ASCO 2024: The art and science of cancer care, from comfort to cure

The Annual Meeting of the American Society of Clinical Oncology (ASCO) is the world’s biggest cancer conference; this year, more than 40,000 clinicians, investors, pharma executives and other professionals involved in cancer research from all around the world met in Chicago on the shores of the majestic Lake Michigan.There was a strong message in this year’s theme: “The art and science of cancer care: from comfort to cure”. This emphasises that the focus of the meeting was not only on innovative treatments, but also on palliative care and approaches to creating better lives for cancer patients.We were there and here are our key highlights from the meeting:

1. Focus on AI

Strikingly, the first plenary presentation included a session on the implementation of AI technologies in clinical practice. In addition, all through the meeting we heard how AI technologies showed promise – from increasing colorectal cancer screening uptake among underserved populations, for example, to how a machine-learning model may predict the risk-benefit of immune checkpoint inhibitors (which help the body’s immune system fight cancer cells) and optimising drug dosing. Moreover, other AI technologies demonstrated their potential in genomics and biomarker discovery, clinical decision support and improving diagnostic accuracy. Particularly interesting was a session on breast cancer diagnostics, which highlighted an increasing number of AI-related tests coming to market, including AI-supported mammography, automatic scoring of breast cancer biomarkers, automatic detection of lymph-node metastasis, and clinical-decision support tools.2. Liquid biopsy for breast cancerAnother interesting presentation regarded the use of liquid biopsies (which work by detecting cancer-specific biomarkers that are released in the blood) to predict breast cancer relapse. During the presentation, it was shown that in a 76-patient study, a new test called NeXT was able to correctly identify 10 women whose cancer relapsed long before the disease was visible on the scans, with no false-negative cases. This result further paves the way for the implementation of liquid biopsies in clinical practice.

Moderna/Merck cancer vaccine in melanoma

Moderna presented a three-year update of a Phase 2b randomised KEYNOTE-942/mRNA-4157-P201 study, a clinical trial evaluating mRNA-4157 (V940), an investigational individualised neoantigen therapy (INT), in combination with KEYTRUDA, Merck’s anti-PD-1 therapy (pembrolizumab), in patients with resected high-risk melanoma (stage III/IV) following complete resection (with a sample size of 157). The idea with this type of approach is to immunise the patient after tumour resection with tumour antigens which have been specifically based on the unique mutational signature of the DNA sequence of the patient’s tumour. It was impressive to see that the combination of vaccine plus pembrolizumab demonstrates a clinically meaningful and durable improvement in recurrence-free survival, the primary endpoint of the study, reducing the risk of recurrence or death by 49%. After three years, 75% of those who had the vaccine and pembrolizumab were still cancer-free, compared to 56% of people who only received pembrolizumab. This is quite significant and a landmark result in the cancer vaccines field.

Immunotherapy before surgery

In two landmark presentations, we saw the relevance of using immunotherapy approaches ahead of surgery (known as neoadjuvant immunotherapy) in some types of cancer. In the NICHE trial, a neoadjuvant combination of ipilimumab and two doses of nivolumab treatment in 20 patients with a high mutational load colorectal cancer resulted in a major pathological response in 19 out of the 20 patients. Moreover, Professor Christian Blank (of the Netherlands Cancer Institute) presented ground-breaking results from the NADINA trial, which examined the efficacy of neoadjuvant immunotherapy versus adjuvant immunotherapy (i.e. post-surgery) in treating stage III melanoma. The study involved 423 patients. The key findings highlight that the neoadjuvant approach greatly improves outcomes for patients, with a 68% reduction in risk of recurrence of the disease. For the patients with major responses, the results were particularly promising: a 95% event-free survival rate at 12 months. These results could redefine the treatment of stage III melanoma.

Pharma industry progressKey developments

from the large healthcare firms included the promising results from the Novartis NATALEE trial for early-stage breast cancer, Verastem’s combination therapy in pancreatic cancer, and Novartis’s Scemblix treatment for chronic myeloid leukaemia. All showed improved patient outcomes and fewer side effects.

