June 2020, Vol 11, No 3

At the 2020 virtual American Association for Cancer Research (AACR) annual meeting, part I, a team of oncologists from different COVID-19 hotspots around the world gave a snapshot of wisdom gleaned from their experience thus far. Understanding of COVID-19 is rapidly evolving; the summaries below represent the experience as of late April 2020.

Two studies presented at the 2020 American Association for Cancer Research virtual annual meeting confirm the value of different liquid biopsies in the early detection of different types of cancer.

Telehealth (or telemedicine) has emerged as an essential component of healthcare during the COVID-19 crisis. In a recent webcast of the Association for Value-Based Cancer Care (AVBCC), a panel of experts discussed the current benefits and ongoing challenges of this technology, as well as its potential impact on patients and practices in the years to come.

The combination of the checkpoint inhibitor durvalumab (Imfinzi), the poly ADP-ribose polymerase (PARP) inhibitor olaparib (Lynparza), and chemotherapy with paclitaxel used as neoadjuvant therapy improved the pathological complete response (pCR) of patients with high-risk HER2-negative stage II or III breast cancer compared with the physician’s choice of chemotherapy.

A bispecific chimeric antigen receptor (CAR) T-cell product directed against CD19 and CD22 antigens induced a complete response (CR) in 5 of 12 (42%) evaluable children and young adults with relapsed or refractory acute lymphoblastic leukemia (ALL).

The addition of the checkpoint inhibitor atezolizumab (Tecentriq) to the 2 targeted therapies—the BRAF inhibitor vemurafenib (Zelboraf) and the MEK inhibitor cobimetinib (Cotellic)—improved progression-free survival (PFS) and the duration of responses compared with the 2 targeted therapies plus placebo in patients with newly diagnosed advanced melanoma and BRAF V600E/K mutation, according to the phase 3 IMspire150 clinical trial.

Tumors with KRAS mutation are notoriously difficult to treat. Early data presented at the 2020 American Association for Cancer Research virtual annual meeting suggest 2 new routes for the treatment of cancers with KRAS mutation, including (1) the combination of a RAF/MEK inhibitor and a FAK inhibitor, and (2) the use of onvansertib, an investigational competitive inhibitor of the PLK1 enzyme, together with chemotherapy.

On May 8, 2020, the FDA accelerated the approval of a new kinase inhibitor, selpercatinib (Retevmo; Loxo Oncology) capsules, for the treatment of 3 types of cancer—metastatic non–small-cell lung cancer (NSCLC), metastatic medullary thyroid cancer, and other types of thyroid cancer—that are associated with RET gene mutations or fusions, as determined by an FDA-approved test. Selpercatinib is the first therapy approved specifically for the treatment of patients with cancer that is linked to RET mutations or fusions. The FDA granted selpercatinib breakthrough therapy and orphan drug designations.

On May 6, 2020, the FDA accelerated the approval of oral capmatinib (Tabrecta; Novartis), a kinase inhibitor, for the treatment of adults with metastatic non–small-cell lung cancer (NSCLC). Capmatinib is the first agent approved by the FDA for the treatment of metastatic NSCLC associated with mutations that lead to mesenchymal-epithelial transition (MET) exon 14 skipping, as determined by an FDA-approved test. The FDA granted capmatinib breakthrough therapy and orphan drug designations.

On April 17, 2020, the FDA approved pemigatinib (Pemazyre; Incyte), an oral kinase inhibitor, as the first treatment for adults (aged ≥18 years) with previously treated, locally advanced or metastatic cholangiocarcinoma that is associated with a fibroblast growth factor receptor 2 (FGFR2) gene fusion or other rearrangements, as detected by an FDA-approved test. This is the first targeted therapy approved for patients with advanced cholangiocarcinoma. Until now, the standard of therapy for this patient population has been chemotherapy combinations.