Eric Van Cutsem Head, Digestive Oncology, University Hospital Gasthuisberg and Professor of Internal Medicine, University of Leuven, Belgium Published more than 185 peer-reviewed articles and more than 300 other texts or chapters in books On editorial board of many international journals Chairman of the EORTC GI group Member of the general assembly of PanEuropean Trials on Adjuvant Colon Cancer Chairs the ministerial commission on colon cancer prevention in Flanders Vice-president of the International Digestive Cancer Alliance Member of the ASCO Cancer Education Committee University Hospital Gasthuisberg

Challenges for the treatment of colorectal cancer and gastric cancer Eric Van Cutsem University Hospital Gasthuisberg Leuven, Belgium

Friday 8 February 2008 Agenda Chair’s opening Eric Van Cutsem Forging a new standard in metastatic CRC Eric Van Cutsem Mounting evidence in early CRC Axel Grothey 10.10Capecitabine: the new standard chemotherapy in advanced gastric cancer? Werner Scheithauer 10.40Discussion 11.00Coffee break

American Cancer Society: cancer facts and figures 2007 Incidence Mortality Digestive system cancer: estimated new cases and deaths in the USA Estimated new cases/ deaths in the USA (per year) Stomach Small intestine ColonLiverPancreas 150, , ,000 75,000 50,000 25,000 0

CRC: what are the challenges that we face in the next decade? Feasibility of metastasectomy and optimal management of wound-healing/bleeding events Establish optimal treatment duration for novel therapies Determine optimal combination partners Dose modifications for novel therapies and the impact on clinical outcomes Determine whether novel therapies can replace 5-FU as the backbone for CRC therapy CRC = colorectal cancer; 5-FU = 5-fluorouracil

Rivera F, et al. Cancer Treat Rev 2007;33:315–24 Gastric cancer: ‘classical’ chemotherapy regimens provide limited benefit Months Time to progression Overall survival –5 months 7–10 months Outcomes with cisplatin/5-FU or cisplatin/5-FU/epirubicin regimens

No global ‘standard of care’ in metastatic gastric cancer Surgery only curative option –50% patients present with unresectable disease Addition of docetaxel to cisplatin/5-FU improves survival 1,2 –however, safety issues limit the use of the docetaxel/cisplatin/5-FU regimen in daily practice Still unmet need in metastatic gastric cancer Ajani JA, et al. J Clin Oncol 2007;18:4001–3 Van Cutsem E, et al. J Clin Oncol 2006;24:4991–7

Gastric cancer: what are the challenges that we face in the next decade? Determine optimal combination regimens Establish a backbone chemotherapy Continue to evaluate novel treatment options Determine whether novel therapies can improve survival and enhance quality of life Extend treatment to a wider range of patients