American Cancer Society Investigators Present Studies on COVID-19 Pandemic, Racial/Ethnic Disparities, and Coverage for Genomic Testing
Investigators at the American Cancer Society presented results of several studies during poster sessions at the 2022 ASCO Annual Meeting. Summaries of a few of these studies are provided here. COVID-19 and Cancer Mortality According to a new study led by researchers at the American Cancer Society,...
Expert Point of View: Kimmie Ng, MD, MPH
The study’s invited discussant was Kimmie Ng, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Co-Director of the Colon and Rectal Cancer Center at Dana-Farber Cancer Institute, Boston. “Neoadjuvant dostarlimab-gxly for 6 months represents a promising new treatment for...
100% Complete Response Rate in 14 Patients With Rectal Cancer Treated With Neoadjuvant Dostarlimab-gxly
In a study of 18 patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, 6 months of neoadjuvant treatment with the anti–PD-1 agent dostarlimab-gxly alone led to clinical complete responses in 100% of the study’s first 14 patients.1 These results were presented at the 2022...
Treatment of Anal High-Grade Squamous Intraepithelial Lesions to Prevent Anal Cancer in Persons With HIV
In the phase III ANCHOR study reported in The New England Journal of Medicine, Palefsky et al found that treatment of high-grade squamous intraepithelial lesions was successful in preventing anal cancer vs active monitoring in persons infected with HIV. Study Details In the multicenter trial, 4,446 ...
Overall Survival in Patients With Metastatic Colorectal Cancer in Phase III Trials and SEER Database Over a 30-Year Period
In a study reported in JAMA Network Open, Shen et al found that data from both phase III trials and the Surveillance, Epidemiology, and End Results (SEER) database indicate significant improvements in overall survival for patients with metastatic colorectal cancer over a 30-year period. Increases...
Michael J. Overman, MD, and Smitha Krishnamurthi, MD, on RAS Wild-Type Metastatic Colorectal Cancer: Refining Treatment Strategy
Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Smitha Krishnamurthi, MD, of the Cleveland Clinic, review three abstracts, all of which enrolled patients with newly diagnosed RAS and BRAF wild-type metastatic colorectal cancer with left-sided primary tumors. The discussion centers on what the study results indicate about the use of an EGFR therapy and weighing the risk to quality of life from rash, in particular (Abstracts LBA3503, LBA3504, LBA3505).
Addition of Atezolizumab to FOLFOXIRI/Bevacizumab for Metastatic Colorectal Cancer
In an Italian phase II trial (AtezoTRIBE) reported in The Lancet Oncology, Antoniotti et al found that the addition of atezolizumab to FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, irinotecan) and bevacizumab improved progression-free survival in the first-line treatment of patients with...
Michael J. Overman, MD, and Jeanne Tie, MBChB, MD, on Colon Cancer: Guiding Adjuvant Chemotherapy With ctDNA
Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Jeanne Tie, MBChB, MD, of Peter MacCallum Cancer Centre, discuss results from the DYNAMIC trial, in which a circulating tumor DNA (ctDNA)-guided approach reduced the use of adjuvant chemotherapy without compromising recurrence-free survival in patients with stage II colon cancer (Abstract LBA100).
mFOLFOXIRI/Panitumumab vs mFOLFOX/Panitumumab for the Initial Treatment of RAS and BRAF Wild-Type Metastatic Colorectal Cancer
In an Italian phase III trial (TRIPLETE) presented at the 2022 ASCO Annual Meeting (Abstract LBA3505) and simultaneously published in the Journal of Clinical Oncology, Rossini et al found that mFOLFOXIRI (modified fluorouracil, leucovorin, oxaliplatin, and irinotecan) plus panitumumab did not...
'Unprecedented' 100% of First 14 Untreated Patients With Rectal Cancer Respond to PD-1 Blocker Dostarlimab-gxly
Rarely, if ever, has one abstract presented at the ASCO Annual Meeting warranted its own session—but that happened with a small but mighty study from Memorial Sloan Kettering. In a study of patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, 6 months of treatment with the ...
Panitumumab Plus mFOLFOX6 Improves Overall Survival in a Type of Newly Diagnosed Metastatic Colorectal Cancer
The use of panitumumab plus mFOLFOX6 significantly improved overall survival in patients with RAS wild-type metastatic colorectal cancer that was classified as left-sided compared with patients who received mFOLFOX6 plus bevacizumab, according to findings presented during the Plenary Session by...
Study Reveals Racial Disparities in Guideline-Concordant Care for Patients With Early-Onset Colorectal Cancer
In a large national study, Black patients diagnosed with early-onset colorectal cancer received worse and less timely care than their White counterparts. Differences in health insurance coverage type, a modifiable factor, according to the findings, accounted for the largest identified contributor...
ctDNA May Help Identify the Need for Adjuvant Therapy in Stage II Colon Cancer
In patients with stage II colon cancer where cancer DNA was not present in the blood (as circulating tumor DNA, or ctDNA), adjuvant chemotherapy could be skipped without compromising recurrence-free survival. Conversely, for patients where ctDNA was present after surgery, the rate of recurrence...
New Research Finds Computer-Assisted Colonoscopy May Identify More Precancerous Polyps Than Traditional Colonoscopy
Colonoscopies performed with computer-aided detection, or artificial intelligence (AI), saw an increase in the overall rate of detection of adenoma, or cancerous and precancerous polyps, by 27% in average-risk patients, according to new data presented by Shaukat et al at Digestive Disease Week 2022 ...
