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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 ...
In a Japanese phase III trial (TOPIC-NEC) reported in JAMA Oncology, Morizane et al found no difference in overall survival with etoposide/cisplatin (EP) vs irinotecan/cisplatin (IP) in chemotherapy-naive patients with advanced digestive system neuroendocrine carcinoma. Study Details The open-label ...
As reported in the Journal of Clinical Oncology by Thierry André, MD, and colleagues, the French (GERCOR) phase II NEONIPIGA trial has shown a high pathologic complete response rate with nivolumab/ipilimumab neoadjuvant therapy in patients with localized deficient mismatch repair...
As reported in the Journal of Clinical Oncology by Bauer et al, the phase III INTRIGUE trial showed no significant progression-free survival benefit with second-line ripretinib vs sunitinib in imatinib-pretreated patients with gastrointestinal stromal tumor (GIST), including among patients with KIT ...
In the 5-year follow-up of the Korean KLASS-02 trial reported in JAMA Surgery, Son et al found similar 5-year overall survival and relapse-free survival among patients with R0 resection using laparoscopic vs open distal gastrectomy in patients with locally advanced gastric cancer. Late...
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology® covering eight tumor types. Guidelines are now published for more than 60 tumor types, subtypes, and topics. During the NCCN’s 27th Annual Conference, which was again...
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).
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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 ...
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...
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 ...
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).
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).
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...
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.
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).
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, ...
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...
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 ...
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...