New experimental targets for gastric cancer Andrés Cervantes
|
|
- Andrew McKinney
- 6 years ago
- Views:
Transcription
1 New experimental targets for gastric cancer Andrés Cervantes Professor of Medicine
2 Outline Acquired capabilities of Cancer IGFR pathway PI3K-AKT-m-TOR pathway MET pathway FGFR pathway Check point inhibitors
3 Acquired Capabilities of Cancer 1. Self-Sufficiency in Growth Signals a. Receptors: EGFR-family, IGF1R, MET, FGFR b. Downstream effectors: PI3K, mtor, AKT 2. Insensitivity to Antigrowth Signals 3. Evading Apoptosis 4. Limitless Replicative Potential 5. Sustained Angiogenesis 6. Tissue Invasion and Metastasis Cancer cells Immune cells Fibroblasts Endothelial cells Hanahan & Weinberg, Cell 100, 2000
4
5 ADQUIRED CAPABILITIES OF CANCER: SELF SUFFICIENCY IN GROWTH SIGNALS RECEPTORS: EGFR FAMILY MET FGFR DOWNSTREAM EFFECTORS: PI3K AKT m-tor
6 Rationale for Targeting Other Receptors & Downstream Signaling Proteins Met receptor Hepatocyte growth factor (HGF) & c-met highly expressed in GC specimens: 73% and 77% (Chen, 2007) MET gene amplification in 10-15% GC (Bechletner, 2008) Estimulation of c-met with HGF induces signal transduction, that is abrogated with c-met TKIs (Catenacci, 2008) Met inhibitors in the clinic in GC: Foretinib - GSK089 (Jhawer, 2009) and XL880 (Jhawer, 2008)
7
8 Targeted therapies in First-line treatment for Advanced Gastric Cancer: Summary of Phase III Trials TRIAL CHEMOTHERAPY BIOLOGICAL HR OS P value Increase in median survival ToGA 1 AVAGAST 2 EXPAND 3 REAL-3 4 RILOMET-1 5 N: 609 METGASTRIC 6 N: 562 Cisplatin+5FU/ca pecitabine Cisplatin+ capecitabine Cisplatin+ capecitabine Oxaliplatin+ epirubicin + capecitabine Cisplatin+ epirubiicin+ capecitabine Trastuzumab months Bevacizumab months Cetuximab months Panitumumab months Rilotumumab ,9 months Stopped in futility analysis FOLFOX6 Onartuzumab months 1.Bang YJ, Lancet Van Cutsem E, J Clin Oncol Lordick F, Lancet Oncol Waddell T, Lancet Oncol Lancet Oncology Shah M, JAMA Oncology,
9
10 Rilotumumab versus placebo plus ECX as first line treatment in MET-positive gastric or esophagogastric junctional cancer Catenacci DVT, et al. Lancet Oncol 2017; 5:
11 Rilotumumab versus placebo plus ECX as first line treatment in MET-positive gastric or esophagogastric junctional cancer Catenacci DVT, et al. Lancet Oncol 2017; 5:
12 Molecular Heterogeneity and Receptor Coamplification Drive Resistance to Targeted Therapy in MET-Amplified Esophagogastric Cancer Kwak EL, et al. Cancer discov 2015; 5:
13 Molecular Heterogeneity and Receptor Coamplification Drive Resistance to Targeted Therapy in MET-Amplified Esophagogastric Cancer Kwak EL, et al. Cancer Discov 2015; 5:
14
15
16 Dienstmann R,et al. Ann Oncol 2014; 25:
17
18 Dienstmann R,et al. Ann Oncol 2014; 25:
19 High-level clonal FGFR amplification and response to FGFR Inhibition in a translational clinical trial Pearson A, et al. Cancer Discovery 2016,
20 ADQUIRED CAPABILITIES OF CANCER: SELF SUFFICIENCY IN GROWTH SIGNALS RECEPTORS: EGFR FAMILY IGFR1 c-met DOWNSTREAM EFFECTORS: PI3K AKT m-tor
21 Rationale for Targeting Other Receptors & Downstream Signaling Proteins PI3K-mTOR inhibitors RAD001 (everolimus) is a derivative of rapamycin which act as a signal transduction inhibitor of mtor RAD001 attenuates production of HIF-1α and VEGF in GC in vitro and markedly inhibits NCI-N87 GC xenografts growth (Cejka, 2008) Preliminary results showed that RAD001 monotherapy is generally well tolerated with promising activity in pts with previously treated advanced GC 1 1 Muro et al. J Clin Oncol 2008 (ASCO)
22 THE PHOSPHATIDYLINOSITOL 3 KINASE (PI3K) SIGNALING PATHWAY
23 Comprehensive Molecular Characterization of Gastric Adenocarcinoma: Molecular platforms The Cancer Genome Atlas Research Network. Nature 2014; 513:
24 Comprehensive Molecular Characterization of Gastric Comprehensive Adenocarcinoma: Molecular Molecular Characterization platforms of Gastric Adenocarcinoma: Molecular platforms Array-based somatic copy number analysis Whole exome sequencing Array-based DNA methylation profiling Messenger RNA sequencing microrna sequencing Reverse Phase Protein Array (RPPA) The Cancer Genome Atlas Research Network. Nature 2014; 513:
25 50% 9% 20% 22% The Cancer Genome Atlas Research Network. Nature 2014; 513:
26 Comprehensive Molecular Characterization of Gastric Adenocarcinoma: PI3KCA mutations by subtype The Cancer Genome Atlas Research Network. Nature 2014; 513:
27 MTOR AND PHOSPORILATED MTOR IN GASTRIC CANCER NEGATIVE NEGATIVE POSITIVE POSITIVE 1072 samples from gastric cancer patients after surgery Immunohystochemical assessment of mtor and pmtor Yu G, et al. Clin Cancer Res 2009; 15:1821
28 Yamada, et al. Proc ASCO GI 2009 Everolimus in gastric cancer EVEROLIMUS IN GASTRIC CANCER Phase I: 2 PRs out of 4 patients with metastatic, heavily pretreated cancer of the stomach or gastroesophageal junction Phase II: No OR, DCR was 55% (29/53pts), mpfs was 83 days (95%CI: days) Baseline 2 months after RAD mg
