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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...
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...
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)....
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...
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...
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...
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...
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...
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 ...
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...
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 ...
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...
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)...
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...
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...
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...
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, ...
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...
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...
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,...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
The invited discussant of KEYNOTE-859,1 Elizabeth Smyth, MD, consultant in gastrointestinal oncology at Cambridge University Hospitals NHS Foundation Trust in the United Kingdom, called the findings “practice-changing” but cautioned that better patient selection is needed to optimally apply them....
Results of the interim analysis of KEYNOTE-859 are in, and they confirm the overall survival benefit of first-line immunotherapy plus chemotherapy in advanced gastric cancer.1 Pembrolizumab plus a fluoropyrimidine- and platinum-containing doublet provided a statistically significant improvement in...
In a Canadian population–based retrospective cohort study reported in JAMA Surgery, Hallet et al found that increased familiarity among surgeon-anesthesiologist dyads—measured by annual number of procedures performed together—was associated with better short-term postoperative outcomes in complex...
Discussant of the INTRIGUE abstract, Breelyn A. Wilky, MD, Director of Sarcoma Medical Oncology, Deputy Associate Director for Clinical Research, University of Colorado, Aurora, called the data presented “compelling evidence of the power of ctDNA [circulating tumor DNA] to identify predictive...
Circulating tumor DNA (ctDNA) analysis of KIT exon mutations may help to predict which second-line therapy is best for patients with advanced gastrointestinal stromal tumor (GIST), according to data presented during the ASCO Plenary Series: January 2023 Session.1 Exploratory analysis of the phase...
Results of the interim analysis of KEYNOTE-859 are in, and they confirm the overall survival benefit of first-line immunotherapy plus chemotherapy in advanced gastric cancer. Pembrolizumab plus a fluoropyrimidine- and platinum-containing doublet provided a statistically significant improvement in...
In a French noncomparative phase II trial (PRODIGE 41-BEVANEC) reported in The Lancet Oncology, Walter et al found that the addition of bevacizumab to FOLFIRI (irinotecan, leucovorin, and fluorouracil) did not appear to improve overall survival in the second-line treatment of patients with advanced ...
Kohei Shitara, MD, of Japan’s National Cancer Center Hospital East, discusses the SPOTLIGHT study’s phase III findings on zolbetuximab plus mFOLFOX6 as first-line treatment for patients with the biomarker claudin-18.2–positive and HER2-negative locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma. The regimen seems to have led to an improvement in both progression-free and overall survival, with survival benefits also observed across most subgroups. Zolbetuximab plus mFOLFOX6 is potentially a new standard-of-care treatment for this population (Abstract LBA292).
Souya Nunobe, MD, PhD, of Japan’s Cancer Institute Hospital and the Japanese Foundation for Cancer Research, discusses 5-year follow-up results of the phase III OPAS-1 trial, which compared four and eight courses of S-1, a novel oral fluoropyrimidine derivative adjuvant chemotherapy for patients with stage II gastric cancer. These final follow-up findings confirmed the benefit of S-1 and its use for 1 year to treat this population (Abstract 381).
In a study reported in JAMA Oncology, McDonald et al found that receipt of blood or marrow transplantation (BMT) was associated with an increased risk of subsequent malignant neoplasms of the gastrointestinal (GI) tract. As stated by the investigators, “Survivors of BMT are at increased risk of...
Filippo Pietrantonio, MD, of Italy’s Istituto Nazionale dei Tumori, discusses phase II results from the INFINITY trial of tremelimumab and durvalumab as neoadjuvant treatment of patients with microsatellite instability–high (MSI) resectable gastric or gastroesophageal junction adenocarcinoma (GAC/GEJAC). These results open the way to investigate nonoperative management in patients with clinical, pathologic, and molecular complete response after T300/D (300 mg of tremelimumab and 1,500 mg every 4 weeks of durvalumab) (Abstract 358).
Circulating tumor DNA (ctDNA) analysis of KIT exon mutations may help predict which second-line therapy is best for patients with advanced gastrointestinal stromal tumor (GIST), according to data presented by Bauer et al during the January ASCO Plenary Series session (Abstract 397784). An...
In a study reported in The Lancet Oncology, Wang et al identified mutations linked to high tumor mutation burden in microsatellite-stable (MSS) gastrointestinal cancers that may be associated with efficacy of immune checkpoint inhibitor therapy. Study Details Molecular alterations in 48,606...
Manik A. Amin, MD, of Dartmouth Cancer Center, discusses the future of immunotherapy in gastrointestinal cancers, the challenges of creating effective adoptive cell therapies, and the next generation of immune checkpoint inhibitors.
Initial data from the global phase III SPOTLIGHT trial could herald the use of a new targeted agent for a subset of patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma. First-line treatment with zolbetuximab, which targets the transmembrane protein claudin 18.2...
The field of precision oncology has become so complex that even experienced oncologists can find it challenging to decipher the molecular test results of tumor tissue and navigate treatment options for patients. Investigators revealed that a new program may aid gastrointestinal cancer physicians in ...
In a UK study reported in The Lancet Oncology, Lee et al found that systematic random biopsies were more likely than endoscopically targeted biopsies to first detect signet ring cell carcinoma during endoscopic surveillance of individuals meeting testing criteria for hereditary diffuse gastric...
As reported in the Journal of Clinical Oncology by Yamaguchi et al, an exploratory cohort analysis in a Japanese/South Korean phase II trial (DESTINY-Gastric01) indicated that fam-trastuzumab deruxtecan-nxki (TDX-d) showed activity in previously treated—but anti-HER2 treatment–naive—patients with...
In the phase II FIGHT trial reported in The Lancet Oncology, Zev A. Wainberg, MD, and colleagues found numerically better progression-free survival with the addition of the anti-FGFR2b antibody bemarituzumab to mFOLFOX (modified fluorouracil, leucovorin, and oxaliplatin) in patients with...
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 ...