The Korean Cancer Study Group (KCSG) said Korean institutions and researchers in oncology have significantly advanced their capabilities to a world-class level, citing two local clinical trials on breast cancer patients presented at a U.S. cancer conference.
In a news conference on Wednesday, the KCSG presented Korean researchers’ achievements introduced at the recent annual meeting of the American Society of Clinical Oncology (ASCO) 2019 held in Chicago from June 1-5.
|Korean Cancer Study Group President Kang Jin-hyoung speaks at the KCSG’s news conference in Seoul, Wednesday.|
According to the group, local researchers announced 184 studies in oral abstraction and poster sessions at ASCO 2019.
Among them, two trials were noteworthy which were on young breast cancer patients, it said. One was led by Samsung Medical Center’s Hematology Oncology Department Professor Park Yeon-hee, and the other was by Seoul National University Hospital’s Oncology Internal Medicine Department Professor Im Seock-ah.
Both of them studied premenopausal patients with breast cancer.
“In Korea, 50 percent of metastatic breast cancer patients are aged 50 or under who are in the premenopausal stage. Compared to the Western breast cancer patients, 70-85 percent of whom develop the disease after menopause, Korean patients are younger,” the KCSG said.
When the onset of breast cancer comes at a young age, cancer progression can be fast and more aggressive because cell cycle-related proteins and intracellular signaling proteins help cancerous cells grow faster. “Most multinational clinical trials initiated in the West have been for postmenopausal women with a high incidence of the disease. Such studies had limitations to apply to many young, premenopausal patients with breast cancer in Korea,” the KCSG said.
As young breast cancer patients’ functions of ovaries remain intact, they have to receive ovariectomy to receive the Western standard cancer treatment, it added.
At ASCO 2019, Professor Park had an oral abstract presentation on KCSG-BR 15-10, a study in premenopausal women with hormone receptor-positive (HR+) metastatic breast cancer.
Also called “Young-PEARL,” the phase-2 trial compared cyclin-dependent kinase 4/6 (CDK4/6) inhibitor palbociclib plus endocrine therapy (exemestane+leuprolide) with monotherapy of capecitabine, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor
The trial took place at 14 medical institutions associated with the KCSG’s breast cancer division from 2015 to 2019.
At the 17th month of follow-up, the palbociclib-endocrine group had 20.1 months of progression-free survival, versus 14.4 months PFS in the capecitabine group, Park said at the ASCO 2019. The combo therapy reduced the risk of disease progress and mortality by 34 percent, compared to the capecitabine group. Grade 3 or more hematologic toxicities were more common in palbociclib than in capecitabine.
“As the combo of endocrine treatment and a targeted therapy showed improved results compared to chemotherapy, the study showed a possibility that endocrine treatment could become standard therapy for premenopausal patients,” Park said at the event.
Professor Im also disclosed the results of MONALEESA-7 trial on premenopausal patients with HR+/HER2− advanced breast cancer in an oral abstract presentation. The study was a phase-3 comparison between existing endocrine with CDK4/6 inhibitor ribociclib and endocrine with placebo.
“The study was initially planned for the Asia Pacific, but it progressed to a massive phase-3 trial where European and American researchers joined. From the beginning to the end, professor Im took a leading role,” the KCSG said.
The trial data showed that the ribociclib+endocrine group had 70.2 percent overall survival (OS), while the endocrine+placebo group had 46 percent OS. The ribociclib+endocrine group had a 29 percent less mortality rate than the control group.
“Toxicity and side effects were similar to those reported in the past. Ribociclib was the first breast cancer targeted therapy to extend OS while maintaining the quality of life of cancer patients,” Im said.
The KCSG said MONALEESA-7 trial was significantly meaningful for many premenopausal, young breast cancer patients in Korea and that it was published in the New England Journal of Medicine with professor Im cited as the lead author.
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