It is my pleasure to share with you our summary of this year’s annual meeting of the American Society of Clinical Oncology (ASCO), which took place as usual in Chicago.
You will find challenging results, both intellectually speaking as well as clinical: Are there intrinsic differences in CDK4 inhibitors or should we further define hormone receptor-positive metastatic breast cancer (mBC) patients who could best benefit from treatment? We will have to look closer to HER2 status results from our patients, as mBC patients seem to benefit from the targeting conjugate agent trastuzumab deruxtecan – even if they have low expression! Personalised medicine for BC advances with new potentially clinical relevant prognostic biomarkers both in locally advanced BC as well as in ductal carcinoma in situ.
As invasive treatments become safer and easier accessible, there is a tendency to integrate them more and more in oligometastatic disease. A new study provides evidence that this may not be beneficial in BC, underlining the need for evidence-based treatment decision-making rather than “common sense”. And maybe I should mention the highly paradigm-changing LUMINA study which may lead to spare patients with very early, good prognosis BC to undergo adjuvant radiotherapy (of course, peer-reviewed published results as well as more long-term follow-up are mandated).
In non-small cell lung cancer, long-term (5 yr) results of the Checkmate 224 trial seem to point to a clear advantage of double checkpoint inhibition over standard chemotherapy with quite impressive overall survival results even in patients with low or absent PD-L1 scores.
New patients with rectal cancer may have lately approached you, declaring that they no longer required surgery nor radiotherapy, just this new drug from America… This somewhat misleading information derives from a phase 2 study with neoadjuvant dostarlimab (a PD-1 inhibitor) in mismatch repair-deficient stage II and III rectal adenocarcinomas – leading to a 100% response rate (yes it is!) – without concurrent or consecutive chemo- or radiotherapy, clearly showing the power of immune checkpoint blocade in microsatellite instability-high or mismatch repair-deficient tumours. However, it is too early to conclude practice changes for our localised or locally advanced rectum cancer patients.
This is of course just my selection of our selection of ASCO this year. So, please sit back and check out what is new as from today, on your own.
Dr Stefan Rauh is currently working as haematooncologist in the oncology department of Centre Hospitalier Emile Mayrisch, Esch, Luxembourg. He is mainly involved in clinical work but also in research and teaching activities and is interested in public policy and international cooperation projects in oncology. He is member of the ESMO Practicing Oncologist’s Working Group since 2011 (chair 2014-2018), member of the ESMO Public Policy Committee, and has been an ESMO Executive Board member in 2015-2016. He is coauthor of the 2017 ESMO European Cancer Patient Coalition (ECPC) Patient Survivorship Guide and an invited expert for the ECPC.
Conflict of Interest Statement: Nothing to declare.
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