Abstract
We have reviewed the pivotal presentations related to gastrointestinal malignancies from 2009 annual meeting of the American Society of Clinical Oncology with the theme of "personalizing cancer care". We have discussed the scientific findings and the impact on practice guidelines and ongoing clinical trials. Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing human epidermal growth factor receptor 2. Gemcitabine plus cisplatin has become a new standard for first-line treatment of advanced biliary cancer. Octreotide LAR significantly lengthened median time to tumor progression compared with placebo in patients with metastatic neuroendocrine tumors of the midgut. Addition of oxaliplatin to fluoropyrimidines for preoperative chemoradiotherapy in patients with stage II or III rectal cancer did not improve local tumor response but increased toxicities. Bevacizumab did not provide additional benefit to chemotherapy in adjuvant chemotherapy for stage II or III colon cancer. In patients with resected stage II colon cancer, recurrence score estimated by multigene RT-PCR assay has been shown to provide additional risk stratification. In stage IV colorectal cancer, data have supported the routine use of prophylactic skin treatment in patients receiving antibody against epidermal growth factor receptor, and the use of upfront chemotherapy as initial management in patients with synchronous metastasis without obstruction or bleeding from the primary site.
Highlights
We have reviewed the pivotal presentations related to gastrointestinal malignancies from 2009 annual meeting of the American Society of Clinical Oncology with the theme of “personalizing cancer care”
Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing Human epidermal growth factor receptor 2 (HER2)
Gemcitabine plus cisplatin has become a new standard for first-line treatment of advanced biliary cancer
Summary
We have reviewed the pivotal presentations related to gastrointestinal malignancies from 2009 annual meeting of the American Society of Clinical Oncology with the theme of “personalizing cancer care”. Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing human epidermal growth factor receptor 2. In the 2009 annual meeting of the American Society of Clinical Oncology (ASCO), it has become clear that targeted therapies and personalized medicine for many cancer types will soon become the standard of care. Phase II studies incorporating trastuzumab with cisplatin-based regimen in patients with advanced gastric cancer overexpressing HER2 have shown encouraging activities [7,8]. The ToGA trial presented at ASCO 2009 screened approximately 3,800 gastric cancer patients from 24 countries [9] They noted that HER2 expression was detectable in 22% of patients and the concordance rate between IHC and FISH was high at all levels of HER2 positivity [10]. The role of trastuzumab as a single agent or as a part of perioperative therapy is worth investigation
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