Afsaneh Barzi, MD, PhD, on Colorectal Cancer: Early Data on Regorafenib and Pembrolizumab
Afsaneh Barzi, MD, PhD, of City of Hope Comprehensive Cancer Center and AccessHope, discusses results from a phase I/II study of regorafenib and pembrolizumab in refractory microsatellite-stable colorectal cancer. Although the trial did not meet its primary endpoint, the median overall survival is “provocative,” says Dr. Barzi. An analysis of biomarkers to identify patients with a longer duration of benefit is ongoing (Abstract 15).
Heinz-Josef Lenz, MD, on Colorectal Cancer: Update From the CheckMate 9X8 Trial on Nivolumab, mFOLFOX6, and Bevacizumab
Heinz-Josef Lenz, MD, of USC Norris Comprehensive Cancer Center, discusses phase II results from the CheckMate 9X8 study, which compared nivolumab plus fluorouracil/leucovorin/oxaliplatin (mFOLFOX6) and bevacizumab vs mFOLFOX6 and bevacizumab in the first-line treatment of metastatic colorectal cancer. A subgroup of patients may benefit from adding nivolumab to the standard of care in this setting (Abstract 8).
Addition of Diet and Lifestyle Factors to Recurrence and Mortality Prediction Models for Patients With Stage III Colon Cancer
In a study reported in the Journal of Clinical Oncology, Cheng et al found that the addition of patient-reported diet and lifestyle factors to prediction models based on clinical and pathologic characteristics improved predictions of disease recurrence and mortality among patients with stage III...
Mehmet Altan, MD, on Solid Tumors: Interim Safety and Efficacy Results on NKTR-255 Plus Cetuximab
Mehmet Altan, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from a phase Ib dose-escalation study, which showed early evidence of activity for NKTR-255, an investigational IL-15 receptor agonist, plus cetuximab in patients with solid tumors. Treatment appeared to lead to expansion and proliferation of NK and CD8+ cells (Abstract 957).
Study Uses Data From a Nationally Representative Colonoscopy Registry to Gather Information on Early-Onset Colorectal Precancerous Lesions
In a study published in the journal Gastroenterology, Trivedi et al described an increase in early-onset colorectal cancer and precancerous polyps, based on a large, nationally representative study of patients younger than 50 who underwent colonoscopy. It was the first large-scale study to look at...
Single-Cell Transcriptomic and Imaging Atlas of Colorectal Polyps Provides Insights for Cancer Surveillance
A team of researchers has revealed some of the mechanisms by which polyps develop into colorectal cancer, setting the framework for improved surveillance for the disease. Their study, published by Chen et al in the journal Cell, describes findings using a single-cell transcriptomic and imaging...
Does Geography Play a Role in Early-Onset Colorectal Cancer in Young Black Men?
Although the incidence and mortality rates in colorectal cancer have dropped by 3.6% each year from 2007 to 2016 for people aged 55 and older—mainly because of increased colorectal cancer screening, advances in therapy, and reductions in smoking—these rates have increased by 2% each year during the ...
I Don’t Know Why I Got Young-Onset Colorectal Cancer
Throughout my adolescence and early adulthood, I had been plagued with digestive issues, including bouts of gastritis and constipation, which seemed normal for me and wasn’t too concerning. But by the time I turned 30, in 2015, the acid reflux I had been experiencing became so frequent and...
Study Examines Rates of Breast and Colorectal Cancer Screening Among Rural Women
Women who live in urban areas and those residing in rural areas get screened for breast cancer at similar rates, but rural women get screened for colorectal cancer at significantly lower rates than their urban counterparts, research published by Shete et al in JAMA Network Open showed. The...
Solving the Conundrum of Young-Onset Colorectal Cancer
Although research so far has failed to uncover the root causes of the development of young-onset colorectal cancer, what is certain is that although colorectal cancer rates are declining in older adults, they are on a steady rise in people younger than age 50, especially those between the ages of...
Colorectal Cancer Screening: Preferences of Gastroenterologists and Primary Care Clinicians
Despite the availability of several effective screening tests, colorectal cancer screening rates remain below national goals. Although colonoscopy is the most often recommended screening method, a new study has found that the preferences of primary care clinicians have shifted toward noninvasive...
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. Study Details The...
Update on the Role of Low-Dose Aspirin in Colorectal Cancer Prevention
Updating its 2016 recommendation on the use of aspirin to prevent cardiovascular disease and colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement. It noted the potential harms of daily aspirin, with the most serious being bleeding in the...
