At ASCO 2017, and subsequently the ESMO congress 2017, a number of studies were presented which, in part, may change the present standard of
therapy in gastrointestinal oncology. The German FLOT4 trial established perioperative
Docetaxel,
Oxaliplatin and
5-Fluorouracil (5-FU) as the new treatment standard for resectable
adenocarcinoma of the gastroesophageal junction and the stomach. In
hepatocellular carcinoma (HCC), two large studies did not show a survival benefit for selective internal
therapy (
SIRT), so an increasing use of
SIRT in HCC is not recommended. On the other hand, the multityrosinekinase inhibitor
Lenvatinib seems to be a promising alternative to
sorafenib in first line treatment of metastatic HCC. In early
colon cancer-following the data from the large IDEA initiative-three months of
capecitabine and
oxaliplatin is recommended for low-risk stage III
cancers (T1 - 3, N1), while in high-risk stage III
cancers (T4 or N2) patients should still receive six months of
oxaliplatin and a fluoropyrimidine. Aside from regular exercise, one study found that regular intake of tree nuts (at least 2 servings per week), may decrease the risk of recurrence. In first line metastatic
colorectal cancer (mCRC),
SIRT should not be applied, whereas in BRAF mutant
cancers, the combination of
irinotecan,
cetuximab and
vemurafenib seems to be a promising second line treatment option. In
biliary tract cancer, after curative resection, six months of
capecitabine is considered the new treatment standard. Finally, in
pancreatic cancer, targeting the
tumor stroma with pegylated
hyaluronidase (
PEGPH20) may be a new treatment option that needs to be proven in phase 3 studies.