GI CANCERS

General Cancer

Consistent benefits and safety were seen with TAS-102 (trifluridine/tipiracil; Lonsurf) in a real-world treatment setting for patients with refractory metastatic colorectal cancer, according to preliminary data from the phase IIIb open-label PRECONNECT trial. 

A strategy of escalating regorafenib from 80 mg to 160 mg per day was superior to starting at a dose of 160 mg per day in patients with refractory metastatic colorectal cancer, according to results from the regorafenib dose optimization study presented at the 2018 World Congress on GI.

According to findings from the IMblaze370 study, atezolizumab alone or in combination with cobimetinib did not demonstrate superior overall survival when compared with regorafenib for the treatment of patients with chemorefractory metastatic colorectal cancer. Findings from the study were presented at the 2018 World Congress on Gastrointestinal Cancer.

Manish A. Shah, MD, director of Gastrointestinal Oncology at Weill Cornell Medicine, discusses the need for targeted therapies beyond the second-line setting in esophageal cancer. While this is a deadly disease with most metastatic patients dying within a year, a recent clinical trial with pembrolizumab addresses an unmet need in the population, Shah says.

According to findings from the phase III KEYNOTE-061 study, second-line treatment with pembrolizumab (Keytruda) did not significantly improve overall survival or progression-free survival compared with paclitaxel in patients with advanced or metastatic gastric or gastroesophageal junction cancer with a PD-L1 combined positive score ≥1.

In findings from the phase III TAGS study reported at the 2018 World Gastrointestinal Cancer Congress, TAS-102 (trifluridine/tipiracil; Lonsurf) was found to be an effective treatment option for patients with heavily pretreated metastatic or advanced gastric cancer, providing a 31% reduction in the risk of death compared with placebo.

Treatment with&nbsp;trifluridine/tipiracil combined with bevacizumab improved&nbsp;progression-free survival over capecitabine plus bevacizumab in patients with&nbsp;metastatic colorectal cancer who are not eligible for chemotherapy or surgical resection,&nbsp;according to findings presented at the 20th World Conference of Gastrointestinal Cancer.&nbsp;<br /> &nbsp;

Bert H. O&rsquo;Neil, MD, recently shared his considerations for treatment when treating patients with gastrointestinal cancers. O&rsquo;Neil reviewed how he would treat patients with colon cancer and patients with hepatocellular carcinoma based on case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives presentation.<br /> &nbsp;

John Marshall, MD, recently shared the treatment considerations and decisions he makes when treating patients with gastrointestinal (GI) cancers. Marshal, chief of the Division of Hematology/Oncology, director of the Otto J. Ruesch Center for the Cure of GI Cancer, Medstar Georgetown University Hospital, in Washington, DC, explained his treatment decisions based on a case scenario during a <em>Targeted Oncology </em>live case-based peer perspectives presentation.

Maria Svensson, MD, Lund University, discusses the growing interest in checkpoint inhibitor blockade treatments for gastrointestinal cancers. In the past, there have been promising results with this treatment in metastatic disease.

Yelena Y. Janjigian, MD, has been appointed chief of the Gastrointestinal Medical Oncology Service in the Division of Solid Tumor Oncology, Department of Medicine at Memorial Sloan Kettering Cancer Center in New York. She will succeed Leonard Saltz, MD, who had held this position for 5 years. Saltz will assume the position of executive director for clincal value and sustainability.

The combination of the VEGFR/FGFR inhibitor lenvatinib and the PD-1 inhibitor pembrolizumab induced a confirmed overall response rate of 26.9% (95% CI, 11.6%-47.8%) in patients with unresectable hepatocellular carcinoma, according to results from a 2-part, phase Ib trial.

The 2018 ASCO Annual Meeting was a great success, with over 40,000 people in attendance and over 5000 abstracts presented from June 1-5 in Chicago, Illinois. Data from several phase III trials in lung cancer were presented, with especially significant results in non&ndash;small cell lung cancer. Other big areas during this year&rsquo;s meeting included breast, gastrointestinal, genitourinary, and hematologic cancers.

In results from the phase III REACH-2 trial,&nbsp;ramucirumab reduced the risk of death by 29% versus placebo as a second-line treatment for&nbsp;patients with advanced hepatocellular carcinoma. Results from the study were presented during the&nbsp;2018 ASCO Annual Meeting.

According to updated findings from the phase III ASPECT trial presented at the 2018 ASCO Annual Meeting, a combination of 2 over-the-counter drugs can reduce the risk for high-grade dysplasia or esophageal cancer in patients with&nbsp;Barrett&rsquo;s esophagus if taken for at least 7 years.&nbsp;These results also demonstrated that high-dose esomeprazole in combination with a low-dose aspirin was associated with delaying all-cause mortality.

According to preliminary findings from the phase III PREOPANC-1 trial, preoperative treatment with chemotherapy and radiation improved overall survival for patients with resectable or borderline resectable pancreatic cancer compared to immediate surgery. These data, presented at the 2018 ASCO Annual Meeting, demonstrated the potential role for neoadjuvant treatment in the pancreatic cancer treatment paradigm.

The review period for lenvatinib as a first-line treatment for patients with unresectable hepatocellular carcinoma has been extended by the FDA. According to Eisai and Merck, the companies codeveloping the drug, this will allow ample time to review the application.&nbsp;

Richard Kim, MD, recently discussed the treatment considerations and decisions he makes when treating patients with hepatocellular carcinoma. Kim, an associate professor oncology, University of South Florida College of Medicine, and medical oncologist, Gastrointestinal Oncology Department, Moffitt Cancer Center, explained his treatment decisions based on 2 case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives program.

A supplemental new drug application seeking the approval of cabozantinib for the treatment of patients with previously-treated advanced hepatocellular carcinoma has been accepted by the FDA, according to a statement from Exelixis, the company developing the agent.

Laura Dawson, MD,&nbsp;discusses the current and future role of SBRT in the treatment of liver tumors.