Association of TP53 Gain-of-Function and Non–Gain-of-Function Mutations With Outcomes in Left-Sided vs Right-Sided Metastatic Colorectal Cancer
In a study reported in the Journal of Clinical Oncology, Pan et al found that overall survival was poorer among patients with metastatic right-sided vs left-sided colorectal cancer with TP53 mutations, driven by poorer outcomes in those with non–gain-of-function mutations, and that gain-of-function ...
Trends in Incidence of Colorectal Cancer Among Black and White Individuals Aged 40 to 49 Years From 2000 to 2017
In a study reported in JAMA Network Open, Montminy et al found that the incidence of colorectal adenocarcinoma in people aged 40 to 49 years in the United States has increased in White individuals and remained stable in Black individuals between 2000 and 2017, with incidence rates being equivalent...
Long-Term Outcomes With Chemoradiotherapy Before vs After Chemotherapy in Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer
Long-term results of a German phase II trial (CAO/ARO/AIO-12) reported in JAMA Oncology by Fokas et al showed similar disease outcomes, chronic toxicity, and quality of life with chemoradiotherapy before vs after chemotherapy in the total neoadjuvant treatment of patients with locally advanced...
Treatment Adherence, Toxicity, and Outcomes With Adjuvant Fluoropyrimidine Plus Oxaliplatin in Early-Onset Colorectal Cancer
In an analysis of data from the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) database reported in the Journal of Clinical Oncology, Fontana et al found a greater risk of relapse and cancer-specific mortality after adjuvant fluoropyrimidine/oxaliplatin chemotherapy in patients...
U.S. Multisociety Task Force on Colorectal Cancer Releases Updated Screening Recommendations
The U.S. Multisociety Task Force on Colorectal Cancer—representing the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy—has updated its colorectal cancer screening recommendations, which were last published...
Study Finds Similar Survival Rates Among Patients With Metastatic Colorectal Cancer Younger and Older Than Age 50
Even though patients with metastatic colorectal cancer younger than age 50 tend to be more fit and receive more intensive treatment than older patients, survival for both groups is roughly the same, according to a study published by Lipsyc-Sharf et al in the Journal of the National Cancer...
FOCUS4-C Trial: Hint of Activity Reported With Adavosertib in Metastatic Colorectal Cancer
The novel WEE1 inhibitor adavosertib, given after induction chemotherapy, yielded a 65% reduction in the risk of disease progression or death compared with active monitoring in patients with metastatic colorectal cancer and TP53/RAS mutations, according to the randomized phase II FOCUS4-C trial....
Expert Point of View: Federica Di Nicolantonio, MD, PhD
“KRAS G12C inhibitors as monotherapy yield a relatively low overall response rate, but when you combine them with an EGFR [epidermal growth factor receptor] inhibitor, the response rate is nearly double,” said Federica Di Nicolantonio, MD, PhD, Professor of Oncology at the University of Turin in...
KRAS G12C Inhibitor Adagrasib Shows Activity in Colorectal Cancer
Adagrasib, a covalent inhibitor of KRAS G12C, combined with cetuximab, showed activity in patients with metastatic colorectal cancer in the phase I/II KRYSTAL-1 trial, as presented during a Presidential Symposium at the European Society for Medical Oncology (ESMO) Congress 2021 by Jared Weiss, MD,...
FDA Expands Cetuximab Label for Encorafenib Combination in BRAF V600E Mutation–Positive Metastatic Colorectal Cancer
The U.S. Food and Drug Administration (FDA) has granted approval of a new indication for the EGFR inhibitor cetuximab (Erbitux) in combination with encorafenib (Braftovi) for the treatment of adults with metastatic colorectal cancer and a BRAF V600E mutation, as detected by an FDA-approved test,...
Nivolumab/Low-Dose Ipilimumab Produces Responses in Patients With MSI-H/dMMR Metastatic Colorectal Cancer
As reported in the Journal of Clinical Oncology by Heinz-Josef Lenz, MD, and colleagues, in the phase II CheckMate 142 trial, first-line treatment with nivolumab plus low-dose ipilimumab produced a high rate of durable responses in a cohort of patients who had received no prior treatment for...
Filippo Pietrantonio, MD, and Federica Morano, MD, on Colorectal Cancer and the MAYA Trial Strategy: Temozolomide, Ipilimumab, and Nivolumab
Filippo Pietrantonio, MD, and Federica Morano, MD, both of the Istituto Nazionale dei Tumori, discuss results from the MAYA trial, which provided proof of concept that temozolomide-induced hypermutation may be exploited to achieve durable responses to low-dose ipilimumab plus nivolumab in patients with microsatellite stable metastatic colorectal cancer (Abstract 383O).
