ESMO

Report on EORTC @ESMO 2017 in Madrid, Spain, 8 -12 September 2017

ESMO 2017 congress, in partnership with EACR, was hosted in Madrid this year. It attracted nearly 24000 participants from 131 countries. 1736 abstracts were selected for presentation of which 55 were late breaking.

EORTC presented 8 abstracts at the congress, 3 were selected as oral presentations and 5 abstracts were selected as poster presentations.

One in four patients with small breast cancers exhibited an aggressive phenotype

‘Not all small node negative (pT1abN0) breast cancers are similar: Outcome results from an EORTC 10041/BIG 3-04 (MINDACT) trial substudy‘ was presented by Dr Konstantinos Tryfonidis during the Profferred Paper session Breast cancer, early on Friday, 8 September 2017. Read more about it here.

Final Results of the EORTC STBSG, AGITG, UNICANCER, FSG, ISG, and GEIS Randomized Trial

This EORTC Intergroup study is an international collaboration between EORTC Soft Tissue and Bone Sarcoma Group, Australasian Gastro-Intestinal Trials Group (AGITG), UNICANCER, French Sarcoma Group (FSG), Italian Sarcoma Group (ISG) and Spanish Group for Research on Sarcomas (GEIS).

EORTC emphasizes the importance of the collaboration of academic clinical trial groups, allowing to conduct large scale clinical trials especially in rare tumours.

The final results of the EORTC Soft Tissue and Bone Sarcoma Group Intergroup randomized trial with adjuvant imatinib versus no further therapy after surgery in localised, high/intermediate-risk patients with gastrointestinal stromal tumours (GIST) were presented at the ESMO 2017 Congress in Madrid.

908 patients were randomized in 112 hospitals and 12 countries, between December 2004 and October 2008 to imatinib 400 mg daily or no further therapy after R0-R1 surgery, for 2 years. The primary endpoint was imatinib failure-free survival (IFFS), while relapse-free survival (RFS), relapse-free interval, overall survival (OS) and toxicity were secondary endpoints.

The final results showed that 5- and 10-year IFFS was 87% and 75%, respectively, in the imatinib arm versus 83% and 74%, respectively, in the control arm; RFS was 70% versus 63% at 5 years and 63% vs 61% at 10 years; and OS revealed to be 93% versus 92% at 5 years and 80% versus 78% at 10 years. Among 526 patients with high-risk GIST by local pathology, 10-year IFFS and RFS were 69% versus 61%, and 48% versus 43%, respectively.

There was no significant difference in giving or not giving imatinib after surgery. However, a follow up of 9.1 years presented a trend towards a better long-term IFFS and RFS in imatinib treated patients in the high-risk subgroup. Although not statistically significant, this trend was consistent with the results reported by the Scandinavian/German trial, showing a sustained, small but significant long-term overall survival benefit in high-risk GIST patients treated for 3 years with adjuvant imatinib.

Final results of the EORTC 300073 SURTIME Trial in metastatic renal cell carcinoma

EORTC GU Group presented the results of the SURTIME trial. In clinical practice, patients diagnosed with metastatic renal cell carcinoma (mRCC) with the primary tumour in situ, are offered cytoreductive nephrectomy (CN) followed by targeted therapy. This randomized trial explored a period of targeted therapy with sunitinib prior to CN as an alternative approach.

As the study did not reach the recruitment target, it was decided to report the progression-free rate (PFR) at week 28 as the primary endpoint (approved by independent data monitoring committee (IDMC)), which required 98 patients. Overall, 99 patients were randomized on a 1:1 ratio to immediate CN followed by sunitinib or to 3 cycles of sunitinib followed by CN and sunitinib. Overall survival (OS), adverse events and post-operative progression were secondary endpoints.

In the immediate CN group, 92% of patients underwent CN and 87% received post-CN sunitinib. In the deferred CN group, 98% of patients received sunitinib, 83% underwent CN, and 65% had post-CN sunitinib. PFR was 42.0% and 42.9%   in the immediate and deferred groups, respectively.

After a median follow-up period of 3.3 years, it was concluded that the sequence of cytoreductive nephrectomy and sunitinib did not affect the progression free survival after 28 weeks, although an OS signal was seen for deferred CN. As the trial accrued poorly it was deemed that the results remain exploratory. There were shortcomings of PFS endpoint due to the frequent treatment breaks, and it was noted that the sample size precludes definitive conclusions from other endpoints, although CN after sunitinib appears to be safe.

Learn more about EORTC poster abstracts in the coming news.

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