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Gastrointestinal Cancer

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...

Gastrointestinal Cancer

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 ...

Gastrointestinal Cancer

Updated Findings Bolster the Use of Checkpoint Inhibitors in Treatment of Liver Cancer

Although optimal regimens are still being determined, checkpoint inhibition has clearly established itself in the treatment of hepatocellular carcinoma, as judged by the number of abstracts on the topic at the 2021 Gastrointestinal Cancers Symposium. The ASCO Post brings readers short summaries of ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of Andecaliximab to mFOLFOX6 in First-Line Treatment of HER2-Negative Advanced Gastric Cancer

As reported in the Journal of Clinical Oncology by Manish A. Shah, MD, and colleagues, the phase III GAMMA-1 trial showed no improvement in overall survival with the addition of andecaliximab to modified oxaliplatin, leucovorin, and fluorouracil (mFOLFOX6) in the first-line treatment of...

Gastrointestinal Cancer
Immunotherapy

Expert Point of View: John C. Krauss, MD

The invited discussant of the GARNET study, John C. Krauss, MD, Medical Oncology Director of the Multidisciplinary Colorectal Cancer Clinic, Rogel Cancer Center of the University of Michigan, Ann Arbor, observed that “impressive” response rates to dostarlimab were demonstrated in a “relatively...

Gastrointestinal Cancer
Immunotherapy

Anti–PD-1 Antibody Dostarlimab Active in Mismatch Repair–Deficient Gastrointestinal Tumors

Dostarlimab, a monoclonal antibody targeting PD-1, showed antitumor activity in patients with mismatch repair–deficient (dMMR) gastrointestinal tumors in the phase I GARNET study, reported at the 2021 Gastrointestinal Cancers Symposium by Thierry André, MD, of Sorbonne University and Saint-Antoine...

Gastrointestinal Cancer
Genomics/Genetics
Issues in Oncology
COVID-19

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...

Immunotherapy
Gastroesophageal Cancer
Gastrointestinal Cancer
Colorectal Cancer
Bladder Cancer
Skin Cancer
Sarcoma
Hepatobiliary Cancer

FDA Pipeline: Priority Reviews for Immunotherapies in Gastric Cancers, Anal Cancer

The U.S. Food and Drug Administration (FDA) recently granted Priority Review to nivolumab as either adjuvant or first-line therapy in several types of gastric cancers, as well as to a novel PD-1 inhibitor for locally advanced or metastatic squamous cell carcinoma of the anal canal. The FDA also...

Gastrointestinal Cancer
Colorectal Cancer
Gastroesophageal Cancer

Anti–PD-1 Therapy Dostarlimab for dMMR Gastrointestinal Cancers: Safety and Efficacy Examined

Dostarlimab, a monoclonal antibody targeting PD-1, showed strong and durable antitumor activity in patients with mismatch repair–deficient (dMMR) gastrointestinal tumors in the phase I GARNET study, reported Thierry André, MD, of Sorbonne Université and Hôpital Saint Antoine, Paris, and colleagues...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Bemarituzumab Plus Chemotherapy Improves Outcomes in Advanced Gastric/Gastroesophageal Junction Cancer

Gastric cancer has a new 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 rates in the randomized phase II ...

gastrointestinal cancer

Rutika Mehta, MD, MPH, on Gastric Cancer: Adjuvant Chemotherapy With S-1 and Docetaxel

Rutika Mehta, MD, MPH, of the H. Lee Moffitt Cancer Center and Research Institute, discusses the 3-year regression-free and overall survival results from the JACCRO study, which compared the efficacy of S-1, an oral prodrug of fluorouracil, vs S-1 plus docetaxel after curative resection of stage III gastric cancer (Abstract 159).

gastrointestinal cancer
issues in oncology

Afsaneh Barzi, MD, PhD, on Disparities in Access to Screening and Treatment of GI Cancers

Afsaneh Barzi, MD, PhD, of the City of Hope Comprehensive Cancer Center and the University of Southern California, discusses reasons for the incomplete understanding of the molecular landscape of minority patients with cancer, lack of screening chief among them. This underrepresentation, Dr. Barzi says, is more marked in gastrointestinal malignancies than other solid tumors, and she recommends ways to improve the outlook.

