U. S. Multisociety Task Force on Colorectal Cancer Offers Management Strategies for Malignant Colorectal Polyps
Early identification and removal of cancerous colorectal polyps are critical to preventing the progression of colorectal cancer and improving survival rates. The U.S. Multisociety Task Force on Colorectal Cancer has released new guidance for endoscopists on how to assess colorectal lesions for...
Effect of Anterior Approach vs Conventional Hepatectomy in Resection of Colorectal Liver Metastases on Intraoperative Tumor Cell Dissemination
In a German single-institution study reported in JAMA Surgery, Rahbari et al found that the anterior approach to the resection of colorectal liver metastases was not associated with a reduction in the detection of intraoperative circulating tumor cells vs conventional hepatectomy. As stated by the...
Addition of Irinotecan to Neoadjuvant Capecitabine Chemoradiation Guided by UGT1A1 Genotype in Locally Advanced Rectal Cancer
In a Chinese phase III trial reported in the Journal of Clinical Oncology, Zhu et al found that the addition of irinotecan to neoadjuvant capecitabine chemoradiation (CapIriRT)—with irinotecan dosing guided by UGT1A1 genotype—followed by capecitabine/irinotecan (XELIRI) significantly improved...
Surgical Technical Skill and Long-Term Survival After Surgery for Colon Cancer
In a study reported as a research letter in JAMA Oncology, Brajcich et al found that higher-rated surgical technical skill was associated with significantly improved long-term survival in patients undergoing surgery for colon cancer. Study Details In the study, surgeons were recruited from the...
Medicaid Expansion Associated With Decreased Mortality in Patients With Newly Diagnosed Breast, Colorectal, and Lung Cancers
In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major types of cancer are significantly lower than in states that have not expanded their Medicaid, according to findings from a new study published by Miranda B. Lam, MD, MBA, and ...
After Surgery for Colorectal Cancer, Intensive Monitoring of Little Benefit: PRODIGE 13
Is intensive monitoring of patients after curative colorectal cancer resection warranted? Not necessarily, according to the findings of PRODIGE 13, reported at the European Society for Medical Oncology (ESMO) Virtual Congress 2020.1 “After curative surgery, the addition of CEA [carcinoembryonic...
Should Patients With a Complete Response to Neoadjuvant Chemoradiation for Rectal Cancer Also Undergo Surgery?
A nonsurgical treatment option for rectal cancer that preserves quality of life may be safe for selected patients, according to a new study comparing it with standard surgical treatment. These findings were published by Beard et al in the Journal of the American College of Surgeons and were...
USPSTF Issues Draft Recommendation on Screening for Colorectal Cancer
On October 27, the U.S. Preventive Services Task Force (USPSTF) posted a draft recommendation statement on screening for colorectal cancer. For the first time, the Task Force is recommending that screening start at age 45. This is a B recommendation, meaning the USPSTF recommends the service; that...
Becoming Acquainted With Cancer
Editor’s Note: The ASCO Post learned of the death of Patrick Beauregard due to colorectal cancer on September 6, 2020. Just weeks after my wedding in late summer of 2017, I had a sudden bout of abdominal pain so severe that it sent me to the emergency room. I was just 29 years old and in great...
First-Line Pembrolizumab in Metastatic Colorectal Cancer: Quality of Life Also Improved
In KEYNOTE-177, the anti–PD-L1 antibody pembrolizumab reduced the risk of disease progression by 40% vs chemotherapy in a targeted subset of previously untreated patients with metastatic colorectal cancer. Now, in terms of health-related quality of life, pembrolizumab is also the clear favorite,...
ASTRO Issues Clinical Guideline on Radiation Therapy for Rectal Cancer
A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance for physicians who use radiation therapy to treat patients with locally advanced rectal cancer. Recommendations outline indications and best practices for pelvic radiation treatments, as well as the...
Addition of Oxaliplatin to Preoperative Capecitabine-Based Chemoradiation and Adjuvant Capecitabine in Locally Advanced Rectal Cancer
As reported in the Journal of Clinical Oncology by Schmoll et al, the phase III PETACC 6 trial has shown no benefit of the addition of preoperative and adjuvant oxaliplatin to preoperative capecitabine-based chemoradiation and adjuvant capecitabine in patients undergoing total mesorectal excision...
