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colorectal cancer
immunotherapy

Julien Taïeb, MD, PhD, on Colorectal Cancer: Recent Findings on Avelumab vs Standard Second-Line Chemotherapy

Julien Taïeb, MD, PhD, of Paris Descartes University, discusses phase II results from the SAMCO-PRODIGE 54 trial, which shows the efficacy and safety of avelumab in the second-line treatment of patients with deficient DNA mismatch–repair microsatellite-instability metastatic colorectal cancer. According to Dr. Taïeb, the study indirectly suggests this population should be treated as soon as possible with an immune checkpoint inhibitor (Abstract LBA23).

Colorectal Cancer

Study Shows Many Patients Prefer Stool Test to Colonoscopy for Colorectal Cancer Screening

Three-quarters of surveyed people preferred to do a fecal immunochemical test (FIT) rather than undergo a colonoscopy for their regular colorectal cancer screening, according to a new Cedars-Sinai study published by Makaroff et al in Clinical Gastroenterology and Hepatology. “One of the big issues...

Colorectal Cancer

Precision Physical Activity Prescriptions May Improve Survival in Patients With Stage III Colon Cancer

Physical activity may be associated with improved outcomes for patients undergoing postoperative treatment for stage III colon cancer, according to findings from a new study out of Pennington Biomedical Research Center published by Brown et al in the Journal of Clinical Oncology. The study assessed ...

colorectal cancer

MSI-High Rectal Adenocarcinoma

This is Part 4 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.     In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the management of microsatellite instability (MSI)-high rectal adenocarcinoma. The patient is a 62-year-old man with a large fungating nonobstructive tumor 6 cm from the anal verge, which is invading the mesorectum, and with enlarged mesorectal and superior hemorrhoidal lymph nodes. Immunohistochemistry reveals a dMMR tumor with loss of MLH1/PMS2, MLH1 promotor hypermethylation, and a BRAF V600E mutation. The faculty discuss next steps for this patient, including the current standard of care of trimodality therapy for locally advanced rectal adenocarcinoma, as well as ongoing trials that are evaluating the possibility of de-escalating trimodality therapy by omitting radiation or surgery.

colorectal cancer

HER2-Positive Colorectal Cancer

This is Part 3 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.     In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the management of HER2-positive colorectal cancer. The patient is a 45-year-old man who presents to the clinic with diarrhea, constipation, and periodic blood in his stool over the past 6 months. Colonoscopy reveals a nonobstructing tumor 16 cm from the anal verge, and CT scans reveal bilateral liver metastases with a primary rectosigmoid cancer with bulky adenopathy, as well as nonspecific subcentimeter lung nodules. After starting a course of FOLFOXIRI and bevacizumab, next-generation sequencing reveals that the patient is HER2-positive. The faculty discuss the next steps for this patient in light of the recent MOUNTAINEER trial and discuss the role of HER2 positivity in colorectal cancer.

colorectal cancer

Role of Neoadjuvant Therapy in T4 Colon Cancer

This is Part 2 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.     In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the role of neoadjuvant therapy in T4 colon cancer. The patient a 65-year-old woman who is diagnosed with a moderately differentiated adenocarcinoma with a partial mismatch repair mutation; flexible sigmoidoscopy reveals an ulcerating fungating lesion about 20 cm from the anal verge, and CT scans show no evidence of distant metastatic disease. The faculty discuss the next treatment options for this patient, given that patients with T4 tumors typically have higher risk of recurrence. Dr. Krishnamurthi reviews the findings of the FOxTROT and OPTICAL trials, which evaluated preoperative chemotherapy in T4 colon cancer. The faculty also discuss the potential role of preoperative immunotherapy for pMMR colon cancer.

colorectal cancer

Role of Circulating Tumor DNA in Early-Stage Colon Cancer

This is Part 1 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable.     In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the role of circulating tumor DNA (ctDNA) in early-stage colon cancer. The patient is a 48-year-old woman with low-risk stage II colon cancer who underwent right hemicolectomy with no signs of metastasis. Immunohistochemistry revealed intact mismatch repair protein expression, and circulating tumor DNA was negative. She presents to the clinic asking about the best course of action after her surgery. The faculty discuss the role of ctDNA in guiding therapy in patients with low-risk colon cancer in light of the recent DYNAMIC, CIRCULATE-Japan, and GALAXY studies.