Primary Tumor Resection Followed by Systemic Treatment vs Systemic Treatment Alone in Metastatic Colorectal Cancer: 60-Day Mortality
As reported in JAMA Surgery by van der Kruijssen et al, 60-day post–random assignment mortality results in the Danish/Dutch phase III CAIRO4 trial showed higher rates of mortality in patients with metastatic colorectal cancer who received primary tumor resection plus systemic treatment vs those...
Does a Longer Interval Before Surgery Among Patients With Locally Advanced Rectal Cancer Lead to Worse Survival?
In an Italian retrospective cohort study reported in JAMA Surgery, Deidda et al found that a longer vs shorter delay to surgery among patients with locally advanced rectal cancer with minor or no pathologic response to neoadjuvant chemoradiotherapy was associated with significantly poorer overall...
Jenny F. Seligmann, MBChB, PhD, on Colorectal Cancer: Adavosertib Compared With Active Monitoring
Jenny F. Seligmann, MBChB, PhD, of the University of Leeds, discusses phase II findings that suggest adavosertib improved progression-free survival, compared with active monitoring, by inhibiting the WEE1 kinase in patients with RAS- and TP53-mutant metastatic colorectal cancer. In the trial, adavosertib’s activity tended to be even greater in left-sided tumors (Abstract 382O).
Radioembolization Plus Second-Line Chemotherapy for Colorectal Liver Metastases
In the phase III EPOCH trial reported in the Journal of Clinical Oncology, Mary F. Mulcahy, MD, and colleagues found that the addition of transarterial yttrium-90 radioembolization (TARE) to second-line chemotherapy significantly prolonged progression-free survival and hepatic progression–free...
Addition of Panitumumab to Fluorouracil/Leucovorin as Maintenance Therapy for RAS Wild-Type Metastatic Colorectal Cancer
In the German phase II PANAMA trial reported in the Journal of Clinical Oncology, Modest et al found that the addition of the monoclonal antibody panitumumab to fluorouracil (5-FU)/leucovorin maintenance therapy improved progression-free survival in patients with RAS wild-type metastatic colorectal ...
Adavosertib for Patients With TP53- and RAS-Mutant Metastatic Colorectal Cancer
As reported in the Journal of Clinical Oncology by Seligmann et al, the phase II FOCUS4-C trial has shown activity of the WEE1 kinase inhibitor adavosertib in patients with TP53- and RAS-mutant metastatic colorectal cancer with disease control after first-line chemotherapy. As state by the...
FDA Expands Cetuximab Label With Combination of Encorafenib for Pretreated BRAF V600E Mutation–Positive Metastatic Colorectal Cancer
The U.S. Food and Drug Administration (FDA) has granted approval of a new indication for cetuximab (Erbitux) in combination with encorafenib (Braftovi) for the treatment of adult patients with metastatic colorectal cancer and a BRAF V600E mutation, as detected by an FDA-approved test, after prior...
Hepatectomy With or Without Adjuvant mFOLFOX6 for Liver-Only Metastatic Colorectal Cancer: Disease-Free and Overall Survival
In the Japanese phase II/III JCOG0603 trial reported in the Journal of Clinical Oncology, Kanemitsu et al found that the addition of adjuvant mFOLFOX6 (fluorouracil, leucovorin, and oxaliplatin) to hepatectomy improved disease-free survival in patients with liver-only metastatic colorectal cancer;...
Capecitabine Maintenance After First-Line Therapy for Metastatic Colorectal Cancer
In the FOCUS4-N trial reported in the Journal of Clinical Oncology, Adams et al found that capecitabine maintenance improved progression-free—but not overall—survival vs active monitoring in patients with stable disease or objective response after first-line therapy for metastatic colorectal...
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,...
COVID-19 Lockdown May Be Associated With Higher Tumor Burden in Newly Diagnosed Patients With Metastatic Colorectal Cancer
In a French study reported in JAMA Network Open, Thierry et al found that tumor burden (assessed as plasma circulating tumor DNA [ctDNA]) was significantly higher among patients with newly diagnosed metastatic colorectal cancer screened for a clinical trial after vs before the first COVID-19...
Association of Skeletal Muscle Area and Adiposity Measures With Inflammation and Outcomes in Nonmetastatic Colon Cancer
In a study reported in JAMA Network Open, Fleming et al found that low skeletal muscle area and high visceral-to-total fat ratio were associated with increased expression of proinflammatory cytokines and VEGF as well as worse 5-year outcomes in patients with nonmetastatic colon cancer. Study...
