M.D., Associate Professor of Medicine, Adult GI Medical Oncologist & Director of the Gastrointestinal Oncology Program, University of Chicago
In addition to his clinical practice, Dr. Catenacci is an active basic and clinical researcher, focusing on the treatment of gastroesophageal (esophagus, gastroesophageal junction, and stomach) cancers. His bench-to-bedside translational research has an overarching goal to validate and improve personalized treatment, immunotherapy, and precision medicine for gastroesophageal cancer and other GI cancers. A major focus of his research is on the quantification of tumor genetic molecular heterogeneity both between individuals with gastroesophageal cancer, but importantly also within a given individual within one tumor site, and from one tumor site to another, and how this impacts personalized targeted therapeutic approaches. Additionally, Dr. Catenacci designs and executes novel clinical trials to implement treatment strategies based on these laboratory and clinical discoveries. Dr. Catenacci serves as Associate Editor for the Journal of American Medical Association Network Open (JAMA Netw Open) and is on the editorial board of the Journal of Clinical Oncology Precision Oncology (J Clin Oncol PO).
Precision Medicine For Gastroesophageal Adenocarcinoma
This talk will cover the topic of targeted therapies in gastroesophageal adenocarcinoma (GEA) and attempt to explain why they have had limited efficacy despite recognition of numerous ‘targetable’ molecular events. Molecular heterogeneity that exists between patients, but also within an individual’s primary tumor, between their primary tumor and synchronous metastatic tumors, and in all of their lesions over time, will be the focus of the discussion. Current biomarker profiling is typically performed on one biopsy site (usually only the primary tumor at diagnosis), yet this fails to capture the molecular heterogeneity of GEA through space and time, with likely major clinical implications. Classic trial designs and treatment paradigms are challenged by this molecular heterogeneity, intensified by both numerous but low incidence oncogenic driver events coupled with the relative scarcity of tissue from a single biopsy site. There is therefore need for novel trial designs and next-generation biomarker profiling technologies that address these concerns, that provide targeted therapy algorithms for patients with multiple simultaneous molecular aberrations, and that have access to a readily-available portfolio of targeted therapies. A novel approach to these hurdles, a study called PANGEA, will be introduced.
Session Abstract – PMWC 2019 Silicon Valley
Session Synopsis: Precision oncology adoption into the clinical oncology workflow has been slow despite the technical and scientific advancements in molecular diagnostics and targeted therapeutics. Precision oncology incorporates in-depth genomic analysis of the patient’s tumor, interpretation of genomics results by the molecular tumor board (MTB), translation of findings into actionable therapeutic approaches, as well as navigation of the insurance and payor landscape in support of patients and providers. This session includes participants from various cancer centers that will share their learnings and the resulting added value to their institutions and medical communities, as well as the challenges they have to overcome when applying precision oncology through the MTB process.