Gastrointestinal Cancer

Joleen M. Hubbard, MD, discusses key survival data from the phase 1b study of the PolyPEPI1018 vaccine and the impact of these findings on continued investigations of this vaccine in metastatic colorectal cancer.

Manisha Palta, MD, discusses the clinical implications of the phase 3 NRG/RTOG 1112 trial in patients with locally advanced hepatocellular carcinoma.

The risk for developing hepatocellular carcinoma appears to increase with subsequent generations for Americans of Mexican descent, according to findings from a study of US-born Hispanics/Latinos living in Los Angeles, California.

Shubham Pant, MD, discusses the rationale, trial design, and key efficacy and safety data from an expansion cohort of the phase 2 RAGNAR trial in biliary tract cancers.

Experts in liver cancer treatment provide insight on real-world trials of immune checkpoint inhibitor combinations in HCC and opine on trial endpoints when immune therapy is utilized.

Drs Abou-Alfa, Singal, and Lewandowski discuss use of immune checkpoint inhibitors and liver function.

Adding the PD-1 inhibitor pembrolizumab to gemcitabine and cisplatin led to a significant improvement in overall survival compared with gemcitabine and cisplatin alone as first-line therapy in patients with advanced or unresectable biliary tract cancer.

Bavituximab in combination with pembrolizumab produced responses in patients with previously untreated advanced hepatocellular carcinoma.

Second-line ripretinib produced a clinical benefit in patients with advanced gastrointestinal stromal tumor harboring KIT exon 11 and 17/18 mutations who progressed on or were intolerant to imatinib.

The addition of the novel bispecific antibody CTX-009 to paclitaxel showed promising efficacy in the second- and third-line settings for patients with advanced biliary tract cancer.

Both veliparib plus total neoadjuvant therapy and pembrolizumab plus total neoadjuvant therapy failed to improve short-term outcomes in unselected patients with locally advanced rectal cancer.

Third-line bevacizumab plus trifluridine/tipiracil demonstrated a survival and disease control benefit vs trifluridine/tipiracil alone in patients with refractory metastatic colorectal cancer and all clinically relevant subgroups.

Newer frontline therapies demonstrated a real-world improvement in survival and responses compared with sorafenib in patients with hepatocellular carcinoma.

The combination of SEA-CD40, gemcitabine, nab-paclitaxel, and pembrolizumab demonstrated early evidence of efficacy in patients with metastatic pancreatic ductal adenocarcinoma, according to updated results from the phase 1 SGNS40-001 study.

Treatment with or without bevacizumab added to atezolizumab plus cisplatin/gemcitabine demonstrated a modest clinical benefit for patients with advanced biliary tract cancer.

Tislelizumab monotherapy resulted in favorable health-related quality of life outcomes compared with sorafenib as frontline treatment for patients with unresectable hepatocellular carcinoma.

The addition of stereotactic body radiation therapy to sorafenib led to an improvement in overall survival, progression-free survival, and time to disease progression compared with sorafenib alone in patients with locally advanced, hepatocellular carcinoma.

The addition of nab-paclitaxel to gemcitabine and cisplatin did not result in a statistically significant improvement in overall survival over gemcitabine/cisplatin alone in patients with newly diagnosed, advanced biliary tract cancers.

Blank-microsphere transarterial chemoembolization plus low-dose lenvatinib and sequential microwave ablation elicited responses and a tolerable safety profile in patients with large hepatocellular carcinoma.

The presence of anti-drug antibodies appeared to have no effect on efficacy or safety of durvalumab monotherapy or the STRIDE combination of durvalumab plus tremelimumab in patients with unresectable hepatocellular carcinoma.

Second-line lenvatinib may produce a survival benefit in patients with advanced hepatocellular carcinoma who have progressed on immunotherapy.

Patients with HER2-overexpressing metastatic or advanced gastric/gastroesophageal junction adenocarcinoma treated with HER-Vaxx plus standard-of-care chemotherapy had a statistically significant survival benefit compared with those who received chemotherapy alone.

Frontline zolbetuximab plus mFOLFOX6 significantly improved progression-free and overall survival vs placebo/mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative locally advanced unresectable or metastatic gastric/gastroesophageal junction adenocarcinoma, according to primary phase 3 data from the SPOTLIGHT trial.

Nivolumab in combination with chemotherapy or ipilimumab maintained a clinically meaningful overall survival benefit vs chemotherapy alone in patients with treatment-naïve advanced esophageal squamous cell carcinoma.

The combination of nivolumab (Opdivo) and chemotherapy continued to provide a clinically meaningful long-term survival benefit and deeper responses than chemotherapy alone in previously untreated patients with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma, according to 3-year follow-up data from the phase 3 CheckMate-649 trial.

Neoadjuvant treatment with the combination of tremelimumab and durvalumab produced responses and was well tolerated in patients with mismatch repair–deficient and microsatellite instability–high, Epstein-Barr virus–negative gastric or gastroesophageal junction adenocarcinoma.

Adjuvant treatment with the combination of atezolizumab and bevacizumab demonstrated a statistically significant improvement in recurrence-free survival compared with active surveillance in patients with early-stage hepatocellular carcinoma at high risk of disease recurrence.

The panel reviews the HIMALAYA and IMbrave-150 clinical trials of checkpoint inhibitor combination therapy strategies in advanced HCC.

A deeper dive on immune checkpoint inhibitors in HCC including review of the mechanisms of action of the IO agents.

Mohamad Bassam Sonbol, MD, discusses key considerations for treatment selection in patients with gastroesophageal junction cancers.