Novel approaches and future strategies in management of upper GI tumours

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Published: 8 May 2019
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Prof David Ilson - Memorial Sloan Kettering Cancer Center, New York City, USA

Prof David Ilson speaks to ecancer at the 2019 International Gastrointestinal, Liver and Uro-Oncology Conference (IGILUC) in Cairo about the current data surrounding the treatment of upper gastrointestinal tumours.

Prof Ilson states that perioperative chemotherapy is standard practice for gastric cancer treatment in Western countries, whereas upfront surgery followed by adjuvant chemotherapy is more common in Asia.

He also describes several studies, including one where the use of the FLOT regimen (fluorouracil plus leucovorin, oxaliplatin and docetaxel) was revealed to be superior as a preoperative treatment compared to typical ECF chemotherapy.

Prof Ilson also discusses the role of radiation in the treatment of gastric cancer and describes the CRITICS trial - in which no survival benefit was achieved from the use of perioperative chemotherapy and the addition of postoperative radiation.

He also mentions the potential benefits of combining radiation and chemotherapy for the treatment of oesophagus and gastro-oesophageal junction cancers.

Prof Ilson concludes the interview by outlining the potential for MSI-H (microsatellite instability) to be a favourable biomarker for these gastric cancer patients, along with the role of PET scan guided chemotherapy.