Highlights From #GI21 with Dr. Marcia Cruz-Correa

In today's episode, Dr. Marcia Cruz-Correa, executive director of the University of Puerto Rico Comprehensive Cancer Center, discusses key abstracts from the 2021 Gastrointestinal Cancers Symposium.

Transcript

ASCO Daily News: Welcome to the ASCO Daily News podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. My guest today is Dr. Marcia Cruz-Correa. She is the executive director of the University of Puerto Rico Cancer Center, where she also leads the gastrointestinal cancer program.

Dr. Cruz-Correa served as the chair of the 2021 Gastrointestinal Cancer Symposium, and joins me today to share some highlights from the meeting. She receives research funding from the Pan American Center for Oncology Trials. Dr. Cruz-Correa, welcome to the ASCO Daily News podcast.

Dr. Marcia Cruz-Correa: Thank you very much. My pleasure to be part of this podcast.

ASCO Daily News: The symposium covered a vast array of studies across the spectrum of gastrointestinal malignancies, and it explored some very timely and important issues, including disparities in cancer care and COVID-19 vaccines. What are some of the highlights that you'd like to share with us today?

Dr. Marcia Cruz-Correa: Many people contributed to making GI21 an overwhelming success. This was a challenge amid all the distance and all the logistics. But we really were able to engage a community of practicing medical oncologists, surgical oncologists, gastroenterologists among many other health care providers and also allied professions, as well as industry. And I can tell you that there were a few overarching themes that I want to maybe highlight.

And for me, one of them was how global we are as a community of practicing physicians and oncologists. We deal with patients that present usually with advanced disease. And we try to integrate the best science, and marry that with what you have available.

And one aspect that was very important, and was seen in multiple abstracts, is that nowadays, even though we have targeted therapy and we try to identify that special biomarker that is present in the patients that you're treating, unfortunately, sometimes one marker is not enough. And several abstracts highlighted the importance of combination therapy, where you have chemotherapy therapy, classic cytotoxic therapy, along with targeted therapy. And there were a few abstracts that look into that.

There's one which is the IMbrave study, and the CheckMate 040 study. Those are Abstract 478, where the investigators were highlighting how combining therapy for patients with hepatocellular carcinoma--it's really the way to go, and they look at three different immunotherapy dosing, with two checkpoint inhibitors, and then a chemotherapy, specifically cabozantinib. And they were able to show that the combination of agents seemed to work better.

And this was repeated in several abstracts, showing you that it's not a one drug fits all. And I think that that's important to keep in mind. Because I think as a scientist, we like to simplify, right? We like to go down to one target, one disease, one treatment. And that's the best way to think about processes, right? Because it's cleaner.

But human beings are not that simple, right? We have the heterogeneity, not only in the genes that we inherit, but also in the cells that become damaged, and then they are malignant cells. So when you think about one target, of course, that's the simplest way to see it, and it's wonderful that we can actually evaluate that. But that will not be the answer for all the patients.

So we're learning that even when you classify it and you identify a signature for that particular patient, it might be that it only represents a small percentage of all the signatures that the patient has. So it's almost like in one way, we are trying to simplify, but in the other one, we realize the complexity of dealing with patients with cancer.

ASCO Daily News: Absolutely. Are there other abstracts that stand out for you that you believe will be practice-changing?

Dr. Marcia Cruz-Correa: Yes. Yes, absolutely. There are a few. I want to mention one abstract, Abstract 160. It's the FIGHT trial, which stands for first-line treatment of advanced gastric/gastroesophageal junction adenoma. I love the title, FIGHT. Because that's what we do with our patients, right?

But this abstract was wonderful, because it demonstrated that evaluating a specific agent--in fact, in this particular trial, we were looking at the combination therapy for patients with gastric cancer. And the biomarker that was evaluated, it's FGFR2b. Basically, it's in the epithelium. It's a receptor that was evaluated by doing immunohistochemistry.