Back a few days now from the always intense American Society of Clinical Oncology (ASCO) annual meeting in Chicago, and I’ve been reflecting on the take-aways for lung cancer from all of the presentations, posters and discussions. There weren’t major breakthroughs for lung cancer patients, but there was a lot of energy and forward momentum and I am feeling really positive about how much attention is being paid (finally!) to people with lung cancer.
Here are three things that particularly struck me:
- There was more interest in lung cancer than ever by the attendees. The poster session the first day, where almost 170 different research project results were displayed, was so jam-packed that I could hardly walk through to see all of the information. The oral presentations and the education sessions also had amazing numbers of people listening, learning and engaging—definitely more than I have seen in my previous seven ASCOs. People attending ASCO included scientific researchers and pharmaceutical/biotech/device, etc. companies, but also many, many practicing physicians who are just trying to get better at treating their patients. ASCO seems to be doing an overall better job of providing meaningful sessions for this third group, and the breakthroughs we’ve already seen HAVE to be understood and implemented by all doctors treating lung cancer patients, or we will not see an increase in overall survival of the disease. That brings me to my next take-away.
- There was a LOT of research information presented on lung cancer. One major area of focus was consolidating the knowledge we have— looking at research from the past several years and anything new, how do we sequence or combine surgery, radiation, chemotherapy, targeted therapies in the most effective way? How do we treat different sub-populations, like the elderly, most effectively. Is there enough research in these areas to make a decision, or do we keep doing more studies? One conclusion relates to the elderly. We know older people can have vastly different states of health and disease, but treating decisions have often been made by age group as a whole. There is now evidence that age is NOT the number to use for deciding to provide certain chemotherapies. Elderly patients have to be fully evaluated on health status too, and, if your doctor isn’t doing this, demand it or change doctors. Another standard of care with tons of evidence to support it, but with uneven implementation around the country—molecular testing of tumors.
- The other big category is new treatments in early stages of research. Immunotherapy and heat shock protein (HSP) inhibitors were two really interesting areas, but the research is still in its first stages. Therapies for additional targets, like RET, ROS and MET, are also in development, as are second or even third generation targeted therapies to deal with EGFR and ALK inhibitor resistance. Early results are exciting, but the only way we will move forward is through clinical trials. With the really small populations affected (less than 1-2% in some cases), the research community is going to have to change how they offer enrollment and probably exclusion criteria too, or they will never get enough patients involved for us to get answers to these questions. And patients and caregivers are going to have to be really informed going into their appointments.
Exciting times in lung cancer, and to keep the momentum going for the best care for people with lung cancer, we all need to get informed, get involved, and stay committed.