2010 ASCO Annual Meeting highlights new research findings on cancer

NYU Cancer Institute fellow to be honored for pediatric oncology research

Experts from The Cancer Institute at NYU Langone Medical Center will present new research findings at the 46th Annual Meeting of The American Society of Clinical Oncology (ASCO) in Chicago, Illinois. The conference will run from June 4-8, 2010 and scientists from the NYU Cancer Institute will be available to discuss various topics including improved ways to diagnose melanoma in lymphatic vessels, genetic differences in melanoma subtypes and post-transplant lymphoproliferative disorders that are a potential serious complication after organ or bone marrow transplant.

Laura Hogan, MD, pediatric hematology and oncology fellow at the NYU Cancer Institute will receive The Brigid Leventhal Merit Award at ASCO for her outstanding work in pediatric oncology research. Dr. Hogan is the fellow with the highest ranking pediatric abstract at the 2010 Annual Meeting entitled, "High Throughput Transcriptome Sequencing of Pediatric Relapsed Acute Lymphoblastic Leukemia (ALL)."

Abstract # 9521: Sunday, June 6th at 2:00 PM in Chicago, IL
High Throughput Transcriptome Sequencing of Pediatric Relapsed Acute Lymphoblastic Leukemia (ALL)
Presenter: William Carroll, MD, director, NYU Cancer Institute and Julie and Edward J. Minskoff Professor of Pediatrics, Oncology
Lead Author: Laura Hogan, MD, Pediatric Hematology/Oncology Fellow, NYU Cancer Institute

Acute lymphoblastic leukemia is the most common childhood cancer and relapse occurs in approximately 20% of patients. For relapsed pediatric acute lymphoblastic leukemia (ALL) cases, researchers have investigated RNA transcriptome sequencing to identify gene mutations. Some of these mutations are located in novel genes that haven't been associated with cancer previously. While some of these mutations are shared among patients, others are unique to an individual. In this study, researchers indicate that a diversity of pathways may be responsible for relapse in pediatric ALL. This study was completed in collaboration with two other institutions and research was supported by grants from the American Society of Hematology, St. Baldrick's Foundation, and the National Cancer Institute.

Abstract # 8596: Sunday, June 6th at 8:00 AM in Chicago, IL
Prognostic Relevance of Increased Detection of Lymphovascular Invasion in Primary Melanoma Using D2-40 and CD34 Compared to Routine Histology
Presenter: Farbod Darvishian, MD, assistant professor, Department of Pathology, NYU School of Medicine

Lymphovascular invasion (LVI) in melanoma is the identification of tumor cells within the lymphatic vessels. The presence of melanoma tumor cells inside these vessels has been shown to be associated with poorer patient prognosis. This negative prognostic marker for melanoma patients can sometimes be difficult to detect using routine histology techniques. However, use of immunohistochemical markers such as D2-40 or CD34 can increase the number of cases of LVI identified, but the prognostic relevance of this increased detection has not previously been assessed. In a study of 246 melanoma patients, researchers show that LVI detected using these immunohistochemical markers is a better predictor of outcome than LVI detected by histology alone. Results suggest that in melanoma cases when LVI is reported, the use of D2-40 or CD34 should be considered. Authors conclude, the use of these two special stains that highlight the vessels, help physicians better detect more cases of LVI than with the current histology techniques. The increased number of cases of LVI detected using these stains is clinically relevant, and thus if LVI is reported, pathologists should consider using these markers in addition to the current standard technique.

Abstract # 8553: Sunday, June 6th at 8:00 AM in Chicago, IL
The Use of Integrative Genomics to Define Molecular Signatures of Melanoma Histologic Subtypes
Presenter: Amy Rose, MD, Melanoma Research Fellow, Ronald O. Perelman, Department of Dermatology, NYU Langone Medical Center
Lead author: Iman Osman, MB, BCh., MD, associate professor, Ronald O. Perelman, Department of Dermatology, NYU Langone Medical Center

Researchers investigated the molecular and genetic differences between the two most common melanoma subtypes: nodular melanoma and superficial spreading melanoma. Using an integrative genomic approach, researchers identified differences in genes related to the cellular metabolism between nodular melanoma and superficial spreading melanoma. Also, researchers identified genomic deletions that only occur in superficial spreading melanoma. These study results challenge the idea that nodular melanoma is a progression of superficial spreading melanoma, supporting the researchers' hypothesis that they are distinct biologic entities characterized by different molecular pathways. This finding emphasizes the importance of characterizing the genetic background of tumor subtypes rather than treating all melanoma as a homogenous entity. Researchers conclude that by identifying specific molecular defects that may contribute to the formation of the two most common subtypes of melanoma, they might be able to eventually develop subtype-specific treatments that are more specific and thus possibly more effective in treating one type of melanoma versus the other.

