ASCO '19: Enthusiasm for Lung, Breast & Prostate Cancer Innovation

InCrowd share insights on the areas showing the most exciting data and developments at ASCO

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The annual American Society of Clinical Oncology (ASCO) meeting presents an excellent snapshot of what’s hot—or not—among target prescribers as the global pharma industry addresses new therapeutic options in one of the most dominant pharmacologic domains. 

Each year InCrowd surveys ASCO attendees to monitor perceptions on the most exciting data and developments presented there. In 2019, data were compiled from n=80 oncologists and hematology-oncologists who attended ASCO 2019, participated in its sessions and responded within two days of ASCO 2019’s conclusion. Survey results reflect tremendous enthusiasm in several key treatment areas.

Lung cancer (19%), breast cancer (16%), and prostate cancer (13%) were the most exciting data and developments presented this year.  Hematologic cancers (12%) were the fourth most cited therapeutic area.

Prostate cancer excitement increased in 2019. Driven by the brands Enzamet and Titan, attendee excitement and interest in genitourinary (prostate cancer) data and developments increased in 2019— from 3% in 2018, to 13% in 2019. Enzamet was the single-most referenced individual trial of the 2019 conference as the data for enzalutamide clearly caught the attention of attendees. This data regarding a survival benefit in metastatic hormone-sensitive patients was cited as a reason that treatment with enzalutamide ‘the earlier the better’ is a main takeaway from the conference for some physicians.

Several still seek to compare enzalutamide to apalutamide and how to sequence therapy. Additional stratification by low vs. high-volume disease was requested to help further clarify the ideal treatment approach moving forward.

The drug Titan was also frequently cited and many attendees called the way it captured the benefit of apalutamide in mCSPC a conference highlight. Respondents who focused on the prostate cancer track within the conference cited the enzalutamide and apalutamide data alongside each other. There was a strong sense of optimism that clinicians are in a position to better optimize outcomes for hormone and/or castration sensitive prostate cancer patients after this conference.

Lung and breast cancer developments topped the rankings in both 2018 and 2019—with 25% of 2018 ASCO attendees ranking these as the most exciting or interesting developments in 2018— higher than the 19% and 16% of top interests respectively in 2019. 

On lung cancer, many attendees noted the long-term survival data for pembrolizumab as one of their highlights from this year’s conference. Having almost 20% of mNSCLC patients surviving after 5 years was seen as confirmation that checkpoint inhibitors (pembrolizumab specifically) represent the definitive standard of care. In such a competitive class, physicians expressed interest in seeing how other checkpoint inhibitors will compare and if/when the sequencing algorithm for these agents will become clear, as they plan treatment across multiple lines of therapy.

With AMG-510, the early data shared for this KRAS G12C-targeted agent received quite a few mentions, with physicians noting the strong unmet need for their KRAS-mutated patients and eagerness to see this drug and others continue in development.

With the brand PACIFIC, the overall survival data benefit for durvalumab as consolidation therapy following chemoradiation in Stage III NSCLC was also noted as an exciting development.

In breast cancer topics, Monaleesa 7 was one of the most cited individual trials from this year’s conference. This presentation of ribociclib’s OS data for premenopausal women was cited as a powerful demonstration of the CDK4/6 inhibitor class. Physicians were excited to “finally” have OS data to define the role of ribociclib for HR+/HER2-breast cancer, and are eager to see how other agents will compare and if a comparable benefit can be achieved in post-menopausal women.

With PARP inhibitors in TNBC, each of olaparib and talazoparib received several mentions from attendees who cited interest in the PARP inhibitor class for triple negative breast cancer patients, an area of particular unmet need. They expressed confidence in the clinical efficacy of this class and eagerness to see combinations (especially with checkpoint inhibitors) further studied.

SOLAR-1, the recently-approved alpelisib, a novel PI3KCA inhibitor, and its companion diagnostic also generated excitement from attendees. While early adopters are eager to have a new option in their treatment armamentarium, several highlighted that they would like to better understand ideal patient selection (how/when to utilize the CDx) as well as the tolerability of this agent before using them.

Similarly to 2018, CAR-T dominated ASCO attendee interests in hematologics cancers—lymphomas and leukemias—with many generic mentions of ‘CAR-T’ therapy as an exciting development/disclosure within this track. Physicians express that they are looking to learn more in the coming years about how to select amongst the options in development, small sample trial data, and the cost-effectiveness relative to quality of life tradeoff.

In 2019, the frontline data for venetoclax + obinutuzumab (VenG) in CLL was cited by several physicians as an exciting development, as was the Venetoclax + Ibrutinib Combination. On the latter, a few attendees noted that they were excited about this combination of current CLL market leaders as trials advance.

Additional insights can be found in InCrowd’s full post-ASCO 2019 perceptions report, available at this link.

Author’s bio: Diane Hayes, Ph.D., is president and co-founder of InCrowd, a real-time market insights technology firm to the life sciences. An epidemiologist, scientist, researcher, and writer, Diane worked on large NCI/NIH sponsored clinical trials while in academia for 10 years. For nearly 20 years she directed clinically focused, evidence-based research and analysis for life science companies, health plans, insurers, hospitals, healthcare systems, ACOs, and government agencies.