ESMO 2014-WRAP UP

• Date: 30 Sep 2014
• Author: Evandro de Azambuja, Congress Daily Editor-in-Chief
• Affiliation: Institut Jules Bordet, Brussels, Belgium

This article was extracted from the Congress Daily News

Compared to 2012 we had a 24% increase in abstract submission and a 23% increase in registered attendees. We have heard an enormous amount of information from the cutting edge of clinical research over the last few days and the Editorial Team and I would like to take this opportunity to share our particular highlights from the scientific programme with you.

Markus Joerger (Associate Editor)

Significant for me from this year’s Congress are encouraging data from studies with checkpoint inhibitors indicating that immunotherapy can be extended to include tumours once considered to be poorly immunogenic. Presentations from early phase studies demonstrated good activity and tolerability with the anti-PD-1 antibody pembrolizumab as a single agent in head and neck and gastric cancers (Abstracts LBA31 and LBA15). Tumour PD-L1 expression appeared to be a useful predictive biomarker, highlighting the possibility of tailoring this treatment to patients most likely to benefit. Combinations of different types of checkpoint inhibitors (Abstract 1050O) and checkpoint inhibitors with standard therapy (Abstract 1053PD) also showed promising activity in renal and prostate cancers, respectively. The ability of the checkpoint inhibitors to prevent tumours from evading the immune system means that patients with many different tumour types may be able to benefit from this approach.

Floriana Morgillo (Associate Editor)

Our increased understanding of the wide range of genomic variants within a tumour type has opened the door to the development of therapies specifically targeted to these variants. My choice of exciting findings from ESMO 2014 comes from two presentations that featured promising results with targeted agents in non-small-cell lung cancer (NSCLC) subtypes. One reported that the BRAF inhibitor, dabrafenib, which is used to treat BRAF V600E-mutated melanoma, produced responses in nearly one-third of patients with NSCLC harbouring the same mutation (LBA38_PR). The other study (LBA39_PR) indicated that a combination of the irreversible pan-HER tyrosine kinase inhibitor, neratinib, and the mTOR inhibitor, temsirolimus, may be a feasible approach to the treatment of patients with HER2-mutated tumours, which should be investigated further. These agents have the potential to successfully treat two more ‘slices’ of NSCLC and the results give us hope that different targeted treatments may provide efficacy in other subtypes.

Giuseppe Curigliano (Guest Associate Editor)

It is of course always exciting to hear about new strategies being developed to combat cancer. However, my top pick of ESMO 2014 is the news that in the ghrelin receptor agonist anamorelin, we finally have an agent that can effectively and significantly reduce the effects of cancer cachexia. In our efforts to successfully treat the disease, it is easy to forget that this devastating condition will affect many of our cancer patients, irrespective of tumour type. It is associated with morbidity and death in a substantial number of patients and is a cause of extreme anxiety to them. The results from the phase III ROMANA 1 and 2 studies in NSCLC (1483O_PR) demonstrated significant benefits with anamorelin in body mass, body weight and patients’ symptoms and concerns about anorexia-cachexia. These findings suggest that anamorelin has the potential to improve the lives of a significant number of cancer patients.

Evandro de Azambuja (Editor-in-Chief)

For me, the results from the CLEOPATRA trial (Abstract 350O_PR), demonstrating that the addition of pertuzumab to first-line trastuzumab and docetaxel significantly prolonged overall survival in patients with HER2-positive metastatic disease, really stood out. This treatment combination has the potential to make a real difference to the lives of patients, increasing survival in HER2-positive metastatic breast cancer. Once considered a very aggressive disease, its prognosis has greatly improved with the use of anti-HER2 targeted agents. On a negative, but no less important note, the failure of lapatinib to improve on trastuzumab in early stage HER2-positive disease in one trial and the increased toxicity in another 1 (LBA7, Abstract 253O) will also help to define treatment strategies. These results highlight the urgent need for biomarkers to identify patients benefiting from a given treatment, taking into account treatment efficacy and toxicities. Finally, our increased understanding of the molecular complexities of breast cancer, as evidenced by the identification of significant genomic and immunologic differences between metastatic and primary tumour sites (Abstract 351O) and the identification of further predictive biomarkers (Abstract 254O) should help us to develop new strategies that will offer hope of a better outcome for our breast cancer patients.

I would like to thank the Editorial Team for their tremendous efforts in bringing you the Congress Daily newspapers. I would also like to remind delegates not to miss the very first  ESMO ASIA Congress, which is being held in Singapore from 18–21 December 2015. The programme for the meeting, put together by an international committee, will allow delegates the rare opportunity to mix with regional and international experts in oncology. Finally, I hope you found the ESMO 2014 as stimulating and worthwhile as I did. I look forward to seeing you at the European Cancer Congress in Vienna, 25-29 September in 2015 and at the ESMO ASIA Congress.