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An Expert’s Guide to ESMO 2021: A Preview of the Top Abstracts

Eva M. Ciruelos, MD, PhD

Associate Professor
Medicine and Surgery
Complutense University
Medical Oncologist, Breast Cancer Coordinator
Medical Oncology Dpt, Hospital 12 de Octubre and HM Hospitales
Madrid, Spain

Eva Ciruelos, MD has disclosed that she has received consulting fees from AstraZeneca, DSI, Lilly, MSD, Novartis, Pfizer, and Roche, and fees for non-CME/CE services from AstraZeneca, DSI, Lilly, Merck Sharp & Dohme, Pfizer, and Roche.

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Karim Fizazi, MD, PhD

Full Professor
Cancer Medicine
Gustave Roussey
Villejuif, France

Karim Fizazi, MD, PhD, has disclosed that he has received consulting fees from AAA, Amgen, Astellas, AstraZeneca, Bayer, Clovis, CureVac, ESSA, Genentech, Janssen, Merck Sharp & Dohme, Orion, and Sanofi.

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Eric Van Cutsem, MD, PhD

Professor of Medicine
University of Leuven
Head, Digestive Oncology Unit
University Hospital Gasthuisberg
Leuven, Belgium

Eric Van Cutsem, MD, PhD, has disclosed that he has received consulting fees from AbbVie, Array, Astellas, AstraZeneca, Bayer, Beigene, Biocartis, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Daiichi, Halozyme, GSK, Helsinn, Incyte, Ipsen, Janssen Research, Lilly, Merck Sharp & Dohme, Merck KGaA, Mirati, Novartis, Pierre Fabre, Roche, Seattle Genetics, Servier, Sirtex, Terumo, Taiho, TRIGR, and Zymeworks and research grants from Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Ipsen, Lilly, Merck Sharp & Dohme, Merck KGaA, Novartis, Roche, and Servier.

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Vamsidhar Velcheti, MD

Associate Professor, Thoracic Oncology
Director, Thoracic Oncology Program
Department of Medical Oncology
New York University
New York, New York

Vamsidhar Velcheti, MD, has disclosed that he has received consulting fees from Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Foundation Medicine, Merck, and Novartis.

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Released: September 15, 2021

During the 2021 ESMO Congress, exciting and important results from many clinical trials will be reported. In this commentary, oncology experts have highlighted the abstracts they are most looking forward to. We will cover these abstracts in more detail as a part of CCO’s Independent Conference Coverage of ESMO 2021. As the meeting unfolds, remember to check the CCO website for downloadable slidesets including the data from these highlighted studies and more. After the conference, we will also have CME-certified online activities and expert analyses and perspectives on the clinical implications of these new data. 

Top Picks: Genitourinary Cancers
Several studies in genitourinary cancers with the potential to change practice are being reported at the 2021 ESMO Congress.

Karim Fizazi, MD, PhD: In prostate cancer, we are anticipating the late-breaking abstract with results from the STAMPEDE trial (abstract LBA4_PR) of abiraterone acetate with or without enzalutamide added to androgen-deprivation therapy in the adjuvant setting in men with high-risk localized disease. The previous analysis, reported in 2017, supported a notable effect on prostate-specific antigen–driven relapse-free survival, and they are looking forward to seeing the updated data.

Their colleagues will also report the overall survival data from the PEACE-1 trial (abstract LBA5_PR), which evaluated a triple systemic combination of androgen-deprivation therapy, docetaxel, and abiraterone in men with de novo metastatic prostate cancer. They previously reported a progression-free survival benefit with the addition of abiraterone with nearly 2.5 additional years without progression or death. They will also report quality-of-life results with lutetium-PSMA-617, which was previously shown to improve overall survival in the phase III VISION trial (abstract 576MO).

Among new agents, we will see preliminary data from the phase IB COSMIC-021 trial (abstract LBA24) of cabozantinib in combination with atezolizumab in patients with metastatic castration-resistant prostate cancer.

In bladder cancer, I am looking forward to seeing the efficacy data from the phase III GETUG/AFU VESPER V05 trial (abstract 652O) of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) or gemcitabine and cisplatin as perioperative chemotherapy for patients with muscle-invasive bladder cancer. The results of this trial should help us decide whether we should favor dd-MVAC or gemcitabine and cisplatin as the preferred regimen for neoadjuvant therapy.

