Tom Bird Clinical Oncologist Bristol Haematology & Oncology Centre

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Presentation transcript:

Tom Bird Clinical Oncologist Bristol Haematology & Oncology Centre Oncology Update Tom Bird Clinical Oncologist Bristol Haematology & Oncology Centre UGI SSG Meeting 10th May 2019

Topics Action points from last meeting Current Trials SWAG Oncology Guidelines Oncology Journal Watch

Action Point 1: It may be relevant to look into intra-peritoneal oncology treatment for palliative patients which is surgically delivered via a port-a-cath; this will be discussed with the oncologists.

Intraperitoneal Chemotherapy No high level prospective evidence of a prolonged survival benefit in gastric cancer in either radical or palliative setting GASTRICHIP trial evaluating adjuvant HIPEC Colorectal: No established role Ovarian: ?Possible survival benefit but not routinely used

Intraperitoneal Chemotherapy X X X

Action Point 2: Oesophageal & Junctional Adenocarcinoma: The guidelines on who is suitable to receive tri or bi modality need to be clarified after results of a related clinical trial have been published.

European Journal of Cardio-Thoracic Surgery, Volume 51, Issue 3, March 2017, Pages 421–431, https://doi.org/10.1093/ejcts/ezw315

European Journal of Cardio-Thoracic Surgery, Volume 51, Issue 3, March 2017, Pages 421–431, https://doi.org/10.1093/ejcts/ezw315

NEOAEGIS ESOPEC

Topics Action points from last meeting Current Trials SWAG Oncology Guidelines Oncology Journal Watch

Current BHOC Trials Oesophago-gastric Peri-op: NEOAEGIS KEYNOTE 585 Radical: SCOPE2 Post-radical: ADDASPIRIN CYTOFLOC 1st line palliative: PLATFORM Pancreas Peri-op: None 1st line palliative: P.PANC / PRIMUS (good PS): 1st line palliative: ACCELERATE (poor PS) HCC Locally advanced: TACE-3 Advanced: COSMIC-312 Biliary tract 1st line palliative: TOPAZ-1

Topics Action points from last meeting Current Trials SWAG Oncology Guidelines Oncology Journal Watch

SWAG Oncology Guidelines Local Guidelines for use in BHOC clinic Potential to adopt/adapt them to be network guidelines Weston Taunton

Topics Action points from last meeting Current Trials SWAG Oncology Guidelines Oncology Journal Watch

DFS: 1 year: 69.0% vs. 53.7% 2 years: 47.0% vs. 30.7% 3 years: 39.7% vs. 21.4%

PDL1≥1 Median OS: 9·1 months (95% CI 6·2–10·7) vs. 8.3 months

Pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer: Phase III KEYNOTE-181 study

Median OS: 35mo (95%CI 27- 46) vs. 50 months (95%CI 38-NR) Est 3yr OS: 48% (95%CI 43-54) vs. 57% (52-62) Est 5yr OS: 36% (95%CI: 30-42) vs. 45% (38-51)

30 day post-op death: 2% in the FLOT group vs. 3% in the ECF/ECX group Surgical complications: 51% in the FLOT group vs. 50% in the ECF/ECX group 90-day mortality rate: 8% in the ECF/ECX vs. 5% in the FLOT group

Questions & Discussion