Researchers with the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) and PrECOG, LLC will present a wide range of research findings at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, occurring virtually June 4-8. Read the summaries below and click on the abstract number to link to more information.

Highlights

Congratulations to ECOG-ACRIN leader Joseph Sparano, MD (Montefiore Medical Center/Albert Einstein College of Medicine) for being honored by ASCO with the 2021 Gianni Bonadonna Breast Cancer Award and Lecture. Learn more about Dr. Sparano’s extensive contributions to research.

Breast Cancer – Platinum chemotherapy fails in the randomized phase III study EA1131. First author Ingrid Mayer, MD (Vanderbilt-Ingram Cancer Center): "While platinum chemotherapy has been routinely adopted by many to treat basal-like triple-negative breast cancer still present after initial chemotherapy, the results of the randomized phase III trial EA1131 show that it should no longer be used in this setting. The group of women in the trial who received platinum chemotherapy had more serious side effects than those who received the standard chemotherapy drug capecitabine." Abstract 605 (oral presentation)

Breast Cancer – E1Z11 is the first racially diverse study of severe joint pain, a common side effect in postmenopausal women with HR-positive early breast cancer taking aromatase inhibitors. First author Vered Stearns, MD (Johns Hopkins University): "More Black and Asian postmenopausal women than white women with early breast cancer developed severe musculoskeletal pain within the first year of aromatase inhibitor therapy (AI). However, the rates of early discontinuation of AI therapy were similar across the three groups. The E1Z11 biospecimens bank and patient-reported outcomes data are a treasure trove for future discovery across the three racial cohorts. For example, there will be data from this trial on the tolerability of AIs from the patient's perspective, yielding important insights on how to support women from minoritized groups to gain maximum benefit from treatment." Abstract 12003 (oral presentation)

Throat Cancer – E3311 finds outstanding three-year progression-free survival and quality of life outcomes from a less intense treatment. First author Robert L. Ferris, MD, PhD (UPMC Hillman Cancer Center): "Primary transoral surgery followed by reduced-dose radiation therapy is safe in patients with intermediate-risk HPV-positive oropharyngeal cancer, with favorable quality of life and functional outcomes. With three years of follow-up, this group continued to have better outcomes than the group on usual high-dose radiation plus chemotherapy. Our patient stratification identified low and intermediate-risk patients well, preserving patients' throat function and sparing them unnecessary short- and long-term toxicities. These data support ECOG-ACRIN's plans for a phase III confirmatory trial." Abstract 6010 (poster discussion)

Breast Cancer – An inflammation biomarker may predict distant recurrence in HER2-negative breast cancer. First author Joseph A. Sparano, MD (Montefiore Medical Center/Albert Einstein College of Medicine): "We found an association between higher levels of the cytokine IL-6 at diagnosis and a significantly higher risk of distant recurrence in patients with high-risk stage 2-3, HER2-negative breast cancer, despite optimal adjuvant systemic therapy. This discovery provides a foundation for confirmatory validation of IL-6 as a prognostic biomarker, and potentially as a predictive biomarker for testing therapeutic interventions targeting the IL-6/JAK/STAT3 pathway." Abstract 520 (poster discussion)

Lymphoma – Bortezomib did not significantly improve the primary endpoint of progression-free survival when added to the combination of bendamustine and rituximab (BR) as initial treatment for patients with mantle cell lymphoma. These are the results of the E1411 trial. Mitchell Reed Smith, MD, first author. Abstract 7503 (oral presentation)

Other Research Results

Bladder Cancer – Neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy improves overall survival in muscle-invasive bladder cancer, but about half of patients are cisplatin-unfit or refuse it. Results from study PrE0807 by PrECOG. Petros Grivas, MD, first author. Abstract 4518 (poster discussion)

Breast Cancer – Social determinants of health (SDH) and genetic ancestry have been independently implicated in breast cancer presentation, treatment, and mortality. This analysis assessed the association between SDH, genetic ancestry, and clinical outcomes in patients enrolled in an adjuvant breast cancer clinical trial (E5103). Samilia Obeng-Gyasi, MD, first author. Abstract 6527 (poster)

