ELCC 2022
Lecture Board: Maximilian Hochmair, MD; Jordi Remon, MD, PhD; Fred R. Hirsch, MD, PhD
Publishing Editor: Anna Fenzl, PhD
Preface
The European Lung Cancer Congress (ELCC) that took place virtually on 30th March – 2nd April 2022 effectively disseminated the latest advances in lung and thoracic malignancies and gave 131 speakers from all around the world the chance to present promising new research avenues as well as the opportunity for discussions and new perspectives.
Looking more closely at upcoming and established immunotherapy standards
Adjuvant treatment using immune checkpoint inhibition after complete resection of early-stage lung cancer is being investigated considering the modest survival benefit conferred by platinum-based combination chemotherapy in this setting. IMpower010 was the first phase III immunotherapy study to demonstrate a significant disease-free survival (DFS) improvement in the adjuvant setting after platinum-based chemotherapy. Patients included in this trial had undergone complete resection of stage IB-IIIA NSCLC and subsequently received 1–4 cycles of cisplatin-based chemotherapy.
Oncogene-driven lung cancer: EGFR, METex14, ROS1, RET
The neoadjuvant potential of the third-generation EGFR TKI osimertinib was assessed in the multicenter, single-arm, phase II NEOS study that included patients with resectable, stage II-IIIB N2, EGFR-mutant (ex19del/L858R) adenocarcinoma of the lung. Forty patients received osimertinib 80 mg QD for 6 weeks prior to surgery.
SCLC: prognostic determinants and new treatment modalities
The global, randomized, open-label, phase III CASPIAN trial was initiated to test the anti-PD-L1 antibody durvalumab with or without the CTLA-4 inhibitor tremelimumab in addition to etoposide-platinum chemotherapy (EP) as first-line treatment in patients with extensive-stage small-cell lung cancer (ES-SCLC).
EXPERT VIDEOS
All video interviews from ELCC 2022
Jordi Remon outlines what needs to be considered in the context of neoadjuvant and adjuvant immunotherapy in patients with resectable lung cancer, how tyrosine kinase inhibitors can contribute to effective perioperative treatment, treatment approaches in patients with oncogene-driven lung cancer who develop brain metastases as well as in patients with CNS affection whose tumors do not harbor genetic drivers. Current challenges in selecting the best immunotherapeutic approach for the individual patient with mNSCLC and how to deal with them as well as promising potential predictive biomarkers of ICI in patients with NSCLC are highlighted, too.
Lizza Hendriks discusses how clinical trials should be adapted considering the increasing use of brain metastasis screening in lung cancer patients, the immune micro-environment of CNS metastases, the role of the treatment sequence in the management of patients with brain lesions and summarizes how patients with low PD-L1 expression, frail/elderly patients and those with actionable mutations can be addressed, followed by depicting novel biomarkers for precision immunotherapy.
Jarushka Naidoo depicts recent developments in the first-line therapy of limited-stage small cell lung cancer (SCLC), treatment options for patients with newly diagnosed extensive-stage SCLC, agents emerging for the management of patients with platinum-refractory disease, the molecular types of SCLC and how they respond to targeted therapies and ICIs and gives an overview of the greatest difficulties in the field of irAEs.
At this year’s conference, which took place in Geneva from 10th to 13th April, more than 120 speakers shared their knowledge with around 1,600 delegates from 75 countries. The comprehensive program that included a wide range of session types and the presentation of 210 abstracts aimed at conveying a broad view of the current knowledge ranging from screening and the very early disease to current and potential future treatment approaches for different types of thoracic tumors.