ASCO 2023 to Highlight Treatment Options, Partnerships With Patients in Guiding Cancer Care

Chimeric antigen receptor (CAR) T-cell therapies. Antibody drug conjugates. Targeted therapies. And, more recently, personalized mRNA vaccines, used in combination with immunotherapy.

Each year, attendees at the American Society of Clinical Oncology (ASCO) marvel at the ever-growing variety of cancer treatment options, and the 2023 meeting that runs June 2-6 promises to be no exception. This year’s meeting in Chicago promises headlines in breast, ovarian, and lung cancer, along with steps forward in classic Hodgkin lymphoma, to name a few.

But this year, those being treated get equal billing. The relationship between the clinician and patient—and specifically, the patient’s voice in guiding care—is reflected in the theme, “Partnering With Patients: The Cornerstone of Cancer Care and Research,” to be presented at Saturday’s opening session by ASCO President Eric P. Winer, MD, FASCO, who is director of the Yale Cancer Center and physician-in-chief of Smilow Cancer Hospital.

Winer

In a message in The ASCO Post, Winer wrote that the clinician-patient relationship has been affected both positively and negatively in recent years. Easy access to medical information can educate, but also create confusion or spread disinformation, he wrote.

“Despite many challenges, it is critical that we, as a community, work to build stronger partnerships between clinicians and patients,” Winer said, not only to boost satisfaction for both but also to achieve goals such as increased clinical trial enrollment.

Alongside this year’s clinical findings are multiple sessions that take on these questions as well as those of patient access and health equity, which has been a theme at ASCO in recent years. Ahead of this year’s meeting, ASCO highlighted research that shows states that expanded Medicaid saw reduced cancer mortality and racial disparities in gastrointestinal cancer compared with non-expansion states.

A highlight of the meeting will be a Monday session, “ASCO Patient Forum: Communicating the Needs of People With Cancer,” aimed specifically at patients with cancer and advocates to address unmet needs, including those of diverse populations. Winer will lead the session with ASCO Chief Equity, Diversity, and Inclusion Officer and Vice President Sybil R. Green, JD, RPh, MHA, and Fumiko Chino, MD, assistant attending radiation oncologist at Memorial Sloan Kettering Cancer Center, and an advocate on behalf of patients and family caregivers.

ASCO’s opening session will also feature remarks by the group’s former president, National Cancer Institute Director Monica M. Bertagnolli, MD, and US Surgeon General Vivek Murthy, MD, MBA, who will address the need for well-being in the nation’s health care workforce.

Clinical trial results no longer focus solely on whether a therapy offers more months of progression-free survival, as questions today also involve quality of life, specifically adverse events (AEs) and increasingly, financial toxicity. Both Medicare and commercial insurers seek to collect patient data through the use of electronic patient-reported outcomes, or ePROs, which participants in Enhancing Oncology Model will be required to use.

Engaging in shared decision-making with one’s oncologist is something that patients with cancer have come to expect, said Lalan Wilfong, MD, vice president for payer relations and practice transformation at The US Oncology Network, who will be part of a Sunday morning panel discussion on lessons from Oncology Care Model (OCM). In an interview with The American Journal of Managed Care® to preview the ASCO meeting, Wilfong said patient care plans are one requirement of the OCM that has become an industry standard.

“Many patients now are asking for these care plans, wanting to know what chemotherapy they are getting and the side effects, and what type of cancer they have and things like that,” he said. “Many patients are also expecting navigation services [to] help prevent them from going to the hospital.

“So, you have to adopt some of these features just to make sure you're providing good care for your patients,” he added. “Gone are the days where patients will just blindly go to their oncologist without having that additional support, because they'll find somebody else.”

As the number of therapeutic options increases, the patient’s care goals—including tolerance for AEs—increasingly becomes a factor in making clinical decisions. Sequencing of therapies in diseases such as lymphoma or multiple myeloma becomes critical; this discussion may include factors such as the patient’s ability to wait for a customized CAR T-cell therapy, and the decision-making process may compare the availability of these therapies with a bispecific antibody.

Results to be presented during the meeting include:

• Late-breaking results from the phase 3 MIRASOL study, an initial report of mirvetuximab soravtansine (Elahere) vs investigators choice of chemotherapy in platinum-resistant, advanced high-grade epithelial ovarian, primary peritoneal, or fallopian tube cancer with high folate receptor-alpha expression.
• The phase 3 INDIGO trial, a global, randomized, double blinded study of vorasidenib versus placebo in patients with residual or recurrent grade 2 glioma with an IDH1/2 mutation. Results will be presented in Sunday's plenary session.
• Also in Sunday's plenary session, the overall survival analysis form the ADAURA trial involving adjuvant osimertinib (Tagrisso) in patients with resected EGFR-mutated stage IB-IIIA non-small cell lung cancer.
• Capping Sunday's plenary session is SWOG S1826, a randomized study of nivolumab (Opdivo) + AVD versus brentuximab vedotin (Adcetris) + AVD in advanced stage classic Hodgkin lymphoma.
• The phase 3 NATALEE trial involving ribociclib plus endocrine therapy as adjuvant treatment in patients with HR+/HER2- early breast cancer.
• The phase 3 DUO-O trial, involving durvalumab (Imfinzi) with paclitaxel/carboplatin and bevacizumab followed by maintenance durvalumab, bevacizumab, and olaparib (Lynparza) in patients with newly diagnosed advanced ovarian cancer without a tumor BRCA1/2 mutation.
• In multiple myeloma (MM), results include data from the TRiMM-2 study of talquetamab and daratumumab (Darzalex), as well as CARTITUDE-4 data on the CAR T-cell therapy ciltacabtagene autoleucel (Carvykti). Also in MM, additional data from MonumenTAL-1 on talquetamab as a monotherapy and MajesTEC-1 for teclistamab will be represented, along with the RedirectTT-1 study using these 2 therapies in combination.
• Plenary updates to be presented Saturday include data from PhALLCON, a phase 3 study of ponatinib vs imatinib in newly diagnosed patients with Philadelphia chromosome-positive acute lymphoblastic leukemia, and for KRYSTAL-1, regarding the activity and safety of adagrasib in patients with advanced solid tumors with a KRAS G12C mustation.
• A rapid update comes Saturday for the phase 3 GLOW trial evaluating zolbetuximab with the chemotherapy combination CAPOX (including capecitabine and oxaliplatin) for the first-line treatment of patients with CLDN18.2-positive, HER2-negative, locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma. Zobetuximab is an investigational first-in-class Claudin-18.2 (CLDN18.2) targeted monoclonal antibody.
• Following last year’s show-stopper with DESTINY-Breast04, Monday will bring interim results for DESTINY-PanTumor-2, regarding the safety and efficacy of trastuzumab deruxtecan (Enhertu) in patients with HER2-expressing solid tumors.