ENGOT-ov45) trial - Improved Progression Free Survival, OC

Ruxolitinib  in OC

Bevacizumab  use in ovarian cancer clear cell carcinoma, Japanese study

Discussion of prior 3 OC studies 

Relacorilant in recurrent OC ,  <2 month PFS as well as OS

 Trabectedin in OC, Fallopian tube cancer - No improvement in OS survival , OC

PESCO trial P1 expansion trial Pembro,  maveropepimut-S & cyclophosphamide, OC

Discussion of prior 3 studies 

Keynote 826  Cervical cancer

ENGOT Cx8/GOG 3024/innovaTV 205 Cervical Cancer 

Covid 19 in Gyn cancer patients 

Thank you Dr Shannon Westin for tweeting from the session. 

Next up  Addressing Challenges in Ovarian Cancer Management. 

Dee
Every Day is a Blessing!
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Wednesday, June 5, 2019

Gyn Cancer Education Sessions at #ASCO19

Here is a short summary( Tweets) and notes from the Gyn Cancer Education Sessions I attended at this year's ASCO Annual Meeting. Please note these sessions were not necessarily only ovarian cancer sessions.
Abstracts are available online at https://abstracts.asco.org/239/IndexView_239.html

6/1/2019 Pharma to Table
Levinson  - Immunotherapy in Gyn Cancers


Rubin- Recognizing and Managing Immun-related Toxicities
irAE = immun-related Adverse Events
Events could include - cough, colitis, endocrine issues, pneumonitis
With adverse events is was recommended to not reduce the dose but rather hold the dose

Moore - Response Predictions and Signatures for Immuntherapy
Tumor Burden is number of mutations in a tumor.


Dorigo - The Future of Immunotherapy in Gyn Cancers
TIL - Tumor Infiltrating Lymphocytes
Trials ongoing with HPV positive ovarian cancer ( yes , HPV can cause more than cervical and head and neck cancers. ) , CAR-T cells and vaccines
Trials like this one opening soon.
6/2/2019 Are We Hitting the Bull's -eye with Targeted Therapy
Clinical Science Symposium
This session reviewed a number of Abstracts.
Abstract 5509 - Sex hormone, Insulin and insulin-like growth factors in High stage endometrial cancers
Drs Huang, Bae-Jump


Abstract 5010 - Phase 2 trial ribociclib and letrozole in ER positive ovarian and endometrial cancers Drs  Colon-Otero and Mackay


Abstract 5011 - Phase 2 avelumab plus entinostat or placebo in epithelial ovarian cancer
Drs. Cadoo and Hays



6/2/2019 Wanna Get Away - Continuous treatment vs Treatment Holidays in Gyn Cancers
Dr Buckanovich - Successful Maintenance?

Dr  Oza - Maintenance Standard of Care


 Dr Rustin - Maintenance - Not Ready for Prime Time

Dr. Trent - Sarcoma Perspective

6/2/2019 Gyn Cancers is it Time to Put Away the Knife? 
For this session I did not have a good view of the screen so here are the high points from my notes.

Dr. Duska  - Adv OC -Time to Put Away the Knife?
NACT ( Neoadjuvent chemotherapy) is a viable option for a certain population of patients with ovarian cancer

Dr Pfisterer  We need a sharper smarter knife
Residual Tumor is an independent prognostic indicator. The Goal is R0 ( no visible disease left) . What prevents R0 . Factors that influence R0 are Inoperability (sugery not tolerated), Insufficiency (surgeon not capable of performing surgery . Patient survival better when surgery is done by a gyn onc.) Irresectability ( surgery not possible due to location of tumor.)

Dr Ramirez Has Laparoscopy Sung its Final Song in Cervix Cancer
Reported on LACC Study (https://www.nejm.org/doi/full/10.1056/NEJMoa1806395)  Study found that radical hysterectomy by MIS (minimally invasive survery ) lead to lower rates of disease free survival compared to open hysterectomy.

