Sunday, September 14, 2014

2:45 p.m., PT

Bruce G. Haffty, MD, FASTRO

2014 ASTRO President

56th Annual Meeting

American Society for Radiation Oncology

“Targeting Cancer: Technology & Biology”

News Briefing

Disclosures:

Nothing to disclose.

2014 Annual Meeting Statistics

• Record-breaking 2,874 completed abstracts submitted.

• 2,370 abstracts being presented.

• 364 oral scientific presentations including 4 plenary

papers.

• 1,862 posters and 144 digital posters.

• Total of 50 educational sessions.

• Top number of submissions from U.S. (1,681); 575

studies from Asia (Japan=206; China=191; Korea=93;

Taiwan=33; India=31; Hong Kong=8; Singapore=7;

Philippines=3; Thailand=2; Malaysia=1); 171 studies

from Canada; 54 studies from Germany; and 31 studies

from the United Kingdom.

• More than 11,000 attendees.

About ASTRO

• Founded in 1958.

• More than 10,000 members from around the

world.

• Nearly every practicing radiation oncologist

in the U.S. is a member of ASTRO.

• ASTRO members include oncologists from all

disciplines and specialists in the entire

radiation oncology team.

• ASTRO provides extensive education

programs, grants to researchers and

programs to support global cancer efforts.

2014 Presidential Address

Back to the Future: 30 Years in Breast Cancer

Monday, September 15

1:30 – 2:15 p.m., PT

Esplanade Ballroom

2014 Keynote Speakers

• Monday, September 15, 9:15 a.m., Esplanade

Ballroom

“New Horizons in Oncologic Imaging”

Hedvig Hricak, MD, PhD, Chair of the

Department of Radiology and the Carroll

and Milton Petri Chair at Memorial Sloan

Kettering Cancer Center

2014 Keynote Speakers

• Tuesday, September 16, 9:15 a.m., Esplanade

Ballroom

“New Approaches to Targeting K-Ras”

Frank McCormick, PhD, FRS, DSC (hon),

Professor Emeritus and the David A.

Wood Distinguished Professor of Tumor

Biology and Cancer Research at the

University of California, San Francisco

2014 Keynote Speakers

• Wednesday, September 17, 9:15 a.m.,

Esplanade Ballroom

“Human Error and Just Culture”

Sidney Dekker, PhD, MA, MSc, Professor

and Director of the Safety Science

Innovation Lab at Griffith University,

Brisbane, Australia

Top Science at the 2014 Annual Meeting

We are all focused on improving our patients’

quality of life, and more and more, many of our

trials are focused on the patients’ perspective –

of their treatment, the side effects of their

treatment and their quality of life.

2014 Clinical Trials Session Sunday, September 14

3:15 – 4:45 p.m., PT

Esplanade Ballroom

2014 Plenary Papers Monday, September 15

2:15 – 3:25 p.m., PT

Esplanade Ballroom

Top Science at the 2014 Annual Meeting (continued)

Several studies looked at the ideal length of time for

ADT for prostate cancer patients, including a plenary

study from Spain that combined HDRT and ADT.

Another notable study examines hypofractionated RT,

measuring quality of life, and bowel, bladder and sexual

function for three different patient groups.

A study of more than 5,600 breast cancer patients and

lymphedema, or severe arm swelling, which is often

considered a significant side effect of RT. When patients

were asked about the severity of their lymphedema, the

results are very interesting.

Top Science at the 2014 Annual Meeting (continued)

A multi-center study from Canada evaluated single-

fraction RT vs. multiple fraction RT for patients with

uncomplicated bone metastases.

A TROG Trial, from Australia and New Zealand, for

esophagheal cancer patients experiencing dysphagia

(problems swallowing), during RT or chemo + RT.

One of this year’s Late Breaking Abstracts, presented in

the Plenary Session, is focused on RT for patients with

malignant spinal cord compression.

Top Science at the 2014 Annual Meeting (continued)

Several lung cancer studies that show promise in overall

survival—the characteristics of each patient’s tumor

that may predict their treatment outcome; treatment

for those patients for whom surgery is not an option; as

well as the benefits of quitting smoking even after a

cancer diagnosis.

Hodgkin’s disease is a less-frequent cancer, however, we

are striving to continually improve the survival rates. A

study of more than 41,000 patients assessed those who

received consolidated RT vs. those who did not receive

RT.

Top Science at the 2014 Annual Meeting (continued)

A study from Taiwan evaluated VEGF-A and TGF-ß1 in

patients with esophageal cancer. A pre-treatment blood

test of patients’ VEGF-A and TGF-ß1 may help us define

which patients will benefit most from chemotherapy

combined with RT.

Hodgkin’s disease is a less-frequent cancer, however, we

are striving to continually improve the survival rates. A

study of more than 41,000 patients assessed those who

received consolidated RT vs. those who did not receive

RT.

Top Science at the 2014 Annual Meeting (continued)

Our new Meet-the-Expert session on Wednesday

morning will feature three studies on new biologic

findings that will likely be the building blocks for

additional research. These studies are more technical

and, as such, will be presented in a bit more detail.

