The March of Immunotherapy Continues at ESMO 2020

Liam Davenport

September 14, 2020

The use of immunotherapy for upper gastrointestinal tumors and renal cancer, ALK- and EGFR-targeted agents in non–small cell lunger cancer (NSCLC), and the next step in personalized prostate cancer management will all be subjects of headlining presentations at the ESMO Virtual Congress 2020.

The conference will, like so many other major events, be held online this year because of the COVID-19 pandemic.

John B. Haanen, PhD, ESMO 2020 scientific chair, who is from the Netherlands Cancer Institute, Amsterdam, the Netherlands, told Medscape Medical News that because the congress is being held online this year, fewer abstracts were submitted; nevertheless, "We were very happy too see...that the quality was very good."

The number of submissions was not the only problem the organizing committee had to face in transforming the ESMO Congress into a virtual meeting.

They were unable to fit the scientific and educational programs together and so have had to split them over two consecutive weekends. Moreover, many of the sessions were highly interactive and needed to be either adapted or omitted.

"So the program is somewhat different," Haanen said. He noted that "the presentations were also made shorter, especially on the educational sessions, because...we can't expect people to sit behind screens for hours listening to long presentations."

He added: "That was out of the question."

Haanen is nevertheless hopeful that the virtual meeting will be "very exciting."

Solange Peters, MD, PhD, ESMO president, who is also affiliated with the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, said in a press conference that it was a "sacrifice" to move ESMO 2020 online and that "there were very sad moments" when deciding on the content.

However, there were some benefits from the change.

She said that all of the ESMO meetings this year have seen "huge" increases in the number of attendees and the geographical span or reach of each of the conferences.

"So suddenly you also realize that, what is one of the missions of ESMO being to convey education globally...was probably better reached, better achieved with the virtual format," she commented.

Presidential Symposia

Turning to the program, Haanen first picked out the third presidential symposium, which will be held on Monday, September 21. This will focus entirely on upper gastrointestinal tumors in both the adjuvant and metastatic setting.

He said that in recent years, "very little progress has been made" in this area, with treatment mostly consisting of chemotherapy and chemoradiotherapy.

However, this year's presentations will explore the addition of immunotherapy either to chemotherapy or as an adjuvant treatment following completion of standard-of-care treatment for local disease.

Haanen said that the results will be "very interesting...and may change current practice," something that "is very important for both doctors and their patients."

On Saturday, September 19, the first presidential symposium will include two presentations on lung cancer that Haanen said will offer some "exciting new [results] that I am sure will change clinical practice."

One will be on the CROWN phase 3 trial comparing lorlatinib and crizotinib in the first-line treatment of patients with advanced ALK-positive NSCLC.

The other will present results on central nervous system disease recurrence from the ADAURA phase 3 trial of osimertinib adjuvant therapy in patients with resected EGFR-mutated NSCLC.

The same session will also see new data in advanced renal cell carcinoma from CheckMate 9ER, in which the c-Met and VEGFR2 inhibitor cabozantinib (Cabometyx) was combined with nivolumab (Opdivo) and compared to sunitinib (Sutent) in untreated patients.

"Last year, there were already some exciting results of the combination of axitinib [Inlyta], either with pembrolizumab [Keytruda] or with avelumab [Bavencio] the first-line setting in metastatic clear cell renal cell lung cancer," Hannen said.

"Clearly there was a survival advantage over the standard of care, sunitinib," he added.

This year, not only will efficacy data from CheckMate 9ER be presented but also quality-of-life results.

"That's very important, because what everybody is afraid of is that, by adding drugs, you always get more impact on the quality of life, but you will see that the quality-of-life results are very exciting," he said.

The second presidential symposium will feature studies on prostate cancer, notably the phase 3 IPATential150 trial of abiraterone (Zytiga) plus either ipatasertib or placebo in metastatic castration-resistant prostate cancer.

Ipatasertib targets Akt, and Haanen said that "by adding it to, let's say, standard-of-care treatment...the question of course of will be, Does that have a better outcome?"

He believes the results will be a "very nice illustration" that prostate cancer management is heading in the direction of personalized treatment.

Alongside the presidential symposia, there will be a number of proffered paper sessions on the latest results in all aspects of oncology, including results from the ASCENT trial in triple-negative breast cancer, as well as a dedicated COVID-19 track.

Haanen said that the ESMO Virtual Congress 2020, coming after the AACR and ASCO annual meetings, has the "advantage" of being able to present the latest outcomes of patients treated with chemotherapy and immunotherapy against the backdrop of the pandemic.

This will include a study from the ESMO Resilience Task Force on the impact of COVID-19 on oncology professionals both in terms of their personal distress and burnout and their job performance.

"I think that is very important," Haanen said, "especially because the whole thing with COVID-19 is not yet over, and everybody is preparing for a second wave in the fall and winter.

"It may help us give us clues on how we can protect ourselves or each other to prevent burnout or other problems that we as healthcare caregivers face in this difficult period."

Next Year

For next year, Peters remains hopeful that the ESMO 2021 meeting will take place as planned in Paris.

She anticipates that, indeed, ESMO meetings will be able to take place from spring next year.

This will depend on a vaccine for COVID-19 becoming widely available, although oncologists in some countries may still not be able to travel.

This means "starting probably with hybrid formats, with some of the faculty being on site and some not, [and] the same thing for the attendees," Peters said.

She suggested that for ESMO Congress 2021 to work as an on-site meeting will require at least half or two thirds of the originally anticipated number of attendees.

"I hope that Paris next year will happen," Peters said, adding that it "will probably happen with less attendees ― that's fine, but [still] with a large number of faculty and attendees."

The commentators have disclosed no relevant financial relationships.

European Society for Medical Oncology (ESMO) Annual Meeting 2020.

For more from Medscape Oncology, join us on Twitter and Facebook.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.