On 27 September, an official total of 28,571 participants from 138 different countries descended on Barcelona for the ESMO annual meeting. ‘ESMO’ has for some time been a highlight of the year for researchers, clinicians and related health-care professionals, patients and their representatives owing to both the quantity and quality of new data that are reported, and this year’s meeting did not disappoint in this regard.

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Building on the theme of “Translating science into better patient care”, this meeting featured an impressive number of talks and other sessions focusing on the importance of good translational research to the improvement of patient outcomes. The importance of “achieving great things together” was also recognized in the opening address, and by ESMO’s collaborations with the European Association for Cancer Research, the European Oncology Nursing Society, and commitment to supporting a greater level of patient advocacy.

Notable new data reported at the meeting included the expansion of the role of poly (ADP-ribose) polymerase (PARP) inhibitors to patients with non-BRCA1/2 mutant homologous recombination repair (HRR)-deficient ovarian cancers in the first-line setting. Data supporting a similar approach in patients with HRR-deficient advanced-stage prostate cancer provided an indication that the effectiveness of this approach is not limited to ovarian cancer only.

Elsewhere, mature overall survival (OS) data from several practice-changing phase III trials confirmed the benefits of various approaches: CDK4/6 inhibitors were confirmed as prolonging OS in women with hormone receptor-positive, HER2-negative breast cancer; osimertinib was demonstrated to be superior to earlier-generation tyrosine-kinase inhibitors in patients with EGFR-mutant non-small-cell lung cancer (NSCLC); and the combination of ipilimumab with nivolumab was shown to provide superior OS compared with chemotherapy as a first-line treatment of patients with advanced-stage NSCLC. Furthermore, an update from the CheckMate 067 trial, which included 5-year follow-up data on the performance of ipilimumab plus nivolumab, confirmed the sustained benefits of this combination in patients with metastatic melanoma.

Further highlights included the emergence of new treatment options for patients with historically difficult-to-treat cancers, including an improvement in progression-free survival with the IDH1 inhibitor ivosidenib in patients with IDH1-mutant cholangiocarcinomas, and an improvement in OS among patients with oesophageal squamous cell carcinomas with nivolumab, relative to chemotherapy.

The issue of how to treat patients who ultimately have disease progression following a response to immune-checkpoint inhibitors also received some attention. Partial responses, but not complete responses, were reported among 70 patients who were re-challenged with durvalumab on disease progression, having initially responded to treatment with this anti-PD-1 antibody administered for a fixed duration of 1 year.

The often overlooked, but nonetheless highly relevant, area of cancer prevention received attention in the form of a Keynote Lecture by Jack Cuzick, who highlighted the notable successes of HPV vaccination programmes in countries in which vaccines are administered universally, and in community settings such as schools and colleges, as opposed to clinic-based programmes, which typically lead to lower levels of coverage.

The contents of this year’s ESMO also reflected the changing needs of society. A group of six delegates from Sweden travelled to the meeting by train in order to raise awareness of the environmental implications of the air miles accumulated by the large number of international delegates. In this regard, some credit should go to ESMO for endeavouring to make many of the presentations available online. In the future, an increased number of ‘satellite’ meetings in which sessions are streamed in realtime to audiences in various global locations, perhaps with the potential for interaction between delegates in different locations, could further mitigate these negative environmental effects. Similarly, cost considerations came to the fore in an increasing number of talks and the challenges in this area were summarized neatly by melanoma patient advocate Bettina Ryll: “Do not punish patients in desperate situations for society’s mistakes in handling innovation.”