ALEXANDRIA, Va. – Ten studies exploring new approaches for the treatment of gastrointestinal cancers will be presented at the upcoming 2024 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium, taking place in San Francisco, CA, and online, January 18-20. 

ASCO Experts are available to provide outside commentary and perspective on the studies below. Contact the ASCO Media Team to schedule an interview. 

Abstract 249: A randomized controlled phase III trial comparing thoracoscopic esophagectomy and open esophagectomy for thoracic esophageal cancer: JCOG1409 (MONET trial).
Abstract presentation part of session beginning at 9:15 a.m. PT on Thursday, January 18.
“The non-inferiority of thoracoscopic esophagectomy to transthoracic open esophagectomy in terms of overall survival after esophagectomy for thoracic esophageal cancer was confirmed after adjusting for multiplicity. Patients who underwent thoracoscopic esophagectomy showed remarkably better relapse-free survival, relatively less postoperative pain and pneumonia, and less respiratory dysfunction at 3 months after surgery compared to open esophagectomy,” said lead study author Hiroya Takeuchi, MD.

“Minimally invasive surgery has exploded, with patient and market factors preceding oncologic outcomes as the drivers. The authors have randomized patients to open and minimally invasive surgery for esophageal cancer and found that cancer outcomes may be equal or in fact superior in the minimally invasive group,” said ASCO Expert Jennifer Tseng.

Abstract LBA248: A two-arm randomized open-label prospective design superiority phase III clinical trial to compare the efficacy of docetaxel-oxaliplatin-capecitabine/5 fluorouracil (DOC/F) followed by docetaxel versus CAPOX/mFOLFOX-7 in advanced gastric cancers (DOC-GC study).
Abstract presentation part of session beginning at 9:15 a.m. PT on Thursday, January 18.
“The addition of docetaxel to FOLFOX/CAPOX in advanced HER2 negative gastric/gastro-esophageal adenocarcinomas did not improve overall survival, progression free survival or patient related outcomes. FOLFOX or CAPOX should remain the chemotherapy backbone in advanced HER2 negative gastric/gastro-esophageal adenocarcinomas when combinations with targeted therapies or immunotherapeutic combinations are being considered in the future,” said lead study author Anant Ramaswamy, DM.

“More is not always more in the setting of advanced cancer. This phase III trial evaluated both the addition of more chemo and longer duration of therapy. Adding docetaxel to a doublet regimen of CAPOX or mFOLFOX did not improve overall survival in advanced gastric cancer. In addition, chemotherapy beyond 6 months did not improve survival,” said ASCO Expert Pamela Kunz.

Abstract LBA244: Chemotherapy plus camrelizumab versus chemotherapy alone as neoadjuvant treatment for resectable esophageal squamous cell carcinoma (ESCORT-NEO): A multi-center, randomized phase III trial.
Abstract presentation part of session beginning at 1:15 p.m. PT on Thursday, January 18.
“Esophageal squamous cell carcinoma accounts for most esophageal cancer cases worldwide and is more common in Asia and Africa. Standard neoadjuvant treatment consists of chemotherapy and/or chemoradiation. This phase III trial demonstrates that neoadjuvant chemotherapy plus camrelizumab almost doubles pathologic complete response.” said ASCO Expert Pamela Kunz.

Two Studies Exploring Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel in Gastric and Gastroesophageal Junction Cancer Will be Presented at the Meeting

Abstract LBA246: Pathological complete response (pCR) to 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) with or without durvalumab (D) in resectable gastric and gastroesophageal junction cancer (GC/GEJC): subgroup analysis by region from the Phase 3, randomized, double-blind MATTERHORN study.
Abstract presentation part of session beginning at 1:15 p.m. PT on Thursday, January 18.

Abstract 247: Pembrolizumab plus FLOT vs FLOT as neoadjuvant and adjuvant therapy in locally advanced gastric and gastroesophageal junction cancer: Interim analysis of the phase 3 KEYNOTE-585 study.
Abstract presentation part of session beginning at 1:15 p.m. PT on Thursday, January 18.

“The standard of care for resectable gastric and GEJ adenocarcinoma is FLOT. The global MATTERHORN study now demonstrates that the addition of durvalumab to FLOT prolongs pathological complete response in this patient population, and the global phase III KEYNOTE-585 study demonstrates that the addition of pembrolizumab to FLOT prolongs pathological complete response and event-free survival in this patient population. Both studies will likely change practice,” said ASCO Expert Pamela Kunz.

