American Society of Clinical Oncology (ASCO) Conference

Please see our report on the ASCO Conference this past June 1-5, 2012 from KCRF Director, Frank Kalman.

I am pleased to share some highlights of my experience at this year’s ASCO Conference in Chicago, which I was able to attend due to a generous grant from ASCO to our Foundation. The conference disseminates cutting-edge information to 30,000 doctors from all over the world, working on all types of cancers.

While pediatric oncologists were few in number at the event, their influence was pervasive and significant.

Mouse anti-body and T-cell therapy “combos” or “CAR T-Cell therapy” (chimeric antigen receptor) research generated media interest due to results from leukemia and lymphoma cancer trials using these approaches. I was glad to see Baylor/Texas Children’s Hospital among those using this approach. It reaffirmed the KCRF decision to donate to this center and specifically the work of Dr. Malcolm Brenner and Dr. Chrystal Louis there.

Mouse anti-body and T-cell therapy “combos” or “CAR T-Cell therapy” (chimeric antigen receptor) research generated media interest due to results from leukemia and lymphoma cancer trials using these approaches. I was glad to see Baylor/Texas Children’s Hospital among those using this approach. It reaffirmed the KCRF decision to donate to this center and specifically the work of Dr. Malcolm Brenner and Dr. Chrystal Louis there.

While our daughter, Calli, was the first child to receive one version of the modified CAR T cell vaccine at Baylor it didn’t work for her; however, it was a home run for several of the other kids. Early results as reported in the medical journal “Blood” stated a 30% reduction in relapse rates. Since then one of the non-relapse kids passed away reducing that percentage. There is a lot of work being done in immunotherapy now.

ALK Gene and Neuroblastoma Dr. Mosse of Children’s Hospital of Philadelphia was awarded the James B Nachman ASCO Junior Faculty Award in Pediatric Oncology. She presented the results of her ALK trials. The result reported in her anaplastic large cell lymphoma (ALCL), and inflammatory myofibroblastic tumors (IMT) appeared to be better than in her Neuroblastoma trial. The agent used in these phase I trials was crizotinib. In the NB trial she had two groups of children: One group of 8 had the had the ALK mutation while the second group of 19 kids ALK mutation status was unknown. Of the kids with the mutation she reported one child with complete remission, a second child with stable disease and third child with prolonged stable disease.

Based on the outcomes of the study, phase II trials are being designed with the goal of applying to the U.S. Food and Drug Administration for a pediatric indication, Dr. Mossé said.

Opening Ceremony – Pioneers Of Cancer Research

During the opening ceremony, Dr. Link, president of ASCO and the department head of pediatric hematology and oncology at Stanford, addressed the conference, stating: “first we must honor the great pioneers of cancer research.” Behind him on the stage were pictures of pediatric oncologists Dr. Donald Pinkel and Dr. Joseph Simon – both directors of St Jude Children’s Hospital, among others.

Dr. Link referred to these “pioneers” as responsible for developing and introducing many of the strategies and therapies in the ight against pediatric cancers and later adopted by the adult cancer research community.

Dr. Link said that to increase the success rate in the fighting all cancers, pediatric oncology’s culture of collaboration and learning is essential. Collaboration among institutions and disciplines is key and has been the domain of pediatrics.

He went on that in the pediatric world, each patient has always been considered a source of vital data. Now, with the advent of electronic health records, each adult patient will too become a tremendous source of information by providing data such as tumor biology, treatment, outcome and so on.

This will allow investigators to data-mine vast amounts of data real time

Combined with advances in genomics and the introduction of electronic health records, he expects this will lead to more appropriate, refined and effective treatments.

He referred to acute lymphoblastic leukemia (ALL), which consists of 16 subgroups, each requiring a different approach to treatment. Here is the beauty of electronic health records.

Genomics In Detection and Prevention

Dr. Joshua David Schiffman, a pediatric oncologist investigator at the University of Utah, spoke of his work in genetic counseling along with some very powerful conclusions.

Dr. Schiffman stated that in high-risk patients suffering from rare diseases, as many as a third of their family members were at risk of cancer. In one case they identified gene mutations that correlated with brain cancer. A scan of the individual’s brain resulted in detection of a very early stage brain tumor that was removed well ahead of any potential danger to the individual

Some of the rare diseases Dr. Schiffman suggested should be investigated in family members include Adrenocortical Carcinoma, Rhabdomyosarcoma, Choroid Plexus Carcinoma, Osteosarcoma, Paraganglioma, GIST, Renal Cell Carcinoma, Pheochromocytoma. Please note Neuroblastoma was not mentioned.

Potential Paradigm Shift In Cancer Treatment

The advancements in genomics could lead to a new paradigm shift. Instead of diagnose and treat the new paradigm would become predict and prevent. This could lead to better controlling a number of diseases. An example sited by Dr. Link was the history of diphtheria in the United States, which was essentially eradicated in 1956.

AnOunce He also presented a chart titled “Average Years of Life Lost to Cancers” It did a very good job of illustrating the need for funding in pediatric cancer research.  On average for all cancers, the number of years lost for a patient is 15 years. The average years lost for childhood cancer is 69.3 years. Since Neuroblastoma is a disease of infants, this is the disease that steals the most life away from those it affects.

There is Hope

The take away from the ASCO conference was two-fold:

First, so many brilliant, hard working people all over the world are doing so much outstanding work.

Second, it drove home the idea that, especially with childhood cancers, one must go to the leading centers to find out what’s really happening because of what it takes to monitor and assess all the work being done worldwide. Moreover, leading institutions and investigators, especially in pediatric research, share and are aware of each others promising work.

Let’s help them!
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