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gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Gulam A. Manji, MD, PhD, on Gastric and Gastroesophageal Junction Adenocarcinomas: New Data on Pembrolizumab Plus Capecitabine and Oxaliplatin

Gulam A. Manji, MD, PhD, of Columbia University Medical Center, discusses phase II results on perioperative combination chemotherapy and pembrolizumab in patients with resectable gastric cancer. The combination appeared to result in many complete pathologic responses (Abstract CT009).

Gastrointestinal Cancer

Study Explores Racial Disparities Among Patients Undergoing Gastrointestinal Cancer Surgery

Black adult patients are more likely than White patients to receive substandard gastrointestinal cancer surgery, according to a large study led by researchers at Yale Cancer Center published by Bakkila et al in JAMA Network Open. “The COVID-19 pandemic has brought to light previously reported race...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

KEYNOTE-811: Pembrolizumab Plus Trastuzumab and Chemotherapy in Previously Untreated Advanced HER2-Positive Gastric Adenocarcinoma

As reported in Nature by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center, and colleagues, the first interim analysis of the phase III KEYNOTE-811 trial has shown a significantly higher objective response rate with the addition of...

Colorectal Cancer
Hepatobiliary Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Recent FDA Approvals in Gastrointestinal Cancer

Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Adding First-Line Nivolumab to Chemotherapy Improves Survival in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinomas

As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...

Gastrointestinal Cancer

Younger Patients With Appendicitis May Be at Increased Risk for Appendiceal Cancer

Although appendectomy is still the most effective treatment for acute appendicitis, nonoperative management is increasingly common, as recent studies—such as one published in November 2020 in The New England Journal of Medicine and a second published in December 2021 in the same journal—have shown...

Issues in Oncology
Gastrointestinal Cancer

Cancer Risk Among Patients With Pediatric-Onset Inflammatory Bowel Disease

In a meta-analysis of population-based studies reported in JAMA Network Open, Elmahdi et al found that although the reported incidence of cancers in individuals with pediatric-onset inflammatory bowel disease (IBD) is low, the condition is associated with a significantly increased risk of cancers...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Expert Point of View: Stefano Cascinu, MD

Stefano Cascinu, MD, of the Comprehensive Cancer Center, Università Vita-Salute, IRCCS-Ospedale San Raffaele, Milan, Italy, was the invited discussant of KEYNOTE-5901 and CheckMate 649.2 “These landmark studies could change the treatment paradigm of advanced esophageal and gastric cancers. They...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Checkpoint Inhibitors in Esophagogastric Cancer: Updates of Landmark Trials

Updates of landmark trials of immune checkpoint inhibitors as first-line therapy for advanced HER2-negative esophagogastric cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium. The studies upheld previous findings of an overall survival benefit when these agents are paired...

Gastroesophageal Cancer
Colorectal Cancer
Gastrointestinal Cancer
Immunotherapy

Updated Findings on T-DXd in Gastrointestinal Malignancies

Updates of phase II studies evaluating fam-trastuzumab deruxtecan-nxki (T-DXd) in gastrointestinal cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium, continuing to offer support for the antibody-drug conjugate in these malignancies. In HER2-expressing gastric cancer, T-DXd...

Gastrointestinal Cancer

Pembrolizumab Plus Trastuzumab and Chemotherapy in Previously Untreated Advanced HER2-Positive Gastric Adenocarcinoma

As reported in Nature by Yelena Y. Janjigian, MD, and colleagues, the first interim analysis of the phase III KEYNOTE-811 trial has shown a significantly higher objective response rate with the addition of pembrolizumab to trastuzumab and chemotherapy in patients with previously untreated advanced ...

Pancreatic Cancer
Gastrointestinal Cancer

KRYSTAL-1: Adagrasib Controls Disease in Gastrointestinal Malignancies Beyond Colorectal Cancer

A disease control rate of 100% was achieved in gastrointestinal cancers treated with the KRAS G12C inhibitor adagrasib in the phase II KRYSTAL-1 trial, presented at the 2022 ASCO Gastrointestinal Cancers Symposium.1 The population included primarily those with pancreatic cancer; other noncolorectal ...

