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The document "SCARCE, no FACE (5-FU, atezolizumab, cisplatin, docetaxel) in advanced anal canal cancer" presents a study on the effectiveness of anti-PD-1 immunotherapy with atezolizumab in combination with chemotherapy for the treatment of advanced anal cancer. The study included 99 patients in 21 French centers, showing similar results between the experimental and control groups in terms of progression-free survival and overall survival. The addition of atezolizumab did not show significant benefit, but further studies are needed to confirm these results. [Extracted from the article]

Résumé: Le traitement systémique du carcinome hépatocellulaire (CHC) est profondément modifié par l'avènement en première ligne de la combinaison d'une immunothérapie (atézolizumab) et d'un antiangiogène (bévacizumab). D'autres combinaisons comportant des immunothérapies pourraient être validées dans un futur proche. Ces nouveaux traitements transforment le pronostic de la maladie... mais également les modalités de prise en charge, les parcours patients et l'organisation médicale avec un passage des traitements oraux gérés en consultation à des traitements intraveineux hospitaliers. Cette revue a pour objectif de décrire les nouveaux parcours de soins, en détaillant les modalités pratiques de choix du traitement, le bilan prétraitement, la gestion en hospitalisation de jour du traitement et de ses potentiels effets secondaires. Le rôle de l'hépato-gastroentérologue dans ce nouveau parcours de soins restera central en collaboration étroite (et non en concurrence) avec les oncologues médicaux, la prise en charge maintenant complexe des CHC nécessitant d'associer les compétences hépatologiques et oncologiques. Systemic treatment of hepatocellular carcinoma (HCC) was dramatically modified by the advent of immunotherapy (atezolizumab) and anti-angiogenic (bevacizumab) combination in first line. Other combinations with immunotherapies could be validated in the near future. These new treatments are transforming the prognosis of the disease... but also the modalities of care pathways and the medical organization with a shift from oral treatments (out-patient consultation) to in-hospital intra-venous treatments. The purpose of this review is to describe the new care pathways, detailing the practical modalities of treatment choice, pre-treatment check-up, management of the treatment and its potential side effects. The role of the Hepato-Gastroenterologist in this new care pathway will remain central in close collaboration (and not in competition) with medical oncologists, since the more and more complex management of HCC requires obviously the association of hepatological and oncology skills. [ABSTRACT FROM AUTHOR]

Résumé: L'actualité en oncologie digestive a été riche aux eJFHOD 2020 et ce compte-rendu n'en rapporte qu'une sélection. Suite aux résultats de l'étude BEACON CCR, une nouvelle AMM européenne est délivrée pour l'encorafénib associé au cétuximab dans les cancers colorectaux avec mutation BRAF V600E en deuxième ligne. L'ADN tumoral circulant et la présence de dépôts tumoraux sont des facteurs pronostiques importants dans les cancers colorectaux localisés. Les arguments s'accumulent pour la place de l'immunothérapie dans les cancers de l'œsophage. La médecine personnalisée est prometteuse dans les cancers des voies biliaires alors que le Folfirinox est tenu en échec en première ligne dans l'essai de phase II AMEBICA. Enfin, les actualités dans le carcinome hépatocellulaire se poursuivent, la combinaison atézolizumab-bévacizumab est un nouveau standard de première ligne avec une autorisation temporaire d'utilisation de cohorte depuis le 20 juillet 2020, et les futurs essais cliniques évaluant la radiothérapie intra-artérielle sélective devront inclure une dosimétrie personnalisée. There was a lot of news in digestive oncology at eJFHOD 2020 and this report is only a selection.. Following the results of the BEACON CCR study, a new European Marketing Authorization has been issued for encorafenib combined with cetuximab in colorectal cancers with BRAF V600E mutation in the second line. Circulating tumor DNA and the presence of tumor deposits are important prognostic factors in localized colorectal cancers. There is growing evidence for the role of chekpoint inhibitors in esophageal cancer. Personalized medicine is promising in biliary tract cancers whereas Folfirinox fails in the first-line AMEBICA phase II trial. Finally, the atezolizumab-bevacizumab combination is a new first-line standard with temporary authorization for cohort use since July 20, 2020, and future clinical trials evaluating selective intra-arterial radiotherapy should include personalized dosimetry. [ABSTRACT FROM AUTHOR]

Small cell lung cancer accounts for 14% of all lung cancers. It remains a major challenge for oncology as the progresses made in the past three decades are modest. After a rapid overview of current knowledge regarding somatic genomic alterations, this state-of-art addresses pathways to improve small-cell lung cancer outcome such as the targeting of DNA damage repair mechanisms firstly anti-PARPs, inhibitory molecules of EZH2, derepression of the NOTCH pathway, rovalbituzumab-tesirine, inhibition of serine/threonine Aurora A kinase, temozolomide and its dependence on methylation of the MGMT promoter. This first chapter suggests the beginning of precision medicine in small cell lung cancer. The last section focuses on the development of immuno-oncological agents and the information collected from phase 1 and 2 studies: the low intensity of PD-L1 tissue expression and the possible relationship of the activity of these agents as a function of tumor mutational burden are pointed out., (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Classical therapeutic strategy for advanced and metastatic non-small cell lung cancer, without activable oncogenic driver mutation, has been based mainly on cytotoxic chemotherapy with modest benefits in terms of increased survival., Background: A better understanding of the mechanisms involved in the regulation of the immune system led to the development of antibodies directed against immune checkpoints such as PD-L1. The first encouraging clinical data from phase I studies assessing anti-PD1 and anti-PD-L1 antibodies have been confirmed in randomised phase III trials., Conclusions: These new drugs now constitute a standard second-line treatment for metastatic tumours and in the future, at least for pembrolizumab, in the first line. Their adjuvant role after locoregional treatment with curative intent is currently under investigation., (Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Treatments for patients with metastatic or advanced urothelial carcinomas on progression after first line chemotherapy or unfit for cisplatin are currently limited. Atezolizumab (Tecentriq ® ) is a monoclonal antibody targeting PD-L1. The first of IMVIGOR 210 phase II trial (NCT02951767) investigated atezolizumab as front line treatment among 119 patients with metastatic urothelial cancer unfit for cisplatin. Response rate was 23% and median overall survival 15.9 months. The second cohort (NCT02108652) included 310 patients whose tumors were progressing after first line platinum-based chemotherapy. Response rate was 15% and median overall survival 7.9 months. Among patients with high PD-L1 expression on infiltrating immune cells (ICs), response rate was 26% and median overall survival 11 months. Atezolizumab was well-tolerated in both cohorts with 66% of treatment-related toxicities including 12% (cohort 1) and 7% (cohort 2) of grade 3-4 adverse events. These results led to an approval by the FDA in United States and the EMA in Europe. In France, atezolizumab was available through an early access agreement by the French National Agency for Medicines and Health Products (ANSM) for patients with metastatic or advanced urothelial carcinomas on progression after first line chemotherapy or unfit for cisplatin. So far, its avaibility in France within the EMA approval is pending its pricing., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)