10th International Conference of ACOS, June 13-15 2012

Abstract

10th International Conference of the Asian Clinical Oncology Society (ACOS) was held in conjunction with 38th Annual Meeting of the Korean Cancer Association during the period of June 13-15, 2012 in COEX, which is the flagship conference facility of Korea located in the city of Seoul. Four sessions were allocated for gynecologic oncology in total. Four special lectures, four educational lectures, six oral presentations, and twenty-two poster presentations were delivered. The theme of educational lectures for gynecologic oncology was 'New Concepts in Epithelial Ovarian Cancer' encompassing the debate of adopting upfront surgery or chemotherapy for advanced ovarian cancer. In this context, individual lectures covered neoadjuvant chemotherapy, upper abdominal surgery, secondary cytoreduction, and new chemotherapy options. Choosing initial treatment modality depends largely on the tumor burden of given patient and building a prediction model for resectability of ovarian cancer might be warranted as Sokbom Kang suggested. Kimio Ushijima summarized recent trial results of chemotherapy for recurrent ovarian cancer dedicating large part to the molecular targeting agents such as vascular endothelial growth factor (VEGF) inhibitors, Ang1 and 2 receptor inhibitors, and PARP inhibitors. Bevacizumab, which is anti-VEGF and one of the most vigorously tested targeting agent, showed the promising results by GOG 218 and ICON7, again recently turned out to improve response rate and extend progression-free survival when combined with gemcitabine and carboplatin in platinum sensitive recurrent ovarian cancer on OCEANS trial. Four special lectures were given under the theme of 'Unresolved Issues in Endometrial Cancer'. Fertility preservation is widely advocated in recent years because the prognosis is excellent when diagnosed in early endometrial cancer even if the prevalence is relatively low (2.1-14.4%) in women under the age of 40. Still, the selection of patient, assessment of myometrial invasion, concurrent ovarian cancer, the formulation, dosage, duration of progestin-base regimen, monitoring response to progestin therapy, management for maintenance of complete response, and so forth are some of those awaits consensus formation. The Chang Gung Memorial Hospital group from Taiwan summarized the recent issues regarding fertility saving in early endometrial cancer along with presentation of their own data. Another aspect of conservative management of endometrial cancer being issued is whether to perform systemic lymph node dissection. While the risk evaluation by imaging modalities and histological typing/grading serves pivotal role in determining nodal metastasis, recent randomized controlled trials failed to demonstrate survival benefits in low risk patients. Thus Karen Chan concluded that a systemic lymphadenectomy can be safely avoided in the majority of low risk endometrial cancer patients. In contrast, widely accepted consensus about the adjuvant therapy in intermediate- or high-risk endometrial carcinoma is still far from established, although the role of chemotherapy is recently more recognized in adjuvant setting. The gestational trophoblastic neoplasia is a big health threat in many Asian countries in spite of dramatic decrease of prevalence in selected area for the last two decades. After reviewing intensively four randomized controlled trials and four case control studies, Taek-Sang Lee concluded that pulsed dactinomycin might be superior to weekly parenteral methotrexate warranting rigorously designed randomized trials. Six gynecologic cancer topics were presented orally. Notably, Ju-Won Roh presented 'clinical significance of EZH2 expression and therapeutic effect of its silencing in endometrial cancer', leading to receiving Merit Award. EZH2, which is a member of Polycomb-group (PcG) family acting mainly as a gene silencer, is a surrogate target for therapy because it is overexpressed in a number of malignancies and the relevancy with endometrial cancer has not been elucidated. She examined therapeutic effect of in vivo EZH2 silencing alone using siRNA or combined with chemotherapy and showed that EZH2 silencing enhanced cytotoxicity of paclitaxel, docetaxel and cisplatin in endometrial cells and suppressed tumor growth. 10th International Conference of ACOS was crowded with 1,450 delegates from 30 countries. The organizing committee declared it was the most successful one ever among the ACOS conferences so far and vowed to keep the momentum of international exchange.