1. Copyright © 2011 Research To Practice. All rights reserved. Faculty 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 Eileen M O’Reilly, MD Eric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD

2. Copyright © 2011 Research To Practice. All rights reserved. Case presented by Dr Polkinghorn 66 yo man: PMH- Hepatitis C and rising AFP (120K) –? missed diagnosis, now multiple hepatic lesions consistent with HCC. Child Pugh B cirrhosis 2/2010: Treated with TACE x 3  falling AFP Sorafenib (before and following TACE) x 4-6 mos –AFP  to 300 but toxicity (? related to underlying cirrhosis) Cytopenias, HFS, diarrhea, abdominal pain Sorafenib on hold. AFP remains low

3. Copyright © 2011 Research To Practice. All rights reserved.

4. Case presented by Dr Polkinghorn 66 yo man: PMH- Hepatitis C and rising AFP (120K) –? missed diagnosis, now multiple hepatic lesions consistent with HCC. Child Pugh B cirrhosis 2/2010: Treated with TACE x 3  falling AFP Sorafenib (before and following TACE) x 4-6 mos –AFP  to 300 but toxicity (? related to underlying cirrhosis) Cytopenias, HFS, diarrhea, abdominal pain Sorafenib on hold. AFP remains low

5. Copyright © 2011 Research To Practice. All rights reserved.

6. Case presented by Dr Polkinghorn 66 yo man: PMH- Hepatitis C and rising AFP (120K) –? missed diagnosis, now multiple hepatic lesions consistent with HCC. Child Pugh B cirrhosis 2/2010: Treated with TACE x 3  falling AFP Sorafenib (before and following TACE) x 4-6 mos –AFP  to 300 but toxicity (? related to underlying cirrhosis) Cytopenias, HFS, diarrhea, abdominal pain Sorafenib on hold. AFP remains low

7. Copyright © 2011 Research To Practice. All rights reserved. First Interim Results of the Global Investigation of Therapeutic Decisions in Hepatocellular Carcinoma (HCC) and of its Treatment with Sorafenib (GIDEON) Study: Use of Sorafenib by Oncologists and Nononcologists in the Management of HCC Venook AP et al. Proc ASCO GI 2011;Abstract 157

8. Copyright © 2011 Research To Practice. All rights reserved. GIDEON Study: First Interim Analysis Venook AP et al. Proc ASCO GI 2011;Abstract 157.

9. Copyright © 2011 Research To Practice. All rights reserved. Case presented by Dr Polkinghorn 66 yo man: PMH- Hepatitis C and rising AFP (120K) –? missed diagnosis, now multiple hepatic lesions consistent with HCC. Child Pugh B cirrhosis 2/2010: Treated with TACE x 3  falling AFP Sorafenib (before and following TACE) x 4-6 mos –AFP  to 300 but toxicity (? related to underlying cirrhosis) Cytopenias, HFS, diarrhea, abdominal pain Sorafenib on hold. AFP remains low

10. Copyright © 2011 Research To Practice. All rights reserved. Faculty 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 Eileen M O’Reilly, MD Eric Van Cutsem, MD, PhD Andrew X Zhu, MD, PhD Charles D Blanke, MD David Cunningham, MD Steven A Curley, MD

11. Copyright © 2011 Research To Practice. All rights reserved. Doxorubicin plus sorafenib vs doxorubicin alone in patients with advanced hepatocellular carcinoma: a randomized trial Abou-Alfa GK et al. JAMA 2010;304(19):62154-60

12. Copyright © 2011 Research To Practice. All rights reserved. Case presented by Dr Polkinghorn 66 yo man: PMH- Hepatitis C and rising AFP (120K) –? missed diagnosis, now multiple hepatic lesions consistent with HCC. Child Pugh B cirrhosis 2/2010: Treated with TACE x 3  falling AFP Sorafenib (before and following TACE) x 4-6 mos –AFP  to 300 but toxicity (? related to underlying cirrhosis) Cytopenias, HFS, diarrhea, abdominal pain Sorafenib on hold. AFP remains low