Session III: Esophageal and Gastric Cancer
SESSION III WEBCAST (with Slides - needs a registration)
The authors conclude that the real-world data of the large observational trial showed comparable clinical outcomes to those of clinical trials in advanced gastric cancer treated with nivolumab (NIVO). This trial revealed the tumor behaviour and some pts who experienced rapid tumor growth after NIVO treatment in clinical practice; biomarkers for HPD & the definition should be established. The results of the microbiome biomarker study will be presented at a future meeting.
The authors conclude that in the population studied the genotype cagA+/cagE+/vacA s1ms1 is a marker for increased risk of GC, whereas cagA-/cagE-/vacA s2m2 a marker for decreased risk.
The authors externally validated a prognostic nomogram to predict 3-year and 5-year OS in a joint indipendent cohort of resectable GEA. This tool incorporates readily available and inexpensive pts & disease characteristics as well as immune-inflammatory determinants. It has been shown to be accurate (well-calibrated with good discriminative ability), generalizable, and clinically effective. Although a prospective validation in a larger patient population is warranted, the NOMOGAST could represent a useful tool to be implemented in the clinic to assist decision-making & clinical trial design.
Oral-9: Discordant prognostic significance of negative lymph node size in patients with oesophageal cancer treated with either surgery or neoadjuvant chemotherapy and surgery – results from the MRC OE02 trial
The authors conclude that with surgery only cancer immunity circle ( Surgery= release of cancer cell antigens followed by cancer antigen presentation followed by priming & activation followed by the trafficking of immune cells to tumors followed by tumor infiltration with immune cells followed by recognition of cancer cells by T-cells followed by killing of cancer cells) seems to work in patients with large LNneg. With chemotherapy (CT) plus surgery does CT interrupt the antitumor effect of lymphocytes? The authors hypothesize that CT hampers the immune cells from the infiltration into the tumor.
The authors conclude that the addition of trastuzumab did not increase DFS when added to trimodality treatment of esophageal cancer and didn't increase PCR or OS either. There was no increase in cardiac toxicity or AEs with the addition of trastuzumab.
Oral-11: Trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-positive advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma: A randomized, phase 2, multicenter, open-label study (DESTINY-Gastric01)
The authors conclude that pts receiving T-DXd had a significantly higher ORR than those receiving standard chemotherapy (51.3% vs. 14.3%; p<.0001) as well as longer OS (median, 12.5 vs. 8.4 months, p=.0097). Similarly, median PFS (5.6 vs. 3.5 months) and duration of confirmed response (11.3 vs. 3.9 months) were longer with T-DXd.
T-DXd's safety profile was generally manageable and consistent with previous studies. The most common AEs were GIT or hematologic in nature. Signs & symptoms of ILD, a known risk with T-DXd, were actively monitored & managed with dose modification & discontinuation, corticosteroids, and supportive care in accordance with the study protocol.
The authors conclude that based on thes finding T-DXd can be an effective treatment option for pts with advance HER2+ gastric or GEJ adenocarcinoma who have progressed after trastuzumab-containing regimen.
The authors conclude that 19% of pts whose disease progressed on 2nd-line pembrolizumab (PEMBRO) experienced long-term OS; all received subsequent therapy. 2nd-line PEMBRO followed by any subsequent therapy was associated with longer OS than 2nd-line paclitaxel followed by any subsequent therapy. 2nd-line PEMBRO followed by ramucirumab + paclitaxel was associated with longer OS than 2nd-line paclitaxel followed by any subsequent therapy. 2nd-line PEMBRO followed by ramucirumab + paclitaxel was not associated with longer OS from randomization than 2nd-line PEMBRO followed by any subsequent therapy.
Servier Satellite Symposium: