ESMO 2020 – Solid Tumors – virtual
Lecture Board: Emiliano Calvo, MD, PhD; Andrés Cervantes, MD, PhD; Ronan Kelly, MD, MBA; Christian Schauer, MD
Medical Writer: Judith Moser, MD
Publishing Editor: Anna Fenzl, PhD
Preface – ESMO 2020 Solid Tumors
Preface – ESMO 2020 Solid Tumors Ronan Kelly, MD, MBA – Director of the Charles A. Sammons Cancer Center at Baylor University Medical Center – Dallas, Texas, USA Dear Colleagues, Notable advances that have been achieved in the treatment of solid tumors were discussed at the virtual ESMO Congress 2020, among them remarkable results obtained in the field of gastroesophageal tumors. …
...Milestones of PD-1 inhibition in gastric and esophageal cancer
Gastric cancer, gastroesophageal junction (GEJ) adenocarcinoma, and esophageal adenocarcinoma are substantial causes of cancer-related mortality worldwide and have poor 5-year overall survival (OS) when diagnosed at an advanced stage. Median OS with standard first-line chemotherapy for advanced or metastatic, HER2-negative gastric and GEJ cancer is less than 1 year.
Getting innovation from the laboratories into clinical practice
The ESMO congress has provided amazing new data on gastroesophageal cancer, and great contributions by different authors all over the world have been presented. Patients with advanced gastric cancer used to have a median overall survival of less than 1 year when treated with conventional chemotherapy. For the first time, this was prolonged to more than 1 year due to the addition of checkpoint inhibition.
Ovarian cancer: taking PARP inhibition one step further
Niraparib has been approved as maintenance treatment for patients with platinum-sensitive recurrent ovarian cancer (OC) based on the results of the NOVA trial. The starting dose used in NOVA was 300 mg orally daily. A retrospective analysis indicated that individualized starting doses based on baseline body weight and platelet counts might improve the safety profile of niraparib without compromising efficacy.
Novel combination approaches in various solid tumors
The anti-angiogenic multikinase inhibitor lenvatinib has been shown to exert immunomodulatory effects that enhance the anti-tumor activity of anti-PD-1 antibodies. In the early-phase setting, lenvatinib plus pembrolizumab induced partial responses in patients with different tumor types.
序言
2020年线上ESMO大会上讨论了在治疗实体瘤方面取得的显著进展，其中包括在胃食管肿瘤领域获得的引人注目的成果。对于患有转移性胃癌和食道癌的患者，长期结果仍然很差，并且最近几年进行的几项评估PD-(L)1抑制的临床试验显示出中等至阴性的结果。 但是，免疫检查点抑制在这些难于治疗的肿瘤中的治疗作用已于2020年9月显现，2020线上ESMO举行的主席研讨会完全专注于可能改变临床实践的在可手术疾病的转移条件以及辅助条件（首次）下的III期试验。
胃癌和食管癌中PD-1抑制取得的里程碑式进展
胃癌、胃食管连接部（GEJ）腺癌和食道腺癌是全球范围内与癌症相关死亡的重要原因，并且在晚期被诊断出时其5年总生存率（OS）较差。对于晚期或转移性HER2阴性胃癌和GEJ癌，标准一线化疗的中位OS不到1年。 一些针对胃癌和GEJ癌的抗PD-(L)1单一疗法的临床研究得到了阴性结果。然而，在2017年的随机化、双盲、安慰剂对照的III期ATTRACTION-2试验中显示，在至少两条先前治疗线之后，纳武单抗改善胃癌和GEJ癌患者的生存率。
将创新从实验室带入临床实践
ESMO大会提供了胃食管癌方面令人惊喜的新数据，并介绍了世界各地不同作者的巨大贡献。 接受常规化疗治疗的晚期胃癌患者的中位总生存期不到一年。由于检查点抑制的添加，该生存期首次延长到超过一年。在主席研讨会III上报告了两个随机化研究，表明在向常规化疗中加入纳武单抗后，胃癌和胃食管连接部癌患者的预后有所改善。
卵巢癌：将PARP抑制更进一步
根据NOVA试验的结果，尼拉帕利已被批准作为铂敏感性复发性卵巢癌（OC）患者的维持治疗。 NOVA中使用的起始剂量为每天口服300 mg。回顾性分析表明，基于基线体重和血小板计数的个性化起始剂量可能会改善尼拉帕利的安全特性，而不会影响疗效。该方法通过NORA研究在铂敏感性复发性OC的中国患者中进行了测试，这些患者具有高级别浆液性或高级别主要浆液性的组织学或有种系BRCA突变。
多种实体瘤中的新型组合方法
抗血管生成多激酶抑制剂乐伐替尼已显示出发挥免疫调节作用，增强抗PD-1抗体的抗肿瘤活性。 在早期条件下，乐伐替尼加派姆单抗在不同肿瘤类型的患者中引起部分缓解。正在进行的II期LEAP-005研究正在六种类型的经治疗晚期实体瘤中评估最多35个周期的乐伐替尼每日口服20 mg加派姆单抗200 mg Q3W。
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More InformationAndrés Cervantes talks about novel findings obtained in the field of gastric cancer, gastroesophageal junction adenocarcinoma and esophageal cancer as well as developments in hepatocellular carcinoma and investigational immunotherapies that might evolve into new treatment approaches.
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More InformationEric Van Cutsem gives an overview of practice-changing results obtained for gastrointestinal cancers including colorectal cancer, gastric cancer and esophageal cancer and describes progress that has recently been made with respect to certain biomarkers.
The ESMO congress has provided amazing new data on gastroesophageal cancer, and great contributions by different authors all over the world have been presented. Patients with advanced gastric cancer used to have a median overall survival of less than 1 year when treated with conventional chemotherapy. For the first time, this was prolonged to more than 1 year due to the addition of checkpoint inhibition.