Current approaches for managing an array of malignancies was the focus of the Hot Topics in Surgical Oncology session presented at Clinical Congress in Boston, Massachusetts.
Panelists discussed the optimal use and sequencing of targeted therapies and immunotherapy for breast cancer and melanoma; management of unanticipated peritoneal disease while performing minimally invasive surgery and classification of mucinous neoplasms; and neoadjuvant treatments approaches for pancreatic and rectal cancer.
“There are best practices at individual institutions, and there are clinical trials that are ongoing to try to define optimal management of these diseases,” said co-moderator Tari A. King, MD, FACS, vice-chair for multidisciplinary oncology, and chief of the Department of Surgery in the Division of Breast Surgery at Brigham and Women’s Hospital in Boston. “These are areas that are still evolving, where best practices are being defined, and we wanted to bring the latest evidence to the audience.”
Most of the topics featured two speakers representing institutions with potentially different pathways for managing a particular malignancy. Some panelists presented case studies and others led brief discussions in which they described the evolving indications for systemic adjuvant therapies and provided updates on staging and molecular testing.
“We asked speakers to fill their 15-minute time slot in a way that best highlights the issues and controversies that are at the forefront of these disease settings,” said Dr. King.
Session highlights included the presentation on pancreatic cancer, which has traditionally been diagnosed at fairly advanced stages, but as patients are diagnosed earlier, some data suggest optimizing the use of neoadjuvant therapy to improve survival rates. Another presentation revealed data showing some rectal cancers may be best treated simply with neoadjuvant therapy in combination with radiation, possibly without surgery.
“Clinical trial data continue to evolve, and it's important to select patients appropriately for these approaches,” said Dr. King.
For breast cancer and melanoma, panelists discussed the progress that has been made in identifying which patients will truly benefit from preoperative systemic therapy—sometimes as targeted therapy, sometimes as immunotherapy.
“Understanding the importance of sequencing of treatments and using preoperative therapy in appropriate patients is really important in both breast cancer and melanoma,” noted Dr. King.
No matter how varied these malignancies are, the keystone of this session was the presentation of current clinical evidence and ongoing trials that are attempting to address new, and often controversial, management options.
The full agenda for this year’s session included:
Watch and Wait or Resection for T3 Rectal Cancer
Matthew F. Kalady, MD, FACS, Columbus, OH
Uma R. Phatak, MD, FACS, Galveston, TX
Multimodality Approaches in Locally Advanced and Inflammatory Breast Cancer
Oluwadamilola M. Fayanju, MD, FACS, Philadelphia, PA
Mediget Teshome, MD, FACS, Houston, TX
Immunotherapy, Targeted Therapies and Surgery for Patients with Melanoma
Mark B. Faries, MD, FACS, Santa Monica, CA
Genevieve M. Boland, MD, PhD, FACS, Boston, MA
Diagnosis and Management of Peritoneal Surface Malignancies
Kiran K. Turaga, MBBS, FACS, New Haven, CT
Laura A. Lambert, MD, FACS, Salt Lake City, UT
Neoadjuvant Approaches to Resectable Pancreatic Cancer
Susan Tsai, MD, MHS, FACS, Milwaukee, WI
This session is available for on-demand viewing on the virtual meeting platform.
