Thread by @TumorBoardTues

Good Morning #GImedTwitter

🌅🌄🌇Whether you are waking up in San Francisco…..or not (Curse you COVID-19😡)

🧑‍🏫Get ready for 3 packed days of presentations at #GI22

And to get the🧠started, we are going to share our
Top 10 Targeted Therapy Abstracts🎯

#TumorBoardTuesday

#TumorBoardTuesday

1⃣/
Once again HER2🎯💊is everywhere #GI22

👉The DESTINY trials have been👍4⃣T-DXd

✅DESTINY-CRC01
➡️T Yoshino, et al "RAPID" Abs 119
⏩53 "Group A" HER2+ RASWT CRC pts
⏩ORR 45%, mOS 15.5 mos
👍Even with prior HER2 Tx
😨But GR>=3 AEs in 65% of pts, 9% ILD

#TumorBoardTuesday #GI22

2⃣/
✅DESTINY-Gastric 01
➡️K Yamaguchi, et al "RAPID" Abs 242
⏩Randomized Ph II trial of >=2nd line💊
👉T-DXd vs. Physician’s choice (PC) which was Iri or Paclitaxel
⏩mOS 12.5 v 8.9 mos
⏩ORR 51% vs 14%
😨But Grade >= 3 AEs were 86% vs 57%

#TumorBoardTuesday #GI22

3⃣/
🧑‍🏫Also take a look at:
✅ @YJanjigianMD , et al Abs 295
➡️T-DXd➕5FU/Cape

✅N Li, et al, Abs 296
➡️SHR1210 (anti-PD-1) ➕trastuzumab➕CAPEOX 👉As NEOADJUVANT💊for HER2+ GC/GEJ
⏩31% path CR rate

🧑‍🏫Remember Pembro➕Tras➕CAPEOX
➡️75% ORR in KN-811

#TumorBoardTuesday #GI22

4⃣/
There were a few “me too” anti-PD-1 MSI-high trials

✅But the GERCOR NEONIPIGA trial stood out to me
➡️T Andre, et al "RAPID"Abs 244
⏩Neoadj Ipi/Nivo➡️Surgery➡️Adj nivo in MSI-H
#GastricCancer & #EsophagealCancer
⏩32 pts
⏩59% path CR rate‼️

#TumorBoardTuesday #GI22

5⃣/
✅Also in the MSI-high group
➡️MA Lumish, et al "Rapid" Abs 16
⏩Neoadj dostarlimab (anti-PD-1) in localized dMMR #RectalCancer
⏩12 pts
➡️ORR = 100%

👉Small#⃣, and still very short follow up⏳
👉But VERY promising🙏

#TumorBoardTuesday #GI22

6⃣/
✅🗣️of Immuno💊
➡️A Nakata, et al Abs 346
⏩Retro👀review
⏩136 #GIcancer pts w/🧬profiling & also had Immuno💊(mostly gastric/esoph)
⏩7.4% w/SWI/SNF🧬muts
👉9 ARID1A/2 & 2 SMARCA4

⬆️OS4⃣SWI/SNF vs no SWI/SNF
👉mOS NR vs. 10.3 mos
👉ORR 30% vs. 12%

#TumorBoardTuesday #GI22

7⃣/
✅DDR/HRD🎯trials

➡️E Tan et al Abs 663
⬆️OS in #GIcancer w/HRD🧬muts vs. no muts
⏩mOS 68.9 vs. 24.3mos
🤔No diff in ORR to plat💊❓

➡️S Amin et al Abs 599 & W Li et al Abs 601
🗣️Need to test for🧬muts in PDAC early
🔦NB: I am on these abstracts

#TumorBoardTuesday #GI22

8⃣/
✅DDR/HRD🎯trials

➡️WW Ma et al Abs 563
⏩Rucaparib➕5FU/nal-iri Ph1
🤔Phase II in PDAC coming

➡️@aparna1024 et al Abs 564
⏩Niraparib➕antiPD-1 dostarlimab in PDAC
😞⛔️benefit in 15pts
💥BUT⛔️DDR pre-selection
🤔Would that have made a difference❓

#TumorBoardTuesday #GI22

9⃣/
✅Unless I missed it (and apologies if I did) I only saw one KRASG12C abstract
➡️@GIcancerDoc et al "RAPID" Abs 519
⏩KRYSTAL-1, adagrasib in #PancreaticCancer & other #GIcancers w/KRASG12C🧬muts
⏩27 eval pts – 41 % ORR‼️
👉50% in the PDAC pts👏

#TumorBoardTuesday #GI22

1⃣0⃣/
✅Finally, unfortunately there were two⛔️🎯💊 TAPUR trials

➡️GM Vaccaro et al Abs 107
⏩10 eval MSS #Colorectalcancer pts with
👉TMB >= 9
⏩Only 1 PR w/Ipi➕Nivo

➡️JL Grem et al Abs 106
⏩Temsirolimus in PIK3CA🧬mut #CRC
👉ORR=0% in 10 eval pts