ESMO 2019 ratifies the need to implement genomic analysis in cancer treatment
Summary of the congress of the European Society of Medical Oncology
• During the congress, OncoDNA organised a debate entitled Precision medicine in oncology in Europe: dream or reality? In it, European specialists gave accounts of their experiences related to the use of genomic analysis and liquid biopsies.
• ESMO also presented studies, trials and reports that indicate the benefits of using these types of tools for patients, with strong implications for ovarian and prostate cancer.
October 10, 2019 - Gosselies, Belgium
The annual congress of the European Society of Medical Oncology, ESMO, has concluded in Barcelona. Five days in which the latest developments in the diagnosis and treatment of cancer were shared. And personalised medicine was a particular focus.
During the event, OncoDNA, a Belgian company specialising in precision oncology for cancer treatment, organised the debate "Precision medicine in oncology in Europe: dream or reality?" This discussion dealt with the use of next-generation sequencing platforms (NGS), liquid biopsies, the financing of molecular profiles by the various European national health systems, and the effectiveness of precision oncology, versus limited access to drugs and diagnostic systems.
There was talk of the positive impact of using tools that provide more information about a patient’s tumour by using the smallest amount of sample (tissue or blood) possible. “Most oncologists have to limit their tests because of the low availability of tumour tissue they have from each patient. Instead of doing the tests individually, we must offer formulas that allow multiplexing or make it possible to analyse the greatest number of markers in a single analysis”, says Dr Jean-François Laes, scientific and operations director of OncoDNA, who participated in the debate.
According to the speakers, the arrival of liquid biopsy - a field in which OncoDNA has been a pioneer - has been of vital importance in precision oncology, although it remains behind tissue biopsy in terms of its use in clinical practice.
Together with Dr Laes, speakers at the round table were: Dr Philip Beer, a specialist in precision oncology at various public and private centres in the United Kingdom; Professor Özlem Er, head of the Department of Medical Oncology at the Maslak-Acibadem University Hospital in Istanbul (Turkey); Professor Jesús García-Foncillas, director of the OncoHealth Oncology Institute (Spain); Professor Marc Peeters, head of the oncology department of the University Hospital of Antwerp (Belgium); and Professor Pascal Pujol, president of the French Society of Personalised Medicine and head of service at the University Hospital of Montpellier.
All of them stressed the need to encourage the use of genomic tests and liquid biopsies with increasingly wide ranges of analysis in daily clinical practice. This is mainly in order to find out the complete molecular profile of each tumour and thus to be able to give the patient personalized treatment from the beginning of the disease, with greater probability of success.
Some of those present said that there is urgent demand from the medical community for financial support initiatives for these tests to appear. In fact, several successful examples were mentioned, such as the Belgian Liberal Mutuality, the MDLUX project in Luxembourg, and the insurance companies in the United Kingdom. “They are essential to universalize access and ensure that precision oncology is not a luxury, but a reality for everyone”, says Dr Laes.
NEWS IN OVARIAN CANCER
During ESMO, various studies and reports were presented in which the usefulness of molecular profiles in oncological diagnosis and treatment from the early stages was corroborated. One example is that of three phase III randomised clinical trials whose results have established the benefit of PARP inhibitors as initial therapy in ovarian cancer cases. “In all three trials, progression-free survival improved, which was higher for patients with mutations in the BRCA1 / 2 genes”, says Jean-François Laes.
In the first, maintenance with niraparib improved Progression Free Survival (PFS) for patients with platinum sensitive disease. In the second, it was maintenance with olaparib combined with bevacizumab that made the PFS improve. And in the third, this improvement was achieved by adding a veliparib-based treatment to the initial chemotherapy. “Through the new version of the OncoSTRAT & GO profile of OncoDNA, which combines the study of tumour tissue (panel of 313 genes) with that of blood (germline alterations analysis), we can detect more accurately the mutations in BRCA1 / 2 (as well as ATM, MSH2, RAD50, etc.). Very valuable information so that the patient can benefit from treatments such as those mentioned”, explains Laes.
Similar reports were presented for prostate cancer, such as the phase III PROfound study in which patients received the Lynparza PARP inhibitor. These mutations were also detected in BRCA 1 and 2, and also in the ATM gene, and thanks to this treatment they have been able to duplicate the PFS. “This demonstrates that, once again, OncoDNA is again at the forefront, presenting new developments that quickly move to clinical practice with proven evidence of utility”, says the scientific and operations director of OncoDNA.