The 2021 ASCO Annual Meeting, the 57th in the society’s history, was only the second to be held virtually. We at Nature Reviews Clinical Oncology — and undoubtedly many other delegates — miss the excitement and interactions that in-person meetings provide. Nevertheless, the apparently greater accessibility afforded by the online format seems highly relevant to the theme of the 2021 meeting. This year’s president, Lori J. Pierce, put equity at the forefront with the aim of including ‘Every patient. Every day. Everywhere.’, across all three pillars of ASCO’s mission — research, education and quality care. Hence, several sessions were devoted to identifying and addressing disparities in clinical oncology, for the benefit of not only under-represented and underserved groups but also the community as a whole.
With regard to EGFR-wild-type NSCLC, multiple phase III trials revealed that patients with resectable disease can benefit from immune-checkpoint inhibitors (ICIs). In CheckMate 816, addition of the anti-PD-1 antibody nivolumab to neoadjuvant chemotherapy increased the pathological complete response rate from 2.2% to 24.0% (P < 0.0001). Moreover, in the IMpower010 trial of the anti-PD-L1 antibody atezolizumab versus best supportive care after postoperative chemotherapy, the median disease-free survival (DFS) was 42.3 months versus 35.3 months in all randomized patients (P = 0.0205), with comparable results in the PD-L1+ subgroup. Updated data from the PACIFIC trial also underscore the benefit of durvalumab, another anti-PD-L1 antibody, after definitive chemoradiotherapy for patients with unresectable stage III NSCLC: 5-year PFS and overall survival (OS) of 33.1% and 42.9%, respectively, compared with 19.0% and 33.4% with placebo. Beyond NSCLC, adjuvant PD-1 blockade with pembrolizumab improved DFS in patients with renal cell carcinoma in the placebo-controlled, phase III KEYNOTE-564 trial (HR 0.68, 95% CI 0.53−0.87; P = 0.001).
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