NCI-CCC GI Tumor Board Question   

PUMP-2 trial combined FUDR via HAIP with gemcitabine and cisplatin, no immunotherapy was on the protocol. 

4 months of Neoadjuvant GAP resulted in conversion from unresectable to resectable. 

Based on CheckMate 577?Is DFS endpoint sufficient to establish SOC or is OS benefit needed?

Total neoadjuvant therapy (TNT) included FOLFOX x 4 months and concurrent chemo-RT

If so, how many cycles would you give? Both the MAGIC and FLOT trials showed difficulty with administering adjuvant chemotherapy.

Previously untreated

Pathology details: 75% high grade large cell neuroendocrine tumor of the cecum (20-30 mitoses per 10 hpf, Ki67 75%) and 25% adenocarcinoma. Patient ha...

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

Would you try atezolizumab/bevacizumab or switch to a TKI?

Does the advent of more effective therapies like peptide receptor radioligand therapy (PRRT) and capecitabine and temozolomide (CAPTEM) dampen enthusi...

Would you use FOLFIRINOX as in Prodige 23 or FOLFOX as in RAPIDO?

The patient went straight to gastrectomy for clinical T1 gastric adenocarcinoma, but post-op was up-graded to T4 disease.   Both ARTIST and Inte...

What are there most evidence-based options?

Upfront surgery vs neoadjuvant therapy? And if neoadjuvant therapy, which regimen? Patient has a good PS.

Would you offer chemotherapy alone per data from BILCAP or is there any role of radiation?

How would the new data presented at ASCO GI 2021 from from Alliance A021501 influence your answer?