ESMO Open

Molecular Tumor Board of the University Medical Center Groningen (UMCG-MTB): outcome of patients with rare or complex mutational profiles receiving MTB-advised targeted therapy
de Jager VD, Plomp P, Paats MS, van Helvert S, Elst AT, van den Berg A, Dubbink HJ, van Geffen WH, Zhang L, Hendriks LEL, Hiltermann TJN, Hiddinga BI, Hijmering-Kappelle LBM, Jalving M, Kluiver J, Koopman B, van Kruchten M, van der Logt EMJ, Piet B, van Putten J, Reitsma BH, Rutgers SR, de Vries M, Stigt JA, Groves MR, Timens W, Willems SM, van Kempen LC, Schuuring E and van der Wekken AJ
Molecular tumor boards (MTBs) are considered beneficial for treatment decision making for patients with cancer with uncommon, rare, or complex mutational profiles. The lack of international MTB guidelines results in significant variation in practices and recommendations. Therefore, periodic follow-up is necessary to assess and govern MTB functioning. The objective of this study was to determine the effectiveness of MTB treatment recommendations for patients with rare and complex mutational profiles as implemented in the MTB of the University Medical Center Groningen (UMCG-MTB) in 2019-2020.
Prognostic value of tumor-infiltrating lymphocytes in distal extrahepatic bile duct carcinoma
Jun SY, An S, Hong SM, Kim JY and Kim KP
The assessment of tumor-infiltrating lymphocytes (TILs) has led to the development of various immunotherapies beyond their predictive potential in gastrointestinal malignancies. However, the clinicopathologic and prognostic values of TILs have yet to be well elucidated in distal extrahepatic bile duct carcinoma (DBDC).
Challenges in using tumor mutational burden as a post-treatment biomarker
Taban H and Ergun Y
Incorporating immunotherapy in the management of early-stage estrogen receptor-positive breast cancer
Nader-Marta G, Waks AG, Tolaney SM and Mayer EL
What constitutes meaningful benefit of cancer drugs in the context of LMICs? A mixed-methods study of oncologists' perceptions on endpoints, benefit, price, and value of cancer drugs
Datta SS, Sharma V, Mukherjee A, Agrawal S, Sirohi B and Gyawali B
The importance of surrogate endpoints, magnitude of clinical benefit of cancer drugs, and their prices have often been debated in the oncology world. No study, however, has systemically explored oncologists' perception regarding these issues.
Long-term outcomes of PARP inhibitors in ovarian cancer: survival, adverse events, and post-progression insights
Tuninetti V, Marín-Jiménez JA, Valabrega G and Ghisoni E
Poly-ADP-ribose polymerase inhibitors (PARPis) have revolutionized the management of BRCA-mutated (BRCA) and homologous recombination deficiency (HRD)-positive ovarian cancer (OC). While long-term analyses clearly support the use of PARPi as maintenance therapy after first-line chemotherapy, recent data have raised concerns on detrimental overall survival (OS) in non-BRCA OC, a greater incidence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), and unfavorable outcomes following subsequent platinum-based chemotherapy in pretreated OC patients. In this report we discuss the long-term follow-up results from phase III trials in pretreated OC patients, which led to the Food and Drug Administration's withdrawal of PARPi indications in this setting. We summarize the newly available evidence concerning the risk of MDS/AML and the post-progression efficacy results after PARPi. We emphasize the importance of long-term follow-up and real-world data coming from international registries to define the efficacy and safety of stopping PARPi at relapse at a pre-specified time. To this point, biomarkers able to identify the patients who will experience long-term remission with PARPi maintenance or develop early resistance are urgently needed to guide treatment decision and duration.
Disease-free survival as surrogate for overall survival in real-world settings for esophageal cancer: an analysis of SEER-Medicare data
Ajani JA, Leung L, Kanters S, Singh P, Kurt M, Kim I, Pourrahmat MM, Friedman HS, Navaratnam P and Reardon G
Establishing surrogate endpoints for overall survival (OS) may expedite assessment of new therapies in esophageal cancer (EC) and gastroesophageal junction cancer (GEJC). This study aimed to evaluate disease-free survival (DFS) as a surrogate endpoint for OS.
