By Erin Burgess, AGITG
For 2020, the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting (ASM) went virtual for the first time. Over 460 delegates connected online to share the latest updates in GI cancer clinical trials and research. What is traditionally a three-day meeting was condensed into an accessible, COVID-safe one-day format that included all the highlights of the ASM.
For Meeting Convenor, Professor Stephen Ackland, it was his first year at the helm. He welcomed delegates from across Australia and New Zealand, as well as Invited Faculty from Japan and the United Kingdom. “At the AGITG we have a family culture. We like to demonstrate that people can speak their minds at meetings, have fun, and interact well,” he said, setting the tone for a lively and engaging day ahead.
Professor Kohei Shitara presented the Opening Keynote, ‘Gastric Cancer: Current practice and controversies/developments’, sponsored by Servier. Professor Shitara is a medical oncologist at Japan’s National Cancer Centre East, and is also the Lead Investigator of the AGITG’s INTEGRATE II study in Japan. He began by outlining the standard treatment for gastric cancer, and recent phase III trials investigating this cancer. “Success rates in the gastric cancer field are very low, so we should improve the strategy to develop new agents,” he noted, and stated the importance of recognising that not all gastric cancers are the same. He identified studying new treatments for HER2 positive patients as one area that held promise for the future.
The Opening Keynote set the theme of upper GI cancers for the morning session, which continued with updates on the AGITG’s trials in Upper GI cancers. These included NABNEC (Doctor Lorraine Chantrill), DYNAMIC-Pancreas (Doctor Belinda Lee), MASTERPLAN (Doctor Andrew Oar), INTEGRATE IIa/b (Associate Professor Nick Pavlakis), TOPGEAR (Professor Trevor Leong), ACTICCA-1 (Doctor Jenny Shannon), PALEO (Doctor Fiona Day), Neo-CREATE (Doctor Amitesh Roy), CONTROL NETS (Associate Professor Nick Pavlakis), and ALT-GIST (Doctor Lorraine Chantrill). Doctor Chantrill chaired the session, and acknowledged that a number of these trials were studying rare or less common cancers, gaining much-needed knowledge in areas including neuroendocrine tumours, oesophago-gastric cancer, and gastro-intestinal stromal tumours.
Then it was time for the New Concepts Symposium, chaired by Doctor Katrin Sjoquist. This session, which was sponsored by Servier, is one of the highlights of the ASM every year. Three new research concepts were presented, with each presenter given 15 minutes to pitch their concept to the group. Doctor Arwa Abdelmogod, Doctor Natalie Collier and Associate Professor Jeanne Tie all shared their concepts, and members attending the meeting voiced their opinions through an online poll to help determine who would be awarded the Best New Concept Award. Doctor Sjoquist noted that each of the submissions were of exceptionally high quality, and that competition for the Best New Concept was fierce.
The concepts presented were:
- Doctor Arwa Abdelmogod: ‘Phase II genomically-stratified study of combination Olaparib and Cediranib in relapsed platinum-sensitive pancreatic cancer’
- Doctor Natalie Collier: ‘Phase 2 trial of Interim MRI, FDG PET, and circulating tumour HPV DNA during chemoRadiotherapy In p16-positive AnaL squamous cell carcinoma: The IMPERIAL study’
- Associate Professor Jeanne Tie: ‘RESOLUTE: Randomised Phase II Trial to Evaluate the Strategy of Integrating Local Ablative Therapy with First-Line Systemic Treatment for Unresectable Oligometastatic Colorectal Cancer’
Before the Best New Concept Award was announced, Professor Trevor Leong chaired the Best of Posters Session. He began with a review of the 40 submitted posters that were available for attendees to view virtually throughout the day in the meeting platform. Professor Leong noted that research in biomarkers, as well as translational and lab research, were key themes amongst the posters. The three posters selected for presentations were all from early-career researchers, and were of exceptionally high quality.
Three standout posters were presented:
- Doctor Vanessa Wong: ‘The clinical significance of BRAF V600E mutation in metastatic colorectal cancer arising from a left sided primary’
- Doctor Oliver Piercey: ‘Adjuvant chemotherapy in elderly patients with stage III colorectal cancer’
- Mr Jordan Santucci: ‘Investigating the “real-world” clinical impact of treatment sequencing in advanced pancreatic cancer outcomes: a PURPLE translational registry analysis’
The Best of Posters Session was followed by the AGITG Awards presentation, recognising the achievements of AGITG members in research and fundraising. Doctor Lorraine Chantrill, AGITG Chair, presented the session, which was sponsored by AstraZeneca.
