Belinda Lee, MBBS, on Early-Stage Pancreatic Cancer: New Data on Guiding Adjuvant Chemotherapy
2024 ASCO Annual Meeting
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.
The ASCO Post Staff
Muhit Özcan, MD, of Turkey’s Ankara University School of Medicine, discusses the ongoing phase III BELLWAVE-010 study of nemtabrutinib plus venetoclax vs venetoclax plus rituximab in previously treated patients with relapsed or refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) (Abstract TPS7089).
The ASCO Post Staff
Lisa A. Carey, MD, of University of North Carolina, Chapel Hill and UNC Lineberger Comprehensive Cancer Center, and Kevin Kalinsky, MD, of the Winship Cancer Institute of Emory University, discuss the first phase III findings showing a benefit of continued CDK4/6 inhibition with abemaciclib plus fulvestrant, following disease progression in patients with hormone receptor–positive, HER2-negative advanced breast cancer (LBA1001).
The ASCO Post Staff
Yasmin H. Karimi, MD, of the University of Michigan Comprehensive Cancer Center, discusses data reaffirming the efficacy and feasibility of using epcoritamab plus R-DHAX/C (rituximab, dexamethasone, cytarabine, and oxaliplatin or carboplatin) in autologous stem cell transplant–eligible patients with diffuse large B-cell lymphoma. Response rates were reported to be high, and most patients proceeded to transplant (Abstract 7032).
The ASCO Post Staff
Narjust Florez, MD, of Dana-Farber Cancer Institute, and David R. Spigel, MD, of Sarah Cannon Research Institute, discuss phase III findings showing that durvalumab as consolidation treatment after concurrent platinum-based chemoradiotherapy improved survival outcomes compared with placebo in patients with limited-stage small cell lung cancer. According to Dr. Spigel, these data support durvalumab as a new standard of care in this population (Abstract LBA5).
The ASCO Post Staff
Yasmin H. Karimi, MD, of the University of Michigan Comprehensive Cancer Center, discusses 2.5-year follow-up data on epcoritamab monotherapy for patients with relapsed or refractory large B-cell lymphoma. The subcutaneous regimen continues to demonstrate durable responses (Abstract 7039).