From Cashews to the Genome: Takeaways from Major Cancer Meeting

The value of eating nuts, the potential of immunotherapy, and the arrival of new precision treatment cocktails were among the many things that Wilmot doctors learned while recently attending the largest meeting in the world for oncologists.

 

Aram Hezel, M.D., and Richard Dunne, M.D., are part of Wilmot’s gastrointestinal (GI) cancers program, with the largest team of specialists in the Finger Lakes region. They offered their takeaways from the American Society of Clinical Oncology (ASCO):

• Immunotherapy is hot. Immune therapy harnesses a person’s own immune cells to fight cancer. The role of immune therapy for solid tumors is growing, with several studies showing potential to treat cancers of the stomach, liver, colon, and lung. Immunotherapy has been tested more extensively in people with lymphoma and leukemia (blood cancers), but scientists are accelerating plans for other types of cancer. Patients with certain tumor markers respond better to immune therapy, and doctors are still conducting research to determine who is likely to receive long-lasting, positive effects and less toxicity from the treatment.
• Eating nuts as part of a healthy diet can cut the risk of colon cancer recurrence nearly in half. A large study showed that patients with stage 3 colon cancer had a 42 percent lower risk of the cancer coming back after treatment, and a 57 percent lower risk of death, if they ate two or more ounces (about ¼ cup) of nuts a week compared to people who did not eat nuts. The benefit was limited to tree nuts such as almonds, walnuts, cashews, and pecans.  
• Chemotherapy after surgery for biliary tract cancer improves chances of survival. The biliary tract includes the gallbladder and bile ducts inside and outside the liver. This conclusion from a large study will likely become the new standard of care.
• But sometimes, less is more. Some patients with colon cancer are probably fine with less chemotherapy after surgery. Six clinical trials with more than 12,800 patients confirmed that three months of chemo after surgery was nearly as effective as six months for patients with stage 3 colon cancer.
• And chemo isn’t the only option. Defining solid tumors by their genomic signature is becoming the new norm, rather than viewing the disease as cancer of a specific body part. The result: Newer, more precise treatments for patients. Drugs that target certain biomarkers can be used effectively on a variety of cancers (if the gene signature fits), and sometimes in combination with other therapies.
• Online house calls? A study showed that a web-based system for patients to report symptoms—including when they’re very ill or at the end of life—helps people to live longer and better. The standard way is for patients to take the initiative to track and remember their symptoms and then report them to nurses and doctors. But the evolving model uses electronic reminders and an online portal for patients, resulting in quicker responses from the medical team.