Roxanne Nelson

September 20, 2012

September 19, 2012 — The 2012 European Society for Medical Oncology (ESMO) Congress, being held September 28 to October 2 in Vienna, Austria, promises to be a record-breaking meeting; 16,500 attendees are expected and about 2200 abstracts were submitted for consideration (up 30% from previous years).

The key message this year is that "personalized medicine is becoming a reality," according to Josep Tabernero, MD, chair of the ESMO 2012 Scientific Committee.

Some of the results being presented will be practice changing and some will provide more options to patients, Dr. Tabernero told Medscape Medical News. Importantly, "we are going to have data presented from about 410 phase 3 trials," he noted.

In addition, there will be about 50 late-breaking abstracts, which is an increase over previous years. "The late breakers give late news that has just become available in the previous few weeks," he explained, adding that they usually contain "last-minute statistical analyses of phase 3 studies."

Practice-changing data will be presented in the fields of lung cancer, renal cell carcinoma, sarcoma, and HER2-positive early breast cancer. There will also be data presented on other cancer types "including hepatocellular carcinoma, melanoma, and gastrointestinal cancers, especially colorectal," said Dr. Tabernero.

Focus on Personalized Medicine

There will be a strong focus on personalized medicine. Different subtypes of tumors are being identified, which could lead to changes in treatment protocols. "This is rapidly evolving," he explained. "The key message for the future of medical oncology is that we can't treat all patients in the same manner.... We have to identify the primary drivers of the tumors and identify which patients will benefit from one treatment and not from another."

One of the most important examples of personalized medicine to be presented is of a drug designed for specific alterations in patients with advanced lung cancer, explained Dr. Tabernero. "We have the final data showing an advantage in survival, but the key message is that we have reduced the time of the bridge between basic science to the clinical setting, where patients can benefit from the drug. The data we present today will be applicable to the patients tomorrow," he noted.

Clinical Results and Expert Discussions

Clinical results from and/or expert discussions on the following will be presented:

  • crizotinib (Xalkori, Pfizer) in a molecularly defined subset of patients with lung cancer (first phase 3 trial)

  • sorafenib (Nexavar, Bayer) used in heavily pretreated patients with lung cancer (first positive biomarker analysis)

  • a new drug option and different strategies that target renal cell carcinoma

  • combination therapy with MEK and BRAF inhibitors showing a "clinically meaningful" response in delaying resistance in patients with melanoma

  • determining the standard duration for adjuvant treatment of HER2-positive early and metastatic breast cancer

  • defining the role of targeted treatments for esophageal cancer that progresses after chemotherapy for gastrointestinal tumors

  • the use of combination therapies for gastrointestinal tumors in a specific ethnic group

  • new targets and targeted agents for hepatocellular carcinoma

  • a new predictive marker for the antiangiogenic treatment of tumors of the central nervous system

  • a drug combination opportunity for patients with platinum-resistant recurrent ovarian cancer

  • a long-term study comparing single and combination chemotherapy for the first-line treatment of advanced soft tissue sarcoma

Other Conference Highlights

There will once again be an extensive program geared toward cancer patients. It will address patient awareness and understanding of personalized medicine, the lack of understanding of risk factors for cancer by the general public and oncology professionals, the need for thrombosis prophylaxis in cancer patients, and the accessibility of pain killers.

Among the topics covered in the special symposiums is the impact of genetic information on clinical practice. According to Judith Balmaña, MD, who will cochair that session, approximately 10% of the most prevalent cancers are related to a genetic mutation.

Although the causes of some familial cancers are not currently known, it is expected that more such genetic mutations will be identified in the near future, Dr. Balmaña, who is from the Medical Oncology Department at the Vall d'Hebron University Hospital in Barcelona, Spain, said in a statement.

"It is important to note that the proportion of hereditary cancers may be higher among less common tumors," she noted. "It is crucial to identify these patients to offer them and their family members personalized management for the risk of secondary tumors and to administer adequate measures for cancer prevention," she explained.

The economic burden (direct and indirect) of cancer in Europe, health economics, and drug costs will be discussed by experts at the meeting.

The unsustainability of cancer care "is a very important subject, and there are going to be good sessions on this topics," said Dr. Tabernero. "The cost of healthcare is a worldwide problem."

Society needs to be able to pay for the therapy, which is where personalized medicine comes into play. "We need to focus on particular patient populations, to give the right treatment to the right person," Dr. Tabernero said. "We have to define the populations who will benefit."

Our patients deserve "treatment options that have clinically meaningful benefits rather than statistically meaningful benefits," he noted.

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