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Solid Tumors
Gastrointestinal Cancer

Pembrolizumab in Advanced Gastric Cancer

On September 22, 2017, pembrolizumab (Keytruda) was granted accelerated approval for treatment of recurrent locally advanced or metastatic, gastric or gastroesophageal junction adenocarcinoma with tumors expressing programmed cell death ligand 1 (PD-L1), as determined by a U.S. Food and Drug...

Solid Tumors
Gastrointestinal Cancer
Gastroesophageal Cancer

Metastatic Gastric Cancer: Dual HER2-Targeting Study Does Not Meet Primary Endpoint

Dual HER2 targeting in metastatic gastric and gastroesophageal junction cancers did not significantly improve outcomes over trastuzumab (Herceptin) alone—both in combination with chemotherapy—according to the results of the phase III JACOB study reported at the 2017 European Society for Medical...

gastrointestinal cancer

Adding Targeted Agent to Chemotherapy in Second-Line Treatment of Advanced Gastric Cancer

In the Asian phase III GOLD trial reported in The Lancet Oncology, Bang et al found that the addition of olaparib (Lynparza) to paclitaxel did not significantly improve overall survival among patients with previously treated advanced gastric cancer, including those with...

Gastrointestinal Cancer

Quick Takes on Studies in Noncolorectal Gastrointestinal Cancers

In this roundup, The ASCO Post offers a glance at key findings from studies in noncolorectal gastrointestinal malignancies presented at the European Society for Medical Oncology (ESMO) 2017 Congress from investigators around the world. Docetaxel-Based Triplet in Gastric Cancer The superiority of...

Gastrointestinal Cancer

EXPERT POINT OF VIEW: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of University Hospitals Leuven, Belgium, commented that both ATTRACTION-02 and KEYNOTE-059 suggest that anti-PD [programmed cell death protein] antibodies have activity in advanced gastric cancer, but their findings differed with regard to the impact of ...

Gastrointestinal Cancer

Anti–PD-1 Agents Gaining Momentum in Gastric Cancer

In updates of two important studies in metastatic gastric cancer reported at the European Society for Medical Oncology (ESMO) 2017 Congress, nivolumab -(Opdivo) and pembrolizumab (Keytruda) demonstrated activity—but to varying degrees and with some nuances. “Anti-PD [programmed cell death protein]...

gastrointestinal cancer

Survival in Patients Treated With Adjuvant Chemoradiotherapy After Resection of Gastric Cancer

In the CALGB 80101/Alliance trial, no difference in overall survival was found for adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil (ECF) vs fluorouracil and leucovorin (5-FU/LV) after curative resection of gastric cancer. The findings were reported in the Journal of Clinical ...

gastrointestinal cancer

Immunotherapy for Previously Treated Advanced Gastric Cancer

In an Asian phase III trial (ONO-4538-12, ATTRACTION-2) reported in The Lancet, Kang et al found that nivolumab (Opdivo) produced an improvement in overall survival vs placebo in patients with advanced gastric or gastroesophageal junction cancer who had disease refractory to or who were intolerant...

gastrointestinal cancer

Nivolumab Approved in Japan for Unresectable Advanced or Recurrent Gastric Cancer That Has Progressed After Chemotherapy

On September 22, Bristol-Myers Squibb Company announced that the Japanese Ministry of Health, Labor and Welfare (MHLW) approved nivolumab (Opdivo) for the treatment of unresectable advanced or recurrent gastric cancer which has progressed after chemotherapy. This approval was based on the phase III ...

gastrointestinal cancer

Addition of MET Inhibitor to First-Line Chemotherapy in Advanced Gastric Cancer

The phase III RILOMET-1 trial showed no survival benefit of adding the MET inhibitor rilotumumab to first-line epirubicin, cisplatin, and capecitabine in patients with advanced MET-positive gastric or gastroesophageal junction adenocarcinoma. These results were reported in The Lancet Oncology by...

gastrointestinal cancer

FDA Grants Accelerated Approval to Pembrolizumab for Advanced Gastric Cancer

On September 22, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with recurrent locally advanced or metastatic, gastric or gastroesophageal junction adenocarcinoma whose tumors express programmed cell death ligand 1 (PD-L1) as...

