D. Facchinelli, A. Polino and A. Stathis
IOSI - Oncology Institute of Southern Switzerland
As in the last editions, the most effective way to overcome some of the logistic issues due to the big number of par-ticipants was to use different locations for parallel sessions across the town, in the nearby university and cinema. The
Break and lunch on the lakeside.
Conference area from a bird’s eye perspective.
weather was gorgeous and the participants enjoyed the walk through the city and the opportunity to have lunch and take a break on the lakeside. Finally, new this year, a climate protection run was organized and performed in Lugano with participation of approximately 150 among the ICML participants. The Foundation for the Institute of Oncology Research (IOR) has compensated 2000 tones of greenhouse gas emissions by investing in South Pole’s climate protection project Paradigm Cookstoves and Wa-ter in Kenya and the run organized in Lugano was part of this project.
Regarding the scientific content, the day before the of-ficial opening of the Congress (19th June), there was as always a closed workshop where the hottest question of the moment is generally discussed by the experts. The topic of this year was «bridging liquid biopsy into man-agement of lymphoma patients: development for clinical research and recommendations for clinical practise». New basic and clinical data were presented in a very intense workshop, which was co-chaired by D. Rossi (Bellinzona), W.H. Wilson (Bethesda) and E. Zucca (Bellinzona). This workshop was organized in cooperation with the Ameri-can Association for Cancer (AACR) and the European School of Oncology (ESO) and with the endorsement of the Leukemia & Lymphoma Society (LLS).
The Henry Kaplan Memorial Lecture, coupled with the San Salvatore Award, is always a significant keynote lec-ture presented at ICML. This time it was the turn of Carl June (Philadelphia), who discussed «next generation CAR-T cells for lymphoma and beyond», describing the process of developing this technology, the current state of the art and future perspectives.
The importance and expansion of CAR-T cells over the last years, with innovative constructs in the way of clini-cal development, has been well captured in this meeting with a dedicated session and 12 oral presentations. The current and future molecular targets, toxicity and its man-agement and possible associations with other drugs were widely discussed.
The Gianni Bonadonna Memorial Lec-ture, sponsored by the AACR, was presented by Ari Melnick (New York). The topic was precision epigenetic therapy for B-cell lymphoma, used as adjuvants to immunotherapies by restoring the ability of T‐cells to recog-nize lymphoma cells.
Another very significant mo-ment was, during the AACR-IC-ML joint session, the presentation by Dr. Singh (New York) on the
«designer organoids for modelling epigenetic, signalling and therapies in lymphoma» discussing the discover-ies enabled by designer lymphoid organoids and on‐chip technologies in understanding critical pathways that have emerged as ther-apeutic targets in lymphoma.
The most interesting papers were presented in the Plenary Session, having in this edition one abstract on chronic lym-phocytic leukemia (CLL) and three abstracts (one transla-tional and two clinical) on diffuse large B-cell lymphoma (DLBCL). In CLL, P. Langerbeins (Cologne) presented re-sults of a large randomized trial in patients with asymp-tomatic early stage disease showing for the first time that treatment with the BTK inhibitor ibrutinib results in im-proved progression-free and event-free survival in compari-son to observation. However, currently there is no overall survival benefit and therefore watch and wait results the standard approach for these patients. In DLBCL, results of two important clinical trials evaluating the addition of the immunomodulatory agent lenalidomide to the standard R-CHOP chemotherapy in treatment naïve DLBCL pa-tients were presented for the first time. U. Vitolo (Torino) presented results of the ROBUST phase III trial in patients with ABC DLBCL showing no benefit from the addition of lenalidomide. On the other hand G.S. Nowakowski (Roch-ester) presented results of ECOG-ACRIN1412 random-ized phase II trial in unselected DLBCL (including both ABC and GCB) which differently than the ROBUST trial showed an improvement in progression free survival in the experimental arm. Taken together, while results of these trials will not change the standard of care in DLBCL, they provide important information that could be used in the
KONGRESSBERICHT
San Salvatore Awardee 2019:
Carl H. June (Philadelphia, PA, USA).
Gianni Bonadonna Memorial Lecture, Laudatio:
Margaret Shipp (Boston, MA, USA).
planning and design of future clinical trials evaluating the addition of new drugs to R-CHOP and may help to better select the patients that could benefit from such treatments.
The paper presented by C. Rushton (Burnaby) on the ge-netic defects in patients with DLBCL resistant to standard chemotherapy adds important information on the molecu-lar mechanisms that lead to failure of standard therapies.
The high educational content of the meeting is high-lighted by the different meet the professor sessions and clinical discussion cases with the interaction of clinicians, pathologists and nuclear medicine doctors. Some of the more lively sessions are represented by the clinical case discussions, in which lately «US vs Europe» discussions are held, in order to better appreciate differences in the daily management of lymphoma patients of both sides of the Atlantic. This time it was «Texas against Spain». As always, also this time specific sessions were organized for radio-oncologists, pathologists and pediatric oncologists.
It is difficult to summarize all the works that were pre-sented this year as important abstracts including data on new drugs and new treatment modalities were presented and discussed. Novel monoclonal antibodies (including an-ti-CD19, anti-CD40), bispecific antibodies, new antibody drug conjugates and second generation BTK, PI3K inhibi-tors clinical data were presented, showing that clinical re-search in lymphoma is rapidly expanding and may lead to significant improvements in patient care in the next years.
In addition, preclinical and clinical results with new drug combinations were presented including chemotherapy-free combinations in indolent lymphomas as well as in aggres-sive lymphomas. Westin JR (Houston) showed interesting results with the combination of rituximab, lenalidomide, and ibrutinib alone prior to combination with chemothera-py for patients with newly diagnosed DLBCL introducing a
new concept of chemotherapy-free treatment in this disease that may merit further exploration.
Finally, S.V. Rajkumar (Rochester) gave a brilliant talk on a special lecture with the title «The high cost of cancer drugs: what can we do?». Indeed, the expansion of new drugs and their introduction into clinical practice is creat-ing a question on their high costs and whether the health economic systems will be able to support them. Dr Raj-kumar critically presented the problem of the high costs associated with new anti-cancer drugs and what should be done in the future. This is an aspect that oncologists and haematologists should consider and especially those that are involved in clinical cancer research.
Overall, the meeting had an enormous success, for many of the attendees this was the most successful ICML, proving once more that ICML is one of the most important confer-ences in the field of lymphoid neoplasms. Participants re-newed the appointment in two years time for the 16th-ICML to be held in June 15-19, 2021 celebrating 40 years since the first ICML back in 1981. ICML will likely continue to expand and Lugano will continue to host this important meeting, which indeed among the lymphoma specialists around the world is usually called the «Lugano meeting».
The expansion of the infrastructures in the city of Lugano and of the University will help to logistically support it.
KONGRESSBERICHT
Take Home Messages: Jonathan Friedberg (Rochester, NY, USA).
Secretariat & Local Organizing Committee.
Correspondence:
PD. Dr. med. Anastasios Stathis
IOSI - Oncology Institute of Southern Switzerland ORBV - San Giovanni Hospital
CH-6500 Bellinzona anastasios.stathis@eoc.ch
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