Highlights from

ESMO 2019

European Society for Medical Oncology Congress 2019

Barcelona 27 September - 01 October 2019

Interview with Prof. Josep Tabernero, ESMO President (2018-2019)

Conducted on 7 October 2019 by Dr Rachel Giles

Josep Tabernero is President of ESMO and Director of the Vall d’Hebron Institute of Oncology, in Barcelona, Spain, and Head of Medical Oncology at Vall d’Hebron University Hospital. He leads translational research and phase 1 studies, with special emphasis on ERK and PI3K pathway inhibitors and novel immunotherapies, and is also involved in phase 2 and 3 studies with new chemotherapy agents against gastrointestinal tumours.

ESMO: Pushing the Boundaries Beyond Standard of Care

ESMO is the leading European professional organisation for medical oncology. As President of ESMO, Prof. Tabernero talks to Medicom about some of the many ESMO 2019 Congress highlights and future directions in the field.

Medicom: What were the emerging trends from the ESMO 2019 Congress? JT: There were many exciting developments at several levels. If we look at the science, we had breaking data on new indications and tumour subtyping, advances in personalised and genomic-driven targeted therapies, and novel insights into immune checkpoint inhibitors as monotherapy and in combination. Importantly, considering the 20 years’ chaptering of the promise and pitfalls of PARP inhibitors (PARPi), we have now seen that they are delivering on their promise in the BRCA-mutant as well as the BRCA non-mutant population of ovarian cancer in the first-line setting, as maintenance therapy, and also in combination with chemotherapy in breast cancer. Congress conversations were also triggered by the first ever data showing that PARPi seem to really benefit a population of patients with advanced prostate cancer that have different DNA repair alterations.

In other tumour types new data presented compounds that are related to a genomic dysregulation of malignant cells; for example, the IDH1-mutated population in biliary tract cancer in the second line setting, where survival benefit with ivosidenib was reported. Findings on CDK inhibitors in the first-line setting in patients with metastatic ER+ breast cancer, as well as survival data with osimertinib; patients with EGFR mutations in the first-line setting, were also presented. As we all keenly anticipated, more data on immune checkpoint inhibitors for first-line therapy against gastric cancer, non-small cell lung cancer, and bladder cancer, among others, showcased throughout the course of our meeting. The first results on immunotherapy as neoadjuvant treatment in the triple-negative breast cancer population also headlined. The bottom line here is that immunotherapy is moving forward to earlier settings of different tumour types.

As interestingly, results from the BEACON CRC phase 3 study showed that the triple or double combination of cetuximab, encorafenib, and binimetinib, significantly improves overall survival compared with standard of care in patients with BRAF V600E-mutant metastatic colorectal cancer.

During a special symposium on precision medicine, results reported by a Dutch consortium showed benefit in patients with very advanced disease who received treatment with experimental therapies based on tumour exome sequencing.

Beyond the myriad of preclinical, translational, and clinical advances to first outing during the Congress, our Society is dedicated to offering a comprehensive, multidisciplinary educational programme that draws the attendance of many other stakeholders in oncology, also spanning several different specialties. It is thanks to the broad scope and appeal of our meetings that our educational agenda represents a must-attend for basic researchers, epidemiologists, oncologists, radiotherapists, surgeons, nurses, and, as importantly, patient advocates. Reflective of this essential connectivity, this year’s meeting was also co-organised in collaboration with the European Association of Cancer Research (EACR), and the European Oncology Nursing Society (EONS). Such important partnerships are key as we join together to advance cancer treatment and care aimed at improved outcomes for those who matter most – our patients. But finally, and as crucially, I must also mention the work that ESMO is doing in the public policy arena as it strives to promote the best cancer care and cancer care access worldwide. With regards to anti-cancer medicines, many initiatives driven by ESMO, including its Magnitude of Clinical Benefit Scale and Essential Medicines group, tackle important issues including essential cancer drug shortages. Also, in the area of innovative and more expensive medicines, we are creating models that promote value in cancer care that could ultimately facilitate value-based reimbursement in different parts of the world.

My next point on public policy is that ESMO has a deep-rooted and great collaboration with patients and advocacy groups in order to promote the best cancer care, as well as essential cancer prevention initiatives. Our policy-oriented partnering with advocacy groups does not only include our Congress’ public policy track, but also many other activities throughout the year that help to firmly position cancer at the forefront of policy-making processes and agenda-setting. These include close collaboration with the World Health Organization, including our attendance at its World Health Assembly meetings, where ESMO is invited for official comment on topics of importance for the practice of medical oncology and the care of cancer patients. Needless to say, we are extremely proud of all the collaborations that ESMO shares, develops, and nurtures with different professional societies, advocacy groups, and international organisations.

Medicom: What are the unmet needs? Where should resources be allocated?

JT: We need to invest much more in prevention and education for prevention. Between 40-50% of cancers could be prevented, or diagnosed early through well-established screening programmes. This is an area where we need to invest in and develop those actions that are going to be most effective in achieving these goals. We must all consequently focus more attention on prevention programs and allocate the necessary resources to this area of high priority.

Top image: STEVE GSCHMEISSNER / SCIENCE PHOTO LIBRARY

Article image: Medicom

The content and interpretation of these conference highlights are the views and comments of the speakers/authors.