ASCO 2010|May 15, 2011 9:41 pm

General Poster Session ASCO 2010

I went through the general poster session and selected what I thought were the top 10 posters. I based this loosely on two criteria: innovation and clinical relevance. There were many other interesting posters and often the general poster session has some of the most interesting studies, because the oral and “discussed” posters are often kind of pet projects of the selection committees. In any event, I make no apologies for my selections and freely acknowledge that there are other worthy posters not covered here.

#1 poster
Clinico-pathologic correlates of BRAF mutation status in 207 consecutive patients with metastatic melanoma

BRAF expression vs survival in an Australian cohort. They wanted to see if BRAF mutations affected survival. The cohort was only 207 patients, and all types of BRAF mutations were included. Overall, any BRAF mutation seemed to carry a reduced survival. This is interesting and important because it is inevitable at this point that all patients will be tested for this mutation at some point in their treatment, soon.

#2 poster
Chemoablation of metastatic melanoma with rose bengal (PV-10)

This study is an update of an ongoing Phase 2 program looking at Provectus’ Rose ┬áBengal PV-10 injections for regional metastases. The data appear consistent with prior posters. There is clearly activity against the injected nodule. There is also “bystander effect’ where non-injected nodules regress, about 30-40% of the time as far as I can tell, including some instances where the injected nodule did not respond. The mechanism of action remains somewhat mysterious. Clearly this activity warrants additional study, ultimately in a Phase 3 trial. That study has not been designed yet but conceivably could be underway by the end of the year.

#3 poster
PLX4032 (RG7204), a selective mutant RAF inhibitor: Clinical and histologic characteristics of therapy-associated cutaneous neoplasms in a phase I trial.

The Plexxikon drug, PLX4032 was a star at last year’s ASCO but is much lower profile. One of the significant side effects of the drug seems to be the development of non-melanoma low grade skin cancers. This poster looks at those lesions and associated data. Since all data thus far on the drug (also now known as RG7204 due to licensing by Roche/Genentech) has been very positive, it will be important, if the drug is approved, to be prepared fro these lesions.

#4 poster
The use of integrative genomics to define molecular signatures of melanoma histologic subtypes.

This study is important because it addresses the genetic differences between subclasses of melanoma. The more we get away from “superficial spreading melanoma” and “nodular melanoma” and start to talk about the specific invidual genetic profiles of a person’s melanoma, the more effective we will be in treating this cancer.

#5 poster
Phase II trial of high-dose interleukin-2 (IL-2) with priming and concomitant sargramostim (GM-CSF) in patients with advanced melanoma.

This is a combination that has always made sense to me. Although this was a small Phase II study, it is an important one because it shows that you can give these two drugs together, although unfortunately without apparent incremental benefit. Sometimes a negative study is important just to put the idea to rest.

#6 poster
Durable response of the triple combination of temozolomide, sorafenib, and bevacizumab to treat refractory stage IV acral melanoma.

Triple drug combination therapy for metastatic melanoma with Temodar, avastin, and Nexavar, specifically treating acral melanoma metastases. The response rate was pretty good (25.7%) and some of the responses were durable or long-lasting. There was also a substantial stable disease rate, therefore showing good disease control. This is a relatively small study with only 35 patients but its results suggest a “signal’ that should be investigated further.

#7 poster
Tumor SPARC microenvironment signature (SMS) and plasma levels in a phase II trial of unresectable stage IV melanoma treated with nab-paclitaxel and carboplatin: A translational study of NCCTG trial N057E.

This is another effort to correlate gene expression signature with clinical response to therapy, a very important trend in the future. We should all be on the lookout for what studies should be done in the future to ensure melanoma patients receive treatment personalized to their particular tumor characteristics. HOWEVER, we are not there yet!

#8 poster
A phase II study of tasisulam sodium (LY573636) as second-line treatment for patients with unresectable or metastatic melanoma.

Tasisulam is a novel agent with multiple mechanisms of action that is currently being tested in a registration Phase III trial in second line therapy for melanoma, compared to Taxol. This poster describes the Phase II trial that led to the current trial. The response rate was 12% with a SD rate of 35%.

#9 poster
Hair depigmentation as an indicator of durable response to CTLA-4 therapy.

Interesting look at how patients with durable clinical responses to anti-CTLA4 therapy may get hair depigmentation, usually their eyebrows initially. If ipi is approved, this is an interesting look into how patients and their bodies may respond to this novel drug.

#10 poster
Utility of 3-year torso CT and head imaging in asymptomatic patients with high-risk melanoma.

This looks at an area without established guidelines, the ideal frequency and duration of post-surgical follow-up imaging studies. Ultimately, they conclude that routine CT scans are not justified.

As always, the General Poster Session at ASCO 2010 was very interesting and filled with many intriguing posters. In many cases it is hard to know why certain abstracts were presented in oral sessions, while others were “discussed” posters, and these were relegated to the General Poster Session.

Eric D. Whitman, MD

Senior Editor


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