Researchers from the Abramson Cancer Center and Perelman School of Medicine at the University of Pennsylvania presented data on the latest advances in clinical cancer research at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting on June 2-6 in Chicago, Illinois.
Incoming ASCO Leaders from Penn Medicine
ASCO President-Elect Lynn M. Schuchter, MD, FASCO, the Madlyn and Leonard Abramson Professor of Clinical Oncology and director of the Tara Miller Melanoma Center, began her term as ASCO President for 2023-2024 at the end of the Annual Meeting. Learn more about her election to the top professional society for cancer care.
In addition, Angela DeMichele, MD, MSCE, the Jill & Alan Miller Endowed Chair in Breast Cancer Excellence, will serve as chair of the Scientific Program Committee, and Charu Aggarwal, MD, MPH, the Leslye M. Heisler Associate Professor for Lung Cancer Excellence in Hematology-Oncology, will serve as chair of the Communications Committee for the 2024 ASCO Annual Meeting.
Neha Vapiwala, MD, FACR, FASTRO, FASCO, was also inducted as an ASCO fellow. This distinction recognizes members for their extraordinary volunteer service, engagement, dedication, and commitment to ASCO.
Two Penn Medicine Abramson Cancer Center Faculty Members Receive Top ASCO Awards
Real-World Data Suggests Stopping Immunotherapy after Two Years is Reasonable in Patients with Advanced Lung Cancer
Penn Medicine researchers presented results from clinical trials for recurrent glioblastoma and metastatic HR+/HER2- breast cancer. Experts presented studies focused on serious illness conversations for patients with cancer, the effect of Medicaid expansion on clinical trial enrollment, and infertility among female oncologists. Key presentations included:
Central Nervous System Tumors
- Phase II study of immunotherapy with fractionated stereotactic radiotherapy for recurrent glioblastoma (Abstract 2004): In a single-center, multi-arm study involving patients with recurrent glioblastoma, Stephen Bagley, MD, MSCE, an assistant professor of Hematology-Oncology and Neurosurgery, and colleagues, evaluated the immunotherapy drugs retifanlimab (an anti-PD1 agent) and INCAGN01876 (a GITR agonist) in combination with fractionated stereotactic radiotherapy, which was administered as an immunostimulatory strategy. In the cohort of patients who received the immunotherapy drug combination as neoadjuvant therapy prior to surgery, patients who also received neoadjuvant radiotherapy (Cohort B1) experienced a clear overall survival benefit compared to patients who received only neoadjuvant immunotherapy (Cohort B2). Stronger and more sustained inflammatory and cellular immune responses in the peripheral blood were also seen in Cohort B1, supporting preclinical evidence that fractionated stereotactic radiotherapy may help stimulate an anti-tumor immune response. Efficacy of the treatment regimen was not observed in Cohort B2 or the other group of patients whose treatment plans did not include surgery (Cohort A).
- BRACELET-1 (PrE0113), a Phase II study of oncolytic reovirus for metastatic HR+/HER2- breast cancer (Abstract 1012): This multicenter clinical trial enrolled 48 patients with HR+/HER2- metastatic breast cancer who were randomized to receive either chemotherapy alone (Cohort 1), chemotherapy in combination with pelareorep, an oncolytic reovirus engineered to attack cancer cells (Cohort 2), or both treatments with the addition of the immunotherapy avelumab (Cohort 3). As the trial co-PI and Penn Medicine site PI Amy Clark, MD, an assistant professor of Hematology-Oncology, and colleagues, found, the early data indicates chemotherapy plus pelareorep has a higher response rate and 6-month progression-free survival compared to chemotherapy alone, and pelareorep increased T-cell responses in blood samples. One third of patients discontinued either pelareorep or avelumab due to adverse side effects from treatment.
Equity in Oncology
- Survey on infertility and elective fertility preservation in female oncologists and trainees (Abstract 11001): Emily MacDuffie, MD, a Radiation Oncology resident, and colleagues, designed a survey to learn more about attitudes toward family planning and use of assisted reproductive technology among self-identified United States female oncologists of all career levels. Medical training often coincides with peak fertility years, and female physicians are known to have higher rates of infertility than the general population. Of 1,005 female oncologists surveyed, one-third (32%) reported experiencing infertility. Among those who experienced infertility, 39% reported out-of-pockets costs of $10,000 or more for assisted reproductive technology. About three-quarters of female attending physicians (76%) and trainees (72%) who were interested in future fertility preservation were unsure of the feasibility to do so.
Health Services Research, Quality Improvement, Care Delivery and Regulatory Policy
- End-of-life spending analysis from serious illness communication nudge study (Abstract 6515): This secondary analysis follows the results of randomized clinical trial, published in JAMA Oncology in January, that found machine learning-triggered nudges to prompt serious illness communication among patients with cancer improved end-of-life care. In this follow-up, lead author Ravi B. Parikh, MD, an assistant professor of Medical Ethics and Health Policy and Medicine, and colleagues, found that the intervention also resulted in lower spending on care in the last 180 days of life, driven primarily by lower spending on chemotherapy, outpatient care, and other therapies.
- Patient- and clinician-directed strategies to improve serious illness communication (Abstract 1514): Following the above nudge model to prompt serious illness conversations, this randomized clinical trial added another layer: a patient-facing message sent electronically before a clinic visit, with a three-question survey designed to prime patients for a serious illness conversation with their oncology team. In a study that enrolled 4,450 patients with cancer, Samuel Takvorian, MD, MS, an assistant professor of Hematology-Oncology, and colleagues, found that when both patients and physicians received a nudge, serious illness conversations were more likely to take place, compared to a control group or only one party receiving the nudge.
- Medicaid expansion and accrual of Black and Hispanic patients to cancer clinical trials (Abstract 1510): Using anonymous data from 75,700 participants across 1,409 clinical trials and 351 sites, Takvorian and colleagues compared clinical trial demographics in states that did and did not expand Medicaid eligibility under the Affordable Care Act to determine if the expansion increased the percentage of Black and Hispanic patients enrolled in oncology clinical trials. Although Medicaid expansion alone did not make a statistically significant impact, in states that mandated Medicaid cover the routine costs of trial participation, Black and/or Hispanic participant enrollment significantly increased.