ASCO GI: Understanding Tumor Biology Key to Treatment of Gastrointestinal Cancers

ORLANDO, Jan. 25 -- Treatment of gastrointestinal cancers can be improved with a more thorough understanding of tumor biology, researchers here reported.

"In pancreatic cancer, particularly, cytotoxic chemotherapy has a minimal impact on pancreatic cancer and therefore an approach that targets the biology of the disease is being pursued with a number of agents," said Hedy Lee Kindler, M.D., an associate professor of medicine at the University of Chicago.

Speaking at a satellite symposium titled Translating Molecular Advances into Improved Outcomes for Gastrointestinal Malignancies, Dr. Kindler discussed recent trials in which epithelial growth factor receptor inhibitors and vascular endothelial growth factor (VEGF) receptors such as Avastin (bevacizumab) were being considered for treatment of pancreatic cancer.

The satellite symposium was presented in conjunction with the Gastrointestinal Cancers Symposium here. The symposium was sponsored by Genentech BioOncology.

Avastin, the VEGF inhibitor, has been embraced by oncologists who were interested in its potential as an add-on to traditional chemotherapy regimens. But a spate of recent reports has demonstrated that the drug has limits.

For example, Dr. Kindler and colleagues reported that in a phase III trial Avastin did not extend survival for patients with advanced pancreatic cancer.

The chair of the satellite symposium, Aimery de Gramont, M.D., a professor of medicine and the director of oncology at Hopital Saint Antoine in Paris, gave a presentation called Ongoing Clinical Trials Integrating Antiangiogenic Agents in the Adjuvant Setting.

Dr. de Gramont offered an overview of trials of targeted therapies in the adjuvant setting and discussed various antiangiogenic strategies that are being studied in patients with advanced colorectal cancer.

Al Benson III, M.D., a professor of medicine at the Feinberg School of Medicine at Northwestern University, discussed the continuum of care for patients with advanced colorectal cancer, explaining how treatment with Avastin and other cytotoxic and targeted therapies fit into treatment algorithms.

Treatment of gastric cancer, especially certain diffuse cancers, might provide clues that could be used to treat other malignancies, suggested Manish Shah, M.D., an assistant attending physician in the division of gastrointestinal oncology at the Memorial Sloan-Kettering Cancer Center, New York.

"It is important to understand this disease which is a worldwide problem," Dr. Shah said in his talk, Molecular Biology and New Targeted Options for Gastric Cancer.

Dr. Kindler disclosed financial support Genentech, Lilly Oncology and Roche. Dr. Benson has disclosed that he has received grant/research support from and acted as a consultant to Genentech, Roche, Sanofi-Aventis, Pfizer, ImClone and Bristol-Myers Squibb. Dr. de Gramont has received support from Gercor, Paris, France. Dr. Shah received support from Sloan-Kettering and the University of Pittsburgh Medical School.

The Gastrointestinal Cancers Symposium was jointly sponsored by American Society of Clinical Oncology, the American Society for Therapeutic Radiology and Oncology, the American Gastroenterological Association Institute and the Society of Surgical Oncology.