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ECCO 2017, Amsterdam - Webcasts on Demand

THE RIGHT TREATMENT FOR THE RIGHT PATIENT AT THE RIGHT TIME

  • ECCO 2017 webcasts - Part 1

    Welcome & Introduction" by Nicholas Thatcher

    Nicholas Thatcher introduces the symposium topic: “Debating the optimal management in advanced and metastatic lung cancer: The right treatment for the right patient at the right time”.
    Nicholas Thatcher - Welcome and Introduction at ECCO 2017 NSCLC
  • ECCO 2017 webcasts - Part 2

    'Identifying the right patient: histological and molecular profiling challenges' by Keith Kerr

    With more insights into the molecular characteristics of lung cancer cells and the evolvement of new technologies diagnosis and treatment is more targeted and equally complicated – a lecture of Keith Kerr, University of Aberdeen.
    Keith Kerr -  Identifying the right patient: histological and molecular profiling challenges at ECCO 2017 NSCLC
  • ECCO 2017 webcasts - Part 3

    "Maximizing Treatment Outcomes in Patients with Advanced Metastatic Lung Cancer" by Giorgio V Scagliotti

    Giorgio Scagliotti builds a modern-day algorithm for selecting individualized therapies in nonsquamous non-small cell lung cancer and squamous non-small cell lung cancer based on molecular biomarkers and clinical trial results. He highlights the improvements in our abilities to better target therapies but also addresses the limitations in translating clinical trial data to the clinical setting, and discusses the gaps in therapy that still remain in this patient population. Finally, he comments on the issues remaining with effectively incorporating immunotherapy strategies into the clinic.
    Giorgio V Scagliotti - Maximizing Treatment Outcomes in Patients with Advanced Metastatic Lung Cancer at ECCO 2017 NSCLC
  • ECCO 2017 webcasts - Part 4

    "The right time, the right sequence" by Nicholas Thatcher

    Using a case study in a 76-year old male with squamous non-small cell lung cancer, Dr Thatcher explores the significance of clinical trial results from a clinician’s perspective versus those of a patient. He suggests that while a 6-week increase in overall survival may be considered to be a minimal improvement by clinicians, to the patient it could mean a great deal. He also challenges the guidelines that currently define the age that is “too old” for chemotherapy, citing evidence that in people over 70 years of age chemotherapy can have substantial benefits.
    Nicholas Thatcher - The Right Time, the Right Sequence and the Right Combination for the Right Result at ECCO 2017 NSCLC
  • ECCO 2017 webcasts - Part 5

    "Medical management of advanced NSCLC" by Christian Manegold

    Three antiangiogenic agents have been incorporated into current treatment algorithms for non-small cell lung cancer (NSCLC). Dr Manegold reviews clinical trial data that supports the addition of these agents to platinum-based chemotherapy, as well as the addition to other targeted agents such as monoclonal antibodies or small tyrosine kinase inhibitors. He discusses early results from small clinical trials that combine antiangiogenic agents with immune-checkpoint inhibitors. He also explores the questions that remain for creating a treatment algorithm for combining antiangiogenic agents with immune-checkpoint inhibitors for NSCLC therapy.
    Christian Manegold - Medical management of advanced NSCLC at ECCO 2017
  • ECCO 2017 webcasts - Part 6

    Interview with Nicholas Thatcher

    Watch here what Nicholas Thatcher has to tell about the Satellite Symposium.

Ecco 2017 Q&A

In which scenario is mutation testing recommended? What genomic alterations are observed in patients with non-small cell lung cancer after treatment with tyrosine kinase inhibitors directed against anaplastic lymphoma kinase fusion proteins? These issues among others were discussed in the ECCO symposium on non-small cell lung cancer 2017. This is a selection of the questions and answers from the symposium. At the end of this session, the audience interacts by answering the knowledge questions again and panel members discuss the results.

Read the Q&A

Read the Q&A

Q: Should we check for epidermal growth factor (EGFR) mutations in and squamous non-small cell lung cancer (SQ-NSCLC) patients?
A: It is hard to justify testing for these markers in our standard European populations, as the vast majority will have SQ-NSCLC driven by cigarette smoking. The exception for testing would be in a non-smoker or in a person who has not smoked for decades.

Q: If you do not have the drug to treat a T790m mutation, what is the point of looking for it?
A: There used to be no point in looking for it aside from an academic interest, but now that an intervention exists it is now of greater interest to investigate.