Gastrointestinal Cancer

Regorafenib in Hepatocellular Carcinoma Previously Treated With Sorafenib

On April 27, 2017, the indications for regorafenib (Stivarga) were expanded to include treatment of patients with hepatocellular carcinoma who have been previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data The new approval was based on the finding of improved overall survival...

gastrointestinal cancer

ESMO 2017: Pembrolizumab Shows Promising Response Rate in Pretreated Metastatic Gastric Cancer

Pembrolizumab (Keytruda) has shown a promising response rate in patients with pretreated metastatic gastric cancer, according to late-breaking results from the KEYNOTE-059 trial presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA28_PR). The expected...

gastrointestinal cancer

Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

In a single-center experience reported in JAMA Surgery, Eng et al found that an increased intraoperative fluid rate was associated with increased perioperative morbidity in patients with peritoneal cancer undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Study...

lung cancer
gastrointestinal cancer

Health-Related Quality of Life With Everolimus vs Placebo in Patients With Neuroendocrine Tumors

As reported in The Lancet Oncology by Pavel et al, no significant difference in deterioration of health-related quality of life was observed with everolimus (Afinitor) vs placebo in the phase III RADIANT-4 trial, which included patients with advanced nonfunctional well-differentiated...

Gastrointestinal Cancer

Relationship Between Molecular Subtypes of Gastric Cancer and Prognosis

In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability, genomically stable, and chromosomal instability. However, their clinical significance is unknown.  Now, a study by Bo Hwa Sohn, PhD,...

Gastrointestinal Cancer

Positioning Lu-177 Dotatate Therapy and 68-Ga Dotatate Scans in Management of Neuroendocrine Tumors

The results of the phase III NETTER-1 trial, recently published in The New England Journal of Medicine,1 have been met with great interest by clinicians who treat neuroendocrine tumors. In patients with advanced midgut lesions, treatment with the radiopharmaceutical lutetium Lu-177 dotatate...

Gastrointestinal Cancer

‘Sidedness’ in Colon Cancer: Using the Data in the Clinic

The evidence from clinical trials has established that “side matters” when it comes to colorectal cancer outcomes. How do clinicians use this information in their practices? Christina Wu, MD, of Emory University, shared her thoughts with attendees at the 2017 Debates and Didactics in Hematology and ...

gastrointestinal cancer

Adding First-Line Selective Internal Radiotherapy to Chemotherapy in Patients With Liver Metastases From Colorectal Cancer

A meta-analysis of three randomized trials (FOXFIRE, SIRFLOX, and FOXFIRE-Global) indicates no overall survival benefit of adding first-line selective internal radiotherapy to chemotherapy in patients with liver metastases from colorectal cancer. The findings were reported by Wasan et al in The...

Breast Cancer
Leukemia
Supportive Care
Gastrointestinal Cancer

FDA Actions Yield Extended Approvals of Novel Agents, Advisory Committee Votes Favorably on Two Biosimilars and Pediatric Indication for CAR T-Cell Therapy

DURING JULY, the U.S. Food and Drug Administration (FDA) and its Oncologic Drugs Advisory Committee (ODAC) made a number of approvals and recommendations on a variety of oncology products.  Neratinib  ON JULY 1 7, the FDA approved neratinib (Nerlynx) for the extended adjuvant treatment of adult...

gastrointestinal cancer

Classifying Gastric Cancers by Subtype May Provide Tailored Treatment Options

Gastric cancer is the third leading cause of cancer death in both men and women worldwide. In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability (MSI), genomically stable (GS), and...

gastrointestinal cancer

ESMO World GI 2017: Study Explores Association of Mediterranean Diet Components With Advanced Colorectal Polyps

The benefits of a Mediterranean diet are well known when it comes to colorectal protection, but it’s hard to know specifically what elements of the diet are the healthiest. Now a new study, presented by Fliss Isakov et al at the ESMO 19th World Congress on Gastrointestinal Cancer, suggests...

Gastrointestinal Cancer

Some Patients With Stage III Low-Risk Colon Cancer May Require Less Oxaliplatin Therapy

Patients with stage III colon cancer considered at low risk for recurrence may be treated effectively—and incur less neurotoxicity—with 3 months of an oxaliplatin-based regimen as compared with the standard 6 months, according to the results of the International Duration Evaluation of Adjuvant...

Gastrointestinal Cancer

Expert Point of View: Daniel G. Coit, MD

“While these results are clearly superior to historical controls, the study prompts a number of questions,” session moderator, ­Daniel G. Coit, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center in New York, commented in an interview. “Nearly half of the patients received systemic ...

Gastrointestinal Cancer

Hyperthermic Intraperitoneal Chemoperfusion May Be Efficacious for Peritoneal Metastases

Hyperthermic intraperitoneal chemoperfusion is efficacious when used as part of multimodality therapy for low-volume peritoneal metastases of gastric cancer, suggests a prospective single-arm phase II trial.1 Among the 19 patients enrolled, all of whom had stage IV disease with ­either...

gastrointestinal cancer

10-Year Outcomes With Two Dose Levels of Imatinib in Unresectable or Metastatic GIST

Casali et al have reported 10-year progression-free and overall survival rates among patients with locally advanced unresectable or metastatic gastrointestinal stromal tumors (GISTs) receiving imatinib at 400 or 800 mg/d in the phase III European Organisation for Research and Treatment of Cancer,...

