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Reid M. Ness, MD, MPH, on Colorectal Cancer: Updates in Screening Recommendations
Reid M. Ness, MD, MPH, of Vanderbilt-Ingram Cancer Center, discusses significant updates to the NCCN Clinical Practice Guidelines in Oncology for colorectal cancer screening: lowering the age from 50 to 45 for the initiation of average-risk screening for all combinations of race, ethnicity, and...
Screening Platform May Contribute to Detection of Early-Stage Pancreatic Cancers, Other Malignancies
A novel screening platform flagged more than 95% of stage I pancreatic cancers, in addition to other early-stage malignancies, according to a pilot study published by Hinestrosa et al in Nature Communications Medicine. If validated by future studies, the approach may offer a new way to detect the...
Tumor Budding May Provide Independent Prognostic Value for Disease-Free and Overall Survival in Patients With Stage III Colon Cancer
Tumor budding is an emerging prognostic biomarker in colon cancer and currently influences decision-making in patients with pT1 and stage II colon cancer. In stage III colon cancer, its prognostic impact has been limited to small and retrospective cohorts. In a post hoc analysis of the IDEA-France...
Highlights From the NCCN 2022 Annual Conference
The NCCN 2022 Annual Conference took place from March 30 to April 1 as a virtual event. Designed to meet the educational needs of the interprofessional oncology care team, the conference offered more than 30 educational sessions featuring the latest advances and experts in oncology care. On this...
Risk of Colorectal Cancer May Be Linked to Cumulative Time With Excess Body Weight
In a German study reported in JAMA Oncology, Li et al found that assessment of risk of colorectal cancer based on cumulative lifetime excess weight may be more accurate than risk indicated by single body mass index (BMI) measurements. As stated by the investigators, “Excess weight is associated...
Short-Term Radiotherapy Plus Preoperative Chemotherapy vs Long-Term Chemoradiotherapy for Locally Advanced Rectal Cancer
In the Chinese phase III STELLAR trial reported in the Journal of Clinical Oncology, Jin et al found that preoperative short-term radiotherapy followed by chemotherapy was not inferior in 3-year disease-free survival vs a standard schedule of long-term chemoradiotherapy in patients with locally...
Expert Point of View: Mandana Kamgar, MD, MPH
The ASCO Post invited Mandana Kamgar, MD, MPH, Assistant Professor of Medicine at the Medical College of Wisconsin, LaBahn Pancreatic Cancer Program, Milwaukee, to comment on the KRYSTAL-1 trial. “The KRYSTAL-1 study in totality is a multiphase and multiarm ongoing study exploring the role of...
KRYSTAL-1: Adagrasib Controls Disease in Gastrointestinal Malignancies Beyond Colorectal Cancer
A disease control rate of 100% was achieved in gastrointestinal cancers treated with the KRAS G12C inhibitor adagrasib in the phase II KRYSTAL-1 trial, presented at the 2022 ASCO Gastrointestinal Cancers Symposium.1 The population included primarily those with pancreatic cancer; other noncolorectal ...
Adjuvant Therapy for Colon Cancer: Impact of Stopping Treatment Early
For patients with stage III colon cancer, early discontinuation of adjuvant chemotherapy leads to worse outcomes—but early discontinuation of oxaliplatin did not. These findings, which came from an analysis of the large ACCENT and IDEA clinical trials databases, were presented at the 2022 ASCO...
Expert Point of View: Rona Yaeger, MD
Rona Yaeger, MD, Assistant Attending Physician at Memorial Sloan Kettering Cancer Center, New York, offered her thoughts on the findings of Morris et al for the combination regimen of encorafenib, cetuximab, and nivolumab in microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer...
High Response Rate Seen With Nivolumab Added to Encorafenib and Cetuximab in BRAF V600E–Mutated Metastatic Colorectal Cancer
The combination of encorafenib, cetuximab, and nivolumab produced responses in 50% of patients and disease control in 96% of patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer in a phase I/II trial reported at the 2022 ASCO Gastrointestinal Cancers Symposium. The...
Recent FDA Approvals in Gastrointestinal Cancer
Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...
Expert Point of View: Benoit Rousseau, MD, PhD
Benoit Rousseau, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, called the findings of the phase II GERCOR NIPICOL trial “interesting and convincing.” Long-term follow-up showed the 3-year progression-free survival rate to be 70% after 1 total year of treatment with nivolumab plus...
