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We are reporting from the 2023 ESMO Congress!

Get ready for highlights of some of the top news presented each day during the meeting—and soon we’ll speak with Dr Filippo Pietrantonio to discuss some new data in gastrointestinal cancer.

Welcome to OncLive News Network! I’m Caroline Seymour.

Findings from the phase 3 CodeBreaK 300 trial (NCT05198934) showed that the combination of sotorasib (Lumakras) and panitumumab (Vectibix) led to a significant improvement in progression-free survival (PFS) vs standard of care chemotherapy in patients with chemotherapy refractory 

 G12C–mutant metastatic colorectal cancer. Moreover, the combination was tolerable and resulted in lower rates of grade 3 or greater treatment-related adverse effects vs standard of care therapy.

In the phase 3 KEYNOTE-671 trial (NCT03425643), neoadjuvant therapy with pembrolizumab (Keytruda) plus chemotherapy followed by resection and adjuvant pembrolizumab produced a statistically significant improvement in overall survival (OS) compared with neoadjuvant chemotherapy and resection alone in patients with resectable stage II, IIIA, or IIIB (N2) non–small cell lung cancer. Median OS was not reached (NR) (95% CI NR-NR) in the pembrolizumab arm vs 52.4 months (95% CI 45.7-NR) in the placebo arm, reflecting a 28% reduction in the risk of death.

Finally, in results from the phase 3 PSMAfore trial (NCT04689828), treatment with 

Lu-PSMA-617 (LuPSMA; lutetium Lu 177 vipivotide tetraxetan; Pluvicto) prolonged radiographic PFS (rPFS) vs an androgen pathway receptor inhibitor change in taxane-naive patients with PSMA-positive metastatic castration-resistant prostate cancer, with a favorable safety profile. At a median follow-up of 15.9 months, the hazard ratio for rPFS was 0.43 in favor of the radioligand therapy. 

Please be sure to check out more of our coverage from the 2023 ESMO Congress at OncLive.com.

That’s all for today. Tomorrow, we’ll sit down with Drs Jacob Sands, Ignace Vergote, Paolo Tarantino, and Yelena Janjigian, who will share their perspectives on breaking research in lung, gynecologic, breast, and gastrointestinal cancers.

Thank you for watching OncLive News Network: On Location, I’m Caroline Seymour.

Videos

OncLive® will be LIVE with OncLive® News Network: On Location at the 2023 ESMO Congress. Each day, we will broadcast a series of interviews with top thought leaders, to learn their thoughts and reactions to data presented across oncology during the conference.

Gathering Insights in Gastrointestinal Cancers From ESMO 2023: Dr Pietrantonio

Filippo Pietrantonio, MD, medical oncologist, Fondazione IRCCS Istituto Nazionale dei Tumori, discusses the primary results from the phase 3 CodeBreak 300 trial (NCT05198934) of sotorasib (Lumkras) plus panitumumab (Vectibix) in 

 G12C–mutated metastatic colorectal cancer (mCRC).

This study compared sotorasib, a KRAS G12C-inhibitor, in combination with panitumumab, an anti-EGFR antibody, vs the standard of care (SOC) in patients with chemorefractory 

 G12C–mutated mCRC who had progressed on 1 to 3 prior lines of therapy.

Pietrantonio explains that patients were randomly assigned to 1 of 3 dosing regimens: sotorasib at 960 mg daily plus intravenous (IV) panitumumab at 6 mg/kg, 240 mg of sotorasib daily plus IV panitumumab 6 mg/kg, or investigator's choice of regorafenib (Stivarga) or trifluridine/tipiracil (TAS-102; Lonsurf).

The study successfully met its primary end point, with both combination arms showing significantly improved progression-free survival (PFS) compared with SOC, Pietrantonio reports. The 960 mg dosing regimen demonstrated a clinically meaningful benefit in PFS, overall response rate, disease control rate, and duration of response, followed by the 240 mg dose, and the SOC. Overall survival (OS) data were not mature at the time of data cutoff. Regarding safety, the combination's toxicity profile was deemed manageable and consistent with that of the individual components, Pietrantonio states.

