What is New from the Gastrointestinal Cancer Symposium

I am sitting at the Oakland airport waiting for my flight from San Francisco to Los Angeles going home from the Gastrointestinal Cancer Symposium. This is the only GI symposium in the United States which brings together all the experts dealing with patients with GI cancer, including surgeons, radiation oncologists, medical oncologists, gastroenterologists, and scientists.

We all realize that it takes a team to provide the best care, particularly with novel developments in technologies such as virtual colonoscopies, new drugs, new surgical techniques and new insights on cancer risk and prevention strategies.

This symposium looks at patients from all different angles. Today was the colorectal session. It started with the keynote lecture on epigenetics. This is a new way to control the genes within cancer cells. We are learning that this way to control genes may be very important. We have developed methods to measure the amount of methylation in the genes in a tumor.

In early human development, methylation is how cells develop into different organs. Since every body cell has the same chromosomes, genes needed to become a liver cell or kidney cells are changed. Making sure each cell develops into the right organ is partly controlled by methylation.

Tumors also take advantage of this process to grow faster and spread more easily. We are just starting to understand this process.

In leukemia, they already have developed drugs to attack this kind of methylation, or silencing of genes, and successfully treat a specific subset of leukemia. There is no doubt that we will make significant progress in the coming years and hopefully develop new drugs to attack this mechanism.

The Symposium didn’t report any new breakthrough treatments. However every session clearly showed that we have made much progress in understanding how cancer develops and grows and why some patients are more sensitive than others to treatment.

KRAS testing, which is now a standard method to decide whether EGFR inhibitors will be effective or not, is only the beginning. With better understanding of the molecular highways of cancer, we will use the novel drugs being developed in a much smarter way. There is the feeling we will make more progress in the years to come.