Breast Cancer – Management of ductal carcinoma in situ (DCIS) remains variable, requiring an understanding of patient preferences and concerns to enhance the treatment decision-making process. This analysis from study E4112 compared DCIS patients’ surgical treatment preferences (lumpectomy vs. mastectomy) before and after breast MRI and surgeon consultation. Soudabeh Fazeli Dehkordy, MD, first author. Abstract 6564 (poster)

Colorectal Cancer – Cancer therapy costs continue to rise, resulting in financial burden (FB). An alaysis of data from study EAQ162CD shows that among patients with colorectal cancer who were treated with curative intent in community settings, FB at treatment initiation and three months are highly correlated. Financial resources predict FB at treatment initiation. Sheetal Kircher, MD, first author. Abstract 1518 (poster discussion)

Esophagus Cancer – EA2174: A phase II/III study of perioperative nivolumab and ipilimumab in patients with locoregional esophageal and gastroesophageal junction adenocarcinoma. Results of a safety run-in. Jennifer Eads, MD, first author. Abstract 4064 (poster)

Lung Cancer – Molecular biomarker testing is integral to the care of patients with non-small cell lung cancer. This abstract is an assessment of precision oncology in the community setting. Julia Trosman, PhD, first author. Abstract e18649 (publication only)

Myeloma – This analysis sought to understand the relationship between baseline allostatic load, symptom burden, and mortality among patients with multiple myeloma enrolled in the E1A11 therapeutic trial. Samilia Obeng-Gyasi, MD, first author. Abstract 12102 (poster)

Various Cancer Types – In NCI-MATCH, the largest precision medicine cancer trial, the results of the single-arm phase II subprotocol, Arm U, show that defactinib monotherapy has limited clinical activity in a cohort of previously treated patients with solid tumors exhibiting NF2 loss. David Jackman, MD, first author. Abstract 3087 (poster)

Prevention Trials in Progress

Breast Cancer Screening Mammography – TMIST: A description of ECOG-ACRIN's experience with engaging the radiology community in the National Cancer Institute's National Clinical Trials Network. TMIST (EA1151) is the largest randomized clinical trial for breast cancer screening. Etta Pisano, MD, first author. Abstract TPS10609

Pancreas Cyst Surveillance – EA2185: Comparing the Clinical Impact of Two Pancreatic Cyst Surveillance Programs. EA2185 is the first large surveillance trial of its kind. David Weinberg, MD, first author. Abstract TPS10608

Trials in Progress – Treatment of Rare and Uncommon Cancers

Anal Cancer – EA2176: A phase III study of immune checkpoint inhibition with chemotherapy in treatment-naive metastatic anal cancer patients. Marc Roth, first author. Abstract TPS3614

Esophagus Cancer – EA2174: A phase II/III study of perioperative nivolumab and ipilimumab in patients with locoregional esophageal and gastroesophageal junction adenocarcinoma. Jennifer Eads, MD, first author. Abstract TPS4651

Kidney Cancer – PROSPER / EA8143: A phase III RandOmized Study comparing PERioperative Nivolumab versus observation in patients with renal cell carcinoma undergoing nephrectomy. Mohamad Allaf, first author. Abstract TPS4596

Mesothelioma -- DREAM3R / PrE0506: Durvalumab with chemotherapy as first-line treatment in patients with advanced pleural mesothelioma, a phase III randomized trial by PrECOG. Patrick Forde, MD, first author. Abstract TPS8586

Myeloma – EQUATE / EAA181: A randomized phase III trial for patients with newly-diagnosed multiple myeloma not intended for early autologous transplantation. Shaji Kumar, MD, first author. Abstract TPS8052

Urinary Tract Cancer – INSPIRE / EA8185: A phase II study of bladder-sparIng chemoradiation with durvalumab in patients with clinical stage 3, node posItive urothelial carcinoma. This trial is a collaboration between ECOG-ACRIN and NRG Oncology. Monika Joshi, MD, first author. Abstract TPS4590

Trials in Progress – Treatment of Common Cancers

Lung Cancer – EA5181: A randomized phase III trial of durvalumab as concurrent and consolidative therapy or consolidative therapy alone for patients with unresectable stage 3 non-small cell lung cancer. John Varlotto, MD, first author. Abstract TPS8584

Prostate Cancer – INDICATE / EA8191: A phase III study of local or systemic therapy intensification as dIrected by PET in prostate cancer patients with post-prostatectomy biochemical recurrence. Neha Vapiwala, MD, first author. Abstract TPS5098