Gastrointestinal Cancer

Length of Hospital Stay With Laparoscopic vs Open Gastrectomy for Gastric Cancer

In the Dutch LOGICA trial reported in the Journal of Clinical Oncology, van der Veen et al found that laparoscopic gastrectomy was not associated with shorter hospital stay vs open gastrectomy in patients with gastric cancer. Study Details In the trial, conducted at 10 sites in the Netherlands,...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Approves Fam-Trastuzumab Deruxtecan-nxki for Previously Treated Patients With HER2-Positive Gastric Cancers

On January 15, the U.S. Food and Drug Administration (FDA) approved fam-trastuzumab deruxtecan-nxki (Enhertu) for adult patients with locally advanced or metastatic HER2-positive gastric or gastroesophageal junction adenocarcinoma who have received a prior trastuzumab-based regimen....

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Zev A. Wainberg, MD, on Gastric/Gastroesophageal Junction Adenocarcinoma: Bemarituzumab and FOLFOX

Zev A. Wainberg, MD, of UCLA Medical Center, discusses phase II results from the FIGHT study, which combined bemarituzumab with modified FOLFOX6 in first-line treatment of advanced gastric/gastroesophageal junction adenocarcinoma. This is reportedly the first randomized trial of any FGFR inhibitor, validating this target in gastric cancer (Abstract 160).

Gastrointestinal Cancer

Study Focuses on Single-Cell Analysis of Peritoneal Carcinomatosis

Researchers profiled more than 45,000 individual cells from patients with peritoneal carcinomatosis and defined the extensive cellular heterogeneity, as well as identified two distinct cell subtypes correlated with patient survival. The findings were published by Wang et al in Nature Medicine....

Gastrointestinal Cancer
Symptom Management

Initiative to Increase Referrals of Patients With Gastrointestinal Cancer to a Specialized Rehabilitation Program

In a single-institution study reported in JCO Oncology Practice, Nadler et al describe the development of an intervention at Princess Margaret Cancer Centre, Toronto, that succeeded in increasing referrals of patients with gastrointestinal cancer to a cancer rehabilitation program. As stated by the ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Avelumab Maintenance vs Continued Chemotherapy After First-Line Induction for Advanced Gastric Cancer

As reported in the Journal of Clinical Oncology by Markus Moehler, MD, and colleagues, the phase III JAVELIN Gastric 100 trial showed no improvement in overall survival with avelumab maintenance vs continued chemotherapy after first-line induction in HER2-negative, unresectable, locally advanced or ...

Lung Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

FDA Pipeline: Priority Reviews in NSCLC, Gastric Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to a PD-1 inhibitor for the treatment of patients with locally advanced or metastatic non–small cell lung cancer (NSCLC), and also granted Priority Review to a HER2-directed antibody-drug conjugate for patients with...

Lung Cancer
Kidney Cancer
Leukemia
Solid Tumors
Gastroesophageal Cancer
Gastrointestinal Cancer
Pancreatic Cancer
Prostate Cancer
Genomics/Genetics
Immunotherapy

FDA Pipeline: Priority Reviews in EGFR-Mutant Lung Cancer, Advanced Renal Cell Carcinoma; Fast Track Designations in CLL and Solid Tumors

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for EGFR-mutant lung cancer and advanced renal cell carcinoma; granted Fast Track designation to agents in chronic lymphocytic leukemia (CLL) and locally advanced or metastatic solid tumors; and more....

Hematologic Malignancies
Immunotherapy
Gastroesophageal Cancer
Gastrointestinal Cancer

FDA Pipeline: Designations for Treatments of Rare Blood Cancer, B-Cell Malignancies, and Gastric Cancers

Recently, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to an antibody-drug conjugate for the treatment of patients with relapsed or refractory blastic plasmacytoid dendritic cell neoplasm (BPDCN); gave Fast Track designation to a novel chimeric antigen...

