Byoung Chul Cho, MD, PhD – Division of Medical Oncology, Yonsei Cancer Center – Yonsei University College of Medicine – Seoul, South Korea
The ESMO Virtual Congress 2020 has attracted more than 30,000 registrants from over 150 countries to whom content presented at more than 70 sessions has been made available. The 2,137 abstracts reported at the conference included 87 late breaking abstracts. Sessions were provided for 135 proffered papers, 195 mini orals, and 1,807 ePosters. Twelve simultaneous publications of studies in peer-reviewed journals underscore the scientific significance of the analyses that were shared with the audience by over 230 invited speakers.
For us as lung cancer specialists, the ESMO 2020 congress harbored a range of notable abstracts that will most likely change our clinical practice in the years to come. In the field of early-stage lung cancer, the LungART study was the first trial to prospectively demonstrate the lack of added benefit of postoperative irradiation in patients with completely resected NSCLC and pN2 nodal involvement. Immunotherapy continues to excel in the management of early and metastatic NSCLC, as demonstrated by long-term study updates such as those for PACIFIC and KEYNOTE-024. New checkpoint inhibitors keep arriving that show efficacy in various settings. The PIONeeR project is dedicated to improving the understanding and prediction
of resistance to PD-(L)1-targeted compounds. Also, interactions between radiotherapy and immunotherapy have recently moved into the focus of research. In the treatment of malignant mesothelioma, evidence for the successful use of immune checkpoint inhibition is being built up at present.
Noteworthy insights have also been gained regarding targeted therapies. Among ALK inhibitors, lorlatinib has demonstrated convincing activity in the first-line treatment of patients with ALK-positive NSCLC. In KRASG12C-mutated disease, a first-in-class inhibitor is being explored, with encouraging results. Novel combination approaches are investigated in patients with EGFR-activating mutations. The idea is to enhance the efficacy of established therapies and to delay or prevent the emergence of resistance in a highly targetable setting where treatment initially works well in most patients, but responses inevitably abate over time. Current approaches include, among others, the combined administration EGFR-targeted agents and anti-angiogenic compounds, as well as MET inhibition plus EGFR inhibition. Also, the refined use of standard therapies can contribute to outcome optimization. Thus, the management of thoracic cancer is continuously improving together with heightened tolerability as an important part of a modern treatment approach.
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