Abstract # 8056: Saturday, June 5 at 8:00 AM in Chicago, IL
T-Cell Monomorphic Post-Transplant Lymphoproliferative Disorders (T-Cell m-PTLD): Clinical Characteristics and Prognostic Assessment of a Serious Complication after Transplant
Presenter: Catherine Diefenbach, MD, assistant professor, Department of Medicine, NYU Cancer Institute
Lead author: Francesca Montanari, MD, Post Doctorate Research Fellow, NYU Cancer Institute

A serious complication after organ and bone marrow transplant is post-transplant lymphoproliferative disorder (PTLD). This very uncommon condition involves the uncontrolled proliferation of lymphocytes, causing lymphoid malignancies. The majority of PTLD coincides with Epstein-Barr virus (EBV) driven B-cell proliferations. Although it is rare, T-cell monomorphic-PTLD (T-cell m-PTLD) has been observed. Due to the small number of patient cases ever reported, this rare lymphoma remains a poorly characterized and understood entity. Researchers report that to their knowledge this study includes the largest series of T-cell m-PTLD cases to be reported by a single institution. In the study, researchers analyzed and compared the prognosis of T-cell m-PTLD patients with B-cell m-PTLD patients, diagnosed and treated during the same time frame. Researchers believe some of the unique clinical features of T-cell m-PTLD include EBV negativity, late onset and advanced stage at diagnosis. However, the study shows that the less favorable prognosis of T-cell m-PTLD is independent of any of these factors. This suggests that these diseases may share the same poor risk biological features as their non-PTLD T-cell counterparts. The authors conclude that T-cell origin is an independent poor prognosis marker in PTLD.

Abstract # 2020: Saturday, June 5 at 8:00 AM in Chicago, Illinois
Change in Pattern of Relapse in Newly Diagnosed High-Grade Glioma Following Bevacizumab Therapy
Presenter: Deborah Gruber, MD, clinical assistant professor, Department of Neurology, NYU Cancer Institute
Lead author: Michael Gruber, clinical professor, Departments of Neurology and Neurosurgery, NYU Cancer Institute

Vascular endothelial growth factor (VEGF) is found in endothelial cells of blood vessels and stimulates the growth of new blood vessels. When you have cancer, VEGF enables it to spread to other organs (metastasize). Bevacizumab is a VEGF inhibitor that has recently been approved by the FDA for the treatment of malignant high-grade gliomas (HGGs) that progress after initial therapy. Recent research shows this VEGF inhibitor may encourage greater invasiveness in patients with newly diagnosed and recurrent HGGs. In the study, researchers assessed tumor recurrence patterns in HGGs and their relation to survival in newly-diagnosed patients treated with bevacizumab. A retrospective analysis was completed for patients with newly diagnosed HGGs initially treated with surgery, radiation therapy, and the drug- temozolomide. Patients were given bevacizumab at 10 mg/kg once every two weeks until disease progression or toxicity. Research shows bevacizumab improve progression free and overall survival in patients. However, researchers concluded there is a marked increase in the number of diffuse recurrences over local recurrences following the additional bevacizumab therapy treatment. This shift in the pattern to diffuse recurrence is worrisome to researchers. Future clinical trials are needed to investigate strategies to block this more invasive progression.

Abstract # 8571: Sunday, June 6 at 12:00 PM in Chicago, IL
Hair Depigmentation as an Indicator of Durable Response to CTLA-4 Therapy
Presenter: Anna C. Pavlick, MS, MD Associate Professor of Medicine and Ronald O. Perelman Department of Dermatology, Director, NYU Melanoma Program, NYU Cancer Institute

Treatment with Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) monoclonal antibodies for metastatic melanoma has been known to induce immunologically related adverse events like skin eruptions and itching in some patients. However, it was unclear if these events are linked with clinical responses. Researchers report, for the first time, the occurrence of hair depigmentation following therapy with CTLA-4 monoclonal antibodies correlates with durable clinical responses. No non-responders to the treatment developed any hair depigmentation. This is the first documentation of hair depigmentation following treatment with CTLA-4 monoclonal antibodies for the treatment of metastatic melanoma. The occurrence of hair depigmentation is clinically important, since this may be an early clinical biomarker signaling a complete response to therapy by patients. Patients were treated in clinical trials sponsored by Bristol Myers Squibb and Pfizer.


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