ASCO Inventory 2020 Anti-Cancer Progress:

Recently, the American Society of Clinical Oncology (ASCO) released its 2021 Progress Report on Cancer as scheduled. The
report describes the most important advances in cancer clinical research over the past year, including breakthroughs in targeted treatment in multiple digestive and lung cancers, positive advances in a variety of combinations of anticancer therapies, new treatment options for patients with refractive cancers, and highlights asco's recommended research directions.
addition, this year's report specifically calls for health equality to ensure that every cancer patient everywhere can benefit from these latest developments. progress in
: Molecular analysis drives the diagnosis and treatment of gastrointestinal cancers including esophageal, stomach, small intestine, gallbladder and bile cancer, pancreatic cancer, colorectal cancer and cancer, accounting for 26% of new cancers and 35% of all cancer-related deaths worldwide.
surgery, radiotherapy and chemotherapy have been the main treatments for digestive cancer, but with limited effect.
By identifying specific gene mutations, amplifications, or fusions, optogenetic genetic characteristics, protein expression, and so on, doctors can choose highly specific anti-cancer therapies that match the molecular characteristics of patients - not only prolonging the survival of cancer patients, but minimizing adverse reactions.
in the past year, several important advances have pushed the precision treatment of digestive tract cancer further.
HER2 antibody association drugs to improve the survival rate of stomach and colorectal cancer: about 20% of patients with stomach cancer and gastroesophageal cancer are HER2-positive, and curtojudan combination chemotherapy is the standard first-line treatment.
the innovative antibody-coupled drug Enhertu (trastuzumab deruxtecan) is expected to bring new treatments to HER2-positive patients.
Phase 2 trial, DESTINY Gastric-01, showed that 51.3 per cent of patients receiving Enhertu responded to treatment in second-line treatments for HER2-positive stomach and gastroesophageal cancer, while only 14.3 per cent in the chemotherapy group and longer total survival in the Enhert group (12.5 months vs 8.4 months).
Enhertu also showed hope in HER2-positive colorectal cancer patients.
phase 2 trial TESTINY-CRC01, nearly half (45.3%) of patients with HER2-positive metastatic colorectal cancer who progressed after two or more treatment options experienced objective remission after receiving Enhertu treatment.
new treatments for specific DNA mutation metastatic colorectal cancer: about 5% of metastatic colorectal cancer patients have DNA mutations that are microsatellitric instability (MSI-H) or misalmetric repair defects (dMMRs).
phase 3 trial KEYNOTE-177 interim analysis data show that the target PD-1 immuno checkpoint inhibitor pembrolizumab doubled the progression-free survival of patients with advanced MSI-H/dMMR colorectal cancer (medium time 16.5 months vs 8.2 months)! In June 2020, the FDA approved pembrolizumab for first-line treatment in patients with non-removable or metastatic MSI-H/dMMR colorectal cancer.
aspirin's role in the prevention of genetically high-risk cancers was also included in this year's ASCO report.
Lynch syndrome is a genetic disorder associated with an increased risk of multiple cancers, with a lifetime risk of colorectal cancer in patients with Lynch syndrome at 20-80 percent, compared with a 4 to 5 percent risk in the general population.
International Multi-Center Trial CAPP2 followed up for nearly 20 years, showing that taking aspirin halves the risk of colorectal cancer in patients with Lynch syndrome, and that this prevention effect can be maintained for up to 10-20 years! Other important advances in targeted therapy provide targeted treatment for early stage cancer patients with early non-small cell lung cancer (NSCLC), postoperative platinum-containing chemotherapy is standard treatment, but only reduces the risk of recurrence death by about 16%.
ADAURA trial, patients with stage II-IIIA EGFR-positive NSCLC received oxytinib after surgery, which reduced the risk of recurrence or death by 83% compared to a placebo doubling the 24-month disease-free survival rate (90% vs 44%).
this trial strongly supports targeted therapies for early cancer.
antibody association drug Enhertu (trastuzumab deruxtecan) for lung cancer with more targets is also showing hope in NSCLC.
about 2% of lung adenocarcinomas are HER2-positive.
phase 2 test, 61.9% of patients with late HER2-positive NSCLC responded to Enhertu, with a medium disease progressity of 14 months.
about 1% to 2% of NSCLC patients carry the RET gene fusion.
2020, two RET inhibitors, Selpercatinib and Gawretinib, were approved by the U.S. FDA for the treatment of NSCLC patients with RET gene fusion.
LIBRETTO-001 trial, the total remission rate (ORR) of selpercatinib was 64% in 105 adult patients who had previously received retinal drug chemotherapy.
AARROW trial data show that in 87 patients who had previously received platinum-containing chemotherapy, the total remission rate for patients treated with pralsetinib was 57%.
about half of patients with her2-positive breast cancer who have been treated with multiple combination therapies to prolong their survival will experience brain metastasis, which usually progresses rapidly within 6-12 months.
Tucatinib combined standard therapy (trot-pearl monotherapy and carpedabin) brought about changes that significantly delayed the brain metastasis process in HER2-positive breast cancer patients, reducing the risk of brain metastasis or death by 68% compared to standard therapy.
combination therapy has also been approved by the FDA.
