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Gastrointestinal Cancers Symposium, Jan. 25-27, 2008

2008 Gastrointestinal Cancers Symposium

The 2008 Gastrointestinal Cancers Symposium took place Jan. 25-27 in Orlando, Fla., and addressed recent developments in the prevention, screening and treatment of cancers affecting the esophagus, stomach, liver, pancreas, small bowel, colon and rectum.

Nicholas J. Petrelli, M.D., of the Helen F. Graham Cancer Center in Wilmington, Del., a member of the steering committee and the symposium's immediate past chair, cited several pieces of significant new research, including a study from Johns Hopkins University and the University of Pittsburgh showing that colon cancer-specific antigen 2 in serum may be an accurate biomarker for both colorectal cancer and pre-malignant colorectal lesions. "This is important because we don't have a blood test to detect colorectal cancer," Petrelli said. "Colonoscopy -- an invasive procedure -- is still the standard of care. A blood test would go a long way in helping us move forward in detecting this disease. So this is exciting research, which obviously needs to be validated."

Among studies that assessed cancer risk, program chair Jordan Berlin, M.D., of the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., cited a study from British researchers showing a high prevalence of overweight/obesity and metabolic syndrome in patients with Barrett's esophagus (78 percent and 46 percent, respectively) and in patients with non-Barrett's acid reflux (75 percent and 32 percent, respectively). They also found an association between central fat, metabolic syndrome and the adipocytokine profile in long-segment Barrett's that could contribute to the development of esophageal adenocarcinoma.

"We have a growing number of cases of esophageal adenocarcinoma, which used to be the uncommon form, but is now the more common form," Berlin said. "It looks like this increase is in tandem with the obesity epidemic. But it's going up in men more so than women, especially in white men. Since obesity affects all populations, we still have to tease out the data a little bit more."


Among studies affecting clinical practice, Berlin cited the CONCEPT trial presented by Howard S. Hochster, M.D., of the New York University Medical Center, which assessed the ability of calcium-magnesium infusions to prevent oxaliplatin-related neurotoxicity in patients with advanced colorectal cancer. Begun in 2005, the CONCEPT trial was terminated because initial reports suggested that the infusions inhibited oxaliplatin's effectiveness.

"Now it looks like the initial reports may have been wrong," Berlin said. "So it's possible we can go back to giving calcium and magnesium."


The symposium also presented further data on sorafenib, the first drug shown to be more effective than placebo in treating liver cancer. Berlin cited a study presented by Ghassan K. Abou-Alfa, M.D., of the Memorial Sloan-Kettering Cancer Center in New York, which randomly assigned 96 patients with advanced liver cancer to receive either sorafenib plus doxorubicin or doxorubicin plus placebo. The researchers found that patients on the two-drug combination had a significantly longer time to progression (8.6 months versus 4.8 months) and improved overall survival (13.7 months versus 6.5 months).

"The results suggest that sorafenib and doxorubicin -- a drug we used to use -- are very promising in combination, possibly even better than for sorafenib alone," Berlin said.


GCS: KRAS Gene Status Predicts Vectibix Response

THURSDAY, Jan. 24 (HealthDay News) -- In patients with advanced colorectal cancer, those with a normal form of the KRAS gene are significantly more likely to have a favorable response to the fully human monoclonal antibody panitumumab (Vectibix) than those with mutations of the KRAS gene, according to research presented this week at the 5th annual Gastrointestinal Cancers Symposium in Orlando, Fla.

Abstract #278

GCS: Insurance Status May Affect Cancer Diagnosis

THURSDAY, Jan. 24 (HealthDay News) -- When patients are diagnosed with colorectal cancer, those who are uninsured or covered by Medicaid are significantly more likely to have advanced-stage disease than those covered by private insurance or Medicare, according to research presented this week at the 5th annual Gastrointestinal Cancers Symposium in Orlando, Fla.

Abstract #275

GCS: CCSA-2 Blood Test Accurate for Colorectal Cancer

THURSDAY, Jan. 24 (HealthDay News) -- Colon cancer-specific antigen-2 (CCSA-2) may be an accurate biomarker of colorectal cancer, according to preliminary research presented this week at the 5th annual Gastrointestinal Cancers Symposium in Orlando, Fla.

Abstract #276

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