Dr Boggess - There is still a Role of MIS in Cervical Cancer 

6/3/2019 The More Things Change the Ovarian Cancer Edition
Monk - Is It Time to Change Upfront Chemotherapy For Ovarian Cancer

Dr Randall HIPEC: Standard of Care or Hype



Dr. Grisham - Low Grade Ovarian Carcinoma: Fitting the Square Peg in the Round Hold



 Tomorrow  I will share information from sessions dealing with communication ( Tweets Chats & Posts and Navigating a New Cancer Diagnosis).


Dee
Every Day is a Blessing!

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Wednesday, March 20, 2019

SGO meeting Tuesday

Here are the top tweets from the SGO meeting on Tuesday!  

Treating the Whole Patient
Patient Perspective on Clinical Trials


 Maintenance Olaparib


GAS6 and chemoresistance

Immunotherapy



Cisplatin/Gemzar/Pembrolizumab

Next year's meeting is in Toronto. And the gavel has passed to Dr Huh!

Thank you to  @KMKoerten , @Stigetta, @DeannaTeoh , @drcarolbrownMSK , @SGO_org, @DDNewsOnline, @BPothuri for tweeting from the meeting!


Dee
Every Day is a Blessing!
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Sunday, March 12, 2017

SGO Meeting Highlights via Twitter ~ Day One, March 12, 2017

The Society of Gynecologic Oncology (@SGO_org) is holding it's Annual Meeting March 12th -15th, 2017. I'm unable to attend in person, but I will be following hashtag #SGOmtg to catch the latest news and developments. My plan is to compile noteworthy tweets each day of the meeting and share those in a blog post. 

Here are some tweets I found of interest today-  Sunday March 12th.







So thankful for the advocates, gyn oncs and researchers sharing what they learn via Twitter. 

Dee
Everyday is a Blessing! 
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Saturday, June 11, 2016

The Days of ASCO 16: Ovarian Cancer Research

This post will concentrate on information I learned during the gynecologic cancer sessions which focused on ovarian cancer. A future blog post will discuss research presented on other gynecologic cancers.

Intraperitoneal Chemotherapy for Ovarian Cancer: Trials and Tribulations
Presenters: Drs. Walker, Gourley, Mackay 
A discussion of GOG252 ( phase III trial) that compared IP and IV chemotherapy. All arms received Bevacizumab.
  • Arm 1: intravenous carboplatin AUC (area under the curve) 6/intravenous weekly paclitaxel at 80 mg/m2
  • Arm 2: intraperitoneal carboplatin AUC 6/intravenous weekly paclitaxel at 80 mg/m2
  • Arm 3: intravenous paclitaxel at 135 mg/m2 on day 1/intraperitoneal cisplatin at 75 mg/m2 on day 2/intraperitoneal paclitaxel at 60 mg/m2 on day 8. (Control)
This ASCO POST article  on this session also discusses the trial.

Walker  
Progession Free Survival (PFS) for all arms was similar
IP cisplatin arm had increased blood pressure with Bevacizumab
16% of the IP patients moved into the IV arm which may have influenced results
Neurotoxicity side effect in all arms were equal. All are lower than in GOG 172.
Questions asked regarding the  GOG 252 results:
    Did the dose dense paclitaxel in control make the control arm better than the control arms in the  other studies? 
    Did the addition of Bevacizumab negate the previous positive IP results? 
    Did the surveillance with CT every 6 months decrease PFS results?

Gourley
Other studies ( GOG 104,114,172) showed longer PFS using IP compared to  IV 
The subgroup of BRCA1/2 patients could benefit from IP

  Mackay
"There are still unresolved issues" regarding the use of IP chem
No evidence for combining IP/IV with Bevacizumab
No data so therefore no role of HIPEC ( hyperthermic interperitoneal chemotherapy) to treat ovarian cancer outside of clinical trial. 
Need to understand the microenvironment and biology of  OC
Would use of IP chemotherapy benefit subgroups of patients based on histologic or molecular profiles or platinum sensitivity? 

