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]

@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

[Daniel Catenacci @DocCatenacci]

Already Approved in Japan 3/26/24. Different manufacturing sites for the two countries hopefully??

https://t.co/JeLyV1oUo2

[Daniel Catenacci @DocCatenacci]

#SPOTLIGHT #GLOW #Zolbetuximab #Vyloy

"Zolbetuximab BLA resubmitted 5/9/2024, after CRL issued on 1/4/2024 by FDA due to 3rd-party manufacturer deficiencies seen during the pre-license inspection of the facility." Target Action Date: 11/9/2024

https://t.co/nf0AlEEY3J.