ESMO Manifesto - Translating Scientific Evidence Into Effective Public Health Policy

Madrid, Spain – Evidence is building up that strong political action has the potential to tackle two of our era’s biggest challenges: climate change and the increasing burden of cancer on society. At the opening press conference of the ESMO Congress 2023 taking place 20-24 October in Madrid, Spain, a slew of studies marking meaningful advances in the treatment of various tumour types was announced together with new insights into potential cancer risks from air pollution,  which ESMO has translated into a concrete call to action for policymakers with a Public Policy Manifesto addressing this and other critical issues for oncology.  

In a context where air pollution is increasingly understood to be a driver of both global warming and cancer on a broader scale than previously suspected, mitigation strategies take on a new importance that ESMO has already been actively advocating for in EU policy circles. “With its 33,000 members, ESMO is producing the science and the information that national and EU political decision-makers need to adapt our healthcare systems to evolving priorities in oncology,” said ESMO Director of Public Policy Prof. Jean-Yves Blay, highlighting the role of cancer prevention in improving the resilience of Europe’s health systems, an imperative widely recognised since the pandemic and reiterated in the ESMO Public Policy Manifesto.  

“We need, on the one hand, structural resilience to ensure cancer patients can continue to be treated in periods of crisis, and, on the other, a resilient oncology workforce,” said Blay. “We have seen shortages of human resources in many countries at the same time as we have experienced increasing workloads due to the growing number of cancers being diagnosed and treated each year, and which are putting pressure on all healthcare systems indiscriminately.” 

The Public Policy Manifesto, which crystallises ESMO’s evidence-based approach to tackling cancer both within the bloc and, when feasible, globally, prepares the ground for effective policymaking in anticipation of the 2024 elections for the European Parliament by highlighting necessary measures to protect the oncology workforce and cancer patients—including in times of crisis—as well as major axes of cancer prevention ranging from air pollution and asbestos exposure to tobacco and alcohol consumption.  

As Blay reported, another challenging question on which ESMO wants to work with EU policymakers concerns how best to ensure equitable access to the transformative therapies entering clinical practice today for all patients, including those with rare cancers, in the future. “This is particularly relevant in the current context of evolving EU regulation on health technology assessment,” he noted. Equity is also what motivates ESMO’s advocacy, including through the new manifesto, for the right of cancer survivors to have their disease forgotten when they seek financial services upon returning to normal life.  

ESMO is also working to help shape the implementation of EU legislation such as the In Vitro Diagnostic Regulation and the upcoming European Health Data Space, which will have an impact on cancer research and will be critical to bringing Europe’s expertise in health technology to global fruition. “ESMO is unique in its size, its global perspective, and its ability to disseminate practice-changing evidence across a broad range of oncological diseases, as is being demonstrated once again with this year’s Congress,” said Blay. “National and EU policymakers therefore naturally listen to the quality of expertise we provide.” 

A look at the highlights of the ESMO 2023 scientific programme  

As the Society’s flagship annual meeting, the ESMO Congress is one of the foremost forums in which evidence is discussed and disseminated, within the oncology community and to the wider public. Accordingly, the scientific programme of the ESMO Congress 2023 is the reflection of a field of medicine where progress is rapid and wide-sweeping, with important clinical trial results announced in a multitude of tumour types and disease settings.  

“This ESMO Congress is full of data that will truly change practice for our patients, but in particular, 2023 will go down as the year of lung cancer abstracts,” emphasised ESMO 2023 Scientific Chair Prof. Silke Gillessen, anticipating the profusion of therapeutic advances that will be the subject of many presentations over the next five days.  

In the field of gynaecological malignancies, promising new results covering the entire spectrum of cervical cancer and with the potential to change the treatment landscape, will also be presented throughout the ESMO Congress. 

ESMO President Prof. Andrés Cervantes commented: “Cervical cancer is still very prevalent, especially in low and middle-income countries, and this Congress brings good news to women suffering from all stages of the disease.”   

Meanwhile, new treatment combinations (1) (2) could for the first time in decades lead to changes in the standard of care for advanced urothelial carcinoma, the most common form of bladder cancer. “In particular, a new drug combined with immunotherapy will, if approved, replace the standard chemotherapy that we have been administering for over 20 years as the first line of treatment,” Gillessen continued.  