 Divide and Conquer: Epithelial OC Beyond BRCA
Kristeleit, Kohn , Goodfellow 

 This session discussed genes and pathways that influence the development of ovarian cancer. In addition to germline BRCA 1/2  mutations you can also find somatic BRCA 1/2 mutations, BRCA1 methylation, EMSY amplification, TP53, mutation, tumour suppressors RB1, NF1, RAD51B and PTEN ( which can lead to chemo resistance) and overexpression of MDR1.



Some clinical trials are also looking at Wee1 inhibition ( phase II), Hypoxia, combining parp inhibitors and immunotherapy, and PD1, PDL1 immunotherapy. 

 Symptom Management for Patients with Gynecologic Cancers 
Le, McCormack , Mayer  
Menopause
Dr Le spoke about the impact of menopause symptoms ( hot flashes, genitourinary ) after surgery. She recommended asking patients about what menopausal symptoms they were experiencing, assess the risk of hormone therapy and refer to  gynecologist/PCP for hormonal or non-hormonal treatment. 

 Survivorship Care Plans
Dr Mayer presented background information about the quality of life issues of women diagnosed with ovarian cancer. This slide shows the informational needs of ovarian cancer survivors ( Papadakos, 2012). Younger women had greater needs than older women. 
She concluded that women with gynecologic cancers can experience a number of long terms and late side effects, they have unmet needs especially fear of recurrence ,  patient reported outcomes can help identify the issues and survivorship care plans can help address those needs. 

 Oral Abstracts- Ovarian Cancer

5501- Overall survival (OS) in patients (pts) with platinum-sensitive relapsed serous ovarian cancer (PSR SOC) receiving olaparib maintenance monotherapy
Patients receiving maintenance olaparib after responding to platinum therapy had an overall survival advantage. Patients with a BRCA mutation and platinum sensitive relapsed serous ovarian cancer showed a significant progression free survival benefit. Germline and somatic BRCA mutation gave the same results. 

 

5502 Hormonal maintenance therapy for women with low grade serous carcinoma of the ovary or peritoneum Low grade ovarian cancer is more platinum resistant than high grade ovarian cancer. Women with stage II-IV low grade ovarian cancer who received hormonal maintenance chemotherapy following primary treatment had a statistically significant improvement in progression free survival compared with women who were under surveillance . 

 

LBA5503 OV21/PETROC: A randomized Gynecologic Cancer Intergroup (GCIG) phase II study of intraperitoneal (IP) versus intravenous (IV) chemotherapy following neoadjuvant chemotherapy and optimal debulking surgery in epithelial ovarian cancer (EOC).  After 3-4 courses of IV platinum chemotherapy followed by optimal debulking surgery women were optimized to 1) IV carbo/taxol , 2) IP cisplatin / IV taxol or 3) IV taxol/ IP carboplatinum.  The IP carboplatin based regimen, post neoadjuvant chemotherapy and debulking surgery, was tolerated and a lower number of women showed progression at 9 months compared to IV therapy. 

 

5504 Multicenter phase II study of intraperitoneal carboplatin plus intravenous dose-dense paclitaxel in patients with suboptimally debulked epithelial ovarian or primary peritoneal carcinoma Prospective study of stage II-IV OC. Chemotherapy with dose dense Placitaxel / Cisplatin  is safe and effective for suboptimal residual ovarian patients.

 

5505 The MITO8 phase III international multicenter randomized study testing the effect on survival of prolonging platinum-free interval (PFI) in patients with ovarian cancer (OC) recurring between 6 and 12 months after previous platinum-based chemotherapy: A collaboration of MITO, MANGO, AGO, BGOG, ENGOT, and GCIG  This study showed that  prolonging the platinum-free interval by using a non platinum based chemotherapy  does not improve and even worsens efficacy outcomes in patients with partially platinum sensitive recurrent ovarian cancer . 

 

5507 Performance characteristics and stage distribution of invasive epithelial ovarian/tubal/peritoneal cancers in UKCTOCS This study was first discussed at ASCO 2015 and this abstract presented a further analysis. Patients were randomized to either the Multi modal (MM) Risk of Ovarian Cancer Algorithm (ROCA) arm or ultrasound (USS)  for screening. Sensitivity of the MM was 86% with 4 operations per invasive cancer detected. Sensitivity of the USS was 63 % with 17 operations per invasive cancer detected.

