Gabriel A. Brooks, MPH, MD, on Colorectal Cancer: Expert Perspective on the Need to Deintensify Oxaliplatin
2022 ASCO Gastrointestinal Cancers Symposium
Gabriel A. Brooks, MPH, MD, of the Norris Cotton Cancer Center, discusses key studies that, when synthesized, suggest the benefits of oxaliplatin may be less than often assumed. The toxicities are well described (especially neuropathy), and the agent should be used cautiously and sparingly beyond the third month of adjuvant treatment for patients with colon cancer and in the elderly or frail with metastatic disease.
The ASCO Post Staff
Afsaneh Barzi, MD, PhD, of City of Hope Comprehensive Cancer Center and AccessHope, discusses results from a phase I/II study of regorafenib and pembrolizumab in refractory microsatellite-stable colorectal cancer. Although the trial did not meet its primary endpoint, the median overall survival is “provocative,” says Dr. Barzi. An analysis of biomarkers to identify patients with a longer duration of benefit is ongoing (Abstract 15).
The ASCO Post Staff
Tanios S. Bekaii-Saab, MD, of Mayo Clinic, discusses new findings from the KRYSTAL-1 study, which suggested adagrasib monotherapy is well tolerated and demonstrates clinical activity in pretreated patients with unresectable or metastatic pancreatic cancer or other gastrointestinal tumors harboring a KRAS G12C mutation. Adagrasib is an inhibitor of the KRAS G12C mutation (Abstract 519).
The ASCO Post Staff
Thierry André, MD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results from the GERCOR NEONIPIGA study, which suggests neoadjuvant therapy with nivolumab and ipilimumab may be associated with a high pathologic complete response rate in patients with localized microsatellite instability–high or mismatch repair–deficient esophagogastric adenocarcinoma. This study raises the question of whether surgery could be delayed or avoided for some patients (Abstract 244).
The ASCO Post Staff
Melissa Amy Lumish, MD, of Memorial Sloan Kettering Cancer Center, discusses new findings showing a 100% complete response rate to PD-1 blockade alone among the first 11 patients with locally advanced mismatch repair–deficient rectal cancer treated with this approach. None of the patients required chemoradiation or surgery, thus avoiding their attendant morbidities, and so PD-1 blockade may represent a new treatment paradigm. Follow-up on the durability of response is needed (Abstract 16).
The ASCO Post Staff
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.
