IBS, ABS….AND ABS? GP EDUCATION NIGHT 25 TH FEB 2015 DR KATRIN (New trials, new drugs and good advice)

EVERYTHING OLD IS NEW AGAIN… New treatments Old treatments Old news New trials

NEW DRUGS Some promising  Regorafenib in advanced oesophago-gastric ca

‘OLD TREATMENTS’ Aspirin  Beneficial in high risk groups as primary prevention  FAP, Lynch syndrome  Latency period of 5+ years  Under investigation for secondary prevention  ASCOLT study  Adding adjuvant aspirin vs placebo following completion of adjuvant treatment  AGITG/Australia participating

OLD NEWS (FOR SOME)? Effect of exercise  Evidence in other cancers  secondary prevention/breast  CHALLENGE (CO21)  Structured exercise programme plus general health advice vs health advice only  Currently enrolling St George (TSH shortly)  Medically fit colon cancer patients (high risk stage II and stage III) completed adjuvant chemotherapy within the past days. Current physical activity levels 150 minutes of moderate-to-vigorous or >75 minutes of vigorous exercise/week).  ECHO  Exercise during adjuvant chemotherapy for ovarian cancer

NEW TYPES OF TRIALS One site, many diseases Baskets, buckets & umbrellas

NEW TYPES OF TRIALS Considering different targets within the one cancer type  E.g. IMPACT – molecular targets in pancreas cancer Considering common targets across different primary cancer types Worldwide approaches – baskets, buckets & umbrellas Australia – GCCTI

“BASKET/BUCKET” Evaluate effect of a single drug on a single mutation in a variety of cancers

Evaluate impact of different drugs on different mutations either in a single type of cancer or a variety of tumour types e.g. PARAGON (ANZGOG ) “UMBRELLA” TRIALS

PERSONALISED/PRECISION TRIALS Tumours tested for ‘actionable’ mutations Targeted vs ‘standard’ (e.g. MPACT)

QUESTIONS