Mar 29, 2019

Meet The Professors: Clinical Investigator Perspectives on Key Questions and Emerging Research in the Management of Colorectal, Gastric and Hepatocellular Cancer. Proceedings from a CME symposium held at the 2019 Gastrointestinal Cancers Symposium. Featuring perspectives on the following topics and cases from Dr Ghassan Abou-Alfa, Dr Peter C Enzinger, Dr Tim Greten, Dr David H Ilson, Dr Wells A Messersmith and Prof Eric Van Cutsem:

Gastric and Gastroesophageal Cancer

• Case (Dr Enzinger): A 72-year-old woman with metastatic squamous cell carcinoma of the esophagus and a high PD-L1 combined positive score (CPS) receives third-line pembrolizumab (00:00)
• KEYNOTE-181: Results of a Phase III trial of pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal carcinoma (4:34)
• Sequencing anti-PD-1 checkpoint inhibitors for patients with metastatic HER2-negative gastric cancer and a PD-L1 CPS of 1 or higher (7:37)
• Case (Dr Ilson): A 71-year-old man with microsatellite-stable gastroesophageal junction (GEJ) adenocarcinoma and a high PD-L1 CPS (11:57)
• Research supporting the FDA approval of pembrolizumab for recurrent or advanced gastric or GEJ adenocarcinoma with a PD-L1 CPS of 1 or higher after 2 or more lines of chemotherapy (16:03)
• Clinical implications of the negative Phase III KEYNOTE-061 trial of pembrolizumab versus paclitaxel for previously treated advanced gastric or GEJ cancer (17:26)
• ATTRACTION-2: Results of a Phase III trial of nivolumab versus placebo for unresectable advanced or recurrent gastric or GEJ adenocarcinoma after at least 2 previous chemotherapy regimens (19:51)
• Second-line therapy options for patients with metastatic microsatellite-stable gastric cancer who experience disease progression on first-line FOLFOX (20:51)
• Results of the Phase III TAGS study: Efficacy, tolerability and potential clinical role of TAS-102 for patients with heavily pretreated metastatic gastric cancer (23:52)
• INTEGRATE: Results of a Phase II trial of regorafenib for patients with refractory gastric cancer (28:03)
• Select ongoing Phase III studies of other novel agents and strategies for metastatic gastric or GEJ cancer (30:30)
• Approach to second-line therapy for patients with metastatic HER2-positive, microsatellite-stable gastric cancer who experience disease progression on FOLFOX/trastuzumab (33:24)
• Case (Dr Enzinger): A man with moderately differentiated HER2-positive metastatic GEJ adenocarcinoma (35:18)
• Case (Dr Ilson): A 67-year-old woman with proximal gastric adenocarcinoma receives neoadjuvant FOLFOX (37:54)

Hepatocellular Carcinoma (HCC)

• Perspective on the recent advances in the treatment of HCC (42:10)
• Selection of first-line therapy for patients with HCC (46:05)
• Case (Dr Abou-Alfa): A 63-year-old man with a history of hepatitis C is diagnosed with HCC with metastasis to the bone (47:23)
• Choice of lenvatinib versus sorafenib as first-line therapy (50:15)
• Efficacy and tolerability of lenvatinib versus sorafenib as up-front therapy in the Phase III REFLECT trial (Study 304) (51:27)
• Therapeutic options for patients with HCC in the second-line setting (54:00)
• Results of the Phase III RESORCE trial of regorafenib for patients with unresectable HCC who experience disease progression on sorafenib (57:28)
• Case (Dr Abou-Alfa): A 71-year-old man with Stage IV hepatitis C-related HCC requires a dose reduction with second-line cabozantinib (59:42)
• Activity and side-effect profile of cabozantinib; results from the Phase III CELESTIAL trial of cabozantinib for patients with advanced HCC (1:00:59)
• Case (Dr Greten): A 72-year-old man with a history of hepatitis B and high alpha-fetoprotein (AFP) receives ramucirumab after disease progression on sorafenib (1:03:09)
• REACH-2: A Phase III study of ramucirumab as second-line treatment for patients with advanced HCC and elevated AFP after first-line sorafenib (1:04:05)
• Case (Dr Greten): A 37-year-old man with HCC metastatic to the omentum achieves a pathologic complete response with durvalumab (1:07:21)
• Role of molecular profiling for patients with HCC (1:11:18)
• KEYNOTE-224: A Phase II study of pembrolizumab in patients with advanced HCC previously treated with sorafenib (1:13:4)
• Activity of nivolumab in the Phase I/II CheckMate 040 study for patients with advanced HCC (1:15:47)
• Response and tolerability of atezolizumab/bevacizumab for patients with advanced HCC on a Phase Ib trial (1:17:14)
• Ongoing investigation of anti-PD-1/PD-L1 and anti-CTLA-4 combinations in HCC (1:19:52)

Colorectal Cancer (CRC)

• Treatment algorithm for metastatic CRC (mCRC) based on tumor sidedness and biomarker status (1:22:06)
• Efficacy and tolerability of anti-EGFR antibodies (1:26:52)
• Case (Prof Van Cutsem): A 59-year old woman with mCRC, a BRAF V600E mutation and microsatellite-stable disease receives cetuximab, encorafenib and binimetinib on the BEACON CRC trial after disease progression on FOLFOX/bevacizumab (1:31:07)
• Management of mCRC with a BRAF V600E mutation (1:33:42)
• Results of the SWOG S1406 trial of irinotecan and cetuximab with or without vemurafenib for mCRC with a BRAF mutation (1:37:13)
• Efficacy and safety of encorafenib, binimetinib and cetuximab in the Phase III BEACON CRC study for patients with mCRC and a BRAF V600E mutation (1:38:35)
• Case (Dr Messersmith): A 40-year old man with microsatellite instability (MSI)-high mCRC and Lynch syndrome achieves a near-complete response after receiving an anti-PD-L1 antibody on a clinical trial (1:40:16)
• Role of checkpoint inhibitors for patients with MSI-high mCRC (1:41:42)
• Efficacy of anti-PD-1/PD-L1 antibodies in patients with microsatellite-stable disease (1:45:40)
• Ongoing Phase III trials evaluating immune checkpoint inhibitors for patients with MSI-high mCRC (1:47:55)
• Case: A 56-year-old woman with mCRC and a KRAS exon 2 mutation receives regorafenib as third-line therapy (1:49:17)
• ReDOS: Optimal dosing of regorafenib in refractory mCRC; REVERCE: Sequencing of regorafenib and cetuximab for previously treated mCRC (1:57:01)
• Efficacy and safety of TAS-102 in mCRC (1:58:58)

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