 

 5508 Baseline quality of life (QOL) as a predictor of stopping chemotherapy early, and of overall survival, in platinum-resistant/refractory ovarian cancer (PRROC): The GCIG symptom benefit study (SBS) This Symptom Benefit study showed that Global Health status, Physical function,  Role Function and Abdominal/ GI symptoms were independent predictors for overall survival were significantly associated with stopping chemotherapy early. The worse symptoms the shorter survival. Assessment could help identify patients who may not benefit from palliative chemotherapy. 


Clinical Sciences Session: Leveraging the Immuno-molecular Landscape of Gynecologic Cancers - OVARIAN CANCER

5510 Kurian This study included over 95,000 women with ovarian cancer were tested using the Myriad 25 gene hereditary panel test . Personal histories were also taken. 

Most of the women had BRCA1/2 mutations.  ATM ( a mutation associated with breast cancer)  was seen for the first time . 

5511 Tanyi Mesothelin is a tumor associated antigen in ovarian cancer. This immunotherapy study was Phase 1 and included 6 women with recurrence ovarian cancer . Each women received an intravenous infusion of autologous T cells transduced to express a chimeric antigen receptor directed against mesothelin (CART-meso). The infusion was found to be safe. 

 

Education Session : Neoadjuvant Chemotherapy : Location , Location Location                    Leary and Chi  

There is a risk of progression while on neoadjuvant chemotherapy (NACT). There may also be a risk of driving chemo resistance on NACT. Previous studies showed improved survival but there was no quality control of the surgical aspect of the trials. How much disease remained after surgery? Ultimately it is the clinicians decision whether or not to use neoadjuvant chemotherapy. 

Here is an SGO video on ovarian cancer research at #ASCO16 on ovarian cancer. Presenter is Dr Shannon Westin, MD Anderson.



Dee 
Every Day is a Blessing! 

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Friday, June 26, 2015

Science , Communities and Life with Cancer- The 3rd Annual AstraZeneca Bloggers Summit

On June 24th,  I attended the 3rd Annual AstraZeneca Bloggers Summit.  The day gave me an opportunity to meet other bloggers and to learn about social media and topics of interest to cancer patients and survivors.

What I learned at the Summit can be separated into three areas-science, communities and life with cancer.

The Science:
Photo provided by AstraZeneca
Deborah Torgersen-Paul, PhD (Executive Medical Science Liaison, AstraZeneca) presented the Evolution of Science and Understanding Cancer. Dr Torgersen-Paul began her presentation with a discussion of how the Human Genome Project changed our understanding of cancer.  She then went on to explained the role of oncogenes, tumor suppressor genes, cell death from chemotherapy and apoptosis( a cells normal death). She described driver mutations and how small molecules (such as Parp inhibitors) are used. She also discussed immunotherapy (which I heard a lot about while at the ASCO meeting this year). Some cancers don't stimulate the immune system as well as others so if we can find ways to boost our body's immune system the better we can destroy the cancer cells.  She also described work going on in immuno-oncology in which chemotherapy and immunotherapy are given together.  Lastly, she spoke of the research into circulating tumor DNA (ctDNA) , also  called a liquid biopsy,  and its role in screening for different cancers.

 After the presentation we took a tour of the Phase 1 laboratories at MedImmune where the Summit was held.
Oncology Bloggers at the Summit had the opportunity to see the MedImmune Phase1 labs.

Our Communities:

Photo provided by AstraZeneca
Ciaran Blumenthal (@momfluential) , a social media and marketing expert provided insight into "The Story of Us: Best Practices for Growing Communities Online". We ( the oncology bloggers)  were all at the summit because we share our story with a community of followers. Ciaran began by defining a community and the differences between online and "in real life" communities. She then talked about how characters can develop the community - content creators, experts, influencers and supersharers. She stressed the importance of the Hashtag in social media. From my own experience, the #gyncsm hashtag has been important in growing and sharing information among members of the gynecologic cancer community especially between our monthly chats. She then went on to discuss online platforms - blogs, Instagram, Twitter, YouTube, Pinterest and the strategies that can be used to grow a community. She stressed how content is key!

