What are your top takeaways in GI Cancers from ASCO 2024?

1. LBA1: Prospective randomized multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (ESOPEC trial) - This trial is the first phase III prospective data showing a PFS and OS bene...

1. ESOPEC – as signaled by its plenary presentation, periop FLOT is certainly an impressive option for >cT1N+ esophageal adenocarcinoma but I’m troubled by the chemoradiation arm seeming both less tolerable & less effective on this study than it did in the seminal CROSS trial over a decade ago, and I ...

1. The plenary presentation concerning FLOT (periop, chemo only, 4 c before, 4 after) v. CROSS (chemoXRT c/ low-dose carbo/taxol neoadj, usually followed by nivo after surgery unless pCR at time of surgery) will change practice immediately. The study is not perfect. As many observers have pointed out...

There were a number of takeaways from ASCO 2024 and here are a few abstracts with potential as works in progress:

1. Abstract 4020: Safety, tolerability, and efficacy of 212Pb-DOTAMATE as a targeted alpha therapy for subjects with unresectable or metastatic somatostatin receptor-expressing gastroent...

1. I think TRANSMET was the most groundbreaking one yet with several questions that came up with the design of the study… I thought this indicates that transplants can be considered for a very selected case but should not be generalized to the overall population! The patients enrolled in this study re...

Here are my takeaways

1. CheckMate 9DW

• Still think decision-making on 1L therapy in patients with advanced HCC will be on a case-by-case basis taking into account disease factors & baseline comorbidities
• Both CheckMate 9DW & HIMALAYA trials did not enroll patients with VP4 disease and had smaller p...

1. ESOPEC study results --> Practice changing.
   
   
2. COLLISION --> Improves the safety of local therapy in patients with colorectal liver mets.
   
   
3. NEOPRISM-CRC --> Adds more data to the neoadjuvant immunotherapy paradigm of localized MSI-H colon cancer.

Well first, the prospective randomized multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (ESOPEC trial) is paradigm shifting as we improve the median OS and importantly, the...