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,...
Is There a Link Between Use of Antibiotics and Early-Onset Colorectal Cancer?
Study findings presented by Perrott et al at the ESMO World Congress on Gastrointestinal Cancer (Abstract SO-25) showed that the use of antibiotics may be linked to colon tumor formation across all patient age groups, especially in those younger than 50 years. These results raise fresh concerns...
Using ctDNA to Measure Minimal Residual Disease in Patients With Colorectal Cancer
A team of investigators in Japan used a personalized assay for circulating tumor DNA (ctDNA) levels in plasma to monitor minimal residual disease following surgery in patients with resectable colorectal cancer. Their subgroup analysis found statistically significant associations between ctDNA...
Mechanisms of Acquired Resistance to KRAS G12C Inhibition in Patients With Cancer
In a study reported in The New England Journal of Medicine, Awad et al identified potential mechanisms of acquired resistance to the KRAS G12C inhibitor adagrasib in patients receiving the agent for treatment of KRAS G12C–mutant cancers. As noted by the investigators, clinical trials of the KRAS...
Addition of Pembrolizumab to Chemoradiotherapy in Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer
As reported in JAMA Oncology by Osama E. Rahma, MD, and colleagues, initial results of the phase II NRG-GI002 trial showed no improvement in mean neoadjuvant rectal score with the addition of pembrolizumab to chemoradiotherapy in total neoadjuvant therapy for patients with locally advanced rectal...
Better Responses to Hepatic Arterial Infusion Therapy Among Patients With KRAS Wild-Type Metastatic Colorectal Cancer
Patients with colorectal cancer and unresectable liver metastases and KRAS wild-type disease experienced better responses to hepatic arterial infusion pump chemotherapy than did patients with KRAS mutations, a retrospective cohort study found. At a median follow-up of 14.6 months, “KRAS-positive...
How RAS Mutations in Early-Onset Colorectal Cancer May Impact Patient Survival
Although both incidence and mortality rates in colorectal cancer have been declining among people older than 65 by 3.3% and 3% annually, respectively, among individuals younger than age 50, the incidence rate has risen about 2% annually, and death rates have increased by 1.3% annually.1 Colorectal...
Survival of Patients With Colon Cancer Enrolled in the U.S. Military Health System
A study by Lin et al comparing patients with colon cancer enrolled in the U.S. Military Health System, which provides universal health-care to its beneficiaries, with those in the general population has found that patients in the Military Health System had an 18% lower risk of death compared with...
Retrospective Study Explores Variation in Colorectal Cancer Risk in Families With Lynch Syndrome
In a retrospective cohort study reported by Win et al in The Lancet Oncology, researchers in the International Mismatch Repair Consortium found marked variation in the risk of colorectal cancer in families with Lynch syndrome carrying the same pathogenic variant in DNA mismatch repair genes. The...
Alkylating Signature in Colorectal Cancer May Be Linked to High Red Meat Intake
The association between the consumption of red and processed meats and the development of colorectal cancer, as well as pancreatic and prostate cancers, has been known since 2015, when the International Agency for Research on Cancer (IARC) classified the consumption of red meat as probably...
Colorectal Cancer Incidence and Mortality in European Countries
In a European population-based study reported in The Lancet Oncology, Cardoso et al found that colorectal cancer incidence and mortality declined more in European countries with long-standing colonoscopy or fecal test screening programs since the year 2000 compared to countries with more recently...
Is Tumor Mutational Burden Predictive of Survival Outcomes in Solid Tumors Treated With Immune Checkpoint Inhibitors?
In a letter to the editor in The New England Journal of Medicine, Benoit Rousseau, MD, PhD, and Michael B. Foote, MD, of Memorial Sloan Kettering Cancer Center (MSK), and colleagues presented evidence that a high tumor mutational burden (TMB) threshold of 10 alone may not be sufficient to predict...
Data Analysis on Early-Onset Colorectal Cancer Sheds Light on the Rising Rates in Young Adults
In May 2021, the U.S. Preventive Services Task Force (USPSTF) announced that it was updating its recommendation for when individuals at average risk of colorectal cancer should begin screening. Echoing the recommendation from the American Cancer Society in 2018, the USPSTF now recommends that those ...
Cathy Eng, MD, on Colorectal Cancer: FOLFOXIRI, Cetuximab, and Bevacizumab as First-Line Treatment
Cathy Eng, MD, of Vanderbilt-Ingram Cancer Center, discusses two abstracts from a session she co-chaired: the phase II DEEPER trial, which explored the use of FOLFOXIRI plus cetuximab vs FOLFOXIRI plus bevacizumab as first-line treatment in metastatic colorectal cancer with RAS wild-type tumors; and the phase II FIRE-4.5 study, which investigated FOLFOXIRI plus either bevacizumab or cetuximab as first-line treatment of BRAF V600E–mutant advanced disease (Abstracts 3501 and 3502).
