T. Feys MBA, MSc

Highlights from the 2017 Society of Gynecologic Oncology (SGO) annual meeting on women’s cancer

SUMMARY

From 12–15^th March, the Society of Gynecological Oncology hosted its 48^th annual meeting. The meeting continues to be one of the key educational and scientific events for physicians treating and caring for women with gynaecologic cancer. This summary will discuss some of the key studies presented during the meeting, with a focus on medical oncology. For a complete overview of abstracts presented in National Harbor we refer to the Society of Gynecological Oncology website: www.sgo.org.

(BELG J MED ONCOL 2017;11(3):134–137)

Highlights in oncology 2016

SUMMARY

Every year brings new knowledge and insights that help to direct research that ultimately leads to improved care for patients with cancer. This report, which is based on the clinical cancer advances 2017 article published by the American Society of Clinical Oncology, reviews the most important advances made in the different fields of oncology that are most likely to impact daily clinical practice.¹ Over the last few years, immunotherapy has become a new treatment option for patients with a growing number of cancer types. Building on the initial successes with immunotherapy, a key next step is to understand why currently fewer than half of patients benefit from immunotherapy and why the benefit, if it occurs, may be short lived. In 2016, several reports revealed early insights into patient and cancer characteristics that might predict whether immunotherapy could work well in an individual patient. Many studies also assess whether combining immunotherapy with other cancer treatments might extend the potential of this new group of therapies.

A second part of this report focuses on targeted therapies. The research into cancer biology is propelling rapid development of novel treatments targeting the key molecules that allow cancers to grow and spread. In 2016, this strategy resulted in new targeted therapies for patients with advanced lung, breast, and kidney cancer, as well as several hard-to-treat forms of blood cancer. In addition to this, new molecular technologies are emerging that can quickly pinpoint molecular changes in the tumour or free-floating cancer DNA in the blood.

(BELG J MED ONCOL 2017; 11(2):37–45)

The role of immunotherapy in non-metastatic non-small cell lung cancer

The progress that has been made in the last decades in the treatment of stage IV non-small cell lung cancer (NSCLC) has overall not been translated to the curative setting of stage I to III disease. In fact, the list of failed clinical trials aimed at improving the cure rates in this setting is long. The successes with immune checkpoint inhibition in stage IV NSCLC formed the basis to also study these agents in the curative NSCLC setting. Several studies are underway evaluating the potential of adjuvant immune checkpoint inhibition in stage II and IIIA disease and promising data have also been generated in the pre-operative setting. In addition to that, immune checkpoint inhibition is also being studied as consolidation treatment following chemoradiotherapy in locally advanced, unresectable NSCLC. The PACIFIC trial forms the first of these studies to yield results and showed that the PD-L1 inhibitor durvalumab significantly prolongs the progression-free survival (PFS) compared to placebo in patients with locally advanced, unresectable stage III NSCLC. More mature (overall survival, OS) results of this study are eagerly awaited as are the results of the other clinical studies evaluating immune checkpoint inhibitors in the curative NSCLC setting.

Highlights in thoracic oncology

Summary

The main focus of attention at ESMO 2016 in the filed of lung cancer was again the use of checkpoint inhibitors. Two studies evaluating a PD1-inhibitor in the first line treatment of metastatic non-small-cell lung cancer (NSCLC) were presented with conflicting results. In addition to this, positive results with the PD-L1 inhibitor atezolizumab were presented together with promising findings with neo-adjuvant nivolumab in the management of early stage NSCLC. ESMO 2016 also featured important data on (new) targeted agents. In this light, the results of the ASCEND-5 study, assessing the efficacy and safety of ceritinib in patients with advanced ALK+ NSCLC who progressed on prior crizotinib and chemotherapy, were presented. Also the final results of the phase III LUX-Lung 7 study, and of the IMPRESS trial will be discussed in this summary. Finally, data were presented with the MEK inhibitor selumetinib in advanced NSCLC.

(BELG J MED ONCOL 2016;10(8):319–24)

Breast cancer highlights

(BELG J MED ONCOL 2016;10(8):308–13)

Broadening the possibilities for checkpoint inhibitors

The past years brought early reports suggesting that immune checkpoint inhibitors targeting PD-1 and PD-L1 are effective across a range of different cancer types, beyond melanoma and lung cancer. A particularly encouraging finding was that immunotherapy was effective against many tumors that were resistant to traditional treatments.

The CTLA-4 and PD-1/PD-L1 pathways: leading the way in cancer immunotherapy

The cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) and programmed death 1 (PD-1) / programmed death-ligand 1 (PD-L1) immune checkpoints are negative regulators of the T-cell immune function. Inhibition of these targets, resulting in an increased activation of the immune system, has led to new immunotherapies for melanoma, non–small cell lung cancer, and other cancers. To set the stage for the impressive clinical data that have been produced with these agents, this introductory article will describe the similarities and differences of both pathways and will touch upon the implications of their inhibition.