Preface ASCO 2021
Martin Reck, MD, PhD
Department of Thoracic Oncology
Airway Research Center North,
German Center of Lung Research
Lung Clinic Grosshansdorf
Grosshansdorf, Germany
Dear Colleagues,
As in 2020, the 2021 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held online, with both the scientific and education programs taking place on June 4-8. Among more than 2,500 abstracts presented, findings in the area of lung cancer made for exiting news. Immune checkpoint inhibition has been moving forward in the continuum of care across the treatment lines and is now defining new standards in early-stage lung cancer. In patients who underwent complete resection, the IMpower010 trial established PD-L1 inhibition as a new adjuvant option in stage II-IIIA, PD-L1–expressing NSCLC. Previously, based on the PACIFIC study, another PD-L1 inhibitor has already transformed the treatment of patients with unresectable stage III tumors responding to chemoradiation. Here, the updated results have revealed lasting benefits.
Important data have also been obtained for targeted therapy that involves not only individualized tailoring of treatment but also the handling of resistance that emerges with it. Various mechanisms of resistance depending on the type of the administered agent have been identified for EGFR-mutant lung cancer. The answer can be targeting of alternative aberrations such as HER3 or the use of regimens that inhibit both likely resistance mechanisms and the primary target. Inactivating somatic mutations such as STK11 and KEAP1 can also have a predictive effect regarding the activity of KRAS inhibition from the outset, according to exploratory analyses of the CodeBreaK100 trial. Immunotherapy and targeted treatment may intertwine, which applies particularly to the KRAS-mutated setting as demonstrated by various analyses reported at ASCO 2021. Sequencing can play an important role in terms of use of checkpoint inhibitors and targeted
tyrosine kinase inhibitors but also antiangiogenic agents, with a view to creating an immunosupportive tumor microenvironment.
Moreover, small-cell lung cancer is being increasingly characterized at the molecular level, with differential expression of genes and biomarkers possibly informing therapeutic vulnerabilities in the future. For the time being, innovative strategies such as bispecific T-cell engager therapies are tested in patients with relapsed SCLC who have a high unmet medical need. While the armamentarium is being refined to improve efficacy and tolerability at the individual patient level, we hope to meet again at future conferences to hear about breakthroughs that will further advance daily patient care.
