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Gastrointestinal Cancer

NO-CUT Trial: Nonoperative Management of Benefit for Many Patients With Rectal Cancer

Total neoadjuvant therapy (TNT) followed by rectal surgery is the standard of care in proficient mismatch repair (pMMR) locally advanced rectal cancer, but studies are finding that patients with clinical complete response may often avoid surgery and be followed “nonoperatively.” In the first...

Gastrointestinal Cancer

The Evolving Epidemiology of Gastrointestinal Stromal Tumors in Major Organ Sites

Based on a descriptive, U.S. population–based cohort study reported in JAMA Network Open by Alvarez et al, over the past 2 decades, the incidence of gastrointestinal stromal tumors in major organ sites has increased among several patient populations. The findings may assist in directing future...

Gastrointestinal Cancer

Advanced GIST: Long-Term Outcomes With Discontinuation vs Continuation of Imatinib

In a long-term follow-up of a French phase III trial (BFR14) reported in The Lancet Oncology, Jean-Yves Blay, MD, and colleagues found that discontinuation of imatinib in patients with advanced gastrointestinal stromal tumors (GIST) with at least stable disease was associated with markedly poorer...

Gastrointestinal Cancer
Issues in Oncology
Supportive Care

Stiripentol Could Prolong Efficacy of Chemotherapy in Patients With Gastric Cancer

Targeting lactate with the epilepsy drug stiripentol may reverse chemotherapy resistance in patients with gastric cancer, according to a recent study published by Chen et al in Nature. Background Chemotherapy attacks cancer cells by damaging their DNA. The cancer cells then try to rapidly repair...

Gastrointestinal Cancer
Neuroendocrine Tumors

Advanced Neuroendocrine Tumors: Adding Lu-177 Dotatate to Standard First-Line Therapy

As reported in The Lancet by Simron Singh, MD, MPH, FRCPC, and colleagues, primary results of the international, multicenter, randomized phase III NETTER-2 study have shown significantly improved progression-free survival with the addition of the radioligand lutetium-177 dotatate (Lu-177 dotatate)...

Gastroesophageal Cancer
Gastrointestinal Cancer

Advanced Gastric or Gastroesophageal Junction Cancer: Addition of Relatlimab to Immunochemotherapy

In the phase II RELATIVITY-060 study, results of which were reported in the Journal of Clinical Oncology, Susanna Hegewisch-Becker, MD, PhD, and colleagues found that the addition of the LAG-3–blocking antibody relatlimab to first-line nivolumab plus chemotherapy did not improve the objective...

Breast Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer

FDA Approves Trastuzumab Biosimilar Trastuzumab-strf

The U.S. Food and Drug Administration (FDA) has approved trastuzumab-strf (Hercessi), a biosimilar to trastuzumab (Herceptin), for the treatment of HER2-overexpressing breast cancer and gastric or gastroesophageal junction adenocarcinoma. Trastuzumab-strf is indicated for adjuvant treatment of...

Gastroesophageal Cancer
Gastrointestinal Cancer

Immunotherapy Plus FOLFIRI for Advanced Gastric/Gastroesophageal Junction Adenocarcinoma

In a French noncomparative phase II trial (PRODIGE 59-FFCD 1707-DURIGAST) reported in JAMA Oncology, Tougeron et al found limited activity of FOLFIRI (leucovorin, fluorouracil, and irinotecan) plus durvalumab or durvalumab/tremelimumab in the second-line treatment of advanced...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Bispecific Immune Checkpoint Inhibitor Improves Survival in Patients With Gastric Cancer, Regardless of PD-L1 Status

The PD-1/CTLA-4 bispecific antibody cadonilimab plus chemotherapy improved progression-free and overall survival in patients with untreated, HER2-negative, locally advanced or metastatic gastric or gastroesophageal junction (GEJ) cancer—including those with PD-L1–low tumors—compared with...

Supportive Care
Breast Cancer
Gastrointestinal Cancer

Topical Diclofenac to Prevent Capecitabine-Associated Hand-Foot Syndrome

In an Indian single-center phase III trial (D-TORCH) reported in the Journal of Clinical Oncology, Santhosh et al found that topical diclofenac gel significantly reduced the risk of capecitabine-associated hand-foot syndrome vs placebo gel in patients with breast or gastrointestinal cancer who were ...

