GIASCO 2019

Every year, over 3,500 medical oncologists, researchers, physicians, and research advocates gather in San Francisco, California for the Gastrointestinal Cancers Symposium (GIASCO) to discuss the latest research in GI cancers, including those of the colon and rectum. This year was no different. Fight Colorectal Cancer (Fight CRC) staff and five dedicated research advocates were at the forefront of the science, attending plenaries, breakout sessions, and even a lab tour!

Breaking down the research

Here are the research studies we were following closely ahead of time-based on what we were hearing from our patient community, along with the updated results:

• Abstract 688: Updated results of the BEACON CRC safety lead-in: Encorafenib (ENCO) +binimetinib (BINI) + cetuximab (CETUX) for BRAFV600E-mutant metastatic colorectal cancer (mCRC). First Author: Scott Kopetz, MD, PhD
  • Of 29 colorectal cancer patients included in the study with BRAF-V600e mutations, the overall response rate was 48% and the overall survival was 15.3 months. According to Fight CRC Medical Advisory Board member, Axel Grothey, “the randomized phase III BEACON study has finished accrual and could set a new standard of care.”
• Abstract 680: A phase Ib study of pembrolizumab (Pem) in combination with stereotactic body radiotherapy (SBRT) for resectable liver metastatic colorectal cancer (CRC). First Author: Anita Ahmed Turk, MD, BA
  • This study investigated the safety of combining stereotactic body radiotherapy (SBRT) with pembrolizumab before liver resection, combined with additional cycles of pembrolizumab post-operatively. Researchers concluded that the combination of SBRT with pembrolizumab and surgical resection is well tolerated and immunotherapy associated toxicities were not elevated.
• Abstract 613: A randomized phase II study comparing oral S-1 plus a 24-hour infusion of irinotecan (Iri) and bevacizumab (Bev) with FOLFIRI plus bevacizumab in patients with metastatic colorectal cancer (MCRC). First Author: Sotaro Sadahiro, MD, PhD
  • Researchers compared FOLFIRI plus Bevacizumab (Bev), a first-line treatment for metastatic colorectal cancer (mCRC), to S1 plus Irinotecan (Iri) and Bevacizumab and found that the combination of Iri + S1+ Bev was highly effective and well tolerated for a first-line treatment in patients with mCRC.
• Abstract 595: Guanylate cyclase c (GUCY2C) as a preventative and therapeutic target in colorectal cancers (CRCs) arising through divergent genomic pathways. First Author: Babar Bashir, MBBS
  • A hormone known as guanaylin is lost during tumor development in tubular adenomas, serrated adenomas, and MSI mutations. The loss of this hormone silences GUCY2C, a tumor-suppressing receptor. These findings suggest guanylin could be a potential biomarker to the development of colon and rectal cancers. Additionally, researchers believe there is potential for oral hormone replacement to restore the function of GUCY2C as a tumor-suppressing receptor.
• Abstract 703: Pharmacogenomics-guided chemotherapy and supportive care for patients with metastatic colorectal cancer. First Author: Pashtoon Murtaza Kasi, MD, MSc
  • Researchers conducted a study to understand the feasibility of integrating pharmacogenomic testing into clinical practice. Pharmacogenomics helps to understand how an individual will respond to certain medications based on their genes. Researchers ultimately determined that it is feasible for this type of testing to be incorporated.

Watch and wait

This year, one of the themes that emerged from GIASCO included research investigating watch and wait (WW) approaches, including the GRECCAR6 trial, and a retrospective single-center study to name a few. Watch and wait is a strategy where a treatment (such as surgery) is not given until a patient’s condition changes or symptoms appear. Their status, however, is closely monitored. Prior to GIASCO 2019, a study was published in the Journal of the American Medical Association that assessed a watch and wait strategy for rectal cancer patients who had a complete response after neoadjuvant therapy and determined that there was worse overall survival in the watch and wait group (OS=73%) versus those who had a pathologic complete response after total resection (OS=94%). Although there have been new studies highlighting watch and wait for outcomes in rectal cancer, some of which were presented at GIASCO, it is still not utilized in clinical practice. Additional research and clinical trials are needed to provide the evidence to integrate watch and wait for practices into the standard of care.

Research advocacy activities

This year, not only did research advocates attend research sessions, the Fight CRC Immunotherapy work group meeting, and poster walks to learn more about the science, but they also gained hands-on experience touring Arcus Biosciences laboratory located in Hayward, California. The afternoon began with a presentation and discussion with Arcus Biosciences president, Juan Jaen, and concluded with a field trip around the laboratory with VP of Technology, Steve Young. Research advocates had the opportunity to hear about Arcus’ clinical trial pipeline, see drugs in development, and even got a chance to look at HeLa cells under a microscope!

Being at GIASCO helped me to better prepare myself for the role of research advocate by networking with seasoned advocates and by gaining current knowledge on what’s happening in the field of GI oncology. It was a very valuable experience. -Kimberly Bush, Caregiver

Fight Colorectal Cancer believes that the patient voice is integral to the research process. We will continue advocating for research and communicating the latest out to our community of champions and fighters. If you missed our GIASCO recap webinar, be sure to listen to the recording. Dr. Dusty Deming and Dr. Nataliya Uboha break down additional research and what it means for patients. Did you see our Facebook lives with Dr. Cathy Eng and Dr. Dusty Deming?

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