Daniel Catenacci

Medical Oncologist. "Targeted therapies for targeted populations”

[Daniel Catenacci @DocCatenacci]

Personalized Antibodies for Gastroesophageal Adenocarcinoma (PANGEA): A Phase II Study Evaluating an Individualized Treatment Strategy for Metastatic Disease https://t.co/J9JpKnj1t3

[Daniel Catenacci @DocCatenacci]

@peacfull97 @IFTVMarco Switzerland is not a small team which was who they placed second to in group stage in 2022, Norway for 2026 which you could see not as small team, and Spain in 2018. The problem is Europe does not have enough slots compared to other places in the world, namely Africa/Asia

[Daniel Catenacci @DocCatenacci]

@CR8charts @HKane Watch it in slow motion there is no contact

[Daniel Catenacci @DocCatenacci]

@fernandbteich Yes, I would probably for ESCC, especially for higher PDL1 (like >10) although your point is quite valid.

[Daniel Catenacci @DocCatenacci]

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

[Daniel Catenacci @DocCatenacci]

#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?

[Daniel Catenacci @DocCatenacci]

@fernandbteich First, #CM577 should be considered obsolete anyway for adenocarcinoma due to #ESOPEC & #MATTERHORN.

But yes, OS in CM577 would be even less impressive if the control arm actually got SOC antiPD1 in first line at recurrence when appropriate (ie PDL1+ and or MSI-H).

[Daniel Catenacci @DocCatenacci]

@fernandbteich Oh sorry I misunderstood your comment ‘drawing the line’. Yes, rather than requiring proof before doing certain treatments, some do it until it is disproved 10 times before it is stopped, maybe.

[Daniel Catenacci @DocCatenacci]

@PiessenG @MagnusNsurgonc Those numbers are DFS.
If you’re just looking at the numbers, would you rather live (OS) 39.2 months or 52.8 months? 🤔👇🏼

[Daniel Catenacci @DocCatenacci]

#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?

[Joao Fogacci @FogacciJoao]

@pashtoonkasi @NEJM @OncoAlert @sitcancer @DocCatenacci @GIcancerDoc @agrothey @EileenMOReilly @AnwaarSaeed3 @marklewismd @ILSONDavid @HH_Oncodr @KlempnerSam 💡Some OncGI fellows have pointed:

➡️Supplementary Appendix:

📌 CPS PDL1 =/> 5 (371 pt): 29.4 ❌ 10.2 m
📌 CPS PDL1 <5 ( 295 pt) : 16.3 ❌ 11.1 m

[Daniel Catenacci @DocCatenacci]

@fernandbteich Where to draw the line to what is called HER2+ for trastuzumab? Why is the FISH ratio of 2 used, not 1.9 or 2.5? Or Claudin18.2+ for zolbetuximab why is 2+ in 75% of cells used? They are not perfect either, but it is done, which is better than giving those drugs to everybody.

[Daniel Catenacci @DocCatenacci]

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

[Daniel Catenacci @DocCatenacci]

@LizzySmyth1 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

[Daniel Catenacci @DocCatenacci]

@LizzySmyth1 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

[Daniel Catenacci @DocCatenacci]

@LizzySmyth1 🦗🦗

I just read the paper.

Can you please tell me the HR for OS in the ITT full analysis population? I can’t find it!

Any reason you can think of that HR results for OS (not just EFS) of ITT & by PDL1 <1, <5, or <10 aren’t in the publication or the supplement?

[Daniel Catenacci @DocCatenacci]

@LizzySmyth1 5? 10?

[Daniel Catenacci @DocCatenacci]

https://t.co/Uw0lq66gJc

[Daniel Catenacci @DocCatenacci]

@SalemGIOncDoc For sure. And for 5-9. But let’s take the small victories when they come!

[Daniel Catenacci @DocCatenacci]

Better late than never, I guess.

[Lizzy Smyth @LizzySmyth1]

📢 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..)

[Daniel Catenacci @DocCatenacci]

@TimTheSurgeon Please share what you heard.

[Daniel Catenacci @DocCatenacci]

@aysegulilhanmut MSS. For MSI-H, for me, it remains to be seen if it should be IO alone or IO+chemo.

[Daniel Catenacci @DocCatenacci]

#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

[Lizzy Smyth @LizzySmyth1]

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

[Krishan Jethwa @KrishanJethwa]

🚨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

https://t.co/8As1EhDnup