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The multikinase inhibitor regorafenib (Stivarga) prolonged progression-free survival vs placebo in patients with previously treated advanced gastric carcinoma, in a phase II trial reported in the Journal of Clinical Oncology by Pavlakis et al. A regional difference in treatment effect was observed. ...
A large prospective Swedish study reported by Susanna C. Larsson, PhD, of the Unit of Nutritional Epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, and colleagues found a 2.2-fold increased risk of gallbladder cancer in people who consumed two or ...
Immune checkpoint inhibitors have emerged as one of the most promising new areas of drug development in oncology. Broad activity has been observed for these agents across a spectrum of hematologic malignancies and solid tumors. As reviewed in this issue of The ASCO Post, Muro and colleagues now...
The KEYNOTE-012 phase Ib trial assessed single-agent pembrolizumab (Keytruda) in patients with advanced programmed cell death ligand 1 (PD-L1)–positive gastric cancer, triple-negative breast cancer, urothelial cancer, and head and neck cancer. The activity of pembrolizumab in study patients with...
Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...
A novel immunotherapy agent, the first in its class, reduced disease progression by more than 50% when added to standard chemotherapy for patients with advanced gastric cancer, according to results from an international phase II trial presented at the 2016 ASCO Annual Meeting.1 The drug, IMAB362,...
Marcel Verheij, PhD, of the Netherlands Cancer Institute, and John Marshall, MD, of Georgetown University Lombardi Comprehensive Cancer Center, discuss findings from this multicenter phase III study of neoadjuvant chemotherapy followed by either surgery and chemotherapy or surgery and chemoradiotherapy in resectable gastric cancer (Abstract 4000).
Salah-Eddin Al-Batran, MD, of the Institute of Clinical Cancer Research and Nordwest Hospital, discusses findings from this international phase II study of epirubicin, oxaliplatin, and capecitabine with or without IMAB362, as first-line treatment of gastric and gastroesophageal junction adenocarcinoma (Abstract LBA4001).
Findings from the European phase II FAST study showed that the novel, first-in-class antibody IMAB362 can significantly extend median survival when added to standard chemotherapy (13.2 vs 8.4 months) for patients with advanced gastric cancer. This therapy targets a protein called claudin-18 splice...
As reported by Muro et al in The Lancet Oncology and Nanda et al in the Journal of Clinical Oncology, single-agent pembrolizumab (Keytruda) showed activity in programmed cell death ligand 1 (PD-L1)–positive advanced gastric cancer and metastatic triple-negative breast cancer in the...
In a French phase II trial reported in The Lancet Oncology, Mir et al found that pazopanib (Votrient) plus best supportive care increased progression-free survival vs best supportive care in patients with advanced gastrointestinal stromal tumors (GIST) resistant to imatinib and sunitinib. Study...
The investigational drug LOXO-101, which selectively targets a family of proteins called neurotrophic tyrosine kinase receptors (NTRKs), produced significant tumor regression in patients whose tumors had NTRK gene fusions, according to data from a phase I clinical trial presented by Hong et al at...
As reported in the Journal of Clinical Oncology by Heikki Joensuu, MD, PhD, of the Comprehensive Cancer Center Helsinki, Finland, and colleagues, the second planned analysis in the Scandinavian Sarcoma Group XVIII/AIO trial showed a recurrence-free survival benefit and a continued overall survival ...
In a long-term follow up of two large U.S. prospective cohorts reported in JAMA Oncology, Cao et al found that regular use of aspirin was associated with a reduced risk of gastrointestinal (GI) tract cancers. In 2015, the U.S. Preventive Services Task Force recommended the use of aspirin in...
In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...
A radiolabeled somatostatin analog compound, 177Lu-DOTA0-Tyr3-Octreotate (Lu-177 dotatate), reduced the risk of disease progression or death by 79% in the international phase III NETTER-1 population of previously treated, advanced neuroendocrine tumors of midgut origin.1 Lu-177 dotatate belongs to...
In the Asian phase III REGATTA trial reported in The Lancet Oncology, Fujitani et al found that the addition of gastrectomy to chemotherapy did not improve overall survival in patients with advanced gastric cancer with a single noncurable factor. Study Details In this open-label trial conducted...
