SWOG Sails Into ASCO On A Raft of Research

At ASCO 2018, SWOG investigators will report on trials involving treatment and prevention strategies for breast, lung, prostate, colorectal, and pancreatic cancers, as well as melanoma and myeloma. SWOG investigators will also report on cancer prevention, symptom control, and survivorship topics, including a symptom control and quality of life study that was selected as a “Best of ASCO” submission and the subject of an oral presentation by Dr. Sherry Shen, a SWOG investigator and an internal medicine resident at NewYork-Presbyterian/Columbia University Irving Medical Center.

Shen analyzed data from S0927, a SWOG breast cancer trial led by SWOG investigator and NewYork-Presbyterian/Columbia University Irving Medical Center physician Dr. Dawn Hershman which closed in 2013. Shen’s analysis uncovered an important result: omega-3 fatty acid supplements can significantly reduce the joint pain that is a common side effect of aromatase inhibitors (AIs), a common treatment for hormone-sensitive breast cancers. But only obese women – those with a body mass index over 30 – saw a reduction in their joint pain. Women of healthy weight, or those who were overweight, did not benefit from taking omega-3 fatty acid supplements. These results are significant because tens of thousands of women each year are treated with AIs, pills that stop the production of estrogen and essentially starve hormone-positive breast cancer cells. Obese patients have higher rates of AI-related pain, and their treatment options are limited.

“If our results are confirmed, omega-3 fatty acids can be considered for treatment of AI-related pain among obese breast cancer patients,” Shen said. “And if that pain is reduced, more women may continue to take their medication. Ultimately, this would lead to better health, and better quality of life, for many women.”

Here are other SWOG highlights at ASCO 2018:

• Results of tissue sample profiling using specimens from SWOG’s S0800 neoadjuvant breast cancer trial show changes in the immune microenvironment before and after chemotherapy – one of the first looks at immune cell changes in breast cancer tissue. The biomarker study, led by SWOG member Lajos Pusztai, MD, DPhil, and Xiaotong Li of Yale Cancer Center, revealed novel immunological processes and genes associated with higher immune infiltration and better chemotherapy response, as well as processes associated with worse response. The results also identified new immunotherapeutic targets that could improve complete breast cancer chemotherapy response rates, as well as improve outcomes for patients still left with residual cancer after chemotherapy.
   
• Results from S1304, a phase 2 multiple myeloma trial, provide the only randomized comparison of different doses of the proteasome inhibitor carfilzomib when taken with dexamethasone to treat relapsed or refractory patients. Led by SWOG investigator Sikander Ailawadhi, MD, of Mayo Clinic Florida, the study found that high doses of the anti-cancer drug provided no benefit to progression-free survival rates, or overall survival rates. In fact, the high dose led to an increase in certain adverse events.
   
• Results from S1204, led by SWOG investigator Scott Ramsey, MD, of Fred Hutchinson Cancer Research Center, provide important information on cancer and serious co-infections. Ramsey and his team found that the prevalence of Hepatitis B and Hepatitis C in newly diagnosed cancer patients is substantially higher than the general population – 3.9 percent versus 1.9 percent. Many of these infections were previously undiagnosed, suggesting that more screening is necessary. Ramsey and his team also tested newly diagnosed cancer patients for HIV/AIDS, and found a low rate of undiagnosed infections.

A member of the National Cancer Institute’s National Clinical Trials Network (NCTN), SWOG collaborates on treatment trials with its network partners. One of those multi-group studies, Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, will be featured at the ASCO 2018 plenary session. TAILORx was designed and managed by the ECOG-ACRIN Cancer Research Group and is the largest adjuvant breast cancer treatment trial ever conducted, enrolling 10,273 women. The ASCO presentation will focus on the trial’s evaluation of the efficacy of endocrine therapy (ET) alone versus ET plus chemotherapy in early stage breast cancer patients with a 21-gene recurrence score result of 11 to 25. SWOG investigators Daniel Hayes, MD, a former ASCO president from the University of Michigan Comprehensive Cancer Center, and Kathy Albain, MD, the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine, are on the TAILORx team.

“SWOG always proves its value at ASCO,” said SWOG Chair Charles D. Blanke, MD. “We have a deep bench of experts who work on the full spectrum of challenges in cancer treatment, prevention, and survivorship. Because of our size, and our independence, we can lead trials other organizations can’t or won’t. I’m really proud of the work we’re presenting in Chicago.”