Veena Shankaran, MD, on Colorectal Cancer: Cumulative Financial Hardship of Treatment
Veena Shankaran, MD, of the Seattle Cancer Care Alliance, discusses study findings from a national sample of patients with metastatic colorectal cancer who are on systemic therapy. A year into their treatment, nearly three out of four patients had major financial hardships despite access to health insurance coverage (Abstract 137).
Trends to Watch in Early-Onset Cancer Among Young Adults
Although cancer incidence and mortality rates for all cancers combined are considerably lower in younger adults than older adults, a disturbing pattern is beginning to emerge in the development of early-onset cancers, typically diagnosed in older patients, occurring in younger adults. The rising...
A Primary Care Physician Explores Barriers to Cancer Prevention and Clinical Trial Accrual
To accelerate progress in the survival rates of people with cancer in the United States and to reduce cancer disparities across the entire spectrum of cancer from diagnosis to survivorship, there needs to be increased access to cancer screening and prevention programs. To shed light on this...
Study Finds Racial Disparities in Management of Colorectal Cancer Spreading to the Liver
Colorectal cancer is more prevalent among Black people, a group with the highest rates of death for an illness that is curable if caught early. “The unfortunate reality is that minorities, especially Black people, have a much lower chance of getting life-saving cancer treatment. Health care works...
Study Finds Disparities in Microsatellite Instability/Mismatch Repair Biomarker Testing for Patients With Stage IV Colorectal Cancer
Immune checkpoint inhibitors have improved outcomes for patients with a variety of cancer types, including those with advanced colorectal cancers that test positive for microsatellite instability/mismatch repair deficiency (MSI-high/MMRd). While testing rates for patients with MSI-high/MMRd...
Activity of the KRAS G12C Inhibitor Sotorasib in KRAS p.G12C–Mutant Advanced Solid Tumors
As reported in The New England Journal of Medicine by David S. Hong, MD, and colleagues, the phase I CodeBreaK100 trial showed activity of the oral KRAS G12C inhibitor sotorasib in heavily pretreated patients with KRAS p.G12C–mutant advanced non–small cell lung cancer (NSCLC), colorectal cancer,...
I’ve Turned My Pain Into a New Life Purpose
The first half of 2016 was arguably the most exciting of my life. My wife, Jaione, and I had decided to leave the United Kingdom and move with our two children, Andrew, then 14, and Alba, then 10, to Denver, where I was taking on a leadership role in corporate affairs for a brewery company. By the...
Elderly Patients With Advanced Colorectal Cancer Treated With Adjuvant Oxaliplatin Plus Fluoropyrimidines: Tolerability and Benefit
Among patients with stage III colon cancer, patients aged 70 or older were less tolerant of adjuvant oxaliplatin/flouropyrimidine therapy, in addition to having poorer relapse-free interval rates on the regimen, according to findings from a large subgroup analysis of the phase III TOSCA trial...
Thierry Andre, MD, on Colorectal Cancer: Health-Related Quality of Life With Pembrolizumab vs Chemotherapy
Thierry Andre, MD, of Hôpital Saint-Antoine, discusses phase III KEYNOTE-177 findings on the reduced risk of disease progression or death in patients receiving pembrolizumab monotherapy as a first-line treatment of microsatellite instability–high and/or mismatch repair–deficient metastatic colorectal cancer (Abstract 396O).
Can Drinking Coffee Daily Improve Survival in Patients With Advanced Colorectal Cancer?
In a large group of patients with metastatic colorectal cancer, consumption of a few cups of coffee a day was associated with longer survival and reduced risk of disease progression, according to findings reported by Mackintosh et al in JAMA Oncology. The findings, based on data from a large...
Eflornithine Plus Sulindac vs Either Agent Alone in Preventing Progression of Familial Adenomatous Polyposis
In a phase III trial reported in The New England Journal of Medicine, Burke et al found that the combination of eflornithine and sulindac did not reduce the risk of disease progression vs either agent alone in patients with familial adenomatous polyposis. Study Details In the international trial,...
Association of Immunoscore With Time to Recurrence in Stage III Colon Cancer
In a study reported in the Journal of Clinical Oncology, Mlecnik et al found that high Immunoscore values were associated with reduced risk of disease recurrence and better outcomes with chemotherapy vs no chemotherapy in patients with stage III colon cancer. Study Details The international...
