Home / Innere Medizin / Onkologie / ESMO 2018: 55 take-home messages
Congress summary

ESMO 2018: 55 take-home messages

«A congress after which we have to change our practice,» was the conclusion of many experts interviewed by the medonline team during ESMO 2018. Here, we summarize their highlights from the congress.

Anal Cancer

  • First-line treatment with carboplatin/paclitaxel improves the survival of patients with anal carcinoma by eight months, defining a new standard (Rao S et al., Abstract LBA21).
Interview

Assoz.-Prof. Dr. Renate Schaberl-Moser,
Universitätsklinik für Innere Medizin,
Graz

 

Breast cancer

Advanced stage:

  • IMpassion130: Atezolizumab plus nab-paclitaxel improves the overall survival of patients with PD-L1 positive, triple-negative breast cancer (Schmid P et al., Abstract LBA1_PR).
  • SOLAR-1: The PI3K-Inhibitor alpelisib confers a significant progression free survival advantage for patients with PI3K mutated tumors (André F et al., Abstract LBA3_PR).
  • PALOMA-3: The improvement of overall survival with palbociclib is clinically relevant. CDK4/6 inhibitors continue to be definite constituents of therapy (Cristofanilli M et al., Abstract LBA2_PR).
ESMO 2018: Immunotherapy to improve outcome of triple-negative breast cancer

In this year’s ESMO’s first Presidential symposium, for the first time a survival benefit for patients with breast cancer treated with immunotherapy could be demonstrated.

Read article

Early stage:

Interview

OA Dr. Christoph Suppan,
Universitätsklinik für Innere Medizin,
Graz

Go to video

 

Cholangiocellular Carcinoma

  • S-1, an oral prodrug of 5-FU in combination with gemcitabine and cisplatin is a new and feasible first-line option for cholangiocellular carcinoma (Sakai D et al., Abstract 615O).
Interview

Assoz.-Prof. PD Dr. Armin Gerger,
Universitätsklinik für Innere Medizin,
Graz

Go to video

 

Nasopharyngeal and Oropharyngeal Cancers

ESMO 2018: First line immunotherapy extends survival in head and neck cancer

Pembrolizumab extends overall survival (OS) in advanced Head and Neck cancer with a PD-L1 expression rate of ≥1% - in spite of low response rates, and unchanged progression-free survival (PFS).

Read article
Interview

Assoz.-Prof. PD Dr. Armin Gerger,
Universitätsklinik für Innere Medizin,
Graz

Go to video

 

Colon Carcinoma/Colorectal Carcinoma

ESMO 2018: Immunotherapy in neoadjuvant setting for colon cancer

Checkpoint inhibitors have previously shown durable responses in metastatic colorectal cancers. A new study investigates whether neoadjuvant treatment works in mismatch repair deficient (dMMR) early-stage colon cancer.

Read article

ESMO 2018: Immunotherapy may become new first-line therapy for MSI-high mCRC

For the first time, a phase II trial shows a clear benefit for a first-line immunotherapy in patients with metastatic colorectal cancer with high microsatellite instability.

Read article
Interview

Assoz.-Prof. Dr. Renate Schaberl-Moser,
Universitätsklinik für Innere Medizin,
Graz

Go to video

 

Hepatocellular Carcinoma

Interview

Assoz.-Prof. PD Dr. Armin Gerger,
Universitätsklinik für Innere Medizin,
Graz

Go to video

Gastric Cancer

  • TAS-102, as the third line of therapy in advanced gastric cancer, improves overall survival by two months in third line for patients with gastric cancer (Arkenau H-T et al., Abstract LBA25).
Interview

Assoz.-Prof. PD Dr. Armin Gerger,
Universitätsklinik für Innere Medizin,
Graz

Go to video

 

