Portal de Periódicos da CAPES

ASTRO Annual Meeting Preview

2014; Wolters Kluwer; Volume: 36; Issue: 17 Linguagem: Inglês

10.1097/01.cot.0000454158.68442.54

1548-4688

Sarah DiGiulio,

Space exploration and regulation

Figure“Both on the biology front and on the technology front, there have been major advances in the radiation oncology field, and the theme for this year's ASTRO Annual Meeting highlights how advances in those areas have improved delivery of radiation, and therefore the outcomes of our patients including their quality of life.” That was the word from American Society for Therapeutic Oncology President Bruce G. Haffty, MD, speaking in an interview about a month before the meeting, which will be held Sept. 14-17 at the Moscone Center in San Francisco. The technology side has seen improvements in novel image-guided radiation treatment, more precise targeting of the tumor, and more sophisticated computerized planning to optimize radiation to the tumor, while minimizing dose to the surrounding tissue, said Haffty, who is also Professor and Chairman in the Department of Radiation Oncology at the Robert Wood Johnson Medical School and Dentistry of New Jersey. And in biology, research is revealing how to better and more effectively use radiation therapy in combination with novel drugs—including immunotherapies and targeted drugs—to improve patient outcomes, he said. “We're learning about molecular pathways, how radiation affects those pathways, how radiation interacts with the cancer on a molecular level, and how to capitalize on that understanding to improve outcomes and quality of life in the patients we treat with radiation.” Immunotherapy Makes the Plenaries Immunotherapy—and the implications for its combination with radiation therapy—will be highlighted at this year's meeting, said Benjamin Movsas, MD, FASTRO, Vice-Chair of the Annual Meeting Scientific Committee. As he explained in a separate interview, the program includes several presentations related to the topic, as well as a plenary talk on the potential clinical implications of combining radiation therapy and immunotherapy in melanoma and breast cancers. “This is really a very exciting and mostly untapped area—that radiation therapy may actually in some ways activate the immune system to help fight cancer—which will be highlighted in the plenary session,” said Movsas, who is also Chair of the Radiation Oncology Department at Henry Ford Health System. “Our field is recognizing that part of our future is harnessing the potential of biology in radiation oncology even more than has been done in the past.”ASTRO President BRUCE G. HAFFTY, MD. ASTRO President BRUCE G. HAFFTY, MD: “We're learning about molecular pathways, how radiation affects those pathways, how radiation interacts with the cancer on a molecular level, and how to capitalize on that understanding to improve outcomes and quality of life in the patients we treat with radiation.”Three additional plenary papers will be presented at the meeting, covering: (1) Results of the GICOR study evaluating long- and short-term androgen-deprivation therapy in patients with intermediate- and high-risk localized prostate cancer treated with high-dose radiation therapy; (2) Results results from the Radiation Therapy Oncology Group (RTOG) 0126 Phase III randomized study of high-dose versus standard-dose 3D-conformal radiotherapy/intensity-modulated radiation therapy in patients treated for localized prostate cancer; and (3) Results of the ICORG 05-03 prospective randomized non-inferiority Phase III trial comparing two radiation schedules in patients with malignant spinal cord compression not proceeding with surgical decompression. Clinical Trials Session Ranking just behind the four plenary papers are the nine abstracts chosen for the Clinical Trials Session (Sun., Sept. 14, 3:15 pm). These studies, Haffty noted, are significant because of the quality of the research and because they inform directions for future research—and many of the studies will have direct clinical implications on practice. Plus, he added: “Several trials presented in these sessions discuss shorter, more efficient courses of radiation compared with longer courses, which impacts not only outcomes, but also the costs and value of radiation treatment.” One abstract presents research from a randomized trial evaluating quality of life following a more abbreviated type of breast irradiation, Movsas said. “While that abbreviated treatment is more convenient for the patient, what about quality of life afterward?”BENJAMIN MOVSAS, MD, FASTRO. BENJAMIN MOVSAS, MD, FASTRO: “We have something for everybody—whether it be panels, challenging cases, eContouring sessions, oral sessions, etc. We're presenting the latest research in a way that is really clinically relevant.”Another abstract reports on a randomized trial that evaluated whether use of manuka honey could prevent the swallowing side effects of patients receiving radiation therapy and chemotherapy for lung cancer. “Fortunately many more of our patients are surviving longer, so it is rewarding to see that so many people in our field are focusing their efforts on