Dear Colleagues,
I am delighted to introduce Medicom’s current ASCO 2020 conference report.
This could have been a yearly routine – but as everywhere in our private and professional life, COVID has changed it all! No live meeting this year – confinement obliges... Instead a huge virtual meeting with a record number of attendees. And, along with some remarkable study results in the treatment of solid tumors, this was the first major oncology conference to present results from the oncology community concerning management of our “high-risk” patients during times of the pandemic. Reassuringly, and with little surprise, mortality in cancer patients seems to correlate with advanced cancer stage, poor performance status and higher age…
To my mind, the general picture hasn’t become all that clearer, as “high-risk subgroups” are not necessarily the same according to different studies and results are still often based on retrospective data and generalized conclusions with little influence on patient management: If 78% of patients with lung cancer AND COVID needed to be admitted to the hospital (in the TERAVOLT registry), does this mean that all patients with lung cancer were screened for COVID? All registered? (certainly not!). So, what shall be the take-home message?? In COVID-times we are even more bombarded with sometimes immature or very partial results than before, with – to my mind – often little practical value, and a certain taste of the sensationalism and alarmism we got so familiar with in the lay press. Let’s hope that sound, thorough science and research will survive COVID…
Favorable pandemic “collaterals” are the advances of implementing telemedicine and home care, showing ever more the advantages beyond quality of life, as 2 interesting studies from the US and Italy show. There’s a lot more in ASCO 2020, here’s a sample:
- E2108 should settle the question of breast surgery’s benefit in systemically treated advanced breast cancer patients.
- Are all checkpoint inhibitors alike? Maybe not so. At least that’s what the most recent published study involving standard chemotherapy and immunotherapy, here pembrolizumab, seems to underline: unlike the studies with durvalumab and atezolizumab (both PD-L1 inhibitors), pembrolizumab did not show a survival benefit in advanced small cell lung cancer patients..
- Big news: the ADAURA study, showing very significant disease-free survival benefit using osimertinib in EGFRmutant resected lung cancer patients (after adjuvant chemotherapy): a first establishing an indication of targeted agents in the adjuvant treatment of oncogene-addicted localized non-small cell lung cancer.
- In bladder cancer, immunotherapy might be better administered as “adjuvant” after first line chemotherapy – a significant survival benefit: this is what JAVELIN Bladder 100 suggests with avelumab.., and it might also become a standard in adjuvant treatment of muscle invasive disease (atezolizumab in the IMVigor 010 study).
- ARAMIS and SPARTAN – and THeraP: hormonal and radionuclide treatment with big benefits in castration-resistant metastatic prostate cancer; Lu-PSMA has been widely used in countries where it is available – unfortunately without sound comparative survival data…
Check it out!
Yours, sincerely,
Stefan Rauh
Biography

Dr Stefan Rauh is currently working as haemato-oncologist 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 co-author 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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Table of Contents: ASCO 2020
Featured articles
COVID-19 & Telemedicine
COVID-19 and Cancer Consortium Registry: initial results
Oncology hospital-at-home model reduces hospitalizations, emergency department visits, and costs
Nurse-led telephone triage system reduces hospitalizations, helps patients manage symptoms at home
Melanoma
Adjuvant pembrolizumab: durable RFS for stage III melanoma
Adjuvant pembrolizumab: durable RFS for stage III melanoma
Pembrolizumab plus low-dose ipilimumab well tolerated after progression on PD1 antibody therapy
Toripalimab plus axitinib effective in metastatic mucosal melanoma
Breast & Ovarian Cancer
Advanced breast cancer: locoregional therapy does not improve OS
T-DM1 does not improve safety or efficacy in HER-2 positive early breast cancer; favorable iDFS reported
Maintenance olaparib improves OS in relapsed ovarian cancer with BRCA1/2 mutation
Combination pembrolizumab/chemo improves PFS in metastatic TNBC
Effect of veliparib with or without cisplatin in breast cancer: results of SWOG S1416
PHOEBE, a phase 3 trial comparing pyrotinib and lapatinib in HER2-positive metastatic breast cancer
BYLieve demonstrates efficacy of PIK3CA-directed treatment post CDK4/6-ihibition
Strategies emerge for chemotherapy de-escalation in HER2-positive breast cancer
Multiple Myeloma
Carfilzomib: no PFS benefit for multiple myeloma
Lung Cancer
ES-SCLC: tremelimumab + durvalumab + chemotherapy misses endpoint
Adjuvant osimertinib in NSCLC: practice changing ADAURA trial
ES-SCLC: pembrolizumab KEYNOTE-604 data
Second-line gemcitabine plus ramucirumab significantly improves overall survival
Tiragolumab and atezolizumab: ORR in NSCLC
MET-amplified advanced NSCLC responds well to MET inhibitor capmatinib
Genitourinary Cancer
Urothelial cancer: avelumab works as maintenance therapy
ARAMIS final OS and nmCRPC safety outcomes
Final survival results from phase 3 SPARTAN trial
Novel drug for kidney cancers/VHL patients
Primary analysis from IMvigor010, adjuvant atezolizumab in high risk muscle-invasive urothelial carcinoma
First randomised trial of Lu-PSMA in mCRPC progressing after docetaxel
Gastrointestinal Cancer
HER2-expressing metastatic colorectal cancer: trastuzumab deruxtecan
REGOMUNE: a phase 2 study combining regorafenib and avelumab
Cardiotoxicity: consider switching to S-1
Perioperative chemotherapy for resectable pancreatic ductal adenocarcinoma
Real-world data of sequential sorafenib followed by regorafenib in unresectable HCC
Paediatric Cancer
Sustained improvements in quality of life with larotrectinib
Promising first immunotherapy trial in placental trophoblastic tumours
Precision medicine for poor-prognosis paediatric patients
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Final survival results from phase 3 SPARTAN trial
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