The American Society of Clinical Oncology's annual Gastrointestinal Cancers Symposium was held Jan. 20 to 22 in San Francisco and attracted more than 3,000 participants from around the world. The conference highlighted recent advances in the prevention, screening, and treatment of gastrointestinal cancers, with presentations and abstracts focusing on cancers of the esophagus, stomach, hepatobiliary tract, pancreas, small bowel, colon, and rectum.
In the randomized, double-blind, placebo-controlled, multicenter phase III RADIANT-2 trial, James C. Yao, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues found that the addition of everolimus, an oral mammalian target of rapamycin inhibitor, to octreotide LAR among patients with advanced neuroendocrine tumors improved progression-free survival with an acceptable safety profile. Patients received oral everolimus plus octreotide LAR or placebo plus octreotide LAR.
"The study treated patients with progressive well- or moderately-differentiated advanced neuroendocrine tumors and history of carcinoid symptoms. Everolimus was associated with a 5.1-month improvement in median progression-free survival. Median progression-free survival was 16.4 months in the everolimus arm compared to 11.3 months in the placebo arm. This corresponded to an hazard ratio of 0.77, or a 23 percent reduction in risk of progression," Yao said.
In the RADIANT-3 study, Yao and colleagues also found that the addition of everolimus to best supportive care significantly improved progression-free survival in patients with advanced pancreatic neuroendocrine tumors. The investigators randomized patients with advanced low- or intermediate-grade pancreatic neuroendocrine tumors to everolimus plus best supportive care or placebo plus best supportive care.
According to Yao, everolimus improved progression-free survival from 4.6 to 11.0 months (hazard ratio, 0.35). The most common adverse events associated with everolimus treatment were stomatitis, rash, diarrhea, fatigue, and infections (primarily upper respiratory), which were mostly grade 1 or 2. In terms of grade 3 or 4 toxicity associated with everolimus, stomatitis (6.9 percent), anemia (6 percent), and hyperglycemia (5 percent) were the most common.
In a phase II, multicenter study, Nicholas P. Campbell, M.D., of the University of Chicago, and colleagues found that sorafenib was effective for patients with gastrointestinal stromal tumors (GIST) resistant to standard therapies. The investigators evaluated the effectiveness of sorafenib in 38 GIST patients whose disease was resistant to imatinib or sunitinib and imatinib treatment.
The investigators found that sorafenib controlled tumors in 68 percent of patients, with 13 percent of patients experiencing a partial response and an additional 55 percent experiencing stable disease. The one-year survival rate was 44 percent and the two-year survival rate was 21 percent. Side effects associated with sorafenib treatment included hypertension, fatigue, and hand-foot syndrome.
"There is an urgent need for additional agents to treat patients with imatinib- and sunitinib-refractory GIST, since there are no FDA-approved options for these patients other than resumption of imatinib," Campbell said in a statement.
Multiple authors disclosed financial relationships with Bayer, the manufacturer of sorafenib (Nexavar), as well as with other pharmaceutical companies.
In the phase III AVANT study, Aimery De Gramont, M.D., of Hôpital Saint-Antoine in Paris, and colleagues found that the addition of bevacizumab (BEV), a humanized anti-vascular endothelial growth factor monoclonal antibody, did not improve disease-free survival (DFS) when added to 5-fluorouracil-based chemotherapy regimens (FOLFOX4 or XELOX) in patients with metastatic colorectal cancer. The investigators randomized 3,451 patients with high-risk stage II or III colon cancer who had undergone surgical resection to one of three treatment groups between December 2004 and June 2007.
"The primary end point of the AVANT study was not met. BEV does not prolong DFS when added to either FOLFOX4 or XELOX in patients with stage III colon cancer. The safety profile of BEV was consistent with prior study results," the authors write.
ASCO: New Radiation Approach Effective in Anal Cancer
WEDNESDAY, Jan. 19 (HealthDay News) -- The combination of chemotherapy with intensity-modulated radiation therapy (IMRT) is equally as effective for the treatment of anal cancer after two years as the combination of chemotherapy and conventionally delivered radiation therapy, as well as less toxic, according to a study presented at the American Society of Clinical Oncology's annual Gastrointestinal Cancers Symposium, held from Jan. 20 to 22 in San Francisco.
ASCO: Gene Test May Predict Colorectal Cancer Recurrence
WEDNESDAY, Jan. 19 (HealthDay News) -- A novel microarray-based genetic test, ColoPrint, appears to effectively determine the risk of colorectal cancer recurrence among patients with localized, stage II disease, according to a study presented at the American Society of Clinical Oncology's annual Gastrointestinal Cancers Symposium, held from Jan. 20 to 22 in San Francisco.
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