looking at quality of life—and looking at it from the patient perspective.” The other abstracts from the Clinical Trials session will report on: Biomarkers to help prognosticate treatment options and outcomes for patients with prostate cancer; Initial findings from the RTOG 0436 randomized Phase III trial examining the addition of cetuximab to paclitaxel, cisplatin, and radiation for patients with esophageal cancer who have undergone surgery; A study evaluating the patterns of disease recurrence in an international, multicenter, randomized trial analyzing the role of thoracic radiation therapy in extensive-stage small-cell lung cancer; The Trans Tasman Radiation Oncology Group (TROG) 03.01 NCIC CTG ES.2 multinational, Phase III study comparing quality of life and palliation of dysphagia in patients with advanced esophageal cancer treated with radiotherapy or chemoradiation therapy; Results of a study examining the utilization of radiation therapy and its impact on overall survival in early-stage Hodgkin's disease; Results of RTOG 0621, a single-arm, Phase II trial evaluating the addition of androgen deprivation and docetaxel to adjuvant radiation therapy for patients with high-risk prostate cancer post-prostatectomy; and Results of a randomized trial comparing acute toxicity and quality of life at six months in patients who received hypofractionated whole-breast irradiation versus conventionally fractionated whole-breast irradiation. ASTRO had a record number of abstract submissions for the annual meeting this year—2,824 in total, Movsas said. The final program will include 364 oral scientific presentations, 1,862 posters, and 144 digital posters. Breast Cancer Management Update This year's Presidential Symposium (Sun., Sept. 14, 8:10 am-12:15 pm) focuses on the local-regional management of breast cancer, and will include sessions on local management, local-regional treatment after preoperative systemic therapy, and regional management. “There have been a lot of changes in the local-management of breast cancer, specifically in respect to radiation,” he said. “Radiation is being used increasingly to treat the regional lymph nodes, and we'll be discussing the benefits of that in terms of patient outcomes. There are cases where, based on the biology of the tumor, the breast cancer can be treated less aggressively with radiation. And, we'll be talking about pre-operative systemic therapy and about how we can tailor chemotherapy or hormone therapy before surgery, and then how radiation is modified. “There have been a lot of major findings in the last couple of years that have affected how the role of local-regional treatment of breast cancer is rapidly evolving,” Haffty said. Keynote speakers at this year's meeting will include: Hedvig Hricak, MD, PhD, Chair of the Department of Radiobiology at Memorial Sloan Kettering Cancer Center, delivering the talk, “New Horizons in Oncologic Imaging—Unraveling Pathways to Synergy” (Mon., Sept. 15, 9:15 am); Frank McCormick, PhD, FRS, the David A. Wood Distinguished Professor of Tumor Biology and Cancer Research, Professor Emeritus of the University of California San Francisco Diller Family Comprehensive Cancer Center, delivering the talk, “New Approaches to Targeting K-Ras” (Tues., Sept. 16, 9:15 am); and Sidney Dekker, PhD, MA, MSc, Professor and Director of the Safety Science Innovation Lab at Griffith University, delivering the talk “Human Error and Just Culture” (Wed., Sept. 17, 9:15 am). More Choosing Wisely, Plus ROILS Rollout Other updates at the Annual Meeting will include another Choosing Wisely announcement. As part of the American Board of Internal Medicine Foundation's continuing national campaign, a second list of five radiation oncology-specific treatments that are commonly ordered but that may not always be necessary will be released. This follows the announcement of ASTRO's first Choosing Wisely first list at the 2013 Annual Meeting (OT 10/25/13 issue). “Last year we highlighted five items—which have now actually caught on quite well, and people are beginning to change practice habits,” Haffty said. And there are some studies being presented as part of the scientific program, he added, which report implications of last year's list—“how they affect practice.” Additionally, the meeting will feature information about the Society's new Radiation Oncology Incident Learning System (ROILS) which ASTRO launched with the American Association of Physicists in Medicine earlier this year (OT 7/25/14 issue). The patient safety initiative will allow physicians to submit errors, near-errors, or any other safety issues that happen during the course of radiation therapy to a centralized database, so that others can learn from those experiences, Haffty explained. Back by Popular Demand... Movsas said that following the positive reception from the ASTRO membership and meeting-goers, these components of last year's Annual Meeting will be returning and expanded for the 2014 schedule: Digital Posters: Investigators will present these posters on an interactive touch screen, equipped to include video and audio. Sessions are structured this year to include time for