Jeremy Shapiro

Impact Spotlight: The ICECREAM Trial

This year marks the 30th anniversary of the GI Cancer Institute and AGITG. This year, we are looking back at the highlights from our past clinical trials which have led to breakthroughs in medical knowledge and better treatments for patients. We could not make these breakthroughs without the incredible dedication and support of our researchers, community supporters, and most of all, our patients and their families.

Colorectal cancer is the second leading cause of cancer death in Australia. If diagnosed early, it is one of the most treatable forms of cancer, but once it is advanced there are often few effective treatment options available. Research has shown that patients with a rare genetic mutation called G13D may respond to treatment differently. The ICECREAM trial, led by Professor Jeremy Shapiro, aimed to find out more about what treatments worked best for these patients.

The ICECREAM trial investigated the efficacy of a combination of two treatments, cetuximab and irinotecan, compared to cetuximab alone, for patients with metastatic colorectal cancer and the G13D genetic mutation when other standard treatments had stopped working.

All patients had weekly infusions of cetuximab. Half the patients were randomly allocated to also receive the standard chemotherapy, irinotecan. Treatment continued until the disease worsened or patients or their treating doctors decided to stop.

Ultimately, ICECREAM found that contrary to some earlier reports, cetuximab is not a useful treatment for tumours with G13D mutations. Although the combination treatment did show a minor benefit, given the side-effects observed and uncertainty about the need for cetuximab, these results do not justify the routine use of this drug combination for patients with this type of mutation.

While presenting the trial results, Principal Investigator Professor Jeremy Shapiro said, “The results of this important trial will add two further pieces to the complex colorectal treatment jigsaw.” By providing specific data on how patients with this genetic mutation respond to treatment, ICECREAM was a step towards personalising the treatment of patients with this multifaceted form of cancer.


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