{"id":9910,"date":"2022-06-10T14:13:22","date_gmt":"2022-06-10T14:13:22","guid":{"rendered":"https:\/\/colorectalcc.wpengine.com\/non-classifiee\/asco-2022\/"},"modified":"2023-08-17T07:40:10","modified_gmt":"2023-08-17T07:40:10","slug":"asco-2022","status":"publish","type":"post","link":"https:\/\/www.colorectalcancercanada.com\/fr\/blogue\/asco-2022\/","title":{"rendered":"ASCO 2022"},"content":{"rendered":"

[:en]\"\"
\nJune 2022.
\nKey Updates from ASCO 2022<\/p>\n

1. Immunotherapy treatment results in an \u201cunprecedented\u201d clinical complete response in 100% of first 14 patients with rectal cancer <\/strong><\/p>\n

In a study<\/a> of patients with locally advanced mismatch repair-deficient (dMMR) rectal cancer, 6 months of treatment with the immunotherapy agent dostarlimab-gxly alone led to a clinical complete response (the absence of all detectable cancer) in 100% of the study\u2019s first 14 patients. Currently, the standard treatment for locally advanced rectal cancer involves treatment with chemotherapy and radiation followed by surgery to remove the rectum. With the experimental treatment, none of the patients have had to undergo treatment with chemotherapy, radiation, or surgery, and there were no grade 3 or 4 adverse events experienced by the patients. By eliminating the need for standard therapies, patients are spared the significant risk of morbidities such as urinary, sexual, and defecatory dysfunction that are associated with these treatments.<\/p>\n

Though the patients have been followed for an average of only 6.8 months, four patients have been followed for nearly 2 years, and only four have received less than 6 months of the required treatment. In dMMR rectal cancer, the use of PD-1 inhibitors like dostarlimab-gxly may be a potential treatment to replace some or even all the standard of care treatments currently in place to treat rectal cancer \u2013 chemotherapy, chemotherapy plus radiation, or chemotherapy, radiation and surgery. The researchers caution, however, that the study population is small and therefore these findings must be replicated in larger populations with longer follow-up before any definitive changes to the standard of care treatment can be made.<\/p>\n

2. Use of ctDNA to identify need for adjuvant therapy in stage II colon cancer<\/strong><\/p>\n

Results<\/a> from the phase II DYNAMIC trial demonstrated that adjuvant (post-operative) chemotherapy could be omitted for patients with stage II colon cancer who did not show detectable levels of circulating tumour DNA (ctDNA) in the blood without compromising recurrence-free survival. For patients with ctDNA present in the blood after surgery, the rate of cancer recurrence was low among those that did receive adjuvant chemotherapy, suggesting a survival benefit from the additional treatment with chemotherapy.<\/p>\n

ctDNA is a tool that can detect minimal residual disease, or very small amounts of remaining cancer cells after surgery. This can be used to better predict a patient\u2019s risk for disease recurrence and selection of specific patients who are most likely to benefit from additional adjuvant therapy.<\/p>\n

The DYNAMIC study findings are encouraging because they show that with adjuvant therapy, ctDNA-positive patients can receive significant benefit from the additional chemotherapy. Next steps including a randomized trial assigning ctDNA-positive and ctDNA-negative patients to adjuvant treatment vs. no treatment, to provide more conclusive evidence of the impact or lack of impact in the two patient subsets.<\/p>\n

3. Panitumumab plus mFOLFOX6 improves Overall Survival in left-sided RAS wild-type mCRC<\/strong><\/p>\n

Findings from the PARADIGM phase III study<\/a> showed that the use of the targeted therapy panitumumab plus the chemotherapy regimen mFOLFOX6 (5-FU, folinic acid, oxaliplatin) significantly improved overall survival of patients with metastatic colorectal cancer (mCRC) tumours identified as RAS wild-type that originated on the left-side of the colon. Patients were randomly assigned to receive panitumumab plus mFOLFOX6, or bevacizumab plus mFOLFOX6. Patients who received panitumumab had an overall survival of 37.9 months vs 34.4 months for those who received bevacizumab, and experienced a 18% lower risk of death.<\/p>\n

These findings highlight the important of early molecular profiling of tumours to select the optimal treatment option for patients at the right time. If a tumour is RAS wild-type and originates on the left-side of the colon, the study findings suggest that initial treatment with panitumumab plus mFOLFOX6 is superior to first-line treatment with bevacizumab plus mFOLFOX6.[:fr]\"\"
\nJuin 2022.<\/p>\n

Les principales mises \u00e0 jour provenant de la conf\u00e9rence ASCO 2022<\/strong><\/p>\n