Gastrointestinal Cancer
Colorectal Cancer
Issues in Oncology

Increased Recognition of Colorectal Cancer in Young Adults, Even Those Aged 20 to 29, as Evidence Continues to Accumulate

The incidence of colorectal cancer continues to increase among young adults, with the sharpest increase among those aged 20 to 29, according to a recent article in the Journal of the National Cancer Institute.1 This trend has been called disturbing and ominous, but the widely reported results of...

head and neck cancer
lymphoma
gastrointestinal cancer

Protein Component of the Epstein-Barr Virus May Promote the Development of Cancer

After an infection with the Epstein-Barr virus (EBV), the virus persists in the body throughout a person's lifetime, usually without causing any symptoms. About one-third of infected teenagers and young adults nevertheless develop infectious mononucleosis, which usually wears off after a few weeks. ...

Pancreatic Cancer
Gastrointestinal Cancer
Colorectal Cancer

‘Collateral Lethality’ May Offer New Therapeutic Approach to Cancers of the Pancreas, Stomach, and Colon

Cancer cells often delete genes that normally suppress tumor formation. These deletions also may extend to neighboring genes, an event known as “collateral lethality,” which may create new options for the development of therapies for several cancers. Scientists at The University of Texas MD...

Gastrointestinal Cancer

Expert Point of View: Heinz-Josef Lenz, MD

Heinz-Josef Lenz, MD, of the University of Southern California in Los Angeles, said the results of the ONO-4538 trial were impressive in light of this challenging patient population. “You see a significant benefit in a highly refractory gastric cancer population,” he said. Dr. Lenz cautioned:...

Gastrointestinal Cancer

Nivolumab, as Salvage, Improves Overall Survival in Gastric Cancer

Gastric cancer can apparently be added to the growing list of malignancies for which drugs targeting the programmed cell death protein 1 (PD‑1) receptor are effective, according to the results of the phase III ONO-4538 investigation conducted in Asia and presented at the 2017 Gastrointestinal...

gastrointestinal cancer

Small-Intestine GIST Treated Surgically Associated With Better Prognosis in Younger Patients

Gastrointestinal stromal tumors (GIST) arise is the wall of the digestive tract and most often occur in the stomach or small intestine. Though more common in later in life, GISTs can occur in adolescents and young adults (AYA) under 40 years old as well. In an article published by Fero et al in...

gastrointestinal cancer

Masanori Terashima, MD, PhD, on Gastric Cancer: Results of the JCOG1001 Trial

Masanori Terashima, MD, PhD, of Shizuoka Cancer Center, discusses phase III study findings evaluating bursectomy for patients with subserosal/serosal gastric cancer (Abstract 5).

gastrointestinal cancer

Salah-Eddin Al-Batran, MD, on Gastric Cancer: RADPAC Trial Results

Salah-Eddin Al-Batran, MD, of the Institute of Clinical Cancer Research and Nordwest Hospital, discusses study findings on paclitaxel with and without RAD001 in patients with gastric cancer whose disease has progressed after therapy with a fluoropyrimidine/platinum-containing regimen (Abstract 4).

gastroesophageal cancer
gastrointestinal cancer

2017 GI Cancers Symposium: Nivolumab Demonstrated Efficacy and Improved Survival in Patients With Previously Treated Advanced Gastric Cancer

Results of the ONO-4538-12 trial demonstrated that nivolumab (Opdivo) significantly reduced the risk of death by 37% (hazard ratio [HR] = 0.63; P < .0001) in patients with previously treated advanced gastric cancer refractory to or intolerant of standard therapy, a condition without current ...

gastrointestinal cancer

No Improvement in Event-Free Survival Reported With More Extensive or Serial Resections in Wild-Type GIST

Findings from the National Institutes of Health Pediatric and Wildtype Gastrointestinal Stromal Tumors (GISTs) Clinic, reported in the Journal of Clinical Oncology by Weldon et al, indicate that more extensive or serial resections are not associated with improvement in event-free survival in...

