Two Leading Experts Detail Hot Topics in GI Cancers to Be Presented at Upcoming ISGIO Meeting

Eileen M. O’Reilly, MD

As cochairs of the 2024 International Symposium of Gastrointestinal Oncology (ISGIO) meeting, Eileen M. O’Reilly, MD, and Tanios S. Bekaii-Saab, MD, FACP, will be a part of conversations and presentations analyzing the plethora of updated data published in the gastrointestinal (GI) cancer treatment landscape in 2024 from a multidisciplinary angle. During ISGIO 2024, which is being held from October 11 to 12 in Hollywood, Florida, case-based learning, panel discussions, and debates will be of interest for attendees.¹

“This is a multidisciplinary conference, [and] it’s meant to be interactive in an engaging format with great faculty. A tremendous range of topical issues in GI oncology are being covered,” O’Reilly said in an interview with OncLive®. “Everything from biomarker-directed therapy in treatment selection to the latest in neoadjuvant treatment [to] how we should use immunotherapy—whether it’s 1 drug or 2 drugs depending on the disease status—[will be discussed]. The conference will cover the major findings reported in the last 6 months, so it’s very topical, and a great opportunity for junior faculty, fellows, networking, and mentorship.”

Tanios S. Bekaii-Saab, MD, FACP

In a separate interview with OncLive®, Bekaii-Saab added that, “GI malignancies have become quite complex, and the role of a medical oncologist is central to these discussions. For instance, with hepatocellular carcinoma [HCC], we were a secondary thought approximately 10 to 15 years ago. Today we’re central, treating patients in the more advanced setting, bringing many of them to locoregional therapies, and bringing some patients to transplantation.”

Updated findings in HCC that may be discussed at the conference include those from the phase 3 CheckMate 9DW trial (NCT04039607), which were presented at the 2024 ASCO Annual Meeting. Data from the study revealed that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) was superior in terms of overall survival (OS) vs lenvatinib (Lenvima) and sorafenib (Nexavar) in patients with unresectable disease. At a median follow-up of 35.2 months (range, 26.8-48.9), the median OS among patients treated with nivolumab plus ipilimumab (n = 335) was 23.7 months (95% CI, 18.8-29.4) vs 20.6 months (95% CI, 17.5-22.5) with lenvatinib/sorafenib (n = 333; HR, 0.79; 95% CI, 0.65-0.96; P = .018).²

“Things have become much more complex even for the medical oncologists, as we try to navigate the complexities of the different diseases we treat. For instance, a plenary session at ASCO [2024 examined] the value of radiation with chemotherapy vs chemotherapy [alone], both followed by surgery. It appears that for most patients, we probably do not need any more radiation therapy in gastroesophageal cancers in the early stages,” Bekaii-Saab noted.

Data from the phase 3 ESOPEC trial (NCT02509286) presented at ASCO 2024 demonstrated that perioperative chemotherapy with docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT protocol) improved OS compared with neoadjuvant chemoradiation (CROSS protocol) in patients with resectable esophageal cancer. At a median follow-up of 55 months, the median OS was 66 months (95% CI, 36-not estimable) among patients in the intention-to-treat population who received FLOT (n = 221) vs 37 months (95% CI, 28-43) among those who were treated with CROSS (n = 217; HR, 0.70; 95% CI, 0.53-0.92; P = .012).³

“Of course, that discussion [of radiation omission] is important to have with our radiation oncology colleagues because they still [believe] there may be some patients who may benefit from radiation. [Perhaps for an] elderly patient who is frail [and] would not be able to go through FLOT, then chemotherapy/radiation may be an option,” Bekaii-Saab said.

Bekaii-Saab is the leader of the gastrointestinal cancer program at the Mayo Clinic Comprehensive Cancer Center, as well as the medical director of the Cancer Clinical Research Office and vice chair and section chief for medical oncology at Mayo Clinic in Phoenix, Arizona.

“In targeted therapies a lot is happening in GI malignancies—biliary, esophageal, gastric and colorectal [cancers]. At ISGIO we [will] have a molecular tumor board, which will be interesting and hopefully fun. We’ll all learn a lot from that, with colleagues who are outstanding individuals in the field—stay tuned,” O’Reilly said. “In the esophagogastric space, there are a lot of data emerging as to where immunotherapy fits and which immunotherapy [to administer] and in what setting. It’ll be great to see a state-of-the-art data review there and hopefully the discussion will drill down on some of these topics.”

O’Reilly is the Winthrop Rockefeller Endowed Chair of Medical Oncology, chair of the Human Research Protection Program and Institutional Review Board, codirector of Medical Initiatives at the David M. Rubenstein Center for Pancreatic Cancer Research, section head of Hepatopancreaticobi, and a gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center in New York, New York.

“Please come join us at ISGIO. We’re excited to host the meeting this year and [believe] it’s going to be a great program,” O’Reilly said, adding that there is “a lot to learn and [the meeting is] updated [and] very timely, occurring right after ESMO. We’ll have [data from] AACR, ASCO, ESMO GI, and the main ESMO meeting. For those who are in the world of GI oncology, are interested, or are in related fields, this should be a great and very timely meeting.”

References

1. 2024 International Symposium of Gastrointestinal Oncology (ISGIO). Physicians’ Education Resource. Accessed July 29, 2024. https://www.gotoper.com/courses/meeting-of-the-international-society-of-gastrointestinal-oncology
2. Galle PR, Decaens T, Kudo M, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW. J Clin Oncol. 2024;42(suppl 17): LBA4008. doi:10.1200/JCO.2024.42.17_suppl.LBA4008
3. Hoeppner J, Brunner T, Lordick F, et al. Prospective randomized multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (ESOPEC trial). J Clin Oncol. 2024;42(suppl 17):LBA1. doi:10.1200/JCO.2024.42.17_suppl.LBA1