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Published on 3 October 2008

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ESMO Congress: the latest developments in medical oncology


The 33rd ESMO Congress in Stockholm will present a rich and diversified programme, providing an update on progress in translational research and oncology practice, and presenting the latest developments in drugs and therapeutics

Jose Baselga

ESMO President


The 33rd Congress of the European Society for Medical Oncology (ESMO) will be held at the Stockholm International Fair in Alvsjo, Stockholm, Sweden, from 12 to 16 September 2008.
The congress will present a rich and diversified programme
with keynote lectures, educational, challenge-your-expert and controversy sessions, special and joint symposia, patient-case sessions and, for young oncologists, a masterclass, forum and
breakfast sessions.

Scientific results submitted for presentations during the Congress in Stockholm span 23 different categories, and highlight the progress in translational research and medical oncology practice that scientists and practitioners face in the most progressive field of medicine. Incorporating the latest
developments in drugs and therapeutics will lead to some important changes in everyday clinical practice, including a better understanding of the need for more collaboration in cancer research and an integrated multidisciplinary approach to the treatment of patients.

Dr C Manegold from Heidelberg University Medical Centre, Germany, on behalf of an international study team, will present results of BO17704 (AVAIL), a double-blind trial that randomised 1,043 patients to cisplatin/gemcitabine for up to six cycles adding either bevacizumab (7.5mg/kg or 15mg/kg) or placebo, administered until disease progression in patients with histologically or cytologically documented untreated locally advanced, metastatic or recurrent nonsquamous, nonsmall-cell lung cancer (NSCLC). In their presentation, the authors will demonstrate data of the longer follow-up study of firstline
bevacizumab therapy with the primary endpoint as progression-free survival, and the secondary endpoints regarding overall survival, response rates, duration of response and safety.

Dr T Mok from the Chinese University of Hong Kong will present results on efficacy, symptom improvement and tolerability of the IRESSA Pan Asia Study (IPASS), a randomised, open-label, firstline study of gefitinib versus carboplatin/paclitaxel conducted in chemo-naive, never or light ex-smokers with good performance status, adenocarcinoma histology and stage IIIB/IV NSCLC. Exploratory endpoints included the association of different outcomes according to the epidermal growth factor
receptor mutation status.

Dr R Midgley, on behalf of the VICTOR Trial Group, will give an overview of the results of a phase III randomised, placebo-controlled double-blind trial of rofecoxib in patients after potentially curative surgery and completion of adjuvant therapy for stage II/III colorectal cancer. While the trial was planned
so that 7,000 patients received 25mg of rofecoxib daily or an identical placebo for two or five years, it unfortunately had to be terminated early due to the worldwide withdrawal of rofecoxib. Authors will present the data for the preplanned event-driven
interim analysis for the 1,167 patients who received rofecoxib and the 1,160 patients on placebo. Furthermore, the researchers extracted genomic DNA from 939 VICTOR patients. Following the characterisation of linkage disequilibrium across the PTGS2 (COX-2) gene, study investigators will discuss whether COX-2 genotyping might identify a subgroup of
responsive patients.

Dr Bradley Monk from the University of California, Irvine, USA, will present the results of a large trial in recurrent ovarian cancer. A total of 672 patients were randomised in the phase III study of trabectedin with pegylated liposomal doxorubicin
(PLD), versus PLD only. This multicentre study was designed to establish clinical activity of a nonplatinum-based doublet therapy for second-line recurrent ovarian cancer. The study compared efficacy and safety of trabectedin in patients relapsing within, or
beyond, a platinum-free interval of six months since completion of first-line therapy.

Dr SM Lee, on behalf of Medical Research Council BR12 Collaborators and NCRI Brain Tumour Clinical Studies Group, UK, will present the results of the first randomised comparison of procarbazine, CCNU and vincristine versus temozolomide subrandomised between two different schedules (five-day
or 21-day) in chemo-naive patients with radiologically confirmed, recurrent high-grade glioma. The presentation will challenge the current understanding of temozolomide scheduling and dose intensity.