Abstract 605: Alternating application of gemcitabine/nab-paclitaxel (Gem/nab-Pac) and Gem monotherapy or continuous application of Gem/nab-Pac after induction treatment for first-line treatment of metastatic pancreatic cancer (mPC): First results from the randomized phase 2 ALPACA study from the German AIO study group (AIO-PAK-0114).
Abstract presentation part of session beginning at 10:30 a.m. PT on Friday, January 19.
“The ALPACA trial provides evidence that alternating cycles of  gemcitabine/nab-paclitaxel (Gem/nab-Pac) and single-agent Gem after three Gem/nab-Pac induction cycles does not impair the outcome of patients with metastatic pancreatic cancer and may be associated with improved tolerability. By applying a lower dose intensity of nab-Pac as investigated in the ALPACA trial, pancreatic cancer patients may be spared toxicity and hospitalizations while maintaining quality of life and treatment efficacy,” said lead study author Klara Dorman, MD.

“At a time when patients with advanced cancers are living longer it is critical to find ways to improve quality of life without compromising efficacy. The ALPACA trial shows that reducing doses of chemotherapy (alternating Gem/nab-Pac with Gem alone) is feasible, better tolerated, and does not compromise OS,” said ASCO Expert Pamela Kunz.

Abstract 54: Patient-reported outcomes from the BESPOKE CRC study.
Abstract presentation part of poster session beginning at 6:30 a.m. PT on Saturday, January 20

Abstract 116: Quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) analysis of fruquintinib + best supportive care (BSC) compared with placebo + BSC in metastatic colorectal cancer (mCRC): Results from the FRESCO-2 trial.
Abstract presentation part of poster session beginning at 6:30 a.m. PT on Saturday, January 20.

Abstract 27: INTERCEPT Program of circulating tumor DNA (ctDNA) testing for minimal residual disease (MRD) in colorectal cancer (CRC): Results from a prospective clinical cohort.
Abstract presentation part of poster session beginning at 6:30 a.m. PT on Saturday, January 20.

“Circulating tumor DNA defined minimal residual disease (MRD) is highly prognostic for recurrence in patients with colorectal cancer after curative intent treatments, even after adjusting for current clinicopathological features such as stage as shown in prior clinical trial datasets. Here we present a large real world prospective experience confirming the strong prognostic implications of minimal residual disease after surgery and during surveillance. Our study adds to the body of literature that helps improve stratification of colorectal cancer patients after surgery based on risk of recurrence that will eventually aid in better approaches for adjuvant therapies and improve staging. When MRD is detected during surveillance, there is a window of opportunity during the lead time to prevent eventual recurrence. Clinical trials are ongoing testing this hypothesis,” said lead study author Giulia Maddalena, MD.

“INTERCEPT is a large prospective cohort study of postoperative ctDNA in stage II-IV patients. Samples were collected quarterly during the patient's surveillance period. A single ctDNA was collected in approximately 1/3 of all 1,140 patients enrolled. After a short median follow up of 10.4 months, the investigators were able to differentiate the significance of ctDNA regardless of stage and its impact on DFS. Based on these findings, ctDNA may be considered a standard of care for all stages of colon cancer and is prognostic of DFS,” said ASCO Expert Cathy Eng.

Abstract 9: Circulating tumor DNA (ctDNA) for informing adjuvant chemotherapy (ACT) in stage II/III colorectal cancer (CRC): Interim analysis of BESPOKE CRC study.
Abstract presentation part of session beginning at 9:15 a.m. PT on Saturday, January 20. 
“BESPOKE is a multicenter, prospective, observational study that evaluates the role of postoperative ctDNA as a surrogate marker for minimal residual disease (MRD). Early results suggest that postoperative ctDNA impacts DFS and subsequent adjuvant chemotherapy was noted to be beneficial in only those patients that were ctDNA positive. At 12 weeks, those with ctDNA positive clearance fared better for DFS. These results indicate the potential utility of ctDNA in guiding the role of adjuvant chemotherapy and also the impact of ctDNA clearance on overall prognosis,” said ASCO Expert Cathy Eng.

ASCO Research to be Presented During 2024 ASCO Gastrointestinal Cancers Symposium

Abstract 106: Talazoparib in colorectal cancer with BRCA1/2 mutations
Abstract presentation part of session beginning at 6:30 a.m. PT on Saturday, January 20. 

Abstract 308: Abemaciclib in esophageal cancer with CDKN2A loss or mutation
Abstract presentation part of session beginning at 11:45 a.m. PT on Saturday, January 20.
 

View the News Planning Team disclosures: https://old-prod.asco.org/sites/new-www.asco.org/files/content-files/about-asco/pdf/2024-asco-gi-npt-disclosures.pdf

View Dr. Tseng's disclosures: (Link will be updated)
  

ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY GASTROINTESTINAL CANCERS SYMPOSIUM IS REQUESTED IN ALL COVERAGE. 

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