CONGRESS HIGHLIGHTS

Highlights in breast cancer

BJMO - volume 15, issue 8, december 2021

A.M. Dekker MSc, H. Wildiers MD, PhD, K. Punie MD, T. Feys MSc, MBA

At this year’s annual meeting of the European Society of Medical Oncology (ESMO) experts shared some game-changing data for the treatment of breast cancer (BC). In advanced HER2+ metastatic breast cancer m(BC), the DESTINY-Breast03 trial performed a head-to-head comparison of T-DM1 and trastuzumab deruxtecan (T-Dxd) following initial treatment with trastuzumab and a taxane, showing a major PFS benefit for T-DXd without major toxicity issues, establishing T-DXd as the new standard of care in this setting. In luminal breast cancer, the final analysis of the GIM-4 study supports the use of 7 years instead of 5 years adjuvant endocrine therapy in postmenopausal patients with hormone receptor positive (HR+)/HER2- early BC. For advanced stage HR+/HER2- BC, the MONALEESA-2 study shows >1y OS benefit when adding the CDK4/6 inhibitor ribociclib to letrozole as first-line treatment. Finally, in triple negative breast cancer (TNBC), the phase III BrighTNess study showed that addition of carboplatin to neoadjuvant chemotherapy provides long term EFS benefit. In metastatic TNBC, OS data of KEYNOTE-355 further support the use of first-line pembrolizumab plus chemotherapy in advanced PD-L1+ TNBC.

(BELG J MED ONCOL 2021;15(8):390–7)

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Highlights in genitourinary cancers

BJMO - volume 15, issue 8, december 2021

D. De Maeseneer MD, S. Rottey MD, PhD, T. Vermassen PhD

ESMO 2021 again provided a variety of innovations in the management of genitourinary cancers. In prostate cancer (PCa), results of STAMPEDE suggest that early intensification of adjuvant therapy with ADT and abiraterone could become a new standard in high-risk non-metastatic PCa (currently off-label). Studies in metastatic castration-resistant PCa (mCRPC) indicated promising activity of 77Lu-PSMA-617 plus pembrolizumab and of cabozantinib plus atezolizumab. In the field of kidney cancer, patient-reported outcome data of KEYNOTE-564 further support adjuvant pembrolizumab as a new standard of care. Other studies in renal cell cancer (RCC) showed that treatment breaks during tyrosine kinase inhibitor therapy may be highly cost-effective without an effect on patient survival, that antibiotics can severely compromise survival outcomes in nivolumab-treated metastatic RCC patients and that therapeutic targeting of HIF-2α and VEGF may be effective in patients with metastatic clear cell RCC. In addition, cabozantinib proved to be safe and effective in patients with metastatic collecting ducts carcinoma. In urothelial cancer, dose-dense MVAC was identified as a safe and effective neoadjuvant treatment option for patients with muscle-invasive bladder cancer (MIBC). In metastatic urothelial cancer the addition of cetrelimab to erdafitinib seemed to increase treatment effects, while the EphrinB2-blocking agent sEphB4-HAS was found to have synergistic activity with pembrolizumab. Finally, an exploratory analysis of the pivotal IMvigor 130 trial found that cisplatin but not carboplatin seems to enhance anti-tumour immunity.

(BELG J MED ONCOL 2021;15(8):398–405)

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Highlights in respiratory oncology

BJMO - volume 15, issue 8, december 2021

J. Blokken PhD, PharmD, T. Feys MSc, MBA

At this year’s ESMO meeting, much of the attention in the field of lung cancer went to early-stage nonsmall cell lung cancer (NSCLC) with interesting results from the Lung Art, COAST, GEMSTONE-301 and IMpower010 trials. For metastatic NSCLC, immunotherapy again walked away with much of the attention. In addition to this, several studies investigated the potential of combining anti-EGFR and anti-angiogenic agents, while others investigated novel targeted agents, including trastuzumab deruxtecan, poziotinib, plinabulin and datopotamab deruxtecan. Finally, we will highlight the most interesting results in other thoracic malignancies, including malignant pleural mesothelioma, extensive-stage small cell lung cancer, thymoma and thymic carcinoma.

(BELG J MED ONCOL 2021;15(8):406–14)

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Highlights in digestive oncology

BJMO - volume 15, issue 8, december 2021

H. Dedecker MD, H. Prenen MD, PhD, L-A. Teuwen MD, M. Peeters MD, PhD, T. Vandamme MD, PhD

The 2021 edition of ESMO was held virtually between the 16th and 21st of September 2021. The main goal of this overview is to highlight the most striking abstracts in the field of digestive oncology for daily clinical practice. First, the upper gastro-intestinal tract tumours will be discussed, followed by an overview of the congress highlights related to cancers of the lower gastro-intestinal tract.

(BELG J MED ONCOL 2021;15(5):415–20)

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Highlights in head and neck cancer

BJMO - volume 15, issue 8, december 2021

W. Lybaert MD

ESMO Congress 2021 was held from the 16th till the 21st of September, once again in a virtual format. During this congress, more immunotherapy data were shown in the neoadjuvant setting of resectable head and neck cancer, in the concomitant radiotherapy setting and first-line recurrent/metastatic disease. In addition, a nomogram was created for patients undergoing concomitant chemoradiotherapy that can be used as a web-based tool for our clinic. Other data underscore that treatment of elderly patients with a head and neck cancer nowadays require a comprehensive geriatric assessment. In this report, these and other important studies related to head-and-neck cancer will be discussed, together with some comments on the clinical relevance of these findings.

(BELG J MED ONCOL 2021;15(8):421–7)

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Highlights in gynaecological oncology

BJMO - volume 15, issue 8, december 2021

A. Enguita PhD, T. Feys MSc, MBA

The 2021 annual ESMO meeting featured several presentations with the potential to shift the standard of care in gynaecological cancers. In cervical cancer, Keynote-826 identified pembrolizumab + chemotherapy (with or without bevacizumab) as a potential new standard of care for patients with persistent, recurrent, or metastatic cervical cancer. In addition, also the antibody drug conjugate tisotumab vedotin showed encouraging and durable anti-tumour activity in this setting. In the field of the ovarian cancer, PARP inhibition again walked away with most of the attention, but also the glucocorticoid receptor modulator relacorilant and combination therapy with the immune checkpoint inhibitor atezolizumab and bevacizumab yielded interesting data. Also for patients with advanced endometrial cancer, ESMO 2021 proved to be of interest, with important updates on the use of pembrolizumab in this setting.

(BELG J MED ONCOL 2021;15(8):428–35)

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