In metastatic prostate cancer, a new type of precision nuclear medicine capable of delivering targeted radiation to cancer cells, and thus preserving surrounding tissue, showed its potential to move up in the therapeutic sequence by delaying disease progression compared to the standard second-line treatment. (3) Findings which, according to Gillessen, are made all the more promising by the good tolerability of the novel therapy.  

Based on further results to be presented during a presidential session on Sunday, two other targeted therapeutic approaches are also pushing back the survival horizon for heavily pretreated patients with metastatic breast (4) and colorectal cancers. (5) “KRAS mutations are present in almost half of all colorectal cancers and have traditionally been associated with poorer prognosis because they limited the treatment options available to patients. Now, a new combination of antibodies and RAS inhibitors has been shown to improve survival compared to the standard of care and, incredibly, turned this mutation into a positive predictor of better outcomes,” said Cervantes, highlighting the significance of this breakthrough for patients.  

In a phase III trial described by Gillessen as a research prowess for a rare disease, important new answers were also obtained regarding the optimal course of treatment for people suffering from RET-mutant medullary thyroid cancer—a rare endocrine tumour—as a selective RET inhibitor demonstrated its superiority to other, broader-spectrum targeted therapies approved in this indication. (6)  

“This year is one that will be remembered in oncology, and not just by the record 30,000 attendees we are expecting to join the Congress from 144 countries,” concluded ESMO 2023 Press Officer Dr. Angela Lamarca. “With over 2,500 studies to be presented, including 147 presidential and proffered papers set to change clinical practice, there will be a before and an after to the ESMO Congress 2023.”  

Notes to Editors  

Please make sure to use the official name of the meeting in your reports: ESMO Congress 2023  

Official Congress Hashtag: #ESMO23. Follow it to stay up to date and use it to take part in the conversation on X (Twitter), LinkedIn, Instagram, Facebook  

Disclaimer 

This press release contains information provided by the author of the highlighted abstract and reflects the content of this abstract. It does not necessarily reflect the views or opinions of ESMO who cannot be held responsible for the accuracy of the data. Commentators quoted in the press release are required to comply with the ESMO Declaration of Interests policy and the ESMO Code of Conduct. 

References   

1. Abstract LBA7 ‘Nivolumab plus gemcitabine-cisplatin versus gemcitabine-cisplatin alone for previously untreated unresectable or metastatic urothelial carcinoma: results from the phase 3 CHECKMATE 901 trial’ will be presented by Michiel S. Van der Heijden during the Presidential Session, Sunday 22 October, 16:42 - 16:54 CEST in Madrid Auditorium - Hall 6. 
2. Abstract LBA6 ‘EV-302: A 2-arm, open-label, randomized controlled phase 3 study of enfortumab vedotin in combination with pembrolizumab vs chemotherapy alone in previously untreated locally advanced metastatic urothelial carcinoma (la/Muc)’ will be presented by Thomas B. Powles during the Presidential Session, Sunday 22 October, 16:30 - 16:42 CEST in Madrid Auditorium - Hall 6.  
3. Abstract LBA13 ‘Phase 3 trial of [177Lu]Lu-PSMA-617 in taxane-naive patients with metastatic castration-resistant prostate cancer (PSMAfore)’ will be presented by Oliver Sartor during the Presidential Session, Monday 23 October, 17:10 - 17:22 CEST in Madrid Auditorium - Hall 6. 
4. Abstract LBA11 ‘Randomised phase 3 study of datopotamab deruxtecan vs chemotherapy for patients with inoperable or metastatic hormone receptor-positive, HER2-negative breast cancer: First results from TROPION-Breast01’ will be presented by Aditya Bardia during the Presidential Session, Sunday 22 October at 16:30 - 16:42 CEST in Madrid Auditorium - Hall 6.  
5. Abstract LBA10 ‘Sotorasib plus panitumumab versus standard-of-care for chemorefractory KRAS G12C-mutated metastatic colorectal cancer (MCRC): CodeBreak 300 phase 3 study’ will be presented by Filippo Pietrantonio during the Presidential Session, Sunday 22 October at 17:50 - 18:02 CEST in Madrid Auditorium - Hall 6. 
6. Abstract LBA3 ‘Randomized Phase 3 Study of Selpercatinib versus Cabozantinib or Vandetanib in Advanced, Kinase Inhibitor-Naïve, RET-mutant Medullary Thyroid Cancer’ will be presented by Julien Hadoux during the Presidential Session, Saturday 21 October, 17:10 - 17:22 CEST in Madrid Auditorium - Hall 6.