Previewing ASCO 2024: A Sneak Peek Into ARC-9, ESOPEC

Zev Wainberg, MD, MSc, of University of California, Los Angeles, and Nataliya Uboha, MD, PhD, of University of Wisconsin School of Medicine and Public Health, highlight the innovative ARC-9 study on rechallenging FOLFOX chemotherapy in colorectal cancer, as well as other exciting developments set to occur at the 2024 ASCO Annual Meeting.

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Dr. Uboha: I am going to pivot a little bit and talk about ASCO. I know you are the lead author on the ARC-9 abstract that is being presented for oral presentation in the colorectal session. Can you tell us a little bit about the design of this study and what we are hoping to hear?

Dr. Wainberg: It is an interesting study design because it challenges the dogma that you cannot rechallenge with chemotherapy. One of the ideas behind the ARC-9 study is that in the colorectal cancer community, as patients progress and move further away from frontline FOLFOX therapy, there has been a tendency to rechallenge with FOLFOX. This observation was made several years ago and was occurring more frequently than expected, but there was no real prospective data, only clinical observations by community oncologists and others.

The premise of the study is to see what happens when you rechallenge with FOLFOX chemotherapy and add in novel agents, which in this case are etrumadenant and zem. Etrumadenant is an A2AR inhibitor that blocks the adenosine receptor pathway. By rechallenging with FOLFOX and comparing it in a randomized trial to one of the existing standards of care—regorafenib at the time the study was launched—we aim to improve outcomes. The data is embargoed, but I think it is very interesting. I like seeing prospective data where none exists, so we will see how it is received by the community.

Dr. Uboha: Yeah, I am looking forward to hearing this. Is there anything else you are excited about at the upcoming ASCO meeting?

Dr. Wainberg: I think it is going to be a good ASCO. We have the head-to-head study of FLOT versus chemoradiation, which is part of the plenary and we have already seen some of that data, so that will be good. We also have some really promising studies with gastroesophageal cancer involving novel antibody combinations, bispecifics, and ADCs. Over the weekend, I heard some buzz about colon cancer and liver transplantation, although I have not heard the results yet.

If you look at the colon cancer oral session, there is a significant presentation on liver transplantation for liver-predominant metastatic colon cancer.

Dr. Uboha: Talk about moving the needle

Dr. Wainberg: Yeah, we will see how that goes. I think it will be good.