1. Le traitement d\u2019immunoth\u00e9rapie nous permet une r\u00e9ponse clinique compl\u00e8te \u00ab sans pr\u00e9c\u00e9dent \u00bb dans 100% des 14 premiers patients atteints de cancer colorectal \u00bb<\/strong><\/p>\n

Dans une \u00e9tude<\/a> portant sur des patients atteints d\u2019un cancer rectal localement avanc\u00e9 d\u00e9ficient en r\u00e9paration des m\u00e9sappariements (dRM)(dMMR), 6 mois de traitement avec seul l\u2019agent d\u2019immunoth\u00e9rapie dostarlimab-gxly ont conduit \u00e0 une r\u00e9ponse clinique compl\u00e8te (l\u2019absence de tout le cancer d\u00e9tectable) chez 100% des 14 premiers patients de l\u2019\u00e9tude. \u00c0 l\u2019heure actuelle, le traitement standard du cancer du rectum localement avanc\u00e9 comprend un traitement par chimioth\u00e9rapie et radioth\u00e9rapie suivi d\u2019une chirurgie pour enlever le rectum.<\/p>\n

Avec le traitement exp\u00e9rimental, aucun des patients n\u2019a d\u00fb subir de traitement de chimioth\u00e9rapie, le rayonnement, ou de chirurgie. Aucun \u00e9v\u00e9nement d\u00e9favorable n\u2019a \u00e9t\u00e9 subi par les patients de la cat\u00e9gorie 3 ou 4. En \u00e9liminant le besoin de th\u00e9rapies standard, les patients sont \u00e9pargn\u00e9s du risque significatif de morbidit\u00e9s telles que le dysfonctionnement urinaire, sexuel, et d\u00e9f\u00e9cateur qui sont associ\u00e9s \u00e0 ces traitements.<\/p>\n

Bien que les patients aient \u00e9t\u00e9 suivis pendant une moyenne de 6,8 mois seulement, quatre patients ont \u00e9t\u00e9 suivis pendant presque 2 ann\u00e9es, et seulement quatre ont re\u00e7u moins de 6 mois du traitement exig\u00e9. Dans le cas du cancer du rectum dRM, l\u2019utilisation d\u2019inhibiteurs pd-1 comme le dostarlimab-gxly peut \u00eatre un traitement potentiel pour remplacer une partie ou m\u00eame la totalit\u00e9 des traitements standard actuellement en place pour traiter le cancer du rectum \u2013 chimioth\u00e9rapie, chimioth\u00e9rapie plus radioth\u00e9rapie, ou chimioth\u00e9rapie, radioth\u00e9rapie et chirurgie. Les chercheurs mettent toutefois en garde contre le fait que la population \u00e0 l\u2019\u00e9tude est petite et que, par cons\u00e9quent, ces r\u00e9sultats doivent \u00eatre reproduits dans de plus grandes populations avec un suivi plus long avant que des changements d\u00e9finitifs puissent \u00eatre apport\u00e9s au traitement standard.<\/p>\n

Toutefois, les chercheurs exigent de prendre en consid\u00e9ration le fait que la population incluse dans l\u2019\u00e9tude est petite et que, par cons\u00e9quent, ces r\u00e9sultats doivent \u00eatre reproduits dans de plus grandes populations avec un suivi plus long avant que des changements d\u00e9finitifs puissent \u00eatre apport\u00e9s au traitement standard.<\/p>\n

2. L\u2019utilisation de l\u2019ADNtc pour d\u00e9terminer le besoin d\u2019introduire une th\u00e9rapie auxiliaire dans le traitement du cancer du c\u00f4lon de stade II<\/strong><\/p>\n

Les r\u00e9sultats<\/a> de l\u2019essai DYNAMIC de phase II ont d\u00e9montr\u00e9 que la chimioth\u00e9rapie auxiliaire (postop\u00e9ratoire) pouvait \u00eatre omise dans les cas de patients atteints d\u2019un cancer du c\u00f4lon de stade II n\u2019ayant pas d\u00e9montr\u00e9 de niveaux d\u00e9tectables d\u2019ADN tumoral circulant (ADNtc) dans le sang sans compromettre la survie sans r\u00e9cidive.<\/p>\n

Dans les cas de patients d\u00e9montrant la pr\u00e9sence d\u2019ADNtc dans le sang apr\u00e8s une chirurgie, le taux de r\u00e9cidive de cancer \u00e9tait bas parmi ceux qui ont re\u00e7u la chimioth\u00e9rapie auxiliaire. Ceci sugg\u00e8re qu\u2019il y a un avantage au niveau de la survie d\u2019administrer un traitement additionnel avec la chimioth\u00e9rapie.<\/p>\n

