The second AGITG Idea Generation Workshop was held virtually on Friday 6 November, facilitated by Professor Martin Stockler and Associate Professor Lara Lipton. This year, ideas focused on early-stage oesophageal cancer. Concepts were presented across medical oncology, radiation oncology, surgery and nutrition, and the attendees discussed how each could be developed into clinical trials.
Idea 1: Presented by Doctor Sweet Ping Ng
Title: Use of Multiparametric MRI as Early Imaging Biomarker of Response for Patients with Localised Oesophageal Cancer Undergoing Curative-Intent Radiotherapy
How would you describe your idea?
“Using functional MRI we can potentially have an interim response evaluation during the course of radiotherapy to identify early responders versus non-responders, allowing patient-specific response-adapted personalisation of therapy and improve therapeutic ratio (highest cure with least toxicity).
“Currently patients undergo the entire course of curative-intent radiotherapy (which can be toxic) with no interval assessment of treatment response. I hope to generate interest across all disciplines in exploring novel imaging techniques for treatment response during radiotherapy as it is an area of unmet need particularly in patients with oesophageal cancer.”
Idea 2: Presented by Doctor Andrew Oar
Title: Exploratory Study Using Digital Spatial Profiling on Diagnostic Biopsies and Surgical Resection Specimens for Patients Receiving Curative Intent Trimodality Therapy for Oesophageal Cancer
How would you describe your idea?
“It is increasingly recognised that tumour growth, metastatic potential and treatment resistance are a complex interplay between tumour and its surrounding tissue. New and revolutionary technology (Digital Spatial Profiling) is now providing the ability to interrogate tumour and its surrounding tissues to understand the complicated relationship between tumours, inflammatory cells, pathways and biological mediators.
“Digital Spatial Profiling has the potential to revolutionise the way we treat cancer patients.”
Idea 3: Presented by Doctor Adnan Nagrial
Title: Phase 2 Study of Adjuvant Chemo-Immunotherapy Following Chemoradiation and Surgery in Resectable Oesophageal Cancer
How would you describe your idea?
“This idea asks the question of whether giving further chemotherapy an immunotherapy after surgery for oesophageal cancer will improve cure rates. At the Idea Generation Workshop I hope to gain feedback from my colleagues and create the best study possible, and gain consensus on which study design will best answer the question.”
Idea 4: Presented by Clinical Dietitian Irene Deftereos
Title: PRO-NUTRIENT: Proactive Nutrition Intervention and Early feeding in Neoadjuvant Therapy for oesophageal cancer
How would you describe your idea?
“My idea aims to address the high prevalence of malnutrition in people with oesophageal cancer through improved nutritional management. I strongly believe that a multi-disciplinary approach to nutrition care and research in cancer produces the best outcomes for patients. The AGITG Idea Generation Workshop will give me a great opportunity to discuss my idea with a wide variety of experts including consumers.
“I hope that the workshop and support from AGITG will assist in developing my idea into meaningful clinical research that significantly improves the outcomes of patients with oesophageal cancer in the future.”
Idea 5: Presented by Professor Andrew Barbour
Title: PRECISE: PRE-operative response-based Chemotherapy and post-operative Immunotherapy for operable Stage oEsophageal and gastro-oesophageal junction cancer
How would you describe your idea?
“Results from the AGITG DOCTOR trial showed that early metabolic response (EMR) on PET scan to induction Cisplatin/5-FU chemotherapy in oesophageal adenocarcinoma is associated with favourable survival outcomes.
Building on the results of DOCTOR, DOCTOR 2.0 proposes initial chemotherapy with FLOT, with non-EMR patients to be randomised to receive FLOT/DCF + RT or concurrent FOLFIRI + RT.”
Idea 6: Presented by Doctor Mei Chan
Title: Biomarker Tailored Treatment for Early Stage Oesophageal Cancers
How would you describe your idea?
“This idea is a feasibility study using blood-based biomarker (ctDNA) and metabolic response assessment to assess its role in prognostication and guidance in treatment strategies for oesophagogastric cancers. The Workshop is an opportunity to seek support and advice from AGITG to develop our concept into a trial protocol and explore avenues of grant funding with the help of AGITG.”
At the Workshop, all six ideas were discussed and potential avenues to develop them further were discussed. Several ideas presented are currently being progressed through the AGITG into research concepts. When fully developed, they will be presented to the AGITG Upper GI Working Party.