Colorectal Cancer

Association of Distance to Treatment Facility, U.S. Region, and Insurance Status With Diagnosis of Advanced Colon Cancer

In a National Cancer Database analysis reported in JAMA Network Open, Brand et al found that patients with colon cancer who lived farther from their treatment facility and those with no insurance or Medicaid alone were more likely to present with advanced-stage disease. As stated by the...

Colorectal Cancer
Genomics/Genetics

ctDNA Analysis of Acquired EGFR Resistance Alterations With First-Line Cetuximab Plus Chemotherapy in Patients With Metastatic Colorectal Cancer

In a circulating tumor DNA (ctDNA) substudy from the CALGB/SWOG-80405/Alliance trial reported in the Journal of Clinical Oncology, Kanwal Raghav, MD, MBBS, and colleagues found that first-line use of the anti-EGFR antibody cetuximab combined with chemotherapy was associated with only a small number ...

Colorectal Cancer

Recurrence-Free Survival as Surrogate for Overall Survival in Patients Undergoing Resection of Colorectal Liver Metastases

In a single-center retrospective study and a separate meta-analysis reported in The Lancet Oncology, Ecker et al found low correlations between recurrence-free survival and overall survival among patients undergoing resection of colorectal cancer liver metastases. As stated by the investigators,...

Cost of Care
Breast Cancer
Colorectal Cancer
Lung Cancer
Prostate Cancer

Costs of Cancer Treatment for Younger, Privately Insured Patients

A new, large study led by researchers at the American Cancer Society (ACS) and The University of Texas MD Anderson Cancer Center showed the rising costs of cancer treatment led to increases in total costs of care, and when compounded with greater cost-sharing, increased out-of-pocket costs for...

Colorectal Cancer

Use of Trimodality Therapy in Stage II/III Rectal Cancer in the United States: 10-Year Period

In a retrospective cohort study reported in JAMA Oncology, Hagen F. Kennecke, MD, and colleagues found that among U.S. patients with clinical stage II/III rectal cancer diagnosed between 2006 and 2016 who received trimodality therapy, use of postoperative chemoradiation therapy (CRT) decreased and...

Colorectal Cancer
Genomics/Genetics

Acquired EGFR Inhibitor Resistance Alterations Identified in ctDNA Analysis in Patients With Refractory Metastatic Colorectal Cancer

In a study reported in the Journal of Clinical Oncology by Topham et al, circulating tumor DNA (ctDNA) analysis indicated significantly increased frequencies of multiple potential EGFR inhibitor resistance alterations among patients with refractory metastatic colorectal cancer with vs without prior ...

Colorectal Cancer
Immunotherapy

Early Research Identifies Effective Combination Immunotherapy for Subgroup of Patients With Metastatic Colorectal Cancer

A physician-scientist at City of Hope has identified a novel combination immunotherapy regimen—a triplet therapy consisting of regorafenib, ipilimumab, and nivolumab—that demonstrated significant response in patients with chemotherapy-resistant, microsatellite-stable metastatic colorectal cancer....

Colorectal Cancer

FRESCO-2: Fruquintinib for Patients With Refractory Metastatic Colorectal Cancer

Researchers reported study results showing that fruquintinib, a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor receptors (VEGFR), significantly improved overall survival and progression-free survival in patients with refractory metastatic colorectal cancer. Findings...

Colorectal Cancer

Updated Results From the KRYSTAL-1 Study of Adagrasib in Advanced KRAS G12C–Mutated Colorectal Cancer

Updated results from KRYSTAL-1, a multicohort phase I/II study, evaluating adagrasib—an investigational, highly selective, and potent oral small-molecule inhibitor of KRAS G12C—with or without cetuximab in patients with advanced colorectal cancer harboring a KRAS G12C mutation were presented by...

colorectal cancer

Marinde J.G. Bond, PhD Candidate, on Colorectal Liver Metastases: FOLFOX/FOLFIRI, Bevacizumab, and Panitumumab

Marinde J.G. Bond, PhD Candidate, of the University Medical Center, Utrecht, discusses phase III findings from the CAIRO5 study of the Dutch Colorectal Cancer Group, the first such trial in defined subgroups of patients with initially unresectable colorectal cancer liver metastases and left-sided and RAS/BRAF V600E wild-type tumor. The study compared FOLFOX/FOLFIRI plus either bevacizumab or panitumumab (Abstract LBA21).  