Top Picks: Gastrointestinal Cancers

Eric Van Cutsem, MD, PhD: In gastrointestinal cancer, there are 3 late-breaking abstracts of interest. New data will be presented on the CheckMate 649 trial (abstract LBA7) evaluating nivolumab plus chemotherapy or ipilimumab vs chemotherapy alone as first-line treatment for advanced gastric, gastroesophageal junction, and esophageal adenocarcinoma in patients with a PD-L1 combined positive score ≥5. Results from the other 2 arms of the CheckMate 649 trial with FOLFOX (oxaliplatin, leucovorin, and fluorouracil) or XELOX (oxaliplatin plus capecitabine) with or without nivolumab were presented previously at ASCO 2021. I am also looking forward to the preliminary analysis of a phase II trial evaluating the antibody–drug conjugate trastuzumab deruxtecan (T-DXd) in patients metastatic or unresectable, HER2-positive gastric or gastroesophageal junction cancer who have progressive disease on or after a trastuzumab-containing regimen (abstract LBA55). Finally, at the 2021 ESMO Congress, we will see results of the phase III EPOCH study (abstract LBA21). This is an important study evaluating chemotherapy with radioembolization vs standard chemotherapy as second-line treatment of metastatic colorectal cancer. The results from all 3 of these studies are highly anticipated and could greatly influence clinical practice.

Top Picks: Breast Cancer

Eva Ciruelos, MD: A few interesting late-breaking abstracts will also be presented in breast cancer. We will see final results from the KEYNOTE-355 trial (abstract LBA16). This is the first phase III trial that has shown efficacy of pembrolizumab in combination with different chemotherapy backbones (nab-paclitaxel, paclitaxel gemcitabine, or carboplatin) in triple-negative advanced breast cancer. After the voluntary withdrawal of the indication for atezolizumab plus nab-paclitaxel in metastatic triple-negative breast cancer whose tumors express PD-L1 based on questions regarding efficacy of atezolizumab in combination with a taxane regimen and with positive results with neoadjuvant pembrolizumab plus paclitaxel and carboplatin in the KEYNOTE-522 trial for patients with stage II or III triple-negative breast cancer, the KEYNOTE-355 trial results are awaited with anticipation.

I am also looking forward to the results of the global phase III DESTINY-Breast03 trial (abstract LBA1). T-DXd is a novel antibody–drug conjugate that targets HER2 antigen and has shown revolutionary results in a phase Ib trial in patients with heavily pretreated HER2-positive advanced breast cancer. This trial was designed to compare T-DXd vs trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer in the second line. These results may be practice changing and could affect the current landscape of breast cancer treatment. Finally, I am looking forward to results from the phase III SYD985.002/TULIP trial (abstract LBA15) comparing [vic-]trastuzumab duocarmazine, a new anti-HER2 antibody–drug conjugate, vs physician’s choice of treatment in patients with previously treated HER2-positive locally advanced or metastatic breast cancer. If these data are positive, trastuzumab duocarmazine may be a potential new option in the rapidly evolving treatment landscape for these patients.

Top Picks: Lung Cancer

Vamsidhar Velcheti, MD: In lung cancer, we will also see the release of late-breaking abstracts with preliminary data of the phase II DESTINY-Lung01 trial (abstract LBA45) of T-DXd in patients with HER2-mutated metastatic non-small-cell lung cancer and the phase I TROPION-PanTumor01 (abstract LBA49) trial evaluating datopotamab deruxtecan, an anti-TROP2 antibody, in patients with advanced or metastatic non-small-cell lung cancer and actionable genomic alterations. I am also excited about the 3-year overall survival results from the phase III CASPIAN study (abstract LBA61). This study assessed durvalumab and platinum/etoposide with or without tremelimumab in first-line extensive-stage small-cell lung cancer.

Remember to Check the CCO Website Often During and After ESMO!
Downloadable slideset summaries of these studies and more will be available on the CCO website as the data are released. After the Congress, comprehensive analyses by our expert faculty members will explore the clinical implications of the data in CME-certified text-based modules.

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