Dr. Ahn on Neoadjuvant Treatments for Patients With Gastric Cancer

Daniel H. Ahn, DO, internist, Mayo Clinic, discusses advances in neoadjuvant therapies for patients with gastric cancer during the 2017 OncLive State of the Science Summit on Gastrointestinal Malignancies.

The combination of PD-1 inhibitors plus chemotherapy have demonstrated excitement in this setting, Ahn explains. Currently, the treatment strategy is chemotherapy, usually with carboplatin/paclitaxel (Abraxane), in combination with concurrent chemoradiation—a regimen that is based off the CROSS trial.

However, there appears to be interesting data that PD-1 inhibitors plus chemotherapy may not only have a local benefit, but there may potentially be an abscopal effect where it not only controls the local disease, but also prevents any disseminated or metastatic disease in the future, he explains.

A phase Ib study being conducted out of Mayo Clinic is exploring the combination of carboplatin/paclitaxel with pembrolizumab (Keytruda) in combination with radiation therapy.

Additionally, PET-CT scan is being further investigated as a way to identify patients who are actually responders to chemotherapy and radiation. Preliminary data presented at the 2017 Gastrointestinal Cancers Symposium show that this could be a viable way to treat patients with gastroesophageal cancer. However, more mature data is needed.