The much-anticipated 2021 ASCO Annual Meeting has come and gone, and we have experienced a lot: over 5000 abstracts, almost 300 booths and exhibits, and 17 industry expert theaters. It is impossible to cover all of the groundbreaking data that we saw, but some key themes became clear during the meeting. First, many agents are moving to earlier stages of cancer treatment, notably in the adjuvant setting, and there is a focus on a potential for cure or for treating cancer as a chronic disease by taking this more proactive treatment approach. Second, innovative modalities continue to make an impact in the treatment of a wide range of cancers, and though trials of established immunotherapies continue to generate excitement, new agents in development in this class also made a splash.
Several key presentations, including the three noted below, focused on adjuvant treatment strategies and demonstrated the value of established agents in this treatment space.
- The phase 3 OlympiA trial (LBA1) demonstrated the efficacy of olaparib in the adjuvant setting in breast cancer, with significant improvement in both invasive and distant disease-free survival.
- Similarly, the KEYNOTE-564 (LBA5) study showed the benefit of pembrolizumab, becoming the first positive phase 3 study of an adjuvant immunotherapy in renal cell carcinoma.
- Lastly, the IMpower010 trial (abstract 8500) was designed to assess efficacy of adjuvant atezolizumab v. best supportive care (BSC), and it showed a significant benefit in the atezolizumab arm—the first demonstration of the benefit of an immunotherapy in the adjuvant setting in non-small cell lung cancer.
This is just a small sample of the studies that are advancing options in the adjuvant setting. In addition, multiple innovative modalities were showcased at ASCO 2021:
- A plenary session discussion (LBA4) introduced results from a phase 3 trial of lutetium-177-PSMA-617, a targeted therapy in development for metastatic castration-resistant prostate cancer. The phase 3 VISION trial enrolled a patient group of high unmet need, and the study results demonstrated prolonged overall survival with this novel therapy.
- The novel immunotherapy relatlimab is being studied in combination with nivolumab for the treatment of melanoma in the neoadjuvant setting (Abstract 9502) and in the first-line setting for advanced disease (Abstract 9503). Nivolumab plus relatlimab achieved high rates of pCR (59%) in the neoadjuvant setting, and significant improvement over nivolumab alone in the first-line setting.
- Finally, CAR-T/TCR therapies are starting to expand their footprint in the treatment of cancer, including in solid tumors (Abstract 11504), and in early lines of therapy (Abstract 8013).
What does this mean for the healthcare marketers?
The earlier treatment of cancer has multiple implications. Earlier treatment may reduce the focus on metastatic disease because the hope is for cure at an early stage, or at least a long delay to metastases. This will disrupt entire treatment paradigms and force us to rethink communication around agents that are used in multiple lines of therapy: Are they best used early? If used in early treatment, can they also be used in later lines of therapy? We will need to position each agent optimally in the treatment algorithm.
The development of the plethora of innovative treatment modalities means that all therapeutic areas will see a more competitive landscape, with multiple classes of agents from which to choose. We will need to better delineate positioning, and more specifically define appropriate patient types for each available molecule. The oncology space will continue to change quickly and it will be crucial to communicate with oncologists so they can be confident in their treatment decisions. Our role in this communication will become even more important.
The above are just a few examples of the innovative and potentially practice-changing presentations at ASCO 2021. You’ll find many more here.