Retrospective Study Explores Association Between Race/Ethnicity and Overall Survival in Colorectal Liver Metastases
A research letter published by Thornblade et al in JAMA Network Open examined the impact of race or ethnicity on rates of chemotherapy, liver resection, and survival among patients with metastatic colorectal cancer. “The unfortunate reality is that minorities, especially Black people, have a much...
Meta-analysis of FOLFOXIRI/Bevacizumab vs Doublets/Bevacizumab as Initial Treatment for Unresectable Metastatic Colorectal Cancer
In a patient-level meta-analysis reported in the Journal of Clinical Oncology, Chiara Cremolini, MD, PhD, and colleagues found that infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus bevacizumab was associated with significantly greater overall survival vs...
Effect of Muscle Mass and Radiodensity on Postoperative Complications and Outcomes of Colon Cancer Surgery
In a retrospective cohort study reported in JAMA Surgery, Xiao et al found that low skeletal muscle index and low skeletal muscle radiodensity were associated with an increased risk of complications and poor outcomes following surgery for colon cancer. Study Details The study involved data on...
Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile
“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...
Addition of Bevacizumab to mFOLFOX6 for the First-Line Treatment of RAS-Mutant Unresectable Colorectal Liver Metastases
In a Chinese single-institution trial reported in the Journal of Clinical Oncology, Tang et al found that the addition of first-line bevacizumab to mFOLFOX6 (modified fluorouracil, leucovorin, and oxaliplatin) resulted in a higher rate of conversion to R0 resection in patients with RAS-mutant,...
Pembrolizumab for First-Line Treatment of Unresectable or Metastatic MSI-H or dMMR Colorectal Cancer
On June 29, 2020, pembrolizumab was approved for the first-line treatment of patients with unresectable or metastatic microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) colorectal cancer.1 Supporting Efficacy Data Approval was based on findings in the randomized,...
Second-Look Surgery Plus HIPEC vs Surveillance for Patients at High Risk for Colorectal Peritoneal Metastases
In a French phase III trial (PROPHYLOCHIP–PRODIGE 15) reported in The Lancet Oncology, Goéré et al found that second-look surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) did not improve disease-free survival vs standard surveillance in patients at high risk of developing colorectal...
Xavier Llor, MD, PhD, on Colorectal Cancer: Why Are More Younger People Being Affected?
Xavier Llor, MD, PhD, of Yale University School of Medicine, discusses the steep rise of early-onset colorectal cancer over the past 15 years, which cannot be explained by genetic predisposition but may be prompted by environmental factors (Session ED35).
Does Periodontal Disease Increase the Risk of Colorectal Cancer?
Periodontal disease was associated with an increased risk of two precursors of colorectal cancer, according to results of a study published by Lo et al in Cancer Prevention Research. “Periodontal disease is prevalent among adults, with periodontitis affecting more than 40% of the U.S. population,”...
Modeling Study Aims to Estimate the Effect of the COVID-19 Pandemic on Cancer Deaths in England
In a population-based modeling study reported in The Lancet Oncology, Maringe et al estimated that delays in diagnosis due to the COVID-19 pandemic could result in 3,291 to 3,621 additional deaths from breast, colorectal, esophageal, and lung cancers within 5 years. As stated by the investigators,...
Adjuvant Chemotherapy vs Active Surveillance: Survival After Resection of Isolated Synchronous Colorectal Peritoneal Metastases
In a Dutch population-based observational cohort study reported in JAMA Oncology, Rovers et al found that adjuvant systemic chemotherapy was associated with improved overall survival vs active surveillance after upfront resection of isolated synchronous colorectal peritoneal metastases. Study...
Common Hypertension Medications May Also Reduce Risk of Colorectal Cancer
Medications commonly prescribed to treat high blood pressure may also reduce the risk of colorectal cancer, according to new research published by Cheung et al in the journal Hypertension. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) are often prescribed...
Expert Point of View: Christopher Leigh Hallemeier, MD
The invited discussant for the RAPIDO and PRODIGE 23 trials, Christopher Leigh Hallemeier, MD, Associate Professor of Radiation Oncology at the Mayo Clinic, Rochester, noted the standard approach to locally advanced rectal cancer has been, for the past 2 decades, a long course of chemoradiotherapy...
Two Studies Validate Neoadjuvant Chemotherapy With Short-Course Radiotherapy or Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer
In the treatment of resectable, locally advanced rectal cancer, researchers are trying to identify the most effective chemotherapy regimens, the best radiotherapy approaches, and the optimal sequence of these modalities. Two phase III trials presented during the ASCO20 Virtual Scientific Program...
