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Gastrointestinal Cancers Symposium, Jan. 15-17

The 12th Annual Gastrointestinal Cancers Symposium

The American Society of Clinical Oncology's 12th annual Gastrointestinal Cancers Symposium was held from Jan. 15 to 17 in San Francisco and attracted approximately 3,000 participants from around the world, including gastrointestinal oncology specialists as well as clinical practitioners and other health care professionals. The conference featured presentations focusing on the latest advances in the diagnosis and management of gastrointestinal cancers.

In one study, Josep Tabernero, M.D., of the Vall d'Hebron Institute of Oncology in Barcelona, Spain, and colleagues compared the efficacy and safety of ramucirumab plus FOLFIRI chemotherapy versus FOLFIRI alone in patients with advanced colorectal cancer. The patient's disease had progressed on or after initial therapy consisting of oxaliplatin, a fluoropyrimidine, and bevacizumab.

"The primary outcome measure was improvement in overall survival. We found that the combination of ramucirumab plus FOLFIRI chemotherapy met the primary end point, with an increase in overall survival that was statistically significant," Tabernero said. "In addition, we found that improvement in progression-free survival was also statistically significant."

In conducting a sub-group analysis, the investigators evaluated whether some sub-groups of patients would benefit from the combination approach more than other sub-groups. The researchers found that the benefit was consistent across all sub-groups in both progression-free survival and overall survival.

"In terms of safety, we found that the addition of ramucirumab increased the incidence of treatment adverse events, including fatigue, neutropenia (without increasing febrile neutropenia rate), hypertension, and thrombocytopenia," Tabernero said. "Overall, we concluded that the addition of ramucirumab to FOLFIRI chemotherapy improved both overall survival and progression-free survival in the second-line setting, and if ramucirumab is approved for this indication, this treatment would certainly be a very reasonable choice."

The study was funded in part by Eli Lilly, the manufacturer of ramucirumab; several authors disclosed financial ties to the pharmaceutical industry.

Abstract No. 512

In another study, Chiara Cremolini, M.D., of the Tuscan Tumor Institute in Pisa, Italy, and colleagues found that FOLFOXIRI chemotherapy in combination with bevacizumab was superior to the standard FOLFIRI chemotherapy with bevacizumab.

"The results are not only statistically significant but clinically relevant as well. Specifically, we found that the FOLFOXIRI plus bevacizumab regimen extended overall survival and doubled the estimated five-year overall survival rate as compared to standard FOLFIRI chemotherapy with bevacizumab," Cremolini said. "In terms of clinical practice recommendations, FOLFOXIRI chemotherapy plus bevacizumab is not the absolute choice for every patient, but it is a new option for the upfront treatment of unresectable metastatic colorectal cancer patients, especially for those in generally good condition who can tolerate the regimen."

The study was funded in part by a research grant from F. Hoffmann-La Roche, the manufacturer of bevacizumab; several authors disclosed financial ties to the pharmaceutical industry.

Abstract No. 657

Angus George Dalgleish, M.D., of St. George's University of London, evaluated whether the systemic immunomodulator IMM-101, a heat-killed mycobacterial product which induces protective CD8+ cytotoxic T cells, could be useful in the first-line treatment of pancreatic cancer.

"Standard treatment commonly includes gemcitabine, so we decided to compare the effectiveness and safety of gemcitabine with IMM-101 versus gemcitabine alone," Dalgleish said. "We had previously found some synergy between immunomodulators and gemcitabine, and this evidence justified performing the trial."

A survival benefit was demonstrated with the combination of gemcitabine and IMM-101 in 82 of the 110 patients with metastatic disease, from 4.4 to 7.5 months, or 70 percent.

"The other key finding was the relative lack of toxicity associated with IMM-101," Dalgleish said. "We have seen in a lot of other trials that adding an extra agent into the algorithm can add more toxicity, but in this study there appeared to be no increased toxicity tied to IMM-101, which makes it an ideal platform for further study of treatments for pancreatic and other forms of cancer."

Dalgleish disclosed financial ties to several pharmaceutical companies, including Immodulon Therapeutics, the manufacturer of IMM-101.

Abstract No. 336

ASCO: Option to Skip Surgery Viable for Some With Rectal CA

TUESDAY, Jan. 13, 2015 (HealthDay News) -- Some rectal cancer patients may fare just as well by forgoing surgery in favor of chemotherapy/radiation and "watchful waiting," according to research presented Monday at the American Society of Clinical Oncology's annual Gastrointestinal Cancers Symposium, held from Jan. 15 to 17 in San Francisco.

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ASCO: Vitamin D Tied to Colon Cancer Progression, Survival

TUESDAY, Jan. 13, 2015 (HealthDay News) -- Higher vitamin D levels in patients with advanced colorectal cancer appear to improve response to chemotherapy and targeted anti-cancer drugs, researchers say. The report is scheduled for presentation this week at the American Society of Clinical Oncology's annual Gastrointestinal Cancers Symposium, held from Jan. 15 to 17 in San Francisco.

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