From ESMO 2017

In September 2017, ∼24,000 delegates from 131 countries attended ESMO 2017 Congress. Burning topics in clinical oncology were discussed in the meeting's 192 sessions and 56 satellite symposia — perhaps the high temperatures registered in Madrid during that week emanated from the conference centre.

This year, the conference programme was developed by ESMO in partnership with the European Association for Cancer Research (EACR), acknowledging that both societies have very similar aims. Indeed, old-established models whereby hypotheses are first tested in the laboratory and then in the clinical setting were questioned at this conference. A greater focus is currently placed on approaches in which tumour biology informs clinical decisions; one of the most fascinating examples is the study of clinical samples in order to establish the evolution of each patient's cancer, with important therapeutic implications.

Unsurprisingly, the importance of therapeutic strategies targeting more than one tumour vulnerability was frequently addressed in this conference. Particular attention was paid to several ongoing trials of new combinations of immune-checkpoint inhibitors with agents targeting complementary immune-related mechanisms. The safety and tolerability of such regimens remains to be determined, leading some researchers to propose sequential treatments instead of combination treatments. Other approaches discussed included exploiting synthetic lethality.

Those delegates who expected to hear results from the latest clinical trials must not have been disappointed by the number of new studies presented (1,736 abstracts selected out of 3,260 submissions). Some of the data, however, had not yet reached maturity and will need to be revisited in the future. In such studies, a meaningful clinical benefit cannot be established on the basis of the current follow-up durations and the end points selected. This situation is increasingly common in the oncology field, as discussed in one of the most eye-opening sessions. How we define the real value of a given treatment is not an easy question to solve; an answer will only be possible with well-designed studies. We hope to keep learning from meaningful research next year in Munich.