ESMO 2024

We’ve heard it before, but maybe - just maybe - we’re at the brink of a new frontier for cancer care. ESMO 2024 has just wrapped up in Barcelona and the take-home message is unlike any other oncology congress in recent memory. There’s a palpable shift in energy and expectation, with advances in immuno-oncology (IO) and antibody-drug conjugates (ADCs) poised to redefine standards of care. Incredibly, those advances are helping inspire a change of emphasis in cancer communications, reframing the narrative to focus on ‘living’ rather than ‘surviving’. It feels like a breakthrough moment, and there should be no turning back.

Our VML Health team hoofed the halls, soaked up the symposia, and embraced the energy at ESMO 2024. Here are our top 5 headlines.

1. IO and ADCs are the future of cancer care

Nobody would say that IOs and ADCs are new kids on the block in cancer care - they’ve both been around for some time. However, data presented at ESMO 2024, prove that the science behind each of them is coming of age, with scope to deliver much more in the future. If we’re talking about moving into a new era for cancer care, there’s no question these innovations will be leading the charge.

IOs continue to cement their value as monotherapy or in combination in the peri-surgery setting, significantly improving outcomes as neoadjuvant and adjuvant therapies. For example, data reported in a Presidential Symposium showed that early-stage immunotherapy alongside standard chemotherapy significantly prolongs overall survival in triple-negative breast cancer. Similarly, in muscle-invasive bladder cancer, new data from the NIAGARA study shows that the addition of an immunotherapy-based treatment alongside neoadjuvant chemotherapy leads to ‘practice changing’ improvements in event-free and overall survival.

Immunotherapy continues to keep its promise and hope of long-term survival. We are seeing many studies in many different cancers showing that immunotherapy can work for a long time.

Alessandra Curioni-Fontecedro

Professor of Oncology at the University of Fribourg

Throughout the Congress, studies consistently showed immunotherapy improving long-term survival in a variety of cancers, including stage III melanoma and small-cell lung cancer. As Alessandra Curioni-Fontecedro, Professor of Oncology at the University of Fribourg, told an ESMO audience: Immunotherapy continues to keep its promise and hope of long-term survival. We are seeing many studies in many different cancers showing that immunotherapy can work for a long time.”

Advances in antibody-drug conjugates are similarly impressive. Once again, ADCs aren’t new – Pfizer brought the first one to market (in AML) more than 20 years ago – but developments in the last few years have revitalized the field, and success stories like Enhertu have only elevated their profile. Data presented at ESMO indicates that ADCs have the potential to establish themselves as the new standard of care across multiple tumors and lines of therapy. For example, phase 3b/4 studies show ADCs offer hope for patients with HER2-positive metastatic breast cancer, including those with brain metastases. Research also suggests that broadening the use of current ADCs to a wider population, as well as exploring novel ADCs in advanced or metastatic breast cancer, could play a big role in targeting HER2 and HER3 to drive better outcomes.

We also heard how Claudin-targeted ADCs are showing promise in the treatment of solid tumors, representing a significant advance in the pursuit of precision oncology. According to Dr Valentina Gambardella from the INCLIVA Biomedical Research Institute: “The specificity of these targets, combined with the potency of ADCs, offers a promising approach to treating solid tumours that have become resistant to other forms of therapy.”

Clearly, the oncology community is appreciative of the efficacy and tolerability of ADCs compared to traditional chemotherapy. We’re only just beginning to understand what they can bring to the table, either as monotherapies or in combination, but the potential is really exciting. However, the availability of multiple ADCs in market, and the prospect of many more in development, raises important questions: How can we further improve their tolerability? How early should we use them and which combinations is best? How should we approach sequencing? How can we improve use of biomarkers to better predict response?

The answers will no doubt emerge over time as the momentum behind ADCs continues. For now, there’s a clear movement toward elevating these products from a focus on refractory disease to earlier lines of therapy in the metastatic setting. It’s going to be fascinating to see whether, in the coming years, they can crack the early-stage space and replace chemotherapy.

The specificity of these targets, combined with the potency of ADCs, offers a promising approach to treating solid tumours that have become resistant to other forms of therapy.

Dr Valentina Gambardella

INCLIVA Biomedical Research Institute

2. It’s cancer care, not treatment

It goes without saying that when it comes to demonstrating the benefits of new therapies, efficacy is key. However, as improvement in outcomes become incremental in subsequent lines of therapy in the metastatic setting – for example, 5.1 months PFS versus 3.6 months PFS – safety and tolerability are becoming more and more important. ESMO 2024 showed that pharma companies are acknowledging this, embracing a more holistic view of the patient experience.

