JSCO2016: International Session 3 Gastric Cancer

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The 54th Annual Meeting of Japan Society of Clinical Oncology (JSCO2016)

"Renovation of Cancer Medicine in the Mature Society"



International Session 1: Lung Cancer
International Session 2: Colorectal Cancer
International Session 3: Gastric Cancer
International Session 4: Urological Cancer (Prostate and Renal Cancer)
International Session 5: Supportive Care for Adverse Events
International Session 6: Gynecological Cancer (Uterine Body Cancer and Ovarian Cancer)
International Session 7: Central Nervous System Tumor
International Session 8: New Development of Particle Beam Therapy for Cancer
International Session 9: International Cooperation in Radiation Medicine
International Session 10: Recent Advances In Cancer Immunotherapy
International Session 11: Breast Cancer
International Session 12: Pharmacology of Antitumor Agents: New Drug Application (NDA)
International Session 13: Malignant Lymphoma
International Session 14: Palliative Care
International Session 15: Radiation Therapy
International Session 16: Head and Neck Cancer
International Session 17: Skin Cancer (Malignant Melanoma)
International Session 18: Hepato-Biliary and Pancreas Cancers
International Session 19: Leukemia
International Session 20: Ethics for Clinical Research
International Session 21: Esophageal Cancer
International Session 22: Bone and Soft Tissue Tumor
FACO/JSCO Joint Symposium

Abstract Archives (in Japanese)


International Session 3: Gastric Cancer


Gastric cancer treatment guideline in Japan
Keisuke Koeda (Department of Surgery, Iwate Medical University)
The standard treatment for gastric cancer has been generally regulated by treatment guideline in Japan. The Japanese Gastric Cancer Treatment Guide Line (JGL) was first published in 2001 to provide general as well as specialized clinicians with knowledge on standard treatments, based on evidence where available, and consensus. The current fourth edition of JGL was published in 2014.
The JGL has been updated promptly on the website from the Japanese Gastric Cancer Association. Here I describe the latest topics of surgery and chemotherapy with some introductions in our daily practice.
Surgery: The standard operations are total and distal gastrectomy with D2 lymph-nodes dissection. Several limited operations such as proximal gastrectomy, pylorus preserving gastrectomy, and laparoscopic gastrectomy are often performed mainly for early stage cancers. Recently, the results of two RCTs by Japanese Clinical Oncology Group (JCOG) have been reported. JCOG 0110 recommends that prophylactic splenectomy should be avoided in total gastrectomy for proximal gastric cancer because cancer does not invade the greater curvature. JCOG 0705 (REGATTA) showed no survival benefit of additional gastrectomy over chemotherapy alone in patients with non-curative advanced gastric cancer.
Chemotherapy: Two agents, oxaliplatin and ramcirumab, have been newly approved for gastric cancer. Oxaliplatin is mainly used for first-line treatment in non-resectable or recurrent cancer, and for adjuvant chemotherapy. Ramcirumab is used for second-line treatment with or without paclitaxel. The prolonged overall survival may be expected by these agents, but there seems to be issues that should be resolved (patient selection, appropriate dose and toxicity management).


Gastric cancer: 2015-2016 in review in Europe
Andrés Cervantes (Medicine, Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Spain)
This abstract aims at reviewing the most important aspects reported by European investigators during the current and last year. This presentation will be covering the main international oncology journals as well as international congresses as ESMO or ASCO. The topics covered will cover the multidisciplinary treatment of localized gastric and gastro-esophageal junction cancers, the treatment of advanced or metastatic tumors, including targeted therapies and some relevant aspects of translational research. An special attention will be given to mechanisms of resistance of HER2 amplified tumors, the role of the FGFR and MET pathway, as well as to the development of experimental therapies.The importance of tumor heterogeneity and the impact of the new molecular classification will be also underlined.


Gastric cancer: Year in review in Asia
Hyun Cheol Chung (Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Korea)
During the last 10 years, many progresses in advanced gastric cancer made strong evidences in survival prolongation and quality care of palliative chemotherapy comparing to best supportive care. This consensus includes doublet regimen in the first-line treatment in Asia comparing to triplet regimen in Western countries, and clinical rationale for the second-line and third-line chemotherapy. As a first-line, platinum or 5-fluorourail-based regimen is the golden standard, while paclitaxel is the treatment of choice as a second-line. Even if paclitaxel plus ramucirumab is approved as the second-line regimen, this regimen is not used as a routine practice due to reimbursement issue of ramucirumab. For HER2 positive patients, since XP/FP plus trastuzumab was approved as a standard treatment, there have been no data for the better combination regimen as a first-line or second-line for the failures. Unfortunately GATSBY trial could not showed the superiority of T-DM-1 over paclitaxel as a second-line treatment even if it has a good tolerability.
Last year, there has been a break out in immune-oncology treatment. Many trials are being done in first-line, second-line and third-line treatment designs, combination designs with chemotherapy or immune-oncology agents, head-to-head designs between immune-oncology agent and chemotherapy, maintenance treatment after induction of first-line treatment. As more targeted agents are being developed with potential efficacy and tolerable toxicity pattern and more knowledge of genomics are being gathered, single drug and multi-target, multi-drug and multi-target trials are being tried very rapidly. In the basket trial, gastric cancer is enrolled as a separate cohort or multi-drugs are being tested in gastric cancer as an umbrella design. During the last year, genome knowledge-based clinical trial, trial with immune-oncology agent and targeted agent were the key words in gastric cancer. New trials and finding will be discussed in detail.


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