Gastroesophageal Cancer
Gastrointestinal Cancer

Adding First-Line Nivolumab to Chemotherapy in Advanced Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinoma

As reported in the Journal of Clinical Oncology by Yelena Y. Janjigian, MD, and colleagues, 3-year follow-up of the phase III CheckMate 649 trial has shown the continued benefit of the addition of nivolumab to chemotherapy in the first-line treatment of advanced gastric, gastroesophageal junction,...

Gastrointestinal Cancer
Gastroesophageal Cancer

Fruquintinib Plus Paclitaxel as Second-Line Treatment for Gastric or Gastroesophageal Junction Cancer

The combination of fruquintinib and paclitaxel is a potential new second-line treatment for patients with advanced gastric or gastroesophageal junction cancer, according to data presented during the ASCO Plenary Series: February 2024 Session (Abstract 438780). Results of the phase III FRUTIGA...

gastroesophageal cancer
gastrointestinal cancer

Ian Chau, MD, on Gastrointestinal Cancers: Real-World Effectiveness of Nivolumab Plus Chemotherapy

Ian Chau, MD, of The Royal Marsden Hospital, discusses reportedly the first study to evaluate the real-world effectiveness of nivolumab as a first-line treatment of advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma. The combination therapy improved overall survival compared with chemotherapy alone. Dr. Chau presents the 18-month follow-up results (Abstract 295).

gastrointestinal cancer
immunotherapy

Yasunobu Ishizuka, MD, on Gastric Cancer: Does Nivolumab Infusion Time of Day Matter?

Yasunobu Ishizuka, MD, of Japan’s Aichi Cancer Center, discusses study results showing that scheduling infusions of nivolumab monotherapy before mid-afternoon for patients with metastatic gastric cancer may alter treatment efficacy. Several studies have suggested that circadian rhythm is essential in immune system function, including anticancer immunity (Abstract 268).

gastrointestinal cancer
neuroendocrine tumors

Lorraine A. Chantrill, PhD, MBBS, on Gastrointestinal Neuroendocrine Carcinomas: First-Line Treatment With Nab-Paclitaxel Plus Carboplatin

Lorraine A. Chantrill, PhD, MBBS, of Australia’s Wollongong Hospital, New South Wales, discusses phase II findings on the combination of nab-paclitaxel plus carboplatin as a first-line treatment for patients with gastrointestinal neuroendocrine carcinomas. According to Dr. Chantrill, this regimen appears to be active in these tumors and warrants further evaluation in a phase III trial (Abstract 589).

gastroesophageal cancer
gastrointestinal cancer

Anant Ramaswamy, DM, on Advanced Gastric Cancers: New Findings on Adding Docetaxel to Doublet

Anant Ramaswamy, DM, of Tata Memorial Centre, discusses phase III results of a study that added docetaxel to a doublet regimen of fluorouracil or capecitabine and oxaliplatin, which did not improve overall survival in patients with advanced gastroesophageal junction and gastric cancers. Continuing chemotherapy beyond 6 months also did not appear to improve survival in this population (Abstract LBA248).

Gastroesophageal Cancer
Gastrointestinal Cancer

Additional Analysis of MATTERHORN Confirms Global Benefit of Durvalumab Plus FLOT in Gastric/Gastroesophageal Junction Cancer

Subgroup analyses of the randomized double-blind phase III MATTERHORN trial continue to show the benefit of adding perioperative durvalumab to standard chemotherapy in patients with locally advanced, resectable gastric or gastroesophageal junction cancer. Detailed findings on pathologic complete...

Gastroesophageal Cancer
Gastrointestinal Cancer

Perioperative Pembrolizumab Plus Chemotherapy in Locally Advanced Gastric/Gastroesophageal Cancer

As reported in The Lancet Oncology by Kohei Shitara, MD, and colleagues, interim analyses of the phase III KEYNOTE-585 trial have shown that the addition of perioperative pembrolizumab to chemotherapy improved pathologic complete response, but did not significantly improve event-free survival, in...

Gastrointestinal Cancer

Expert Point of View: Elizabeth Smyth, MD

ASCO discussant Elizabeth Smyth, MD, a consultant medical oncologist at Oxford University Hospitals National Health Service Foundation Trust in the United Kingdom, commented on the EDGE-Gastric trial. This regimen, which evaluated dual checkpoint blockade with next-generation agents, aims to...

