Tom Feys MBA, MSc

Highlights in breast cancer

During the 2020 Virtual ESMO meeting, long-awaited results were presented of several important breast cancer studies. For hormone receptor positive (HR+) breast cancer, ESMO 2020 featured conflicting results on the use of CDK4/6 inhibitors in the adjuvant treatment of patients with hormone-receptor positive (HR+) early breast cancer. In HR+ metastatic breast cancer, final overall survival data were presented of the SOLAR-1 trial evaluating alpelisib in PIK3CA mutant patients. In triple negative breast cancer (TNBC), new data on immune therapy were presented. In early-stage TNBC, the addition of atezolizumab to neoadjuvant chemotherapy resulted in a significant increase in the rate of pathological complete responses (pCR). In the metastatic setting, final results of the IMpassion130 trial confirmed the benefit of atezolizumab combined with nab-paclitaxel as first-line treatment for metastatic PD-L1 positive TNBC. Unexpectedly, the IMpassion131 trial evaluating atezolizumab plus paclitaxel in first-line treatment of patients with metastatic TNBC failed to meet its primary endpoint. Finally, the phase III randomized controlled ASCENT trial identified the antibody-drug conjugate (ADC) sacituzumab govitecan as a safe and highly effective treatment option for heavily pre-treated metastatic TNBC patients.

Highlights in respiratory oncology

At ESMO 2020, again many interesting studies in the field of respiratory oncology were presented. For non-metastatic non-small cell lung cancer (NSCLC), there was a focus on neoadjuvant immunotherapy, adjuvant treatment with osimertinib and post-operative conformal radiotherapy. When addressing metastatic NSCLC, much attention went to combination strategies such as combining EGFR and VEGF inhibitors, an EGFR-MET antibody plus a tyrosine kinase inhibitor or VEGF and PD-1 inhibitor combinations. In addition, the question was raised on whether immunotherapy can cure metastatic NSCLC. Finally, this overview will describe important results in the field of non-metastatic and metastatic small-cell lung cancer (SCLC).

Highlights in melanoma

Summary

Over the last decade, the treatment of advanced melanoma underwent a dramatic improvement. Initially, immune checkpoint inhibitors and targeted agents proved their worth in the treatment of advanced, unresectable melanoma patients. More recently, however, interest grew in combining both these therapeutic approaches in patients with BRAF mutant advanced melanoma. During ASCO 2020, results were presented of two clinical trials evaluating this strategy. Following the initial successes in the unresectable melanoma setting, immune checkpoint inhibition and targeted therapy were also evaluated as adjuvant therapy in patients with resected stage III melanoma. At ASCO 2020, updated results were presented of two pivotal trials in this setting, while other studies looked into the potential benefit of using immune checkpoint inhibitors as neoadjuvant therapies, rather than in the postoperative setting. In addition to this, immunotherapy also proved to have potential in the treatment of patients with mucosal melanoma, or leptomeningeal disease.

(BELG J MED ONCOL 2020;14(5):209-15)

Highlights in breast cancer

Summary

During the 2020 Virtual ASCO meeting, no less than 226 presentations were dedicated to breast cancer. It is beyond the scope of this article to discuss all these abstracts, but instead we try to focus on the data that are most relevant for your daily clinical practice.

(BELG J MED ONCOL 2020;14(5):191-200)

Highlights in geriatric oncology

Summary

Cancer is primarily a disease of older adults, and as a result improving the care for older patients with cancer is becoming increasingly important. In this respect, the 2020 virtual ASCO meeting featured a fascinating and very important session entitled “You’re only old once: improving outcomes for older adults with cancer.” In this session, positive results were presented of four randomised controlled trials evaluating whether or not geriatric assessment has the potential to improve treatment outcomes in older patients with cancer. Three of these trials focused on the geriatric management of patients receiving chemotherapy or other cytotoxic agents, while a fourth study evaluated to what extent perioperative oncogeriatric management could improve the outcome of patients undergoing surgery for gastrointestinal cancer. Overall, all these studies indicate that an integrated geriatric oncology assessment provides an important clinical benefit to older cancer patients.

(BELG J MED ONCOL 2020;14(5):218-21)

Highlights in gynaecological cancers

Summary

The highlights in gynaecologic cancers from ASCO 2020 include data on the role of secondary cytoreductive surgery for women with recurrent ovarian cancer as well as several abstracts on the use of PARP-inhibitors in patients with platinum-sensitive relapsed ovarian cancer. In addition, several presentations focused on novel therapeutic strategies for patients with ovarian cancer, including immune-checkpoint inhibitors and the antibody-drug conjugate mirvetuximab soravtansine. Finally, the effectivity of sequential chemoradiation and the combination of the anti-PD1 antibody camrelizumab with the VEGF-targeting agent apatinib in patients with cervical cancer will be discussed.

(BELG J MED ONCOL 2020;14(5):227-32)

Highlights in genito-urinary cancer

(BELG J MED ONCOL 2020;14(5):233-40)