1. IBS, ABS….AND ABS? GP EDUCATION NIGHT 25 TH FEB 2015 DR KATRIN SJOQUIST @ONCODOCSYDNEY (New trials, new drugs and good advice)

2. EVERYTHING OLD IS NEW AGAIN… New treatments Old treatments Old news New trials

3. NEW DRUGS Some promising  Regorafenib in advanced oesophago-gastric ca

4. ‘OLD TREATMENTS’ Aspirin  Beneficial in high risk groups as primary prevention  FAP, Lynch syndrome  Latency period of 5+ years  Under investigation for secondary prevention  ASCOLT study  Adding adjuvant aspirin vs placebo following completion of adjuvant treatment  AGITG/Australia participating

5. OLD NEWS (FOR SOME)? Effect of exercise  Evidence in other cancers  secondary prevention/breast  CHALLENGE (CO21)  Structured exercise programme plus general health advice vs health advice only  Currently enrolling St George (TSH shortly)  Medically fit colon cancer patients (high risk stage II and stage III) completed adjuvant chemotherapy within the past 60-180 days. Current physical activity levels 150 minutes of moderate-to-vigorous or >75 minutes of vigorous exercise/week).  ECHO  Exercise during adjuvant chemotherapy for ovarian cancer

6. NEW TYPES OF TRIALS One site, many diseases Baskets, buckets & umbrellas

7. NEW TYPES OF TRIALS Considering different targets within the one cancer type  E.g. IMPACT – molecular targets in pancreas cancer Considering common targets across different primary cancer types Worldwide approaches – baskets, buckets & umbrellas Australia – GCCTI www.gccti.org.auwww.gccti.org.au

8. “BASKET/BUCKET” Evaluate effect of a single drug on a single mutation in a variety of cancers

9. Evaluate impact of different drugs on different mutations either in a single type of cancer or a variety of tumour types e.g. PARAGON (ANZGOG ) “UMBRELLA” TRIALS

10. PERSONALISED/PRECISION TRIALS Tumours tested for ‘actionable’ mutations Targeted vs ‘standard’ (e.g. MPACT)

11. QUESTIONS