PD-L1 thresholds predict efficacy of immune checkpoint inhibition in first-line treatment of advanced gastroesophageal adenocarcinoma. A systematic review and meta-analysis of seven phase III randomized trials
Formica V, Morelli C, Fornaro L, Riondino S, Rofei M, Fontana E, Smyth EC, Roselli M and Arkenau HT
High expression of programmed death-ligand 1 (PD-L1) has been recognized as a marker of improved efficacy of immunotherapy in gastroesophageal adenocarcinoma (GEA); however, the optimal PD-L1 cut-off is still debated. The aim of the present review was to analyze available phase III trials and to identify the appropriate PD-L1 expression cut-off for GEA.
Determining fitness for enfortumab vedotin and pembrolizumab in metastatic bladder cancer: the time to move beyond isolated comorbidity assessments
Russell BM, Fein DEC and Bellmunt J
Bespoke ctDNA for longitudinal detection of molecular residual disease in high-risk melanoma patients
Genta S, Araujo DV, Hueniken K, Pipinikas C, Ventura R, Rojas P, Jones G, Butler MO, Saibil SD, Yu C, Easson A, Covelli A, Sauder MB, Fournier C, Saeed Kamil Z, Rogalla P, Arteaga DP, Vornicova O, Spiliopoulou P, Muniz TP, Siu LL and Spreafico A
Locally advanced melanoma has a variable prognosis. Currently, there are no reliable criteria to stratify the risk of disease relapse and identify those patients who will benefit the most from adjuvant therapies. Circulating tumor DNA (ctDNA) is an emerging biomarker measuring the presence of tumor-derived DNA in blood.
Clinical outcomes of early-stage triple-negative breast cancer after neoadjuvant chemotherapy according to HER2-low status☆
Raghavendra AS, Zakon DB, Jin Q, Strahan A, Grimm M, Hughes ME, Cherian M, Vincuilla J, Parker T, Tarantino P, Mittendorf EA, King TA, Valero V, Tripathy D, Tolaney SM, Tayob N, Lin NU, Stover DG, Barcenas CH and Garrido-Castro AC
The impact of human epidermal growth factor receptor 2 (HER2) expression determined by immunohistochemistry (IHC) on outcomes in early-stage triple-negative breast cancer (eTNBC) is unclear. Using a large, multi-institutional cohort, we evaluated outcomes by HER2 IHC status in patients with eTNBC who received neoadjuvant therapy (NAT).
Cancer care equality: for the interests of patients with cancer
Zhu Z and Pan X
A simple prognostic score to predict recurrence after pancreaticoduodenectomy for ampullary carcinoma: results from the French prospective FFCD-AC cohort
Roth G, Pellat A, Piessen G, le Malicot K, Schwarz L, Gallois C, Tougeron D, Hautefeuille V, Jary M, Benoist S, Amil M, Desgrippes R, Muller M, Lecomte T, Guillet M, Locher C, Genet C, Manfredi S, Bouché O and Taieb J
Ampullary carcinoma (AC) is a rare and severe gastrointestinal cancer with a disease recurrence rate of around 40% after curative-intent surgery and for which the main prognostic factors and adjuvant treatment decision remain a matter of debate.
Tislelizumab plus chemotherapy as first-line treatment of locally advanced or metastatic nonsquamous non-small-cell lung cancer (final analysis of RATIONALE-304: a randomized phase III trial)
Lu S, Wang J, Yu Y, Yu X, Hu Y, Ma Z, Li X, He W, Bao Y and Wang M
The purpose of this study was to report an updated, final analysis with longer follow-up for the open-label phase III RATIONALE-304 study of first-line tislelizumab plus chemotherapy versus chemotherapy alone for advanced nonsquamous non-small-cell lung cancer (nsq-NSCLC).
Tislelizumab plus chemotherapy versus chemotherapy alone as first-line treatment for advanced squamous non-small-cell lung cancer: final analysis of the randomized, phase III RATIONALE-307 trial
Wang J, Lu S, Yu X, Hu Y, Zhao J, Sun M, Yu Y, Hu C, Yang K, Song Y, Lin X, Liang L, Leaw S and Zheng W
First-line tislelizumab plus chemotherapy significantly improved progression-free survival (PFS) versus chemotherapy alone in advanced squamous non-small-cell lung cancer (sq-NSCLC) at the interim analysis of the phase III RATIONALE-307 trial. We present the final analysis of this trial.
