ESMO 2019 – Solid Tumors – Barcelona
Lecture Board: Hendrik-Tobias Arkenau, MD, PhD; Nicoletta Colombo, MD; Pascal Hammel, MD; Maha Hussain, MD;
Paolo Nuciforo, MD, PhD; Bertrand Routy, MD, PhD; Gert Schachtner, MD; Christian Schauer, MD; Agostina Stradella, MD
Medical Writer: Dr. Judith Moser
Preface
With “memo inOncology” Springer has created a medical education platform that is globally accessible and offers value to health care professionals in oncology (www.memoinoncology.com). Over the last four years, we have reported from major conferences such as ASCO, ESMO, WCLC, ELCC or ESMO Asia on recent highlights in the field of lung cancer.
PD-1 inhibition in gastric and esophageal cancer, hepatocellular carcinoma, and urothelial carcinoma
Adenocarcinoma of the stomach and gastroesophageal junction (GEJ) ranks fifth among the most common malignancies worldwide and is the third leading cause of cancer-related death in both sexes. Most patients are diagnosed at an advanced stage due to the asymptomatic early feature of the disease.
Potential role of the microbiome in carcinogenesis and response to checkpoint inhibition
Bacteria are of eminent importance for health and the functioning of the human body that contains more bacterial than human cells, at a ratio of 1.3 to 1. More than 10,000 different microbe species have been identified in the body. Ten to 100 trillion symbiotic microbial cells are harbored by each individual, primarily in the gut.
PARP inhibition in gynecological cancers: recent insights
Poly(ADP-ribose) polymerase (PARP) inhibitors have been established as an important drug class for the treatment of advanced ovarian cancer (OC), which is a leading cause of cancer deaths in women. Olaparib and niraparib have been widely approved for maintenance treatment of OC patients who responded to platinum-based chemotherapy.
New applications of PARP inhibitors
Metastatic castration-resistant prostate cancer (mCRPC) that progresses after androgen-receptor(AR)–targeted therapy (i.e., enzalutamide or abiraterone) and taxane-based chemotherapy is associated with a poor prognosis [1]. Only few treatment options are available for these patients.
Increasing PARP inhibitor activity via several mechanisms of action
Several studies showing favorable results with PARP inhibitors have been reported at this year’s ESMO Congress. In particular, the results of the PAOLA study can be considered a major breakthrough. The addition of olaparib to bevacizumab maintenance therapy in patients with ovarian cancer after first-line chemotherapy resulted in improved progression-free survival, not only in patients whose tumors were BRCA-mutant, but also in those with BRCA wildtype.
序言
借助“memo inOncology”，施普林格创建了一个能够全球访问的医学教育平台，向肿瘤学领域的医疗保健专业人士提供有价值的内容（www.memoinoncology. com）。在过去的四年中，我们报道了ASCO、ESMO、WCLC、ELCC或ESMO Asia等重大会议在肺癌领域的最新内容荟萃。我们的大会报告及其中文和日文译本在国际上受到了极大关注。
胃癌和食管癌、肝细胞癌以及尿路上皮癌中的PD-1抑制
胃和胃食管交界处（GEJ）发生的腺癌在全球最常见的恶性肿瘤中排名第五，在男性和女性中均为癌症相关死亡的第三大主要原因[3]。由于该疾病无早期症状的特征，因此大多数患者在晚期才得以诊断。尽管全球发病率下降且治疗取得显著进展，仍需进一步努力来改善预后。 食管癌在全球最常见的癌症中排名第七。
微生物组在癌变和对检查点抑制的应答中的潜在作用
细菌对于人体的健康和功能具有至关重要的作用，人体含有的细菌比人体细胞更多，比例为1.3:1。人体内已鉴定出超过10,000种不同的微生物物种。每个人都携带10至100万亿个共生微生物细胞，这些微生物主要在肠道中。它们的基因数量超过人类基因组的基因数量，比例大致为100:1。肠道微生物组完成了许多与免疫系统的代谢和调节有关的重要任务（表)。
妇科癌症中的PARP抑制：最新见解
聚(ADP-核糖)聚合酶（PARP）抑制剂已被确定为治疗晚期卵巢癌（OC）的重要药物类别，而晚期卵巢癌是女性癌症死亡的主要原因。奥拉帕尼（olaparib）和尼拉帕尼（niraparib）已被广泛批准用于对铂类化疗有应答的OC患者的维持治疗。在2019年ESMO大会上介绍的数据提供了有关在早期线中以及与其他药物类别组合使用PARP抑制的信息。
PARP抑制剂的新应用
在雄激素受体（AR）靶向治疗（即恩杂鲁胺（enzalutamide）或阿比特龙（abiraterone））和紫杉烷类化疗后发生进展的转移性去势抵抗性前列腺癌（mCRPC）与预后不良相关联。这些患者仅有很少的治疗选择。高达25 %的mCRPC男性在BRCA1、BRCA2、ATM或其他DNA损伤修复（DDR）基因中携带有害的种系和/或体细胞改变，包括在同源重组修复（HRR）中具有直接或间接作用的那些 。
通过多种作用机制提高PARP抑制剂活性
在本年度ESMO大会上报告了若干项研究，显示使用PARP抑制剂获得了有利结果。特别是，PAOLA研究的结果可以认为是一项重大突破。一线化疗后在卵巢癌患者的贝伐珠单抗维持治疗之外添加奥拉帕尼不仅在BRCA突变肿瘤患者中带来无进展生存期改善，而且在BRCA野生型患者中也是如此。在总人群中，PFS增加了6个月。
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EXPERT VIDEOS
All video interviews from ESMO 2019
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More InformationHendrik-Tobias Arkenau discusses combination studies of novel PARP inhibitors with other drugs.
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More InformationFlorian Lordick on the use of anti-PD-1 and other emerging therapies in gastric and oesophageal cancers.
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More InformationMarkus Möhler presents novel findings on anti-PD-1 therapies and explains differences regarding the outcome of anti-PD-1 therapies in Asian and Caucasian populations.
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More InformationSimon Chowdhury talks about the use of PARP inhibitors in prostate cancer as well as the impact of pamiparib in patients with advanced solid tumors.
Over the last four years, we have reported from major conferences such as ASCO, ESMO, WCLC, ELCC or ESMO Asia on recent highlights in the field of lung cancer. Our congress reports and translations thereof into Mandarin and Japanese have received great international interest.