News from ASCO 2018

TAILORx, an incredibly large adjuvant breast cancer treatment trial, demonstrated that 70 percent of women with early-stage breast cancer would not benefit from post-operative chemotherapy. These are women with hormone receptor-positive, HER2-negative, and axillary node-negative breast cancer – which make up about half of all cases diagnosed in the U.S. A tumor gene expression assay was used to help determine risk and treatment strategy – chemo or hormone therapy – and women were followed for an average of nine years.
 
The findings mean that thousands of women each year will be spared the physical, emotional, and financial toll of chemotherapy.
 
Results from the CARMENA trial, also released at ASCO, informed us that some patients with metastatic renal cell cancer can safely forgo removal of their kidney. Again, the findings mean that some patients can be spared an expensive, and difficult, procedure. Less treatment, when we can safely achieve it, is, of course, always better.
 
Here’s what’s even more notable: The National Cancer Institute funded TAILORx with tax dollars through our very own National Clinical Trials Network (NCTN). ECOG-ACRIN led the trial, and SWOG and other network groups took part. It should also be noted that CARMENA itself received monies from the French government.
 
This all emphasizes an important truth about cancer research. Publicly funded trials are the best way to protect the public interest. Our work through the NCTN and NCORP allows us to conduct studies that could not arise through any other venue. Both NCI programs are needed to conduct large trials which investigate not only new drugs but better ways to use the drugs already on hand, including alternate (sometimes shorter!) schedules and combinations of agents from different manufacturers.
 
Another ASCO 2018 highlights for me: hearing NCI Director Dr. Ned Sharpless address the McCormick Place plenary crowd. Dr. Sharpless possesses a unique brand of optimism and practicality, and he is genuinely excited about the future of the nation’s premier cancer research sponsor. He also announced an additional $10 million in funding for the NCTN – which will guarantee more trials like TAILORx.
 
Another ASCO highlight – or, more accurately, another insight – came from the non-treatment side. A study on end-of-life decision making conducted by researchers at Case Western Reserve University found that physicians think they know what patients want when it comes to goals for end of life care. But we do not. In almost 30 percent of the cases, physician and patient goals didn’t line up, showing that we need to significantly improve our communication. We simply cannot do well by our patients if we don’t know what they want and expect from treatments we offer.
 
SWOG had a really nice showing at ASCO this year, with 30 presentations. In addition, several members, like Julie Gralow and Gabe Hortobagyi, earned major awards. Others were inducted as Fellows of the American Society of Clinical Oncology (FASCO). To learn more, read our press release and see our winners from a past Front Line post. Meanwhile, SWOG had some of the most influential Tweeters! Nice work, Mark Lewis and Monty Pal.
 
Thanks to everyone for representing SWOG, and the NCTN, with such distinction.