Public Release: 

Research roundup from Penn's Abramson Cancer Center

University of Pennsylvania School of Medicine

CHICAGO -- Researchers from the Abramson Cancer Center of the University of Pennsylvania and Penn's Perelman School of Medicine will present results from several clinical trials and other key studies during the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting from May 29 through June 2.

Results of Phase II Trial Show Successful Antitumor Response Rate in Patients with Advanced BRCA-Related Ovarian Cancer

Olaparib, an experimental twice-daily oral cancer drug, produces significant antitumor responses in more than a third of patients with BRCA-related advanced ovarian cancer, including those who previously received multiple rounds of chemotherapy. The new research, presented by Susan M. Domchek, MD, executive director of the Basser Center for BRCA at the Abramson Cancer Center of the University of Pennsylvania, focuses on a specific subgroup of patients from a previously reported phase II study of the drug's efficacy in patients with ovarian cancer. (Abstract # 5529)

The majority of patients in the study (137 of 167) had already received at least two other therapies. Thirty four percent of patients in that group responded to the therapy for at least eight months. Among the 30 patients who had received less prior therapies, 47 percent responded to the treatment.

Based on the data, which also revealed no new side effects, olaparib was approved in December 2014 by the U.S. Food and Drug Administration (FDA) for use in patients no longer responding to conventional therapy.

Domchek will present the team's findings on Saturday, May 30 in the Patient and Survivor Care poster session from 1:15 am to 4:45 pm in McCormick Place S Hall A.

Targeted Therapy Everolimus Shows Promise in Advanced Thyroid Cancer Patients Who Stop Responding to Sorafenib

Treating advanced thyroid cancer patients who progressed on the targeted therapy sorafenib with everolimus stabilized their disease for an average of nearly 14 months, according to new research from a phase II trial being presented by Marcia S. Brose, MD, PhD, an associate professor of Otolaryngology: Head and Neck Surgery and Hematology/Oncology, and director of Penn's Center for Rare Cancers and Personalized Therapy. (Abstract #6072)

In 2013, sorafenib became the first, FDA-approved drug in 40 years to treat advanced (radioactive iodine-refractory differentiated) thyroid cancer patients who don't respond to standard therapies; however, some patients do not fully respond to the targeted therapy. Some progress in some tumors sites, while stabilizing in others.

This is the first demonstration of how everolimus can be combined safely and at full dose with sorafenib, the authors found, offering a promising second line of treatment to keep the cancer at bay for longer in this patient population. The novel approach may also have implications for other tumor types.

One patient achieved a partial response and 18 patients had stable disease after a six-month follow up. The progression-free survival for the patients on the combination was 13.9 months. No complete responses were observed in the 35 patients enrolled in the study.

Brose will present the team's findings on Saturday, May 30 in the Head and Neck Cancer poster session from 1:15 am to 4:45 pm in McCormick Place S Hall A.

Lenvatinib Improves Overall Survival in Older Advanced Thyroid Cancer Patients

The multi-targeted tyrosine kinase inhibitor lenvatinib improved overall survival in older (>65) advanced thyroid cancer patients but not younger patients, according to new research from the SELECT trial to be presented by Marcia S. Brose, MD, PhD, an associate professor of Otolaryngology: Head and Neck Surgery and Hematology/Oncology, and director of Penn's Center for Rare Cancers and Personalized Therapy. (Abstract #6048)

Patients older than 65 with advanced thyroid cancer on the placebo arm had worse overall survival than younger patients on the same arm, but the effect of age was completely mitigated with lenvatinib, when patients over 65 were treated with the drug.

A total of 261 patients took lenvatinib and 131 took a placebo. The overall survival was 22.1 months in older patients who went on treatment vs. 18.4 on the placebo.

The findings suggest a rationale for treating an older patient population first with lenvatinib, which was recently approved by the FDA to treat advanced thyroid cancer (radioactive iodine-refractory differentiated) patients who fail standard therapies.

