National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer Friday, January 21, 2011 7:00 PM – 9:30 PM San Francisco, California Moderator Neil Love, MD Faculty Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD Eileen M O’Reilly, MD Eric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD 1 1

Case presented by Dr Moriarty 79 yo man with rectal bleeding Early 2010: Resection of T3bN2 Grade II colon ca  opted for capecitabine in lieu of adjuvant FOLFOX During last 8 weeks of chemotx, ↑CEA (from 3 10) and PET/CT = 4.8 cm hepatic met Started on FOLFOX/bevacizumab to assess “chemosensitivity” prior to local treatment of isolated metastatic lesion

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Case presented by Dr Moriarty 79 yo man with rectal bleeding Early 2010: Resection of T3bN2 Grade II colon ca  opted for capecitabine in lieu of adjuvant FOLFOX During last 8 weeks of chemotx, ↑CEA (from 3 10) and PET/CT = 4.8 cm hepatic met Started on FOLFOX/bevacizumab to assess “chemosensitivity” prior to local treatment of isolated metastatic lesion

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Case presented by Dr Moriarty 79 yo man with rectal bleeding Early 2010: Resection of T3bN2 Grade II colon ca  opted for capecitabine in lieu of adjuvant FOLFOX During last 8 weeks of chemotx, ↑CEA (from 3 10) and PET/CT = 4.8 cm hepatic met Started on FOLFOX/bevacizumab to assess “chemosensitivity” prior to local treatment of isolated metastatic lesion

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Case presented by Dr Moriarty 79 yo man with rectal bleeding Early 2010: Resection of T3bN2 Grade II colon ca  opted for capecitabine in lieu of adjuvant FOLFOX During last 8 weeks of chemotx, ↑CEA (from 3 10) and PET/CT = 4.8 cm hepatic met Started on FOLFOX/bevacizumab to assess “chemosensitivity” prior to local treatment of isolated metastatic lesion

Ongoing Phase II/III Trials: Liver Only CRC Metastases Study Phase Target Accrual Design Study Endpoints HEPATICA III 500 (open) Post-op XELOX +/ bevacizumab 3 yr DFS OS NSABP C-11 670 (on hold) Peri- versus Post-op: mFOLFOX6 or FOLFIRI + bevacizumab RFS NHS: USTCU-EPOC 340 Peri-op FOLFOX +/- cetuximab PFS ORR SIRFLOX II/III 450 XELOX +/- yttrium-90 microspheres NSABP FC-6 II 60 Unresectable: mFOLFOX7 + cetuximab R0 resection rate www.ClinicalTrials.gov, January 2011.

National GI Tumor Board Clinical Investigators Provide Their Perspectives on Current Cases of Gastrointestinal Cancer Friday, January 21, 2011 7:00 PM – 9:30 PM San Francisco, California Moderator Neil Love, MD Faculty Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD Eileen M O’Reilly, MD Eric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD 10 10

Meta-Analysis of Studies with >100 Patients Who Underwent Liver Resections for CLM with >24 Months of Follow-Up (1999-2009): Results Postoperative mortality 0-4% Most common postoperative fatal complications Hepatic failure (23.8%) Sepsis (15.5%) Myocardial infarction (14.3%) Postoperative blood transfusions 36% (64.3% in previous reports) 5-yr survival (range) 38% (16%-71%) Taylor A et al. Proc ESMO 2010;Abstract 632P.

Case presented by Dr Moriarty 79 yo man with rectal bleeding Early 2010: Resection of T3bN2 Grade II colon ca  opted for capecitabine in lieu of adjuvant FOLFOX During last 8 weeks of chemotx, ↑CEA (from 3 10) and PET/CT = 4.8 cm hepatic met Started on FOLFOX/bevacizumab to assess “chemosensitivity” prior to local treatment of isolated metastatic lesion