The 47th Annual Meeting of ASCO featured important discoveries in a variety of areas including: Arandomizedphase3trialdemonstratedthatvemurafenib(also known as PLX4032, a BRAF inhibitor) is the first drug to improve overall survival compared with standard chemotherapy in patients with advanced melanoma, according to researchers at MSKCC in New York City, who call the finding a large step forward in the personalized care of melanoma. The drug also improves progression free survival and response duration in these patients. If approved, it could become the new standard treatment for melanoma patients who have a V600E mutation in the BRAF gene.

A randomized phase 3 trial indicated that first-line treatment with a combination of the immunotherapy drug ipilimumab (Yervoy; Bristol-Myers Squibb Company) and the standard chemotherapy drug dacarbazine (DTIC) improves overall survival in patients with previously untreated metastatic melanoma. It is the first study to demonstrate that combining chemotherapy and immunotherapy is safe and effective for patients with advanced melanoma. The study, conducted by MSKCC, found that overall survival at 3 years was 20.8% for patients treated with the combination versus 12.2% for those receiving chemotherapy alone. The next step is to investigate different therapies with ipilimumab, such as vemurafenib in patients with BRAF mutations and other combinations of targeted agents and immune-modifying agents.

A randomized, phase 3 OCEANS study of bevacizumab (Avastin; Genentech/Roche) in combination with platinum-based chemotherapy demonstrated that women with recurrent ovarian cancer who were treated with the combination lived significantly longer without the disease getting worse; a 52% reduction in the risk of disease progression was noted. At a median follow-up of 24 months, the median progression-free survival was 12.4months for patients in the bevacizumab group compared with 8.4 months for those who received chemotherapy alone. In addition, 79% of women treated with the combination had significant tumor shrinkage, compared with 57% who were treated only with chemotherapy. The next step is to evaluate the role of bevacizumab in combination with chemotherapy for patients with platinum resistant disease and to combine it with other emerging therapies, such as poly(adenosine diphosphate-ribose) polymerase inhibitors, say study leaders at MSKCC.

Threeto5yearsaftertheendoftheircancertreatment, many survivors still experience moderate to severe problems with pain, fatigue, sleep, memory, and concentration, according to researchers from Northwestern University in Chicago, Illinois. One of the largest survivor studies ever conducted, the trial included a sample of 248 primarily female survivors of breast, colorectal, lung, and prostate cancer. The most common symptoms reported were fatigue (16%), disturbed sleep (15%), cognitive difficulties (13%), and pain (13%). In light of these findings, the researchers suggest that medical providers should be educated about survivors' lingering symptoms and survivors should learn about transitioning from treatment to survivorship.