Gastrointestinal Cancer
Immunotherapy

Expert Point of View: Elizabeth Smyth, MD

The overall survival benefit for PD-L1 CPS ≥ 5 tumors in CheckMate 649 is a game-changer. An oxaliplatin doublet plus chemotherapy should become a standard of care for these patients,” according to Elizabeth Smyth, MD, an oncology consultant at Cambridge University Hospital NHS Foundation Trust in...

Gastrointestinal Cancer
Immunotherapy

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 ...

Immunotherapy
Multiple Myeloma
Lymphoma
Gastroesophageal Cancer
Gastrointestinal Cancer
Breast Cancer

FDA Pipeline: Priority Review for Agents in Multiple Myeloma, Anaplastic Large Cell Lymphoma

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to therapies for pretreated patients with multiple myeloma and pediatric patients with ALK-positive anaplastic large cell lymphoma; granted Fast Track designation to novel agents in gastric/gastroesophageal junction...

Gastrointestinal Cancer

Long-Term Outcomes With Neoadjuvant Therapy Followed by Surgery in Rectal Adenocarcinoma: Focus on Pathologic Response

For patients with rectal adenocarcinoma treated with neoadjuvant therapy followed by operative resection, “achieving a pathologic complete response is associated with excellent long-term disease-free and overall survival,” according to the results of a study reported by Naomi M. Sell, MD, MHS, of...

Gastrointestinal Cancer
Genomics/Genetics

Genetic Testing May Be Cost-Effective for Newly Diagnosed Patients With GIST

In a paper published by Banerjee et al in JAMA Network Open, researchers reported that genetic testing is cost-effective and beneficial for newly diagnosed patients with metastatic gastrointestinal stromal tumors (GIST), a type of soft-tissue sarcoma that develops in specialized nerve cells in the...

Gastrointestinal Cancer

Avapritinib Produces High Response Rate in Advanced PDGFRA D842V–Mutant GIST

As reported inThe Lancet Oncology by Michael C. Heinrich, MD, of the VA Portland Health Care System and the Oregon Health & Science University Knight Cancer Institute, and colleagues, the phase I NAVIGATOR trial showed that the PDGFRA and KIT kinase inhibitor avapritinib produced a high...

Gastrointestinal Cancer

Is Infiltrating Tumor Border Configuration Linked to Poor Survival in Colon Adenocarcinoma?

Findings from a retrospective cohort study could fuel the debate over the use of adjuvant chemotherapy in stage II colon cancer, according to data presented during the virtual edition of the 2020 Society of Surgical Oncology (SSO) International Conference on Surgical Cancer Care.1 Results of the...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

First-Line PD-1 Inhibitor With or Without Chemotherapy vs Chemotherapy Alone in Advanced Gastric Cancer: KEYNOTE-062

As reported in JAMA Oncology by Kohei Shitara, MD, and colleagues, the phase III KEYNOTE-062 trial showed no significant improvement in overall or progression-free survival with first-line pembrolizumab with or without chemotherapy vs chemotherapy alone in patients with PD-L1–positive advanced...

Gastrointestinal Cancer

Switch Control Inhibitor for GISTs Harboring Drug-Resistance Mutations: The INVICTUS Trial

In May 2020, the U.S. Food and Drug Administration (FDA) approved ripretinib for patients who have received prior treatment with three or more kinase inhibitors, including imatinib, for advanced gastrointestinal stromal tumors (GIST). The approval was largely based on the findings of the...

Gastrointestinal Cancer

Ripretinib Improves Progression-Free Survival vs Placebo in Previously Treated Advanced GIST

As reported inThe Lancet Oncology by Jean-Yves Blay, MD, of Centre Léon Bérard, Lyon, France, and colleagues, the phase III INVICTUS trial has shown that the oral KIT and PDGFRα tyrosine kinase inhibitor ripretinib significantly prolonged progression-free survival vs placebo in patients with...

