T. Rawson MSc

Highlights of the 23rd annual meeting of the Belgian Society of Medical Oncology (BSMO)

SUMMARY

As always, the annual meeting of the Belgian Society of Medical Oncology (BSMO) wanted to provide a platform for the dissemination of practice-changing information relevant to Oncology within Belgium. In light of the ongoing global pandemic, the 23^rd annual meeting went virtual in 2021. This did not detract from the engaging line up of presentations, with a particular emphasis on treatment breakthroughs in a variety of cancers. In addition to this, several projects with a local impact on the Belgian Oncology landscape were presented. Get up to date with the 2021 BSMO 23^rd annual meeting with these highlights.

BELG J MED ONCOL 2021;15(3):134-44

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Highlights in luminal breast cancer

Among patients with early breast cancer (BC), approximately 75% present with a luminal tumour (HR+).¹ In addition to being the most common BC subtype, luminal BC also causes most deaths.² Interestingly, the deaths caused by this BC subtype occur over a longer period of time compared to what is seen with HER2-positive and triple negative breast cancer (TNBC).^3,4 As such, it is safe to say that luminal BC continues to be an unmet clinical need. To address this need, a long list of clinical trials are looking into novel strategies to optimize the management of patents with luminal BC. SABCS 2020 featured a plethora of abstracts discussing updates of pivotal trials in luminal breast cancer in addition to studies generating promising results with novel therapeutic agents in patients with more advanced HR+ BC.

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Immune checkpoint inhibitor therapy and COVID-19: What do we know so far?

The ongoing coronavirus pandemic has a direct impact on all medical specialities, and oncology is definitely no exception to this. In any case, COVID-19 represents a significant clinical threat to patients with cancer. In fact, recent data show that Belgian cancer patients who were admitted to secondary care with a COVID-19 infection, were 34% more likely to die within 30 days of admission, compared to COVID-19 patients without an active solid tumour.¹ It is well-established that almost all therapeutic modalities used in cancer patients directly interact with the immune system. In this light, concerns have been raised on the potential impact of anticancer therapy on the course of a COVID-19 infection. These concerns were most pronounced in relation to the role of immunomodulatory drugs, such as immune checkpoint inhibitors (ICI) in COVID-19 infected patients. These agents directly bind to lymphocytes and subsequently exhibit pleiotropic effects on the activity of a patient’s immune system. As such, it is no surprise that there is great interest in the potential interaction between ICI therapies and the course of a COVID-19 infection.

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Highlights in breast cancer

During the 2020 Virtual ESMO meeting, long-awaited results were presented of several important breast cancer studies. For hormone receptor positive (HR+) breast cancer, ESMO 2020 featured conflicting results on the use of CDK4/6 inhibitors in the adjuvant treatment of patients with hormone-receptor positive (HR+) early breast cancer. In HR+ metastatic breast cancer, final overall survival data were presented of the SOLAR-1 trial evaluating alpelisib in PIK3CA mutant patients. In triple negative breast cancer (TNBC), new data on immune therapy were presented. In early-stage TNBC, the addition of atezolizumab to neoadjuvant chemotherapy resulted in a significant increase in the rate of pathological complete responses (pCR). In the metastatic setting, final results of the IMpassion130 trial confirmed the benefit of atezolizumab combined with nab-paclitaxel as first-line treatment for metastatic PD-L1 positive TNBC. Unexpectedly, the IMpassion131 trial evaluating atezolizumab plus paclitaxel in first-line treatment of patients with metastatic TNBC failed to meet its primary endpoint. Finally, the phase III randomized controlled ASCENT trial identified the antibody-drug conjugate (ADC) sacituzumab govitecan as a safe and highly effective treatment option for heavily pre-treated metastatic TNBC patients.

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Highlights in gynaecological cancers

In this overview, the key highlights from ESMO 2020 with respect to gynaecological cancers will be discussed. In advanced endometrial cancers, data were presented on the use of letrozole in combination with palbociclib. In addition, to this, promising clinical efficacy was seen for the antibody-drug conjugate tisotumab vedotin in the treatment of patient with recurrent or metastatic cervical cancer. Also in cervical cancer, a study was presented on the optimal management of cervical cancer patients with intraoperatively detected positive pelvic lymph nodes. In ovarian cancers, several updates were presented of pivotal trials evaluating PARP inhibitors. In addition, results if the phase III INOVATYON trial indicate that platinum-based regimens should remain the standard of care for patients with recurrent ovarian cancer who experienced disease progression within six-twelve months after their last line of platinum-based therapy. Finally, results were presented of the IMagyn050 trial assessing the efficacy and safety of bevacizumab in combination with atezolizumab in the treatment of patients newly diagnosed stage III-IV ovarian cancer.

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