ASCO

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Clinical Cancer Advances 2012

• ASCOs eighth annual Clinical Cancer Advances
  report identifies this years most significant
  clinical cancer advances
• Highlights 17 most important advances, along with
  70 other notable advances in prevention and
  screening, treatment, and survivorship
• Overseen by 21-member editorial board of
  oncologists
• Complete 2012 CCA report is available
• Interactive PDF at http//www.cancerprogress.net/c
  ca
• Published in the Journal of Clinical Oncology,
  www.jco.org

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Top Advances of 2012

• Two new therapies delay progression of advanced
  breast cancer
• Pre-operative chemotherapy and radiation improves
  survival for patients with esophageal cancer
• Screening with flexible sigmoidoscopy reduces
  colorectal cancer incidence and death rates
• FDA approved a new targeted treatment for
  patients with advanced prostate cancer

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Top 17 Advances

• Lenalinomide Maintenance Therapy Delays
  Multiple Myeloma Relapse after Stem-Cell
  Transplantation
• Two placebo-controlled phase III trials showed
  that lenalidomide (REVLIMID)may be able to delay
  multiple myeloma relapses
• On average, patients relapsed after 41-46 months
  with lenalidomide therapy versus 23-27 months
  with placebo

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Top 17 Advances

• New Armed Antibody Improves Survival in HER2
  positive Metastatic Breast Cancer
• A randomized phase III trial found that an
  experimental drug called T-DM1 outperforms the
  current standard therapy for metastatic,
  HER2-positive breast cancer that is resistant to
  trastuzumab, increasing survival rates at 2 years
  from 47 to 65
• T-DM1 is a smart bomb consisting of trastuzumab
  antibody linked to the chemotherapy drug DM1
• In November 2012, FDA granted priority review for
  T-DM1

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Top 17 Advances

• 3. Trial Finds Two HER2-Targeted Drugs Are Better
  than One in First-Line Therapy
• A phase III study showed that combining
  trastuzumab (Herceptin) and docetaxel
  (Taxotere) with pertuzumab (PERJETATM) may
  overcome or delay resistance to trastuzumab
  therapy in patients with HER2-positive breast
  cancer
• FDA approved pertuzumab in combination with
  pertuzumab and docetaxel in June 2012 as
  first-line treatment for patients with metastatic
  HER2-positive breast cancer

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Top 17 Advances

• 4. Adding Targeted Therapy to Aromatase
  Inhibitor Delays Disease Progression in
  Postmenopausal Hormone Receptor-Positive Advanced
  Breast Cancer
• Phase III study found aromatase inhibitor
  exemestane (Aromasin) plus everolimus
  (Afinitor) delayed disease progression by six
  months compared with exemestane plus placebo
• FDA approved everolimus in July 2012 to treat
  certain women with advanced breast cancer

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Top 17 Advances

• Preoperative Chemotherapy and Radiation Therapy
  Double Overall Survival for Esophageal and
  Gastroesophageal Junction Cancers
• Phase III trial showed that preoperative
  treatment with carboplatin (Paraplatin) and
  paclitaxel (Taxol) therapy and radiation therapy
  followed by surgery extended median overall
  survival from 24 to 49 months compared with
  surgery alone
• These findings will likely change the standard of
  care for most patients with esophageal and
  gastroesophageal junction cancers

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Top 17 Advances

• Regorafenib Prolongs Overall Survival in Patients
  with Metastatic Colorectal Cancer
• Phase III trial showed that multitargeted drug
  regorafenib (Stivarga) may extend overall
  survival in patients with metastatic colorectal
  cancer whose disease progressed after all
  standard therapies
• FDA approved regorafenib in Septemeber 2012 for
  this population of patients

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Top 17 Advances

• 7. Enzalutamide Improves Survival and Becomes New
  Standard Treatment Option for Men with
  Chemotherapy-Treated Prostate Cancer
• Phase III trial of the androgen inhibitor
  enzalutamide (Xtandi) in men with prostate
  cancer previously treated with docetaxel
  chemotherapy
• Median overall survival with enzalutamide was
  18.4 months compared with 13.6 months with
  placebo
• The FDA approved enzalutamide in August 2012 for
  certain men with metastatic prostate cancer

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Top 17 Advances

• 8. Chemotherapy Plus Bevacizumab Is More
  Effective than Chemotherapy Alone in
  Platinum-Resistant Recurrent Ovarian Cancer
• A Phase III trials found that adding bevacizumab
  (Avastin) to standard chemotherapy delays
  disease progression for women with
  platinum-resistant ovarian cancer
• This is one of the first studies showing improved
  outcomes with targeted therapy and chemotherapy
  combinations in this patient population

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Top 17 Advances

• 9. Cabozantinib Significantly Delays Medullary
  Thyroid Carcinoma Progression
• A randomized Phase III trial of the new
  multitargeted drug cabozantinib showed tumor
  shrinkage in 28 percent of patients treated with
  the drug
• Cabozantinib delayed disease progression by 7
  months compared with placebo
• FDA approval of cabozantinib for patetients with
  advanced, inoperable medullary thyroid carcinoma
  is pending