Gastrointestinal Cancer

Third- or Later-Line Treatment With Infigratinib in Patients With Cholangiocarcinoma and FGFR2 Fusions

At the European Society for Medical Oncology (ESMO) World Congress on Gastrointestinal Cancer 2020 Virtual, Milind Javle, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues reported that third- and later-line treatment with the selective fibroblast growth factor...

Gastrointestinal Cancer
Genomics/Genetics

NTRK Fusions in Gastrointestinal Cancers: Rare but Responsive to Treatment

Although NTRK gene fusions occur in less than 5% of gastrointestinal cancers, it looks like they can be targeted successfully with NTRK inhibitors. In a pooled analysis of three clinical trials, 50% of such patients responded to entrectinib, in an updated analysis presented during the 2020 virtual...

Gastrointestinal Cancer

First-Line S-1 Plus Leucovorin and Oxaliplatin vs S-1 Plus Cisplatin in Advanced Gastric Cancer

As reported in The Lancet Oncology by Kang et al, the Japanese-Korean phase III SOLAR trial showed that oral tegafur/gimeracil/oteracil, a combination known as S-1, plus leucovorin and oxaliplatin was associated with a modest but significant improvement in overall survival vs S-1 plus cisplatin in...

Gastrointestinal Cancer

Avapritinib in Advanced PDGFRA D842V–Mutant Gastrointestinal Stromal Tumors

As reported in The Lancet Oncology by Heinrich et al, the phase I NAVIGATOR trial showed that the PDGFRA and KIT kinase inhibitor avapritinib produced a response in patients with PDGFRA D842V–mutant gastrointestinal stromal tumors (GIST).   The study supported the January 2020 approval of...

Gastrointestinal Cancer
Immunotherapy

Lenvatinib Plus Pembrolizumab for Advanced Gastric Cancer

In the Japanese single-center phase II EPOC1706 trial reported in The Lancet Oncology, Kawazoe et al found high objective response among patients with advanced gastric cancer who received the combination of lenvatinib and pembrolizumab as first- or second-line treatment. Study Details The trial...

Gastrointestinal Cancer
Immunotherapy

Lenvatinib Plus Pembrolizumab for Advanced Gastric Cancer

In the Japanese single-center phase II EPOC1706 trial reported in The Lancet Oncology, Kawazoe et al found high objective response among patients with advanced gastric cancer who received the combination of lenvatinib and pembrolizumab as first- or second-line treatment. Study Details The trial...

Gastrointestinal Cancer

Ursodeoxycholic Acid for Preventing Gallstones After Gastrectomy for Gastric Cancer

In a Korean trial reported in JAMA Surgery, Lee et al found that treatment with ursodeoxycholic acid was successful in preventing gallstone formation in patients who had undergone gastrectomy for gastric cancer. Study Details In the multicenter double-blind trial, 465 evaluable patients undergoing...

Gastrointestinal Cancer

Long-Term Survival Outcomes With Different Durations of Adjuvant Imatinib for Gastrointestinal Stromal Tumors

In a 10-year follow-up of the phase III SSGXVIII/AIO trial reported in JAMA Oncology, Heikki Joensuu, MD, and colleagues found that 3 years vs 1 year of adjuvant treatment with imatinib was associated with superior overall survival among patients with high-risk gastrointestinal stromal tumors. The ...

Gastrointestinal Cancer

Ripretinib in Previously Treated Advanced Gastrointestinal Stromal Tumor

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On May 15, 2020, the receptor tyrosine kinase inhibitor...

