American Society of Clinical Oncology, Jan. 22-24, 2010

American Society of Clinical Oncology Gastrointestinal Cancers Symposium

The American Society of Clinical Oncology's Gastrointestinal Cancers Symposium took place Jan. 22 to 24 in Orlando, Fla., and attracted 2,400 attendees from around the world, including 2,200 professionals. The meeting presented more than 500 abstracts on gastrointestinal cancers affecting the esophagus, stomach, hepatobiliary system, pancreas, small bowel, colon and rectum.

"If we can diagnose cancers earlier, we get better results," said Leonard L. Gunderson, M.D., of the Mayo Clinic in Scottsdale, Ariz., chair of the meeting's steering committee and president-elect of the American Society for Radiation Oncology. "So the meeting's highlights included screening studies that may help us achieve that end."

Advances in early detection were presented at a Jan. 20 presscast. "Growing understanding of molecular biology has helped us make enormous progress in screening, detection and treatment for gastrointestinal cancers," moderator, Robert P. Sticca, M.D., of the University of North Dakota School of Medicine & Health Sciences in Grand Forks, said in a statement. "These studies describe long-awaited approaches, such as an early detection test for pancreatic cancer and a blood test for colon cancer."

During the presscast, researchers from the Garden State Cancer Center in Belleville, N.J., said that an immunoassay which measures blood levels of PAM4 protein can identify most stages of pancreatic cancer.

"Most patients with pancreatic cancer are diagnosed when the disease is advanced and more difficult to cure," lead author, David V. Gold, Ph.D., said in a statement. "In this study, we found that the PAM4 protein is quite accurate at identifying patients with pancreatic cancer and, if validated in larger studies, would be a promising tool for detecting this disease in its earlier, more treatable stages, before it spreads to other organs."

Gunderson cautioned that the test may be valuable for high-risk populations, but not for the general public. "The test only identified 54 percent of stage 1A cancers," he said. "So the hope is that they can further refine the test. We'd like to see an 80 percent or higher accuracy rate for even the earliest stage of disease."

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Other highlights included a Japanese study in which 167 patients with certain forms of esophageal and gastric cancer were randomly assigned to receive surgery with the standard left thoracoabdominal approach or the less-invasive transhiatal approach.

"The surgeons thought for sure that the standard approach of going through the rib cage and abdomen was going to be better, but the study showed the opposite of what they expected," Gunderson said. "Five-year survival was 51 percent with the more conservative approach versus 37 percent with the more aggressive approach. So the point was [that] the lesser surgery was better."

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Kenneth J. Chang, M.D., of the University of California Irvine Medical Center in Orange, Calif., presented results of the first clinical trial of TNFerade Biologic (TNF) -- an adenovector containing the gene for tumor necrosis factor-α -- for locally advanced esophageal cancer. In a study of 24 patients, Chang and colleagues found that TNF in combination with chemoradiation and cisplatin resulted in increased survival compared to historical controls (47.7 versus 9.7 to 34 months).

"This study needs to be expanded further and ultimately put to the test of a randomized trial of preoperative chemoradiation plus or minus TNF," Gunderson said.

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Chris H. Crane, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, presented results of a study showing that a regimen of two cycles of cetuximab, gemcitabine and oxaliplatin, followed by cetuximab, capecitabine and radiation is beneficial for patients with locally advanced pancreatic cancer.

"Even though this group of patients was by and large unresectable, survival results were almost parallel with patients that can be resected," Gunderson said. "Their median survival was 19 months compared to 20 months for surgery alone. They even had a group of six patients with late local relapses and no evidence of metastatic disease. These are intriguing results and show that the dose-escalation of chemotherapy with cetuximab probably makes sense."

The study was supported by Bristol-Myers Squibb.

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Another study, presented by researchers from the United Kingdom, updated results of the largest-ever phase III trial in advanced biliary tract cancer, which showed that, for improving overall survival, gemcitabine in combination with cisplatin is more effective than gemcitabine alone. Their multivariate analysis showed that important baseline predictors of survival include performance status, metastases, neutrophilia, anemia and thrombocytosis.

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ASCO: Sorafenib Benefit in Advanced Liver Cancer Studied

TUESDAY, Jan. 26 (HealthDay News) -- In patients with advanced hepatocellular carcinoma, treatment with sorafenib after one or two standard transarterial chemoembolization (TACE) procedures does not significantly increase time to cancer progression or recurrence, according to research presented at the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, held from Jan. 22 to 24 in Orlando, Fla.

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ASCO: Pazopanib Found Effective for Kidney Cancer

TUESDAY, Jan. 26 (HealthDay News) -- In treatment-naive and cytokine-pretreated patients with advanced and/or metastatic renal cell carcinoma, the oral angiogenesis inhibitor pazopanib may be an effective treatment, according to a study published online Jan. 25 in the Journal of Clinical Oncology to coincide with its presentation at the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, held from Jan. 22 to 24 in Orlando, Fla.

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ASCO: Pancreatic, Gastric Cancer Markers Assessed

MONDAY, Jan. 25 (HealthDay News) -- A simple blood test may identify early pancreatic cancer. In addition, a variation in the CD44 gene may predict more aggressive gastric cancer, according to two studies presented at the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, held from Jan. 22 to 24 in Orlando, Fla.

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ASCO: CRC Detection, Treatment Advances Presented

MONDAY, Jan. 25 (HealthDay News) -- Early colorectal cancer (CRC) and adenomas may be detected by a simple blood test. In addition, a newer chemotherapy regimen may be superior to standard treatment in patients with stage III colon cancer, according to two studies presented at the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, held from Jan. 22 to 24 in Orlando, Fla.

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ASCO: Dietary Polyamines Linked to Colorectal Cancer

MONDAY, Jan. 25 (HealthDay News) -- Polyamines, which are concentrated in foods such as orange juice, meat, green peas and corn, may be associated with an increased risk of colorectal cancer, according to research presented at the American Society of Clinical Oncology's Gastrointestinal Cancers Symposium, held from Jan. 22 to 24 in Orlando, Fla.

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