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Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer Friday, January 21, 2011 7:00 PM – 9:30 PM San Francisco, California Moderator Neil Love, MD Eileen M O’Reilly, MD Eric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD

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Page 1: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Faculty

National GI Tumor Board

Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer

Friday, January 21, 20117:00 PM – 9:30 PM

San Francisco, California

ModeratorNeil Love, MD

Eileen M O’Reilly, MDEric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD

Charles D Blanke, MDDavid Cunningham, MDSteven A Curley, MD

Page 2: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Case presented by Dr Polkinghorn

• 66 yo man: PMH- Hepatitis C and rising AFP (120K)– ? missed diagnosis, now multiple hepatic lesions

consistent with HCC. Child Pugh B cirrhosis • 2/2010: Treated with TACE x 3 falling AFP• Sorafenib (before and following TACE) x 4-6 mos

– AFP to 300 but toxicity (? related to underlying cirrhosis)

• Cytopenias, HFS, diarrhea, abdominal pain• Sorafenib on hold. AFP remains low

Page 3: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Page 4: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Case presented by Dr Polkinghorn

• 66 yo man: PMH- Hepatitis C and rising AFP (120K)– ? missed diagnosis, now multiple hepatic lesions

consistent with HCC. Child Pugh B cirrhosis • 2/2010: Treated with TACE x 3 falling AFP• Sorafenib (before and following TACE) x 4-6 mos

– AFP to 300 but toxicity (? related to underlying cirrhosis)

• Cytopenias, HFS, diarrhea, abdominal pain• Sorafenib on hold. AFP remains low

Page 5: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Page 6: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Case presented by Dr Polkinghorn

• 66 yo man: PMH- Hepatitis C and rising AFP (120K)– ? missed diagnosis, now multiple hepatic lesions

consistent with HCC. Child Pugh B cirrhosis • 2/2010: Treated with TACE x 3 falling AFP• Sorafenib (before and following TACE) x 4-6 mos

– AFP to 300 but toxicity (? related to underlying cirrhosis)

• Cytopenias, HFS, diarrhea, abdominal pain• Sorafenib on hold. AFP remains low

Page 7: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

First Interim Results of the Global Investigation of Therapeutic Decisions in Hepatocellular Carcinoma (HCC) and of its Treatment with Sorafenib (GIDEON) Study: Use of Sorafenib by Oncologists and Nononcologists in the Management of HCC

Venook AP et al. Proc ASCO GI 2011;Abstract 157

Page 8: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

GIDEON Study: First Interim Analysis

Venook AP et al. Proc ASCO GI 2011;Abstract 157.

42%

76%

28%

35%

0% 20% 40% 60% 80% 100%

TreatmentEmergent

Serious AEs

Sorafenib 800 mgInitial Dose

CP-B

Stage 4

Page 9: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Case presented by Dr Polkinghorn

• 66 yo man: PMH- Hepatitis C and rising AFP (120K)– ? missed diagnosis, now multiple hepatic lesions

consistent with HCC. Child Pugh B cirrhosis • 2/2010: Treated with TACE x 3 falling AFP• Sorafenib (before and following TACE) x 4-6 mos

– AFP to 300 but toxicity (? related to underlying cirrhosis)

• Cytopenias, HFS, diarrhea, abdominal pain• Sorafenib on hold. AFP remains low

Page 10: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Faculty

National GI Tumor Board

Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer

Friday, January 21, 20117:00 PM – 9:30 PM

San Francisco, California

ModeratorNeil Love, MD

Eileen M O’Reilly, MDEric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD

Charles D Blanke, MDDavid Cunningham, MDSteven A Curley, MD

Page 11: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Doxorubicin plus sorafenib vs doxorubicin alone in patients with advanced hepatocellular carcinoma: a randomized trial

Abou-Alfa GK et al.JAMA 2010;304(19):62154-60

Page 12: Copyright © 2011 Research To Practice. All rights reserved. Faculty National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current

Copyright © 2011 Research To Practice. All rights reserved.

Case presented by Dr Polkinghorn

• 66 yo man: PMH- Hepatitis C and rising AFP (120K)– ? missed diagnosis, now multiple hepatic lesions

consistent with HCC. Child Pugh B cirrhosis • 2/2010: Treated with TACE x 3 falling AFP• Sorafenib (before and following TACE) x 4-6 mos

– AFP to 300 but toxicity (? related to underlying cirrhosis)

• Cytopenias, HFS, diarrhea, abdominal pain• Sorafenib on hold. AFP remains low