Third International Conference on Biology, Prevention and Treatment of Gastrointestinal Malignancies. Cologne, 23-26 September 1998.

R. Mayer (USA), summarizing the data presented during the three-day conference, stressed the importance of the development of new cytotoxic drugs and -- particularly -- biological therapies as forms of treatment for patients with gastrointestinal malignancies. He also acknowledged the increasing application of molecular biology to gastrointestinal cancer through the identification of genetically-defined high-risk patients who merit costly screening techniques and the increased use of molecular 'markers' to serve as prognostic indicators and criteria for stratification in future clinical trials. Dr Mayer cautioned against allowing long-term frustration over poor surgical outcomes in patients with T3-4 esophageal cancer and enthusiasm derived from uncontrolled (i.e., phase II) trials to lead to the premature acceptance of preoperative chemoradiation therapy as standard treatment for such patients in the absence of properly controlled, adequately powered randomized studies. Dr Mayer reinforced the progress that has been made in the adjuvant treatment of colon cancer and noted the increasing number of new randomized studies that have been proposed to further enhance the likelihood for cure, particularly in patients with stage III disease. Dr Mayer concluded by presenting a series of hypothetical agenda items for the Fourth International Conference on Biology, Prevention, and Treatment of Gastrointestinal Malignancies to be held in the new millennium which he hoped would demonstrate the incorporation of biological agents into clinical trials, would document more concerted efforts to study the biology and improve the treatment for pancreatic cancer, and would begin to consider the use of 'risk-adapted' management strategies into clinical trials, based on such preclinical biological markers as intratumoral thymidylate synthase levels, apoptotic indices, allelic deletions, and the like.