The INTEGRATE Trial is helping answer an important health question. It has provided evidence that a new treatment, regorafenib, acts against advanced oesophago-gastric cancer and is safe. The investigators are now confident that they can look into a larger trial investigating survival. The trial recruited 152 patients from Australia, New Zealand, Korea and Canada. Patients were randomly allocated to regorafenib or a placebo tablet. Two thirds of the participants were put on the trial drug. All had advanced disease that had come back after chemotherapy. Of the patients taking regorafenib, 46% had no growth in their tumour at 8 weeks, compared with 18% taking placebo. The average overall short term survival was better in the regorafenib.

The latest Ministry of Health cancer statistics are now available. The death rate for gastro-intestinal cancers has dropped from 59% to 56%. Pancreatic cancer death rate has dropped the most from 94% to 84% in the last year. Men have considerably higher rates of GI cancers. GI cancers account for 22.5% of all cancers and 30.8% of all deaths from cancer. Help us raise funds to fight this disease. Text GICI to 2449 to donate $3 or www.gicinz.org.nz/donate.

CONTROL NETs
This study has opened in Australia for patients with advanced low or intermediate grade neuroendocrine tumours (NETs). These are uncommon tumours in the gastrointestinal tract which occur particularly in the pancreas or the midgut. Those from each site will be studied separately within the study. In Australia patients may be treated with PRRT, which involves giving a radioactive compound by vein which then targets onto the tumour cells. In the study, for the midgut NETs, they will compare giving PRRT alone with also giving tablet chemotherapy, which will be a combination of capecitabine and temozolomide (called CAPTEM for short). For the pancreatic NETs, the study will compare capecitabine/temozolomide chemotherapy alone with adding PRRT to it. At this stage New Zealand patients will not be able to participate, unless PRRT becomes available. So far, each of these treatments are used in some patients, but there has been very little evidence from trials evaluating them against each other, to help choose the best approach.