29 Gastric Cancer: Second Line Chemotherapy Trials Comparing BSC versus Active Treatment Trial Author Thuss- Patience et al. 1 Year :1 Park et al :1 Ford et al :1 Otshu et al :1 Fuchs et al :1 Patients Random (n) Treatment 1. Eur J Cancer 2011; 47: J Clin Oncol 2012; 30: Lancet Oncol 2014; 15: J Clin Oncol 2013; 31: Lancet 2014; 383: HR OS P value Gain in Median Survival Irinotecan ,4 months Irinotecan Docetaxel ,3 months Docetaxel ,6 months Everolimus months Ramucirumab months
30 Phase II Study of weekly Paclitaxel +/- Olaparib for second line in advanced gastric cancer Stratification: ATM Low A: weekly Paclitaxel R B: weekly Paclitaxel plus Olaparib 100 mg bid Primary end point: PFS Co-Primary end point: PFS in ATM Low Secondary end points: OS, OS in ATM Low, Toxicity Bang JY, et al. J Clin Oncol 2015;33:
31 Bang JY, et al. J Clin Oncol 2015;33: Phase II Study of weekly Paclitaxel +/- Olaparib for second line in advanced gastric cancer
32 Bang JY, et al. J Clin Oncol 2015;33: Phase II Study of weekly Paclitaxel +/- Olaparib for second line in advanced gastric cancer
33 Challenges Target discovery has resulted in numerous novel drugs in clinical development Signal transduction inhibition does not guarantee tumor response: Target presence and dependence Redundancy Cross-talk Molecular-based population enrichment needed Combinations: mechanistic interactions Phase III trials are warranted
34 PD-1 Pathway and Immune Surveillance PD-1 is a negative co-stimulatory receptor expressed primarily on activated T cells 1 Binding of PD-1 to its ligands PD-L1 and PD-L2 inhibits effector T-cell function 1 Expression of PD-L1 on tumor cells and macrophages can suppress immune surveillance and permit neoplastic growth 2 1.Keir ME et al. Annu Rev Immunol. 2008;26: Pardoll DM. Nat Rev Cancer. 2012;12:
35 Pembrolizumab (MK-3475) Is a Humanized IgG4, High-Affinity, Anti-PD-1 Antibody Dual blockade of PD-L1 and PD-L2 No cytotoxic (ADCC/CDC) activity Pharmacokinetics support dosing every 2 weeks (Q2W) or every 3 weeks (Q3W) Low occurrence of anti-drug antibodies, which have no impact on pharmacokinetics Demonstrated clinical activity in multiple tumor types 1-7 Recently approved in the United States for the treatment of patients with unresectable or metastatic melanoma and disease progression following ipilimumab and, if BRAF V600 mutation positive, a BRAF inhibitor 1. Ribas A et al. J Clin Oncol. 2014;32(suppl 5):abstr LBA9000; 2. Rizvi N et al. J Clin Oncol. 2014;32(suppl 5): abstr 8007; 3. Garon EB et al. J Clin Oncol. 2014;32(suppl 5):abstr 8020; 4. Seiwert TY et al. J Clin Oncol. 2014;32(suppl 5):abstr Plimack E et al. Abstr. LBA23. Presented at 2014 by: ESMO Kei Congress, Muro September 26-30, Madrid, Spain. 6. Moskowitz CH et al. Bood. 2014;124(21):abstr 290; 7. Nanda R et al. Abstract 1349 (S1-09) presented at SABCS 2014, Dec 9-13, San Antonio, TX.
36 KEYNOTE-012: Gastric Cancer Cohort Complete Response Discontinuation Permitted c Recurrent or metastatic adenocarcinoma of the stomach or GEJ ECOG PS 0-1 PD-L1-positive tumor a No systemic steroid therapy No autoimmune disease (active or history of) No active brain metastases Pembrolizumab 10 mg/kg Q2W Partial Response or Stable Disease Treat for 24 months or until progression or intolerable toxicity Confirmed Progressive Disease b Discontinue Screening: 65 of 162 (40%) patients assessed for PD-L1 expression had PD-L1-positive tumors Patients: 19 patients from Asia and 20 patients from the rest of the world Treatment: 10 mg/kg IV Q2W Response assessment: Performed every 8 weeks per RECIST v1.1 : Muro K, et al. ASCO GI 2015; Abstract nr.03
37 PD-L1 Expression in Gastric Cancer Samples PD-L1 Negative PD-L1 Positive: Stromal and Tumor Staining PD-L1 Positive: Tumor Staining PD-L1 Positive: Tumor Staining PD-L1 expression was assessed in archival tumor samples using a prototype IHC assay and the 22C3 antibody Positivity was defined as staining in the stroma or in 1% of tumor cells Muro K, et al. ASCO GI 2015; Abstract nr.03
38 PD-L1 Expression in Gastric Cancer Samples Topalian S, et al. Nature Rev Cancer 2016; 16:
39 Pembrolizumab induces Responses in Chemorefractory Gastric Cancer. Muro K, et al. Lancet Oncol 2016; 17:
40 Maximum Percentage Change From Baseline in Tumor Size a Keynote-012 (RECIST v1.1, Central Review) Muro K, et al. Lancet Oncol 2016; 17:
41 64-Year-Old Male With Recurrent Gastric Cancer Treated with Pembrolizumab March 22, 2014 May 8, 2014 July 3, 2014 August 28, 2014 September 26, 2014 November 6, 2014
42 Multifactorial Biomarkers of Clinical Response to PDL-1 Blockade Topalian S, et al. Nature Rev Cancer 2016; 16:
43 KEYNOTE-059 Cohort 1: Efficacy and Safety of Pembrolizumab Monotherapy in Patients With Previously Treated Advanced Gastric Cancer Presented By Charles Fuchs at 2017 ASCO Annual Meeting
44 KEYNOTE-059 (NCT ): Phase 2 Multicohort Study of Pembrolizumab for G/GEJ Adenocarcinoma<br /> Presented By Charles Fuchs at 2017 ASCO Annual Meeting
45 Response in All Patients Presented By Charles Fuchs at 2017 ASCO Annual Meeting
46 Response by PD-L1 Expression Presented By Charles Fuchs at 2017 ASCO Annual Meeting
47 Maximum Percentage Change From Baseline in<br />Target Lesion Sizea Presented By Charles Fuchs at 2017 ASCO Annual Meeting
