colon cancer asco poster review -...

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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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