The 2023 World Conference of Lung Cancer (WCLC), organized by the International Association for the Study of Lung Cancer (IASLC), was grandly held in Singapore from September 9th to 12th. At the WCLC conference, Dr. Clarissa Baldotto, President of the Brazilian Group of Thoracic Oncology, was invited by “Oncology frontier” to talk about the treatment strategies for lung cancer after immunotherapy failure, as well as the current status and future development of oncology in Brazil.
Dr. Clarissa Baldotto
Director of the Oncology Integration Center at Oncologia D’Or
Oncology frontier: Can you tell us about your background and what initially inspired you to pursue a career in medical oncology, particularly in the field of Thoracic and neuro-oncology?
Dr. Clarissa Baldotto: I actually had my first contact with medical oncology during my internal medicine residence and then I graduated from Brazilian National Cancer Institute, the medical oncology Residents. At that time I had a mentor and his work was focused on lung cancer so that’s why I start my interest in lung cancer and I start working with clinical research which was very important. And then I would like to highlight some kind of opportunities. For instance, I had the opportunity to be an IDASC or a recipient, and spend a time at Princess Margaret Hospital. So I think this kind of opportunities are very important to stimulate the young fellows. Regarding Neuro-oncology actually I start being interested in brain metastases because of lung cancer. And also I’m working with Neuro-oncology. I think it’s a very promising area in medical oncology especially regarding to biomarkers development.
Oncology frontier: As the president of the Brazilian Group of Thoracic Oncology, could you highlight some of the key initiatives or projects that the group is currently involved in to advance research and treatment in Thoracic oncology?
Dr. Clarissa Baldotto: The Brazilian group of thoracic oncology is a group composed of medical oncologist, pathologist, thoracic surgeon, and the homologist. Our main focus is education, collaboration, and also stimulate research in the country. We have a lot of different and important projects going on now. I would highlight maybe three important medical meetings, one is national and others are regional, where we want to stimulate and develop the original leadership since Brazil is a huge country. We also work stimulated in supporting initiative, investigator initiative, clinical researches. And also, in a regular base, we try to publish national data because in Brazil we have a lot of disparities. We have private and public health systems. We want to provide data so that the government and other institutions could, based on our data, support important decisions in the country. We also work with education for fellows and young oncologists. And recently we are working with patients to try to improve as a focus in Brazil. Especially now we have a huge project to stimulate molecular testing in the country.
Oncology frontier: Your topic for 2023 WCLC is “Chemotherapy after Immunotherapy Failure- What’s the best strategy?”. Could you provide insights into the rationale behind this research focus and what you hope to discover through your work in this area?
Dr. Clarissa Baldotto: Well today I’m going to talk a little bit about immunotherapy failure. It’s a huge challenge. Actually, I think I’m going to put more questions than answers during my lecture. But what is really important is that most of our patients will progress during immunotherapy treatment. Most of them will progress in the first nine months after treatment. So we still have a big unmet need in this field. I think over the next 10 years, despite a lot of advances in immunotherapy that has been a really game changer, we still rely on docetaxel and anti-angiogenic to treat these patients. Now we have a lot of developments in this field like antibody drug conjugates, new combinations with immunotherapy or not, but still we are waiting for further development in this area.
Oncology frontier: Immunotherapy has been a game – changer in cancer treatment. Could you explain the challenges patients face when they do not respond to immunotherapy and why finding alternative strategies is essential?
Dr. Clarissa Baldotto: Well, as I mentioned, 90% of our patients would progress after being treated with immunotherapy. And for me, the priority, the biggest challenge is to know who is going to respond. We still don’t have a good biomarker to identify patients who are going to have a good outcome after being treated with immunotherapy. And it’s important not only to avoid progressive disease or to increase response, but also to avoid the high cost of an ineffective treatment. So I would say that our biggest challenge now is to develop biomarkers which could identify responders, and how is resistant occurred. So that we can develop more effective treatments in the future.
Oncology frontier: In your role as a Clinical Researcher at Instituto D’Or for Research and Education, can you share some recent or ongoing research projects that you find particularly promising or impactful in the field of thoracic oncology?
Dr. Clarissa Baldotto: Instituto D’Or is a non -profit institute in Brazil, and we are linked to more than 60 hospitals all over the country. Now we are developing a nationwide database so that we can have real time data collected regarding thoracic malignancies in Brazil. This project is also linked to a navigation program where we can drive our patients through this pathway and try to improve our treatment in Brazil. It is still a huge challenge in Brazil to access to treatment now. Maybe we can propose new trials focusing on the needs of our area.
TAG: WCLC 2023, Interview, failure of immunotherapy
