GI CONNECT experts have reviewed practice-changing data on upper and lower GI cancer presented at ASCO 2024. Watch this short video update for the highlights.

 

Upper GI cancer

 

Dr Samuel Klempner and Dr Lizzy Smyth discuss:

 


Lower GI cancer

 

Dr Dominik Modest and Prof. Jenny Seligmann discuss: 

 

Clinical Takeaways

 

Upper GI

  • Abstract LBA1: ESOPEC - perioperative chemotherapy (FLOT) and surgery improves overall survival compared to neoadjuvant chemoradiation (CROSS) plus surgery in patients with resectable oesophageal adenocarcinoma. FLOT is likely to be adopted as the standard approach for these patients.
  • Abstract LBA4001: RENAISSANCE – the trial did not meet its primary endpoint and confirms that patients with limited metastatic disease of the stomach or gastroesophageal junction as defined by the FLOT3 trial have a favourable survival with chemotherapy/targeted therapy, but this is independent of surgical therapy.
  • Abstract LBA4002: ARMANI - Switch maintenance with paclitaxel plus ramucirumab after 3 months of oxaliplatin-based doublets significantly improved PFS and OS compared to continuation of oxaliplatin-based chemotherapy in patients with HER2-negative metastatic gastric/GEJ cancer and may be a new strategy in patients who are not eligible for upfront treatment with immune checkpoint inhibitors. Treating providers need to monitor metastatic gastric/GEJ patients closely to ensure there is the opportunity for second line therapy, particularly in patients who are not eligible for upfront treatment with immune checkpoint inhibitors.

 

Lower GI

  • Abstract 3500: TRANSMET – liver transplantation plus chemotherapy significantly improves the survival of selected patients with unresectable colorectal liver metastases compared to chemotherapy alone; and offers a potential of cure to cancer patients with otherwise poor long-term outcome.
  • Abstract LBA3501: COLLISION – the study results suggested that transitioning from surgical resection to thermal ablation as standard of care for patients with small-size (≤3 cm) colorectal liver metastases would reduce complications, shorten hospital stay and improve local control, without compromising disease-free and overall survival.
  • Abstract LBA3504: NEOPRISM – 9 weeks of neoadjuvant pembrolizumab is effective in downstaging high risk stage 2 or 3 dMMR/MSI-H CRC with a pathological complete response rate of 59%. No patients had relapsed disease after a median follow-up of 9.7 months.
  • Abstract LBA3512: PD-1 blockade for 6-months with dostarlimab in patients with dMMR locally advanced rectal cancer showed that all patients who completed treatment achieved a complete response, without the need for chemotherapy, radiation, or surgery.

Upper and lower GI cancer update from ASCO 2024: Educational objectives

  • To help healthcare professionals understand the latest developments in GI cancer and be able to implement these insights into clinical practice

Dr. Klempner is an Associate Professor at Massachusetts General Hospital and Harvard Medical School and leads the gastric and oesophageal programme. His clinical and translational research is centred on cancer genomics, acquired resistance to targeted therapies and the intersection of genomics and immune mediated therapies to identify novel therapeutic approaches and biomarkers in gastroesophageal cancers. He serves on the NRG non-colorectal committee, co-chairs the NCI oesophagogastric task force, and is on the NCCN guideline committees for gastric and oesophageal cancers. His work is supported by Stand Up 2 Cancer, NCI/NIH, AACR, the Degregorio Foundation, and The Gastric Cancer Foundation and Gateway for Cancer Research. He is active in gastric and oesophageal cancer outreach and patient advocacy.

Assoc. Prof. Samuel J Klempner has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Astellas, AstraZeneca, BMS, Coherus, Daiichi-Sankyo, Eli Lilly, Merck, Novartis, Nuvalent Therapuetics and Sanofi.

Elizabeth (Lizzy) Smyth is a consultant in gastrointestinal oncology. Dr Smyth commenced her oncology training in Dublin, Ireland. In 2009 she was awarded a fellowship from the Irish Society of Medical Oncology to train at Memorial Sloan-Kettering Centre, New York. Following this, she worked at the Royal Marsden Hospital in London from 2011-2018. Her research focus is on clinical trials and translational research in gastroesophageal cancer, and she has worked on trial design and management of national and international trials. She is a member of the European Society for Medical Oncology GI Faculty and leads the EORTC GI Trials Group Gastric Cancer Taskforce. Dr Smyth is committed to furthering national and international collaboration in GI trials research.

Dr Elizabeth Smyth has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Amal Therapeutics, Aptitude Health, Amgen, Astellas, Astra Zeneca, Beigene, BMS, Celgene, Daiichi Sankyo, Elsevier, Everest Clinical Research, First Word Group, Five Prime Therapeutics, Gritstone Oncology, Imedex, Merck, My Personal Therapeutics, Novartis, Pfizer, Roche, Sai-Med, Servier, Viracta, Zymeworks

Dr Jenny Seligmann gained her MBChB and BMedSci at the University of Aberdeen in 2005 then gained her PhD in 2015 from the University of Leeds on Biomarkers of Prognosis and Prediction of Response in Colorectal Cancer. She was appointed a Cancer Research UK Clinical Trials Fellow in 2015, then a University Academic Fellow and Consultant in Medical Oncology in Leeds in 2017. Her research interests are in clinical trials and biomarkers of prediction of response in colorectal cancer. She is involved in several ongoing clinical trials, including the FOCUS-4 trial and has an ongoing lab-based programme of research. She has been involved in several national and international committees, including the UK Colorectal Clinical Studies Group and is currently the EORTC GI Group Young Investigator. She has received several awards including an ASCO Merit Award in 2013.

Prof. Jenny Seligmann has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Merck Serono, Pierre Fabre and Roche Diagnostics. 

Prof. Dr Dominik Modest studied medicine at the Charité in Berlin, Germany and at the University of Bern, Switzerland. Currently, after 10 years at the LMU in Munich, Germany, he is a physician at the Charité Universitaetsmedizin Berlin, Germany. His research activities focus on metastatic colorectal cancer and include the concept and coordination of trials for the FIRE study group and the Arbeitsgemeinschaft Internistische Onkologie (AIO). Prof. Dr Modest also coordinates the translational research components of these trials, aiming to identify prognostic and predictive biomarkers of metastatic colorectal cancer. His research has been published in several papers in scientific journals. In 2015, he received a postdoctoral qualification on factors for personalisation of metastatic colorectal cancer therapy and a full professorship in 2020.  Prof. Dr Modest is an active member of several national and international cancer associations and served as spokesman for the Young Medical Oncologists of the AIO until 2014.

Dr Dominik Modest has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Amgen, Merck, Servier, Pierre Fabre, Sanofi, Lilly, Onkowissen, AstraZeneca, MSD, BMS, Seagen and GSK

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