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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To determine the activity of pre- and post-operative chemoimmunotherapy compared with peri-operative chemotherapy plus post-operative immunotherapy in resectable distal oesophageal and gastro-oesophageal junction (GEJ) cancer and to validate putative biomarkers for immunotherapy benefit. Non-comparative randomised phase II trial.
TUMOUR: Oesophageal Cancer
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.
FOxTROT – 2/3
TUMOUR: Colorectal Cancer
Colon cancer incidence is strongly related to age with its highest incidence in older patients, with 44% of new cases are diagnosed in patients aged 75 or over. Older patients must have access to safe and effective treatments, managing cancer in older adults poses several significant challenges.
FOxTROT-2 aims to investigate whether a modified regime of 6 weeks of chemotherapy prior to surgery and post operation MDT decision regarding Adjuvant Chemotherapy, improves the Disease Free Surivival in older patients with patients with locally advanced operable colon cancer.
TUMOUR: Gastric and Oesophageal cancer
DNA damage repair and the immune system are novel ways in which we are targeting cancer. Traditional anticancer treatment such as chemotherapy and radiotherapy induce DNA damage to destroy cancer cells. We have also been able to harness our immune system to attack cancer cells that have been able to evade detection from it until the advent of immunotherapy. The marker known as STING which detects leaked DNA fragments in our cells, an indicator the cell has been damaged, and instructs the cell to be destroyed. Stomach cancers express low levels of STING and it is thought that this may, in part, explain why they do not respond as well as we would like to traditional treatment.
Through this study, we are aiming to determine what impact STING levels have on the ability for cancer to respond to treatment, how this impacts the immune response to cancer and ultimately the ability to survive. This may also open up new therapies which enhance STING levels that can work hand in hand with our existing treatment to better improve outcomes in patients with stomach and oesophagus cancers.