The 2020 AGITG award recipients were:
- The John Zalcberg OAM Award for Excellence in AGITG Research
This prestigious award for a senior AGITG member was awarded to Professor Niall Tebbutt, the Director of Medical Oncology at the Olivia Newton-John Cancer Research and Wellness Centre. “It’s a great honour to be the recipient of this year’s John Zalcberg Award. There’s no doubt in my mind that over the course of my consultant career that we’ve seen gradual improvements in outcomes for patients with GI cancers, and the work that we’ve done in AGITG has certainly contributed,” Professor Tebbutt said.
- The AGITG Outstanding Site Award
The Outstanding Site Award was presented to Monash Health, and accepted by Unit Manager Karen Gillett. Monash Health received the award in recognition of their commitment to and enthusiasm for conducting AGITG clinical trials.
- The Merck-AGITG Clinical Research Fellowship
The recipient of the 2021-22 fellowship at the Royal Marsden Hospital, UK, was Doctor Fiona Paxton-Hall. Doctor Paxton-Hall is currently a medical oncologist at Mater Hospital Brisbane, with an interest in conducting clinical trials in GI cancer.
- AGITG Member Fundraiser of the Year Award
Doctor Matthew Burge received this award after raising over $47,000 in the past year for the Innovation Fund through the Gutsy Challenge. Dr Burge described his fundraising experiences as “life changing” and thanked his patients and their families for their support.
- Best New Concept Award
Associate Professor Jeanne Tie was awarded the Best New Concept Award for her concept for a phase II trial investigating whether ablation therapy could be combined with other treatments to treat people with advanced colorectal cancer. The Runner-Up was Doctor Natalie Collier with a project investigating the functionality of MRI and FDG PET tests, as well as testing for circulating tumour HPV DNA for patients being treated for some forms of anal cancer.
- Best of Posters Award
This award was presented to Doctor Oliver Piercey for his poster, investigating chemotherapy after surgery for elderly patients with advanced colorectal cancer.
Finally, Dr Chantrill announced the Christine Aiken Memorial Award for Excellence in AGITG Study Coordination, in memory of Christine Aiken, who passed away in 2020. Christine worked for the NHMRC Clinical Trials Centre for 16 years as Trial Coordinator and Associate Oncology Project Manager. She worked exclusively on AGITG projects, and was known for her enthusiasm, commitment, collegiality and expansive knowledge. The inaugural Christine Aiken Memorial Award will be presented in 2021.
After the Awards Session, the second half of the day focused on Lower GI cancers, beginning with updates on AGITG’s Lower GI clinical trials chaired by Professor Chris Karapetis. These trials included SPAR (Doctor Michael Jameson), MONARCC (Doctor Matthew Burge), DYNAMIC-III and DYNAMIC-Rectal (Associate Professor Jeanne Tie), ASCOLT (Professor Eva Segelov), RENO (Professor Chris Karapetis), OXTOX (Professor Janette Vardy), FORECAST-1 (Doctor Grace Gard), and LIBERATE, MODULATE and POLEM (Professor Chris Karapetis). Speaking from Melbourne, Professor Eva Segelov spoke about the current challenges presented by COVID-19, saying, “It’s really hard to appreciate the challenges that we’ve been under, and particularly the challenges in keeping our clinical trials going.” Despite this, in this session it was clear that all 10 lower GI trials had continued to progress throughout the year despite the challenges they faced, thanks to the commitment of the researchers behind them.
After a short break, Doctor Naureen Starling presented the Closing Keynote, sponsored by Servier. Doctor Starling explored ‘Colorectal Cancer: Current Practice and Controversies/Developments’ and spoke from the United Kingdom, where she is Consultant Medical Oncologist at the Royal Marsden Hospital, London. Doctor Starling outlined the role of adjuvant chemotherapy in colorectal cancer treatment, the potential of targeted therapies, including targeting left- and right-sided tumours, immunotherapy, and developing precision therapies through identifying molecular subtypes. She emphasised the significance of minimising the toxicity of treatment. “There is impetus to limit the exposure of patients with potentially curable cancer to unnecessary toxicities,” she noted. This was followed by the final Q&A of the day, chaired by Professor Steven Ackland.
Professor Ackland then closed the meeting, thanking delegates for making the ASM as energising and insightful as it was and inviting them to join the AGITG in Melbourne for the 2021 Meeting. Despite the COVID-19 pandemic, the collegiality and enthusiasm of AGITG members meant that the ASM was not only the group’s first virtual meeting, but one of its best yet. There has been great progress with our research and all AGITG members are to be acknowledged for their commitment to furthering GI cancer research, while always keeping the patient at the centre of their work.