This is the first time an improvement in overall survival was demonstrated using a multi-targeted tyrosine kinase inhibitor in the treatment of a solid tumor, the authors report. Furthermore, this finding suggests that, contrary to current practice in many settings, older patients do better, not worse with treatment.

Brose will present the team's findings on Saturday, May 30 in the Head and Neck Cancer poster session from 1:15 am to 4:45 pm in McCormick Place S Hall A.

Race May be a Predictor of Arm and Shoulder Disability for Breast Cancer Survivors Following Surgery

Race may be an important indicator of arm, shoulder, and hand function in women following breast cancer surgery, radiation or other therapy, according to new research being presented by Lorraine Dean, ScD, an instructor in the department of Biostatistics and Epidemiology. The study, which showed black women have both significantly higher BMI and worse functionality in their upper extremity following breast cancer surgery, is the first to use validated tools to assess how race may be associated with the overall function of the upper extremity in this patient population. (Abstract #9569)

The study was conducted using a self-administered questionnaire used to assess arm function in breast cancer survivors. Based on the results, the authors suggest more research is needed to determine the relationship between race, BMI and upper extremity disability, and should account for additional factors beyond BMI that may contribute to the relationship between race and disability.

Dean will present the team's findings on Saturday, May 30 in the Patient and Survivor Care poster session from 1:15 am to 4:45 pm in McCormick Place S Hall A.

Only a Fraction of Chronic Lymphocytic Leukemia Patients Are Screened for Genetic Abnormalities at Study Enrollment, Despite Available Tests That Help Guide Treatment

Results from a "Connect CLL Registry" study revealed that a majority of chronic lymphocytic leukemia (CLL) patients are not being genetically screened for abnormalities proven to have prognostic value, according to an abstract to be presented by Anthony Mato, MD, MSCE, director of the Center for Chronic Lymphocytic Leukemia (CCCL). Connect CLL is a large, prospective, multicenter registry of almost 1,500 CLL patients. (Abstract #7013)

The analysis found that 58 percent of CLL patients are tested for common genetic abnormalities at study enrollment and that only 28 percent of patients were re-tested for fluorescence in situ hybridization (FISH) and cytogenetic testing (CG), which screen for specific chromosomal and genetic abnormalities in CLL patients. Such tests can help inform diagnosis, prognosis and treatments, including choosing immunochemo or kinase inhibitor therapies and stem cell transplants.

Tests were more likely performed at academic medical center sites and in patients over 75 and those with insurance, among other factors, the researchers found. The results indicate a need for increased awareness of the importance of this testing, the authors say.

Mato will present the team's findings on Sunday, May 31 in the Leukemia, Myelodysplasia, and Transplantation poster session from 8 am to 11:30 am in McCormick Place S Hall A.

Financial Toxicity and Cancer Care: Multiple Myeloma Patients Highly Vulnerable

Insured patients with multiple myeloma may be particularly vulnerable to "financial toxicity" because of the higher use of novel therapeutics and extended duration of myeloma treatment, according to an abstract to be presented by Scott Huntington, MD, MPH, a fellow in the division of Hematology/Oncology. (Abstract #6600)

A relatively new term, "financial toxicity" is described as the burden of out-of-pocket costs experienced by patients that can affect their wellbeing and become an adverse event of treatment.

Out of 100 patients who completed a survey at the Abramson Cancer Center, 59 percent labelled multiple myeloma treatment costs as higher than expected and 70 percent indicated at least minor financial burden.

Thirty-six percent reported applying for financial assistance, including 18 percent of patients who reported incomes over $100,000. Use of savings was common (46 percent), 21 percent borrowed money to pay for medications, and 17 percent reported delays in treatments due to costs.

"Additional attention to rising treatment costs and cost-sharing is needed to address the growing evidence of financial toxicity impacting patients with cancer," the authors write.

Huntington will present the team's findings on Monday, June 1 in the Health Services Research and Quality of Care poster session from 1:15 am to 4:45 pm in McCormick Place S Hall A.

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