Sanjay Popat, PhD, FRCP Consultant Thoracic Medical Oncologist, Royal Marsden Hospital, London, UK
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. Various obstacles of structural and financial nature still tend to impede this process in many countries, and joint efforts need to be put into the task of overcoming them.
This volume of memo inOncology summarises important new data presented at the ESMO Congress in the field of lung cancer treatment. Great progress has been made over the last years in terms of immunotherapeutic approaches as well as targeted therapies, and emerging trial findings underscore the refinement that is going on as treatments are being established in different settings and appropriate patient populations that will derive the greatest benefit from them. Notable outcome improvements can be achieved in the small but important group of patients whose tumours show ALK fusions; today, the armamentarium comprises a number of drugs such as alectinib whose activity has been demonstrated in both Asian patients and a global population, in separate trials. Brigatinib and ceritinib additionally give rise to long-lasting responses, but new compounds are already on the doorstep. In the EGFR-mutant field, there are a number of active agents, and the important question of sequencing these agents is addressed in this issue as trial evidence emerges and contributes to completing the picture. While thoracic oncologists can choose among agents from three generations, considerations are required concerning resistance mechanisms and their implications for subsequent treatment.
Finally, immunotherapy of lung cancer was of course a prominent topic at the ESMO Congress, with data demonstrating effects in the neoadjuvant and radical stage III settings as well as in the palliative situation. Besides the PD-L1 expression status, tumour mutational burden is gaining momentum as a new predictive marker for checkpoint inhibitor therapy and additional data were presented. Once more, the multitude of new and exciting data suggests that our journey towards controlling lung cancer continues at a marked pace.