L\u2019ADNtc est un outil qui peut d\u00e9tecter une maladie r\u00e9siduelle minimale ou de tr\u00e8s petites quantit\u00e9s de cellules canc\u00e9reuses restantes apr\u00e8s la chirurgie. Ceci peut \u00eatre employ\u00e9 pour mieux pr\u00e9voir le risque de r\u00e9cidive chez un patient et mieux proc\u00e9der \u00e0 la s\u00e9lection des patients sp\u00e9cifiques qui sont les plus susceptibles de b\u00e9n\u00e9ficier du traitement auxiliaire suppl\u00e9mentaire.<\/p>\n

Les r\u00e9sultats de l\u2019\u00e9tude DYNAMIC sont encourageants parce qu\u2019ils d\u00e9montrent qu\u2019avec la th\u00e9rapie auxiliaire, les patients positifs \u00e0 l\u2019ADNtc peuvent b\u00e9n\u00e9ficier de mani\u00e8re significative de la chimioth\u00e9rapie suppl\u00e9mentaire. Les prochaines \u00e9tapes, y compris un essai randomis\u00e9 attribuant des patients positifs \u00e0 l\u2019ADNtc et n\u00e9gatifs \u00e0 l\u2019ADNtc \u00e0 un traitement adjuvant par rapport \u00e0 l\u2019absence de traitement, afin de fournir des preuves plus concluantes de l\u2019impact ou de l\u2019absence d\u2019impact dans les deux sous-ensembles de patients.<\/p>\n

3. Le m\u00e9lange de Panitumumab et de mFOLFOX6 am\u00e9liore la survie globale chez les patients atteints de CCRm de type RAS gauche sauvage <\/strong><\/p>\n

Les r\u00e9sultats<\/a> de l\u2019\u00e9tude de phase III PARADIGM ont d\u00e9montr\u00e9 que l\u2019utilisation du panitumumab de th\u00e9rapie cibl\u00e9e plus le r\u00e9gime de chimioth\u00e9rapie mFOLFOX6 (5-FU, acide folinique, oxaliplatine) a am\u00e9lior\u00e9 de mani\u00e8re significative la survie globale des patients pr\u00e9sentant un cancer colorectal m\u00e9tastatique (CRCm) tumeurs identifi\u00e9es comme RAS sauvage-type qui a pris naissance sur le c\u00f4t\u00e9 gauche du c\u00f4lon.<\/p>\n

Les patients ont \u00e9t\u00e9 choisis au hasard pour recevoir du panitumumab plus du mFOLFOX6, ou du b\u00e9vacizumab plus du mFOLFOX6. Les patients qui ont re\u00e7u du panitumumab avaient une survie globale de 37,9 mois comparativement \u00e0 34,4 mois pour ceux qui ont re\u00e7u du b\u00e9vacizumab. Ils pr\u00e9sentaient aussi un risque de d\u00e9c\u00e8s inf\u00e9rieur de 18 %.<\/p>\n

Ces r\u00e9sultats soulignent l\u2019importance du profilage mol\u00e9culaire pr\u00e9coce des tumeurs permettant de viser l\u2019option de traitement optimale pour les patients au propice. \u00a0Dans les cas de tumeurs de type RAS sauvage qui d\u00e9marre sur le c\u00f4t\u00e9 gauche du c\u00f4lon, les r\u00e9sultats de l\u2019\u00e9tude sugg\u00e8rent que le traitement initial avec le panitumumab plus le mFOLFOX6 est sup\u00e9rieur au traitement de premi\u00e8re intention avec le b\u00e9vacizumab plus mFOLFOX6.[:]<\/p>\n","protected":false},"excerpt":{"rendered":"

[:en] June 2022. Key Updates from ASCO 2022 1. Immunotherapy treatment results in an \u201cunprecedented\u201d clinical complete response in 100% of first 14 patients with rectal cancer In a study of patients with locally advanced mismatch repair-deficient (dMMR) rectal cancer, 6 months of treatment with the immunotherapy agent dostarlimab-gxly alone …<\/a><\/p>\n","protected":false},"author":2,"featured_media":9655,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":""},"categories":[42],"tags":[],"class_list":["post-9910","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogue"],"_links":{"self":[{"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/posts\/9910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/comments?post=9910"}],"version-history":[{"count":0,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/posts\/9910\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/media\/9655"}],"wp:attachment":[{"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/media?parent=9910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/categories?post=9910"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colorectalcancercanada.com\/fr\/wp-json\/wp\/v2\/tags?post=9910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}