Across the event, pharma communications spoke to ‘doing it together’, not just providing another option; they spoke to care, not treatment. To ‘life’, not survival. The shift was as noticeable as it was powerful, with patient-first, care-centered language a dominant theme. Notable examples include:

“Allowing her to live a fulfilling life” – Helsinn
“Cancer care is personal for us. Life Forward” – Boehringer Ingelheim
“Leading a revolution in oncology to redefine cancer care” – AstraZeneca
“Helping to bring more life to people with cancer” – Gilead
“Changing the course together” – Astellas
“First-line power, real-life passions” – Takeda
“There’s surviving, and then there’s living” – Orion Pharma & Bayer

The emphasis on living life, not just surviving, and on person-centered care – rather than disease-centered treatment – is a direction of travel that can only improve experiences and outcomes in cancer.

3. There’s a bigger picture, beyond care

As ever, science stole the headlines, but ESMO also revealed a community that’s increasingly recognizing its responsibilities aren’t limited to oncology. As we move beyond the focus on ‘survival’, there’s much more to tackle, like ageing populations, persistent health inequities, and the links between climate and health becoming ever clearer.

The Congress showed that companies are viewing the world more holistically, extending their focus to include sustainability, diversity, and equity. Organizations like AZ advocated a science-based approach to sustainability for a healthier future. BMS and J&J showcased initiatives designed to impact the community at large rather than specific cancer types. Sanofi and Esai campaigned for diversity and inclusion in clinical trials. And the hosts lived up to their responsibilities too, with ESMO providing a 5-day public transport pass for delegates. The bottom line: there’s a bigger picture beyond care, and investment in initiatives to support sustainability and DE&I can only help drive cancer equity.

4. AI is becoming mainstream in oncology

Unsurprisingly, the role of AI – both present and future – featured in many presentations. It confirmed what we already know: AI is becoming more and more integrated in oncology, whether that’s through drug development platforms that help identify optimal molecules or overcome concerns of developing resistance, or tools that enable superior imaging analysis. We’re already seeing the benefits of leveraging data at speed and scale, and it’s only going to continue as we learn more about what technology can do. Such is the opportunity, ESMO has introduced a new event dedicated to AI in cancer. The ESMO AI & Digital Oncology Congress will take place in Berlin, Nov 12-14, exploring the “intersection of AI, digital health, and oncology.”

5. The audience is evidence-driven… but there’s room for innovation

When it comes to the exhibition hall at ESMO, booth engagement seemed lower this year, with fewer tactics to draw audiences (including a notable drop in ‘gaming’ experiences). This reflects the trend for a more consolidated and smarter spend at congresses, with major meetings like ASCO also experiencing a similar dip in engagement this year. That said, there were still some standout experiences and learnings:

Mixed Reality has replaced AR and VR, proving both engaging and educational for delegates. One of the best examples of this was Novartis’ booth experience for radioligand therapy, which told a story about a patient, treatment and imaging – including putting the patient in an MRI machine – in a fun, interactive and educational way. Other highlights include:

Pfizer’s “Cancer doesn’t play fair” commercial – which presented an interesting new take on cancer, with poker animation. Innovative and surprising from both a message and execution POV.
GSK’s shingles vaccine booth, which included a postherpetic neuralgia experience that invited delegates to “experience the shock sensation for yourself.”
Merck took over the outside of the entire metro station near to the congress for its bladder awareness campaign: “Listen to your bladder: unexpected colors in your pee?” This ‘Guerilla tactic’ really stood out.

These examples, and the engagement they achieved in the hall (and outside of it), underline a key learning around medical communications in oncology: yes, the audience is evidence-driven… but there’s always room for innovation.

This September, VML Health took part in the European Society of Medical Oncology’s flagship annual congress, ESMO 2024. This important international meeting hosted in Barcelona, offers a comprehensive view of the drug development landscape in cancer, as well as new data on the benefits of existing therapies and their impact on outcomes.

The VML Health team was represented by experts in client services, digital strategy, medical and science including: Jason Gloye, Dr Susanne Bobadilla, Barbara Macelloni, Dirk Rossbach, Ursula Comi, Rose Weng, Courtney De Souza, Elena Ricci, Davide Tumiatti, Tatiana Rusconi, Eros Verderio, Roberta Pinto, Talal Gariani, Gemma Berniell-Lee.