GemCap ny standard for adjuvant behandling pancreas cancer. PRRT behandling ved NET veldokumentert og må snarest etableres i Norge. Immunterapi ved metastatisk MSI-H kolorektal cancer gir langtidsoverlevere. Halfdan Sørbye, prof Haukeland Univ Sykehus Slide 7 Presented By John Neoptolemos at 2016 ASCO Annual Meeting Survival by Treatment Presented By John Neoptolemos at 2016 ASCO Annual Meeting Treatment Effect by R-Status Er nå ny standard. Innsendt NEJM Formell beslutning fra NGICG gjøres etter publikasjonen. I mellomtiden…….. Presented By John Neoptolemos at 2016 ASCO Annual Meeting ● ● ● Kan gi problemer i tolkningen av 2 andre pågående adjuvante studier: Gem/nab-paclitaxel vs gemcitabine alene (ferdig inkl) FOLFOXIRI vs gemcitabine Behandling ved operable ventrikkel cancer Background (2) Presented By Marcel Verheij at 2016 ASCO Annual Meeting Trial design Presented By Marcel Verheij at 2016 ASCO Annual Meeting Results: Study Profile Presented By Marcel Verheij at 2016 ASCO Annual Meeting Ingen hensikt å bytte til postopr kjemoradioterapi Results: Overall Survival Adjuvante studier: behandling gis preoperativt Presented By Marcel Verheij at 2016 ASCO Annual Meeting Nevroendocrine tumores (NET) Nordiske 2014 Guidelines: Metastaser fra NET i tynntarm. Peptid Reseptor Radionukleotide Therapy = PRRT SA + Chelator + Radioisotope = 90Y-DOTATOC 177Lu-DOTATOC SSR NET cell Slide 4 Presented By Jonathan Strosberg at 2016 ASCO Annual Meeting Progression-Free Survival Presented By Jonathan Strosberg at 2016 ASCO Annual Meeting MVi MÅ nå få denne behandling etablert i Norge. Overall Survival (interim analysis) Per i dag mye for pengene: 32 m for 350 000kr 50 pasienter sendes årlig til 200 behandlinger i utlandet (for få..) OUS søkt HSØ - tidligst 2018 + midler overføres fra utenlandsbudsjettet Presented By Jonathan Strosberg at 2016 ASCO Annual Meeting Slide 4 5% Presented By Dung Le at 2016 ASCO Annual Meeting Slide 6 Presented By Dung Le at 2016 ASCO Annual Meeting Slide 14 Presented By Dung Le at 2016 ASCO Annual Meeting Slide 13 Presented By Dung Le at 2016 ASCO Annual Meeting Slide 17 Presented By Dung Le at 2016 ASCO Annual Meeting Slide 18 Hva sier vi til våre pasienter ?? Teste for MSI før oppstart 1linje sammen med RAS/BRAF Presented By Dung Le at 2016 ASCO Annual Meeting HER2 testing ved mCRC? ● ● ● 5% HER2 amplifisert ved mCRC 2 studie kohorter viser HER2 amplikasjon negative prediktiv markør for effekt av EGFR-hemmer behandling (like mye som RAS mutasjon). Relevant for 1 av 8 pasienter som får EGFR-hemmer i dag…… Nivolumab ± Ipilimumab in Treatment of Patients With Metastatic Colorectal Cancer With and Without High Microsatellite Instability: <br />CheckMate 142 Interim Results Presented By Michael Overman at 2016 ASCO Annual Meeting Slide 8 Presented By Neil Segal at 2016 ASCO Annual Meeting Investigator-Assessed Best Overall Response in <br />Patients With MSI-H Receiving Nivolumab + Ipilimumab Presented By Michael Overman at 2016 ASCO Annual Meeting MSS Clinical activity and safety of cobimetinib and atezolizumab in colorectal cancer Presented By Johanna Bendell at 2016 ASCO Annual Meeting PD-L1 and MEK Inhibition: A Rational Combination Presented By Johanna Bendell at 2016 ASCO Annual Meeting Slide 17 Presented By Neil Segal at 2016 ASCO Annual Meeting Medikamentell behandling ved metastatisk colorektalcancer Studie: BRAF + MEK hemmer 1. linje 2. linje mut BRAF FOLFOXIRI±bev FOLFIRI (FLIRI) + EGFR-hemmer FLIRI FOLFIRI FOLFOX (FLOX/CAPOX) ± bevacizumab FOLFIRI (FLIRI) + bevacizumab FLOX/CAPOX FOLFOX Regorafenib Studie? Sequencial treatment (elderly/fragile) FLOX/CAPOX FOLFOX Flv/Capecitabine/ S-1 (Nordic9) ±bevacizumab FLIRI FLOX/CAPOX Irinotecan FLIRI/ FOLFIRI Cetuximab/panitumumab ± irinotecan 3. linje 3/4 .linje Intensified treatment WT-RAS MSI-H Palliativ intensjon WT-RAS FIRE-3: Sidedness is prognostic… Presented By Kimmie Ng at 2016 ASCO Annual Meeting CALGB/SWOG 80405 Presented By Alan Venook at 2016 ASCO Annual Meeting Venook et al: Major findings Presented By Kimmie Ng at 2016 ASCO Annual Meeting Overall Survival by Sidedness and Biologic Presented By Alan Venook at 2016 ASCO Annual Meeting Lee et al: Major findings Presented By Kimmie Ng at 2016 ASCO Annual Meeting Should EGFR antibodies be withheld in the first-line setting from patients with right-sided primaries? Presented By Kimmie Ng at 2016 ASCO Annual Meeting Slide 4 Presented By Jeanne Tie at 2016 ASCO Annual Meeting Circulating Tumor DNA (ctDNA) Presented By Jeanne Tie at 2016 ASCO Annual Meeting The Potential of Circulating Tumor DNA (ctDNA) to Reshape The Design of Clinical Trials Testing Adjuvant Therapy in Patients with Early Stage Cancers Presented By Jeanne Tie at 2016 ASCO Annual Meeting ● ● ● Methods: 231 pts with Stage II colon cancer Plasma samples collected starting 4-10 weeks after surgery. Somatic mutations in pts' tumors were identified via sequencing, then designed personalized assays to quantify ctDNA in plasma samples. Recurrence-Free Survival<br />(Patients not treated with chemotherapy) Presented By Jeanne Tie at 2016 ASCO Annual Meeting Slide 11 Presented By Jeanne Tie at 2016 ASCO Annual Meeting Slide 15 Presented By Jeanne Tie at 2016 ASCO Annual Meeting
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