M. Peeters MD, PhD

Highlights in digestive oncology

This report will focus on some of the key studies in the field of digestive oncology, presented during the 2019 annual ESMO meeting. During the congress, many studies were presented from early phase I to large phase III trials. Different approaches to activate the immune system against tumours as well as PARP and CDK4/6 inhibitors were once more at the centre of interest for different types of cancer and settings.

Adjuvant chemotherapy of colon cancer: 3 versus 6 months

Summary

For over a decade, oxaliplatin-based adjuvant chemotherapy has been the gold standard for resected early colon cancer. Oxaliplatin is known to cause polyneuropathy, which affects quality of life dramatically. In recent years, there has not been any progress in the development of novel agents to replace oxaliplatin as adjuvant therapy. Consequently, there is a growing interest to investigate whether a shorter course of chemotherapy is sufficient. This article will discuss the history of adjuvant treatment in early-resected colon cancer, the toxicity of oxaliplatin, the results from the IDEA meta-analysis and future prospects.

(BELG J MED ONCOL 2019;13(6):234–239)

Highlights of the 2019 annual meeting of the European Neuroendocrine Tumour Society (ENETS)

MARCH 6-8TH, 2019, BARCELONA

Highlights in digestive oncology

At ASCO 2019, several clinical trials regarding upper and lower gastro-intestinal tumors were presented.

Retrospective study of survival and consecutive treatments of patients treated with aflibercept plus FOLFIRI in second line for metastatic colorectal cancer in Belgium

SUMMARY

A retrospective study in patients treated with aflibercept plus FOLFIRI in second line for metastatic colorectal cancer (mCRC) was conducted in Belgium. A total of 102 patients (64.7% males; 62.9 ± 9.8 [mean ± SD] years-old; 36.3% Eastern Cooperative Oncology Group [ECOG] 0 and 63.7% ECOG 1 status) were included. At the end of the study, 47.1% of patients were deceased and 49% were still alive. The median overall survival (± SD) was 15.7 ±1.2 months (no statistically significant difference [p=0.706; log rank test] in survival as a function of the ECOG status). The median progression-free survival was 7.1 ±1.0 months (no statistically significant difference [p=0.732; log rank test] in progression-free survival as a function of the ECOG status). Aflibercept treatment was still ongoing in 22.5% of the patients. The treatment was stopped in 79 (77.5%) patients. In 16 patients (15.7%), treatment with aflibercept was discontinued due to drug toxicity. The average aflibercept treatment duration was 4.5 ± 4.5 months and the average number of aflibercept administrations was 8.7 ± 6.7. Overall, 62% of the patients having interrupted aflibercept received at least one targeted therapy or one chemotherapy after aflibercept. The three most frequent targeted therapies were regorafenib (46%), panitumumab (30%) and cetuximab (18%). The four most frequent chemotherapies were FOLFIRI (44.7%), FOLFOX (12.8%), irinotecan (12.8%) and capecitabine (12.8%). The results obtained using a retrospective observational real-life setting in Belgium globally corroborate those observed in the VELOUR randomised placebo-controlled trial.

(BELG J MED ONCOL 2019;13(3):98–104)

Molecular test algorithms for digestive tumours

The Belgian Commission of Personalized Medicine has been created to advise the federal government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests. Here, we propose the Belgian strategy for molecular testing in the digestive tumours within a scientific-based framework. For each tested biomarker, a clinical test level is attached, which is key to establish the relevance of the test and to define the reimbursement. For each digestive tumour type, the different molecular tests are represented as decision trees with its test utility, test level and a brief technical test description.

(BELG J MED ONCOL 2019;13(1):4–10)

Highlights in gastro-intestinal oncology

Although none of the submitted abstracts in the field of gastro-intestinal oncology reached the presidential sessions of ESMO 2018, some practice-changing and promising data were presented especially in the field of immunotherapy. This report summarises the highlights in the field of colorectal, anal and upper digestive tract cancer.