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By Miriam Mirza

In recent years, significant strides have been made in evaluating lung cancer’s response to immunotherapy and targeted treatments. At ECR 2024, experts shared insights on the critical role of standardized assessment criteria, the impact of genetic mutations in therapy, and the application of cutting-edge imaging techniques.

Professor Marie-Pierre Revel, Head of the Radiology Department at Cochin Hospital, University of Paris, France, focused on these developments in her presentation ‘Assessing Lung Cancer Response to Immunotherapy and Targeted Therapies’. She stressed the necessity of using standardized criteria for accurate therapy effectiveness assessment. ‘To prevent errors, we must employ standardized criteria such as RECIST,’ she said. 

Prof. Marie-Pierre Revel

Revel recommended tumor biopsy during treatment for more accurate disease progression assessment, especially since dramatic responses are often observed under targeted therapy. ‘These insights are vital for understanding treatment efficacy and tailoring therapeutic strategies,’ she said.

Professor Robin Cornelissen, Head of the Department of Pulmonary Medicine at Erasmus MC Rotterdam, the Netherlands, explored significant aspects and advances in lung cancer treatment in the following talk. He highlighted the role of genetic mutations like EGFR and ALK in developing targeted therapies. ‘Initial steps were taken in the late 2000s with EGFR-TKIs becoming standard therapy thereafter,’ he said.

Cornelissen also stressed the growing importance of immunotherapy, particularly PD-1/PD-L1 blockades, with notable success: ‘Five years on, nearly a third of patients with high PD-L1 expression are still alive,’ he said, anticipating further progress and adjustments in immunotherapy and targeted treatments to combat cancer cell resistance mechanisms.

The community is now increasingly understanding these mechanisms and the tumor microenvironment, underscoring the need for personalized and advanced treatment approaches in lung cancer, he concluded.

Advanced tumor assessment techniques

Professor Helmut Prosch, Assistant Professor of Radiology at the Medical University of Vienna, offered an in-depth analysis of advanced tumor assessment techniques beyond traditional lesion size measurement in his lecture.

Prof. Helmut Prosch

He emphasized the growing relevance of imaging techniques and biological markers in cancer assessment, and identified the integration of radiomics and machine learning as the foundation for developing more precise, individualized patient prognoses. ‘Radiomics allow for a deeper comprehension and categorization of tumors’ heterogeneous nature,’ he said.

Prosch also highlighted the significance of PET-CT imaging in therapy response assessment, offering unique insights into tumor metabolic activity. ‘These imaging and data analysis advancements lead to more accurate, personalized tumor assessments,’ he explained.

The session underscored the complexities and dynamics in lung cancer assessment and treatment. Progressively precise assessment methods, advancements in genetic and immunotherapy research, and increasingly tailored treatment approaches will continue to help in effectively addressing oncological challenges.