ESMO Resilience Task Force recommendations to manage psychosocial risks, optimise well-being, and reduce burnout in oncology
Lim KHJ, Kamposioras K, Élez E, Haanen JBAG, Hardy C, Murali K, O'Connor M, Oing C, Punie K, de Azambuja E, Blay JY, Banerjee S and
Burnout in health care professionals (HCPs) results from exposure to psychosocial risks at work. Left unaddressed, burnout can lead to chronic health problems, increased staff turnover, reduced work hours, absenteeism, and early retirement from clinical practice, thus impacting patient care. The European Society for Medical Oncology (ESMO) Resilience Task Force (RTF) was established in December 2019 to support the well-being of oncology HCPs globally. This ESMO RTF position paper aims to provide a set of recommendations to optimise well-being and mitigate burnout in oncology, and to help individuals and institutions maintain the delivery of optimal cancer care.
Corrigendum to "Prognostic and predictive value of CA 19-9 inlocally advanced pancreatic cancer treated with multiagent induction chemotherapy: results from a prospective, multicenter phase II trial (NEOLAP-AIO-PAK-0113)": [ESMO Open 7 (2024) 100552]
Hartlapp I, Valta-Seufzer D, Siveke JT, Algül H, Goekkurt E, Siegler G, Martens UM, Waldschmidt D, Pelzer U, Fuchs M, Kullmann F, Boeck S, Ettrich TJ, Held S, Keller R, Anger F, Germer CT, Stang A, Kimmel B, Heinemann V, Kunzmann V and
Neuroendocrine neoplasms of head and neck, genitourinary and gynaecological systems, unknown primaries, parathyroid carcinomas and intrathyroid thymic neoplasms: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
Hadoux J, Lamarca A, Grande E, Deandreis D, Kaltsas G, Janson ET, Tombal B, Pavel M, Thariat J, van Velthuysen MF, Herman P, Dromain C, Baudin E, Berruti A and
• This Clinical Practice Guideline provides key recommendations for managing rare endocrine tumours. • Neuroendocrine neoplasms of different origins, parathyroid carcinoma and intrathyroid thymic neoplasms are included. • The guideline covers clinical imaging and pathological diagnosis, staging and risk assessment, treatment and follow-up. • The authors comprise a multidisciplinary group of experts from different institutions and countries in Europe. • Recommendations are based on available scientific data and the authors’ collective expert opinion.
Impact of systemic therapy on clinical T1 small-cell neuroendocrine carcinoma of the bladder
Myers AA, Fang AM, Moussa MJ, Hwang H, Wilson NR, Campbell MT, Msaouel P, Lee BH, Guo CC, Zhang M, Zhao J, Siefker-Radtke AO, Kamat AM and Alhalabi O
The purpose of this study was to analyze survival outcomes and pathologic response of patients with cT1N0 small-cell neuroendocrine carcinoma (SCNEC) of the bladder treated with neoadjuvant chemotherapy (neoCTX).
Diagnosing intravascular B-cell lymphoma using nanopore sequencing of cell-free DNA from cerebrospinal fluid
Schmidt BC, Afflerbach AK, Ludewig P, Dirksen P, Paulsen FO, Magnus T, Alawi M, Schüller U, Weisel K, Bokemeyer C and Christopeit M
Safety of solid oncology drugs in older patients: a narrative review
Rousseau A, Géraud A, Geiss R, Farcet A, Spano JP, Hamy AS and Gougis P
The older population represents ∼50%-60% of the population of newly diagnosed patients with cancer. Due to physiological and pathological aging and the increased presence of comorbidities and frailty factors, this population is at higher risk of serious toxicity from anticancer drugs and, consequently, often under-treated. Despite the complexity of these treatments, a good knowledge of the pharmacology of anticancer drugs and potentially risky situations can limit the emergence of potentially lethal toxicities in this population. This review focuses on optimizing systemic oncology treatments for older patients, emphasizing the unique characteristics of each therapeutic class and the necessity for a precautionary approach for this vulnerable population.