ASCO 2024 Signals a New Era in Expanded Innovation

If only we could extend the reach of today’s oncology treatments to help more patients. That’s been an ongoing wish among oncologists. If ASCO 2024 is any indication, that time is fast arriving—as many presenters shared findings on how current therapies and technologies are expanding to new disease states. It’s part of a growing trend within oncology to repurpose and extend the use of existing therapies into new or different therapeutic areas, which can optimize drug utility and patient outcomes.

Here's what we heard at ASCO 2024 about promising developments in four key areas—exploring new tumor types for established targeted therapies, CAR-T and IO therapies, personalized medicine, and vaccine use:

1. Taking CDK4/6 and PI3K Inhibitors to the Next Frontier of Targeted Therapy

Already well-established in the treatment of breast cancer and hematologic malignancies, CDK4/6 (CDK4/6i) and PI3K (PI3Ki) inhibitors are now being considered as treatment options for a broader array of tumor types. This shift is driven by data suggesting that CDK4/6 and PI3K signaling are critical to the proliferation and survival of various solid tumors, including colorectal and prostate cancers and melanoma. The trial data presented at ASCO highlighted how these inhibitors, either alone or in combination with other treatments, could potentially control tumor growth more effectively.

CDK4/6i, originally approved for certain patients with metastatic breast cancer, are being investigated in various solid tumors, including colorectal, prostate, and non-small cell lung cancers, glioblastoma, and melanoma, as well as in some hematologic malignancies. While the ASCO presentations showed positive results in some tumor types, efficacy remains uncertain in others. PI3Ki, initially utilized in treating certain hematologic malignancies, are making their way into broader oncological use. Notable presentations highlighted studies where these inhibitors have shown effectiveness in breast, colorectal, and lung cancers, suggesting a wider application beyond their original use.

2. Advancements in CAR-T Cell and Immuno-oncology (IO) Therapies

Likewise, there was significant interest around the expansion of CAR-T cell therapy and immune checkpoint inhibitors (ICIs) beyond their traditional areas of hematologic malignancies and lung cancer. Applying CAR-T therapy to solid tumors has been particularly challenging due to immunosuppressive cells and physical barriers that can hinder cellular infiltration. In particular, this year’s ASCO presentations focused on molecular targets and engineering CAR-T cells to enhance efficacy and persistence in the solid tumor microenvironment, as well as the latest clinical trial results, which demonstrated the efficacy of CAR-T therapy in melanoma, ovarian, and gastric cancers.

The synergy between CAR-T therapies and ICIs was another major theme. This treatment combination may enhance the immune system’s response to cancer more effectively than single-therapy treatments. Preliminary data suggest that while CAR-T cells specifically target and kill tumor cells, ICIs modulate the tumor microenvironment, so it’s less hostile to the CAR-T cells, ultimately enhancing overall anti-tumor response. The approach has shown promise in increased durability of response, which is particularly important in solid tumors with high rates of recurrence. This year’s ASCO presentations confirmed the viability of this combination strategy, highlighting the ongoing trials where these combinations are being tested in cancers traditionally resistant to single-therapy treatments. These approaches represent a leap forward in the quest to tailor treatments to the unique genetic makeup of each patient’s cancer.

3. Enhanced Personalized Medicine

The push toward these new applications is also being driven by personalized medicine, which aims to tailor treatments to individual patients based on genomics and individual biomarkers. Genomic assays, for example, are becoming crucial tools in identifying which patients are likely to benefit from certain therapies. This approach not only enhances the effectiveness of treatment but also potentially minimizes unnecessary side effects, allowing for a more patient-friendly therapeutic experience.

Presentations highlighted the continued integration of genomic and molecular profiling in clinical practice, which has enabled a more refined understanding of the individual genetic variations that drive tumor growth and response to therapies. In lung cancer, research is focusing on identifying biomarkers that may predict response to IO-based regimens and using approved targeted therapies in earlier-stage disease. As for presentations on colorectal cancer, speakers emphasized the importance of integrating comprehensive molecular testing with the ability to identify mismatch repair deficiency and alterations in key biomarkers like KRAS, BRAF, and HER2 into their treatment algorithms. Another key topic across tumor types was the utility of liquid biopsy for real-time monitoring of treatment response and resistance.

Tumor-agnostic treatment approaches, which focus on the genetic alterations shared by cancer cells, regardless of their tissue of origin, were also a significant topic in the precision medicine space. This innovative approach gained traction following the success of therapies targeting NTRK fusion and microsatellite instability-high/mismatch repair deficiency. This year’s presentations highlighted recent advancements and ongoing trials investigating novel biomarkers and corresponding therapies that may afford broad-spectrum efficacy, as well as real-world data showing enhanced responsiveness and improved survival associated with tumor-agnostic therapies.

4. Expanded Vaccine use in Oncology

Also, recent advancements in vaccines offer new avenues for cancer prevention and treatment. This shift centers on the development of vaccines aimed at both preventing and treating various forms of cancer.

There is an ongoing effort to create new vaccines for the prevention of cancer by targeting specific types of cancerous cells before they develop. Research presented at ASCO showed promising results in preventing cancers such as certain head and neck and liver cancers, which are known to be caused by viral infections. This expands on the success of vaccines in preventing HPV-driven cervical cancer.

This year’s meeting also showcased innovation in the use of vaccines as a therapeutic strategy. Unlike preventive vaccines, these therapeutic vaccines are designed to treat existing cancer by boosting the immune response against cancerous cells. Perhaps the most discussed approach at ASCO was neoantigen-based vaccines, created to target the patient’s tumor-specific mutations, which demonstrated improved patient outcomes in historically difficult-to-treat glioblastoma and pancreatic cancer.

Realizing the Promise of More Targeted, Less Invasive Care

ASCO 2024 showcased many advancements in the expansion of precision medicine and existing therapies and strategies, which underscores the necessity for ongoing research and collaboration across sectors to ensure not only efficacy and safety, but also equitable access. As this expansion continues, there is hope for a new era in oncology — one where more patients can receive targeted, effective care that is less invasive and more individualized.