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).
Thierry André, MD, on Colorectal Cancer: Pembrolizumab vs Chemotherapy for Metastatic Disease
Thierry André, MD, of Hôpital Saint-Antoine, discusses the phase III results from KEYNOTE-177, which showed that, compared with standard chemotherapy of FOLFOX or FOLFIRI, pembrolizumab doubled median progression-free survival, from 8.2 months to 16.5 months, in patients with microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer (Abstract LBA4).
Jeffrey A. Meyerhardt, MD, MPH, on Colon Cancer: Celecoxib and FOLFOX for Stage III Disease
Jeffrey A. Meyerhardt, MD, MPH, of Dana-Farber Cancer Institute, discusses results from the CALGB/SWOG 80702 trial of celecoxib plus standard adjuvant therapy with fluorouracil, leucovorin, and oxaliplatin (FOLFOX). Adding celecoxib to standard chemotherapy did not significantly improve disease-free or overall survival (Abstract 4003).
Scott Kopetz, MD, PhD, on Colorectal Cancer: Encorafenib Plus Cetuximab With or Without Binimetinib
Scott Kopetz, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses phase III results of the BEACON CRC study, which confirmed that, compared with standard chemotherapy, encorafenib plus cetuximab with or without binimetinib improved overall survival and objective response rate in previously treated patients with BRAF V600E–mutated metastatic colorectal cancer (Abstract 4001).
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...
Pembrolizumab Doubles Progression-Free Survival in MSI-H/dMMR Metastatic Colorectal Cancer
For the first time, upfront treatment with immunotherapy has improved—in fact, doubled—median progression-free survival in a subset of patients with metastatic colorectal cancer. The findings are from the interim analysis of the randomized open-label phase III KEYNOTE-177 trial comparing the...
Can a Culturally Tailored Education Program Improve Colorectal Cancer Awareness and Screening?
People who received information from the Screen to Save program, a culturally tailored initiative from the National Cancer Institute (NCI) Center to Reduce Cancer Health Disparities (CRCHD), increased their knowledge of colorectal cancer and indicated willingness to adopt potentially preventive...
Encorafenib Combined With Cetuximab in Previously Treated BRAF V600E–Mutant Metastatic Colorectal Cancer
On April 8, 2020, encorafenib was approved for use in combination with cetuximab for the treatment of previously treated adult patients with metastatic colorectal cancer with a BRAF V600E mutation detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 Encorafenib is not indicated...
Treating Colorectal Cancer in the Time of COVID-19
The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing the risk of COVID-19...
Regorafenib Plus Nivolumab in Advanced Gastric and Colorectal Cancers
In a Japanese phase Ib/dose-expansion trial reported in the Journal of Clinical Oncology, Fukuoka et al found that the combination of regorafenib and nivolumab showed activity in patients with previously treated gastric cancer and colorectal cancer with microsatellite stable/mismatch...
AI Model Accurately Classifies Colorectal Polyps From Histopathologic Slides
An artificial intelligence (AI) model for automated classification of colorectal polyps could benefit cancer screening programs by improving efficiency, reproducibility, and accuracy, as well as reducing access barriers to pathology services. In a new study published by Wei et al in JAMA Network...
Treatment and Outcomes in Patients With Metastatic Colorectal Cancer in Washington State and Canada
In a study reported in JCO Oncology Practice, Todd A. Yezefski, MD, and colleagues found that the cost of first-line systemic therapy for metastatic colorectal cancer was higher in Western Washington state compared with British Columbia and that survival outcomes were similar. A stated by the...
Radiation and Chemoradiation Interruption and Noncompletion in Squamous Cell Anal Carcinoma
In a Canadian study reported in JAMA Oncology, Raphael et al found that interruption and noncompletion of definitive radiation and chemoradiation for patients with squamous cell anal carcinoma were common, and that failure to complete radiation and chemoradiation was associated with poorer...