Use of GLP-1 receptor agonists to reduce cancer risk Use of GLP-1 receptor agonists to reduce cancer risk

Ozempic _and Wegovy ^are the best-known examples of drugs called GLP-1 receptor agonists (GLP-1 RAs), which mimic the action of GLP-1, a hormone made by the small intestine. These drugs were originally used to treat type 2 diabetes, and recent landmark studies also support their use for weight loss. At ASCO, a retrospective study in patients with a body mass index of at least 35kg/m2 (i.e. severely obese) found that treatment with GLP-1 RAs appears to lower the risk of developing obesity-related cancer, with results similar to bariatric surgery. Specifically, when compared with those who received no treatment, the researchers discovered a 39% reduction in cancer risk for 13 types of such cancers.

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First ChapterPotential CustomersThird chapterFirst ChapterWhen USM, a leading Swiss manufacturer of iron products and window mechanisms, decided to build a new factory, it wanted to transform its manually oriented production plant into a modern industrial enterprise. It knew that its old-fashioned processes could not compete with companies which had already modernised, but the transformation had an unexpected consequence. Instead of continuing to make window mechanisms, the company ended up producing a modular furniture system which has become a modern design classic.USM is a family-owned business founded by Ulrich Schärer in 1885 as a hardware and locksmith’s business in Münsingen, close to Switzerland’s capital city of Bern. His grandson Paul Schärer took over the company in 1961 after studying engineering, and he realised that USM needed to build a larger factory to become more competitive. So he collaborated with architect Fritz Haller to realise his vision of a flexible factory built using a steel modular construction system which could easily be expanded as the business grew.The new factory included a pavilion to house USM’s offices, and the two men wanted to design a furniture system that was flexible enough to adapt to a growing business when it needed more office space. In 1963, they created a pioneering furniture product known as USM Haller Modular Furniture, sold at first for office use but later for home use, and now exported to more than 40 countries around the world.Alexander Schärer, Paul’s son who joined USM in 1993 and led its foreign expansion, says there was an irony in this evolution. “The company intended to continue selling its window mechanisms to the architects who used them for the homes they built, while commercialising the new modular factory construction system. But the window mechanisms were less in demand as factory buildings became air-conditioned, as had its own. So the modular furniture which was intended to be a byproduct of the new building system became the company’s main product.”The system is not complicated. It uses three basic steel and chrome components: spherical joints which connect tubes together, and support panels which come in a variety of attractive colours. So elegant is the design that the USM Haller Modular Furniture has been included in the Architecture and Design collection of New York’s prestigious Museum of Modern Art (MoMA).In 1969, the production and sale of USM Haller Modular Furniture began, with the first large contract signed for the headquarters of Rothschild Bank in Paris. This required substantial retooling to make the manufacturing profitable, but it had two important beneficial consequences: details of the new furniture were featured in architectural journals and caught the attention of architects; and a fashion show was staged in the bank, which attracted a lot of newspaper coverage for the futuristic furniture.Potential CustomersPotential customers were attracted to the pavilion on the Münsingen factory site to see the new furniture system, and USM started recruiting dealers to sell it. Outlets were opened in 20 Swiss cities, starting with Zurich, Lausanneand Bern. And in 1975, a German subsidiary was opened in Bühl to set up a similar dealer network to Switzerland’s.Bühl to set up a similar dealer network to Switzerland’s. “The USM system started as an insider product in Switzerland,” says Alexander Schärer. “It was originally taken up by architects who wanted it to be exclusive to their offices. But it became a branded product in Switzerland in the late 1980s and is now a mainstream product.”The marketing in Germany focused heavily on offices at first, furnishing big banks, lottery companies and other businesses. But in 2008 when banks started collapsing in the financial crisis, USM sold more into the home market, which had already grown in Switzerland.“Offices often buy directly from the company, but homeowners tend to visit showrooms or go to dealers because their orders are generally smaller. Our website has a Configurator section which allows buyers to create their own designs, though many residential customers turn to dealers for guidance to perfect them. In Switzerland 90 per cent of our residential customers go for custom-designed pieces.”It is unusual for homes to be fully fitted out with USM furniture, he adds: residential customers tend to buy it just for parts of their homes, though the system’s flexibility means it can easily be expanded or changed if desired. However, he recalls that one wealthy client fitted out a full Chicago penthouse with the company’s products to provide a home for their artwork and memorabilia.Business developments have led to changes in the ranges of modular furniture. Less filing space is needed in offices, for example, because much more information is now stored online. But there is more demand for partitions and land-scaping for creative spaces and privacy in open-plan offices.The USM business has three main production functions. The main one is manufacturing the modular components, which all takes place at the Münsingen factory and employs just under half of the company’s 400 or so employees. The second function is assembly, which is handled by around a quarter of the employees globally. And a new company is being set up in Leipzig in Germany to carry out the assembly for all of Europe except Switzerland, where it is still done at Münsingen.The third function covers sales, marketing and distribution, which is done by the around a third of the staff, working with a network of more than 400 qualified sales partners. The numbers have grown over the years, as projects for homes are typically smaller than those for offices, needing more people to support sales and the shorter delivery deadlines that residential customers expect. The margins on those smaller projects is better, however, and are likely to rise as the share of sales online increases.One of the attractions of USM’s modular furniture formost buyers is the length of its useful life. Swiss manufacturing is synonymous with precision, quality and dependability, and the modular furniture components are made with first-class materials to the finest level of craftsmanship. Part of the company’s DNA is that its furniture can last 20 years or more, with no need to repair or replace parts –unlike other cheaper self-assembly furniture brands.Third chapterOne of the company’s first patent registrations was for the very durable ball joint used to connect the chrome tubesand the support panels in a rigid framework. The ball joint also contributes to the adaptability of the modular products, which can be altered or extended when adapting to current and future needs while retaining the same degree of robustness. This was recognised in 2018 with cradle to cradle (C2C) certification for two of USM’s ranges whose design, use and recycling of resources mean they are used effectively over their long life cycle.With concerns rising about the impact of global warming, USM is also taking steps to reduce its carbon footprint. Its powder-coating paint process, which generates a lot of heat, has been moved to a basement that therefore requires no heating in winter and minimal cooling in summer. The company has installed solar power on the roof of its largest building to substantially reduce its demand for electricity in summer. It is also building a new heating plant fuelled by locally sourced wood pellets rather than oil, which will reduce the carbon footprint of its heating by around 75 per cent.USM remains a private company and has no problem in raising funds when finance is needed, says Alexander Schärer. Decision-making takes much less time in a family business, which can be vital if restructuring or closing some operations is urgently required. And there are plenty of challenges that he would like to tackle in managing a branded business, attracting the creative people which the company always needs, and increasing the online business from its relatively low 10 per cent share.USM has stood out for its modularity vision and value over more than 50 years. With its Swiss manufacturing strengths and products which can be adapted to suit changing times and needs, he believes there is much more that can be achieved for many years to come.