Gastrointestinal Cancer
Cost of Care
Issues in Oncology

Assessing Value in Gastrointestinal Cancer Treatments

The era of precision oncology, in which molecular biomarkers are used to help guide drug delivery, has dovetailed with the emerging issues of value-based care and cost containment. To shed light on these issues and more, The ASCO Post spoke with Hanna K. Sanoff, MD, MPH, Clinical Medical Director...

Gastrointestinal Cancer

Binimetinib Plus Imatinib in Previously Untreated Patients With Advanced Gastrointestinal Stromal Tumor

In a single-center phase II trial reported in the Journal of Clinical Oncology, Chi et al found that the combination of the MET inhibitor binimetinib and the KIT inhibitor imatinib produced a high response rate in patients with previously untreated advanced gastrointestinal stromal tumor. As stated ...

gastrointestinal cancer

Francesca Battaglin, MD, on Upper GI Cancers and the Potential Value of Recurrent Neoantigens

Francesca Battaglin, MD, of USC Norris Comprehensive Cancer Center and the Keck School of Medicine, discusses findings from one of the largest studies to investigate recurrent neoantigens in upper gastrointestinal cancers. Dr. Battaglin and her team identified peptides with high human leukocyte antigen–binding affinity and an association with a positive tumor inflammation signature in both microsatellite-instable and microsite-stable tumors, suggesting a role for such antigens as potential cancer immunotherapy targets (Abstract 246).

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Zev A. Wainberg, MD, on Gastric or Gastroesophageal Junction Adenocarcinoma: Follow-up Data on Pembrolizumab and Chemotherapy

Zev A. Wainberg, MD, of the University of California, Los Angeles, discusses an update, of 25 additional months, on phase III safety and efficacy results from the KEYNOTE-062 trial. This study compared pembrolizumab with or without chemotherapy vs chemotherapy alone for patients with PD-L1–positive advanced gastric or gastroesophageal junction adenocarcinoma (Abstract 243).

Gastrointestinal Cancer

Similar Efficacy—but Better Tolerability—for Ripretinib vs Sunitinib in Previously Treated Patients With Advanced GIST

In the INTRIGUE trial, the tyrosine kinase inhibitor ripretinib was not superior to sunitinib in the second-line treatment of patients with advanced gastrointestinal stromal tumors (GIST); however, the agent was better tolerated. These findings were presented by Michael C. Heinrich, MD, FACP, and...

gastrointestinal cancer

Yu Sunakawa, MD, PhD, on Gastric Cancer: Predicting Treatment-Related Toxicities With Biomarkers

Yu Sunakawa, MD, PhD, of Japan’s St. Marianna University School of Medicine, discusses his findings from the DELIVER trial, which suggest the gut microbiome may predict skin toxicities in patients with advanced gastric cancer who are treated with nivolumab. In addition, some single nucleotide polymorphisms, such as NOTCH1, SEMA4D, NLRC5, and IL-6R genes, may potentially become markers for diarrhea and skin toxicities with this agent.

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Kohei Shitara, MD, on Gastric and Esophageal Cancers: Long-Term Follow-up on Nivolumab Plus Chemotherapy

Kohei Shitara, MD, of Japan’s National Cancer Center Hospital East, discusses a long-term data follow-up from CheckMate 649, which support the continued use of nivolumab plus chemotherapy as first-line treatment in patients with advanced gastric, gastroesophageal junction, and esophageal adenocarcinomas (Abstract 240).

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of Nivolumab to Oxaliplatin-Based Chemotherapy for HER2-Negative, Unresectable, Advanced or Recurrent Gastric or Gastroesophageal Junction Cancer

In an Asian phase II/III trial (ATTRACTION-4) reported in The Lancet Oncology, Yoon-Koo Kang, MD, and colleagues found that the addition of nivolumab to oxaliplatin-based chemotherapy improved progression-free survival—but not overall survival—as first-line treatment of HER2-negative, unresectable, ...

Gastrointestinal Cancer

Presurgical Chemosensitivity May Play a Role in Informing Postsurgical Treatment for Patients With Gastric Cancer

A study published by Deng et al in JAMA Network Open showed that chemotherapy after surgery for gastric adenocarcinoma was significantly associated with longer survival in patients with chemosensitive disease, but not in those with very sensitive or refractory disease. These findings suggest that...

