Sylvester Researchers Contribute to More Than 80 ASCO21 Abstracts, Posters

Researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine authored more than 80 scientific posters and abstracts selected for the June 4 through 8, 2021, American Society of Clinical Oncology Annual Meeting (ASCO21).

University of Miami President Julio Frenk, M.D., Ph.D., M.P.H., was among the guest speakers at the ASCO21 opening session, addressing the meeting’s theme, Equity: Every Patient. Every Day. Everywhere.

Several Sylvester investigators presented studies related to this year’s theme, including Brandon Mahal, M.D., assistant professor of radiation oncology and assistant director of Community Outreach and Engagement, who was among the authors of “Genomic disparities across Gleason scores” and “Ancestral characterization of the genomic landscape, comprehensive genomic profiling utilization, and treatment patterns may inform disparities in advanced prostate cancer: A large-scale analysis.”

Dr. Mahal and coauthors suggest the ancestral study represents the largest group of African American men in a genomic study defining comprehensive genetic profiling use, the genomic landscape and therapeutic implications of comprehensive genetic profiling in prostate cancer ancestry. They found that African American men were less likely to receive genetic profiling earlier in treatment and less likely to be treated in clinical trials, which could impact the genomic landscape, outcomes, and ultimately disparities.

“Men of African ancestry experience the greatest burden of disease in prostate cancer, and this research indicates that differences in cancer outcomes and tumor genomics are strongly influenced by socioeconomic factors and structural barriers such as access to comprehensive genomic profiling and clinical trial enrollment, and not necessarily inherent differences in biology,” Dr. Mahal said. “To ensure equitable opportunities for precision medicine, we need to expand access to and awareness of advances that impact patient care and outcomes, including timely use of genomic testing to help make informed treatment decisions.”

Reshma L. Mahtani, D.O., associate professor of clinical medicine, was first author on the abstract “Impact of race on biomarker testing among HER2-advanced breast cancer patients in the United States: Results from a real-world study.” The analysis of advanced breast cancer patients’ records revealed African American patients had significantly lower BRCA1/2 mutation testing rates than whites, suggesting the need to increase biomarker testing in African American patients.

Fahmin Basher, M.D., Ph.D., resident physician at the Miller School, coauthored four studies presented at ASCO, including “Differential responses to therapy in Hispanic non-small cell lung cancer patients with EGFR, KRAS, or TP53 mutations.” The study suggests there are certain mutations in Hispanic patients with advanced non-small cell lung cancer that could have prognostic value in predicting responses to therapy.

In other research, Richa Dawar, M.D., voluntary assistant professor of hematology-oncology, and Estelamari Rodriguez, M.D., M.P.H., associate director for community outreach-thoracic oncology, in collaboration with Frank J. Penedo, Ph.D., professor and associate director of cancer survivorship and behavioral translational sciences, presented on the impact of the COVID-19 pandemic on health care workers’ well-being and work-related burnout.

“This work is the result of a survey that we conducted among health care workers at the University of Miami during the middle of the COVID-19 pandemic,” Dr. Rodriguez said. “We found a high burnout rate of 62.5%; high rate of reported new sleep disorders, at 44.8%; concern for decreased leadership opportunities, 32%, and increased home responsibilities, 56%.”

Recognizing how the COVID-19 pandemic has impacted health care workers is important for developing targeted strategies to decrease burnout and improve wellness for health care workers post COVID-19, according to Dr. Rodriguez.

Dr. Rodriguez also cochaired the ASCO21 session “Lung Cancer Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers,” during which investigators presented results of the Phase III Impower010 trial comparing adjuvant chemotherapy versus chemotherapy and immunotherapy.

“For the first time, this study showed that immunotherapy can be effective in preventing recurrences after surgery for early-stage lung cancer. In patients with PDL1 expression, the three-year disease-free survival was 60% versus 48%, which is a 12% improvement (with chemotherapy and immunotherapy),” Dr. Rodriguez said.