48 Nivolumab (ONO-4538/BMS ) as Salvage Treatment After Second- or Later-Line Chemotherapy for Advanced Gastric or Gastroesophageal Junction Cancer (AGC): A Double-Blinded, Randomized, Phase 3 Trial Key eligibility criteria: Age 20 years Unresectable advanced or recurrent gastric or gastroesophageal junction cancer Histologically confirmed adenocarcinoma Prior treatment with 2 regimens and refractory to/intolerant of standard therapy ECOG PS of 0 or 1 R 2:1 Stratification based on: Nivolumab 3 mg/kg IV Q2W Country (Japan vs Korea vs Taiwan) ECOG PS (0 vs 1) Number of organs with metastases (< 2 vs 2) Placebo Primary endpoint: OS Secondary endpoints: Efficacy (PFS, BOR, ORR, TTR, DOR, DCR) Safety Exploratory endpoint: Biomarkers Patients were permitted to continue treatment beyond initial RECIST v1.1 defined disease progression, as assessed by the investigator, if receiving clinical benefit and tolerating study drug Kang YK et al. ASCO GI 2017
49 Probability of Survival (%) Overall Survival Patients, n Events, n Median OS [95% CI], months 12-Month OS Rate [95% CI], % Nivolumab [ ] 26.6 [ ] Placebo [ ] 10.9 [ ] Hazard ratio, 0.63 (95% CI, ) P < At risk: Nivolumab Placebo Time (months) Kang YK et al. ASCO GI 2017
50 RECIST Response and Disease Control ORR, n (%) [95% CI] P value BOR, n (%) Complete response Partial response Stable disease Progressive disease DCR, n (%) [95% CI] P value Nivolumab 3 mg/kg (n = 268) 30 (11.2) [ ] < (11.2) 78 (29.1) 124 (46.3) 108 (40.3) [ ] Placebo (n = 131) 0 [0 2.8] (25.2) 79 (60.3) 33 (25.2) [ ] Median TTR (range), months 1.61 ( ) Median DOR, months [95% CI] 9.53 [ ] Kang YK et al. ASCO GI 2017
51 Maximum Reduction From Baseline in Target Lesions (%) Maximum Reduction in Tumor Burden From Baseline a Nivolumab a Placebo Patients with Tumor reduction: 37.3% 40 Patients with Tumor reduction: 12.4% Kang YK et al. ASCO GI 2017
52 Adverse Event Summary Patients, n (%) AEs Any Serious AEs AEs leading to discontinuation AEs leading to dose delay Nivolumab 3 mg/kg (n = 330) Placebo (n = 161) Any Grade Grade 3/4 Any Grade Grade 3/4 300 (90.9) 131 (39.7) 23 ( 7.0) 63 (19.1) 137 (41.5) 91 (27.6) 13 ( 3.9) 40 (12.1) 135 (83.9) 75 (46.6) 12 ( 7.5) 27 (16.8) AEs leading to death 35 (10.6) 25 (15.5) 63 (39.1) 47 (29.2) 9 ( 5.6) 17 (10.6) TRAEs Any Serious TRAEs TRAEs leading to discontinuation TRAEs leading to dose delay 141 (42.7) 33 (10.0) 9 ( 2.7) 25 ( 7.6) 34 (10.3) 21 ( 6.4) 4 ( 1.2) 14 ( 4.2) 43 (26.7) 8 ( 5.0) 4 ( 2.5) 2 ( 1.2) TRAEs leading to death 5 (1.5) 2 (1.2) 7 (4.3) 4 (2.5) 3 (1.9) 1 (0.6) Kang YK et al. ASCO GI 2017
53 Nivolumab ± Ipilimumab in Patients With Advanced/Metastatic Chemotherapy-Refractory Gastric, Esophageal, or Gastroesophageal Junction Cancer: CheckMate 032 Study Presented By Yelena Janjigian at 2017 ASCO Annual Meeting
54 Checkmate 032 EG Cohort Presented By Yelena Janjigian at 2017 ASCO Annual Meeting
55 Objective Response Presented By Yelena Janjigian at 2017 ASCO Annual Meeting
56 Best Reduction in Target Lesions Presented By Yelena Janjigian at 2017 ASCO Annual Meeting
57 50% 9% 20% 22% The Cancer Genome Atlas Research Network. Nature 2014; 513:
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More informationAdvances in gastric cancer: Biology and Treatment for advanced disease
Advances in gastric cancer: Biology and Treatment for advanced disease Andrés Cervantes Professor of Medicine Outline Molecular classification Pathology Classification after gene expression The Cancer
More informationUpdates and best practices in the management of gastric cancer
Updates and best practices in the management of gastric cancer Olatunji B. Alese, MD Gastrointestinal Oncology, Winship Cancer Institute of Emory University July 28, 2017 1 Incidence 3rd leading cause
More informationIMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS
IMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS Dr Elizabeth Smyth Cambridge University Hospitals NHS Foundation Trust ESMO Gastric Cancer Preceptorship Valencia 2018 DISCLOSURES Honoraria for advisory role
More informationSystemic treatment in early and advanced gastric cancer
Systemic treatment in early and advanced gastric cancer Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer n Surgical resection n Pathology assessment and estimation
More informationESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT
ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT DOCETAXEL, OXALIPLATIN AND FLUOROURACIL/LEUCOVORIN (FLOT) FOR RESECTABLE
More informationChemotherapy for Advanced Gastric Cancer
Chemotherapy for Advanced Gastric Cancer Andrés Cervantes Professor of Medicine DISCLOSURE OF INTEREST Employment: None Consultant or Advisory Role: Merck Serono, Roche, Beigene, Bayer, Servier, Lilly,
More informationCurrent Standard of Care of Gastric Cancer:
Current Standard of Care of Gastric Cancer: Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation of risk Treatment
More informationMetastatic NSCLC: Expanding Role of Immunotherapy. Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian
Metastatic NSCLC: Expanding Role of Immunotherapy Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian Disclosures: No relevant disclosures Please note that some of the studies reported in
More informationNOVITA IN TEMA DI CARCINOMA GASTRICO ROSA BERENATO
NOVITA IN TEMA DI CARCINOMA GASTRICO ROSA BERENATO ONCOLOGIA MEDICA 1 FONDAZIONE IRCCS ISTITUTO NAZIONALE DEI TUMORI MILANO PROGRESS AGAINST METASTATIC GC OS in first-line palliative setting Little progress
More informationCurrent Standard of Care of Gastro- Esophageal Cancer
Current Standard of Care of Gastro- Esophageal Cancer Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation of risk
More informationImmunotherapy for Breast Cancer. Aurelio B. Castrellon Medical Oncology Memorial Healthcare System
Immunotherapy for Breast Cancer Aurelio B. Castrellon Medical Oncology Memorial Healthcare System Conflicts Research support : Cascadian therapeutics, Puma biotechnology, Odonate therapeutics, Pfizer,
More informationESMO Preceptorship Targeted Therapy for Gastric Cancer
ESMO Preceptorship Targeted Therapy for Gastric Cancer Professor Dr. Florian Lordick Professor of Oncology Director University Cancer Center Leipzig (UCCL) Disclosure Florian Lordick declares honoraria
More informationCurrent standards of care in gastric cancer
Current standards of care in gastric cancer Prof Eric Van Cutsem, MD, PhD Digestive Oncology Leuven, Belgium Eric.VanCutsem@uzleuven.be Outline Resectable gastric cancer: the role of neoadjuvant and adjuvant
More informationPatient Selection: The Search for Immunotherapy Biomarkers
Patient Selection: The Search for Immunotherapy Biomarkers Mark A. Socinski, MD Executive Medical Director Florida Hospital Cancer Institute Orlando, Florida Patient Selection Clinical smoking status Histologic
More informationMy name is Dr. David Ilson, Professor of Medicine at Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center in New York, New York.
Welcome to this CME/CE-certified activity entitled, Integrating the Latest Advances Into Clinical Experience: Data and Expert Insights From the 2016 Meeting on Gastrointestinal Cancers in San Francisco.
More informationManagement of advanced Gastric Cancer in the era of targeted therapy
Management of advanced Gastric Cancer in the era of targeted therapy Osman M.Mansour Prof. Medical Oncology, NCI, Cairo University BGO: 28-3 October 215 Gastric Cancer: A Significant Problem in Some Countries
More informationWhere Are We with Check-Point Inhibitors in Gastric Cancer?
21 June 2018, Barcelona Session VII: Metastatic Gastric Cancer Where Are We with Check-Point Inhibitors in Gastric Cancer? Kei Muro, MD. kmuro@aichi-cc.jp Department of Clinical Oncology Aichi Cancer Center
More informationTargeted Therapies in Gastric Cancer : Where Do We Stand Today. Yoon-Koo Kang Asan Medical Center, University of Ulsan Seoul, Korea
Targeted Therapies in Gastric Cancer : Where Do We Stand Today Yoon-Koo Kang Asan Medical Center, University of Ulsan Seoul, Korea Chemotherapy is the standard of care in advanced gastric cancer Median
More informationGetting to the Bottom of Treatment: An Update in the Management of Esophagogastric Cancers
Getting to the Bottom of Treatment: An Update in the Management of Esophagogastric Cancers Disclosures None Cindy L. O Bryant, PharmD, BCOP, FCCP, FHOPA Professor, University of Colorado Skaggs School
More informationMEETING SUMMARY ESMO 2018, Munich, Germany. Dr. Jenny Seligmann University of Leeds, UK HIGHLIGHTS ON COLORECTAL CANCER
MEETING SUMMARY ESMO 2018, Munich, Germany Dr. Jenny Seligmann University of Leeds, UK HIGHLIGHTS ON COLORECTAL CANCER DISCLAIMER Please note: The views expressed within this presentation are the personal
More informationGastric: 16% 18% 27% Esophageal: 5% 10% 19%
2.5% of all cancers Median age 68 years Decline in gastric cancer incidence Increase in esophageal, GEJ, cardia adenocarcinoma OS improvement, 1975-77, 1984-86, 1999-2006 Gastric: 16% 18% 27% Esophageal:
More informationHighlights STOMACH CANCER
UPDATES and NEWS from the Gastrointestinal Cancers Symposium in San Francisco Roma, 10-11 Febbraio 2017 Highlights STOMACH CANCER Lorenzo Fornaro, MD Unit of Medical Oncology 2 Azienda Ospedaliero-Universitaria
More informationConversations in Oncology. November Kerry Hotel Pudong, Shanghai China
Conversations in Oncology November 12-13 Kerry Hotel Pudong, Shanghai China Immunotherapy of Lung Cancer Professor Caicun Zhou All materials are for scientific exchanges. Afatinib and nintedanib are not
More informationPredicting outcome in metastatic breast cancer
Predicting outcome in metastatic breast cancer Aleix Prat, MD, PhD Medical Oncology Department Translational Genomics and Targeted Therapeutics in Solid Tumors Monday, 15 th January, Manchester, UK Disclosures
More informationINMUNOTERAPIA EN CÁNCER GÁSTRICO Y DE LA UGE: DÓNDE ESTAMOS? Maria Alsina Maqueda, MD, PhD Hospital Universitario Vall d Hebron, Barcelona
INMUNOTERAPIA EN CÁNCER GÁSTRICO Y DE LA UGE: DÓNDE ESTAMOS? Maria Alsina Maqueda, MD, PhD Hospital Universitario Vall d Hebron, Barcelona Outline The Immune System Rational to develop immunotherapy in
More informationASCO 2017 updates in Colorectal and Gastric Cancers. May Cho, M.D.