Gastrointestinal Cancer

Association of Autoantibodies to Gastric Mucosa and Risk of Gastric Cancer

In a case-control study reported in JAMA Oncology, Minkyo Song, MD, PhD, and colleagues found that seropositivity for gastric antiparietal cell antibodies (APCAs) was associated with an increased risk of gastric cancer among younger Finnish women who were seronegative for antibodies to Helicobacter ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Study Suggests Lack of Benefit With the Addition of Immune Checkpoint Inhibition to Chemotherapy in Low PD-L1–Expressing Gastric or Esophageal Adenocarcinoma

In an analysis reported in the Journal of Clinical Oncology, Zhao et al found that the addition of an immune checkpoint inhibitor to chemotherapy in trials of first-line treatment of advanced gastric or esophageal adenocarcinoma was not associated with benefit in low PD-L1–expressing subgroups not...

Gastrointestinal Cancer

Addition of FDG-PET/CT and Staging Laparoscopy to the Initial Staging of Locally Advanced Gastric Cancer

In a Dutch cohort study (PLASTIC) reported in JAMA Surgery, Gertsen et al found that staging laparoscopy provided more diagnostic information resulting in change of treatment intent than F-18 fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in patients with...

Gastrointestinal Cancer

Areej El-Jawahri, MD, on the Significance of Patient-Reported Outcomes in Gastrointestinal Cancers

The invited discussant of this study on patient-reported outcomes, Areej El-Jawahri, MD, Associate Director of Cancer Outcomes Research and Education Program and Director of Bone Marrow Transplant Survivorship Program at Massachusetts General Hospital, said these findings underscore the importance...

Gastrointestinal Cancer

Patient-Reported Outcomes in Gastrointestinal Cancers: Predicting Treatment Response and Survival Outcomes

According to data presented during the 2021 ASCO Quality Care Symposium,1 1-month changes in patient-reported outcomes may predict treatment response and survival outcomes in patients with advanced gastrointestinal cancers. The results of a prospective study of 159 patients with metastatic...

Gastrointestinal Cancer

Overall Survival With Laparoscopic vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer

As reported in JAMA Surgery by Huang et al, the Chinese phase III CLASS-01 trial has shown no difference in 5-year overall survival in patients with locally advanced gastric cancer who underwent laparoscopic vs open distal gastrectomy. The previously reported primary analysis of the trial showed no ...

Breast Cancer
Gastrointestinal Cancer
Genomics/Genetics

Rates of Occult Gastric Carcinoma in Patients With Hereditary Lobular Breast Cancer Due to CDH1 Genetic Variants

In a single-institution prospective cohort study reported in JAMA Surgery, Gamble et al found that patients with hereditary lobular breast cancer due to CDH1 variants also had a high prevalence of occult signet ring cell gastric carcinoma. Study Details The study involved 283 patients from 151...

Gastrointestinal Cancer
COVID-19

Rates of Diagnosis of Gastrointestinal Cancers—and Stage at Diagnosis—Before and During the COVID-19 Pandemic in Japan

In a study reported in JAMA Network Open, Kuzuu et al found that the COVID-19 pandemic in Japan was associated with reduced rates of new diagnoses, as well as reduced rates of diagnosis at earlier stages, for some gastrointestinal cancers. Study Details The retrospective cohort study included data...

Gastrointestinal Cancer
Global Cancer Care

Gastrointestinal Oncologist Katherine Van Loon, MD, MPH: A Pioneer in Global Oncology

Katherine Van Loon, MD, MPH, was raised in Miami, until the age of 12, and then her family relocated to Atlanta, where she spent her junior and high school years. “If you ask my parents about my decision to become a doctor, they will say I first declared it at age 5. Nobody knew how that idea came...

Gastrointestinal Cancer
Immunotherapy
Gastroesophageal Cancer

DESTINY-Gastric02: Fam-Trastuzumab Deruxtecan-nxki Produces Responses in Patients With HER2-Positive Gastric Cancers

In the primary analysis of the phase II DESTINY-Gastric02 trial, fam-trastuzumab deruxtecan-nxki (T-DXd) produced clinically meaningful and durable responses in Western patients with advanced HER2-positive gastric or gastroesophageal junction cancers whose disease had progressed after a...

