osu 2014 asco review savvides pres head & neck

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ASCO Review: H&N Cancer Panos Savvides, MD PhD MPH

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Ohio State's 2014 ASCO Review Head and Neck Cancer Update Presentation by Dr. Panayiotis (Panos) Savvides

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Page 1: Osu 2014 asco review savvides pres head & neck

ASCO Review: H&N Cancer

Panos Savvides, MD PhD MPH

Page 2: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 2

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally advanced

head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal Cancer

Predictive and prognostic markers to therapy Cetuximab and HPV

Page 3: Osu 2014 asco review savvides pres head & neck

A phase 3, multicenter, randomized, double-blind, placebo-controlled trial of lenvatinib (E7080) in patients with 131I-refractory differentiated thyroid cancer (SELECT)

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 4: Osu 2014 asco review savvides pres head & neck

Slide 17

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 5: Osu 2014 asco review savvides pres head & neck

Study Rationale

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 6: Osu 2014 asco review savvides pres head & neck

Study 303: Study Schema

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 7: Osu 2014 asco review savvides pres head & neck

Patient Characteristics

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 8: Osu 2014 asco review savvides pres head & neck

Primary Endpoint:<br />Kaplan-Meier Estimate of PFS

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 9: Osu 2014 asco review savvides pres head & neck

PFS by Previous VEGF-Targeted Therapy

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 10: Osu 2014 asco review savvides pres head & neck

PFS Subgroup Analyses

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 11: Osu 2014 asco review savvides pres head & neck

Response Rates

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 12: Osu 2014 asco review savvides pres head & neck

Best Tumor Response

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 13: Osu 2014 asco review savvides pres head & neck

Overall Survival, ITT population

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 14: Osu 2014 asco review savvides pres head & neck

Study Medication Exposure

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 15: Osu 2014 asco review savvides pres head & neck

Treatment-emergent Adverse Events (TEAEs)

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 16: Osu 2014 asco review savvides pres head & neck

Most Frequent Treatment-related Adverse Events (> 20%)

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 17: Osu 2014 asco review savvides pres head & neck

TEAEs of Special Interest

Presented By Martin Schlumberger at 2014 ASCO Annual Meeting

Page 18: Osu 2014 asco review savvides pres head & neck

Clinical trial comparison DECIDE v SELECT

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 19: Osu 2014 asco review savvides pres head & neck

tumor reduction

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 20: Osu 2014 asco review savvides pres head & neck

Primary endpoint: PFS

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 21: Osu 2014 asco review savvides pres head & neck

Survival: Neither sorafenib nor lenvatinib improve survival in these trials

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 22: Osu 2014 asco review savvides pres head & neck

Toxicity and dosing issues

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 23: Osu 2014 asco review savvides pres head & neck

Lingering questions

Presented By A. Colevas at 2014 ASCO Annual Meeting

Page 24: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 24

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally

advanced head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal Cancer

Predictive and prognostic markers to therapy Cetuximab and HPV

Page 25: Osu 2014 asco review savvides pres head & neck

History of Induction Chemotherapy

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 26: Osu 2014 asco review savvides pres head & neck

ICT vs. CRT

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 27: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 27

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally

advanced head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal Cancer

Predictive and prognostic markers to therapy Cetuximab and HPV

Page 28: Osu 2014 asco review savvides pres head & neck

Slide 7

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 29: Osu 2014 asco review savvides pres head & neck

Slide 8

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 30: Osu 2014 asco review savvides pres head & neck

Slide 9

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 31: Osu 2014 asco review savvides pres head & neck

Trial Comparison

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 32: Osu 2014 asco review savvides pres head & neck

Slide 11

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 33: Osu 2014 asco review savvides pres head & neck

Slide 12

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 34: Osu 2014 asco review savvides pres head & neck

Questions Pertained to the Italian Study

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 35: Osu 2014 asco review savvides pres head & neck

Overall Survival based on RT quality/volume

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 36: Osu 2014 asco review savvides pres head & neck

What can we conclude about ICT?

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 37: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 37

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally advanced

head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal Cancer

Predictive and prognostic markers to therapy Cetuximab and HPV

Page 38: Osu 2014 asco review savvides pres head & neck

Chemotherapy in NPC

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 39: Osu 2014 asco review savvides pres head & neck

NCCS Trial Treatment Schema

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 40: Osu 2014 asco review savvides pres head & neck

NCCS Outcomes

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 41: Osu 2014 asco review savvides pres head & neck

Why is NCCS Trial Negative

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 42: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 42

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally advanced

head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal

Cancer Predictive and prognostic markers to therapy Cetuximab and HPV

Page 43: Osu 2014 asco review savvides pres head & neck

Risk Group Definition base on HPV, Tobacco use & T/N status – Possible role for dose de-escalation in a patient subgroup

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 44: Osu 2014 asco review savvides pres head & neck

Slide 28

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 45: Osu 2014 asco review savvides pres head & neck

Results of E1308

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 46: Osu 2014 asco review savvides pres head & neck

Endpoint: 2yr PFS and OS

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 47: Osu 2014 asco review savvides pres head & neck

Questions to address in good risk HPV+ patients

Presented By Quynh-Thu Le at 2014 ASCO Annual Meeting

Page 48: Osu 2014 asco review savvides pres head & neck

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute 48

ASCO 2014 Review: What’s new in H&N?

Results of SELECT, a lenvatinib phase III clinical trial in Radioactive Iodine Refractory Thyroid Cancer: A new treatment standard? Role of induction chemotherapy in locally advanced

head and neck cancer Italian Induction phase III clinical trial Induction in Nasopharyngeal cancer Treatment de-intensification in Oropharyngeal Cancer

Predictive and prognostic markers to therapy Cetuximab and HPV

Page 49: Osu 2014 asco review savvides pres head & neck

Biomarkers

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 50: Osu 2014 asco review savvides pres head & neck

HPV and cetuximab

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 51: Osu 2014 asco review savvides pres head & neck

Cetuximab + Chemotherapy in SCCHN

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 52: Osu 2014 asco review savvides pres head & neck

SPECTRUM: OS and PFS by arm and p16

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 53: Osu 2014 asco review savvides pres head & neck

RT + cetuximab significantly improves LRC and 5-year OS

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 54: Osu 2014 asco review savvides pres head & neck

Slide 10

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 55: Osu 2014 asco review savvides pres head & neck

Slide 11

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 56: Osu 2014 asco review savvides pres head & neck

Interactions between HPV and the EGFR signaling pathway

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting

Page 57: Osu 2014 asco review savvides pres head & neck

Slide 14

Presented By Vassiliki Papadimitrakopoulou at 2014 ASCO Annual Meeting