Life with Cancer:

Photo provided by AstraZeneca
Sage Bolte PhD, director of Life With Cancer,  presented the afternoon sessions geared toward different aspects of living with cancer.

Did you know that patients should be asked their distress level at each doctor visit? Studies have shown that 50% of all cancer patients experience a high level of distress ( emotional , mental, social, spiritual) during treatment. Lung, pancreatic and brain cancer patients report the highest levels. One in four cancer patients will experience depression. It has also been found that patients with lower quality of life experience more depression. When a person has situational depression it has been found that as the stressors patients experience subside so does the depression . When clinical depression occurs medication and therapy( cognitive or behavioral) may be prescribed.

Then Dr. Bolte talked about anxiety and fear.  I could definitely relate. To this day when I have to have a CA-125 test or CT scan my anxiety level shoots through the roof.  And it was good to see some of the things I use to calm down were listed in Dr Bolte's list of things to do to deal with anxiety.
  • Stillness- prayer, mediation, allow to grieve, acknowledge ( I have a favorite mantra.)
  • Motion- exercise, journaling, etc ( I love to paint when I am  anxious.)
  • Ignore- this is ok for short periods of time ( When I learned my friend had passed last month I did choose to ignore it for a few hours. )
For the last session of the day, Dr. Bolte talked about Sexuality and Intimacy. Health care providers are as reluctant as patients to discuss the impact surgery and treatment have on the sexual life of their patients. A number of sexual challenges occur when a person has cancer:
  • Cancer itself
  • Psychological Distress
  • Cancer Therapy
  • Side Effects
  • Alterations in relationships
One of the physical problems associated with the instant menopause many women enter into after gynecologic cancer surgery or due to cancer treatment is vaginal stenosis- a narrowing of the vaginal canal. There are a number of techniques ( dialators, lubricants ) that can be used when the condition develops.

As I was listening to Dr Bolte I noticed that the key word she kept using was communication. Cancer patients / survivors should communicate with their partner, spouse, family, friends and physician so everyone is aware of what you need and don't need. I can agree with that 100%.

One of the best parts of the Summit was being able to spend time with the other bloggers. Since I follow most of the bloggers online it was wonderful meeting them in person. Below is a list of my fellow blogger's names as well as links to their blogs and twitter handles. 

Katie Brown - Lung cancer
Website/blog: www.lungevity.org & www.iamkatiebrown.com 
Twitter @LUNGevity & @brownbeansprout
 
Dian “CJ” Corneliussen-James - metastatic breast cancer
Blog http://www.metavivor.org/blog/
Twitter @METAvivor

 Katherine O'Brien - metastatic breast cancer
Website https://ihatebreastcancer.wordpress.com/
Twitter @ihatebreastcanc

Jennifer Campisano- metastatic breast cancer
Blog http://www.boobyandthebeast.com/
Twitter @Jcampisano

Alana Ray Osborne  - general cancer
Blog: http://www.powerfulpatients.org/blog/
Twitter @alanaray40

Thank you AstraZeneca and MedImmune for such an informative day!

Dee
Every Day is a Blessing!




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Sunday, March 15, 2015

Your Immune System and Cancer Treatment - Cancer Support Community Free Progam

Research into developing  immunotherapy treatments for various cancer has increased dramatically over the past few years. Here is a link to an article on the immunotherapy treatments for advanced melanoma and cervical cancer that were highlighted at the 2014 ASCO Annual meeting. 

In an effort to inform patients about immunotherapy treatments a free workshop on your immune system and immunotherapy as a cancer treatment will be presented in NJ.

Thursday , April 16, 2015
6:00-8:00 PM 
Bridgewater Manor
1251 US 202/206 
Bridgewater NJ
Dinner will be served.

Registration is required . Please contact Cancer Support Community Central Jersey at (908)-658-5400 to register (www.cancersupportcnj.org) .

Please click on the image above for speaker information and sponsors of the event.

Dee
Every Day is a Blessing! 



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