Published on November 5, 2020
Highlights from American Society for Radiation Oncology (ASTRO) Conference
The annual conference of the American Society for Radiation Oncology (ASTRO) highlighted some of the newest innovations in cancer and COVID-19 care. The 62nd Annual Meeting was held at the end of October through an online-only platform.
"Cancer doesn’t wait, even during a pandemic. With the health and safety of cancer patients in mind, we chose to invest in an interactive platform so that we can offer attendees a complete meeting experience,” said ASTRO President and Fellow Dr. Thomas J. Eichler in a news release. Here are a few of the abstracts presented during the event that will lead to next-generation treatments.
Cancer and COVID-19
The lungs are ravaged by the novel coronavirus and researchers are looking at ways to stop the disease and its effects. In a small trial, 10 people with coronavirus-related pneumonia were treated with low-dose whole-lung radiotherapy. This lessened the severity of what is known as a cytokine storm, where the body starts to attack its own cells and tissues rather than just fighting off the virus. Think of arthritis as a comparable disease, where the body’s immune system turns on itself. Organ damage and organ failure with a cytokine storm (which can happen very quickly) is common, but this therapy, which has been tested in early phase I trials, looks promising in slowing down this phenomenon. The group who received the low-dose whole-lung radiation therapy recovered quicker than others who were given supportive care or drug therapies only.1
Late-Stage Breast Cancer
Large tumors cause pain and discomfort in patients with advanced and metastatic breast cancer, affecting their quality of life. Palliative radiation can alleviate some of the pain. This study tested whether de-escalating the total dose of radiation could improve symptoms. Out of 37 patients, nine had surgically inoperable breast cancer and 28 had metastatic breast cancer. A lower dose of radiation over three weeks compared to a higher dose over five weeks improved symptoms and overall quality of life.2
Late-Stage Lung Cancer
Patients with extensive-stage small-cell lung cancer (ES-SCLC) are at risk for brain metastases. In this trial, 403 patients with no prior systemic therapy for ES-SCLC were randomly assigned (1:1) to receive four cycles of carboplatin (Paraplatin) and etoposide (VP-16) with either atezolizumab (Tecentriq) or placebo, followed by maintenance atezolizumab or placebo until disease progression occurred. Those in the drug combination arm of the study had delayed intra-cranial progression.3
Prostate Cancer Imaging
This study looked at new imaging options for men with recurrent prostate cancer. The researchers prescribed fluciclovine (Axumin) positron emission tomography/computed tomography (PET/CT) in addition to conventional imaging to guide radiation therapy after a prostatectomy (partial or complete removal of the prostate). This improved outcomes better than conventional therapy alone.4
Patients with a specific gene deletion may benefit from adjuvant radiation (additional cancer treatment given after the primary treatment to lower the risk that the cancer will return). This was a study of clinical records of patients with prostate cancer. Researchers used a model of genomic subtype prediction based on gene expression data in a retrospective cohort, the genomic subclass of ETS-fusion positive cancers with PTEN deletion were associated with a higher Gleason Score, cancer stage, and poorer metastasis-free survival. Adjuvant radiotherapy in this cohort may help this patient population.5
Medical Marijuana and Cancer
During the 2020 Annual Meeting, ASTRO offered a masterclass on medical marijuana. Results from a recent survey showed that more than 34 percent of survey respondents are interested in expanding their prescription offerings to help with cancer pain and symptoms but did not currently have enough knowledge to prescribe medical marijuana. The session highlighted the therapeutic benefits of various cannabis strains or ratios of THC (psychoactive strains) versus CBD (the non-psychoactive strains). The session also included a discussion of whether data suggests that cannabis can increase the risk of cancer or just the opposite — have clinically significant anticancer activity.
There were many more exciting findings from ASTRO 2020 that will enhance patient care going forward, but we wanted to bring you the highlights. Sign up for Patient Power e-newsletters to have the latest cancer news and updates delivered right to your inbox.
1Hess CB,Buchwald ZS, Stokes WA, et al. Immunomodulatory Low-Dose Whole-Lung Radiation for Patients with COVID-19-Related Pneumonia. International Journal of Rad Onc. October 23-29, 2020. (LBA8)
2Gupta, et al. Comparison of Two Schedules of Weekly Fractionated High Dose Palliative Breast Radiotherapy in Unresectable or Metastatic Breast Cancer. International Journal of Rad Onc. 2020: 08; 3, S12-S13.
3Higgins KA, Curran WJ, V. Liu Jr. S, et al.Patterns of Disease Progression after Carboplatin/Etoposide+ Atezolizumab in Extensive-Stage Small-Cell Lung Cancer (ES-SCLC). International Journal of Rad Onc. October 23-29, 2020. (LBA3)
4Jani A, Schreibmann E, Goyal S, et al. Initial Report of a Randomized Trial ComparingConventional- vs Conventional plus Fluciclovine (18F) PET/CTImaging-Guided Post-Prostatectomy Radiotherapy for Prostate Cancer. International Journal of Rad Onc. October 23-29, 2020. (LBA1)
5Fecteau RE, Liu, D, Barbieri CE, et al. Barbieri Deletion of the Tumor Suppressor Gene PTEN in ETS-Fusion Positive Prostate Cancer Identifies Patients with High Risk Pathology That May Benefit from Adjuvant Radiation. International Journal of Rad Onc. 2020: 08; 3, S4.
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