ASCO 2023 Preview — Partnering with Patients: The Cornerstone of Cancer Care and Research

This weekend, the highly anticipated 2023 annual meeting of the American Society of Clinical Oncologists (ASCO) takes over Chicago’s McCormick Place Convention Center.

From June 2-6, a diverse array of healthcare professionals, including oncologists, researchers, bioinformatics specialists, and patient advocates will converge to share knowledge and insights relating to all aspects of cancer research and care. This year’s theme is “Partnering with Patients: The Cornerstone of Cancer Care and Research,” and the event promises to be a transformative five-days that will shape the future of oncology, offering opportunities for collaboration, innovation, and progress in the fight against cancer.

Many of the presentations will focus on how to help those with cancers for which current immunotherapies, both PD-1/PD-L1 checkpoint inhibitors and cell therapies, are ineffective. Some solutions combine checkpoint inhibitors to block two different pathways simultaneously. Others involve deploying newer immune-based strategies, such as bispecific antibodies and cell therapies, for patient benefit.

Perhaps the most anticipated updates at ASCO 2023 revolve around trials using checkpoint inhibitors to target the TIGIT pathway. Specifically combining the TIGIT-blocking tiragolumab with the standard of care treatment—dual inhibition of the PD-L1 and VEGF-A pathways—demonstrated impressive benefits for patients with advanced, previously untreated liver cancer.

Compared to those who received the standard of care, forty patients who received the triple combination with tiragolumab experienced a more-than-threefold increase in response rate (43% versus 11%) as well as a 58% reduction in the risk of disease progression and nearly seven-month increase in progression-free survival.

Particularly exciting was the impact seen in patients with PD-L1-negative liver tumors. While none of these patients responded to the standard of care, more than 27% derived clinical benefit from the TIGIT-targeting combination. Importantly though, these results come from a small sample size and must be replicated in larger groups. 

Another exciting potential breakthrough comes in the area of sarcoma, for which there remains just one immunotherapy approval that only covers a small subset of patients with this cancer type. The low immunogenicity of sarcomas often render them resistant to checkpoint immunotherapy, but afamitresgene autoleucel, an engineered T cell receptor (TCR) T cell therapy built on the SPEAR platform, showed signs of efficacy in patients with advanced synovial sarcoma. A single dose led to responses in 39% of patients, and those responses lasted a median of one year. Additionally, of those who responded, 90% remained alive at one year.

Bispecific T cell engager (BiTE) antibodies are also showing promise. The use of two bispecifics—the BCMA x CD3-targeting teclistimab plus the GPRC5D x CD3-targeting talquetamab—produced responses in 84% of patients with relapsed or refractory multiple myeloma (52/62) overall, and in 73% of patients (19/26) with extramedullary disease. One potential concern is toxicity issues, which emerged even at low doses and will need to be carefully managed moving forward.

In addition to a poster announcing important updates for the Cancer Research Institute (CRI)’s IPROC combination immunotherapy trial in ovarian cancer, the work of CRI physicians and researchers will also be featured during the conference.

Below are some of the CRI scientist presentations we’re most looking forward to at ASCO 2023: 

• Valsamo ‘Elsa’ Anagnostou, MD, PhD, a CRI Clinical Accelerator Investigator at Johns Hopkins University, led work being highlighted in a poster discussion on “Large-scale transcriptomic profiling of the tumor immune microenvironment in ALK+ lung cancer” and a poster on “Liquid biopsy-informed precision oncology study to evaluate utility of plasma genomic profiling for therapy selection.” Additionally, she contributed to one additional poster discussion and two additional posters.
• Joshua Brody, MD, a CRI Lloyd J. Old STAR at the Icahn School of Medicine at Mount Sinai, contributed to a poster discussion on “Metabolic response rates of epcoritamab + R-CHOP in patients with previously untreated (1L) high-risk diffuse large B-cell lymphoma, including double-hit/triple-hit lymphoma: Updated EPCORE NHL-2 data” as well as a poster on “Glofitamab monotherapy in pts with relapsed/refractory (R/R) large B-cell lymphoma (LBCL): Extended follow-up and landmark analyses from a pivotal phase II study.”

• Tullia Bruno, PhD, a CRI-V Foundation CLIP Investigator at the University of Pittsburgh, contributed to two posters on “Expression of lymphoid structure-associated cytokine/chemokine gene transcripts in tumor and protein in serum: Outcomes for patients with melanoma”and “Interim results from a phase I/II study of duvelisib PI3Kδγ inhibitor and nivolumab in patients with advanced unresectable melanoma who have progressed on anti-PD1 therapy.”

• Sangeeta Goswami, MD, PhD, a CRI CLIP Investigator at the University of Texas MD Anderson Cancer Center, contributed to a poster on “CABOSUN II: Results from a phase 2, open-label, multi-center randomized study of cabozantinib (CABO) vs. sunitinib (SUN) for non-clear cell renal cell carcinoma (NCCRCC).”

• Amanda Lund, PhD, a CRI Lloyd J. Old STAR at NYU Langone Health, contributed to a poster on “Determinants of racial disparities in immune-related adverse events (irAE) with checkpoint inhibition (ICI) in melanoma.”

• David Reardon, MD, a CRI Clinical Accelerator Investigator at Dana-Farber Cancer Institute, contributed to multiple posters, as well as one poster discussion talk on “RANO 2.0: Proposal for an update to the Response Assessment in Neuro-Oncology (RANO) Criteria for high- and low-grade gliomas in adults.”

• Cassian Yee, MD, a CRI-Chordoma Foundation CLIP Investigator at the University of Texas MD Anderson Cancer Center, contributed to one poster on “A phase Ib study of endogenous T cell therapy using SLC45A2-specific CD8 T cells for patients with metastatic uveal melanoma.”