Impressive Clinical Research Despite the Pandemic: European Cancer Congress ESMO 2021

Worldwide, oncology professionals are brought together by one of the two major congresses, the European Cancer Congress 2021, which this year, as in the previous year, due to the COVID-19 Pandemic, is taking place online. The event runs from September 17-21.

The European Society for Medical Oncology (European Society for Medical Oncology, ESMO) has pursued its mission of supporting cancer research from around the world, particularly Europe, since its establishment in 1975.

Despite the current health crisis and its impact on health research, the congress, being held virtually for the second time this year, demonstrates the revival of cancer research. This is very important, because the pandemic and mandatory lockdowns affected clinical trials profoundly.

Treatment Advances Highlighted at ESMO 2021

This year at ESMO 2021, gynecological (female-specific) and gastrointestinal cancers are seeing immunotherapy play an increasingly expanding role, the main feature of the clinical data presented.

Much of the clinical data to be presented at the congress focuses, across various cancer types, on immune checkpoint inhibitors as a class of immunotherapies.

In recent years, lung cancer, melanoma and breast cancer are among the cancers in which we have witnessed numerous major advances in molecular characterization (genetic classification) and treatment.

At ESMO Congress 2021, for mesothelioma, sarcoma and carcinoma of unknown primary (CUP), there will be fascinating patient results showing the need for more comprehensive molecular characterization (genetic testing) across all tumor types. Biomarker discovery and understanding have advanced, so it is now time to look ahead. With options we could not even have imagined until yesterday, it is exciting to learn how using targeted drugs in sarcoma and rare cancers will improve efficacy.

ESMO 2021 will also be a congress for early-stage lung cancer and melanoma, embracing immunotherapy for postoperative preventive treatments.

Finally, this will be the congress of eagerly awaited overall survival data in breast cancer and promising new targets and immune therapies in lung cancer.

The 2 most notable studies are as follows:

• For high-risk stage II melanoma, after complete surgical removal, pembrolizumab (Keytruda) adjuvant use versus placebo is examined in the trial KEYNOTE-716 and
• For stage IB-IIIA non-small cell lung cancer, the comparison of atezolizumab (Tecentriq) immunotherapy with best supportive care after adjuvant chemotherapy is included in IMpower010 study analyses.

Other highlights include:

• For treatment-resistant, recurrent or metastatic cervical cancer, comparing pembrolizumab + chemotherapy with placebo + chemotherapy in the phase III trial KEYNOTE-826 produced results to be presented,
• Comparing nivolumab (Opdivo) + chemotherapy or ipilimumab (Yervoy) with chemotherapy as first-line treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma, the CheckMate 649 study produced results,
• KRASG12C mutation -positive colorectal cancer patients received adagrasib (MRTX849, Mirati Therapeutics) as monotherapy or in combination with setuksimab in a phase 1/2 trial, KRYSTAL-1, whose results are included,
• The first international randomized study of malignant progressive pheochromocytomas and paragangliomas comparing sunitinib (Sutent) with placebo, FIRSTMAPPP, provides data,
• For men with high-risk nonmetastatic prostate cancer, comparing androgen deprivation therapy (ADT) alone with abirateron acetate + prednizolon, with or without enzalutamid, the  STAMPEDE protocol provides a pooled analysis,
• Abirateron acetate + prednizon is investigated for overall survival in a phase 3 trial, PEACE-1, which reports results in enrolled men with previously untreated advanced castration-sensitive prostate cancer.

COVID-19 Vaccination for Cancer Patients

Another focus of last year's congress was the impact of the COVID-19 Pandemic on cancer patients. This year, alongside data on the COVID-19 pandemic's impact on cancer patients, we will see results on the effects of COVID-19 vaccination on patients and their treatments. For example, the TRACERx Renal study's CAPTURE substudy examines adaptive immunity to SARS-CoV-2 infection and vaccination in cancer patients.

In the same session, vaccination against SARS-CoV-2 in patients receiving chemotherapy, immunotherapy or chemo-immunotherapy for solid (organ) cancers is examined in the VOICE study, whose data will be presented.

We will follow ESMO 2021 closely and share the studies' numerical results and our comments with you.