Breast, Lung and Ovarian Cancer Studies Star at ESMO 2019

Bringing together nearly 30 thousand oncology professionals, the European cancer congress ESMO 2019will take place from 27 September - 1 October in Barcelona, Spain.

The European Society for Medical Oncology (European Society for Medical Oncology, ESMO) has supported cancer research worldwide, particularly in Europe, since its founding in 1975.

This year saw record attendance and research submissions, with 2200 original studies accepted. There are also 92 late-breaking abstracts whose results have not yet been announced.

The most notable studies expected to change clinical practice this year concern breast, lung and ovarian cancers.

At the ESMO Congress, one of the world’s two largest oncology meetings, this year will bring "highly innovative strategies" in immunotherapy and "many developments" in precision medicine, according to ESMO Press & Media Chief Dr. Pilar Garrido.

New Results from Breast Cancer Clinical Trials

The most discussed breast cancer trials this year were expected to be long-term results of CDK 4/6 inhibitor studies in advanced hormone-positive tumors resistant to hormonal suppression: MONARCH-2 of abemaciclib (Verzenio) plus fulvestrant, and MONALEESA-3 of ribociclib (Kisqali) plus fulvestrant.

A Change in Standard Ovarian Cancer Treatment?

Several studies appear potentially capable of changing standard ovarian cancer treatment.

PAOLA-1 investigated maintenance olaparib (Lynparza) plus bevacizumab in advanced ovarian cancer treated with platinum-based chemotherapy (LBA-2).

The key point is that this potential dual maintenance/preventive strategy applies to all patients regardless of BRCA1 / 2 mutation status.

New Lung Cancer Data

Lung cancer will feature two studies—one on when to use immunotherapy, the other on precision medicine.

FLAURA was conducted in EGFR mutation-positive patients, representing 10% to 13% of non-small cell lung cancer.

We knew osimertinib (Tagrisso), the experimental arm, was the ideal first-line treatment for advanced EGFR-positive lung cancer, but this year we will hear overall survival results (LBA-5).

The other study is a long-awaited immunotherapy combination trial: CheckMate 227. Nivolumab (Opdivo) plus low-dose ipilimumab (Yervoy) was compared with platinum-based chemotherapy in advanced non-small cell lung cancer. Tumor mutational burden was used as a biomarker for patient selection.

Previously reported progression-free survival and response rates were striking, but overall survival results showed no significant improvement.

This year, results will be based on another biomarker already used in clinical trials, programmed death ligand 1 (PD-L1) . These new data will show whether combined immunotherapy can replace chemotherapy in some patient groups (LBA-4).

Rare Cancers

ClarIDHy will present ivosidenib (Tibsovo) versus placebo in patients with IDH1 mutation-positive tumors, a very rare form of advanced cholangiocarcinoma (bile duct cancer) (LBA11).

If positive and sufficiently favorable, this could provide an effective option among every 6 patients for 1 with this advanced disease. These patients currently have very few options, so the results may be compelling.

IMvigor130 will compare immunotherapy atezolizumab (Tecentriq) versus placebo added to platinum chemotherapy in previously untreated locally advanced or metastatic urothelial carcinoma (bladder cancer).

INVICTUS, a double-blind, placebo-controlled phase 3 trial, will present results testing the new agent ripretinib as at least 4th-line treatment in gastrointestinal stromal tumors (LBA87).

Sessions beyond new clinical data include a symposium focusing on oncologist burnout and related psychological support.