Expert Point of View: John M. Carethers, MD, and Joseph J. Y. Sung, MD, PhD
Session moderators for the CheckMate 142 presentation at the Gastrointestinal Cancers Symposium were John M. Carethers, MD, the John G Searle Professor (and Chair) of Internal Medicine at the University of Michigan, Ann Arbor, and Joseph J. Y. Sung, MD, PhD, the Mok Hing You Professor of Medicine...
CheckMate 142 Updated Analysis: First-Line Nivolumab Plus Low-Dose Ipilimumab in MSI-H/dMMR Metastatic Colorectal Cancer
As a first-line regimen for patients with metastatic colorectal tumors that are microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR), the combination of nivolumab and low-dose ipilimumab yielded an objective response rate of 64%, a complete response rate of 9%, and a disease...
Aspirin Use and Risk of Cancers of the Digestive Tract
Aspirin may be associated with a reduction in the risk of developing several cancers of the digestive tract. The largest and most comprehensive analysis to date of the link between aspirin and digestive tract cancers, published by Bosetti et al in Annals of Oncology, found reductions in the risk of ...
Neoadjuvant Immunotherapy in Early-Stage Colon Cancer
Patients with localized colon cancer may benefit from a short course of neoadjuvant immunotherapy, according to findings from the exploratory phase II NICHE study published by Myriam Chalabi, MD, and colleagues in Nature Medicine. Study Results Forty patients with two colon cancer subtypes—either ...
ASCO Releases Resource-Stratified Guideline on the Treatment of Late-Stage Colorectal Cancer
ASCO has released a new guideline for clinicians and policymakers in resource-constrained settings on treating patients with late-stage colorectal cancer.1 “Around the world, there is a huge variation in resources, and what is available to clinicians may change week to week,” said Mary D....
FDA Approves Encorafenib/Cetuximab for BRAF V600E–Mutated Metastatic Colorectal Cancer
On April 8, the U.S. Food and Drug Administration (FDA) approved encorafenib (Braftovi) in combination with cetuximab (Erbitux) for the treatment of pretreated adult patients with metastatic colorectal cancer with a BRAF V600E mutation detected by an FDA-approved test. BEACON CRC Efficacy was...
Prognostic Impact of Tumor Deposits in Patients Receiving Adjuvant Therapy for Stage III Colon Cancer
In a post hoc analysis of the phase III IDEA France trial reported in the Journal of Clinical Oncology, Delattre et al found that the presence of tumor deposits was associated with poorer prognosis in patients with stage III colon cancer receiving 3 or 6 months of adjuvant FOLFOX (fluorouracil,...
Expert Point of View: John M. Carethers, MD
The analysis of the National Cancer Database is one of a number of studies describing sociodemographic-related disparities in colorectal cancer outcomes, according to session Co-Chair John M. Carethers, MD, Professor and Chair of the Department of Internal Medicine at the University of Michigan,...
Studies Aim to Understand Young-Onset Colorectal Cancer
The incidence of colorectal cancer among adults younger than age 50 has risen more than 50% over the past 25 years. Researchers are attempting to understand this phenomenon, as described in several studies presented at the 2020 Gastrointestinal Cancers Symposium that offered new insights....
Actively Recruiting Clinical Trials on Colorectal Cancer
This Clinical Trials Resource Guide lists actively recruiting trials on colorectal cancer, focusing on novel treatments, combinations of treatments, and testing options to determine which patients may be most likely to benefit from further treatment. More information on these trials is available on ...
Patients With Certain Cancers May Be at a Higher Risk for Atrial Fibrillation
People with a history of cancer have an over twofold risk of developing atrial fibrillation, the most common heart rhythm disorder, compared to the general population, according to research presented at the American College of Cardiology’s Annual Scientific Session (Abstract 1216-235). In...
Expert Point of View: Christopher M. Booth, MD
Christopher M. Booth, MD, the invited discussant of the BEACON CRC quality-of-life findings, applauded the investigators for choosing overall survival and quality of life as endpoints in a trial that benefits a “vulnerable patient population with unmet needs.” Patients with BRAF-mutated metastatic...