Q: Why do you believe that only cell-free DNA rather than circulating tumour cells is of interest?
A: Circulating tumour cells are difficult to obtain in numbers that are sufficient to be useful with current technology. Cell-free DNA is more easily obtained and gives more reliable results.

Q: Do we need to test for programmed cell death 1 ligand (PD-1) for second-line therapy?
A: Yes, however, toxicity is an issue, as is the duration of treatment.

Q: How important is PD-1 testing in selecting patients?
A: Aside from managing toxicity and trying to maximize benefit, it comes down to the number of patients you want to treat to get a result. First- and second-line data show that benefit is driven in patients with a high-level of expression. But there is no clear answer to this question yet.

Q: Afatinib use in patients with an EGFR exon 19 deletion is clinically important, but there are side effects and dose-reduction is often necessary. Can you reduce the dose from 40 mg to 20 mg?
A: Yes, you can.

Q: Should we still use tyrosine kinase inhibitors (TKIs) without using EGFR status (excluding first line and maintenance)?
A: Difficult to answer, but patients with a positive result show greater benefit.

Q: What kind of diagnostic tools (if any) can distinguish true from pseudo progression with checkpoint inhibitors? Do you believe in pseudo progression?
A: No. It is a term that has been invented by people doing clinical trials outside of the academic setting. If in the rare case you think you see it, wait 3 weeks and re-evaluate.

Q: What mutations occur after anaplastic lymphoma kinase (ALK)-TKI treatment, if any?
A: It is known that 50% of the patients receiving crizotinib front line have another type of resistant mutation in the ALK domain. In the other 50% there are other types of genomic alterations.
Second and third generation ALK inhibitors are more active because they are targeting the resistant mutation after crizotinib treatment. Further to this, second and third generation ALK-inhibitors have varying efficacy, hence the choice of ALK-inhibitor may need to be determined by testing which mutation is present.


ECCO 2017 About the Speakers

Keith Kerr, MB ChB, MRCPath, FRCPath

Keith Kerr, MB ChB, MRCPath, FRCPath

Keith Kerr bio speaker at Ecco 2017 - Lungcancer Resource CenterUniversity of Aberdeen, Aberdeen, Scotland

Keith Kerr graduated with a first-class BSc (Hons) in pathology in 1978, an MB ChB in 1981, an MRCPath in 1988, and an FRCPath in 1998; he has been a consultant pathologist in Aberdeen since 1989, was elected Honorary FRCP(Ed) in 2006, and was awarded an Honorary Chair in Pulmonary Pathology by the University of Aberdeen in 2006.

Dr Kerr has worked in diagnostic histopathology throughout his career, with a special interest in thoracic pathology, whilst keeping close links with the clinical practice of thoracic medicine, especially thoracic oncology. He has an active interest in research, both in his own laboratory and through national and international collaboration. He enjoys teaching at under- and postgraduate level.

Dr Kerr has had a career-long interest in lung cancer. He has been a member of the International Association for the Study of Lung Cancer (IASLC) for 16 years and currently serves on the IASLC Board and the IASLC Pathology Committee. He has participated in numerous clinical research lung cancer trials groups and is a member of many societies, including the British Thoracic Society (BTS) and the European Society for Medical Oncology (ESMO). Dr Kerr serves on the ESMO Lung Educational Faculty and was a member of the panel for the 2004 and 2015 World Health Organization lung cancer classification process. He is currently involved in the revision of the BTS mesothelioma guidelines. Dr Kerr is a regularly invited speaker and faculty member at major international conferences, both in pathology and in thoracic oncology. He is an associate editor for the Journal of Thoracic Oncology.

Christian Manegold, MD

Christian Manegold, MD

Christian Manegold bio speaker at Ecco 2017 - Lungcancer Resource CenterMedical Faculty Mannheim, Heidelberg University, Germany

Christian Manegold studied medicine in Berlin and Heidelberg, Germany, graduating with a MD from the Ruprecht Karls University in Heidelberg in 1974. He took up a residency in the pathology department of the same university in 1976 and worked in the USA for 3 years, before returning to Heidelberg in 1979. Professor Manegold gained board certification in internal medicine and in haematology/oncology in 1985 and 1986, respectively; this was followed by a professional appointment as Consultant in Haematology/Oncology at the Thoracic Hospital in Heidelberg, and Head of Interdisciplinary Thoracic Oncology at the Department of Surgery, Heidelberg Medical Centre Mannheim, Germany, a post he held from 2004 to 2013. He was appointed Professor at Ruprecht Karls University in 1996. He has been the Senior Advisor at the Interdisciplinary Cancer Centre in Mannheim since 2013.                                     