ASCO 2017 updates in Colorectal and Gastric Cancers May Cho, M.D. Relevant financial relationships in the past twelve months by presenter or spouse/partner: None The speaker will directly disclosure the
More informationIMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS
IMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS Dr Elizabeth Smyth Royal Marsden Hospital ESMO Colorectal Cancer Preceptorship Valencia 2018 DISCLOSURES Honoraria for advisory role Servier, Celgene, BMS, Five
More informationImmunotherapy in the clinic. Lung Cancer. Marga Majem 20 octubre 2017
Immunotherapy in the clinic. Lung Cancer Marga Majem 20 octubre 2017 mmajem@santpau.cat Immunotherapy in the clinic. Lung Cancer Agenda Where we come from? Immunotherapy in Second line Immunotherapy in
More informationBIOLOGICAL TARGETED AGENTS
BIOLOGICAL TARGETED AGENTS (INCLUDING HER2, EGFR, ANGIOGENESIS) Dr Elizabeth Smyth Royal Marsden Hospital ESMO GI Cancer Preceptorship Singapore 2017 DISCLOSURES Honoraria for advisory role Five Prime
More informationPlotting the course: optimizing treatment strategies in patients with advanced adenocarcinoma
Pieter E. Postmus University of Liverpool Liverpool, UK Plotting the course: optimizing treatment strategies in patients with advanced adenocarcinoma Disclosures Advisor Bristol-Myers Squibb AstraZeneca
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Robert F. Taylor, MD Aurora Health Care
Immunotherapy for the Treatment of Head and Neck Cancers Robert F. Taylor, MD Aurora Health Care Disclosures No relevant financial relationships to disclose I will be discussing non-fda approved indications
More informationVan Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.
Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.
More informationImmune checkpoint blockade in lung cancer
Immune checkpoint blockade in lung cancer Raffaele Califano Department of Medical Oncology The Christie and University Hospital of South Manchester, Manchester, UK Outline Background Overview of the data
More informationInmunoterapia en tumores digestivos no colorrectales
Inmunoterapia en tumores digestivos no colorrectales Santander, 13 de Julio del 2017 Maria Alsina, MD PhD Hospital Universitari Vall d Hebron Outline Introduction Hepatocarcinoma Pancreatic Cancer Gastric
More informationPresentation Number: LBA18_PR. Lecture Time: 09:15-09:27. Speakers: Heinz-Josef J. Lenz (Los Angeles, US) Background
LBA18_PR - Durable Clinical Benefit With Nivolumab (NIVO) Plus Low-Dose Ipilimumab (IPI) as First-Line Therapy in Microsatellite Instability-High/Mismatch Repair Deficient (MSI-H/dMMR) Metastatic Colorectal
More informationPembrolizumab for Patients With PD-L1 Positive Advanced Carcinoid or Pancreatic Neuroendocrine Tumors: Results From the KEYNOTE-028 Study
Pembrolizumab for Patients With PD-L1 Positive Advanced Carcinoid or Pancreatic Neuroendocrine Tumors: Results From the KEYNOTE-28 Study Abstract 427O Mehnert JM, Bergsland E, O Neil BH, Santoro A, Schellens
More informationBiomarkers in Imunotherapy: RNA Signatures as predictive biomarker
Biomarkers in Imunotherapy: RNA Signatures as predictive biomarker Joan Carles, MD PhD Director GU, CNS and Sarcoma Program Department of Medical Oncology Vall d'hebron University Hospital Outline Introduction
More informationNSCLC: immunotherapy as a first-line treatment. Paolo Bironzo Oncologia Polmonare AOU S. Luigi Gonzaga Orbassano (To)
NSCLC: immunotherapy as a first-line treatment Paolo Bironzo Oncologia Polmonare AOU S. Luigi Gonzaga Orbassano (To) The 800-pound gorilla Platinum-based chemotherapy is the SOC for 1st-line therapy in
More informationBeyond HER2: recent advances and future directions in targeted therapies in esophagogastric cancers
Review Article Beyond HER2: recent advances and future directions in targeted therapies in esophagogastric cancers Jimmy Hwang Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC 28204,
More informationUpdated Apr 2017 by Dr. Ko (Medical Oncologist, Abbotsford Cancer Centre)
Metastatic Esophagogastric Cancer Summary Updated Apr 2017 by Dr. Ko (Medical Oncologist, Abbotsford Cancer Centre) Reviewed by Dr. Yoo-Joung Ko (Medical Oncologist, Sunnybrook Odette Cancer Centre, University
More informationImmune Checkpoint Inhibitors for Lung Cancer William N. William Jr.