Gastrointestinal Cancer
Immunotherapy

Expert Point of View: Michael S. Lee, MD, and Autumn McRee, MD

DESTINY-CRC01 study discussant, Michael S. Lee, MD, Assistant Professor of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, called the findings “most promising” for the subsequent anti-HER2 treatment of HER2-positive metastatic colorectal cancer. The...

gastrointestinal cancer

Peter Reichardt, MD, PhD, on GIST: Adjuvant Imatinib for High-Risk Disease

Peter Reichardt, MD, PhD, of Helios Klinikum Berlin-Buch, discusses the 10-year survival analysis of 3 years vs 1 year of adjuvant imatinib for patients with high-risk gastrointestinal stromal tumor. The study found that about 50% of deaths can be avoided with longer imatinib treatment (Abstract 11503).

Colorectal Cancer
Pancreatic Cancer
Lymphoma
Hematologic Malignancies
Kidney Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer

FDA Pipeline: Fast Track Designations in Colorectal and Pancreatic Cancers, Lymphoplasmacytic Lymphoma/Waldenström’s Macroglobulinemia

Over the past month, the U.S. Food and Drug Administration has granted Fast Track designation to agents designed to treat colorectal and pancreatic cancers, in addition to lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia; accepted a new drug application for a treatment for relapsed or...

Gastrointestinal Cancer

Ripretinib in Previously Treated Patients With Advanced GIST: INVICTUS Trial

As reported in The Lancet Oncology by Jean-Yves Blay, MD, and colleagues, the phase III INVICTUS trial has shown that the oral KIT and PDGFRα tyrosine kinase inhibitor ripretinib prolonged progression-free survival vs placebo in patients with advanced gastrointestinal stromal tumors (GIST) whose...

Gastrointestinal Cancer
Immunotherapy

Trastuzumab Deruxtecan vs Chemotherapy for Previously Treated Patients With HER2-Positive Advanced Gastric Cancer

Results of the phase II DESTINY-Gastric01 study—reported at the ASCO20 Virtual Scientific Program (Abstract 4513) and published in The New England Journal of Medicine, by Kohei Shitara, MD, of the National Cancer Center Hospital East, Kashiwa, and colleagues—found that the antibody-drug conjugate...

Gastrointestinal Cancer
Lung Cancer
Leukemia
Hepatobiliary Cancer
Kidney Cancer
Immunotherapy

FDA Pipeline: Two Breakthrough Therapy Designations for Fam-Trastuzumab Deruxtecan-nxki, and More

Over the past few weeks, the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designations for an antibody-drug conjugate in the treatment of gastric and lung cancers. The Agency has also issued Orphan Drug designations for agents being investigated in chronic myeloid...

Gastrointestinal Cancer

FDA Approves Ripretinib for Previously Treated Patients With Advanced Gastrointestinal Stromal Tumor

On May 15, the U.S. Food and Drug Administration (FDA) approved ripretinib (Qinlock) for the treatment of adult patients with advanced gastrointestinal stromal tumor (GIST) who have received prior treatment with three or more kinase inhibitors, including imatinib. INVICTUS Trial Efficacy was...

Colorectal Cancer
Gastrointestinal Cancer
Immunotherapy

Regorafenib Plus Nivolumab in Advanced Gastric and Colorectal Cancers

In a Japanese phase Ib/dose-expansion trial reported in the Journal of Clinical Oncology, Fukuoka et al found that the combination of regorafenib and nivolumab showed activity in patients with previously treated gastric cancer and colorectal cancer with microsatellite stable/mismatch...

Colorectal Cancer
Gastrointestinal Cancer
Hepatobiliary Cancer
Pancreatic Cancer

Aspirin Use and Risk of Cancers of the Digestive Tract

Aspirin may be associated with a reduction in the risk of developing several cancers of the digestive tract. The largest and most comprehensive analysis to date of the link between aspirin and digestive tract cancers, published by Bosetti et al in Annals of Oncology, found reductions in the risk of ...

Gastrointestinal Cancer

Surgical Margins and Survival in Trial of Adjuvant Imatinib for Localized GIST

A post hoc observational study from the phase III EORTC 62024 trial of adjuvant imatinib in patients with localized gastrointestinal stromal tumors (GIST) showed that improvement in survival with R0 vs R1 resection was no longer evident when tumor rupture was excluded from the R1 category. The...

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