Mature Follow-up of BEACON CRC Study Reports Quality-of-Life Measures and Survival Outcomes
For patients with previously treated metastatic colorectal cancer harboring BRAF V600E mutations, the phase III BEACON CRC study showed the benefit for combining two or three targeted agents vs the standard of care.1 With further follow-up, the study has now also shown a benefit for the triplet and ...
TAPUR Basket Study: Biomarker-Driven Treatment Strategies Yield Benefits in Colorectal Cancer
Positive findings on the potential benefit of molecularly targeted drugs in patients with advanced colorectal cancer were presented at the 2020 Gastrointestinal Cancers Symposium, validating the purpose of ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) study.1-3 TAPUR, the first...
Conference Highlights From the 2020 Gastrointestinal Cancers Symposium
This past January, the 2020 Gastrointestinal Cancers Symposium was held in San Francisco. More than 3,600 individuals attended and more than 900 abstracts and posters were presented. Among the highlights presented at the meeting and reported in the pages of The ASCO Post, several studies in...
Reintroduction of FOLFOXIRI Plus Bevacizumab in Patients With Metastatic Colorectal Cancer
In the Italian phase III TRIBE2 trial reported in The Lancet Oncology, Cremolini et al found that reintroduction of FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) plus bevacizumab after progression on upfront treatment with the regimen was associated with improved...
Selected Abstracts on Novel Treatments in Colon, Hepatocellular, and Biliary Tract Cancers
The ASCO Post has reported on the pivotal trials presented at the 2020 Gastrointestinal Cancers Symposium in several issues. Featured here are the findings of several additional abstracts worthy of mention. Intermittent Oxaliplatin in Stage II or III Colon Cancer As adjuvant treatment for stage II...
Colorectal Cancer Statistics 2020 Published
The burden of colorectal cancer is shifting to younger individuals as incidence increases in young adults and declines in older age groups, according to Colorectal Cancer Statistics 2020. The median age of diagnosis dropped from 72 in 2001–2002 to 66 in 2015–2016. This finding and other data were...
Study Examines Survival Rates in Pediatric and Young Adult Patients With Colon Cancer
According to research published by Andrea Hayes-Jordan, MD, FACS, and colleagues in the Journal of the American College of Surgeons, children and young adults with colon cancer are more likely to have shorter overall survival and recurrence-free survival than middle-aged adults. In a...
Expert Point of View: Richard L. Schilsky, MD, FACP, FSCT, FASCO
Richard L. Schilsky, MD, FACP, FSCT, FASCO, ASCO’s Chief Medical Officer and a gastrointestinal oncologist himself, was pleased to see the TAPUR study bearing fruit among patients with metastatic colorectal cancer. “Colorectal cancer is a very common disease, but we have not made much progress in...
ASCO’s TAPUR Study: Biomarker-Driven Treatment Paying Off in Colorectal Cancer
New data presented at the 2020 Gastrointestinal Cancers Symposium are validating the purpose of ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) study, a multibasket trial that matches patients’ genomic alterations to commercially available targeted therapies. The aim is to learn...
Three vs Six Months of Adjuvant Chemotherapy for High-Risk Stage II Colorectal Cancer
As reported in JAMA Oncology by Petrelli et al, noninferiority in relapse-free survival for 3 vs 6 months of adjuvant chemotherapy was not established among patients with resected high-risk stage II colorectal cancer in the Italian phase III TOSCA trial. A potential regimen effect was observed,...
Data From Colorectal Cancer Cohorts of TAPUR Study Presented
Positive findings from three Targeted Agent and Profiling Utilization Registry (TAPUR) study cohorts on the potential benefit of molecularly targeted drugs in patients with advanced colorectal cancer were presented at the 2020 Gastrointestinal Cancers Symposium.1-3 The TAPUR study is the first...
BEACON-CRC: Quality of Life May Be Well Maintained With Targeted Treatment
For patients with previously treated metastatic colorectal cancer harboring BRAF V600E mutations, the phase III BEACON-CRC study showed the benefit for combining two or three targeted agents vs the standard of care.1 The study has now also shown a benefit for the triplet and doublet in maintaining ...