NIPICOL Trial: Promising Outcomes With Shorter Duration of Checkpoint Inhibition in Metastatic Colorectal Cancer
The phase II GERCOR NIPICOL study evaluated 1 year of treatment with nivolumab plus ipilimumab in patients with chemotherapy-resistant metastatic colorectal cancer whose tumors were microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR). With this shortened treatment duration,...
Sotorasib in Previously Treated Patients With KRAS G12C–Mutant Colorectal Cancer
In a prespecified analysis of the phase II CodeBreaK100 trial reported in The Lancet Oncology, Marwan Fakih, MD, and colleagues found that the KRAS G12C protein inhibitor sotorasib showed modest activity in patients with previously treated KRAS G12C–mutant colorectal cancer.1 Study Details The...
Expert Point of View: Elena Élez, MD, PhD
Invited discussant of the two studies, Elena Élez, MD, PhD, of the Colon Cancer Program, Vall d’Hebron Institute of Oncology, Barcelona, Spain, discussed the challenge of treating BRAF-mutant colorectal cancer and what the new data bring to that effort. Dr. Élez noted: “BRAF V600E–mutant...
BRAF-Mutant Colorectal Cancer: Latest Findings for Targeted Treatment
The phase II ANCHOR CRC study, the largest prospective study of BRAF inhibitor–based therapy as first-line treatment of metastatic colorectal cancer, has met its primary endpoint, with 47.8% of patients with metastatic colorectal cancer responding to first-line treatment with encorafenib,...
Addition of Neoadjuvant FOLFIRINOX to Preoperative Chemoradiotherapy in Locally Advanced Rectal Cancer
As reported in The Lancet Oncology by Thierry Conroy, MD, and colleagues, the French phase III UNICANCER-PRODIGE 23 trial has shown that intensification of preoperative therapy with FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, fluorouracil [5-FU]) prior to chemoradiotherapy resulted in...
Gastrointestinal Oncology 2021–2022 Almanac
The past year has seen unprecedented progress across the spectrum of gastrointestinal malignances, including the advancement of immunotherapy and targeted molecular agents and the refinement of adjuvant therapy using novel as well as existing therapies. Three themes emerging from these reports are: ...
Should Patients Aged 80 and Older Receive Single-Agent Immune Checkpoint Inhibitor Treatment?
The checkpoint inhibitors are among the most important advances in oncology in recent times. They have changed the natural history of many tumors, particularly melanoma. They have a favorable toxicity profile, which for most patients is manageable and tolerable. However, there are several...
Sequencing of Drug Combinations Could Amplify Antitumor Immune Response in Liver Cancer
A new therapeutic strategy for hepatocellular carcinoma (HCC) that initially primes the tumor with an immune checkpoint inhibitor before using a multikinase inhibitor has shown efficacy in a study published in the Journal of the National Cancer Institute. Kikuchi et al reported that the new...
Temozolomide Followed by Low-Dose Ipilimumab/Nivolumab in MSS and MGMT-Silenced Metastatic Colorectal Cancer
In an Italian phase II study (MAYA) reported in the Journal of Clinical Oncology, Morano et al found that patients with microsatellite-stable (MSS) and O6-methylguanine–DNA methyltransferase (MGMT)-silenced metastatic colorectal cancer without disease progression on temozolomide derived benefit...
Cardiovascular Mortality and Cancer Mortality Over Time Among Cancer Survivors
In an English retrospective cohort study reported in JACC: CardioOncology, Strongman et al found that cardiovascular mortality in older cancer survivors ultimately exceeded mortality from common primary cancers in the time since their primary cancer diagnosis. However, the eventual predominance of...
Gabriel A. Brooks, MPH, MD, Comments on the ACCENT/IDEA Database Analysis Results
Gabriel A. Brooks, MPH, MD, Associate Professor of Medicine, Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, was invited to discuss the results of the ACCENT/IDEA database analysis of early treatment discontinuation in stage III colon cancer.1 Although the results confirm the...
Adjuvant Therapy for Colon Cancer: Impact of Stopping Treatment Early
For patients with stage III colon cancer, early discontinuation of adjuvant chemotherapy leads to worse outcomes—but early discontinuation of oxaliplatin did not. These findings, which came from an analysis of the large ACCENT and IDEA clinical trials databases, were presented at the 2022 ASCO...