Study Examines Link Between in Utero Events and Risk of Colorectal Cancer in Adult Offspring
Infants whose mothers were obese during pregnancy may have a heightened risk of developing colorectal cancer later in life, according to new research published by Murphy et al in the journal Gut. Obesity is already a well-established risk factor for colorectal cancer, and several studies suggest...
Liquid Biopsy Is Changing Colon Cancer Management
The measurement of circulating tumor DNA (ctDNA) is changing the way gastrointestinal cancers are managed, according to Bassel F. El-Rayes, MD, Professor and Vice Chair for Clinical Research in the Department of Hematology and Oncology, Emory University, and Associate Cancer Center Director,...
Japanese Study Examines How Intervention Encourages Screening for Colorectal Cancer Among Patients With Schizophrenia
Cancer is a leading cause of mortality in patients with mental illnesses. Although individuals with mental illnesses are equally as vulnerable to cancer as the general population, they are at a much higher risk of cancer-related mortality. Owing to a lack of early screening in most cases, such...
Antihypertensive Medications May Improve Survival Among Patients With Stage I to III Colorectal Cancer
Commonly used blood pressure drugs may improve survival for patients with colorectal cancer, a recent study published by Balkrishnan et al in Cancer Medicine suggests. After reviewing outcomes of almost 14,000 patients with colorectal cancer, researchers determined that angiotensin-converting...
Cetuximab Plus Avelumab as Rechallenge Therapy for RAS Wild-Type Metastatic Colorectal Cancer
In an Italian phase II trial reported in JAMA Oncology, Martinelli et al found that cetuximab rechallenge plus avelumab showed activity and was well tolerated in patients with RAS wild-type metastatic colorectal cancer who had responded to first-line chemotherapy plus an anti-EGFR agent and then...
Eric Deutsch, MD, PhD, Comments on the Averectal and AVANA Trials in Rectal Cancer
Eric Deutsch, MD, PhD, Professor and Chair of Radiation Oncology at Gustave Roussy, Villejuif, France, commended the speakers for conducting trials whose results he found “very interesting.” The Averectal trial involved a short course of radiation with modified FOLFOX-6 (oxaliplatin, fluorouracil...
Avelumab Under Study as Adjunct to Neoadjuvant Therapy for Rectal Cancer
In the treatment of newly diagnosed locally advanced rectal cancer, two phase II studies evaluating the addition of the PD-L1 inhibitor avelumab to chemoradiotherapy showed promising rates of pathologic complete response, major pathologic response, and tumor downstaging. The study investigators...
Can Consumption of Vitamin D Reduce the Risk of Early-Onset Colorectal Cancer?
Consuming higher amounts of vitamin D—mainly from dietary sources—may help protect against developing young-onset colorectal cancer or precancerous colon polyps, according to the first study to show such an association. These findings were published by Kim et al in the journal Gastroenterology. The ...
Retrospective Study Compares Characteristics of Early-Onset vs Average-Onset Colorectal Cancer
A large retrospective study has found that early-onset colorectal cancers are clinically and genomically indistinguishable from average-onset colorectal cancers. In addition, the study found that more aggressive treatment based solely on the patient’s age at diagnosis is neither necessary nor...
Evaluation of Baseline Cancer Mortality Risk in Medicaid Expansion and Nonexpansion States
In a study of National Cancer Database data reported in a research letter in JAMA Oncology, Salazar et al found little difference in baseline cancer mortality rates between U.S. states that expanded Medicaid enrollment and nonexpansion states prior to expansion in 2009 and immediately following...
Association of Incomplete Polyp Removal With Risk of Postcolonoscopy Colorectal Cancer
A multicenter cohort study found that incomplete polyp removal—polyp removal where neoplastic tissue is found in any of the marginal biopsies—is a likely contributor to neoplasia recurrence and interval colorectal cancer. The results highlight the critical importance of polyp resection technique in ...
Facing the Trauma of Colorectal Cancer
I first noticed blood in my stool when I was in the 8th grade. My mom and I did an Internet search and were relieved to find that the cause was most likely nothing more serious than hemorrhoids, so I put the problem out of my mind. I played volleyball and had an active social life, and the...
Quality of Life With General Practitioner– vs Surgeon-Led Colon Cancer Survivorship Care
In a 1-year interim analysis of a Dutch study (I CARE) reported in The Lancet Oncology, Vos et al found no clinically meaningful difference in changes in quality of life from baseline among patients with colon cancer with general practitioner– vs surgeon-led survivorship care. In addition,...
