Concepts in Development

The AGITG research development strategy and prioritisation framework outline the process by which concepts progress from embryonic ideas to funded trials. The concepts listed below have been identified as a research priority for AGITG by the Working Parties, Consumer Advisory Panel and Scientific Advisory Committee, and are currently seeking funds to commence the trial.

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SSGXXII

TUMOUR: Gastro-Intestinal Stromal Tumour (GIST)

Three years of imatinib is considered the standard duration of post therapy for patients with operable high-risk GIST. Yet, many patients are still at a high risk of GIST recurrence after completion of three years of adjuvant imatinib, and might benefit from further adjuvant imatinib therapy. The aim of SSGXXII is to compare the effect of giving imatinib for 5 years against 3 years, in patients who have undergone surgery for GIST, with the intent to prevent the tumour from coming back. The trial will look at the effect of the efficacy and safety of 5 years of treatment compared to 3 years.


Neo-IMPACT

TUMOUR: Pancreatic Cancer

Pancreas cancer continues to be a challenging cancer to diagnose, with a 5-year survival rate of 8.9%. Neo-IMPACT is a pilot study to treat people with early stage pancreas cancer chemotherapy with immunotherapy before surgery. In the last 12 months, there have been several advances that indicate that the manipulation of the microbiome, the make-up of the individual’s gut bacteria, may be critical to the success of future research programs in pancreas cancer. Immunotherapy has been shown to be effective across multiple cancers but is yet to show effect in pancreas cancer.


RANDOMS

TUMOUR: Pancreatic Cancer

Pancreatic cancer is a rare cancer with a poor prognosis. It is associated with a high prevalence of weight loss and malnutrition. Identifying and treating this early, through improved assessment techniques, could lead to improved outcomes for patients with Pancreatic Cancer. A simple measurement of weight, or body mass index (BMI), is currently commonly used, although it does not accurately identify those at most risk, or changes in muscle tissue. The most accurate way to measure body composition is using CT scans, however,  this requires skilled staff and is time consuming. Malnutrition and loss of muscle mass can be identified with a quick-to-use tool called the Patient Generated Subjective Global Assessment (PG-SGA).

The PG-SGA is commonly used by dietitians when completing nutrition assessments in patients with Pancreatic Cancer. The relationship between the PG-SGA malnutrition diagnosis and CT-diagnosed low muscle mass has not yet been investigated in Pancreatic Cancer. Given the PG-SGA tool is widely accessible and low cost, comparing its use to the gold standard CT-assessed body composition is warranted. This may improve the management of patients with Pancreatic Cancer in the future.


NEEDS

TUMOUR: Oesophageal Cancer

Currently oesophageal cancer is the 7th most common cancer and the 6th most common cause of cancer deaths worldwide. Most oesophageal cancers are diagnosed in advanced stages. Today, oesophageal squamous cell carcinoma (SCC) has dismal outcomes worldwide. On a population level only a minority of patients with locally advanced resectable stages survive five years. This study aims to optimise the treatment strategy for patients with oesophageal SCC towards better outcomes in terms of survival, preservation of quality of life and health-economics.

The NEEDS trial will assess whether one of the two tested treatment approaches should be preferred in the future as standard therapy for patients with oesophageal squamous cell carcinoma. The study compares neoadjuvant chemoradiotherapy followed by surgery with definitive chemoradiotherapy, using defined chemoradiotherapy options, with post treatment surveillance and surgery (as needed) to obtain local tumor control.


CEND-1

TUMOUR: Pancreatic Cancer

Patients with metastatic pancreatic ductal adenocarcinoma (PDAC) have poor outcomes. Nevertheless, in the past few years, the development of more effective doublet and triplet chemotherapy regimens have improved median survival to approximately 8.5-11 months. The purpose of the CEND-1 study is to determine if the addition of CEND-1 to first line gemcitabine and nab-paclitaxel has sufficient activity and safety in patients with untreated metastatic pancreatic ductal adenocarcinoma.

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