Mark A. Lewis, MD, discusses news in GI oncology from the ASCO23.
Hello. I am Mark Lewis, director of gastrointestinal oncology at Intermountain Health in Utah. I am speaking at the 2023 American Society of Clinical Oncology Annual Meeting in Chicago, where we have seen some interesting new data in gastrointestinal cancers that I'd like to tell you about.
Interestingly enough, one of the challenges that we face as clinicians is to determine the order of treatment we should be providing. There are two things about pancreas cancer that we need to reconcile. One is that it can only be cured in the operating room. The other is it is a systemic illness whereby surgery is almost never enough by itself. It's necessary, but not sufficient.
. Rectal cancer has traditionally been the most and necessarily multidisciplinary cancer in all of GI because it has required, for decades now, a radiation oncologist, a medical oncologist, and a colorectal surgeon. It gets even more nuanced than that because maybe we actually need to manage upper rectal cancer differently than lower rectal cancer. As a general rule, the closer you get to the anal canal, the more fixed the tumor will be in the pelvis and, arguably, the more of a role radiation might have.
Zolbetuximab, this antibody, only works in patients that are high expressors of claudin-18.2. I know this just adds to the alpha-numerical soup of oncology, but I think the future is reflexive testing by our pathologists of these tissue specimens to let the oncologists glean the most value out of that testing. I liken it to if you're trying to wring a wet rag and get every last drop out, in terms of information, that's what we want to be doing with our tissue.
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