This slide show includes highlights from the 2016 ASCO Gastrointestinal Cancers Symposium, including studies on pancreatic cancer patients treated at a high-volume center, Lutathera in patients with midgut neuroendocrine tumors, and more.
Pembrolizumab Shows Promise in Esophageal Cancer:
The PD-1 inhibitor pembrolizumab showed promise in advanced PD-L1âpositive esophageal cancer patients, according to data from the KEYNOTE-028 study presented by Toshihiko Doi, MD, of the National Cancer Center Hospital East in Chiba, Japan (abstract 7). The phase Ib trial included 23 patients (median age, 65) who were treated with pembrolizumab 10 mg/kg every 2 weeks for up to 2 years or until disease progression. The objective response rate (ORR) was 30.4% (29% among 17 squamous cell carcinoma patients and 40% among 5 adenocarcinoma patients). The progression-free survival rates were 30.4% at 6 months and 21.7% at 12 months. Photo Â© ASCO/Todd Buchanan 2016.
Evofosfamide Fails to Show Overall Survival Benefit in Pancreatic Cancer:
Adding evofosfamide to gemcitabine in patients with metastatic pancreatic cancer failed to show an overall survival advantage, according to results from the phase III MAESTRO trial, presented by Eric Van Cutsem, MD, PhD, professor of internal medicine at the University of Leuven in Belgium (abstract 193). This combination had previously shown an improved progression-free survival in a phase II trial. The experimental combination failed to show a statistically significant overall survival improvement over gemcitabine alone (8.7 vs 7.6 months,
= .0589). Photo Â© ASCO/Todd Buchanan 2016.
Treatment at High-Volume Center Improved Pancreatic Cancer Survival:
Patients with pancreatic cancer who received adjuvant chemotherapy at a high-volume center had superior median and 5-year overall survival compared with patients who were treated in a community setting, according to the results of a study presented by Margaret T Mandelson, PhD, MPH, of the Floyd & Delores Jones Cancer Institute at Virginia Mason in Seattle (abstract 191). Study results showed that a highly select group of patients with localized pancreatic cancer who underwent successful surgical resection at a high-volume institution had significantly longer overall survival (44 vs 28 months;
Long-Term Results Support Chemoradiotherapy in Esophageal Cancer:
Mature data from the SCOPE 1 trial, a randomized phase II/III trial comparing definitive chemoradiotherapy plus or minus cetuximab in patients with esophageal cancer, showed unprecedented survival in the chemoradiotherapy alone arm, with rates comparable to surgical trials in this patient population (abstract 118). Results of the trial were presented by Somnath Mukherjee, MD, of the Gray Institute for Radiation Oncology and Biology, University of Oxford, United Kingdom. Patients in the trial treated with cetuximab had a lower median overall survival rate (24.7 vs 34.5 months in patients treated with chemoradiotherapy; hazard ratio, 1.25;
= .137), though the authors attributed this to lower radiotherapy compliance in the cetuximab arm of the trial (78% vs 90%). The 3-year overall survival rate (47.2%) in the chemoradiotherapy arm is comparable to published surgical trials. Photo Â© ASCO/Todd Buchanan 2016.
Lutathera Slows Disease Progression in Midgut Neuroendocrine Tumors:
A novel drug,
Lutetium-DOTATATE (Lutathera), significantly lowered the risk for disease progression or death among patients with previously treated, advanced midgut neuroendocrine tumors, according to the phase III results of the NETTER-1 trial. Compared with patients treated with octreotide LAR 60 mg, treatment with
Lutetium-DOTATATE resulted in about an 80% decreased risk for progression or death, according to data presented by Jonathan R. Strosberg, MD, a medical oncologist at the Moffitt Cancer Center in Tampa, Florida. Median progression-free survival, the trial’s primary endpoint, was not yet reached among patients assigned the novel therapy compared with 8.4 months among patients assigned octreotide LAR (95% CI, 5.8â11 months;
177Lutetium-DOTATATE (HR, 0.21; 95% CI, 0.13â0.34). Photo Â© ASCO/Todd Buchanan 2016.