2020 WCGIC Study Interpretation of Late Colorectal Cancer.

!---- the World Gastrointestinal Oncology Congress (WCGIC), hosted by the European Society of Oncology, is held onlineThe Bowel Cancer Program released 3 LBA studies, six oral reports, and 20 short oral reportsCompared with ASCO, although this year's WCGIC does not have significant research data published, but some exploratory studies are still worth reading, may be able to provide a reference for the majority of clinicians to carry out advanced bowel cancer researchBRAF Mutation Targeting Treatment Heat Continues: BEACON Program For First Line Treatment Limited Data Announcement This WCGIC Conference continues BRAF Mutation Target ingress, a total of 4 research data reports, including: LBA5, publication of ANCHOR research early data; LBA7, BEACON research CEA subgroup analysis; SO-21, BEACON study two drug joint program adverse reaction management; SO-25, Eli treatment BRAF V600 mutation dataANCHOR research is a one-arm, phase II study to see if the BEACON program can win a place in BRAF V600E targeted first-line therapyIt was planned to enroll 90 patients with RAS wild,BRAF V600E mutant advanced bowel cancer in the GROUP and receive three-target combination therapy in beacon studies (Encorafenib and Binimetinib sitowymonotag) with objective mitigation rates (ORR) assessed by the researchers as the primary endpointThe study group has completed a total of 95 patients, this published is the first phase of 41 patients analysis dataData analysis ends February 6, 2020At the main endpoint, the ORR was 50% (95% CI 34% to 66%), the disease control rate (DCR) was 85%, the total remission (CR), the partial remission (PR) was 20 (50%), and the disease was stable (SD) 14 (35%)Median progression-free survival (PFS) was 4.9 months (95% CI 4.4 to 8.1 months)Safety is similar to the BEACON study and has no expected exotoxicityThe incidence of adverse events (AE) was 68%, commonly for diarrhea (15%), anemia (12%), acute kidney injury (12%), nausea (7%), and abdominal pain (5%)The ANCHOR study is the first prospective study to explore first-line targeted combination therapy in populations with BRAF V600E mutationsThe patients in the study group were among the people with poor prognosis (higher median age (67 years), a higher proportion of older patients (61 percent at 65 years of age), 78 percent with at least 2 organ transfers, 51 percent peritoneal transfer, orR still reached 50 percent, median PFS was 4.9 months, and it was worth waiting for the second phase of data to be released in 2021LBA7 is an oral report supplemented later in the General Assembly to analyze the relationship between CEA levels and therapeutic outcomes in BEACON studiesAccording to the patient's baseline CEA level, it is divided into three subgroups: T1, s8 ?g/L; T2, 8 to 66 sg/L;T3, and 66 ?g/LThe lower the baseline CEA level, the lower the tumor load, the longer the expected total survival (OS), in the three-target, dual-target groups were observed similar trends, while in the control group, except for the T1 group of OS better (9.5 months), T2 and T3 median OS similar, both 4.8 months, indicating that the baseline level of CEA is greater than 8 ?g/L, after receiving a significant increase in oS after receiving conventional treatment optionsIn patients with higher baseline CEA levels, the improvement of CEA was more significant, with 52% to 60% of patients improving in the second cycle, 1% to 6% in the control group, and CEA improvement associated with better OSBeacon researchers present management experience in common adverse reactions in Encorafenib's joint sitoxixamcin programme in a short oral report on SO-21Common adverse reactions such as diarrhea, nausea, fatigue, loss of appetite, etcduring the treatment of BRAF inhibitor Encorafenib in combination with sitoxiifi, are also common in systemic therapy in advanced patientsAdverse reactions of level 3 and above occurred in more than 3% of patients, including diarrhea (3%), fatigue (4%), fatigue (4%), anemia (6%) and intestinal obstruction (5%)Compared to the control group, the double target increased the incidence of skin AE (melanosis, 16%; dry skin, 13%; itching, 11%), myalgia (15%), joint pain (23%), reduced creatinine (54%) and headache (20%)A level 2 or level 3 AE due to reoccurrence due to Encorafenib requires a four-week suspension of medication; Overall, adverse events that occur during Encorafenib-sitoxixaxontreatment are generally manageable, reversible, and rarely associated with discontinuation, and active AE management can mitigate and improve adverse reactionsResearchers from Japan shared early data on the BRAF V600E mutation in SO-25 (EPOC1701 study)As a microtube protein polymerization inhibitor, Elibrin is approved for advanced breast cancer treatmentJapanese researchers initiated the study after observing that tumors had shrunk after treatment with Elibrin in some patientsStudy into the brifle patients, received Alibin (1.4mg/m2, 1, 8 days, 21 days/cycle) as a second-line or backline treatmentThe main endpoint is ORROf the 27 patients in the group, the ORR was 0% (95% CI 0-13%), and DCR 41% (95% CI 22% to 61%)Median PFS 1.4 months (95% CI 1.2 to 2.8 months), median OS 5.3 months (95% CI 3.6 to 8.9 months)Common AE are neuscous neutrophils (70%), febrile neutrophils (22%), anorexia (30%) and hair loss (22%)The study did not reach a pre-set endpoint, and biomarker analysis is under way in the hope of screening out the