Thierry André, MD, on Pembrolizumab vs Chemotherapy in MSI-High Colorectal Cancer
Thierry André, MD, of Hôpital Saint-Antoine, discusses final overall survival data for the phase III KEYNOTE-177 study, which confirmed pembrolizumab as a new standard of care for first-line treatment of patients with microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer (Abstract 3500).
Effect of Lower Endoscopy on Colorectal Cancer Incidence and Mortality in Individuals Older Than 75
In a prospective cohort study reported in JAMA Oncology, Ma et al found that lower endoscopy colorectal cancer screening in individuals older than age 75 was associated with reduced colorectal cancer incidence and mortality, although no colorectal cancer mortality benefit was observed in those with ...
Perioperative Systemic Therapy for Patients With Resectable Colorectal Peritoneal Metastases
In the phase II portion of a Dutch phase II/III trial (CAIRO6) reported in JAMA Surgery, Rovers et al found that the addition of perioperative systemic therapy to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) was feasible and safe for the treatment of patients with ...
Study Investigates Nongenetic Factors Linked to Development of Early-Onset Colorectal Cancer
Early-onset colorectal cancer incidence rates in the United States have nearly doubled between 1992 and 2013—up from 8.6 to 13.1 per 100,000 individuals—with most of that increase due to early-onset cancers of the rectum. A new study published by Archambault et al in JNCI Cancer Spectrum focused on ...
Standard Multigene Testing Could Detect More Hereditary Cancer Syndromes in Patients With Colorectal Cancer
Up to 38.6% of people with colon cancer who have a hereditary cancer syndrome—including 6.3% of those with Lynch syndrome—could have their conditions remain undetected with current universal tumor-screening methods, and at least 7.1% of people with colorectal cancer have an identifiable inherited...
With the Exception of Cervical Cancer, HPV-Related Cancers Are on the Rise, Especially in Older Adults
Although the incidence of cervical cancer has decreased by 1.03% a year over the last 16 years—likely due to screening or human papillomavirus (HPV) vaccination—other HPV-related cancers are increasing in both men and women, according to a study by Liao et al presented at a presscast in advance of...
USPSTF Issues New Recommendation Statement on Colorectal Cancer Screening
Prompted by a rise in cases of colorectal cancer in people younger than 50, the U.S. Preventive Services Task Force (USPSTF) has recommended that individuals at average risk for the disease begin screening exams at age 45 instead of the traditional age of 50. The guideline changes, published in...
Trastuzumab Deruxtecan-nxki in HER2-Positive Metastatic Colorectal Cancer: DESTINY-CRC01
In the phase II DESTINY-CRC01 trial reported in The Lancet Oncology, Salvatore Siena, MD, and colleagues found that trastuzumab deruxtecan-nxki produced durable responses in patients with previously treated HER2-positive metastatic colorectal cancer. Study Details In the trial, 78 patients from...
Addition of Celecoxib to Standard Adjuvant Therapy in Stage III Colon Cancer
��As reported in JAMA by Jeffrey A. Meyerhardt, MD, MPH, FASCO, and colleagues, the phase III CALGB/SWOG 80702 (Alliance) trial has shown no disease-free survival benefit with the addition of the cyclooxygenase 2 (COX-2) inhibitor celecoxib to standard adjuvant therapy in patients with stage III...
Risk of Colorectal Cancer and Colorectal Polyps in First-Degree Family Members
Researchers have demonstrated a possible connection between colorectal polyps in close relatives and the risk of developing colorectal cancer. The study, which was published by Song et al in the British Medical Journal, is of potential consequence for cancer screening procedures. Colorectal cancer...
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 improved ...
Study Explores Rates of Germline Mutations in Patients With Colorectal Cancer
In a recent study published by Uson Junior et al in Clinical Gastroenterology and Hepatology, researchers found one in six patients with colorectal cancer had an inherited cancer-related genetic mutation, which may be linked to a predisposition to the disease. In addition, the researchers...
National Survey Finds Average-Risk Individuals Prefer Stool-Based Tests Over Colonoscopy for Colorectal Cancer Screening
A national survey conducted by Zhu et al to identify patient preferences among colorectal cancer screening modalities to improve population adherence to colorectal cancer screening has found, when presented with a choice, most individuals with an average risk of colorectal cancer prefer stool-based ...
FDA Pipeline: Recent Designations in Urothelial Cancer, Cervical Cancer, Cholangiocarcinoma, and More
Recently, the U.S. Food and Drug Administration (FDA) issued regulatory decisions related to treatments for urothelial cancer, cervical cancer, cholangiocarcinoma, solid tumors, and colorectal cancer. Acceptance of Two Supplemental Biologics License Applications for Enfortumab Vedotin-ejfv in...
