The most promising event took place at the largest oncology conference in the world – 06/13/2022

The Asco (American Society of Clinical Oncology) conference ended last week in Chicago, USA. It is the largest oncology event in the world known for presenting updates and major news on cancer treatment. Two years later, in 2022, there was another face-to-face meeting.

In this edition, the main research has led to important findings in approaches that can reduce side effects, such as whether or not the need for chemotherapy is more precisely indicated, e.g.

The most promising presentation, highlighted by the oncologists heard Live wellrecorded cancer remission in 12 patients with rectal cancer who participated, physical examination, endoscopy, positron emission tomography (PET scan), and MRI without tumor evidence.

A six-month study of the immunotherapeutic dostarlimab, a monoclonal antibody, has already been released in Brazil but will arrive in August for use against a rare type of endometrial cancer (tissue that covers the inner wall). uterus).

These vessel cancer patients undergo strenuous treatment: chemotherapy, radiation, and surgery that can cause intestinal, urinary, and sexual dysfunction. Some need colostomy bags.

They went into the investigation thinking that they would have to do these procedures when they were finished, because no one really expected their tumors to go away. But they were surprised: no further treatment was needed.

The drug was given every three months for three weeks and cost about $ 11,000 per dose. It reveals cancer cells, allowing them to identify and destroy the immune system.

In the case of this study, patients with colon cancer were treated for different periods and are monitored for up to two years to six months after treatment, without reporting any serious adverse events to date.

Treatment is limited to 5% to 10% of people with rectal cancer, who must have Lynch Syndrome, the genetic disease that causes the disease. But the new practice is exciting, especially because of the level of sustainable side effects, and could pave the way for new approaches to the disease.

In this study, the experimental method replaced the standard protocol, which typically combines radiotherapy, chemotherapy, and surgery. The intervention is usually very aggressive and the patient needs a colostomy (a process that “excretes” the intestine and a bag that collects waste from the digestive tract).

“Colorectal cancer is highly contagious, with important long-term sequelae, especially for those undergoing radical surgery that endanger the rectal muscle and require a lifelong colostomy,” says Samuel Aguiar, a oncology surgeon with SBCO (Brazil). Oncological Surgery Association).

Chemotherapy: techniques on the map, if expendable

New trends are also trying to map the need for chemotherapy or not, focusing on what is indicated for additional treatment (as a preventive measure against cancer cells used after surgery). As long as the treatment is safe and effective, there is a lot of doubt about the quality of life of the patients because of the side effects.

“When there was no biomarker, we were able to stratify patients and save them from chemotherapy. This gives us the tools to reduce the safety and treatment of very common cancers,” said oncologist Angélica Nogueira Rodrigues, a doctor from Inca (National Cancer Institute). ) and member of the SBOC (Brazilian Clinical Oncology Association).

One of the main studies mapped the presence of “hidden” DNA in the blood of patients with type 2 colon cancer. a small tumor circulating in the blood. Those who tested negative should not receive additional postoperative therapy.

After the assessment, the study did not identify any differences that endangered the health of those who did not take chemo. Survival and cancer recurrence rates ranged from 92.4% to 93.5%, the latter percentage referring to the ctDNA-based approach. Now, researchers say, the hope is to spread the screening to other types of cancer.

Another similar study also assessed the risk of releasing chemotherapy patients over the age of 70 from breast cancer without seeing any change in survival within four years. As well as the approach to patients with small tumors, without the involvement of the armpit, which replaced post-surgery treatment with hormone therapy for hormone therapy. Of the 500 women who followed up after the intervention, only 2.3% had a recurrence of the disease within five years.

Progression of breast cancer

In the case of rare breast cancer, the drug trastuzumab deruxtecan was described as a treatment that could prolong the life of patients for six months after reducing the progression of the disease and the size of the tumor.

The study looked at 557 patients, divided into two groups, classified with a type of HER2-low tumor (previously excluded from this type of treatment, but new research indicated that they could benefit from the approach), all with metastasis. , when the disease has already spread to other organs and / or tissues.

According to the researchers, those who received the medicine were prevented from getting the disease for 10 months, while the other group went down in the middle of the period. The observed side effects were within the standard, treated with symptom-focused medications.

New in prostate treatment

A proposal for a new protocol for the treatment of metastatic prostate cancer was also presented at the Asco congress. In general, advanced tumor approaches use a type of hormone therapy to stop the progression of the disease.

This time, the study used a set of three drugs, including darolutamide, as a combination of direct action against cancer cells.

“We realized that in addition to preventing testosterone production, blocking the action on the tumor cell would make the patient respond better and live longer,” says Oncoclínicas (RJ) oncologist Diego Rosa, who was part of the group. survey with Brazilian participants. According to the study, the drug reduced the risk of death by 32.5%.

In order to use the Brazilian protocol, Anvisa must approve the medication for this specific purpose. “We hope to include it in the ANS list because there will be indications that operators will have to give it to the patient,” Rosas believes.

Hopeful treatment for rare cancer

The main results of the SHINE phase 3 study in patients aged 65 years or older with mantle cell lymphoma were also presented (MCL) newly diagnosed. Research has shown a combination of oral ibrutinib maintenance once daily plus maintenance of bendamustine-rituximab (BR) and rituximab significantly reduced the progression or risk of death by 25% compared to patients receiving placebo plus BR and rituximab maintenance.

Mantle cell lymphoma, rare, occurs in B cells and is in the non-Hodgkin’s lymphoma (NHL) group. This cancer can have many characteristics, such as being able to evolve faster (aggressive) or slower (indolent). Precisely because of this diversity, the symptoms may appear in different ways and the treatment is tailored to each specific case.

Although there is a wide range of therapies available, in most cases this condition is not curable. Therefore, the main goal is to increase the quality of patient survival with quality.

This study is one of the largest clinical trials on first-line MCL and is an important enzyme for the development and differentiation of B lymphocytes from the enzyme Bruton tyrosine kinase (BTKi).

It usually affects people over the age of 65 who are usually unable to undergo intensive chemoimmunotherapy and stem cell transplantation, leading to poor clinical outcomes and the need to develop additional treatment options for these patients.

“There is an urgent need to improve outcomes in elderly patients with MCL,” said Michael L. Wang, a professor in the Department of Lymphoma and Myeloma. MD Anderson Cancer Center, University of Texas (USA), and Principal Investigator in Research. “Considering a median survival time of 6.7 years, the combination of ibrutinib showed the potential for first-line treatment in this population.”

The study included 523 patients aged 65 years or older. All participants were randomly assigned to receive ibrutinib or placebo plus BR for up to six 28-day cycles; Participants with complete or partial responses continued to receive maintenance therapy with rituximab in each second cycle with a maximum of 12 additional doses.

Leave a Comment