Preface – ESMO Lung Cancer 2023

© private – Paul Baas, MD, PhD, Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands

© private – Paul Baas, MD, PhD, Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands

Dear colleagues,

It is a pleasure to present you the memo inOncology 2023. This time we report on the ESMO Congress held in Madrid, Spain, from 20th to 24th October 2023.  It was an outstanding scientific and educational event with more than 33,000 participants from 155 countries. Of the 2,545 presented abstracts reported, fifteen abstracts were selected for presidential symposia to discuss the most exciting updates, practice-changing data, and high-quality education across different tumor types.

This issue of memo inOncology summarizes highlights in the field of lung cancer starting with insights into emerging new therapies. Chapter one draws attention to the ALK inhibitor alectinib, which has been established as a new treatment strategy in patients with resected, stage IB-IIIA NSCLC. Moreover, significant improvements in perioperative IO treatment were reported pembrolizumab and nivolumab in the KEYNOTE-671 and CheckMate 77T trials, respectively.   Analyses of the CheckMate 816 and RATIONALE-315 studies further underscore the benefits of adding immunotherapy to neoadjuvant chemotherapy.

In the field of molecular alterations, new trials were reported, with agents directed against RET, Trop-2, KRASG12C and HER2. Selpercatinib has shown interesting activity in patients with RET-positive disease, while datopotamab deruxtecan has demonstrated antitumor activity in patients with and without targetable driver aberrations.

In the setting of advanced EGFR-mutated NSCLC, the combination of amivantamab and lazertinib outperformed osimertinib in the MARIPOSA trial and represents a new first-line treatment standard. Moreover, amivantamab/lazertinib plus chemotherapy and amivantamab/chemotherapy demonstrated clinical benefit in EGFR-mutated advanced NSCLC after disease progression on osimertinib. In addition, amivantamab plus chemotherapy was shown to be effective in the treatment of advanced NSCLC with EGFR exon 20 insertion mutations.

Furthermore, immunotherapy combinations in advanced-stage NSCLC with failure on EGFR- or ALK-targeted treatment were reported. A combination of atezolizumab and bevacizumab with chemotherapy has demonstrated efficacy in this setting. The results of the PERLA trial indicate superiority of dostarlimab plus chemotherapy over pembrolizumab plus chemotherapy. The SAPPHIRE trial, however, did not show any advantage for the combination of sitravatinib and nivolumab compared to docetaxel. Further research is required to identify effective treatments after development of resistance to checkpoint inhibition in NSCLC.

Finally, in the field of the very resilient small-cell lung cancer, potential new treatment avenues were outlined, including the DLL3-targeted agents BI 764532 and tarlatamab (a bispecific antibody).

Once again, numerous ground-breaking studies were presented at this year’s ESMO meeting that are primed to change the standards of cancer care. Therefore, I strongly recommend you to take the opportunity to catch up on some of the most significant data and discover how they will impact your daily practice.

Enjoy discovering this special memo inOncology issue!