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One of the company’s first patent registrations was for the very durable ball joint used to connect the chrome tubesand the support panels in a rigid framework. The ball joint also contributes to the adaptability of the modular products, which can be altered or extended when adapting to current and future needs while retaining the same degree of robustness. This was recognised in 2018 with cradle to cradle (C2C) certification for two of USM’s ranges whose design, use and recycling of resources mean they are used effectively over their long life cycle.

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One of the company’s first patent registrations was for the very durable ball joint used to connect the chrome tubesand the support panels in a rigid framework. The ball joint also contributes to the adaptability of the modular products, which can be altered or extended when adapting to current and future needs while retaining the same degree of robustness. This was recognised in 2018 with cradle to cradle (C2C) certification for two of USM’s ranges whose design, use and recycling of resources mean they are used effectively over their long life cycle.

Simple title from other article module 

When USM, a leading Swiss manufacturer of iron products and window mechanisms, decided to build a new factory, it wanted to transform its manually oriented production plant into a modern industrial enterprise. It knew that its old-fashioned processes could not compete with companies which had already modernised, but the transformation had an unexpected consequence. Instead of continuing to make window mechanisms, the company ended up producing a modular furniture system which has become a modern design classic.

Simple title of article module 3

When USM, a leading Swiss manufacturer of iron products and window mechanisms, decided to build a new factory, it wanted to transform its manually oriented production plant into a modern industrial enterprise. It knew that its old-fashioned processes could not compete with companies which had already modernised, but the transformation had an unexpected consequence. Instead of continuing to make window mechanisms, the company ended up producing a modular furniture system which has become a modern design classic.

Simple title of article module 3 small print

When USM, a leading Swiss manufacturer of iron products and window mechanisms, decided to build a new factory, it wanted to transform its manually oriented production plant into a modern industrial enterprise. It knew that its old-fashioned processes could not compete with companies which had already modernised, but the transformation had an unexpected consequence. Instead of continuing to make window mechanisms, the company ended up producing a modular furniture system which has become a modern design classic.