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Top 17 Advances

• Combination Chemotherapy Extends Survival in
  Certain Patients with Advanced Non-Small-Cell
  Lung Cancer (NSCLC)
• Phase III trial showed that combination of
  pemetrexed (ALIMTA) and carboplatin (Paraplatin)
  therapy may extend survival for patients with
  NSCLC who have performance score of 2
• The median overall survival was 5.1 months for
  patients treated with pemetrexed and 9.6 months
  for those treated with combination therapy

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Top 17 Advances

• Blocking the Hedgehog Pathway Stops Growth of
  Basal-Cell Carcinomas
• Phase II trial showed hedgehog inhibitor
  vismodegib (ErivedgeTM) is effective in both
  preventing and treating basal-cell carcinomas in
  patients with a rare, treatment-resistant,
  condition known as basal-cell nevus syndrome
• FDA approved vismodegib in January 2012 for
  patients with locally advanced basal-cell
  carcinoma who are not candidates for surgery or
  radiation therapy and for patients whose cancer
  has metastasized

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Top 17 Advances

• Pazopanib Delays Cancer Progression in Patients
  with Chemotherapy-Resistant Metastatic Soft
  Tissue Sarcoma
• Phase III study in patients with advanced soft
  tissue sarcoma that progressed despite standard
  chemotherapy showed that targeted drug pazopanib
  (Votrient) may be beneficial
• On average, the disease progressed after 4.6
  months for patients treated with pazopanib vs.
  1.6 months for those treated with placebo median
  overall survival was similar in the two groups

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Top 17 Advances

• Screening with Flexible Sigmoidoscopy Reduces
  Deaths Resulting from Certain Colorectal Cancers
• A study involving more than 150,000 participants
  found that screening with flexible sigmoidoscopy
  reduces both colorectal cancer incidence and
  mortality
• As compared to usual care, screening with
  flexible sigmoidoscopy led to a 21 reduction in
  colorectal cancer incidence 26 reduction in
  deaths from the disease

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Top 17 Advances

• 14. Study Shows Antipsychotic Drug Olanzapine May
  Control Breakthrough Chemotherapy-Induced Nausea
  and Vomiting
• Phase III trial showed that olanzapine (Zyprexa)
  is significantly more effective than the standard
  anti-nausea drug metoclopramide (Reglan) in
  controlling breakthrough chemotherapy-induced
  nausea and vomiting
• The findings address an unmet need for patients
  who experience such adverse effects despite
  routine preventive treatment

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Top 17 Advances

• 15. Antidepressant Drug Duloxetine Relieves Pain
  from Chemotherapy-Induced Peripheral Neuropathy
• Phase III trial showed that duloxetine
  (Cymbalta) is more effective than placebo for
  the treatment of painful peripheral neuropathy
  related to taxane- or platinum-based
  chemotherapy.
• Findings suggest that duloxetine may be a useful
  new treatment options for patients with cancer
  who suffer from this adverse effect

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Top 17 Advances

• 16. Study Identifies Factors Affecting Whether
  Elderly Patients Can Safely Undergo Chemotherapy
• A study identified measures that are critical for
  helping physicians select appropriate treatments
  for elderly patients with cancer
• The findings suggest that pre-treatment mobility
  and nutritional assessment scores are
  particularly important in determining whether
  patients older than 70 years will benefit from
  chemotherapy

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Top 17 Advances

• 17. Prospective Trial Reveals Factors that
  Predict Risk for Chemotherapy Side Effects in
  Older Adults
• Prospective study proposes a scoring system and
  risk stratification model that identifies adults
  at low, intermediate, and high risk of
  chemotherapy side effects
• The study provides a sorely needed tool to inform
  chemotherapy decision making for elderly patients
  with any type or stage of cancer

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2012 Cancer Policy Developments

• Funding for Clinical Cancer Research
• ASCOs initiative to build a rapid learning
  system for oncology
• ASCOs recommendations to tackle drug shortages
• Recommendations for improving quality and value
  in cancer care

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ASCO Resources
Cancer.Net www.cancer.net
ASCO Guidelines www.asco.org/guidelines
Conquer Cancer Foundation www.conquercancerfoundat
ion.org
ASCO Connection http//connection.asco.org
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ASCO Resources
Cancer Progress www.cancerprogress.net The
cancerprogress.net site provides a dynamic and
interactive history of progress against cancer,
with stories of cancer survivors, advocates and
physicians, and expert perspective on challenges
we face to continue making progress.
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ASCOs Annual Report on Progress Against
Cancerwww.cancerprogress.net/cca

• For additional information, contact Susie
  Tappouni in ASCOs Communications Department
• susie.tappouni_at_asco.org571-483-1355