Dr R James from Maidstone General Hospital, UK, will discuss the long-term outcome of the UKCCCR randomised trial for chemoradiation in the treatment of epidermoid anal cancer. A total of 577 eligible patients were recruited; 285 patients received radiotherapy, and 292 received the same radiotherapy
combined with 5-fluorouracil during the first and final weeks of radiotherapy, and Mitomycin C on day 1. The study investigators will discuss the magnitude of the benefits seen over the first few years compared with the results 12 years later.

Dr P Schoffski from the University Hospital in Leuven, Belgium, will present the results of the phase III trial of sunitinib in imatinib-resistant/intolerant gastrointestinal stromal tumour patients. The results of rank-preserving structural failure time analysis will provide long-term OS data in 243 randomised
patients (sunitinib versus placebo) with implications for other crossover trials. Authors will also present safety data for long-term treatment.

Dr J Droney from the Royal Marsden Hospital/Imperial College London, UK, will provide a platform for a greater understanding of the pharmacogenomics of opioids. A total of 299 patients taking oral morphine for cancer pain were included in the first study to examine the effects of genetic variation in all three
opioid-receptor genes on analgesic response to morphine. Authors will show the association between polymorphisms in mu, delta and kappa opioid receptors with interindividual variation in analgesic response to morphine for cancer pain.

Some of the highlights that will be presented during the ESMO Congress 2008 will include:

  • Molecular analysis for target discovery:identification of ‘Achilles’ heel’: microRNa, SiRNA libraries; protein array.
  • Innovations in breast cancer: modulation of resistance to anti-Her2 therapies; evaluation of predictive markers on circulating tumour cells; new targets for triple-negative tumours; stem cell as a potential target; tools in daily clinical practice to improve treatment.
  • Tailoring therapy in lung cancer: medical implications of resistance to EGFR; personalised cancer therapies for non-EGFR receptor-dependent tumours.
  • New pathways in targeted therapy: IGF-1, PI 3, PARP, Met.
  • Optimal integration of newer agents in the treatment of advanced CRC: genomic and pharmacogenetic markers for treatment decision; upfront sequential vs combination chemotherapy.
  • Renal cell cancer: VEGF biology and resistance; mTOR; tackling future issues.
  • Hitting the cell in ovarian and endometrial cancers: PARP, mTOR, etc.
  • Head and neck cancer: viruses: prevention and therapy; innovations in radiation oncology; how to integrate EGFR inhibitors and beyond.
  • Haematological malignancies: the role of high-dose therapy and allografting stem-cell transplantation in the era of ‘-nibs’ and ‘-mabs’.
  • Communication skills in advanced cancer care: the use of communication skills: lessons derived from microanalytical studies.
  • Advances in soft tissue sarcoma, GIST and beyond: GIST – the role of adjuvant therapy and mutational analysis in treatment decision-making; molecular biology and targeted therapy of sarcomas; hyperthermia improves local control of STS.
  • Emerging therapies for rare tumours: neuroendocrine tumours, HCC, thyroid cancer, papillary RCC.
  • Assessing, reporting and managing the safety of cancer drugs: detecting safety signals; the role of pharmacogenetics in predicting and managing toxicity; handling side-effects of targeted therapies.
  • Integration of targeted therapies with radiation: where are we with radiation modifiers?
  • Unplanned analysis of molecular studies: harmful or safe?
  • Cancer patients: should all receive prophylactically antithrombotic therapy?; dealing with difficult cases in daily clinical practice.
  • New developments in myeloma: prognostic factors and the role of novel drugs; the status of transplantation.
  • Glioma: from imaging to management.
  • Recent progress in immunotherapy: anticancer vaccines; combining immunotherapy with classical anticancer therapy.
  • Advanced prostate cancer: the changing face of hormonal therapy; diabetes and cardiovascular disease in prostate cancer survivors.
  • Latest on oncology in developing countries: cancer burden and the role of prevention; balancing costs and benefits in cancer therapy and prevention.
  • Drug development: how to recognise a promising drug: the role of clinical and biological endpoints; the role of regulatory bodies in the drug approval process.

A webcast, virtual meeting and summary report will be available on the ESMO website after the congress. Please visit:

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