Preface – EANM 2023
© Institut Jules Bordet – Magdalena Mileva, MD, Department of Nuclear Medicine, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
Dear Colleagues,
The 36th annual congress of the European Association of Nuclear Medicine (EANM) was held in Vienna, Austria, and virtually from 9th to 13th September. As always, the very much-anticipated event brought more than 7,600 leading experts from across the globe together to learn and discuss the groundbreaking updates and scientific advancements in nuclear medicine, which were covered in nearly 2,000 oral presentations and e-posters in 156 sessions.
The first chapter of this memo inOncology report sets the stage for groundbreaking new developments in the diagnosis of neuroendocrine tumors (NETs) and spotlights innovative approaches utilizing SSTR-antagonists such as 68Ga-DATA5m-LMA, [18F]-AlF-NOTA-LM3, [68Ga]Ga-DATA5m-LM4 or [99mTc]Tc-TECANT 1 radiotracers.
Subsequently, the latest advancements in NETs are highlighted with emphasis on combining radioligand therapy with standard treatments in patients with progressive advanced non-resectable gastroenteropancreatic NETs. Moreover, the utility of 177Lu-DOTATATE following peptide receptor radionuclide therapy (PRRT) in patients with bronchopulmonary neuroendocrine neoplasms and a personalized PRRT-regime using tailored 177Lu-DOTATATE activity in patients with overexpressing SSTR NETs are outlined.
The section on NET theranostics overviews the interim data of the first-in-class alpha-emitting radiopharmaceutical 225Ac-DOTATATE, data gleaned from a human pilot study with 212Pb-VMT-α-NET, as well as the promising prospects of personalized dosimetry-based PRRT, combining mixed doses of [177Lu]Lu- and [90Y]Y-DOTATATE. It further delves deeper into assessing the predictive potential of full-body longitudinal somatostatin receptor imaging features for predicting clinical outcomes in metastatic NET patients receiving PRRT.
Within the realm of prostate cancer, we witness the transformative potential of non-invasive nuclear medicine techniques, offering both diagnostic and targeted therapeutic solutions. Thus, this report accentuates the early prediction of response to 177Lu-PSMA therapy with 68Ga-PSMA or the new class of 18F-rhPSMA-7.3 PET/CT. Additionally, interim data on the utility of 18F-PSMA-1007 as a surrogate marker for 177Lu-PSMA imaging and treatment effectiveness are summarized.
Furthermore, this special issue encompasses the encouraging advances in PSMA-based therapy in metastatic castration resistant prostate cancer, including insights from the phase III ProstACT GLOBAL study, findings from the phase II IRST-185.03, an overview of the prospective national Swiss registry assessing 177Lu-PSMA for imaging and therapy, as well as a compilation of results from different combinations of 225Ac-TAT/177Lu-PSMA-I&T.
Finally, the section regarding further benefits of PET imaging in prostate cancer covers results from the VISION and the LuTectomy trial, while further discussing the implementation of PSMA-PET imaging after prostate cancer salvage radiotherapy in recurrent or persistent prostate cancer patients after surgery.
Once again, the EANM congress was not only a platform for exchanging groundbreaking scientific insights but also continued to bolster our growth as a specialist community. With the data presented, it is needless to say that the present of nuclear medicine is bright, and that the future holds even greater promise.
I hope you enjoy reading this special issue!
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Preface
The 2020 World Conference of Lung Cancer (WCLC) originally scheduled for August 2020 in Singapore had to be postponed to January 2021 due to the COVID-19 pandemic and was finally held as a worldwide virtual conference from 28th to 31st January. WCLC, which is the leading gathering of international scientists, researchers and patient advocates in the field of lung cancer and thoracic malignancies, continues to provide a forum to connect, share knowledge and learn about the latest developments in the research and treatment of these diseases.
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。
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。
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。
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。
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。