The MRC Clinical Trials Unit together with its collaborators were pleased to have a number of oral and poster presentations presented at the 43rd annual meeting of the American Society of Clinical Oncology (ASCO).
The meeting brought together over 25,000 members of the international cancer community to provide a forum for the latest insights and research into cancer care, treatment and prevention. The event lived up to its billing as the "premier scientific and educational meeting for oncology professionals". A summary of the presentations from the MRC CTU are given below:
LU22: This intergroup randomised trial investigated any benefit of giving platinum-based chemotherapy prior to surgery for patients with non-small cell lung cancer. This is the largest trial of its kind to date and recruited 519 patients from the UK and Europe. Although preoperative chemotherapy was feasible and gave a good response rate, from this trial there was no evidence of an improvement in overall survival with HR 1.02 (95% CI 0.80-1.31, p=0.86). The result was statistically consistent with previous trials: an updated systematic review of all randomised trials shows a 12% relative survival benefit with neo-adjuvant chemotherapy equivalent to an absolute improvement of 5% at 5 years. (Abstract number: 7518).
MS01: Mesothelioma is invariably fatal, with an average survival of less than a year from diagnosis. Treatment options are limited and the addition of chemotherapy to Active Symptom Control (ASC) has never been assessed in a randomised trial. Two chemotherapy regimens were chosen for investigation: mitomycin, vinblastine, cisplatin (MVP) and vinorelbine. The MS01 trial compared ASC alone with ASC plus chemotherapy and accrued 409 patients. Overall, although chemotherapy was feasible, caused little toxicity and did not appear to have a negative impact on Quality of Life, improvement of baseline symptoms at 6 months was no different from ASC alone, and there was no evidence that chemotherapy improved survival (HR 0.89, 95% CI 0.71-1.12, p=0.32). However, exploratory analyses of the 2 chemotherapy regimens used suggested no benefit with MVP (HR = 0.98) but that vinorelbine should be investigated further as the HR for survival vs ASC alone was 0.81 (95% CI 0.63-1.05). (Abstract number 7525).
ASTEC/EN.5: The use of external beam radiotherapy (EBRT) following surgery in women with early endometrial cancer at high risk of relapse has increasingly been questioned. ASTEC/EN.5 was designed to assess impact of EBRT on overall, disease specific and recurrence free survival. 905 women were randomised internationally to EBRT immediately following surgery or no further treatment until clinically indicated. There was no evidence of a difference between the groups in overall, disease specific or recurrence free survival. Women treated with surgery alone had a 5 year overall survival rate of 84% and disease specific survival of 89%. Combined with data from 2 other trials the HR of 1.02 translated into a 0.2% difference in 5 year survival and the 95% confidence intervals can exclude an absolute benefit of EBRT more than 3%. This suggests that EBRT alone does not have a role in the treatment of early endometrial cancer. (Abstract number: 5504).
ICON1 compared adjuvant chemotherapy immediately following surgery for early ovarian cancer, with chemotherapy deferred until clinically indicated. First results published in 2003 showed an improvement in overall and recurrence free survival with adjuvant chemotherapy. With a 10 year median follow up, the updated analysis shows that benefit is maintained (HR 0.71; 95% CI 0.52-0.98). Longer term follow up has allowed some assessment of the effects in subgroups. Women classified as high risk stage I benefit most with a 17% improvement in 5 year overall survival from 58% to 75%. (Abstract number: 5509).
Posters at ASCO included:
- Capecitabine and Oxaliplatin in Elderly Patients with Metastatic Colorectal Cancer - the FOCUS2 Trial (Abstract number: 9030)
- Cetuximab, oxaliplatin and fluoropyrimidine: toxicity during the first 12 weeks of treatment for the first 804 patients entered into the MRC COIN (CR10) Trial (Abstract number: 4070)
- The impact of pre-operative chemotherapy on the quality of life of patients with resectable non small cell lung cancer: Experience from MRC LU22/NVALT2/EORTC 08012 (Abstract number: 9020)
Further oral and poster presentations were given by the MRC CTU Meta-Analysis Group (Abstract numbers 7552; 7521 and 7582). To view these and the oral presentations full abstracts, please visit the ASCO website and search abstracts using the abstract numbers. Alternatively, and for further enquiries please email: email@example.com