Colorectal Cancer

New Risk Stratification System for Completely Resected Stage II or III Colorectal Cancer

As reported in The Lancet Oncology, Kleppe et al have developed a risk stratification system using the DoMore-v1-CRC marker and pathologic staging markers that may permit many patients with stage II or III colorectal cancer to avoid adjuvant chemotherapy. As stated by the investigators, “The...

Colorectal Cancer
Immunotherapy

Expert Point of View: Ryan B. Corcoran, MD, PhD

Ryan B. Corcoran, MD, PhD, commented on the C-800 study for The ASCO Post. Dr. Corcoran is the Mark J. Kusek Endowed Chair in Colorectal Cancer, Director of the Gastrointestinal Cancer Center Program and Scientific Director of the Termeer Center for Targeted Therapy, Massachusetts General Hospital...

Colorectal Cancer
Immunotherapy

Activity Shown for Novel Immunotherapy Combination in Microsatellite-Stable Colorectal Cancer

Expanded data from the phase I C-800 study showed the immunotherapy combination of botensilimab and balstili­mab appeared to be active in patients with microsatellite-stable (MSS) metastatic colorectal cancer. The findings were reported at the European Society for Medical Oncology (ESMO) World...

Colorectal Cancer

Neoadjuvant Chemotherapy and Organ-Preserving Surgery in Early Rectal Cancer

As reported in the Journal of Clinical Oncology by Hagen F. Kennecke, MD, MHA, and colleagues, the Canadian Cancer Trials Group phase II NEO trial has shown that 3 months of neoadjuvant chemotherapy resulted in tumor downstaging and avoidance of radical surgery in a high proportion of patients with ...

Colorectal Cancer

Addition of Galunisertib to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

In a small phase II trial reported in The Lancet Oncology, Yamazaki et al found that the TGF-β type I receptor kinase inhibitor galunisertib appeared to show activity when added to neoadjuvant chemoradiation in previously untreated patients with locally advanced rectal cancer. As stated by the...

Colorectal Cancer

Study Shows AI May Improve Prediction of Colorectal Cancer Recurrence

In a multinational study using artificial intelligence (AI), investigators developed an algorithm to improve the prediction of colorectal cancer recurrence. Study results were published by Pai et al in Gastroenterology. QuantCRC Rish K. Pai, MD, PhD, a pathologist at Mayo Clinic in Arizona and...

Colorectal Cancer

Effect of Physical Activity on Disease-Free Survival in Patients Receiving Adjuvant Therapy for Stage III Colon Cancer

As reported in the Journal of Clinical Oncology by Brown et al, a prospective cohort study nested within the phase III CALGB/SWOG 80702/Alliance trial showed that greater volumes of physical activity in patients receiving adjuvant therapy for stage III colon cancer were associated with significant...

Colorectal Cancer

Study Tests Strategy for Reducing Colorectal Cancer Risk Among Patients With Familial Adenomatous Polyposis

Researchers from the Mayo Clinic Comprehensive Cancer Center and the Mayo Clinic Center for Individualized Medicine are studying the rare genetic condition called familial adenomatous polyposis, looking for potential ways to prevent colorectal cancer in the general population at an earlier, more...

Issues in Oncology
Colorectal Cancer

Models to Assess Impact of Centralization of Specialist Cancer Services in England

In a study reported in The Lancet Oncology, Aggarwal et al identified the impact of several models of centralization of specialist cancer services in England, using rectal cancer surgery as an example. As stated by the investigators, “Centralization of specialist cancer services is occurring in...

Colorectal Cancer

MOUNTAINEER: Tucatinib Plus Trastuzumab Active in Metastatic Colorectal Cancer

In the phase II MOUNTAINEER trial, tucatinib in combination with trastuzumab produced durable responses in patients with previously treated HER2-positive metastatic colorectal cancer. The late-breaking data were presented at the European Society for Medical Oncology (ESMO) World Congress on...

Colorectal Cancer

Global Phase III FRESCO-2 Study Has Met Its Primary Endpoint in Evaluation of Fruquintinib for Metastatic Colorectal Cancer

The pivotal global phase III FRESCO-2 trial evaluating the investigational use of fruquintinib met its primary endpoint of overall survival in patients with advanced, refractory metastatic colorectal cancer. The U.S. Food and Drug Administration (FDA) granted Fast Track designation for the...

