Abstract
The 21st International Congress on Anticancer Treatment, endorsed by the American Society of Clinical Oncology, was held in Paris (France) 1–5 February 2010. It was led and jointly sponsored by Gabriel Hortobagyi and David Khayat and by the University of Texas MD Anderson Cancer Center (TX, USA) and the Hôpital de la Pitié Salpêtrière (Paris, France), respectively. The meeting provided complete updates and innovations in the management of various cancers and supportive care. This well-recognized annual international educational and scientific conference brought together the leading scientists from across the world to share their skills and expertise by participating in this high-quality meeting. This congress provides an exceptional opportunity to meet with fellow professionals and discuss new educational case studies. In the present article, we have highlighted particularly pertinent sessions concerning hot topics for the new areas of cancer.
Conference history
The 21st International Congress on Anticancer Treatment (ICACT), endorsed by the American Society of Clinical Oncology, was held in Paris, France. Jointly sponsored and led by Gabriel Hortobagyi and David Khayat and by the University of Texas MD Anderson Cancer Center (TX, USA) and the Hôpital de la Pitié Salpêtrière (Paris, France), respectively, the meeting was well organized and attended by several thousand participants from many countries. The list of members forming the Scientific Committee included well-known international experts whose involvement was reflected in the scientific excellence of the presentations. The meeting’s primary goal was to offer interdisciplinary or multidisciplinary explorations of focused areas of clinical oncology.
Program
The lecture sessions (Clinical Symposium) were designed for an audience of approximately 30–150 attendees per room. They allowed the participants to directly interact with the leading oncology expert giving the lecture.
The program also included ‘Meet the Professor’ lectures, which were dedicated to enhance attendees’ learning experience: one recognized expert interpreted, reviewed and expanded on selected topics. They were designed for a small audience, no more than 50 persons, and were formatted to allow ample interaction between the speaker and the attendees.
The ‘Presidential Session’ represented the masterpiece of the meeting. Four major lectures were given on: ‘novel approaches to advanced castration-resistant prostate cancer’ by Sternberg, ‘update of adjuvant therapy of breast cancer’ by Swain, ‘predictive markers for EGF receptor (EGFR) therapy’ by Shepherd, and ‘management of advanced colon cancer: state of the art 2010’ by De Gramont.
Finally, all around the congress and each day, a large poster session was presented. Most of them represented rare tumor series or interesting case reports. Of note, case reports from North Africa were largely represented, providing new and important points of view when the oncologists are faced with the following dilemma: how to treat these rare diseases in oncology.
Two awards were attributed: the 18th Claude Jacquillat Award for clinical cancer research and the 17th Raymond Bourgine Award for achievement in cancer research were given to Margaret A Tempero and Pierre Cambon, respectively.
Targeted molecular therapies in breast cancer setting
It is now clear that the biologic and clinical heterogeneity of breast cancer is explained by differences in the genetic composition of the primary tumors. Molecular classification of breast cancer using microarray technology consistently demonstrated the existence of at least four major subtypes: basal-like breast cancers, which express basal cytokeratins and mostly correspond to triple-negative tumors; luminal-A cancers, which are mostly estrogen receptor (ER)-positive and histologically low-grade; luminal-B cancers, which are mostly ER-positive but may express low levels of hormone receptors and are often high grade; and HER2-positive cancers, which show amplification and high expression of the HER2 genes Citation[1].
The development of targeted anticancer therapies stems from advances in molecular biology. Ongoing large academic and industrial clinical trials are now investigating, in the particular scope of breast cancer patients, the potential benefits of new targeted therapies, including ErbB and tyrosine kinase inhibitors, and antiangiogenics Citation[2]. First results demonstrated high efficacy of these drugs nevertheless counterbalanced by the growing clinical and biological evidence that tumor cells may develop unexpected and complex mechanisms of resistance Citation[3]. Moreover, targeted therapies in combination with conventional chemotherapies and radiotherapy may carry a potential risk for additional cardiac toxicity Citation[4].
Predictive markers of efficacy in colorectal cancer
The prognosis of metastatic colorectal cancer remains poor in spite of the advances obtained in recent years with new therapeutic agents, surgical procedures and diagnostic methods. New treatments directed to molecular targets have emerged and are being developed to improve these results, but there is a need to optimize and define the best use of these new approaches. Recent clinical data demonstrated that the efficacy of cetuximab and panitumumab is confined to patients bearing tumors with wild-type K-Ras. Other biomarkers that are being studied and will potentially be of predictive value include B-Raf, N-Ras and PI3K. Other reports tend to demonstrate that tumor overexpression of several genes involved in the EGFR signaling pathway and downstream events might identify patients who are most likely to respond to anti-EGFR agents Citation[5]. Beyond this, current Phase I–III trials address the potential of targeting different or closely associated pathways, the most promising of them being IGF-1-receptor, and the ligands IGF-1 and IGF-2, B-Raf-inhibitors, EGFR2 coinhibition and apoptosis pathways. The development of these innovative treatment modalities is warranted for similar advances in other solid tumors.
Individual customized treatment in lung cancer patients
Personalized treatment involves two major elements. One is appropriate selection of patients for such treatment and the other is introduction of molecular-targeted therapy, that is, therapy against specific molecular targets in cancer. Selection of lung cancer treatment has been historically based on the clinical features of the patient. Advances in molecular biological research have revealed that patients who appear to be in the same population may belong to rather different groups in terms of pharmacogenomics Citation[6]. Progress has been made in studies of gene products, such as RRM1, which is the target of gemcitabine, and those involved in DNA repair, such as ERCC1 and MSH2. At present, ongoing prospective clinical trials are aiming to demonstrate that cisplatin and gemcitabine should not be chosen when ERCC1 and RRM1, respectively, are positive Citation[7]. Another target is represented by EGFR. It clearly appears that the EGFR mutation is both a prognostic and a predictive factor for the efficacy of gefitinib therapy. New facts are emerging through clinical application of advances in molecular biology, very large-scale clinical trials and global studies in selected patients.
Development of oncogeriatry
Oncogeriatry is the clinical discipline concerned with the management of elderly cancer patients. It is based on a global oncological and geriatric approach to the health status of patients. Oncogeriatry has been widely adopted throughout the world, but the approaches used and the organizational solutions provided are complex and varied. Based on the French experience, the different aspects have been largely presented and discussed: clinical management, organization, clinical research and information. Geriatricians, who commonly handle the highly heterogeneous process of aging, have devised a comprehensive multidisciplinary assessment tool called ‘comprehensive geriatric assessment’, in which all aspects of older patients are considered and all resources and abilities are listed. Based on this appraisal, geriatricians can elaborate and co-ordinate an effective care plan with interventions tailored to each individual’s problems. In order to offer a high quality of care for the elderly patients, one must keep in mind that the two principal characteristics of cancer in the elderly are late diagnosis and comorbidity that requires specific geriatric assessment and cooperation between the oncologist and the geriatrician Citation[8].
Summary
The 21st ICACT meeting provided complete updates and innovations in the management of cancer. This well-recognized annual international educational and scientific conference brought together the leading scientists from across the world to share their skills and expertise by participating in this high-quality meeting. This congress provides an exceptional opportunity to meet with fellow professionals and discuss new educational case studies. It also provides an opportunity for the pharmaceutical industry and other companies to present their innovations and research in the exhibition area. Finally, it offers multidisciplinary studies of dedicated fields of clinical oncology that allow attendees to network with world-famous experts in oncology.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
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