-negative breast cancer is the most "dangerous" subtype of breast cancer, and prevention progress in early patients has been a key challenge.
In the KEYNOTE 522 trial, immunotherapy pembrolizumab combined chemotherapy, as a new complementary treatment and complementary therapy, improved the prognosis of early tri-negative breast cancer, significantly increasing the pathological full remission rate (64.8% vs. 51.2%) and survival period compared to chemotherapy alone.
20% of HER2-negative breast cancer patients test positive for hormone-positive hormones (HRs) relapse within 10 years of diagnosis.
cdK4/6 inhibitor abemaciclib has been approved for first-line treatment of advanced HR-positive/HER2-negative breast cancer.
In Phase 3 trial monarchE, abemaciclib was treated with standard endocrinology and also reduced the risk of recurrence of high-risk early HR-positive/HER2-negative breast cancer, increasing the risk of noninvasive survival for 2 years (92.2% vs 88.7%) compared to standard treatment alone.
targeted therapy has improved the treatment of patients with specific mutations NSCLC, and over the past five years immunotherapy has further brought hope to patients who lack specific mutations.
Phase 3 trial CheckMate 227 showed that in first-line treatment in patients with advanced NSCLC, nivolumab and ipilimumab combined therapy significantly improved total survival (PD-L1>1%, 17.1 months vs 14.9 months; PD-L1<1%, 17.2 months vs 12.2 months).
liver cell carcinoma is also the first new treatment approved in more than a decade.
IMbrave150 trial, patients in the Atezolizumab and bevacizumab group had a higher one-year survival rate (67.2% vs 54.6%) and a 42% lower risk of death than the standard therapy Solafini.
the risk of disease progress and death by 41 per cent.
combination therapy has become the first first first-line immunotherapy for liver cancer.
addition, lysoxi monoantigen chemotherapy significantly improved the 3-year survival rate (95.1% vs 87.3%) in mature B-cell non-Hodgkin's lymphoma children.
compared to Aza cytosine monodates, Azatosin-linked venetoclax can extend the survival of patients with acute myeloid leukemia (AML) in old age (14.7 months vs 9.6 months).
to help more patients with resoicable cancers extend their survival, the report notes that this year's advances in clinical studies have also seen an increasing number of treatments for resoicable cancers.
patients with despotic resistance prostate cancer (mCRPC) with BRCA1, BRCA2, or ATM mutations, PARP inhibitor Olapali doubled the progression-free lifetime (7.4 months vs 3.6 months) and significantly extended the total lifetime (19.1 months vs. 14.7 months).
preliminary evidence from phase 3 trials showed that three new androgen-inhibitors, enzalutamide, apalutamide and darolutamide, improved survival rates in patients with mCRPC.
phase 1 trial BLOOM study, Ocythinib significantly reduced the progress of rare brain metastasis (soft meninges) in EGFR-positive NSCLC patients, with a medium non-progressed survival of 8.6 months and a total medium survival of 11 months.
JAVELIN Bladder 100 trial, the use of immunotherapy avelumab maintenance therapy after chemotherapy extended the survival of patients with advanced urethra skin cancer (21.4 months vs optimal until 14.3 months of treatment).
addition of topical radiotherapy to first-line standard chemotherapy increased the 2-year survival rate of metastatic nasopharyngeal cancer (76.4% vs 54.5%).
phase 3 trial MEDALIST, the "First-in-class" drug Luspatercept reduced blood transfusion dependence in patients with low-risk bone marrow growth syndrome (MDS).
CAR-T cell therapy KTE-X19 can improve the survival of most recurring or resuscable heterocytic suite lymphoma (MCL), with a one-year progressive survival rate of 61% and a one-year total survival rate of 83%.
KTE-X19 has also become the third CAR-T therapy approved by the FDA.
To accelerate progress against cancer, ASCO recommends focusing on the direction of research as ASCO reports that as cancer treatment becomes more complex and individualized, research to promote progress against cancer must cover all patient populations with different characteristics and take into account social, economic, and cultural factors that affect health.
the following research directions(in any order) have the potential to significantly improve the knowledge on which clinical decision-making depends and address important unsolved needs in cancer diagnosis and treatment.
to develop and integrate artificial intelligence and deep learning in cancer research.
strategies to predict the effectiveness of immunotherapy.
to optimize multi-modality treatment of solid tumors.
to increase precision medicine research and treatment for pediatrics and other rare cancers.
to optimize the treatment of elderly cancer patients.
increases equitable access to cancer clinical trials.
reduce the side effects of cancer treatment.
reduce obesity to improve cancer incidence and outcomes.
to better identify potential malignant lesions and predict when treatment is needed.
References to The New Year, Sonali M. Smith, et al., (2021). Clinical Cancer Advances 2021: ASCO's Report on Progress Against Cancer. Journal of Clinical Oncology, DOI: 10.1200/JCO.20.03420Note: This article is intended to describe advances in medical and health research and is not recommended for treatment.
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