Colorectal Cancer

Duration of Adjuvant Oxaliplatin With 6 Months of Fluoropyrimidine Treatment in High-Risk Stage II or III Colorectal Cancer

In a Korean phase III noninferiority trial (KCSG CO09-07) reported in the Journal of Clinical Oncology, Kim et al found noninferiority in disease-free survival and reduced risk of neuropathy for adjuvant therapy with 3 vs 6 months of oxaliplatin plus 6 months of fluoropyrimidine treatment in...

Colorectal Cancer

Cathy Eng, MD, FACP, FASCO, Comments on Findings From CAIRO5

The invited discussant of the CAIRO5 presentation at the 2022 ASCO Annual Meeting was Cathy Eng, MD, FACP, FASCO, Professor of Medicine, Hematology, and Oncology at Vanderbilt-Ingram Cancer Center, Nashville. Dr. Eng explained the key questions being asked by the investigators. “If you have a...

Colorectal Cancer

CAIRO5 Determines Optimal Approach to Colorectal Liver Metastases

In the phase III CAIRO5 study, conducted by the Dutch Colorectal Cancer Group, triplet vs doublet chemotherapy plus bevacizumab significantly increased progression-free survival, response rate, and the rate of R0/R1 resections, with and without ablation, in patients with initially unresectable...

Colorectal Cancer

Circulating Tumor DNA–Guided Approach to Treating Stage II Colon Cancer

The use of postoperative circulating tumor DNA (ctDNA) in stage II colon cancer spared many patients the need for adjuvant chemotherapy without compromising recurrence-free survival, according to the phase II DYNAMIC study.1 “The strategy of using ctDNA results to inform treatment almost halved...

Colorectal Cancer

Intermittent FOLFIRI Plus Panitumumab Proves More Effective, Less Toxic Than Continuous Treatment in Metastatic Colorectal Cancer

In patients with RAS/BRAF wild-type metastatic colorectal cancer, FOLFIRI (fluorouracil, leucovorin, irinotecan) plus panitumumab can be given intermittently rather than continuously, without compromising outcomes, according to the results of the IMPROVE study presented at the 2022 ASCO Annual...

Colorectal Cancer

Physician Adenoma Detection Rates and Risk of Postcolonoscopy Colorectal Cancer: Is There a Correlation?

In a retrospective cohort study reported in JAMA, Schottinger et al found that patients treated by physicians with higher adenoma detection rates on colonoscopies negative for cancer had a lower risk of postcolonoscopy colorectal cancer and death from colorectal cancer. Study Details The study...

Colorectal Cancer
Immunotherapy

Chiara Cremolini, MD, PhD, Comments on Findings From the PARADIGM Trial

The invited discussant of PARADIGM, Chiara Cremolini, MD, PhD, Professor of Medical Oncology at the University of Pisa, Italy, said the findings prospectively confirm the superior benefit of FOLFOX (fluorouracil, leucovorin, oxaliplatin) paired with panitumumab rather than bevacizumab in RAS...

Colorectal Cancer
Immunotherapy

In Metastatic RAS Wild-Type Left-Sided Colorectal Cancer, Panitumumab Proves Superior to Bevacizumab

The preferred targeted therapy for left-sided RAS wild-type metastatic colorectal cancer, in combination with standard chemotherapy, is panitumumab, not bevacizumab, based on a head-to-head comparison in the phase III PARADIGM trial. Panitumumab plus chemotherapy yielded the longest overall...

Colorectal Cancer

Analysis Finds Prevalence of Colorectal Cancer Screenings Remains Low in Younger Adults

In 2020, nearly 150,000 Americans, mostly those aged 50 and older, were diagnosed with colorectal cancer. However, about 18,000 of those individuals were younger than age 50. And while colorectal cancer rates have decreased for people over age 50, they have been increasing by 51% since 1994 for...

COVID-19
Colorectal Cancer
Survivorship
Genomics/Genetics

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,...

Colorectal Cancer
Immunotherapy

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...

Colorectal Cancer
Immunotherapy

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...

Colorectal Cancer

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 ...

Colorectal Cancer

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...

colorectal cancer
genomics/genetics

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).

Colorectal Cancer
Immunotherapy

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...

colorectal cancer

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).

Colorectal Cancer

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...

Colorectal Cancer
Immunotherapy

'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 ...

Colorectal Cancer

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...

Colorectal Cancer
Issues in Oncology

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...

Colorectal Cancer

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...

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