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Daniele Santini
Oncologia Medica
Università Campus Bio-Medico
Colon Cancer
ASCO Poster review
AIOM POST ASCO GI REVIEW
Updates and news from
the Gastrointestinal
Cancers Symposium in San Francisco
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AGENDA
Prognostic role of primary tumor: right vs left
Resection of primary in mCRC with synchronous
metastases : resect or not resect?
What is best sequencing: Cet in second or third line?
Older patients
New drugs
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The site of the primary tumor has
prognostic value ?
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Loupakis F, et al. J Natl Cancer Inst 2015
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Presented By Ignacio Matos at Gastrointestinal Cancers Symposium 2016
Prognostic impact of primary tumor site location in
metastatic colorectal cancer (mCRC).
Right
(29.4%)
• peritoneal
metastasis
(28%; p <
0.001)
• KRAS mut,
BRAF V600E
mut
and PIK3CA
mut more
prevalent in
RS tumors
• Surgical
resection of
any met
disease was
performed
less
frequently in
pts with RS
tumors (p <
0.001)
Left
(43.4%)
less likely to
have ≥ 2 met
sites
(32%;
p = 0.01)
Rectum
(27.2%)
Lung metastases
(20%;p < 0.001)
686 pts
+ Prognostic impact of primary tumor site location in
metastatic colorectal cancer (mCRC): Results
Presented By Ignacio Matos at Gastrointestinal Cancers Symposium 2016
Survival After Relapse (SAR) was significantly lower in pts with RS tumors
+ Prognostic impact of primary tumor site location in
metastatic colorectal cancer (mCRC): Results
Presented By Ignacio Matos at Gastrointestinal Cancers Symposium 2016
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Presented By Yu Sunakawa at Gastrointestinal Cancers Symposium 2016
Prognostic impact of primary tumor location on
survival time in patients (pts) with metastatic
colorectal cancer (mCRC) treated with cetuximab
plus oxaliplatin-based chemotherapy: A subgroup
analysis of the JACCRO CC-05/06.
OS
LS vs RS tumor (all population)
36.2 vs. 12.6 months
HR 0.28,
95%CI 0.15-0.53;
p< 0.0001)
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Presented By Yu Sunakawa at Gastrointestinal Cancers Symposium 2016
Prognostic impact of primary tumor location on
survival time in patients (pts) with metastatic
colorectal cancer (mCRC) treated with cetuximab
plus oxaliplatin-based chemotherapy: A subgroup
analysis of the JACCRO CC-05/06.
PFS
LS vs RS tumor (all population)
11.1 vs. 5.6 months
(HR 0.47,
95%CI 0.29-0.82,
p= 0.0041)
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Resection of primary in mCRC with
synchronous metastases :
resect or not resect?
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Presented By Miriam Koopman at Gastrointestinal Cancers Symposium 2016
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Presented By Miriam Koopman at Gastrointestinal Cancers Symposium 2016
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Presented By Johannes H.W. de Wilt at Gastrointestinal Cancers Symposium 2016
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What is best sequencing:
Cet in second or third line?
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Presented By Stefano Cascinu at Gastrointestinal Cancers Symposium 2016
COMETS
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Presented By Stefano Cascinu at Gastrointestinal Cancers Symposium 2016
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Presented By Stefano Cascinu at Gastrointestinal Cancers Symposium 2016
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EGFR inhibition is less active after VEGF
blockade.
In RAS wild type patients progressing after a first
line bevacizumab based therapy cetuximab
should be given as first line or third line.
Presented By Stefano Cascinu at Gastrointestinal Cancers Symposium 2016
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New Drugs
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Dovitinib is an oral inhibitor
of FGFRs and VEGFRs,
PDGFR, c-KIT, FLT-3, CSF1R 1
Exhibits direct anti-tumor and
anti-angiogenic activity 2
1 Lopes de Menezes DE, et al, Clin Cancer Res. 2005;
11:5281-91
2 Renohowe PA, et al, J Med Chem 2009; 52:278-92
DOVITINIB
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Presented By Thomas John Semrad at Gastrointestinal Cancers Symposium 2016
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Presented By Emmanuelle Samalin at Gastrointestinal Cancers Symposium 2016
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Presented By Emmanuelle Samalin at Gastrointestinal Cancers Symposium 2016
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Presented By Emmanuelle Samalin at Gastrointestinal Cancers Symposium 2016
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Presented By Emmanuelle Samalin at Gastrointestinal Cancers Symposium 2016
+ News from… MyPathway Targeted therapy for gastrointestinaI (GI) tumors based on molecular
profiles: Early results from MyPathway, an open-label phase IIa basket
study in patients with advanced solid tumors.
Presented By Herbert Hurwitz,at Gastrointestinal Cancers Symposium 2016
+ MyPathway: Results _ HER2- amplified mCRC
13 pts with HER2
alterations
PR 5pts
SD 4 pts
PD 2 pts
Presented By Herbert Hurwitz,at Gastrointestinal Cancers Symposium 2016
mTTP = 5 months (range
1.2 – 12.4 months)
mDoR = 3.4 months
(range 1.4 – 11.1 months)
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Presented Salvatore Siena at Gastrointestinal Cancers Symposium 2016
HERACLES RESCUE TRIAL
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Older patients
Yoshino et al, WCGIC 2014
RECOURSE
TAS-102 is an oral formulation of an
antimetabolite inhibiting TP
TAS-102
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Presented By Eric Van Cutsem,at Gastrointestinal Cancers Symposium 2016
Significant improvements in OS and PFS were observed in pts ≥65 y
who received TAS-102 vs PBO
DCR (complete or partial response or stable disease) was 48.7%
with TAS-102 vs 15.5% with PBO
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Pts ≥65 y and <65 y showed a generally favorable safety profile.
A significant increase in toxicity in pts ≥75 y was not apparent vs the
overall ≥65 y population.
Presented By Eric Van Cutsem,at Gastrointestinal Cancers Symposium 2016
Results: Safety
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Presented By Eric Van Cutsem,at Gastrointestinal Cancers Symposium 2016
In RAS wt CRYSTAL pts, adding cetuximab to FOLFIRI improved
ORR, PFS and OS in both older (≥65 y) and younger (<65y) pts
+ Safety
In both treatment
arms, older patients
had higher
frequencies of
adverse events
as compared to
younger patients
Presented By Eric Van Cutsem,at Gastrointestinal Cancers Symposium 2016
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Presented By Lorenzo Antonuzzo at Gastrointestinal Cancers Symposium 2016
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Presented By Lorenzo Antonuzzo at Gastrointestinal Cancers Symposium 2016
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Presented By Lorenzo Antonuzzo at Gastrointestinal Cancers Symposium 2016
+ GRAZIE A…
Chiara Cremolini, il mio «Agente
all’Avana» per avermi dato tanti
suggerimenti!
Emanuela Dell’Aquila, la mia «Curatrice
d’immagine» per avermi aiutato a
preparare questa relazione
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Grazie per la
Vostra
Attenzione
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