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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(03): 336-340
DOI: 10.4103/ijmpo.ijmpo_47_19
Review Article

Recent Advances in the Systemic Treatment of Gastrointestinal Malignancy

Ravi Kumar Paluri
Department of Medicine, University of Alabama at Birmingham, AL, India
,
Rojymon Jacob
Department of Medicine, University of Alabama at Birmingham, AL, India
,
Anup Kasi
Kansas University Medical Center, Kansas, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

In the following article, practice changing updates on gastrointestinal cancers management have been discussed. For metastatic colorectal cancer with RAS wild-type, fluoropyrimidine plus panitumumab combination has been the preferred maintenance option for patients who have stopped oxaliplatin. The cytoreductive surgery alone showed satisfactory survival outcomes in colorectal cancer patients with peritoneal carcinomatosis. Dose escalation of regorafenib showed better clinical outcomes than the standard dosing regimen. Adjuvant FOLFIRINOX is the new treatment option for selected resected pancreatic cancer patients. Neoadjuvant treatment is the new paradigm for borderline and resectable pancreatic cancer patients. Several options for advanced hepatocellular cancers now available and more clinical studies are required for optimal treatment sequencing. Trifluridine/tipiracil showed improved overall survival in esophageal cancers beyond the second line.

Keywords

Gastric - gastrointestinal malignancy - pancreatic


Publication History

Received: 25 February 2019

Accepted: 31 March 2019

Article published online:
03 June 2021

© 2019. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Pietrantonio F, Morano F, Corallo S, Lonardi S, Cremolini C, Rimassa L. et al. First-line FOLFOX plus panitumumab (Pan) followed by 5FU/LV plus Pan or single-agent Pan as maintenance therapy in patients with RAS wild-type metastatic colorectal cancer: The VALENTINO study. J Clin Oncol 2018; 36(suppl): Abstract 3505
    CrossrefGoogle Scholar
  • 2 Schmoll H-J, Haustermans K, Jayprice T, Nordlinger B, Hofheinz R, Daisne J. et al. Preoperative chemoradiotherapy and postoperative chemotherapy with capecitabine +/- oxaliplatin in locally advanced rectal cancer: Final results of PETACC-6. J Clin Oncol 2018; 36 (Suppl):abstr 3500
    CrossrefGoogle Scholar
  • 3 Deng Y, Chi P, Lan P, Wnag l, Chen W, Cui L. et al. Modified FOLFOX6 with or without radiation in neoadjuvant treatment of locally advanced rectal cancer: Final results of the Chinese FOWARC multicenter randomized trial. J Clin Oncol 2018; 36 (Suppl):abstr 3502
    CrossrefGoogle Scholar
  • 4 Hong YS, Kim S, Lee J, Nam B, Kim J, Kim K. Long-term results of the ADORE trial: Adjuvant oxaliplatin, leucovorin, and 5-fluorouracil (FOLFOX) versus 5-fluorouracil and leucovorin (FL) after preoperative chemoradiotherapy and surgery for locally advanced rectal cancer. J Clin Oncol 2018; 36 et al. Suppl abstr 3501
    CrossrefGoogle Scholar
  • 5 Overman MJ, Kopetz S, McDermott RS, Aglietta M, Chen F, Gelsomino F. et al. Nivolumab in patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) metastatic colorectal cancer (mCRC): Long-term survival according to prior treatment from CheckMate-142 [ASCO GI abstract 554]. J Clin Oncol 2018:36(Suppl 4S)
    Google Scholar
  • 6 Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M. CORRECT Study Group. et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013; 381(9863): 303-12
    CrossrefPubMedGoogle Scholar
  • 7 Bekaii-Saab T, Ou FS, Anderson DM, Ahn D, Boland P, Ciombor K. et al. Regorafenib dose optimization study (ReDOS): Randomized phase II trial to evaluate dosing strategies for regorafenib in refractory metastatic colorectal cancer (mCRC)—an ACCRU Network study ASCO GI abstract 611. J Clin Oncol 2018:36(Suppl 4S)
    Google Scholar
  • 8 Franko J, Shi Q, Meyers JP, Maughan TS, Adams RA, Seymour MT. et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: An analysis of individual patient data from prospective randomized trials from the analysis and research in cancers of the digestive system (ARCAD) database. Lancet Oncol 2016; 17: 1709-19