Investigators also presented data from the Checkmate 816 trial, in which Sylvester participated, looking at the efficacy of neoadjuvant immunotherapy and chemotherapy versus chemotherapy alone to improve outcomes for early-stage disease. Investigators demonstrated pathologic complete response rates of 24% on patients receiving immunotherapy before surgery.

“We have known that immunotherapy can play a role in allowing patients with advanced lung cancer to live longer, but showing that these therapies can lead to more cures from early-stage lung cancer is a breakthrough,” Dr. Rodriguez said.

Presenting on the study “Phase 1 trial of autologous dendritic cell vaccination with imiquimod immunomodulation in children and adults with refractory sarcoma,” Aditi Dhir, M.D., assistant professor of clinical pediatrics and pediatric hematology/oncology at Sylvester, reported that “dendritic cell vaccines loaded with antigens from patients’ own tumor samples along with the use of imiquimod provides a unique and well tolerated way for treating relapsed and recurrent sarcoma in both children and adults. Further work needs to be done to better understand which histologic subtype would benefit the most.”

Jose Lutzky, M.D., director of cutaneous oncology services at Sylvester, reported on the initiation of a phase II study of nivolumab plus BMS-986016 (relatlimab) in patients with metastatic uveal melanoma.

“Metastatic uveal melanoma has a dismal prognosis. Targeted therapy has been unsuccessful so far and immunotherapy has yielded results that are much inferior to those seen with cutaneous melanoma,” Dr. Lutzky said.

It has been discovered that T-cells from primary and metastatic uveal melanoma highly express LAG-3, a T-cell exhaustion marker, while the expression of CTLA-4 and PD-1 in these cells is quite low, he said.

“This finding led to the hypothesis that targeting LAG-3 could overcome the poor response rates to immunotherapy in metastatic uveal melanoma,” Dr. Lutzky said. “This is the first study evaluating the clinical activity of relatlimab, a LAG-3 blocking antibody in combination with nivolumab in immunotherapy-naïve patients with metastatic uveal melanoma. Extensive correlative studies are performed in conjunction with the clinical trial, which has been activated in November 2020 and has started accruing patients.”

In other ASCO news, ASCO President-elect Eric P. Winer, M.D., announced during ASCO21 that he had appointed Carmen Calfa, M.D., Sylvester breast cancer medical oncologist and assistant professor of clinical medicine at the Miller School, as the new chair-elect of the TAPUR Steering Group for the 2021-2022 term and TAPUR Steering Group chair for the 2022-2023 term. TAPUR is the first clinical trial launched by ASCO aimed at studying FDA-approved targeted therapies in people with advanced cancers for which the therapies are not approved. Dr. Calfa is the principal investigator for Sylvester.

Sylvester investigators were first authors on these studies also presented at ASCO21:

Surgical oncologist Jashodeep Datta, M.D., “Association of total neoadjuvant therapy with major pathologic response and survival in localized pancreatic cancer: A multi-institutional analysis of 504 patients.”

A radiation oncologist, Dr. Mahal presented “Molecular, immunologic, and clinicodemographic landscape of MYC-amplified (MYCamp) advanced prostate cancer (PCa).”

Surgical oncologist Tolga Ozmen, M.D., presented “Long-term results of simplified lymphatic microsurgical preventing healing approach (SLYMPHA) for the prevention of breast cancer-related clinical lymphedema after axillary lymph node dissection.”

Radiation oncologist Alan Dal Pra, M.D., presented “Validation of the decipher genomic classifier (GC) in SAKK 09/10: A phase III randomized trial of dose-escalated salvage radiotherapy (SRT) after radical prostatectomy (RP).”

Medical oncologist Cesar Augusto Perez, M.D., presented “Genomic profiling by cell-free circulating tumor DNA in patients with recurrent adenoid cystic carcinoma (ACC) and the potential activity of selective fibroblast growth factor receptor (FGFR) inhibitors.”

Tags: American Society of Clinical Oncology, Dr. Brandon Mahal, Dr. Reshma Mahtani, President Julio Frenk