Are GI cancers still marooned on an island or are they catching up with other solid tumours in terms of progress?
San Francisco – In the past, whenever I posted updates on any of the GI cancers they attracted noticeably less attention than other solid tumours and rightly so, especially given the lack of new agents and compelling data. If the highlight of a meeting is debating the merits of left versus right side tumour responses or bolus versus infusional administration then the plot has kind of been lost in the morass of abstracts available.
This year, however, things are looking up with a tidy group of studies that have what I call ‘interestingness’ – in other words, results that will tempt us to look deeper rather than merely skim in the hope of something new and shiny.
This weekend in San Francisco saw some highlights (and also lowlights) in the form of new clinical data emerging from the 2020 ASCO GI conference. That means we’re due a review so let’s rock ’n roll though the important studies to see what stands out from the crowd…
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Hitching a ride on the Powell and Mason tram
Gastrointestinal (GI) cancers comprise quite a wide variety of different tumour types, including those of the oesophagus and stomach, pancreas, small bowel and hepatobiliary tract, as well as the colon, rectum and anus.
With the possible exception of oesophagus and gastric/stomach cancers, this bunch of tumour types are generally colld rather than hot tumours for various reasons.
Aside from some recent forays by immune checkpoint blockade in gastric cancer, this field hasn’t had a lot of startling new developments to get excited about of late.
Are things finally changing?
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The first cancer conference of 2018 is now upon us and after enjoying last year’s event in San Francisco, I wanted to take some time to explore some key abstracts of interest at the ASCO GI meeting, which begins tomorrow.
This conference covers various updates on new developments in oesophageal, gastric, colon, pancreatic and colorectal cancers.
Are there any trials or new developments to get excited about at this year’s GI18 meeting?
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San Francisco: A look at what’s new in gastric cancer (GC) from the 2017 ASCO GI meeting.
Day 1 of #GI17 is filling up…
There were several phase 3 trials presented in GC and gastro-esophageal junction (GEJ) carcinoma in both targeted therapies and immunotherapies this past weekend.
- When we look carefully at the latest data, what do we find?
- Where are the opportunities and challenges in this niche?
Another critical question that many observers will be interested in is…
Will BMS’s checkpoint inhibitor, nivolumab (Opdivo), overcome recent setbacks in lung cancer and make a mark in stomach cancer to challenge approved targeted therapies such as ramucirumab (Cyramza)?
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Updated data are often presented at conferences and therefore the results can differ from the submitted abstracts, which are sometimes submitted as placeholders based on immature data cutoffs. That was certainly the case in several examples at the ASCO GI conference in San Francisco last weekend.
After Monday’s look at new developments in the lower GI tract, we now turn our attention today to the upper GI tract with a focus on oesophageal, gastric (stomach), and gastro-esophageal junction (GEJ) cancers.
Over the last five years we have seen new approvals for targeted therapies such as HER2+ gastric cancer and relapsed refarctory gastric cancers with a VEGF inhibitor. Will that trend continue over the next five years or will we see new approaches such as immunotherapy enter the market and dominate?
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We saw at ASCO last year that response to checkpoint immunotherapy is feasible in some patients with colorectal cancer, but what about other gastrointestinal tumours such as pancreatic, duodenal and biliary cancers?
Can their activity extend beyond the obvious hypermutated tumours such as melanoma, lung, renal and bladder cancers?
Many of you will know that most pancreatic cancers, for example, are detected late and prognosis in metastatic disease is generally poor. You also typically don’t see much coverage of the other GI non-CRC cancers from cancer conferences in the medical media outside of pancreatic cancer occasionally.
At the ASCO Gastrointestinal symposium (#GI16) this past weekend, there was some new data of note in these tumour types that is well worth highlighting and discussing because it may have a major impact on the GI landscape.
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