Three Takeaways from ESMO 2019


hero symbol

The European Society for Medical Oncology’s Annual Conference, better known to the research community as "ESMO," was held September 27 - October 1, 2019 in Barcelona, Spain.

Researchers from all over the world gathered at the Fira Barcelona Gran Via event center, nestled right on the coast of Barcelona, to present breaking research, discuss immunotherapy strategies, and understand the best way to place patients at the center of cancer care. 

Several findings came out of ESMO that colorectal cancer survivors will want to know about.

1. A BEACON of Hope

In March 2019, the National Comprehensive Cancer Network (NCCN) updated their treatment guidelines to include a triplet combination of therapies for patients with BRAF V600e-mutated colorectal cancer using encorafenib, cetuximab, and binimetinib. 

The guideline update was based on results from the BEACON trial for patients with BRAF mutations. At ESMO, additional results were presented from the phase III randomized study, showing that in 444 patients, the overall survival on the triplet was 9 months vs. 8.4 months on encorafenib + cetuximab and the objective response rate was 26% vs. 20% respectively.

2. Amgen KRAS Data Doesn’t Live up to the Hype for Colorectal Cancer

AMG-510 is a drug that targets a KRAS mutation, also known as KRAS G12C, which occurs in approximately 3-5% of colon and rectal cancers. Results of the study AMG-510 were presented at ASCO 19, which showed a high response rate in both lung and colorectal cancers.

Unfortunately, further research presented at ESMO indicates that AMG-510 may not have a benefit in colon and rectal cancers. Of the 12 patients with colorectal cancer enrolled in the clinical trial, only one saw a partial response, and 10 had stable disease.

3. The Promise of Liquid Biopsies for Colorectal Cancer

There seems to be a general consensus among the research community that liquid biopsies hold great promise. However, understanding what to do with the results remains a puzzle. 

At ESMO this year, studies presented on liquid biopsies added to the current knowledge about their potential abilities.

The phase III IDEA-FRANCE trial showed that using a liquid biopsy in stage III colorectal cancer patients prior to undergoing surgery, followed by chemotherapy, is a prognostic factor. 

Prognostic factors help understand a patient’s cancer outcome, despite the mode of therapy. Predictive factors provide insight into the outcomes of a specific therapy.

Out of 805 patients who received a liquid biopsy test before adjuvant chemotherapy (treatment given after the initial treatment), 13.5% had circulating DNA (ctDNA) in their blood. For those that were positive for ctDNA, 64% were disease-free at two years, compared to 84% disease-free survival for those that were negative for ctDNA.

This study also showed that six months of adjuvant chemotherapy in those positive for ctDNA had comparable outcomes to three months of adjuvant chemotherapy in those negative for ctDNA.

Research indicates that liquid biopsies are a potential tool in cancer care and, in time, researchers are hopeful that the clinical utility of liquid biopsies will be well established.

ESMO may be over but the research doesn’t stop. Follow us on Twitter @FightCRC for the latest updates in colon and rectal cancer research.