New Research Measures Decrease in Cancer Detection Due to the COVID-19 Pandemic
Research published in JNCCN—Journal of the National Comprehensive Cancer Network examined data from the Ontario Cancer Registry from September 25, 2016, through September 26, 2020, to determine the impact of the COVID-19 pandemic on the number of new cancer cases detected. The researchers found...
War Is Hell. It’s Also a Public Health Disaster, Especially for People With Cancer
We are all following the ongoing Russian invasion of Ukraine with surprise and horror. I’m sure few readers of The ASCO Post imagined the invasion of a European country by its European neighbor was possible again, naively thinking wars like this ended with the Allied victory in World War II. But...
Cancer Risk Among Patients With Pediatric-Onset Inflammatory Bowel Disease
In a meta-analysis of population-based studies reported in JAMA Network Open, Elmahdi et al found that although the reported incidence of cancers in individuals with pediatric-onset inflammatory bowel disease (IBD) is low, the condition is associated with a significantly increased risk of cancers...
ASCO and Ontario Health Provide Updated Recommendations on Using Adjuvant Bone-Modifying Treatments in Nonmetastatic Breast Cancer
An update to a joint guideline from Cancer Care Ontario (now a division of Ontario Health) and ASCO provides revised recommendations for the use of adjuvant bone-modifying agents for patients with nonmetastatic breast cancer, with the overarching goal of improving relapse and survival rates.1,2...
Managing Long-Term Toxicity From Pelvic Radiation Therapy
Advances over the past 3 decades in improvements in cancer prevention and screening strategies and more effective diagnostics and therapies in cancer care have led to unprecedented declines in death rates from all cancers, including prostate, gynecologic, and colorectal/anal cancers. The fastest...
American Cancer Society Reports Breast Cancer Is Now the Leading Cause of Cancer Mortality in Black Women
Breast cancer has surpassed lung cancer as the leading cause of cancer mortality among Black women as of 2019. This news is one of the key findings in Cancer Statistics for African American/Black People 2022, published recently in CA: A Cancer Journal for Clinicians and its consumer-friendly...
Grieving the Loss of Sexual Intimacy as a Result of Cancer and Its Treatment
About 5 years ago, I began experiencing some digestive issues that I initially blamed on the stress from coping with my mother’s diagnosis of Alzheimer’s disease. But after 2 weeks of unrelenting symptoms, including abdominal pain, a change in my bowel habits, and rectal bleeding, I saw my primary...
Cancer in the Arab World: Addressing Challenges to Improve Outcomes
I returned home to the United Arab Emirates in 2017, following my oncology fellowship training and work experience in the United States. I immediately realized that I am now dealing with a considerably different cancer patient population in terms of age of onset, stage at presentation, awareness...
Expert Point of View: Christopher Willett, MD
Christopher Willett, MD, Professor and Chair of the Department of Radiation Oncology at Duke University in Durham, North Carolina, shared his thoughts on the findings of the study by Lumish et al1 with The ASCO Post. He first noted the shift in recent years toward total neoadjuvant therapy in the...
Small Study Reports Neoadjuvant PD-1 Blockade Yields 100% Clinical Complete Response Rate in Locally Advanced Mismatch Repair–Deficient Rectal Cancer
In a small study of patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, treatment with the anti–PD-1 agent dostarlimab-gxly alone led to a clinical complete response rate of 100%. The findings of this study from Memorial Sloan Kettering Cancer Center (MSK) were reported...
Expert Point of View: Benoit Rousseau, MD, PhD
Benoit Rousseau, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, called the findings of the phase II GERCOR NIPICOL trial “interesting and convincing.” Long-term follow-up showed the 3-year progression-free survival rate to be 70% after just 1 total year of treatment with nivolumab...
NIPICOL Trial: Promising Outcomes With Shorter Duration of Checkpoint Inhibition in Metastatic Colorectal Cancer
The phase II GERCOR NIPICOL study evaluated 1 year of treatment with nivolumab plus ipilimumab in patients with chemotherapy-resistant metastatic colorectal cancer whose tumors were microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR). With this shortened treatment duration,...
Mihir Gupta, MD, and Ganesh M. Shankar, MD, PhD, Offer Commentary on the Use of ctDNA to Detect CNS Lymphoma
Mihir Gupta, MD, a neurosurgery resident at the University of California San Diego and postdoctoral fellow at Massachusetts General Hospital Department of Neurosurgery, and Ganesh M. Shankar, MD, PhD, Assistant Professor of Neurosurgery, Massachusetts General Hospital and Harvard Medical School,...
