The highly selective, CNS-active ALK inhibitor alectinib has demonstrated superiority over crizotinib in the first-line setting of ALK-positive NSCLC both in the global phase III ALEX study and the phase III J-ALEX trial, which was conducted in Japanese patients. Alectinib has been approved in the US and Europe and has recently received priority approval in China.

The first-line EGFR TKI choice in patients with EGFR-mutated NSCLC has been under debate ever since the results of the FLAURA were reported. From the current point of view, what are the limitations of this study?

In patients with stage IIIA-N2 NSCLC, current multimodal treatment options include definitive chemoradiotherapy, surgery followed by adjuvant chemotherapy, or neoadjuvant treatment followed by surgical resection. The standard first-line EGFR tyrosine kinase inhibitor (TKI) erlotinib has already demonstrated feasibility in the neoadjuvant treatment setting of stage IIIA-N2 NSCLC.

Patients with early and locally advanced (stage I-IIIA) non–small-cell lung cancer (NSCLC) usually undergo surgery, but long-term outcomes leave much to be desired. After surgery alone, the recurrence rate is substantial at more than 50 %. Perioperative chemotherapy as a means to prevent disease recurrence only confers a 5 % improvement in 5-year survival compared to sole surgery.

The ESMO Congress represents the leading international oncology event in Europe. This year’s conference that took place from 19th to 23rd October in Munich, Germany, was held under the tagline “Securing access to optimal cancer care”. Approximately 25,000 participants including experts from various oncology disciplines, healthcare policy makers, and patient advocates convened from all over the world to discuss innovations and the major challenge of turning new insights into actual improvements in cancer patient care.