Immune Checkpoint Inhibitors for Lung Cancer William N. William Jr. Diretor de Onco-Hematologia Hospital BP, A Beneficência Portuguesa Non-Small Cell Lung Cancer PD-1/PD-L1 Inhibitors in second-line therapy
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Barbara Burtness, MD Yale University
Immunotherapy for the Treatment of Head and Neck Cancers Barbara Burtness, MD Yale University Disclosures AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim, Bristol-Myers Squibb, Merck & Co., Inc.,
More informationAddressing Tumor Molecular Heterogeneity using A Novel Clinical Trial Design - PANGEA
Addressing Tumor Molecular Heterogeneity using A Novel Clinical Trial Design - PANGEA Daniel Catenacci, MD Assistant Professor of Medicine Associate Director GI Oncology Program May 12, 2017 Addressing
More informationMolecular events in gastric cancer
Molecular events in gastric cancer Lorenzo Fornaro, MD Unit of Medical Oncology 2 Azienda Ospedaliero-Universitaria Pisana Istituto Toscano Tumori Pisa- Italy Disclosures No conflict of interest to disclose
More informationIncorporating Immunotherapy into the treatment of NSCLC
Incorporating Immunotherapy into the treatment of NSCLC Suresh S. Ramalingam, MD Roberto C. Goizueta Chair for Cancer Research Assistant Dean for Cancer Research Deputy Director, Winship Cancer Institute
More informationCONSIDERATIONS IN DEVELOPMENT OF PEMBROLIZUMAB IN MSI-H CANCERS
CONSIDERATIONS IN DEVELOPMENT OF PEMBROLIZUMAB IN MSI-H CANCERS December 2017 Christine K. Gause, Ph.D Executive Director, Biostatistics. 2 Microsatellite Instability-High Cancer - USPI KEYTRUDA is indicated
More informationUpdate on the Management of HER2+ Breast Cancer. Christian Jackisch, MD, PhD Sana Klinikum Offenbach Offenbach, Germany
Update on the Management of HER2+ Breast Cancer Christian Jackisch, MD, PhD Sana Klinikum Offenbach Offenbach, Germany Outline Treatment strategies for HER2-positive metastatic breast cancer since First
More informationConflicts of Interest GI Malignancies: An Update on Current Treatment Options
Conflicts of Interest GI Malignancies: An Update on Current Treatment Options Nothing to disclose Trevor McKibbin, PharmD, MS, BCOP Clinical Specialist, Hematology/Oncology Winship Cancer Institute of
More informationGenomics and Genetics in BC: Precise selection for chemotherapy and Immunotherapy. Raanan Berger MD PhD Sheba Medical Center, Israel
Genomics and Genetics in BC: Precise selection for chemotherapy and Immunotherapy Raanan Berger MD PhD Sheba Medical Center, Israel Disclosures Honoraria, Ad board BMS, MSD, Pfizer, Astra Zeneca, Bayer,
More informationTargeting the Oncogenic Pathway as Opposed to the Primary Tumor Site: HER2 as an Example
Targeting the Oncogenic Pathway as Opposed to the Primary Tumor Site: HER2 as an Example Dennis J Slamon, MD, PhD Professor of Medicine Chief, Division of Hematology/Oncology; Director of Clinical/Translational
More informationImmunotherapy in Unresectable or Metastatic Melanoma: Where Do We Stand? Sanjiv S. Agarwala, MD St. Luke s Cancer Center Bethlehem, Pennsylvania
Immunotherapy in Unresectable or Metastatic Melanoma: Where Do We Stand? Sanjiv S. Agarwala, MD St. Luke s Cancer Center Bethlehem, Pennsylvania Overview Background Immunotherapy clinical decision questions
More informationDevelopping the next generation of studies in RCC
Developping the next generation of studies in RCC Bernard Escudier Institut Gustave Roussy Villejuif, France Disclosure Information Advisory/Consultancy Role Pfizer, Exelixis, Novartis, BMS, Bayer, Roche,
More informationColon cancer: Highlights. Filippo Pietrantonio Istituto Nazionale dei Tumori di Milano
Colon cancer: Highlights Filippo Pietrantonio Istituto Nazionale dei Tumori di Milano Agenda 1) Metastatic colorectal cancer First-line treatment molecularly unselected: FOLFOXIRI-bev (CHARTA trial) Later-line
More informationTumores esófago-gástricos, tiene algo que decir la inmunoterapia? Dr. Fernando Rivera Herrero Hospital Universitario Marqués de Valdecilla.
Tumores esófago-gástricos, tiene algo que decir la inmunoterapia? Dr. Fernando Rivera Herrero Hospital Universitario Marqués de Valdecilla. Santander Finantial disclosure Consultor: CELGENE Research fundings:
More informationImmunotherapy for NSCLC: Current State of the Art and Future Directions. H. Jack West, MD Swedish Cancer Institute Seattle, Washington, United States
Immunotherapy for NSCLC: Current State of the Art and Future Directions H. Jack West, MD Swedish Cancer Institute Seattle, Washington, United States Which of the following statements regarding immunotherapy
More informationFabienne Warmerdam Zuyderland
GE Fabienne Warmerdam Zuyderland Disclosure ASCO 2017 travelgrant Pfizer CRC ADJUVANT Less is more? More is More! 1 Less is more? Perspectief INT-0035 stadium III (niets vs 5-FU) 6.5-jaars OS 46% vs. 60%
More informationTargeted Therapies in Metastatic Colorectal Cancer: An Update
Targeted Therapies in Metastatic Colorectal Cancer: An Update ASCO 2007: Targeted Therapies in Metastatic Colorectal Cancer: An Update Bevacizumab is effective in combination with XELOX or FOLFOX-4 Bevacizumab
More informationConcept to Practice: New Advances in the Treatment of GI Cancers
Concept to Practice: New Advances in the Treatment of GI Cancers 2016 Community Oncology Alliance Conference Orlando, FL Thomas George, MD, FACP Director, GI Oncology Program Director, Experimental Therapeutics
More informationImmunotherapy for Upper GI Cancers
Immunotherapy for Upper GI Cancers Esophageal Adenocarcinoma GE Junction Adeno Gastric Carcinoma Ahmed Zakari MD Medical Director of GI Cancer Program, Florida Hospital Cancer Institute Associate Professor
More informationTHE ROLE OF TARGETED THERAPY AND IMMUNOTHERAPY IN THE TREATMENT OF ADVANCED CERVIX CANCER
Gynecologic Cancer InterGroup Cervix Cancer Research Network THE ROLE OF TARGETED THERAPY AND IMMUNOTHERAPY IN THE TREATMENT OF ADVANCED CERVIX CANCER Linda Mileshkin, Medical Oncologist Peter MacCallum
More informationNivolumab: esperienze italiane nel carcinoma polmonare avanzato
NSCLC avanzato: quali novità nel 2018? Negrar, 30 Ottobre 2018 Nivolumab: esperienze italiane nel carcinoma polmonare avanzato Francesco Grossi UOC Oncologia Medica Fondazione IRCCS Ca Granda Ospedale
More informationMaintenance therapy in advanced non-small cell lung cancer. Egbert F. Smit MD PhD Dept Thoracic Oncology Netherlands Cancer Institute
Maintenance therapy in advanced non-small cell lung cancer. Egbert F. Smit MD PhD Dept Thoracic Oncology Netherlands Cancer Institute e.smit@nki.nl Evolution of front line therapy in NSCLC unselected pts
More informationLargos Supervivientes, Tenemos datos?