Overall, this study represents the first phase 3 trial evaluating a KRAS G12C inhibitor with an anti-EGFR antibody in chemorefractory mCRC, Pietrantonio says. The results indicate that sotorasib and panitumumab combinations elicit superior PFS and other efficacy outcomes, with manageable safety profiles compared to standard of care, he concludes. 

Filippo Pietrantonio, MD, discusses the influence of primary results from the phase 3 CodeBreak 300 trial of sotorasib plus panitumumab on KRAS G12C-mutated metastatic colorectal cancer.

Dr Pietrantonio on the CodeBreak 300 Trial in KRAS G12C-mutated mCRC

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses survival rates in patients with colorectal cancer (CRC).

The survival of such patients, says Pietrantonio, is generally poor. Typically, clinical trial data show reported survival rates of up to 5 months. However, he explains, there is some heterogeneity in clinical outcomes, as some patients may actually die sooner, while other patients may have longer survivals even if their disease is defined as refractory.

In order to improve these survival rates, Pietrantonio says that identifying the correct patients that are able to receive further treatments is key. This could be accomplished mainly through clinical selection. Currently, most available drugs cannot rely on biomarkers, thus prognostic stratification is, at present, the most important thing to do.

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses survival rates in patients with colorectal cancer.

Dr. Pietrantonio on Survival Rates in Colorectal Cancer

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses a nomogram that can predict 12-week survival rates for patients with colorectal cancer (CRC).

The nomogram can be utilized to identify patients with CRC who are at higher risk for death within 12 weeks, explains Pietrantonio. It can also be used as a prognostic method for patient selection, as some of these high-risk patients are enrolled on clinical trials.

Pietrantonio stresses the importance of identifying the correct patients that are able to receive further treatments, given that such stratification is currently done mostly through clinical selection due to a lack of reliability with biomarkers in this space.

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses a nomogram that can predict 12-week survival rates for patients with colorectal cancer.

Dr. Pietrantonio on the Design and Rationale Behind a Nomogram to Predict Survival Rates in CRC

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses the benefit of a nomogram that can predict 12-week survival rates for patients with colorectal cancer (CRC).  

If this nomogram were to be implemented in clinical trial assessment or inclusion criteria will help enroll patients that can be treated effectively and will most benefit from treatment.

The nomogram relies on four variable that impact survival; ECOG performance status, primary tumor resection, LDH value, peritoneal disease. These variables are very easy to collect in daily clinical practice, said Pietrantonio.

Dr. Filippo Pietrantonio on Using Nomogram for Patient Selection in CRC Trials

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses a nomogram that is used to predict 12-week survival rates for patients with colorectal cancer (CRC).

Pietrantonio explains that the nomogram can be utilized to identify patients with CRC who are at higher risk for death within 12 weeks.

Additionally, the nomogram can be used as a prognostication method for patient selection, as some of these high-risk patients are enrolled on clinical trials.

Filippo Pietrantonio, MD, Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Fondazione IRCCS Istituto Nazionale dei Tumori, discusses findings of a clinical trial examining a nomogram used to predict 12-week survival rates for patients with colorectal cancer (CRC).

Filippo Pietrantonio, MD

Articles

Gathering Insights in Gastrointestinal Cancers From ESMO 2023: Dr Pietrantonio

Dr Pietrantonio on the CodeBreak 300 Trial in KRAS G12C-mutated mCRC

Dr. Pietrantonio on Survival Rates in Colorectal Cancer

Dr. Pietrantonio on the Design and Rationale Behind a Nomogram to Predict Survival Rates in CRC

Dr. Filippo Pietrantonio on Using Nomogram for Patient Selection in CRC Trials

Dr. Pietrantonio on Nomogram to Predict Survival Rates in CRC