Gastrointestinal Cancer

Early Data Show Novel Immunotherapy Regimen May Improve Outcomes in Advanced Gastric Cancer

Initial findings from the global phase II EDGE-Gastric trial indicate the potential for two novel immune checkpoint inhibitors to improve outcomes in advanced gastroesophageal adenocarcinoma. The findings were reported at the November 2023 ASCO Plenary Session by Yelena Y. Janjigian, MD, Chief of...

Gastroesophageal Cancer
Gastrointestinal Cancer

Investigational Dual PD-1 and TIGIT Blockade in Advanced Gastroesophageal Cancer

Early findings from the phase II EDGE-Gastric trial indicate the potential for two novel agents to make a difference in advanced gastroesophageal adenocarcinoma, according to findings reported at the ASCO Plenary Series: November 2023 Session by Yelena Y. Janjigian, MD, Chief of the...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Amends Pembrolizumab’s Gastric Cancer Indication

On November 7, the U.S. Food and Drug Administration (FDA) revised the existing indication of pembrolizumab (Keytruda) in combination with trastuzumab, fluoropyrimidine, and platinum-containing chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic...

Gastroesophageal Cancer
Gastrointestinal Cancer

Novel Antibody-Drug Conjugate Shows Potential in Treating CLDN18.2-Positive Gastric and GEJ Cancers

A first-in-class, claudin 18.2 (CLDN18.2)-targeted antibody-drug conjugate may be a new treatment option for patients with advanced gastric/gastroesophageal junction (GEJ) cancers, according to data presented by Xu et al during the ASCO Plenary Series: November 2023 Session (Abstract 434420)....

Gastroesophageal Cancer
Gastrointestinal Cancer

Adding Pembrolizumab to Trastuzumab and Chemotherapy in HER2-Positive Gastric/Gastroesophageal Junction Adenocarcinoma: KEYNOTE-811

In interim analyses from the phase III KEYNOTE-811 trial reported in The Lancet, Yelena Y. Janjigian, MD, and colleagues found that the addition of pembrolizumab to trastuzumab and chemotherapy in first-line treatment of patients with locally advanced or metastatic HER2-positive...

Gastrointestinal Cancer

Adding HIPEC to Cytoreductive Surgery in Gastric Cancer With Synchronous Peritoneal Metastases

As reported in the Journal of Clinical Oncology by Rau et al, the German phase III GASTRIPEC-I trial showed no improvement in overall survival with the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery in patients with gastric cancer and synchronous peritoneal...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of First-Line Pembrolizumab to Chemotherapy in HER2-Negative Advanced Gastric Cancer

As reported in The Lancet Oncology by Sun Young Rha, MD, and colleagues, the phase III KEYNOTE-859 trial has shown that the addition of first-line pembrolizumab to chemotherapy was associated with a statistically significant improvement  in overall survival in patients with HER2-negative advanced...

Gastroesophageal Cancer
Gastrointestinal Cancer

Perioperative Chemotherapy and Pembrolizumab in Locally Advanced Resectable Gastric and Gastroesophageal Junction Adenocarcinomas

In a phase II trial reported in JAMA Oncology, Manji et al found that perioperative chemotherapy and pembrolizumab showed activity in locally advanced resectable gastric and gastroesophageal junction adenocarcinoma. Study Details Thirty-four evaluable patients were enrolled in the...

Immunotherapy
Lung Cancer
Breast Cancer
Skin Cancer
Gastrointestinal Cancer

Neoadjuvant Immune Checkpoint Blockade May Be Effective Across Multiple Cancer Types

Neoadjuvant immunotherapy may be effective prior to surgery in multiple types of cancers, according to a recent study published by Topalian et al in Cancer Cell. Background Neoadjuvant immune checkpoint blockades have been a rapidly growing area of research and are currently being tested across...

Lung Cancer
Gastrointestinal Cancer
Supportive Care

Ambulatory Thromboprophylaxis in Patients With Lung and Gastrointestinal Cancers

In an Australian phase III trial (TARGET-TP) reported in JAMA Oncology, Alexander et al found that ambulatory thromboprophylaxis reduced the risk of thromboembolic events in patients starting systemic therapy for lung or gastrointestinal cancer who were at elevated risk of thrombosis. Study ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Quality of Life With Nivolumab Plus Chemotherapy in Advanced Gastric/GEJ Cancer or Esophageal Adenocarcinoma

As reported in the Journal of Clinical Oncology, Markus Moehler, MD, and colleagues found that in the phase III CheckMate 649 trial, the addition of nivolumab to chemotherapy was associated with generally better patient-reported health-related quality of life outcomes in patients with advanced...