President’s Cancer Panel Report: Closing Gaps in Cancer Screening for All Americans
Much progress has been made in the past 50 years since the signing of the National Cancer Act of 1971, which included the establishment of the President’s Cancer Panel. Nevertheless, there remain significant opportunities to make improvements across the cancer spectrum, perhaps none more pressing...
Updated Findings on T-DXd in Gastrointestinal Malignancies
Updates of phase II studies evaluating fam-trastuzumab deruxtecan-nxki (T-DXd) in gastrointestinal cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium, continuing to offer support for the antibody-drug conjugate in these malignancies. In HER2-expressing gastric cancer, T-DXd...
Study Evaluates Whether ctDNA Has Demonstrable Advantage Over Standard Surveillance Methods for Colorectal Cancer
Researchers at City of Hope published data pointing to the limitations of a popular liquid biopsy that is used to detect the recurrence of colorectal cancer in patients who who have undergone surgical resection. The findings were published in JAMA Network Open by Marwan Fakih, MD, and colleagues....
How Does Intake of Unprocessed Red Meat and Processed Meat Impact Risk of Disease Recurrence and Mortality in Patients With Colon Cancer?
In a prospective cohort study reported in JAMA Network Open, Erin L. Van Blarigan, ScD, and colleagues found that higher intake of unprocessed red meat or processed meat was not associated with poorer recurrence-free or overall survival in patients with stage III colon cancer. As stated by the...
Study Finds Taller Adults May Be at Increased Risk for Colorectal Cancer
A new meta-analysis adds to evidence that taller adults may be more likely than shorter ones to develop colorectal cancer or colon polyps that can later become malignant. While the association between taller height and colorectal cancer has been previously investigated, researchers from Johns...
Effect of Screening Initiative on Disparity in Colorectal Cancer Mortality Between Black and White Patients
In an analysis reported in a letter to the editor in The New England Journal of Medicine, Doubeni et al found that a sustained Kaiser Permanente Northern California (KPNC) colorectal cancer screening initiative resulted in increased screening, increased identification of colorectal cancer, and a...
Adagrasib in Advanced KRAS G12C–Mutant Solid Tumors
In a first-in-human phase I/Ib study (KRYSTAL-1) reported in the Journal of Clinical Oncology, Ou et al identified the phase II dose of the oral small-molecule KRAS G12C inhibitor adagrasib and found that the agent was active in patients with advanced KRAS G12C–mutant solid tumors. Study Details...
FDA Approves FoundationOne CDx as a Companion Diagnostic for Pembrolizumab to Identify Patients With MSI-H Solid Tumors
On February 21, the U.S. Food and Drug Administration (FDA) approved FoundationOne CDx to be used as a companion diagnostic to identify patients with microsatellite instability–high (MSI-H) status solid tumors who may be appropriate candidates for treatment with pembrolizumab. FoundationOne CDx is...
Expert Point of View: Rona Yaeger, MD
Rona Yaeger, MD, Associate Attending Physician at Memorial Sloan Kettering Cancer Center, New York, discussed the results of the GALAXY trial,1 first putting them into context with previous studies. As she pointed out, the finding of an 11-fold increase in risk of recurrence in patients who...
GALAXY Trial: Circulating Tumor DNA Appears Prognostic in Resected Colorectal Cancer
The use of circulating tumor DNA (ctDNA) assays in early-stage colorectal cancer is highly prognostic for recurrence and may help identify patients who could benefit from adjuvant chemotherapy, according to findings from the GALAXY trial, presented at the 2022 ASCO Gastrointestinal Cancers...
Understanding How LGBTQI+ Cancer Survivors Experience Cancer Care
Members of the lesbian, gay, bisexual, transgender, and queer/questioning, intersexed (LGBTQI+) community face numerous challenges and barriers when accessing the health-care system in the United States, including cancer care; as a result, they may be at greater risk for developing cancer and...
Centralizing Care for Adolescents and Young Adults With Cancer to Improve Long-Term Survivorship
This past fall, Memorial Sloan Kettering (MSK) Cancer Center in New York expanded its adolescent and young adult (AYA) program with the establishment of the Lisa and Scott Stuart Center for Adolescent and Young Adult Cancers. The Stuart Center is now part of the increasing list of about 50 academic ...