Persistent Racial, Ethnic Disparities Found in Survival Rates for Early-Onset Colon Cancer
The 5-year survival for younger adults with colorectal cancer improved for White patients alone between 1992 and 2013, according to a new analysis presented by Zaki et al at Digestive Disease Week 2022 (Abstract 895). However, no survival gains were found for Black, Hispanic, or Asian patients with ...
Study Finds Screen-Detected Colorectal Cancers May Have More Favorable Stage Distribution Than Colorectal Cancers Detected Otherwise
In a population-based study conducted in nine European countries for which data on mode of detection were available (Belgium, Denmark, England, France, Italy, Ireland, the Netherlands, Slovenia, and Spain), the proportion of colorectal cancer cases detected by screening varied widely between...
Smitha S. Krishnamurthi, MD, on Colorectal Cancer: Treatment Updates
Smitha S. Krishnamurthi, MD, of the Cleveland Clinic Taussig Cancer Institute, discusses prognostic assays for localized colon cancer, the potential clinical uses and current limitations of prognostic assays for stage II to III disease, and checkpoint inhibitor therapy for metastatic colorectal cancer.
Colonoscopy After Positive FIT Test May Reduce Risk of Death From Colorectal Cancer
Recent research underlines the importance of following up with a colonoscopy exam after a positive result on an at-home stool test to screen for colorectal cancer. The test, known as the fecal immunochemical test (FIT), checks for traces of blood in patient-collected stool samples, which can be an...
Age at Initiation of Colorectal Cancer Screening and Risk of Colorectal Cancer Among U.S. Women
In a study reported in JAMA Oncology, Ma et al found that the initiation of lower gastrointestinal endoscopy screening in women younger than age 50 was associated with a reduced risk of colorectal cancer vs no screening, and a greater absolute risk reduction compared with screening starting at age...
Watch-and-Wait Strategy for Organ Preservation in Patients Receiving Total Neoadjuvant Therapy for Rectal Adenocarcinoma
In a phase II trial reported in the Journal of Clinical Oncology, Garcia-Aguilar et al found that total neoadjuvant therapy followed by a watch-and-wait strategy vs total mesorectal excision based on response allowed for organ preservation in approximately half of patients with rectal...
3 vs 6 Months of Adjuvant Oxaliplatin- and Fluoropyrimidine-Based Therapy for Stage III Colon Cancer: Final Analysis
As reported in the Journal of Clinical Oncology by Yoshino et al, the final analysis of survival and safety of the Japanese phase III ACHIEVE trial (part of the IDEA Collaboration) has shown no difference in disease-free or overall survival with 3 vs 6 months of adjuvant mFOLFOX6 (fluorouracil,...
Comparison of 2020 NICE Criteria for Preoperative Radiotherapy in Rectal Cancer Treated by Surgery Alone With Established MRI Prognostic Factors
In a retrospective cohort study reported in The Lancet Oncology, Lord et al found that high-risk patients with rectal cancer treated with surgery alone who were more likely to benefit from preoperative radiotherapy were better selected using proven magnetic resonance imaging (MRI) prognostic...
Concordance With Pretreatment Staging Imaging Guidelines in Rectal Cancer: ASCO QOPI Findings
In an analysis from the ASCO Quality Oncology Practice Initiative (QOPI) reported in JCO Oncology Practice, Chen et al found that a high proportion of patients with rectal cancer do not receive guideline-recommended pretreatment staging transrectal ultrasound or pelvic magnetic resonance imaging...
Overall Survival in KEYNOTE-177: Pembrolizumab vs Chemotherapy in Microsatellite Instability–High or Mismatch Repair–Deficient Metastatic Colorectal Cancer
As reported in The Lancet Oncology by Diaz et al, the final overall survival analysis of the phase III KEYNOTE-177 trial did not show a significant improvement with pembrolizumab vs chemotherapy in patients with newly diagnosed microsatellite instability–high or mismatch repair–deficient metastatic ...
AI May Reduce Miss Rate of Precancerous Polyps During Colorectal Cancer Screening
Artificial intelligence (AI) reduced the rate at which precancerous polyps were missed in colorectal cancer screening by twofold, reported a team of international researchers in a study published by Wallace et al in Gastroenterology. Between February 2020 and May 2021, 230 study participants were...
Changes in the NCCN Guidelines on Colorectal Cancer Screening
The National Comprehensive Cancer Network® (NCCN®) Clinical Practice Guidelines in Oncology: Colorectal Cancer Screening have recently incorporated significant changes, reflecting recommendations that will spare some patients unnecessary interventions and, in other cases, detect cancer earlier. The ...
Researchers Seek to Expand Immunotherapy Options for Patients With Advanced Breast and Colorectal Cancers
Two presentations given at the American Association for Cancer Research (AACR) Annual Meeting 2022 focused on promising strategies for making breakthrough immunotherapies work for more patients. Both studies report findings from clinical trials that advance a novel immunotherapy platform in...
Maria Elena Martinez, PhD, MPH, on Colorectal Cancer Screening in Underserved Populations: COVID, Silver Linings, and Challenges Ahead
Maria Elena Martinez, PhD, MPH, of the University of California, San Diego Moores Cancer Center, provides an overview of the key components of the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science program, challenges posed by the COVID-19 pandemic, and opportunities for overcoming these challenges. Although screening and follow-up may reduce the incidence of and mortality from colorectal cancer, these disparities persist in medically underserved populations (Abstract SY30).
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 sex; and extending the surveillance interval from 5 to 7–10 years following the identification of one to two low-risk adenomas.
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...
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...
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...
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...
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...
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...
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...
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...
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...
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,...
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...