Largos Supervivientes, Tenemos datos? Javier Puente, MD, PhD Medical Oncology Department. Hospital Clinico San Carlos Associate Professor of Medicine. Complutense University of Madrid. Summary Snapshot
More informationImmunotherapy for Breast Cancer Clinical Development
Immunotherapy for Breast Cancer Clinical Development Laurence Buisseret, MD, PhD Breast Cancer Translational Research Laboratory Institut Jules Bordet Université Libre de Bruxelles (ULB) ESMO preceptorship
More informationManagement Guidelines and Targeted Therapies in Metastatic Non-Small Cell Lung Cancer: An Oncologist s Perspective
Management Guidelines and Targeted Therapies in Metastatic Non-Small Cell Lung Cancer: An Oncologist s Perspective Julie R. Brahmer, M.D. Associate Professor of Oncology The Sidney Kimmel Comprehensive
More informationImmunotherapy, an exciting era!!
Immunotherapy, an exciting era!! Yousef Zakharia MD University of Iowa and Holden Comprehensive Cancer Center Alliance Meeting, Chicago November 2016 Presentation Objectives l General approach to immunotherapy
More informationRiunione Monotematica A.I.S.F The future of liver diseases. HEPATIC NEOPLASMS The challenge for new drugs
Riunione Monotematica A.I.S.F. 2016 The future of liver diseases Milan 13 th -15 th October 2016 Centro Congressi Fondazione Cariplo HEPATIC NEOPLASMS The challenge for new drugs Massimo Iavarone Gastroenterology
More informationAdvanced HER2+ Breast Cancer: New Options and How to Deploy Them. José Baselga MD, PhD
Advanced HER2 Breast Cancer: New Options and How to Deploy Them José Baselga MD, PhD HER2 signaling results in a multitude of cellular effects, including increased cellular proliferation HER2 HER3 RAS
More informationDisclosures. Immunotherapyin Head & NeckCancer. Actual landscape of systemic treatment in HNSCC. Head andneckcanceris an immunogeneic tumor
Immunotherapyin Head & NeckCancer Disclosures Astra-Zeneca/medimmune: clinical trial BMS: advisory board, clinical trial Merck: advisory board, clinical trial, research funding Carla van Herpen Medical
More informationMETRIC Study Key Eligibility Criteria
The METRIC Study METRIC Study Key Eligibility Criteria The pivotal METRIC Study is evaluating glembatumumab vedotin in patients with gpnmb overexpressing metastatic triple-negative breast cancer (TNBC).
More informationColorectal Cancer in 2017: From Biology to the Clinics. Rodrigo Dienstmann
Colorectal Cancer in 2017: From Biology to the Clinics Rodrigo Dienstmann MOLECULAR CLASSIFICATION Tumor cell Immune cell Tumor microenvironment Stromal cell MOLECULAR CLASSIFICATION Biomarker Tumor cell
More informationOverview on Gastric Cancer
Chapter 1 Targeted Therapy and Immunotherapy Daniel da Motta Girardi * Department of oncology, Hospital Sirio-Libanês, Brasília, Brazil. *Correspondense to: Daniel da Motta Girardi, Department of oncology,
More informationII sessione. Immunoterapia oltre la prima linea. Alessandro Tuzi ASST Sette Laghi, Varese
II sessione Immunoterapia oltre la prima linea Alessandro Tuzi ASST Sette Laghi, Varese AGENDA Immunotherapy post-chemo ( true 2/3L ) Immunotherapy in oncogene addicted NSCLC (yes/no? when?) Immunotherapy
More informationMÁS ALLA DE LA PRIMERA LÍNEA: SECUENCIA DE TRATAMIENTO. Dra. Ruth Vera Complejo Hospitalario de Navarra
MÁS ALLA DE LA PRIMERA LÍNEA: SECUENCIA DE TRATAMIENTO Dra. Ruth Vera Complejo Hospitalario de Navarra GOALS Prolongation of survival Cure Improving tumour-related symptoms Stopping tumour progression
More informationPost-ASCO Immunotherapy Highlights (Part 2): Biomarkers for Immunotherapy
Post-ASCO Immunotherapy Highlights (Part 2): Biomarkers for Immunotherapy Lee S. Schwartzberg, MD, FACP Chief, Division of Hematology Oncology; Professor of Medicine, The University of Tennessee; The West
More informationMelanoma: Immune checkpoints
ESMO Preceptorship Programme Immuno-Oncology Siena, July 04-05, 2016 Melanoma: Immune checkpoints Michele Maio Medical Oncology and Immunotherapy-Department of Oncology University Hospital of Siena, Istituto
More informationHave Results of Recent Randomized Trials Changed the Role of mtor Inhibitors?
Have Results of Recent Randomized Trials Changed the Role of mtor Inhibitors? Bernard Escudier Institut Gustave Roussy Villejuif, France EIKCS Lyon April 2015 What is the current role of mtor inhibitors?
More informationWhat we learned from immunotherapy in the past years
What we learned from immunotherapy in the past years Paolo A. Ascierto, MD Unit Melanoma, Cancer Immunotherapy and Innovative Therapies Istituto Nazionale Tumori Fondazione G. Pascale, Napoli, Italy Disclosure
More informationCheckMate 012: Safety and Efficacy of First Line Nivolumab and Ipilimumab in Advanced Non-Small Cell Lung Cancer
CheckMate 12: Safety and Efficacy of First Line Nivolumab and Ipilimumab in Advanced Non-Small Cell Lung Cancer Abstract 31 Hellmann MD, Gettinger SN, Goldman J, Brahmer J, Borghaei H, Chow LQ, Ready NE,
More informationOptions for first-line cisplatin-eligible patients
The Past Options for first-line cisplatin-eligible patients Metastatic urothelial cancer Cisplatin-eligible Gemcitabine/ cisplatin MVAC or high-dose intensity MVAC Paclitaxel/ cisplatin/ gemcitabine Bellmunt
More informationReflex Testing Guidelines for Immunotherapy in Non-Small Cell Lung Cancer
Reflex Testing Guidelines for Immunotherapy in Non-Small Cell Lung Cancer Jimmy Ruiz, MD Assistant Professor Thoracic Oncology Program Wake Forest Comprehensive Cancer Center Disclosures I have no actual
More information非臨床試験 臨床の立場から 京都大学医学部附属病院戸井雅和
資料 2 2 非臨床試験 臨床の立場から 京都大学医学部附属病院戸井雅和 1 Preclinical studies Therapeutic Window: Efficacy/Toxicity Disease Specificity Subtype Specificity Combination: Concurrent/Sequential Therapeutic situation: Response/
More informationPredictive Biomarkers for Pembrolizumab. Eric H. Rubin, M.D.
