Recent advances in gastrointestinal cancers

Table 1 Overview of latest phase III trials in gastrointestinal cancers

Studies	Population	Intervention	Control	Primary endpoints	Results
Gastroesophageal cancers
Neoadjuvant
NRG-RTOG 1010	HER2-positive EC or GEJ	Trastuzumab + CXRT + surgery	CXRT + surgery	DFS	19.6 mo vs 14.2 mo (HR = 0.97)
ARTDECO	Locally advanced unresectable EC and GEJ	Standard CXRT + RT boost	Standard CXRT	3-yr LPFS	73% vs 71% (NS)
Adjuvant
Checkmate-577	EC and EGJ and residual pathologic disease	Nivolumab	Placebo	DFS	22.4 mo vs 11 mo (HR = 0.69)
Advanced/metastatic
Checkmate-649	Untreated, unresectable advanced or metastatic GC/EGJ	Nivolumab + CT	CT	OS; PFS	14.4 mo vs 11.1 mo (HR = 0.71); 7.7 mo vs 6 mo (HR = 0.68)
ATTRACTION-4	Untreated, unresectable advanced or metastatic GC/EGJ	Nivolumab + CT	CT + placebo	OS; PFS	17.45 mo vs 17.15 mo (HR = 0.90); 10.45 mo vs 8.34 mo (HR = 0.68)
Keynote-590	Untreated, unresectable advanced or metastatic EC/EGJ	Pembrolizumab + CT	CT + placebo	OS; PFS	12.4 mo vs 9.8 mo (HR = 0.73); 6.3 mo vs 5.8 mo (HR = 0.65)
Hepatocellular carcinoma
Advanced/metastatic
Imbrave 150	Untreated, unresectable HCC	Atezolizumab + bevacizumab	Sorafenib	12-mo OS; PFS	67.2% vs 54.6% (HR = 0.58); 6.8 mo vs 4.3 mo (HR = 0.59)
Colon cancer
Adjuvant
IDEA	Resected stage III CRC	3 mo adj. CAPOX 3 mo adj. FOLFOX	6 mo adj. CAPOX ; 6 mo adj. FOLFOX	5-yr DFS	70% vs 69.3% (HR = 0.95); 68.4% vs 71.7% (HR = 1.16)
Follow-up
PRODIGE 13	Resected stage II or III CRC	Low intensity follow-up	High intensity follow-up	5-yr OS	NS
Metastatic
Keynote-177	Untreated, unresectable metastatic MSI-H/dMMR CRC	Pembrolizumab	CT	PFS	16.5 mo vs 8.2 mo (HR = 0.6)
iPACS	Asymptomatic stage IV CRC	Tumor resection + CT	CT	OS	25.9 mo vs 26.7 mo (HR = 1.10)
Rectal cancer
Neoadjuvant
RAPIDO	Locally advanced rectal cancer	RT + Neoadj. CT + surgery	CXRT + surgery +/-adj. CT	3-yr DrTF	23.7% vs 30.4% (HR = 0.76)
PRODIGE 23	Locally advanced rectal cancer	Neoadj. CT + CXRT + surgery + adj. CT	CXRT + surgery +/-adj. CT	3-yr DFS	75.7% vs 68.5% (HR = 0.69)

CRC: Colorectal cancer; CT: Computed tomography; CXRT: Chemo-radiation therapy; DFS: Disease-free survival; dMMR: Mismatch repair deficient; DrTF: Disease-related treatment failure; EC: Esophageal cancer; GC: Gastric cancer; GEJ: Gastroesophageal junction cancer; HCC: Hepatocellular carcinoma; HR: Hazard ratio; LPFS: Local progression-free survival; MSI-H: Microsatellite instability high; NS: Not significant; OS: Overall survival; PFS: Progression-free survival; RT: Radiotherapy.