March 25, 2021 - Supplement: Gastrointestinal Oncology Almanac (View All Issues)
Gastrointestinal Oncology Highlights 2020–2021 Almanac
Cancers of the digestive tract account for 338,090 new cases and 169,280 deaths annually in the United States. Although the overall mortality from these cancers is decreasing, this has been countered by an increase in the incidence of colorectal cancer in young adults. The rising incidence and poor ...
Treating Colorectal Cancer in the Time of COVID-19
The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. In the spring of 2020, The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing...
KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer
In an updated analysis of the pivotal phase III KEYNOTE-177 trial of pembrolizu-mab for microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to ...
Fam-Trastuzumab Deruxtecan-nxki Shows Benefit in Refractory Colorectal Cancer
Having recently gained approval in metastatic breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd) is now proving its worth in metastatic colorectal cancer, according to results of the phase II DESTINY-CRC01 study in patients with HER2-positive disease.1
T-DXd is an antibody-drug conjugate...
Two Studies Validate Neoadjuvant Chemotherapy With Short-Course Radiotherapy or Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer
In the treatment of resectable, locally advanced rectal cancer, researchers are trying to identify the most effective chemotherapy regimens, the best radiotherapy approaches, and the optimal sequence of these modalities. Two phase III trials presented during the ASCO20 Virtual Scientific Program...
Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile
“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...
Novel Therapies and New Indications for Use in the Treatment of Gastrointestinal Cancers
The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of novel drugs and new indications for treating patients with gastrointestinal malignancies. A summary of these approvals is provided herein.
Nivolumab plus ipilimumab: On March 10, 2020, the FDA granted...
Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults
Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...
IMbrave150 Trial: Atezolizumab Plus Bevacizumab Improves Survival in Unresectable Hepatocellular Carcinoma
As reported in The New England Journal of Medicine by Richard S. Finn, MD, of Jonsson Comprehensive Cancer Center, Geffen School of Medicine at the University of California, Los Angeles, and colleagues, the phase III IMbrave150 trial has shown that anti–PD-L1 plus anti-VEGF therapy with...
IMbrave150: A New Standard of Care to Treat Hepatocellular Cancers?
In 2007, sorafenib became the first approved systemic therapy for hepatocellular cancers and the first agent to improve overall survival in these patients.1 In a similar multikinase inhibitor strategy, lenvatinib was found to be noninferior to sorafenib in overall survival in the same patient...
ASCO Names Advance of the Year: Molecular Profiling Drives Progress in Gastrointestinal Cancers
Molecular profiling allows clinicians to identify the molecular and genetic signatures that help to deliver treatments that are highly specific to a tumor. This tool has made possible a number of advances in the past year that are improving care for patients with gastrointestinal cancers. In...
ClarIDHy Trial: IDH1 Inhibitor Ivosidenib Improves Survival in Cholangiocarcinoma
Ivosidenib, an inhibitor of isocitrate dehydrogenase 1 (IDH1), improved overall survival by almost 3 months in previously treated patients with advanced IDH1-mutated cholangiocarcinoma, compared with placebo, researchers of the global phase III ClarIDHy trial reported at the 2021 Gastrointestinal...
FGFR2 Inhibitor Infigratinib Active in Chemotherapy-Refractory Cholangiocarcinoma
The novel targeted agent infigratinib (BGJ398) showed clinically meaningful activity against chemotherapy-refractory cholangiocarcinoma in patients with fibroblast growth factor receptor (FGFR2) fusions and rearrangements. The confirmed overall response rate was 23% (34% confirmed/unconfirmed), the ...
In Cholangiocarcinoma, Does Chemotherapy Response Vary According to FGFR2 Status?
With inhibitors of fibroblast growth factor receptor 2 (FGFR2) fusion and other genetic alterations now in clinical trials for cholangiocarcinoma, there is interest in better understanding what FGFR2 genetic alterations mean for patients. In particular, little is known about the effects of FGFR2...
Novel CK2 Inhibitor Silmitasertib Shows Promise in Cholangiocarcinoma
A novel inhibitor of casein kinase 2 (CK2) has shown preliminary evidence of efficacy in patients with locally advanced or metastatic cholangiocarcinoma, according to a phase I/IIb study presented at the 2021 Gastrointestinal Cancers Symposium.1
Silmitasertib (CX-4945) is an oral small-molecule...
Cholangiocarcinoma: Often Misdiagnosed, Always Impactful
A large survey of patients with cholangiocarcinoma indicates the toll this cancer takes on patients, even those with early-stage disease, as reported at the 2021 Gastrointestinal Cancers Symposium by Kristen Bibeau, PhD, MSPH, Head of Global Health Outcomes and Real-World Evidence Generation at...
SWOG S1505 Trial Evaluates Neoadjuvant Regimens in Pancreatic Cancer
The much-anticipated SWOG S1505 trial has failed to show that one preoperative regimen is better than another in resectable pancreatic cancer.1 “Perioperative modified FOLFIRINOX and gemcitabine/nab-paclitaxel appear to have similar efficacy, with acceptable safety and resectability rates,”...
New Maintenance Therapies in Metastatic Pancreatic Cancer Aim to End Perpetual Chemotherapy
The advent of effective combination chemotherapies has changed the treatment landscape for metastatic pancreatic cancer, extending median survival and leading to durable responses in a subset of patients. However, perpetual chemotherapy is cumulatively toxic, leading to progressive bone marrow...
An Integrated Framework for Improving Outcomes in Pancreatic Cancer
Drawing on several lines of ongoing research, David A. Tuveson, MD, PhD, has created a theoretical framework to consider while developing clinical trials in pancreatic cancer. In his keynote lecture at the 2020 American Association for Cancer Research (AACR) Special Conference on Pancreatic Cancer, ...
Nivolumab Plus Chemotherapy: New Standard of Care in Advanced Gastric Cancer?
As first-line treatment for advanced gastric cancer, nivolumab plus chemotherapy leads to significantly improved progression-free and overall survival over chemotherapy alone, investigators reported during a Presidential Symposium of the European Society for Medical Oncology (ESMO) Virtual Congress ...
Targeting FGFR2b With Bemarituzumab Plus Chemotherapy in Gastric or Gastroesophageal Junction Cancer
Gastric cancer appears to have a new druggable target: fibroblast growth factor receptor 2b (FGFR2b). Targeting FGFR2b with bemarituzumab plus chemotherapy led to clinically meaningful and statistically significant improvements in progression-free survival, overall survival, and response rate in...
