Transcript Slide 1
News from American Society of Clinical Oncology Meeting June 2011 (Lung and Skin) Paul Donnellan Consultant Medical Oncologist Galway University Hospitals 1 Common causes of cancer death in the United States, 2008 ©2009 by American Association for Cancer Research Rudin C M et al. Clin Cancer Res 2009;15:5622-5625 Figure 3.1: Age-standardised (European) incidence rates for all cancers excluding Persons Incidence Persons Mortality 450 400 300 250 200 150 100 50 Year of diagnosis/death 2007 2005 2003 2001 1999 1997 1995 1993 1991 1989 1987 1985 1983 1981 1979 1977 0 1975 Rate per 100,000 350 Melanoma: Mortality 4 Clinical Images of Pigmented Lesions Tsao, H. et al. N Engl J Med 2004;351:998-1012 Metastatic Melanoma Young age at onset Dismal prognosis – 1yr survival 25%; – 2yr survival 10% (Korn et al JCO 2008) Chemotherapy ineffective – Dacarbazine (DTIC) response rates 10% median survival < 8 months Never shown to improve survival 7 High Dose Interleukin-2 • 16% respond (6% completely and for median duration 10 yrs) Immune ERU… . Kirkwood J M et al. JCO 2008;26:3445-3455 Kaplan–Meier Curves for Overall Survival and Progression-free Survival in the Intention-toTreat Population Hodi FS et al. N Engl J Med 2010;363:711-723 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;363:876878. Targeting Treatment to a Specific Variant in the Melanoma Gene. McDermott U et al. N Engl J Med 2011;364:340-350. Best Tumor Response for Each Patient. Chapman PB et al. N Engl J Med 2011. DOI: 10.1056/NEJMoa1103782 Chapman PB et al. N Engl J Med 2011. DOI: 10.1056/NEJMoa1103782 A 72-year-old man presented for evaluation of progressive dyspnea and cough McMullan, D. M. et al. N Engl J Med 2006;354:397 Smoking image Lung Cancer 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% 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