Welcome to ESMO 2020
An overview of the sessions and attendees at ESMO 2020
The Annual Meeting of the European Society of Medical Oncology (ESMO) took place under a new virtual format on 19–21 September 2020, in collaboration with the European Oncology Nursing Society (EONS). Even during a pandemic, efforts to fight cancer do not stop and leading oncology experts from all corners of the world were reunited as one oncology community to share the latest advances in the field at the ESMO Virtual Congress 2020. Indeed, this year’s tagline of ‘Bringing innovation to cancer patients’ was particularly timely in the current era where there is an urgent need to put the latest real-world evidence into clinical practice. The ESMO Virtual Congress 2020 programme provided the first announcements of practice-changing data and ground-breaking translational cancer research that delegates have come to expect from the Society’s annual Congress.
“The ESMO Virtual Congress 2020 is certainly something new and different, but its essence is there: sharing the latest research results to bring innovations to patients with cancer. ”
Solange Peters, ESMO and Congress 2020 President
Genitourinary cancers
Renal cancer
Toni Choueiri, Dana-Farber Cancer Institute, Boston, USA, presented data from the Phase III CheckMate 9ER study which provided a new first-line (1L) treatment option for patients with metastatic kidney cancer (Abstract 696O_PR; NCT03141177). CheckMate 9ER took two monotherapies used in second-line (2L) treatment – nivolumab and cabozantinib – and combined them for use as a 1L treatment for comparison against sunitinib, the current standard-of-care. The combination was superior to sunitinib for progression-free survival (PFS), overall survival (OS) and response rate, with the risk of progression or death cut by almost 50% and response rate being doubled:
Median PFS data in the CheckMate 9ER study of patients with metastatic kidney cancer receiving ivolumab-cabozantinib vs. sunitinib
In addition, there was a consistent benefit of the combination over sunitinib in numerous subgroups including:
Benefits of nivolumab-cabozantinib in subgroups of patients in the CheckMate 9ER study
Dr Choueiri highlighted that the combination of nivolumab and cabozantinib will be an important treatment option to choose from, particularly given that clinicians are already familiar with both drugs.
“Findings from CheckMate 9ER add to the mounting evidence showing the advantages of combination therapy over single drugs in renal cell cancer.”
Toni Choueiri, Dana-Farber Cancer Institute, Boston, USA
Prostate cancer
Median rPFS in the IPATential150 study of patients with mCRPC and PTEN loss
Phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) and androgen receptor signalling are dysregulated in metastatic castration-resistant prostate cancer (mCRPC). PTEN loss, globally reported in 40–50% of patients with mCRPC, results in activation of AKT and poor clinical outcomes. Primary analysis of data from the Phase III IPATential150 study (NCT03072238) demonstrated that ipatasertib combined with abiraterone acetate plus prednisone led to significantly superior radiographic PFS (rPFS) and antitumour activity compared with placebo plus abiraterone and prednisone in patients with mCRPC with PTEN loss (LBA4).
“Combined androgen receptor (AR) and AKT blockade with ipatasertib plus abiraterone improves clinical outcomes over AR blockade with abiraterone alone for [patients with] PTEN-loss mCRPC, a poor-prognosis subset.”
Johann de Bono, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
Joaquin Mateo, Vall d’Hebron Institute of Oncology and Vall d’Hebron University Hospital, Barcelona, Spain, presented the final OS analysis of the PROfound study which demonstrated that olaparib – a poly (ADP-ribose) polymerase (PARP) inhibitor used to treat breast and ovarian cancer – can extend the lives of some men with prostate cancer (Abstract 610O; NCT02987543). In PROfound, olaparib was compared with the physician’s choice of enzalutamide or abiraterone in patients with mCRPC and homologous recombination repair gene alterations. Olaparib was found to be more effective than the modern hormone treatments, abiraterone and enzalutamide, at slowing down the growth and spread of prostate cancer in patients with advanced disease:
PROfound study: OS benefit with olaparib vs targeted hormone treatments
OS benefit with olaparib vs. targeted hormone treatments observed in the PROfound study
“PROfound is the first randomised study to prospectively demonstrate OS improvement in a molecularly-defined subset of prostate cancer, supporting the implementation of genomic testing in clinical practice.”
Joaquin Mateo, Vall d’Hebron Institute of Oncology and Vall d’Hebron University Hospital, Barcelona, Spain
There is an urgency to develop therapies with novel mechanisms of action to treat prostate cancers resistant to chemohormonal and radiation therapies. While immune therapies have offered limited efficacy in patients with mCRPC, prostate-specific membrane antigen (PSMA) has been identified as a clinically validated therapeutic target in prostate cancer. Ben Tran, Peter MacCallum Cancer Centre, Melbourne, Australia, reported data from a Phase I study of AMG 160 (NCT03792841), a half-life extended, PSMA-targeted, bispecific T-cell engager (BiTE®) immune therapy for mCRPC (Abstract 609O). AMG 160 engages a patient’s own T cells to kill prostate cancer cells via binding of CD3 on T cells and PSMA on cancer cells. Despite multiple prior lines of therapies, AMG 160 showed preliminary evidence of efficacy:
Preliminary data from a Phase I study of AMG 160 in patients with mCRPC
Among 15 patients with measurable disease, there were 3 partial responses and 8 patients with stable disease. The maximum tolerated dose for AMG 160 had not been reached and dosing optimisation continues to be studied.
“Use of AMG 160 appears to represent a tolerable and exciting therapeutic modality for men with mCRPC that warrants further investigation.”
Ben Tran, Peter MacCallum Cancer Centre, Melbourne, Australia
Nicholas James, Institute of Cancer Research, London, UK, presented long-term data from the STAMPEDE study (NCT00268476) which investigated the use of abiraterone acetate plus prednisolone in addition to androgen deprivation therapy (ADT) compared with ADT alone in patients with metastatic hormone-sensitive prostate cancer (Abstract 611O). In this updated analysis with a median follow-up of 6.1 years, a total of 329 deaths were observed among patients randomised to ADT alone versus 244 randomised to ADT in combination with abiraterone acetate and prednisolone.
Key findings from the STAMPEDE study
Five-year OS was 60% with abiraterone acetate and ADT compared with 41% among those patients receiving ADT alone – this corresponded to a 40% relative improvement in survival (HR 0.60; 95% CI: 0.50, 0.71)
In absolute terms, median survival was 6.6 years among those receiving abiraterone acetate and ADT versus 3.8 years among those receiving ADT alone – an absolute median survival benefit of 2.8 years
PFS was similarly improved (HR 0.58; 95% CI: 0.49, 0.69) with an absolute survival difference of 2.5 years
Efficacy data from the STAMPEDE study
Closing Remarks
In summary, ESMO 2020 was a successful virtual meeting with delegates having had the chance to remotely access new data, clinical experiences, patient perspectives, and best practices that will hopefully stimulate new ways of thinking and ultimately translate into optimal patient care within the oncology field. In addition, with the ongoing COVID-19 pandemic and the shift to distance learning and virtual meetings, ESMO acknowledged this opportunity to further extend their educational reach by providing accessible virtual content to physicians located in regions far removed from the cancer conference circuit.
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