Gastrointestinal Cancer
Sarcoma

VOYAGER Trial: Avapritinib vs Regorafenib in Molecularly Unselected Previously Treated Advanced GIST

As reported in the Journal of Clinical Oncology by Yoon-Koo Kang, MD, and colleagues, the phase III VOYAGER trial showed no improvement in progression-free survival with avapritinib vs regorafenib as third- or later-line treatment of patients with molecularly unselected, locally advanced,...

Gastrointestinal Cancer

Effect of Regionalization of Gastric Cancer Care in an Integrated Health-Care System

In a retrospective cohort study reported in the Journal of Clinical Oncology, Teh et al found that regionalization of gastric cancer care in a U.S. integrated health-care system resulted in the increased use of laparoscopic gastrectomy and D2 lymphadenectomy, as well as improved overall survival...

Immunotherapy
Gastrointestinal Cancer

RATIONALE 208: ‘Durable Clinical Activity’ Reported With Tislelizumab in Advanced Liver Cancer

With the investigational checkpoint inhibitor tislelizumab, durable responses were achieved by some patients with previously treated advanced hepatocellular carcinoma, regardless of the number of prior lines of therapy, in the phase II RATIONALE 208 trial. These findings were presented during the...

Gastrointestinal Cancer
Gastroesophageal Cancer

Perioperative or Postoperative Oxaliplatin/S-1 vs Postoperative Oxaliplatin/Capecitabine for Locally Advanced Gastric Cancer

In the Chinese phase III RESOLVE trial reported in The Lancet Oncology, Zhang et al found that perioperative S-1/oxaliplatin was superior to—and adjuvant S-1/oxaliplatin was noninferior to—adjuvant capecitabine/oxaliplatin in terms of disease-free survival in patients undergoing D2 gastrectomy for...

Gastrointestinal Cancer
Immunotherapy

Atezolizumab Plus Bevacizumab in Malignant Peritoneal Mesothelioma

A phase II study published by Kanwal Raghav, MBBS, MD, and colleagues in Cancer Discovery found that combination treatment with the PD-L1 inhibitor atezolizumab and the VEGF inhibitor bevacizumab was well tolerated and resulted in a 40% objective response rate in patients with advanced malignant...

Gastrointestinal Cancer

KIT Inhibitor Combination Shows Efficacy in Refractory GIST

In a phase Ib/IIa trial reported in JAMA Oncology, Wagner et al found that the combination of a type I KIT inhibitor, PLX9486, with the type II inhibitor sunitinib produced clinical benefit and improved progression-free survival rates in patients with refractory gastrointestinal stromal tumors...

Gastrointestinal Cancer
Issues in Oncology

Effect of Obesity on Receipt of Chemotherapy in Patients With Colorectal Cancer

Obese patients with colorectal cancer receive lower cumulative doses of adjuvant chemotherapy relative to their body surface area than nonobese patients, according to results from a large meta-analysis reported by Slawinski et al at the ESMO World Congress on Gastrointestinal Cancer 2021 (Abstract...

Gastrointestinal Cancer
Immunotherapy

DESTINY-Gastric01 Exploratory Biomarker Analysis Examines Efficacy of Trastuzumab Deruxtecan-nxki Among Patients With HER2-Positive and HER2-Low Gastric Cancer

Trastuzumab deruxtecan-nxki demonstrated clinically meaningful benefit across specific subgroups of patients with HER2-positive and HER2-low advanced gastric cancer, according to findings from a post hoc exploratory biomarker analysis presented by Kohei Shitara, MD, and colleagues at the ESMO World ...

Gastroesophageal Cancer
Gastrointestinal Cancer

International Esodata Study Group Model for Predicting 90-Day Mortality After Esophagectomy

In a retrospective analysis reported by researchers from the International Esodata Study Group (IESG) in JAMA Surgery, D’Journo et al developed a model for predicting risk of 90-day mortality following esophagectomy for patients with esophageal or gastroesophageal junction cancer. As stated by the...

