W. Lybaert MD

Highlights in head and neck cancer

SUMMARY

The ASCO annual meeting was held from the 31^st of May until the 4^th of June 2024 in a live and virtual format. During this Meeting, HPV vaccination shows first encouraging prevention results towards head and neck cancer incidence in young persons. Intensity-modulated proton therapy beats intensity-modulated photon therapy as definitive treatment of oropharyngeal cancer regarding toxicity profile. Promising chemotherapy-free regimens are at the horizon in first-line treatment of recurrent/metastatic HNSCC, though more studies in larger patient populations are needed. Also HPV-targeting immunotherapy is entering in the neoadjuvant and metastatic HNSCC setting, studies are running. Antibody-drug conjugates are prudently looking for a place in later-line treatment of HNSCC. Metronomic chemotherapy shows a clinically very relevant OS benefit for ECOG 2 patients. Immunotherapy is promising in the neoadjuvant and adjuvant treatment of locally advanced nasopharyngeal carcinoma. FAPI PET-CT beats ¹⁸F-FDG PET-CT as imaging for medullary thyroid carcinoma.

In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(Belg J Med Oncol 2024;18(5):181–90)

Highlights of the 21^st annual European Neuroendocrine Tumour Society (ENETS) Conference

SUMMARY

During the ENETS Conference, the NETTER-2 trial was again in the spotlight and is shifting [177Lu]Lu-DOTATATE PRRT to the first-line treatment setting of patients with advanced, well-differentiated grade 2 and grade 3 gastroenteropancreatic neuroendocrine tumours (NET). Nuclear medicine treatment for NET is now intensively focusing on alpha-emitting peptide receptor radionuclide therapy (PRRT). Adding immunotherapy to angiogenesis inhibition for NET is again a disappointing story, and all eyes are now set on the CAR T-cell technology to stimulate anti-tumour immune responses. Delta-like ligand 3 is an inhibitory Notch ligand selectively and highly expressed on the cell surface of small cell lung cancer and neuroendocrine carcinoma, and appears to be a promising target for bispecific T-cell engager therapy. In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(BELG J MED ONCOL 2024;18(4):164–75)

Highlights of the Gastrointestinal Cancers Symposium 2024

SUMMARY

This year’s conference was organised in San Francisco from 18–20^th January 2024, again as a hybrid event. It was an excellent meeting, with TIGIT as new immune checkpoint target in oesophageal squamous cell carcinoma. Tinengotinib is a new fibroblast growth factor receptor (FGFR) inhibitor that enriches the armentarium for cholangiocarcinoma. Considering metastasis-directed therapy in oligometastatic pancreatic cancer is worth the effort. Shifting immunotherapy + angiogenesis inhibition to the transarterial chemoembolisation setting is the way forward in hepatocellular carcinoma. Nivolumab + ipilimumab is the second immunotherapy scheme that shows promising results in the first-line treatment of MSI-high/deficient mismatch repair (MMR) metastatic colorectal cancer. The prognostic role of circulating tumour DNA (ctDNA) in colorectal cancer stage II-III is highly consistent between studies, but its predictive role and how and which chemotherapy to use in case of ctDNA-positivity is more variable/immature at this moment and under active investigation. Top story of ASCO GI 2024 is peptide receptor radionuclide therapy (PRRT) entering the first-line treatment algorithm of high grade 2 and grade 3 gastroenteropancreatic neuroendocrine tumours. In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(Belg J Med Oncol 2024;18(3):95–108)

Highlights in head and neck cancer

SUMMARY

The ESMO Congress was held from 20 until 24^th October 2023 in a live and virtual format. During this Congress, the selective RET inhibitor selpercatinib in comparison with cabozantinib or vandetanib settled a new standard-of-care in the first-line treatment of unresectable locally advanced or metastatic RET-mutant medullary thyroid cancer. A meta-analysis of the use of anti-EGFR monoclonal antibodies refined the place of cetuximab in locally advanced (LA) head and neck squamous cell carcinoma (HNSCC). Pembrolizumab seems more efficacious and less immunosuppressive in an adjuvant compared to concomitant setting in LA HNSCC. Detection of circulating tumour DNA (ctDNA) seems feasible before and after curative-intent treatment for LA HNSCC and is strongly correlated with progression-free survival (PFS) and overall survival (OS). In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(Belg J Med Oncol 2023;17(8):286–91)

Highlights in head and neck cancer

SUMMARY

The ASCO Annual Meeting was held from 2–6 June 2023 in hybrid (live and virtual) format. During this meeting, neoadjuvant immunotherapy strategies are further entering the field of nasopharyngeal carcinoma (NPC) and head and neck squamous cell carcinoma (HNSCC). Immunotherapy + chemotherapy gains an overall survival (OS) benefit in first-line recurrent/metastatic (R/M) NPC. Promising chemotherapy-free regimens are at the horizon in first- and second-line treatment of R/M HNSCC, though more studies in larger patient populations are needed. Treating salivary gland tumours with prostate cancer products was not successful in two studies shown during the meeting.

In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(Belg J Med Oncol 2023;17(5):157–68)

Highlights from the European Neuroendocrine Tumour Society congress

SUMMARY

The 2023 edition of the European Neuroendocrine Tumour Society (ENETS) congress was held in Vienna between 22^nd and 24^th March. This article aims to provide an overview of the most remarkable findings and insights presented during this congress.

(BELG J MED ONCOL 2023;17(4):139–49)

Highlights of the ASCO Gastrointestinal Cancers Symposium 2023

SUMMARY

This year’s conference was organised in San Francisco from 19 until 21 January 2023, again as a hybrid event. It was an excellent meeting, not with the immune checkpoint inhibitors in gastroesophageal cancer in first position this time, like last year, but with two new promising targeted therapies in that tumour type: zolbetuximab and regorafenib. Immunotherapy is also pushing more in the neoadjuvant setting of MSI-high local/locally advanced gastric/gastroesophageal junction tumours. NALIRIFOX is a new chemotherapy scheme that beats gemcitabine + nab-paclitaxel in first-line metastatic pancreatic cancer, while the addition of nab-paclitaxel to cisplatin + gemcitabine in first-line advanced biliary tract cancer brings no advantage. Finally, yet importantly, trifluridine/tipiracil + bevacizumab outperforms trifluridine/tipiracil alone in later-line metastatic colorectal cancer. The combination of botensilimab + balstilimab is also very promising in this more refractory disease setting.

In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(BELG J MED ONCOL 2023;17(3):91–9)