Melanoma

  • CheckMate-067: The 4-year follow-up data demonstrate marked benefit for patients with nivolumab/ipilimumab, also in the group of PD-L1 high tumors (Hodi F et al., Abstract LBA44).
  • CheckMate-511 shows improved toxicity of a reduced dosing scheme of ipilimumab combined with standard nivolumab dose, at equal efficacy (Lebbé C et al., Abstract LBA47).
  • A phase-II trial demonstrates low response rate (11%) of nivolumab/ipilimumab in patients with metastatic uveal melanoma (Piulats Rodriguez JM et al., Abstract 1247 PD).
  • COMBI-Ad: The 4-year follow-up data of adjuvant dabrafenib/trametinib show a continued advantage over placebo (Long G et al., Abstract LBA43).
  • OpACIN-neo confirms the high response rate with neoadjuvant nivolumab/ipilimumab. The toxicity with the new dosing regimen is lower than in the prior OpACIN (Rozeman E et al., Abstract LBA42).
  • Phase-Ib/II: The combination of the intratumoral TLR9 agonist SD101/Pembrolizumab shows activity in anti-PD-1 treatment naïve patients with advanced melanoma (Long G et al., Abstract LBA45).
  • Phase-I/II: The TLR9 agonist tilsotolimod/ipilimumab also shows interesting signals in metastatic melanoma refractory to PD-1 inhibition (Diab A et al., Abstract 1245PD).
Breakfast Brief: Melanoma - New developments in sight

Melanoma has long been at the cutting edge of immuno-oncology research, which will likely continue. The way for future headlines is already paved.

Go to video
Interview

Univ.-Prof. Dr. Christoph Höller,
Universitätsklinik für Dermatologie,
Wien

Go to video

 

Renal Cell Carcinoma

  • JAVELIN Renal 101: Avelumab/axitinib improves the progression-free survival vs. sunitinib, and will probably become the standard of care in first-line therapy of RCC (Motzer RJ et al., Abstract LBA6_PR).
  • Gene-signatures of angiogenesis and immuno-oncology might help to select patients for first-line metastatic RCC treatment with either atezolizumab/bevacizumab or sunitinib in the IMmotion150 trial (Rini B et al., Abstract LBA31_PR)
Breakfast Brief: advanced Renal Cell Carcinoma

In this Breakfast Brief, PD Dr. Richard Cathomas, Kantonsspital Graubünden, Chur, presents his Immune-Oncology highlights of the first two days of ESMO Congress 2018.

Go to video
Interview

OA Dr. Thamer Sliwa
3. Medizinische Abteilung,
Hanusch-Krankenhaus Wien

Go to video

 

Lung Cancer

  • A small trial (33 pts) shows that the combination of neoadjuvant nivolumab and ipilimumab or nivolumab alone have similar outcomes in resectable NSCLC, with around 25% of major pathological response. However, tumors from the combination arm showed a higher rate of infiltrating T cells (Cascone T et al., Abstract LBA49).
  • An update of the ALTA-1L trial demonstrates superiority of brigatinib vs. crizotinib in intracranial response in patients with ALK-positive NSCLC and brain metastases. Newly developing brain metastases can be reduced by 50% with brigatinib compared to crizotinib (Popat S et al., Abstract LBA58).
  • A subgroup analysis of the ALEX trial comparing the new generation ALK TKI alectinib to crizotinib, showed that patients with all EML4-ALK variants tend to have a better outcomes with alectinib (Dziadziuszko R et al., Abstract 1379PD).
  • A phase-I trial shows that high GI toxicity of the ALK TKI ceritinib can be improved by reducing the dosage, with no reduction of efficacy (Cho BC et al., Abstract LBA59).
  • Preliminary data of the phase-III study FLAURA shows that in EGFR-positive NSCLC, a significant proportion (around 15%) of patients treated with osimertinib develop MET amplification or modification, or a EGFR C797S mutation (around 7%) (Ramalingam SS et al., Abstract LBA50).
  • The AURA-3 trial that compared osimertinib to chemotherapy in patients refractory to EGFR TKIs harboring the T790M mutation, generally supports the results of the FLAURA study, reveiling that amplifications of MET, HER2, and PIK3CA, or normally rare mutations in BRAF, KRAS and PIK3CA play a role in the resistance to osimertinib (Papadimitrakopoulou VA et al., Abstract LBA51).
  • The phase-II trial GEOMETRY shows that the MET inhibitor capmatinib is active in patients with high-level MET amplifications or Exon 14 MET mutations (Wolf J et al., Abstract LBA52)
  • A phase-II study combining the MET inhibitor tepotinib with gefitinib, shows good results in a subgroup of patients with high-level MET amplifications and MET protein overexpression compared to standard chemotherapy (Cheng Y et al., Abstract 1377O).
  • An update of the phase-II trial PACIFIC in patients with irresectable stage III NSCLC receiving combined radiochemotherapy followed by either durvalumab or placebo found that durvalumab efficacy (progression free survival, overall survival, and overall response rate) is not related to the time to durvalumab treatment after completion of radiochemotherapy (Faivre-Finn C et al., Abstract 1363O).
  • A small randomized phase-II trial in patients with refractory small-cell lung cancer showed that atezolizumab monotherapy shows inferior ORR compared to standard chemotherapy (Pujol J-L et al., Abstract 1664O).
  • The SAKK1512 trial implicates that early prophylactic cranial irradiation in patients with limited disease SCLC does not improve neurocognitive function compared to a sequential regimen (Vees H et al., Abstract 1667PD).
  • SPLENDOUR study: the RANKL inhibitor denosumab given in combination with standard first-line platinum-based chemotherapy does not improve the OS of patients with advanced NSCLC (Peters S et al., Abstract 1385PD).

