In this episode, Medicom’s correspondent covers 6 presentations from the European Society of Medical Oncology (ESMO 2021), held virtually from 16-21 September 2021. Medicom also interviews the presenter of the DESTINY-Breast03 trial, Prof. Javier Cortés, from Barcelona, Spain, included also in this podcast.
The topics discussed are: CDK4/6 inhibitor ribociclib added to endocrine therapy extends overall survival (OS) in treatment-naïve postmenopausal patients with HR-positive/HER2-negative, advanced, metastatic breast cancer. Data from the MONALEESA-2 trial presented at the ESMO Congress 2021 showed that after a median follow-up of >6.5 years, median OS was 12 months longer for first-line ribociclib plus letrozole versus placebo plus letrozole.At a prespecified interim analysis of DESTINY-Breast03, comparing trastuzumab deruxtecan (T-DXd) head-to-head with trastuzumab emtansine (T-DM1), T-Dxd reduced the risk of disease progression or death by 72% compared with T-DM1. There is an exclusive interview with the presenter Prof. Javier Cortés at the end of this podcast. The first interim analysis of KEYNOTE-716 suggests adjuvant pembrolizumab to be superior to standard-of-care observation for adults and children with completely resected high-risk melanoma.The phase 3 CASPIAN trial demonstrated first-line treatment with durvalumab plus platinum–etoposide (EP) to improve overall survival (OS) versus EP alone in patients with extensive stage small-cell lung cancer (SCLC). Three-year median follow-up demonstrates sustained OS benefit.Updated results from the CheckMate-649 study report continued improvement of overall survival (OS) with nivolumab plus chemotherapy versus chemotherapy alone in patients with advanced gastric cancer/gastroesophageal junction cancer/oesophageal adenocarcinoma (GC/GEJC/EAC). In contrast, there was no OS benefit with nivolumab plus ipilimumab versus chemotherapy. An exploratory analysis from the Impower010 trial adds support to the use of post-chemotherapy adjuvant immunotherapy for selected early stage non-small cell lung cancer (NSCLC).
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Table of Contents: ESMO 2021
Featured articles
Breast Cancer
Trastuzumab deruxtecan triples PFS
Novel conjugate meets primary endpoint
Longest survival benefit from first-line CDK4/6 inhibitor
Meta-analysis shows 6-months adjuvant trastuzumab is optimal
Double-positive results for triple-negative metastatic breast cancer
Survival after neoadjuvant therapy with trastuzumab-lapatinib plus chemotherapy
Postmenopausal breast cancer: extended letrozole reduces recurrence
Asian women also benefit from palbociclib plus letrozole
No PEARLs of survival with palbociclib plus endocrine therapy compared with capecitabine, but QoL better
Gastrointestinal Cancer
Neoadjuvant chemotherapy potential alternative to neoadjuvant chemoradiotherapy in LARC
Immune chemo-sensitisation looks promising in microsatellite-stable mCRC
Adagrasib shows promising clinical activity in heavily pretreated KRAS-mutated CRC
Automated detection of microsatellite status on unstained samples in early colon cancer
Consistent benefit of anti-PD-1 therapy for oesophageal and gastric cancer
HIPEC in gastric cancer with peritoneal metastases
ctDNA highly predictive in HER2-positive, advanced gastric or gastro-oesophageal junction cancer
Lung Cancer
Robust anticancer activity of trastuzumab deruxtecan in HER2-mutated NSCLC
Nivolumab/ipilimumab continues to provide survival benefit in unresectable MPM
Adjuvant atezolizumab lowers relapse rate in resected NSCLC
Three-year OS follow-up from CASPIAN trial
TCR clonality predicts pembrolizumab response in NSCLC
Melanoma
Adjuvant immunotherapy reduces risk of disease recurrence in stage II melanoma
IFN-γ signature predicts response to immunotherapy
Updated results of SECOMBIT trial
Combining T-VEC and pembrolizumab does not significantly improve survival in advanced, unresectable melanoma
Durable intracranial responses with nivolumab/ipilimumab
Genitourinary Cancer
TKI drug-free interval strategy not detrimental to conventional continuation strategy in RCC
Modified ipilimumab schedule reduces risk of grade 3/4 adverse events
Optimal neoadjuvant dose ipilimumab/nivolumab in stage III urothelial cancer
Better survival with neoadjuvant dose-dense MVAC regimen in MIBC
PARP inhibitor rechallenge improves PFS in ovarian cancer
Pembrolizumab prolongs survival in persistent, recurrent, or metastatic cervical cancer
Pembrolizumab has durable effect in previously treated MSI-H/dMMR advanced endometrial cancer
HRR mutational status is prognostic and predictive biomarker olaparib activity
Haematological Cancer
Mutational analyses are predictive in malignant lymphomas
Low numbers of M2 macrophages in tumour microenvironment associated with superior response to immunotherapy in Hodgkin lymphoma
COVID-19
Adequate response to SARS-CoV-2 vaccine in cancer patients
Cancer patients more likely to die from COVID-19 when hospital admittance is required
Third global survey of the ESMO Resilience Task Force
High COVID-19 mortality in Swiss cancer patients
Basic Science & Translational Research
Neutrophils negatively correlate with response to anti-PD-1 monotherapy in dMMR tumours
Tetraspecific ANKETs harnesses innate immunity in cancer therapies
Early ctDNA reduction in metastatic uveal melanoma correlates better with OS than RECIST response
Gut microbiota as a potential predictive biomarker
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