Breast Cancer
Gastrointestinal Cancer
Supportive Care
COVID-19

Updates on Cancer Therapies Under Study From 2023 ASCO Breakthrough

Presented here are some brief summaries of novel therapies under study from the 2023 ASCO Breakthrough meeting in Yokohama, Japan. The subjects range from new observations about a HER2-directed bispecific antibody and systemic treatment of gastric cancer to an option for treating hand-foot syndrome ...

Gastrointestinal Cancer

Neoadjuvant FOLFOX vs Chemoradiotherapy in Locally Advanced Rectal Cancer

As reported in The New England Journal of Medicine by Deb Schrag, MD, MPH, FASCO, and colleagues, the phase III PROSPECT trial has shown neoadjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) was noninferior in disease-free survival vs chemoradiotherapy among patients with locally advanced...

Gastrointestinal Cancer

Noninvasive Multitarget Stool DNA Methylation Assay in the Early Detection of Multiple Gastrointestinal Cancers

With an estimated 4.8 million new cases and 3.4 million deaths worldwide recorded in 2018, cancers of the gastrointestinal tract account for over one-quarter (26%) of global cancer incidence and over one-third (35%) of all cancer-related deaths. Although the U.S. Food and Drug Administration (FDA)...

Gastrointestinal Cancer

Roundup of Abstracts on New Therapies for Gastrointestinal Cancers From ASCO 2023

The 2023 ASCO Annual Meeting featured thousands of abstracts. In addition to our in-depth coverage of pivotal research from the meeting, The ASCO Post highlights the following studies of novel therapies for gastrointestinal cancers. Addition of Anti-TIGIT Agent in Unresectable Liver Cancer In the...

Gastroesophageal Cancer
Gastrointestinal Cancer

Individual Patient Meta-analysis of Neoadjuvant Chemotherapy and Chemoradiotherapy for Esophageal or GEJ Carcinoma

In a meta-analysis reported in the Journal of Clinical Oncology, Faron et al found that neoadjuvant chemotherapy and chemoradiotherapy were associated with better survival vs upfront surgery in patients with thoracic esophageal or gastroesophageal junction (GEJ) carcinoma. Study Details The study...

Gastroesophageal Cancer
Gastrointestinal Cancer

Second-Line Trastuzumab, Ramucirumab, and Paclitaxel in Previously Treated Patients With HER2-Positive Advanced Gastric or Gastroesophageal Junction Cancer

In a Korean phase Ib/II trial reported in the Journal of Clinical Oncology, Kim et al found that trastuzumab combined with ramucirumab and paclitaxel showed activity in the second-line treatment of patients with HER2-positive advanced gastric or gastroesophageal junction cancer whose disease...

Gastroesophageal Cancer
Gastrointestinal Cancer

Robotic-Assisted Resection of Challenging Gastric GISTs May Be Safe and Effective

Robot-assisted resection may be safe and effective at removing difficult-to-reach gastric gastrointestinal stromal tumors (GISTs), according to a novel study published by Lwin et al in the Journal of Surgical Research. Background For gastric GISTs, surgery is the standard treatment option; however, ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

T-DXd in HER2-Positive Advanced Gastric or Gastroesophageal Junction Cancer: DESTINY-Gastric02

In the phase II DESTINY-Gastric02 trial reported in The Lancet Oncology, Eric Van Cutsem, MD, PhD, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) was active in patients with HER2-positive advanced gastric or gastroesophageal junction cancer with disease progression on or after a...

Gastrointestinal Cancer
Palliative Care

Perioperative Palliative Care and Health-Related Quality of Life in Patients Undergoing Curative-Intent Surgery for Upper Gastrointestinal Cancers

In a study reported in JAMA Network Open, Aslakson et al found that perioperative surgeon/palliative care team co-management did not improve health-related quality of life vs surgeon team management alone in patients undergoing curative-intent surgery for upper gastrointestinal cancers. Study...

Gastrointestinal Cancer
Issues in Oncology

ASCO Issues Clinical Guidance for Treating Gastrointestinal Cancers Amid Acute Drug Shortages

ASCO has issued new clinical guidance for treating patients with gastrointestinal cancers amid a nationwide shortage of carboplatin and cisplatin. The two chemotherapy agents, in extremely short supply, are essential to treating an array of gastrointestinal cancers—such as esophageal cancer,...