    CrossrefPubMedGoogle Scholar
  • 9 Quenet F, Elias D, Roca L, Goere D, Ghouti L, Pocard M. et al. A UNICANCER phase III trial of hyperthermic intra-peritoneal chemotherapy (HIPEC) for colorectal peritoneal carcinomatosis (PC): PRODIGE 7. J Clin Oncol 2018; 36 (suppl):abstr LBA3503
    CrossrefGoogle Scholar
  • 10 Conroy T, Hammel P, Hebbar M, Abdelghani M, Wei A, Raoul J, Chone L. et al. Unicancer GI PRODIGE 24/CCTG PA.6 trial: A multicenter international randomized phase III trial of adjuvant mFOLFIRINOX versus gemcitabine (gem) in patients with resected pancreatic ductal adenocarcinomas. J Clin Oncol 2018; 36 (suppl):abstr LBA4001
    CrossrefGoogle Scholar
  • 11 Van Tienhoven NA, Versteijne E, Suker M, Groothuis K, Busch O, Bonsing B. et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer (PREOPANC-1): A randomized, controlled, multicenter phase III trial. J Clin Oncol 2018; 36 (suppl):abstr LBA4002
    CrossrefGoogle Scholar
  • 12 Dahan L, Phelip J, Malicot K, Williet N, Desrame J, Volet J. et al. FOLFIRINOX until progression, FOLFIRINOX with maintenance treatment, or sequential treatment with gemcitabine and FOLFIRI.3 for first-line treatment of metastatic pancreatic cancer: A randomized phase II trial (PRODIGE 35-PANOPTIMOX). J Clin Oncol 2018; 36 (suppl):abstr 4000
    CrossrefGoogle Scholar
  • 13 Kunz PL, Catalano Nimeiri H, Fisher G, Longacre T, Suarez C. A randomized study of temozolomide or temozolomide and capecitabine in patients with advanced pancreatic neuroendocrine tumors: A trial of the ECOG-ACRIN Cancer Research Group (E2211). J Clin Oncol 2018; 36 (suppl):abstr 4004
    CrossrefGoogle Scholar
  • 14 Abou-Alfa G, Meyer T, Cheng A, El-Khoueiry A, Rimassa L, Ryoo B. et al. Cabozantinib (C) versus placebo (P) in patients (pts) with advanced hepatocellular carcinoma (HCC) who have received prior sorafenib: Results from the randomized phase III CELESTIAL trial. J Clin Oncol 2018; 36 (suppl):4S Abstr 207
    CrossrefGoogle Scholar
  • 15 Abou-Alfa G, Meyer T, Cheng A, El-Khoueiry A, Rimassa L, Ryoo B. et al. Cabozantinib in patients with advanced and progressing hepatocellular carcinoma. N Engl J Med 2018; 379: 54-63
    CrossrefPubMedGoogle Scholar
  • 16 Zhu AX, Kang Y, Yen C, Finn R, Galle P, Llovet J. et al. REACH-2: A randomized, double-blind, placebo-controlled phase 3 study of ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma (HCC) and elevated baseline alpha-fetoprotein (AFP) following first-line sorafenib. J Clin Oncol 2018; 36 (suppl):abstr 4003
    CrossrefGoogle Scholar
  • 17 Kudo M, Ueshia K, Ikeda M, Torimura T, Tanabe N, Aikata H. et al. Randomized, open label, multicenter, phase II trial comparing transarterial chemoembolization (TACE) plus sorafenib with TACE alone in patients with hepatocellular carcinoma (HCC): TACTICS trial. J Clin Oncol 2018; 36 (suppl):4S Abstr 206
    CrossrefGoogle Scholar
  • 18 Forner A, Reig M, Bruix J. Hepatocellular Carcinoma. Lancet 2018; 391: 1301-1314
    CrossrefPubMedGoogle Scholar
  • 19 Peck-Radosavljevic M, Kudo M, Raoul J, Lee H, Decaens T, Heo J. et al. Outcomes of patients (pts) with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE): Global OPTIMIS final analysis. JCO Abstract 4018
    Google Scholar
  • 20 Basem A, Omar P, Ripat C, Macedo F, Livingstone A, Franceschi D. et al. The impact of the chemoradiation to surgery interval on pathological complete response: Short and long-term overall survival in esophageal cancer patients. J Clin Oncol 2018; 36 (Suppl. 04) 2-2
    Google Scholar
  • 21 Tabernero J, Hitara K, Mansoor W, Arkenau H, Prokharau A, Alsina M. et al. Overall survival results from a phase III trial of trifluridine/tipracial vs placebo in patients with metastatic gastric cancer refractory to standard therapies (TAGS). Ann Oncol 2018; 29 (suppl 5; abstr) LBA-002
    CrossrefGoogle Scholar
  • 22 Fuchs CS, Ozguroglu M, Bang Y, Bartolomeo M, Mandala M, Ryu M. et al. Pembrolizumab (pembro) vs paclitaxel (PTX) for previously treated advanced gastric or gastroesophageal junction (G/GEJ) cancer: Phase 3 KEYNOTE-061 trial. J Clin Oncol 2018; 36 (suppl):abstr 4062
    CrossrefGoogle Scholar