The ESMO Congress is a prestigious event in the activity of doctors working in the field of oncology

There are many reasons why especially medical oncologists, but also other doctors from different specialties who work in the field of oncology must follow the works of the ESMO Congress.

Unfortunately, the organization system is defective in selecting those who can participate in the event. In general, the sponsorship belongs to the pharmaceutical companies that choose the participants according to criteria known only to them. Some companies do not sponsor due to various issues that they take care of, such as the “command center” prohi­bits sponsorships in all countries where companies have branches. Perhaps it would be better if the companies sponsored the hospitals and within the hospitals each doctor would go once a year to a congress that debates current events in his specialty. Doctors who have a teaching or scientific title should be sponsored two times a year and those who have works accepted for presentation should be sponsored whenever they are in this situation.

Unfortunately, no regulation was created to bring order and emulation among doctors, to research more, to publish etc., to be sponsored several times. For now, it is the law of outlawry that we do not comment on.

Some elements resulting from the studies presented at the ESMO Congress that can change medical practice with examples in lung cancer

First of all, it emphasized tumor heterogeneity, which determines the different behavior in terms of evolution and therapeutic response of the same type of tumor.

Nicholas McGranahan, from the UCL Cancer Institute (London, UK), Chair of the special session on “Too Intractable’ Tumors”, stated that, in fact, the three principles of evolution by natural selection (variation, inheritance, selection) apply to cancer. “Intra-tumor diversity is a crucial aspect of why certain tumors are difficult to treat”, he said.

Referring to non-small cell lung cancer (NSCLC), Dr. Shaheenah Dawood, Head of Medical Oncology, Dubai Hospital, UAE, interviewed by ESMO, brought into discussion the importance of real-world data in guiding the treatment.

In real-life settings, more than 40% of NSCLC patients have poor performance status (ECOG 2) are elderly, have comorbidities and poor tolerance to treatments. These patients represent an under studied group, with a relatively poor prognosis and few treatment options.

Unmet need for new therapeutic strategies.

Other important research presented to the ESMO Congress regarding lung cancer were:

Tepotinib-osimertinib combination shows promise for NSCLC with MET amplification

Patients with EGFR-mutated NSCLC and acquired resistance to first-line osimertinib respond well when later given the tyrosine kinase inhibitor in combination with tepotinib.

David Planchard (MD, PhD) selected some of the key studies he is looking forward to at the meeting:

Data from the phase III CodeBreaK 200 study of sotorasib vesrus docetaxel for patients with previously treated non-small cell lung cancer and a KRAS^G12C mutation (abstract LBA10). Sotorasib has previously been shown to provide antitumor activity and a manageable safety profile, for which it received FDA accelerated approval in this setting.

Mature disease-free survival data from the phase III ADAURA trial of osimertinib as adjuvant therapy in patients with resected, EGFR-mutated, stage IB-IIIA NSCLC (abstract LBA47). The presentation at ESMO will show data for two additional years of follow-up, including patterns of recurrence and central nervous system disease-free survival in patients with early-stage lung cancer. Of note, osimertinib is the only FDA-approved targeted therapy in this disease setting.

Interim results from the phase II DESTINY-Lung02 trial of trastuzumab deruxtecan in patients with HER2-mutated metastatic NSCLC who have progressed following one or more systemic therapies (abstract LBA55).

Phase III CheckMate 816: analysis of pathological features and efficacy outcomes with neoadjuvant nivolumab with platinum-doublet chemotherapy in patients with resectable NSCLC (abstract LBA50).

Siow Ming Lee (MD, PhD), from the University College London, reported at the ESMO Congress that the two-year overall survival rate with atezolizumab was 24.3%, compared with 12.4% for single-agent chemotherapy.

Of course, the results of the studies in all forms of cancer were presented and can be consulted by ESMO members on the Oncology Pro platform.