Gastrointestinal Cancer
Health-Care Policy

Medicaid Expansion Associated With a Reduction in Mortality for Black Patients With Gastrointestinal Cancers

Studies showed that racial minorities experience disparities in access to cancer treatment and survival. In an effort to improve access to care for disadvantaged populations, the Affordable Care Act provided funding to states to expand Medicaid eligibility criteria and provide coverage to...

Bladder Cancer
Gynecologic Cancers
Gastrointestinal Cancer
Palliative Care

Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer

In a single-center trial reported in JAMA Surgery, Shinall et al found that specialist palliative care did not improve quality of life or survival vs usual care in patients undergoing nonpalliative major abdominal surgery for cancer. Study Details In the trial, 235 patients scheduled for specified...

Gastrointestinal Cancer
Colorectal Cancer
Issues in Oncology

Association Between Overweight/Obesity and Risk of Gastrointestinal Cancer

Researchers have found that individuals in early and middle adulthood who have a body mass index (BMI) indicating that they have overweight or obesity may be at an increased risk of developing gastrointestinal cancer, according to a new study published by Loomans-Kropp and Umar in JAMA Network...

Gastroesophageal Cancer
Gastrointestinal Cancer
Pancreatic Cancer
Colorectal Cancer
Hepatobiliary Cancer

Risk of Early-Onset Digestive Tract Cancers Among Young Adults With Nonalcoholic Fatty Liver Disease

In a Korean nationwide cohort study reported in the Journal of Clinical Oncology, Park et al found that individuals aged 20 to 39 years with nonalcoholic fatty liver disease (NAFLD) were at an increased risk of developing early-onset digestive tract cancers. Study Details The study included data on ...

Gastroesophageal Cancer
Gastrointestinal Cancer

First-Line Zolbetuximab Plus mFOLFOX6 in CLDN18.2-Positive, HER2-Negative Advanced Gastric or Gastroesophageal Junction Adenocarcinoma

As reported in The Lancet by Kohei Shitara, MD, and colleagues, the phase III SPOTLIGHT trial has shown significantly prolonged progression-free and overall survival with the addition of the anti–claudin-18 isoform 2 (CLDN18.2) antibody zolbetuximab to mFOLFOX6 (modified leucovorin [or...

Gastrointestinal Cancer
Hepatobiliary Cancer

Second-Line Liposomal Irinotecan Plus Fluorouracil/Leucovorin in Metastatic Biliary Tract Cancer

In an updated analysis of a Korean phase IIb trial (NIFTY) reported in JAMA Oncology, Hyung et al found that the addition of nanoliposomal irinotecan to fluorouracil and leucovorin significantly improved progression-free survival in patients with metastatic biliary tract cancer with disease...

Gastrointestinal Cancer
Genomics/Genetics

Endoscopic Surveillance in Patients at Risk for Hereditary Diffuse Gastric Cancer

In a prospective cohort study reported in The Lancet Oncology, Asif et al found that endoscopic surveillance may be an alternative to prophylactic total gastrectomy in patients at risk for hereditary diffuse gastric cancer due to germline CDH1 pathogenic variants. Study Details In the study, 270...

Gastrointestinal Cancer
Genomics/Genetics

Interaction of H pylori Infection and Germline Pathogenic Variants in Risk for Gastric Cancer

In a Japanese study reported in The New England Journal of Medicine, Usui et al found that Helicobacter pylori infection affected the risk of gastric cancer in patients with predisposing germline pathogenic variants, including variants in homologous recombination genes. As stated by the...

Gastrointestinal Cancer

GLOW Trial: Zolbetuximab Plus CAPOX Extends Survival in Gastric Cancer Subtype

First-line treatment with zolbetuximab in combination with capecitabine and oxaliplatin (CAPOX) extended overall survival in patients with claudin-18.2 (CLDN18.2)-positive/HER2-negative locally advanced or metastatic gastric adenocarcinoma, according to results of the GLOW trial reported by Xu et...

Gastrointestinal Cancer

Laparoscopy-Assisted vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer: Relapse-Free Survival at 5 Years

As reported in JAMA Surgery by Etoh et al, 5-year follow-up of the Japanese phase II/III JLSSG0901 trial has shown noninferiority in relapse-free survival with laparoscopic-assisted distal gastrectomy vs open distal gastrectomy in patients with locally advanced gastric cancer. Study Details In the...

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