The U.S. Food and Drug Administration today approved everolimus (Afinitor) for the treatment of adult patients with progressive, well-differentiated nonfunctional neuroendocrine tumors of gastrointestinal or lung origin with unresectable, locally advanced, or metastatic disease. ...
The United Kingdom’s phase II NEOSCOPE trial compared the toxicity and efficacy of two preoperative chemoradiation regimens—carboplatin/paclitaxel and oxaliplatin/capecitabine—and judged one to be the winner. “CarPacRT passed the prespecified efficacy criteria for taking forward to phase III, but...
Second malignancies were not more common among patients who underwent radiotherapy for rectal cancer. In fact, radiotherapy appeared to offer some degree of protection against subsequent cancers, according to the findings of a study from the Netherlands reported at the 2016 Gastrointestinal Cancers ...
Patients with pancreatic cancer who received adjuvant chemotherapy at a high-volume center had superior median and 5-year overall survival than did patients who were treated in a community setting, according to the results of a study presented at the 2016 Gastrointestinal Cancers Symposium.1 This...
Although the results may not yet be as impressive as those seen in melanoma, lung, and kidney cancers, monoclonal antibodies targeting the programmed cell death protein 1 (PD-1) are producing responses, with some durability, in gastrointestinal cancers, according to studies presented at the 2016...
Studies presented at the ASCO Annual Meeting in the field of noncolorectal gastrointestinal cancer both reaffirmed certain standards of care and introduced some practice-changing data, according to A. Craig Lockhart, MD, of Washington University in St. Louis. Perioperative Therapy for Gastric...
Postoperative adjuvant therapy with the oral fluoropyrimidine derivative S-1 improved overall survival and relapse-free survival in patients with stage II or III gastric cancer who had D2 gastrectomy. Five-year survival rates in the phase III study were 71.7% for patients in the S-1 group vs 61.1%...
Gastric cancer is diagnosed in nearly 1 million people globally each year and is responsible for 740,000 deaths, making it the second leading cause of cancer death in the world. According to the American Cancer Society, more than 21,000 people in the United States were diagnosed with gastric...
The FDA has granted imatinib mesylate (Gleevec) regular approval for use in adult patients following surgical removal of CD117-positive gastrointestinal stromal tumors (GIST). The new approval also highlights an increase in overall patient survival when the drug is taken for 36 months rather than...
Richard M. Goldberg, MD, of The Ohio State University Medical Center, chaired the steering committee of the 2012 Gastrointestinal Cancers Symposium in San Francisco, which attracted approximately 4,000 registrants who viewed data from some 700 scientific abstracts. The ASCO Post asked Dr. Goldberg...
Two studies highlighted in press conferences and one presented during an invited lecture at the 2012 Gastrointestinal Cancers Symposium, held recently in San Francisco, suggest that early detection of pancreatic, esophageal, and colorectal cancers could soon improve. Enzyme Immunoassay Spots...
Timothy J. Hobday, MD, of the Mayo Clinic in Rochester, Minnesota, discussed the findings of the RADIANT-2 re-analysis at the 2012 Gastrointestinal Cancers Symposium. Speaking from the perspective of a clinical researcher, he said, “the conclusions of the study are reasonable” and provide “valuable ...
Adding salvage chemotherapy to best supportive care was tolerated and improved overall survival among patients with advanced gastric cancer previously treated with both fluoropyrimidines and platinum, administered simultaneously or concurrently. The authors of the study report, published in the...
Subset analysis of the AVAGAST trial, which evaluated the benefit of bevacizumab (Avastin) in advanced gastric cancer, has demonstrated distinct differences in outcomes according to disease subtype, reported Manish A. Shah, MD, of Weill Cornell Medical College and New York Presbyterian Hospital, at ...
The RAS oncogenes are the most frequently mutated class of oncogenes in human cancers, and this has prompted a search for Ras inhibitors to effectively treat tumors with these mutations. Despite intensive efforts, however, none has materialized clinically because K-Ras is proving to be a very...