Gastrointestinal Cancer

Addition of Neoadjuvant Chemotherapy to Surgery and Adjuvant S-1 in Locally Advanced Gastric Cancer

In the Korean phase III PRODIGY trial reported in the Journal of Clinical Oncology, Yoon-Koo Kang, MD, and colleagues found that the addition of neoadjuvant docetaxel, oxaliplatin, and S-1 (DOS) to D2 gastrectomy followed by adjuvant S-1 was associated with improved progression-free survival in...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of First-Line Nivolumab to Chemotherapy in Advanced Gastric Cancers: CheckMate 649

As reported in The Lancet by Yelena Y. Janjigian, MD, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and progression-free survival among patients with advanced HER2-negative gastric, gastroesophageal ...

Gastrointestinal Cancer

Adjuvant Imatinib Therapy Offers Survival Benefit in Patients With Resected GIST, but Team Effort May Be Needed to Reduce Early Discontinuation Rates

Clinical trial data show that adjuvant imatinib improves recurrence-free survival as well as overall survival, when administered for at least 3 years, among patients who undergo a macroscopically complete resection of a primary gastrointestinal stromal tumor (GIST), Chandrajit P. Raut, MD, MSc,...

Gastrointestinal Cancer
Immunotherapy

Fam-trastuzumab Deruxtecan-nxki for Trastuzumab-Pretreated Advanced HER2-Positive Gastric Adenocarcinoma

On January 15, 2021, the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki was approved for treatment of adults with locally advanced or metastatic HER2-positive gastric or gastroesophageal adenocarcinoma who have received a prior trastuzumab-based regimen.1,2 Supporting Efficacy Data...

Issues in Oncology
Immunotherapy
Breast Cancer
Bladder Cancer
Gastrointestinal Cancer
Hepatobiliary Cancer

FDA ODAC Meeting Focuses on ‘Dangling’ Accelerated Approvals of Anti–PD-1/PD-L1 Antibodies

In a perspective in The New England Journal of Medicine, Julia A. Beaver, MD, and Richard Pazdur, MD, of the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE), discussed issues surrounding “dangling” accelerated approvals of anti–PD-1/PD-L1 antibodies—ie, approvals for...

Gastrointestinal Cancer
Genomics/Genetics

Avapritinib vs Other Tyrosine Kinase Inhibitors for PDGFRA D842V–Mutated Gastrointestinal Stromal Tumors

Data from a study published by Margaret von Mehren, MD, and colleagues in BMC Cancer showed that avapritinib, a platelet-derived growth factor receptor A (PDGFRA) inhibitor, has a “clinically meaningful benefit” for the treatment of gastrointestinal stromal tumors (GIST) with PDGFRA D842V...

Gastrointestinal Cancer
Pancreatic Cancer
Neuroendocrine Tumors

Lenvatinib for Previously Treated Advanced Pancreatic and Gastrointestinal Neuroendocrine Tumors

In a phase II trial (TALENT; GETNE1509) reported in the Journal of Clinical Oncology, Jaume Capdevila, MD, and colleagues found that lenvatinib produced durable responses in patients with previously treated advanced grade 1 or 2 gastroenteropancreatic neuroendocrine tumors. Study Details In the...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Grants Accelerated Approval to Pembrolizumab Combination for HER2-Positive Gastric Cancer

On May 5, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) in combination with trastuzumab plus fluoropyrimidine- and platinum-containing chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic...

Gastrointestinal Cancer
Gastroesophageal Cancer
Hepatobiliary Cancer
Immunotherapy

More From the FDA ODAC: Votes on Agents for Pretreated Hepatocellular Carcinoma and Gastric Cancer

More news has emerged from this week’s meeting of the U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC). The group voted 8 to 0 in favor of continuing the accelerated approval for pembrolizumab in sorafenib-pretreated patients with hepatocellular carcinoma; 6 to 2...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Pipeline: Bemarituzumab Granted Breakthrough Therapy Designation for FGFR2b-Overexpressing, HER2-Negative Gastric Cancer

The U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to bemarituzumab as first-line treatment for patients with fibroblast growth factor receptor 2b (FGFR2b)-overexpressing and HER2-negative metastatic and locally advanced gastric and gastroesophageal adenocarcinoma...

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