Professor Manegold has extensive experience as a clinical investigator, and national and international trial leader as well as a member or leader of independent data monitoring committees (IDMCs) in numerous clinical trials in oncology, both in thoracic cancers and other indications.

Professor Manegold is a member of the German Cancer Society, the European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), and the International Association for the Study of Lung Cancer (IASLC). He was Chairman of the European Organisation for Research and Treatment of Cancer Lung Cancer Group (EORTC-LCG) from 2000 to 2003. He served as Chairman of the IASLC Ethics/Sponsorship Committee from 2007 to 2009 and as member of the IASLC Board of Directors from 2011 to 2015.

Giorgio Scagliotti, MD, PhD

Giorgio Scagliotti, MD, PhD

Giorgio Scagliotti bio speaker at Ecco 2017 - Lungcancer Resource CenterUniversity of Turin, Orbassano, Italy

Giorgio Scagliotti is Professor of Medical Oncology at the University of Turin in Italy, and is also a member of the Academy of Medicine at the same university. He is currently the Chief of the Medical Oncology Division at the San Luigi Hospital, Orbassano (Turin), and Head of the Department of Oncology at the University of Turin. Professor Scagliotti earned his medical degree and completed his postgraduate training in respiratory medicine, internal medicine, and medical oncology at the University of Turin.

Over the past 25 years, his research interests have included experimental studies on basic and clinical applied research in lung cancer, including translational research. He has been, or is currently, the study coordinator for several European and international clinical trials on lung cancer chemotherapy; he has also served as a key investigator in several Italian studies examining the role of chemotherapy in early-stage non-small-cell lung cancer.

Professor Scagliotti is a member of several scientific societies, including the Italian Society of Respiratory Medicine (SIMER), the European Respiratory Society (ERS), the American Society of Clinical Oncology (ASCO), and the International Association for the Study of Lung Cancer (IASLC). He was a member of the International Affairs Committee of ASCO from 2002 to 2005 and an executive board member of IASLC from 2003 to 2007. He also served on the ASCO Publication Committee (from 2005 to 2008) and the Program Committee (from 2005 to 2007). He is currently the President-Elect of IASLC, for a term of office from 2015 to 2017.

Professor Scagliotti is a regular reviewer for several scientific journals. He currently serves on the editorial boards of Critical Review in Oncology, Hematology, and Oncology News. He served as Associate Editor for the Journal of Thoracic Oncology for 10 years and is International Editor for Clinical Lung Cancer. He is the author or co-author of almost 300 publications in peer-reviewed journals, International Editor of the 4th edition of the book Lung cancer: principles and practice, and co-editor of the textbook The IASLC multidisciplinary approach to thoracic oncology, published in 2014.

Nicholas Thatcher, MB, BChir, PhD, FRCP, DCH, DMRT

Nicholas Thatcher, MB, BChir, PhD, FRCP, DCH, DMRT

Nicholas Thatcher bio speaker at Ecco 2017 - Lungcancer Resource CenterChristie Hospital NHS Trust, Manchester, UK

Nicholas Thatcher is Professor of Medical Oncology at Christie Hospital NHS Trust in Manchester, UK. He has held posts in general medicine and oncology at St Bartholomew’s Hospital, the Royal Postgraduate Medical School, and Middlesex Hospital Medical School, all in London, UK. He was appointed to his current post in 1996.

Professor Thatcher studied medicine at the University of Cambridge and St Bartholomew’s Hospital Medical College, graduating with an MB and a BChir degree. He earned his PhD at Manchester University, and holds a diploma of child health and a diploma of medical radiotherapy.

Professor Thatcher’s areas of research interest include non-small-cell lung cancer and small-cell lung cancer, including the integration of chemotherapy and radiotherapy. His current main focus is on the clinical development of targeted drugs. He is a fellow of the Royal College of Physicians (RCP) of London, and is the author of over 350 publications in peer-reviewed journals including The Lancet, Lancet Oncology, Journal of Clinical Oncology, Oncologist, and Lung Cancer. He is joint editor of the textbook New perspectives in lung cancer, with Stephen Spiro.

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Interactive Case Reports

Read more about recent cases from the Journal of Thoracic Oncology. Test your knowledge and answer the questions following the case to get immediate feedback.