The ESMO 2024 Congress was held in Barcelona from 13 to 17 September and showcased several key breakthroughs and practice-changing developments across a variety of cancer types. In this article, Alcimed highlights five major innovations in oncology which emphasizes the growing role of immunotherapy and targeted therapies.
One of the major highlights was the NIAGARA trial for muscle-invasive bladder cancer (MIBC). This Phase III study showed that combining durvalumab (Imfinzi) with neoadjuvant chemotherapy and adjuvant durvalumab monotherapy, significantly improved both event-free survival (EFS) and overall survival (OS) compared to chemotherapy alone. With a 32% reduction in event free survival and a 25% reduction in mortality, this regimen is poised to become a new standard of care for perioperative treatment in bladder cancer. The safety profile was manageable, making this combination a practice-changing option.
Anti-TIGIT therapies have not been very successful so far. This year, GSK/iTeos showed data from their Anti-TIGIT mAB belrestotug in combination with Jemperli (dostarlimab) a PD-1 inhibitor. It demonstrated renewed promise in patients with non-small cell lung cancer (NSCLC) expressing high levels of PD-L1. A Phase II trial showed a 59.4% objective response rate (ORR), outperforming PD-1 monotherapy. Despite the immune-related adverse effects, the findings bring new life regarding the potential of TIGIT inhibitors for boosting the immune response in cancer treatment. GSK/iTeos plan now a phase III study.
KRAS has long been called the undruggable target. KRAS G12D therapies, particularly Astellas’s ASP3082 degrader, were highlighted, but results were underwhelming. In a phase 1 trial, ASP3082 demonstrated only an 8% overall response rate (ORR) among 65 patients with KRAS G12D-positive solid tumors. Astella now believes that dose escalation could potentially improve efficacy. There are concerns regarding dose-limiting toxicities such as liver enzyme elevations and neutrophil count decreases; Astellas believes they are manageable.
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Immunotherapy continues to show life-extending benefits in triple-negative breast cancer, one of the most aggressive breast cancer subtypes. Data presented confirmed long-term survival improvements if pembrolizumab is integrated into the treatment regimen, reinforcing the role of immunotherapy as a crucial component of the treatment paradigm for early-stage triple-negative breast cancer. However, the study also confirms that patients need to be carefully selected and monitored for any toxicities that may occur.
In metastatic castration-resistant prostate cancer (mCRPC), a new combination therapy involving enzalutamide and radium-223 showed promising survival outcomes. This means the radiopharmaceutical boosts the efficacy of the androgen-receptor pathway inhibitor. This combination offers a novel therapeutic option for patients who have exhausted other treatments, enhancing the potential for improved survival in advanced prostate cancer.
The ESMO 2024 Congress highlighted important advancements in cancer care, particularly in bladder cancer, lung cancer, prostate cancer, TNBC, and tumors harboring the KRAS G12D mutation. These breakthroughs emphasize the shift towards personalized medicine and combination therapies, marking a new era in oncology treatment that promises improved outcomes for patients across various cancer types. Alcimed can assist you with your projects related to oncology, don’t hesitate to contact our team!
About the author:
Volker, Great Explorer Oncology in Alcimed’s Healthcare team
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