GI-Related Patient-Reported Outcomes in Individuals Receiving Chemoradiation for Anal Cancer
In a single-institution study reported in JCO Oncology Practice, Kouzy et al found that gastrointestinal (GI)-related patient-reported outcomes among those receiving chemoradiation for anal cancer improved vs baseline at 1 week after treatment initiation, were worse vs baseline at 5 weeks, but did...
Geographic Patterns of Early-Onset Colorectal Cancer Diagnoses in the United States
Over the past 3 decades, colorectal cancer survival in the United States has improved significantly, but in young people—particularly men diagnosed with colorectal cancer before age 50—incidence and mortality due to colorectal cancer are on the rise. Additionally, among patients with early-stage...
Expert Point of View: Axel Grothey, MD
Sharing his perspective on KEYNOTE-177 with The ASCO Post was Axel Grothey, MD, Director of GI Cancer Research at the West Cancer Center, OneOncology, Memphis. “This is a very important, highly anticipated study,” he said. “It’s the first randomized trial of any checkpoint inhibitor in...
Rates of Progression-Free Survival in MSI-H/dMMR Metastatic Colorectal Cancer Doubled by Pembrolizumab
Upfront treatment with immunotherapy not only improved results in a subset of patients with metastatic colorectal cancer, it doubled the rates of median progression-free survival. These findings—the first of their kind—arose from the interim analysis of the randomized open-label phase III...
Conference Highlights From the ASCO20 Virtual Scientific Program
The global outbreak of the COVID-19 pandemic forced many cancer societies, including ASCO, to cancel their in-person meetings this year and instead present the latest advancements and new approaches in oncology care via a virtual platform. For the first time in its 56-year history, the ASCO Annual...
FDA Approves Pembrolizumab for the First-Line Treatment of MSI-H/dMMR Colorectal Cancer
On June 29, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the first-line treatment of patients with unresectable or metastatic microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) colorectal cancer. KEYNOTE-177 Approval was based on...
I’m Not Too Young for Colorectal Cancer
The first symptoms I had of colorectal cancer—blood in my stool and abdominal pain—coincided with surgery I had to remove my appendix in the spring of 2017. My surgeon attributed the symptoms to the appendectomy and to the medications I received both before and after the surgery. In addition to...
Survey Shows Young-Onset Colorectal Cancer May Be Overlooked in Exam Rooms
The Colorectal Cancer Alliance recently released findings from its latest survey of patients with young-onset colorectal cancer and survivors. The Never Too Young Survey shares the self-reported medical, psychosocial, and quality-of-life experiences of this often-overlooked population to better...
Trastuzumab Deruxtecan Shows Benefit in Refractory Colorectal Cancer
Having recently gained approval in metastatic breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd) is now proving its worth in metastatic colorectal cancer, according to results of the phase II DESTINY-CRC01 study in patients with HER2-positive disease.1 T-DXd is an antibody-drug conjugate...
FDA Pipeline: Fast Track Designations in Colorectal and Pancreatic Cancers, Lymphoplasmacytic Lymphoma/Waldenström’s Macroglobulinemia
Over the past month, the U.S. Food and Drug Administration has granted Fast Track designation to agents designed to treat colorectal and pancreatic cancers, in addition to lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia; accepted a new drug application for a treatment for relapsed or...
Cisplatin/Fluorouracil vs Carboplatin/Paclitaxel in Chemotherapy-Naive Patients With Advanced Anal Cancer
In an International Rare Cancers Initiative phase II trial (InterAAct) reported in the Journal of Clinical Oncology, Rao et al found that carboplatin/paclitaxel was associated with less serious toxicity and a trend toward improved overall survival vs cisplatin/fluorouracil in chemotherapy-naive...
Alberto F. Sobrero, MD, on Colon Cancer: Adjuvant Oxaliplatin and Fluoropyrimidine-Based Therapy for Stage III Disease
Alberto F. Sobrero, MD, of the Ospedale San Martino, discusses final results of the IDEA study, which supported the use of 3 months of adjuvant CAPOX, vs 6 months, for most patients with stage III colon cancer. The shorter treatment duration reduced toxicity, inconvenience, and cost (Abstract 4004).
