Advertisement


Belinda Lee, MBBS, on Early-Stage Pancreatic Cancer: New Data on Guiding Adjuvant Chemotherapy

2024 ASCO Annual Meeting

Advertisement

Belinda Lee, MBBS, of Peter MacCallum Cancer Centre, Northern Health, Walter & Eliza Hall Institute, Melbourne, discusses findings from the AGITG DYNAMIC-Pancreas trial on the potential role of serial circulating tumor DNA testing after upfront surgery to guide adjuvant chemotherapy for early-stage disease (Abstract 107).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
I'm here today to talk to you about the DYNAMIC-Pancreas clinical trial. This was a non-randomized phase 2 study looking at the potential role of circulating tumor DNA testing after upfront surgery to guide adjuvant chemotherapy for early-stage pancreatic cancer patients. In this study, we explored the feasibility and clinical utility of tumor-informed ctDNA testing for patients after surgery to see if we could guide their treatment. This study confirmed that the prognostic significance of ctDNA as a biomarker after surgery in early-stage pancreatic cancer. Even when ctDNA is not detected after surgery, there is still a high risk of recurrence that remains. We enrolled 102 patients from 26 Australian cancer centers exploring the feasibility and clinical utility of circulating tumor DNA. We looked to ask questions like, can the use of ctDNA inform us about the risk of recurrence in our patients, and can we use ctDNA to guide the use of adjuvant chemotherapy comparing three versus six months duration of chemotherapy, as well as comparing the use of different intensities of chemotherapy looking at triplet versus doublet chemotherapy in our patients? What we found was that ctDNA does indeed provide prognostic significance in early-stage pancreatic cancer. However, even in the negative ctDNA cohort, the risk of relapse remains. We would still advise that you give six months of adjuvant chemotherapy treatment. While ctDNA-negative indicates as low risk of recurrence, patients should still undergo their adjuvant chemotherapy treatment, and future studies should incorporate the use of ctDNA after treatments from surgery, as well as after adjuvant chemotherapy. Changes in ctDNA may be used to track the changes in the patient's tumor burden throughout their treatment. We could also use ctDNA to integrate ctDNA into new studies looking at novel agents as well.

Related Videos

Clifford A. Hudis, MD, and Karen E. Knudsen, MBA: An ASCO–American Cancer Society Partnership to Benefit Patients

Clifford A. Hudis, MD, CEO of the American Society of Clinical Oncology (ASCO), and Karen E. Knudsen, MBA, CEO of the American Cancer Society, discuss a newly launched collaboration between the organizations to make it simpler for patients to find authoritative cancer information online. The effort creates one of the largest and most comprehensive online resources for credible cancer information, available for free to the public on cancer.org.

 

Leukemia

Yucai Wang, MD, PhD, on Richter Transformation of CLL: Findings on Combination Therapy With an Immune Checkpoint Inhibitor

Yucai Wang, MD, PhD, of the Mayo Clinic, discusses the increased efficacy of combination therapy with pembrolizumab plus a BCR kinase inhibitor compared with pembrolizumab alone in patients with Richter transformation of chronic lymphocytic leukemia (CLL; Abstract 7050).

Breast Cancer

Ciara C. O’Sullivan, MD, MBBCh, on HER2-Positive Breast Cancer: Expert Commentary on Treatments Under Study

Ciara C. O’Sullivan, MD, MBBCh, of Mayo Clinic, discusses three studies of treatment for patients with HER2-positive metastatic breast cancer and their clinical implications: the EMERALD trial of eribulin and taxane; the Patricia Cohort C trial of palbociclib plus trastuzumab and endocrine therapy; and DB07 on trastuzumab deruxtecan with or without palbociclib.

Breast Cancer

Fabrice Andre, MD, PhD, on Breast Cancer: Interim Analysis From DESTINY-Breast07

Fabrice Andre, MD, PhD, of Gustave Roussy and the Université Paris-Saclay, discusses a dose-expansion interim analysis of trastuzumab deruxtecan (T-DXd) monotherapy and T-DXd plus pertuzumab in patients with previously untreated HER2-positive metastatic breast cancer (Abstract 1009).

Lung Cancer

Tony S.K. Mok, MD, on NSCLC: Adagrasib vs Docetaxel in KRAS G12C–Mutated Disease

Tony S.K. Mok, MD, of The Chinese University of Hong Kong, discusses phase III findings from the KRYSTAL-12 study, which showed that adagrasib improved progression-free survival and overall response rate over docetaxel in patients with locally advanced or metastatic non–small cell lung cancer harboring a KRAS G12C mutation who had previously received a platinum-based chemotherapy with anti–PD-(L)1 treatment.

Advertisement

Advertisement




Advertisement