1 news from american society of clinical oncology meeting june 2011 (lung and skin) paul donnellan...
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News from American News from American Society of Clinical Oncology Society of Clinical Oncology
Meeting June 2011Meeting June 2011(Lung and Skin)(Lung and Skin)
Paul DonnellanPaul DonnellanConsultant Medical OncologistConsultant Medical Oncologist
Galway University HospitalsGalway University Hospitals
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Common causes of cancer death in the United States, 2008
Rudin C M et al. Clin Cancer Res 2009;15:5622-5625
©2009 by American Association for Cancer Research
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Melanoma: MortalityMelanoma: Mortality
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Tsao, H. et al. N Engl J Med 2004;351:998-1012
Clinical Images of Pigmented Lesions
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Metastatic MelanomaMetastatic MelanomaYoung age at onsetYoung age at onsetDismal prognosisDismal prognosis– 1yr survival 25%; 1yr survival 25%; – 2yr survival 10% (Korn et al JCO 2008)2yr survival 10% (Korn et al JCO 2008)
Chemotherapy ineffectiveChemotherapy ineffective– Dacarbazine (DTIC) Dacarbazine (DTIC)
response rates 10%response rates 10%median survival < 8 monthsmedian survival < 8 monthsNever shown to improve survivalNever shown to improve survival
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High Dose Interleukin-2High Dose Interleukin-2
• 16% respond (6% completely and for 16% respond (6% completely and for median duration 10 yrs)median duration 10 yrs)
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Immune ERU…Immune ERU…
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.
Kirkwood J M et al. JCO 2008;26:3445-3455
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Kaplan–Meier Curves for Overall Survival and Progression-free Survival in the Intention-to-Treat Population
Hodi FS et al. N Engl J Med 2010;363:711-723
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Intracellular Signaling Pathways in Melanoma Known to Be Important in the Response and Resistance to Targeted Therapy.
Smalley KS, Sondak VK. N Engl J Med 2010;363:876-878.
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Targeting Treatment to a Specific Variant in the Melanoma Gene.
McDermott U et al. N Engl J Med 2011;364:340-350.
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Best Tumor Response for Each Patient.
Chapman PB et al. N Engl J Med 2011. DOI: 10.1056/NEJMoa1103782
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Chapman PB et al. N Engl J Med 2011. DOI: 10.1056/NEJMoa1103782
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McMullan, D. M. et al. N Engl J Med 2006;354:397
A 72-year-old man presented for evaluation of progressive dyspnea and cough
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Smoking image Smoking image
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Lung CancerLung Cancer
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Tarceva• Tablet once a day
• Few side effects
• If have the target mutation, the response to treatment is 5 times higher than with chemotherapy!
• 55% vs 11%
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Crizotinib• Tablet once a day
• Targets EML4-ALK (5% on NSCLC)
• Few side effects
• Dramatic response in patients who have failed chemotherapy
• 90% patients respond
• Randomised Clinical Trial UCHG