ESMO 2018: NSCLC - Checkpoint inhibitors for early-stage disease

Growing evidence raises hopes for neoadjuvant checkpoint inhibition in early NSCLC. At ESMO 2018, exciting new preliminary phase II data from the NEOSTAR trial have emerged supporting this concept.

Read article

Breakfast Brief: An update on lung cancer

In this Breakfast Brief, PD DDr. Sacha Rothschild, Universitätsspital Basel, summarizes his personal highlights of the first two days of ESMO Congress 2018.

Go to video

Breakfast Brief: More lung cancer news

PD DDr. Sacha Rothschild from Universitätsspital Basel, reports about highlights, but also some disappointing news from day three of ESMO Congress 2018.

Go to video

Ovarian Cancer

  • SOLO-1 olaparib in the front-line maintenance setting sets a new standard in BRCA-mutated ovarian cancer (Moore K et al., Abstract LBA7_PR). The duration of maintenance therapy was 2 years in the SOLO-1 trial, the optimal duration is not yet clear. The PAOLA trial investigates olaparib/bevacizumab after completion of primary therapy also in BRCA wild type patients. The combination of a PARP inhibitor plus anti-angiogenic therapy might be promising (NCT02477644 bzw. AGO-Ovar 20).
  • HIPEC: Die Datenlage ist dünn und die Anwendung derzeit nur in Studien gerechtfertigt (Controversy Session, HIPEC: Is there a role in ovarian cancer?).
  • Studie 221 zeigt einen PFS-Vorteil durch zusätzliches peg. liposomales Doxorubicin nach platinsensitivem Rezidiv (Pfisterer J et al., Abstract 933O).
Interview

Univ.-Prof. Dr. Christian Marth,
Leiter der Universitätsklinik für Frauenheilkunde,
Innsbruck

Go to video

 

Prostate Cancer

  • GETUG-12: Adding docetaxel/estramustin in high risk, localized prostate cancer does not confer an overall survival advantage (Fizazi K et al., Abstract 791O).
  • STAMPEDE: Abiraterone plus predniso(lo)ne improves overall survival in hormone-sensitive metastatic low-risk prostate cancer (Hoyle AP et al., Abstract LBA4).
  • ERA 223: The combination of radium-223/abiraterone/predniso(lo)ne should not be used in asymptotic, chemotherapy-naïve castration-resistant prostate cancer with prevalent bone metastasis (Smith M et al., Abstract LBA30).
  • STAMPEDE: Patients with oligometastatic disease and low metastatic burden have a clear advantage of additional localized irradiation of the prostate (Parker C et al., Abstract LBA5_PR).
Interview

OA Priv.-Doz. Dr. Martin Marszalek,
Abteilung für Urologie und Andrologie,
SMZ Ost – Donauspital, Wien

Go to video

 

Sarcoma

Interview

Univ.-Prof. Dr. Thomas Brodowicz,
Universitätsklinik für Innere Medizin,
Wien

Go to video

 

CNS Metastasis and Glioma

  • Recurrent CNS metastases of NSCLC are often similar to the initial metastasis with respect to mutational burden and immune cell infiltration (Berghoff AS et al., Abstract 372O).
  • Intrathecal therapy of cytarabine improves progression-free survival of breast cancer with leptomeningeal carcinomatosis (Le Rhun E et al., Abstract 371O).
  • Glioma: Mismatch repair deficiency, a predictive marker for immunotherapy, is highly prevalent in recurrent gliomas (Lombardi G et al., Abstract 374O).
Interview

Dr. Anna Sophie Berghoff,
Universitätsklinik für Innere Medizin,
Wien

Go to video

Quelle: ESMO 2018

LOGIN

Login

Passwort vergessen?