beneficiaries Immunotherapy: The continued exploration of a new program in the MSS population was launched at the ASCO conference OF THE ASCO CONFERENCE 1 month ago, changing the pattern of microsatellite highly unstable (MSI-H) first-line treatment But immunotherapy is still struggling to find out in larger populations of microsatellite stabilization (MSS) patients Data on the MSS population released at this meeting included: O-20, Rigofini combined navuliu monotomoine in the pMMR population of an I/I.B study; SO-26, PD-1 monoanti-combined BRAF inhibitors and MEK inhibitors used in the BRAF V600E mutation population Richard Kim, a researcher from the United States, published I./I.B data from The Ragofeni in conjunction with Navuli U-Syndite in oral report 20 As of March 2020, 28 patients with advanced pMMR bowel cancer who failed front-line treatment were studied The study was divided into two stages: 12 patients in the first phase, the treatment plan was Navuyu monoto-resuptic 240mg q2w, the rigofini dose increased, in turn, 80 mg, 120 mg, 160 mg; The main endpoint is to determine MTD In a phase-one dose increase study, the recommended dose of rigofini was determined to be 80 mg Of the 21 patients who could evaluate efficacy, the ORR was 4.8%, one was PR, and there was no CR DCR is 71.4% Median PFS was 4.3 months (95% CI 2.1 to 15.6 months) and median OS was 11 months (95% CI 5.9 months to not reach) The main adverse reactions of the level of 3 were rashes (14.3%), hypertension (14.3%), and anemia (7.1%) Overall, the Rigofini joint Navuliu monobitination program achieved some efficacy in the post-line therapy of MSS patients, biomarker analysis is under way, and the second phase continues to enter the group Full data release for the second phase is expected SO-26 explores the efficacy of anti-PD-1 monoanti-combined BRAF inhibitors and MEK inhibitors in the BRAF V600E mutation population (NCT03668431) It is planned to join 25 patients with BRAF mutations, receive Spartalizumab (anti-PD-1 monobagain) 400mg q4w, union Darafini 150mg PO BID and Qumetinib 2mg PO day At present, 21 patients, 17 msS and 4 MSI cases have been enrolled Of all patients, THE ORR was 33% and DCR was 76%, and in MSS people who had not received BRAF inhibitors and immunotherapy, the ORR was 38% and the DCR was 92% Level 3 and above AE includes elevated lipase (14.2%), serum amylase (9.5%), fever (9.5%), colitis (4.7%) and so on Paired baselines and 15-day biopsies in single-cell RNAseq analysis, changes in gene expression of tumor cells and immune cells, increased cytotoxic T-cell immersion, MAPK pathway activation tumor cells decreased, suggesting potential synergies between PD-1 and targeted inhibitors Based on this result, the study expanded the group and included 15 patients with MSS BRAF V600E mutation advanced bowel cancer who had not previously received BRAF inhibitors and anti-PD-1 treatment, and expected a breakthrough in this part of MSS with BRAF mutation patients Summarizing the progress of internal medicine at this conference, BRAF V600E mutation metastatic colorectal cancer patients have a poor prognosis, BEACON study confirmed that a variety of targeted drugs combined treatment of such patients feasible and significant benefits, for such patients to improve survival of new hope The ANCHOR study, presented at this conference, is the first to explore targeted combination first-line therapy in the BRAF V600E mutation population, and although the patients in the group are the population with poor prognosis, the ORR is still 50 percent, with the median PFS at 4.9 months, and the second phase of data is expected to be released in 2021 The 2020 ASCO KEYNOTE-177 shines to change the landscape of MSI-H first-line therapy But in the larger population of MSS patients, immunotherapy is still difficult to explore, in addition to the Rigofini joint Navuliu monototherapy in MSS patients to achieve some efficacy, NCT03668431 study to explore the efficacy of anti-PD-1 monoanti-combined BRAF inhibitors and MEK inhibitors in the population of BRAV600E mutations Through single-cell RNAseq analysis, this treatment strategy can make changes in gene expression of tumor cells and immune cells, increase cytotoxic T-cell immersion, MAPK pathway activation tumor cells decrease, suggesting potential synergies between PD-1 and targeted inhibitors This biomarker division of different populations, in the immune microenvironment better potentially beneficial MSS population, to explore the use of chemotherapy-free drugs for combination of targeted therapy, there is a potential breakthrough, for poor prognosis braF V600E mutation patients to provide new treatment options We look forward to more clinical studies in the future Wang Xiu asked, director physician, professor, doctoral tutor, director of chemotherapy department of Qilu Hospital, Shandong University, director of the Chinese Society of Clinical Oncology (CSCO), member of the Oncologist Branch of the Chinese Physicians Association, chairman of the professional committee of bio-oriented therapy of Shandong Biomedical Engineering Society, deputy chairman of the Shandong Medical Association's cancer credit committee, member of the professional group of the Committee of Rational Drug Administration anti-tumor drugs, China Lung Cancer Journal, International Journal of Oncology, Shandong University Medical Journal, Linda Source: Tumor Information, !-- Content Presentation Ends - !-- Determine stoate at end.