Gastrointestinal Cancer

Liquid Biopsies Identify Molecular Alterations Driving Drug Resistance in Nearly 80% of Patients With Gastrointestinal Cancers

Liquid biopsy technologies are increasingly being used to detect genetic mutations in tumors, giving clinicians the opportunity to see in real time how a patient’s cancer may or may not be responding to treatment. In a study presented recently at the 28th EORTC-NCI-AACR Symposium on Molecular...

gastrointestinal cancer

EORTC-NCI-AACR 2016: Liquid Biopsies Identify Molecular Alterations Driving GI Cancer Drug Resistance in Nearly 80% of Patients

Ryan Corcoran, MD, PhD, Translational Research Director of the Center for Gastrointestinal Cancers at Massachusetts General Hospital (MGH) Cancer Center, described to attendees of the 2016 EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics the results of a program at MGH focused...

cns cancers
gastrointestinal cancer

EORTC-NCI-AACR 2016: ‘Remarkable Antitumor Activity’ in Phase I Studies of PDGFRα and KIT Mutation Inhibitors

Two studies at the 28th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics in Munich, Germany focused on the inhibition of mutations in the KIT and PDGFRα oncogenes. These genes provide instructions for making proteins that are part of a family of proteins called receptor...

Issues in Oncology
Lung Cancer
Gastrointestinal Cancer
Prostate Cancer
Colorectal Cancer

At ESMO 2016, Many Phase III Trials Fail to Meet Primary Endpoints

The 2016 European Society for Medical Oncology (ESMO) Congress revealed many important positive findings from key trials in a number of tumor types, but many highly anticipated phase III trials in advanced disease failed to meet their primary endpoints. The ASCO Post has summarized several of these ...

Gastrointestinal Cancer

New NCCN Patient Resources Assist Decision-Making for Patients With Stomach Cancer

According to the American Cancer Society, it is estimated that more than 26,000 people will be diagnosed with stomach cancer in the United States this year, with nearly 1 million new cases diagnosed worldwide each year, according to the World Health Organization. Because there are no early symptoms ...

gastroesophageal cancer
gastrointestinal cancer

Martin H. Schuler, MD, on Gastric and GEJ Adenocarcinoma: Results of the FAST Study (German Language Version)

Martin H. Schuler, MD, of the University Hospital Essen, discusses in German findings from this phase II trial of epirubicin, oxaliplatin, and capecitabine with or without the antibody IMAB362 as first-line therapy in patients with advanced CLDN18.2+ disease. (Abstract 614O)

gastrointestinal cancer

Yung-Jue Bang, MD, PhD, on Gastric Cancer: Results From the GOLD Trial

Yung-Jue Bang, MD, PhD, of Seoul National University Hospital, discusses phase III study findings on olaparib and paclitaxel in patients with advanced gastric cancer who have progressed following first-line therapy. (Abstract LBA25)

gastroesophageal cancer
gastrointestinal cancer

Martin H. Schuler, MD, on Gastric and Gastroesophageal Junction Adenocarcinoma: Results of the FAST Study

Martin H.  Schuler, MD, of the University Hospital Essen, discusses findings from this phase II trial of epirubicin, oxaliplatin, and capecitabine with or without the antibody IMAB362 as first-line therapy in patients with advanced CLDN18.2+ disease. (Abstract 614O)

Gastrointestinal Cancer

Regorafenib Increases Progression-Free Survival in Advanced Gastric Cancer

The multikinase inhibitor regorafenib (Stivarga) prolonged progression-free survival vs placebo in patients with previously treated advanced gastric carcinoma, in a phase II trial reported in the Journal of Clinical Oncology by Nick Pavlakis, MBBS, PhD, of the University of Sydney, Australia, and...

Gastrointestinal Cancer

Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes when compared with postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Marcel Verheij, MD, PhD, et...

gastrointestinal cancer

World GI 2016: Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes compared to postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Verheij et al at the ESMO 18th World...

gastrointestinal cancer

Higher Prediagnostic Plasma Vitamin D Levels May Be Associated With Prolonged Survival in Pancreatic Cancer

In a study reported by Yuan et al in the Journal of Clinical Oncology, higher prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] levels were found to be associated with prolonged overall survival in patients with pancreatic cancer. Study Details The study involved data from 493 patients from 5...

gastrointestinal cancer

Study Finds Regorafenib Increases Progression-Free Survival in Advanced Gastric Cancer

The multikinase inhibitor regorafenib (Stivarga) prolonged progression-free survival vs placebo in patients with previously treated advanced gastric carcinoma, in a phase II trial reported in the Journal of Clinical Oncology by Pavlakis et al. A regional difference in treatment effect was observed. ...

Gastrointestinal Cancer

Increased Risk of Gallbladder Cancer May Be Associated With Consuming Large Amounts of Sweetened Beverages

A large prospective Swedish study reported by Susanna C. Larsson, PhD, of the Unit of Nutritional Epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, and colleagues found a 2.2-fold increased risk of gallbladder cancer in people who consumed two or ...

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