DocCatenacci's profile picture. Medical Oncologist.                 "Targeted therapies for targeted populations”

Daniel Catenacci

@DocCatenacci

Medical Oncologist. "Targeted therapies for targeted populations”

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Personalized Antibodies for Gastroesophageal Adenocarcinoma (PANGEA): A Phase II Study Evaluating an Individualized Treatment Strategy for Metastatic Disease cancerdiscovery.aacrjournals.org/content/early/…


#CM577 If only we could have known years ago, maybe we could’ve spared all those patients ineffective (worse than nothing?), toxic expensive therapy.

DocCatenacci's tweet image. #CM577 
If only we could have known years ago, maybe we could’ve spared all those  patients ineffective (worse than nothing?), toxic expensive therapy.
DocCatenacci's tweet image. #CM577 
If only we could have known years ago, maybe we could’ve spared all those  patients ineffective (worse than nothing?), toxic expensive therapy.
DocCatenacci's tweet image. #CM577 
If only we could have known years ago, maybe we could’ve spared all those  patients ineffective (worse than nothing?), toxic expensive therapy.

#CM577 there is no benefit (especially CPS0) in CPS low/neg tumors. 44% of pts. And this is not even by histology which would make adenocarcinoma look even worse. Why is this buried in the supplement? & Why would you give this drug for a year to people having no benefit?



#MATTERHORN Phase III FLOT + durvalumab or placebo #dejavu #samsara

HR 0.78 NS per the presentation but not in the paper (rather HR 0.99 <12m HR 0.67) >12m) Where have we seen this tuning fork curve before? ~1/3 pts no diff. CM577 I think it’s a good idea to see the results by PDL1 1, 5, 10: will likely show same thing as all previous studies

DocCatenacci's tweet image. HR 0.78 NS per the presentation but not in the paper (rather HR 0.99 &amp;lt;12m HR 0.67) &amp;gt;12m) 

Where have we seen this tuning fork curve before? ~1/3 pts no diff. CM577

I think it’s a good idea to see the results by PDL1 1, 5, 10: will likely show same thing as all previous studies


Better late than never, I guess.

📢 FDA ODAC gets it ✅️ for patients Immune checkpoint inhibitors are a PD-L1 targeted 🎯 therapy in GEA. No target, no efficacy. Let's focus on: ➡️ alternative targets (CLD 18.2, FGFR2b, MTAP...) ➡️ overcoming immune evasion (bispecifics, T-cell engagers, CAR-T..)



#TOPGEAR @ESMO2024 - periop chemo +/- RT for #GEA - no benefit adding RT - now 6 Phase 3 studies w/o CRT benefit vs or added to neoADJ/ADJ tx for GEA: - CRITICS, ARTIST1, ARTIST2, neoAEGIS, ESOPEC, TOPGEAR - SOC is periop #FLOT for all GEA

DocCatenacci's tweet image. #TOPGEAR @ESMO2024
- periop chemo +/- RT for #GEA
- no benefit adding RT

- now 6 Phase 3 studies w/o CRT benefit vs or added to neoADJ/ADJ tx for GEA:
  - CRITICS, ARTIST1, ARTIST2, neoAEGIS, ESOPEC, TOPGEAR

- SOC is periop #FLOT for all GEA

Time to move away from radiotherapy in operable GEA #ESMO24 TOPGEAR ➡️ no survival benefit when RT added to periop chemo TOPGEAR + ESOPEC : both great trials with a definitive answer = no more RT ✅Great drugs in development - let's focus on systemic Rx for cure @myESMO



Daniel Catenacci reposted

🚨PRODIGE23🚨 Long term results now published! T3-4 rectal adenocarcinoma Randomized: CRT➡️🔪➡️FOLFOX mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX ✅✅✅Improved OS!!! Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS pubmed.ncbi.nlm.nih.gov/38986769/

KrishanJethwa's tweet image. 🚨PRODIGE23🚨

Long term results now published!
T3-4 rectal adenocarcinoma
Randomized:
CRT➡️🔪➡️FOLFOX
mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX

✅✅✅Improved OS!!!

Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS

pubmed.ncbi.nlm.nih.gov/38986769/
KrishanJethwa's tweet image. 🚨PRODIGE23🚨

Long term results now published!
T3-4 rectal adenocarcinoma
Randomized:
CRT➡️🔪➡️FOLFOX
mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX

✅✅✅Improved OS!!!

Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS

pubmed.ncbi.nlm.nih.gov/38986769/
KrishanJethwa's tweet image. 🚨PRODIGE23🚨

Long term results now published!
T3-4 rectal adenocarcinoma
Randomized:
CRT➡️🔪➡️FOLFOX
mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX

✅✅✅Improved OS!!!

Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS

pubmed.ncbi.nlm.nih.gov/38986769/
KrishanJethwa's tweet image. 🚨PRODIGE23🚨

Long term results now published!
T3-4 rectal adenocarcinoma
Randomized:
CRT➡️🔪➡️FOLFOX
mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX

✅✅✅Improved OS!!!

Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS

pubmed.ncbi.nlm.nih.gov/38986769/

Thank you for this very pivotal study to streamline perioperative therapy for esophageal and gastroesophageal junction adenocarcinoma. #ESOPEC

🔥 ASCO 2024 Plenary: Prof Dr @JDekervel (UZ Leuven) and Prof Dr @FlorianLordick (University of Leipzig) discuss the ESOPEC trial, comparing FLOT perioperative chemotherapy with neoadjuvant chemoradiotherapy for adenocarcinoma of the oesophagus or oesophagogastric junction.



Daniel Catenacci reposted

🔥 ASCO 2024 Plenary: Prof Dr @JDekervel (UZ Leuven) and Prof Dr @FlorianLordick (University of Leipzig) discuss the ESOPEC trial, comparing FLOT perioperative chemotherapy with neoadjuvant chemoradiotherapy for adenocarcinoma of the oesophagus or oesophagogastric junction.


Daniel Catenacci reposted

Yes research warranted, not SOC. Control here arm did very well compared to overt stage IV disease, as expected, since these are highly selected patients. This control arm is so critical because it normalizes and shows that they do well, but not due to the surgical intervention.


IKF-575/#RENAISSANCE phase III Addressing #oligometastatic #GEA more aggressively, my heart said yes, but my brain said no:

DocCatenacci's tweet image. IKF-575/#RENAISSANCE phase III

Addressing #oligometastatic #GEA more aggressively, my heart said yes, but my brain said no:

Daniel Catenacci reposted

I guess we must agree to disagree until we see prospective phase 3 data. Thankfully others have actually done this study and asked this very pertinent question as to the utility of RT in EGJ AC and not danced around it for 20+ years. Would you change your opinion based on esopec?


Daniel Catenacci reposted

Do you call the benefit of CROSS over surgery alone ‘modest’ with a HR of 0.75? FLOT had HR of 0.76 over ECF which previously had a HR of 0.74 over surgery alone. There is nothing more to say. Ultimately you either see it and it is obvious or you dont. But you eventually will.


Daniel Catenacci reposted

Unfair comparison of ITT R0 in FLOT vs R0 of those going to surgery in CROSS. Also,Why compare surrogate endpnts of OS when we actually have the OS to compare? The controlled studies are coming.Will be some disappointed folks likely. See here: meetinglibrary.asco.org/record/167399/… @RenoHemonc


Daniel Catenacci reposted

Looking forward to debating Dr Ilson!! (FLOT vs CROSS #31.)@agrothey @ILSONDavid

Looking forward to discussions with my colleagues during Great Debates in GI Malignancies next week! @GreatDebatesGI



Daniel Catenacci reposted

#justmath I particularly like the comment that this is homework for 9-yr olds...@GermanBiotech CROSS-trial comparisons r tricky, but it's the HR compared to controls that are useful here... Of course we await ESOPEC, but for now, the evidence points in a certain direction...no?

DocCatenacci's tweet image. #justmath
I particularly like the comment that this is homework for 9-yr olds...@GermanBiotech 
CROSS-trial comparisons r tricky, but it&apos;s the HR compared to controls that are useful here...
Of course we await ESOPEC, but for now, the evidence points in a certain direction...no?
DocCatenacci's tweet image. #justmath
I particularly like the comment that this is homework for 9-yr olds...@GermanBiotech 
CROSS-trial comparisons r tricky, but it&apos;s the HR compared to controls that are useful here...
Of course we await ESOPEC, but for now, the evidence points in a certain direction...no?

Daniel Catenacci reposted

Hey #medtwitter, I need some help with the math on this one: @OncoAlert If B - A = X & C - A = X & B=C & D - B = X & D - C = Y Can we solve for Y?


Daniel Catenacci reposted

Last, I would say that ~90% of pts will have a PET response w FLOT, & we saw this also w FOLFIRINOX. These pts are not at risk for R1 resection. One might consider CROSS for those ~10% who don’t, with the caveat that those are the resilient tumors that may also be radioresistant.


Daniel Catenacci reposted

Tweet 6/6: From tweet 5/6, if we have a prospective study that seeks organ preservation, documents differences in QOL, & risk of local/distant recurrence & OS comparing dCRT vs, hopefully what is now everyone’s standard, perioperative FLOT, then great, & pts can make a choice.


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