Alex A. Adjei, MD, PhD, Professor of Oncology and Pharmacology Mayo Clinic, Rochester, USA Recipient of the ESMO Lifetime Achievement Award 2021
With the World Conference on Lung Cancer that took place on 8th–14th September 2021 and the ESMO Congress on 16th–21st September, two prestigious cancer congresses have offered a wealth of new preclinical and clinical information in the field of lung cancer. Results from pivotal studies were updated, and fascinating novel treatment approaches were presented to large audiences around the world. More than 22,700 participants from 143 countries registered for the ESMO Congress alone.
This issue of memo inOncology summarizes important findings relating to the management of patients with lung cancer that were presented at both conferences. Among druggable targets, those belonging to the EGFR/HER2 family play an important role in the pathogenesis of lung cancer. The critical role of this pathway is mirrored by the multitude of studies investigating drugs including poziotinib, mobocertinib, amivantamab, and trastuzumab deruxtecan. The antibody-drug conjugates telisotuzumab vedotin and datopotamab deruxtecan have been developed to target c-MET and TROP2, respectively. At the same time, new data are being generated on the ideal use of long-standing EGFR inhibitors such as erlotinib and afatinib.
Checkpoint inhibition is of course a pivotal pillar of treatment that has been established across all lines of therapy and is being implemented in other entities apart from non–small-cell lung cancer, such as small-cell lung cancer and mesothelioma. The combined administration of nivolumab and ipilimumab brought about progress with respect to unresectable malignant pleural mesothelioma. In stage III NSCLC, the PACIFIC trial has set a new standard after chemoradiotherapy of unresectable stage tumors. Consolidation with durvalumab was shown to be life-prolonging under real-world conditions, and combination regimens as well as other checkpoint inhibitors are being tested in the same setting. Patients with metastatic disease who have developed brain lesions derive benefit from checkpoint inhibitor regimens, while new CNS lesions can be prevented.
Anti-cancer vaccines have been evaluated unsuccessfully in NSCLC over the last decade. Therefore, the initial promising results for another type, the anti-cancer vaccine OSE-2101 that has demonstrated a favorable benefit-risk ratio after failure of immune checkpoint inhibition, are notable. Thus, thanks to the commitment of countless researchers, clinicians and patients, the available armamentarium for lung cancer therapy is being expanded to match the requirements of cancer treatment from early-stage to late-stage disease with the aim of providing maximum benefit in each given case.
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