Projects / Strategies for the next years
This summer the GI Group established a new strategy plan and decided to concentrate its efforts for the next three years on the following five priorities:
- TR in collaboration with the Pathobiology and PAMM Groups;
- PET-scan imaging in collaboration with the Imaging Group;
- Management of liver metastasis from CRC;
- Management of elderly patients in collaboration with the ETF;
- Development of a young investigator promotion program.
With this ambitious strategy plan the GI Group hopes to improve synergies in the development of innovative concepts.
New trial projects were developed along these lines:
The EORTC 40081-22083 protocol, IMAGE Response-guided therapy of locally advanced adenocarcinoma of the gastroesophageal junction, has been developed in collaboration with the EORTC Radiation Oncology Group. The trial aims to implement a PET imaging-based treatment algorithm into the neoadjuvant and multimodal care of locally advanced adenocarcinoma at the esophago-gastric junction (EGJ). The current study proposal separates patients who undergo preoperative chemotherapy for locally advanced EGJ cancer into two biologically distinct subgroups: one subgroup for early metabolic responders (with a relatively good prognosis) who will receive standard chemotherapy, and another subgroup for metabolic nonresponders for whom the protocol foresees a randomization into early discontinuation of chemotherapy followed by immediate resection versus an intensified salvage chemoradiation regimen followed by elective resection.
The EORTC 40092 CLOCC2 trial was developed following the EORTC 40004 CLOCC trial, a randomized phase III study of local treatment of liver metastases by radiofrequency ablation (RFA) combined with chemotherapy versus chemotherapy alone in patients with unresectable colorectal liver metastases (ASCO 2010). The CLOCC 2 trial is an innovative study concept combining antigen release and an immune-stimulating antibody for treatment of liver metastases.
The EORTC 40085-75083 trial, Treatment of KRAS wild type advanced CRC patients with 5-FU versus 5-FU+ Cetuximab based on a comprehensive geriatric assessment, was developed in collaboration with the EORTC Cancer in the Elderly Task Force (ETF). This study will enroll patients with advanced CRC who are aged ≥ 80 years or ≥ 70 years having functional limitation.
A recent proposal of the GI Group Colorectal Cancer Task Force is a phase II trial of epidermal growth factor receptor (EGFR) antibody monotherapy in selected patients with metastatic CRC. The aim of this trial will be to explore whether a chemotherapy-free, antibody- based schedule with an EGFR antibody has an acceptable activity for first line therapy of CRC patients with high probability of response to EGFR. In parallel, together with EORTC Headquarters and the Translational Research task force, the setting of a GI screening platform will be advanced. The concept for future studies will be to investigate patients’ tumor for molecular markers in a centralized, multi-laboratory screening platform and, according to the results, offer patients to participate in one of a set of different parallel studies according to their tumor molecular pedigree.