Eastern Canadian Gastrointestinal Cancer Consensus Conference 2018

Abstract

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference was held in Halifax, Nova Scotia, 20–22 September 2018. Experts in radiation oncology, medical oncology, surgical oncology, and pathology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of pancreatic cancer, pancreatic neuroendocrine tumours, hepatocellular cancer, and rectal and colon cancer, including■ surgical management of pancreatic adenocarcinoma,■ adjuvant and metastatic systemic therapy options in pancreatic adenocarcinoma,■ the role of radiotherapy in the management of pancreatic adenocarcinoma,■ systemic therapy in pancreatic neuroendocrine tumours,■ updates in systemic therapy for patients with advanced hepatocellular carcinoma,■ optimum duration of adjuvant systemic therapy for colorectal cancer, and■ sequence of therapy in oligometastatic colorectal cancer.

Basics and Frontiers on Pancreatic Cancer for Radiation Oncology: Target Delineation, SBRT, SIB Technique, MRgRT, Particle Therapy, Immunotherapy and Clinical Guidelines

“…American Society of Clinical Oncology (ASCO) published two separate GLs for resectable and LAPC; two of these were established by multidisciplinary networks, [3,32] while the other three were established by either medical [28,29] or radio-oncological [31] societies. Among the eight national GLs [33][34][35][36][37][38][39][40], one reports the results of a consensus conference [38] and one only deals with LAPC [40]. Of the total, eight were published or updated (including online updates) between 2018 and 2020.…”

“…The neoadjuvant approach is only proposed within a CCT by six of the 12 GLs. The other five mention it as a general alternative option for selected patients [3,29,31,38,39], but only two provide any details: CT only [39] and either CT or RT [38], respectively. One of the GLs does not mention this approach at all [28].…”

“…With respect to RT details, the GL proposed RTCT as definitive or in a sequential integration with CT. With respect to SBRT, three GLs indicate SBRT as a possible clinical option to the main treatment flow [3,30,31], one indicates it as a possible salvage therapy after failure of the complete CT course [40], and one indicates it as an option reserved to CCT [38].…”

“…Neoadjuvant therapy is detailed as CT in two GLs [33,39], up-front RTCT is detailed in two GLs [3,33] and induction CT possibly followed by RT is detailed in six of the GLs (of note, some GLs indicated multiple primary alternatives). In particular, SBRT is indicated as evaluable in clinical practice for BRPC by only one of the GLs [31], while one other mentions it as evaluable within CCT [38].…”

Vista of the Future: Novel Immunotherapy Based on the Human V-Set Immunoregulatory Receptor for Digestive System Tumors

“…They are a heterogeneous group consisting of esophageal, gastric, pancreatic, hepatobiliary, and colorectal cancer [ 9 ]. They all differ in their specific microenvironments, tumor-induced immune responses, and currently available treatment options [ 10 ]. It is imperative to find new therapeutic approaches capable of targeting all GITs, regardless of their wide range and variety [ 11 ].…”