each investigator to present his or her findings at the podium, as well as interact with meeting goers who have questions. There will also be discussants for each session to talk about the findings. Challenging Cases: For these sessions, a panel of experts will present case studies—grouped by disease site—that radiation oncologists might be presented at multidisciplinary tumor board sessions. Audience members will be surveyed for real-time feedback in addition to the experts sharing how they would handle each case. Session times are listed online (astro.org/Meetings-and-Events/2014-Annual-Meeting/Meeting-Program/Schedule-of-Events). SAMs and CMEs: ASTRO has expanded opportunities for meeting-goers to earn Continuing Medical Education Credits (CMEs) (astro.org/Meetings-and-Events/2014-Annual-Meeting/Meeting-Program/Continuing-Education-Credits) and Live Self-Assessment Modules (SAMs) (astro.org/Meetings-and-Events/2014-Annual-Meeting/Registration-Information/Live-SAMs). Preregistration is required for the Live SAM sessions. eContouring Courses: During these sessions meeting goers can practice contouring skills and get in-person feedback from experts. The sessions will be held Saturday, Sept. 13, and Sunday, Sept. 14. Additional registration is required. Full schedule available online (astro.org/Meetings-and-Events/2014-Annual-Meeting/Registration-Information/eContouring). Richard Hoppe on How to Make the Most of ASTRO14 We asked Richard T. Hoppe, MD, Professor of Radiation Oncology and Member of Stanford Cancer Institute, both at Stanford University, who is also a member of OT's Editorial Board, for his recommendations on how to get the most out of the Annual Meeting. Program Stand-Outs He noted these program stand-outs: The Clinical Trials Session and the Plenary Session: “Both present the most recent data on clinical and scientific advances in the field in prostate cancer, lung cancer, esophagus cancer, and breast cancer.” eContouring: “If you haven't participated in the past, these sessions are a definite must. You choose from a variety of disease sites and compare your skills with experts.” Presidential Symposium: “The last Presidential Symposium that focused on breast cancer was 20 years ago! This session provides an intensive update and review of the important issues for radiation oncologists related to the management of breast cancer—an opportunity to hear several of the key experts on this subject in just a few hours.” Challenging Cases Education Sessions: “The audience gets to cast their votes on clinical management issues on a variety of topics. These are extremely valuable for the practicing clinician.” Anything about stereotactic body radiotherapy: “This is a ‘hot’ topic in radiation oncology. It is the subject of two panels (02, Sun., Sept. 14, 1:15 pm; and 18, Wed., Sept. 17, 1:15 pm); three scientific sessions (D, Sun., Sept. 14, 4:45 pm; G, Mon., Sept. 15, 10:45 am; and LL, Wed., Sept. 17, 1:15 pm); a digital poster session (01, Sun., Sept. 14, 1:15 pm); and three educational sessions (303, Tues., Sept. 16, 7:45 am; 401, Wed., Sept. 17, 7:45 am; and 416, Wed., Sept. 17, 3 pm). And these sessions about “cutting-edge applications of radiation therapy”: * Education Sessions: “Integrating Immunotherapy with Radiation Therapy: Opportunities and Challenges” (104, Sun., Sept. 14, 4:45 pm), “Radiation/Chemoradiation and Biological Targeting” (204, Mon., Sept. 15, 7:45 am), and “The Basics of Genomic Radiobiology—Concepts and Clinical Applications” (302, Tues., Sept. 16, 7:45 am); * Scientific sessions: “Biology—Immunotherapy and the Microenvironment” (O, Mon., Sept. 15, 4:15 pm), “Physics—MRI Guided Radiation Therapy” (Tues., Sept. 16, 4:45 pm); and “Biology—Radiation Toxicity and Radioparticles” (Wed., Sept. 17, 3 pm); and * Panels: “Rational Combination of Metallic Nanoparticles and Radiation—Recent Advances and Future Prospects” (Tues., Sept. 16, 2:45 pm), “Integration of Molecular Signatures and Genomic Classifiers Into the Practice of Radiation Oncology” (Tues., Sept. 16, 4:45 pm), and “Modern Technologies for Improving the Therapeutic Ratio of Radiation Therapy in Lymphoma” (Wed., Sept. 17, 1:15 pm). In and Around San Francisco And, as a long-time resident of the San Francisco Bay area, he made these recommendations for enjoying San Francisco itself, beyond the Moscone Center: Visit City Hall, Memorial Opera House, and Symphony Hall (all part of The Civic Center); Ride the cable cars; Visit the Ferry Building (located along the Embarcadero at the foot of Market Street); Visit Fisherman's Wharf (located on the Northern Waterfront); Walk the Golden Gate Bridge and visit Golden Gate Bridge Park (highlights include the Japanese Tea Garden, the Conservatory, California Academy of Science, and the DeYoung Museum); Visit AT&T Park (home of the San Francisco Giants); Take a San Francisco Public Library Walking Tour; Explore the neighborhoods (The Haight, Chinatown, the Castro, and North Beach, among others); and Eat well!—“San Francisco is a food town,” he said. And... Hoppe will be delivering the “Welcome to San Francisco” address at the start of the meeting on Sunday, Sept. 14 at 8 am.