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This article intends to summarize personal highlights of the ESMO (European Society for Medical Oncology) 2018 meeting and does not aim to give a comprehensive overview. We will summarize the most recent presented data on the treatment of non-small cell lung establishing first-line combinational therapies (chemotherapy backbone with immunotherapy) as standard of care. Furthermore highly practice relevant data on the treatment of recurrent or metastatic head and neck squamous cell carcinoma were presented. Next the treatment landscape of metastatic prostate cancer is changing rapidly and some new aspects in metastatic disease are reported.