ESTRO meets Asia 2024 - Abstract Book

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Invited Speaker

ESTRO meets Asia 2024

545

How to validate the added value of these technologies: RCT, model-based, outcome data?

Wai Tong Ng

Clinical Oncology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China. Clinical Oncology, University of Hong Kong, Hong Kong, China

Abstract

Advanced radiotherapy technologies, such as proton therapy, have gained increasing traction in Asia in recent years. However, the added clinical benefit of these techniques compared to standard radiotherapy approaches remains a subject of ongoing debate, particularly in the context of adult cancers. This presentation will examine three primary approaches used to validate the value of proton therapy in the Asian setting: randomized controlled trials, model-based studies, and analyses of real-world clinical outcomes data. Examples will be drawn from several prevalent adult cancers in Asian populations, such as lung and head and neck cancer, as well as the recent findings from a randomized study comparing intensity-modulated radiation therapy and intensity-modulated proton therapy in oropharyngeal cancer, which were presented at the recent ASCO meeting. The strengths and limitations of each validation method will be discussed, along with considerations for study design and data collection that are specific to the Asian patient population. This comprehensive review aims to provide a balanced perspective on the current evidence and ongoing challenges in demonstrating the added value of advanced radiotherapy techniques in the Asian clinical context.

546

Multidisciplinary management of locally advanced lung cancer

Victor Lee

Department of Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, China

Abstract

Management of locally advanced (most commonly referred to stage III) non-small-cell lung cancer (NSCLC) has always been challenging and difficult. Traditionally it used to be upfront surgery followed by postoperative chemotherapy with or without radiation therapy. More recently, following the discovery of targetable mutations and immune checkpoints and their corresponding ligands on the immune cells and tumour cells respectively, there has been a substantial shift in treatment paradigm for this stage of NSCLC. Perioperative treatment with chemotherapy and immune checkpoint inhibitor is gaining popularity for potentially resectable stage IIIA and possibly stage IIIB lung cancer, especially PD-L1 highly expressed NSCLC. Besides, the presence of common driver mutations e.g. EGFR and ALK has also influenced the treatment decision in the past few years, exemplified by the ADAURA trial and more recent NeoADAURA trial for EGFR-mutated NSCLC and ALINA for ALK-rearranged NSCLC.

For unresectable stage III NSCLC, treatment strategy has also been progressing from concurrent/sequential chemoradiation to the same treatment followed by maintenance durvalumab, represented by PACIFIC and PACIFIC-