Predictive Biomarkers for Pembrolizumab Eric H. Rubin, M.D. PD-1 and PD-L1/L2 Pathway PD-1 is an immune checkpoint receptor Binding of PD-1 by its ligands PD-L1 or PD-L2 leads to downregulation of T-cell
More informationMELANOMA METASTASICO: NUEVAS COMBINACIONES. Dr Ana Arance MD PhD Oncología Médica Hospital Clínic Barcelona
MELANOMA METASTASICO: NUEVAS COMBINACIONES Dr Ana Arance MD PhD Oncología Médica Hospital Clínic Barcelona Summary of OS accross clinical trials in patients with metastatic melanoma Ugurel et al. Eur J
More informationAtezolizumab Is a Humanized Anti-PDL1 Antibody That Inhibits the Binding of PD-L1 to PD-1 and B7.1
Phase II, Single-Arm Trial (BIRCH) of Atezolizumab as First-Line or Subsequent Therapy for Locally Advanced or Metastatic PD-L1-Selected Non-Small Cell Lung Cancer (NSCLC) Abstract 16LBA Besse B, Johnson
More informationIl ruolo di PD-L1 (42%) tra la prima e la seconda linea di trattamento
Il ruolo di PD-L1 (42%) tra la prima e la seconda linea di trattamento Alessia Pochesci Divisione di Oncologia Toracica Istituto Europeo di Oncologia, Milano Tutor: Prof.ssa Silvia Novello Dott.ssa Chiara
More informationLa revolución de la inmunoterapia: dónde la posicionamos? Javier Puente, MD, PhD
La revolución de la inmunoterapia: dónde la posicionamos? Javier Puente, MD, PhD Hospital Universitario Clinico San Carlos Medical Oncology Department Thoracic & Urological Cancer Unit Complutense University
More informationImmunotherapy of Melanoma Sanjiv S. Agarwala, MD
Immunotherapy of Melanoma Sanjiv S. Agarwala, MD Professor of Medicine Temple University School of Medicine Chief, Oncology & Hematology St. Luke s Cancer Center, Bethlehem, PA Overview Metastatic Melanoma
More informationCancer Immunotherapy Patient Forum. for the Treatment of Melanoma, Leukemia, Lymphoma, Lung and Genitourinary Cancers - November 7, 2015
Cancer Immunotherapy Patient Forum for the Treatment of Melanoma, Leukemia, Lymphoma, Lung and Genitourinary Cancers - November 7, 2015 Biomarkers and Patient Selection Julie R. Brahmer, M.D. Director
More informationTherapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer
Therapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer Axel Grothey, M.D., Professor of Oncology, Clinical and Translational Science Division of Medical Oncology Mayo Clinic, Rochester,
More informationA Giant Leap in the Treatment Options for Advanced Bladder Cancer
A Giant Leap in the Treatment Options for Advanced Bladder Cancer Yohann Loriot, MD, PhD Department of Cancer Medicine & INSERM U981 Gustave Roussy Villejuif, France Clinical Features of Bladder Cancer
More informationMelanoma. Il parere dell esperto. V. Ferraresi. Divisione di Oncologia Medica 1
Melanoma Il parere dell esperto V. Ferraresi Divisione di Oncologia Medica 1 MELANOMA and ESMO 2017.what happens? New data and updates ADJUVANT THERAPY with CHECKPOINT INHIBITORS (CA209-238 trial) AND
More informationNew Therapies in HCC Bruno Sangro Clínica Universidad de Navarra. IdISNA. CIBERehd. Pamplona, Spain
New Therapies in HCC Bruno Sangro Clínica Universidad de Navarra. IdISNA. CIBERehd. Pamplona, Spain PHC 2018 - www.aphc.info EASL-EORTC Guidelines EASL EORTC Guidelines. J Hepatol. 2012;56:908-43. Systemic
More informationSmall cell lung cancer. Targeted agents in SCLC
Small cell lung cancer Targeted agents in SCLC Enriqueta Felip Vall d Hebron University Hospital, Barcelona, Spain ESMO-The Christie Preceptorship program on Lung Cancer 03 March 2017 SCLC, where are we?
More informationMedical Treatment of Advanced Lung Cancer
Medical Treatment of Advanced Lung Cancer Oncology for Scientists April 26, 2018 Edwin Yau, MD., Ph.D. Assistant Professor of Oncology Department of Medicine Department of Cancer Genetics and Genomics
More informationINMUNOTERAPIA I. Dra. Virginia Calvo
INMUNOTERAPIA I Dra. Virginia Calvo LBA62. Health-related quality of life (HRQoL) for Pembrolizumab or placebo plus Carboplatin and Paclitaxel or nab-paclitaxel in patients with metastatic squamous NSCLC:
More informationThe Current Champion: Angiogenesis inhibitors
The Current Champion: Angiogenesis inhibitors Baek-Yeol RYOO University of Ulsan College of Medicine ASAN Medical Center Dept. of Oncology Seoul, Korea Survival probability Sorafenib: Overall Survival
More informationMerck Oncology Overview. The Development of MSI-H Cancer Therapy. Development of Anti-Cancer Drugs Forum Tokyo, Japan, 18, February 2017
Merck Oncology Overview The Development of MSI-H Cancer Therapy Development of Anti-Cancer Drugs Forum Tokyo, Japan, 18, February 217 Andrew Joe, MD Executive Director, Late Stage Oncology Merck & Co.,
More informationADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS. Andrés Cervantes. Professor of Medicine
ADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS Andrés Cervantes Professor of Medicine 1995 One option Advances in the treatment of mcrc 2000
More information