Plasma vascular endothelial growth factor A (VEGF-A) and tumor neuropilin-1 “are strong biomarker candidates for predicting clinical outcome in patients with advanced gastric cancer” after treatment with bevacizumab (Avastin). This was the conclusion of a mandatory biomarker program following up on ...
Additional noteworthy gastrointestinal cancer studies presented during oral abstract sessions at the 2012 ASCO Annual Meeting included the following trials in metastatic colorectal cancer. Perifosine/Capecitabine Fails in Phase III Trial Adding perifosine, an oral alkylphospholipid inhibitor that...
During the upcoming Gastrointestinal Cancers Symposium, to be held on January 24–26, direct your patients to www.cancer.net/gisymposium, where they can get research highlights from the 2013 Symposium. Also, your patients can download or listen to podcasts with ASCO experts explaining what this...
The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...
A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...
The MTOR serine/threonine kinase pathway is implicated in regulation of neuroendocrine tumor growth. In a study reported in the Journal of Clinical Oncology, Qian and colleagues investigated the potential prognostic significance of MTOR pathway component expression in patients with neuroendocrine...
The FDA has assigned Priority Review to the regulatory submission for ramucirumab as a single-agent treatment for advanced gastric cancer following disease progression after initial chemotherapy. Ramucirumab is a human monoclonal antibody that specifically blocks the vascular endothelial growth...
Progress in the treatment of gastric cancer has lagged behind advances in other solid tumor malignancies. A modest but clear survival benefit with the use of adjuvant therapy combined with surgery has been achieved, including the use of postoperative adjuvant chemotherapy as shown in large-scale...
Vascular endothelial growth factor (VEGF)– and VEGF receptor-2 (VEGFR-2)–mediated signaling and angiogenesis seem to have an important role in the pathogenesis of gastric cancer. In the phase III REGARD trial reported in Lancet, Charles S. Fuchs, MD, MPH, of Dana-Farber Cancer Institute, Boston,...
Disease-free survival is an acceptable surrogate for overall survival in trials of cytotoxic agents for gastric cancer in the adjuvant setting, the GASTRIC group concluded after conducting a meta-analysis of data from 3,288 individual patients enrolled in 14 randomized clinical trials. The trials...
In the global phase III RAINBOW trial in patients with metastatic gastric cancer, the investigational monoclonal antibody ramucirumab significantly improved both progression-free and overall survival, when added to paclitaxel in second-line therapy, as reported at the 2014 Gastrointestinal Cancers...
This Clinical Trials Resource Guide is meant to increase awareness of currently recruiting NCI- or academic institution–sponsored clinical studies for your patients with gastrointestinal cancers. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov, and...
The U.S. Food and Drug Administration (FDA) has approved ramucirumab (Cyramza) to treat patients with advanced or metastatic gastric cancer or gastroesophageal junction adenocarcinoma with disease progression on or after prior treatment with fluoropyrimidine- or platinum-containing chemotherapy....
By detecting certain volatile organic compounds in exhaled breath, NanoArtificial Nose technology (NA-NOSE) was able to differentiate patients with gastric cancer from those with benign lesions, with high accuracy, in a poster that earned a merit award at Digestive Disease Week 2014, the largest...
CD44 is a gastric cancer stem cell marker, and the hedgehog signaling pathway can be dysregulated by cancer stem cells during tumorigenesis. In a study reported in Clinical Cancer Research, Yoon and colleagues found that high CD44 expression was associated with chemotherapy resistance and poorer...
A new report from the International Agency for Research on Cancer (IARC), an agency of the World Health Organization, urges health authorities of countries with high stomach cancer burden to include stomach cancer in their national cancer control programs and allocate more resources to control the...
As reviewed in this issue of The ASCO Post (page 155), the RAINBOW trial is an international phase III study demonstrating improved overall survival with ramucirumab (Cyramza) plus paclitaxel as second-line therapy for patients with advanced gastric/gastroesophageal junction adenocarcinoma over...
In the phase III RAINBOW trial reported in The Lancet Oncology, Hansjochen Wilke, MD, Director of Medical Oncology/Hematology at Kliniken Essen-Mitte, Essen, Germany, and colleagues found that adding the vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor ramucirumab (Cyramza) to...