2014 ASTRO News Briefings

• Monday, September 15, 8:15 a.m., PT

Developments in Prostate Cancer

• Monday, September 15, 11:00 a.m., PT

Palliative Care, Quality of Life and Patient-

Reported Outcomes

• Tuesday, September 16, 7:00 a.m., PT

Advances in Lung Cancer

• Tuesday, September 16, 2:00 p.m., PT

Novel Approaches and Combination Therapies

2014 ASTRO Meet-the-Expert

• Wednesday, September 17, 7:00 a.m. PT

Technology and Biology: The Next Generation

Stereotactic Radiosurgery (SRS) Patient

Registry – A Partnership with the American

Association of Neurological Surgeons

• ASTRO and the American Association of Neurological

Surgeons have joined forces to launch and support a national registry for SRS treatments.

• This registry will define national patterns of care, with an eye to improving health care outcomes, supporting informed decision-making and potentially lowering the cost-of-care for patients.

• The registry will gather data from 30 diverse high-volume sites with data specific to SRS during the next three years.

Stereotactic Radiosurgery (SRS) Patient

Registry – A Partnership with the American

Association of Neurological Surgeons

SRS is a minimally invasive approach that utilizes image guidance and stereotactic principles to deliver radiation to targeted cells within the body, and it has become an important part of the neurological resources for the treatment of brain metastases, benign brain tumors and arteriovenous malformations. We look forward to learning from the data in this registry.

A patient safety initiative of ASTRO and the American

Association of Physicists in Medicine (AAPM)

• Centerpiece of ASTRO’s Target Safely plan.

• Only medical specialty society-sponsored incident

learning system for radiation oncology.

• Mission is to facilitate safer and higher quality care in

radiation oncology by providing a mechanism for

shared learning in a secure and non-punitive

environment.

Patient Safety and Quality Improvement Act of 2005

(PSQIA):

– Provides privilege and confidentiality

protections for data submitted to a PSO.

– PSOs create a secure, non-punitive environment

where healthcare providers can collect,

aggregate and analyze data in order to identify

and reduce risks and hazards associated with

patient care.

• Contract with Clarity PSO, a federally-recognized

PSO.

• Enter data into secure RO-ILS system.

• Data reviewed by radiation oncology experts.

• Aggregate reports are produced and shared with

participants.

• Other publications will be produced to educate the

broader radiation oncology and health care

community.

ASTRO’s second list of radiation oncology-specific

procedures that should be discussed in more detail with

patients.

1. Don’t recommend radiation following hysterectomy for endometrial cancer patients with low-risk disease. Patients with low-risk endometrial cancer, including no residual disease in hysterectomy despite positive biopsy, grade 1 or 2 with <50 percent myometrial invasion and no additional high-risk features such as age >60, lymphovascular space invasion or cervical involvement have a very low risk of recurrence following surgery. Meta-analysis studies of radiation therapy for low-risk endometrial cancer demonstrate increased side effects with no benefit in overall survival compared with surgery alone.

ASTRO’s 2014 Choosing Wisely List

2. Don’t routinely offer radiation therapy for patients who have resected non-small cell lung cancer (NSCLC), negative margins, N0-1 disease. Patients with early-stage NSCLC have several management options following surgery. These options include observation, chemotherapy and radiotherapy. Two meta-analysis studies of post-operative radiotherapy in early NSCLC with node negative or N1 disease suggest increased side effects with no benefit for disease-free survival or overall survival compared to observation. Patients with positive margins following surgery may benefit from post-operative radiotherapy to improve local control regardless of status of their nodal disease.

ASTRO’s 2014 Choosing Wisely List

3. Don’t initiate non-curative radiation therapy without defining the goals of treatment with the patient and considering palliative care referral. Well-defined goals of therapy are associated with improved quality of life and better understanding on the part of patients and their caregivers. Palliative care can be delivered concurrently with anti-cancer therapies. Early palliative care intervention may improve patient outcomes including survival.

ASTRO’s 2014 Choosing Wisely List

4. Don’t routinely recommend follow-up mammograms more often than annually for women who have had radiotherapy following breast conserving surgery. Studies indicate that annual mammograms are the appropriate frequency for surveillance of breast cancer patients who have had breast conserving surgery and radiation therapy with no clear advantage to shorter interval imaging. Patients should wait six to 12 months after the completion of radiation therapy to begin their annual mammogram surveillance. Suspicious findings on physical examination or surveillance imaging might warrant a shorter interval between mammograms.

ASTRO’s 2014 Choosing Wisely List

5. Don’t routinely add adjuvant whole brain radiation therapy to stereotactic radiosurgery for limited brain metastases. Randomized studies have demonstrated no overall survival benefit from the addition of adjuvant whole brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) in the management of selected patients with good performance status and brain metastases from solid tumors. The addition of WBRT to SRS is associated with diminished cognitive function and worse patient-reported fatigue and quality of life. These results are consistent with the worsened, self-reported cognitive function and diminished verbal skills observed in randomized studies of prophylactic cranial irradiation for small

ASTRO’s 2014 Choosing Wisely List

5. Don’t routinely add adjuvant whole brain radiation therapy to stereotactic radiosurgery for limited brain metastases. (continued) cell or non-small cell lung cancer. Patients treated with radiosurgery for brain metastases can develop metastases elsewhere in the brain. Careful surveillance and the judicious use of salvage therapy at the time of brain relapse allow appropriate patients to enjoy the highest quality of life without a detriment in overall survival. Patients should discuss these options with their radiation oncologist.

ASTRO’s 2014 Choosing Wisely List

Questions?

Contact ASTRO’s Press Office

In San Francisco, September 14-17, 2014:

415-978-3503

Via email: press@astro.org

The online press kit:

www.astro.org/AMPress