The 2022 Congress of the European Society for Medical Oncology (ESMO) was held in Paris in September 2022. Eagerly awaited after two years of virtual meetings, pertinent data from several trials were presented in different fields of oncology, high-lightening the outstanding position this congress has achieved among oncology conferences. In this issue of the Magazine of European Medical Oncology (MEMO) a series of articles summarizes the most relevant results in the fields of non-colorectal gastrointestinal cancer, non-small-cell lung cancer (NSCLC), CNS tumours, and breast cancer.

In their article, Dr. Bergen and Dr. Ilhan-Mutlu focus on the DESTINY-Gastric02 trial [1]. In this phase II trial, the antibody-drug conjugate (ADC) trastuzumab deruxtecan (T-DXd) yielded an overall survival of 12.1 months as second-line therapy in patients with HER2-positive gastric- and gastroesophageal junction cancer, leading to European Medicines Agency (EMA) approval in this setting. Beside this study, important results from trials in cholangiocellular carcinoma, pancreatic cancer and hepatocellular carcinoma are also discussed.

Dr. Hovath and Dr. Pall discuss encouraging results of the phase II INCREASE trial investigating neoadjuvant chemo-immunotherapy and updated disease-free survival (DFS) outcomes of the phase III ADAURA trial [2]. While DFS benefit of osimertinib was maintained with longer follow-up, overall survival (OS) results remain immature. In advanced disease, the phase III trial CodeBreak200 compared the KRAS-G12C-inhibitor sotorasib with docetaxel; in this setting, biologically targeted treatment was markedly superior, defining a potential novel treatment standard. Finally, in the relevant population of patients non-eligible for platinum-based chemotherapy, atezolizumab was superior to single agent vinorelbine or gemcitabine.

In contrast to other solid malignancies, little progress was made in primary CNS tumours over the last decade. Despite this apparent stand-still, nearly 40 abstracts from the field of neuro-oncology were presented as reported by Dr. Mair and Dr. Berghoff, with a focus on immunomodulatory agents and novel targeted treatment approaches [3]. In HER2-positive breast cancer patients with active brain metastases, updated results from the TUXEDO‑1 trial revealed maintained quality-of-life and neuro-cognitive functioning on systemic treatment with T‑DXd.

In breast cancer, Dr. Marhold discusses updated results from the DATA trial supporting extended adjuvant endocrine therapy in patients at increased recurrence risk [4]. In the metastatic setting, updated results from the pivotal MONARCH3 trial indicted a clinically relevant albeit formally not significant OS benefit in favour of first-line abemaciclib plus endocrine therapy over antihormonal treatment alone. In heavily pretreated patients with luminal disease, an update from TROPICS02 revealed superior OS with the TROP2-directed ADC sacituzumab govitecan over conventional chemotherapy. Furthermore, thought-provoking data on immunotherapy approaches as well as novel endocrine treatment options are presented.

In summary, these article series review several highlights from the 2022 ESMO congress allowing for a hopeful look into the future.