First-Line Pembrolizumab vs Chemotherapy for MSI-H or dMMR Metastatic Colorectal Cancer: Health-Related Quality of Life
In an analysis from the phase III KEYNOTE-177 trial reported in The Lancet Oncology, Thierry André, MD, and colleagues found that pembrolizumab was associated with clinically meaningful improvements in health-related quality of life (HRQOL) compared with chemotherapy in the first-line treatment of...
Estimated Shifts in Cancer Incidence and Death Over Next 2 Decades
In the next 2 decades, rankings of incidence and death across cancer types in the United States will undergo important changes, according to new research published by Lola Rahib, PhD, and colleagues in JAMA Network Open. The study estimates that pancreatic cancer is on course to become the...
Patients of Different Races With Early-Onset Colorectal Cancer Exhibit Distinct Genetic Features
Racial differences in genetic mutations were observed among patients with early-onset colorectal cancer, according to data presented by Andreana N. Holowatyj, PhD, MS, during the virtual American Association for Cancer Research (AACR) Annual Meeting 2021 (Abstract 101). The incidence of early-onset ...
FDA Approves New Dosing Regimen for Cetuximab in Colorectal Cancer, Head and Neck Cancer
On April 6, the U.S. Food and Drug Administration (FDA) approved a new dosage regimen for cetuximab (Erbitux) of 500 mg/m2 as a 120-minute intravenous infusion every 2 weeks for patients with KRAS wild-type, EGFR-expressing colorectal cancer or squamous cell carcinoma of the head and neck. This...
Does Consumption of Ultra-Processed Food and Drink Increase Colorectal Cancer Risk?
Consumption of ultra-processed food and drink could increase the risk of developing colorectal cancer. This was the conclusion of a large study published by Romaguera et al in Clinical Nutrition based on questionnaires about food behaviors completed by around 8,000 people in Spain. The study, the...
Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults
Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...
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...
Fam-Trastuzumab Deruxtecan-nxki 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...
KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer
In an updated analysis of the pivotal phase III KEYNOTE-177 trial of pembrolizu-mab for microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to ...
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. In the spring of 2020, The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing...
KRAS Mutation Status May Predict Outcomes After Hepatic Arterial Infusion Pump Therapy for Unresectable Colorectal Liver Metastases
KRAS mutational status in patients with unresectable liver metastases from colorectal cancer predicts a worse response to hepatic arterial infusion (HAI) pump chemotherapy, according to research presented by Kolbeinsson et al at the Society of Surgical Oncology 2021 International Conference on...
Circulating Hybrid Cells May Help to Monitor Treatment Response in Patients With Rectal and Esophageal Cancers
An analysis of 58 peripheral blood specimens from patients with rectal and esophageal cancers demonstrated that circulating hybrid cells may be a novel, noninvasive biomarker with potential for monitoring treatment response and disease progression to help guide decisions for further therapy,...
Use of Chemotherapy and Risk of Alzheimer’s Disease in Colorectal Cancer Survivors
In a retrospective cohort study reported in JCO Oncology Practice, Akushevich et al found that receipt of chemotherapy was associated with a reduced risk of Alzheimer’s disease in colorectal cancer survivors. As stated by the investigators, “Evidence on the nature of the relationship between...
Using CT Colonography as a Noninvasive Colorectal Cancer Screening Test for Advanced Neoplasia
According to a report published by Pickhardt et al in the American Journal of Roentgenology (AJR), compared with multitarget stool DNA and fecal immunochemical tests, computed tomography (CT) colonography using a polyp size threshold ≥ 10 mm most effectively targeted advanced neoplasia—preserving...
Complete Mesocolic Excision vs D2 Dissection in Patients Undergoing Laparoscopic Colectomy for Right-Sided Colon Cancer
In an analysis of early safety outcomes in a Chinese phase III trial (RELARC) reported in The Lancet Oncology, Xu et al found similar surgical complication rates with complete mesocolic excision vs D2 dissection in patients undergoing laparoscopic colectomy for right-sided colon cancer. The...
KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer
In an updated analysis of the pivotal phase III KEYNOTE-177 trial in microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to immunotherapy for...
Addition of Primary Tumor Resection to Chemotherapy for Asymptomatic Primary Colorectal Cancer Tumors and Synchronous Unresectable Metastases
In a Japanese phase III trial (JCOG1007; iPACS) reported in the Journal of Clinical Oncology, Kanemitsu et al found that the addition of primary tumor resection to chemotherapy did not improve overall survival vs chemotherapy alone in patients with asymptomatic primary colorectal cancer tumors and...
Expert Point of View: Michael J. Overman, MD
The study’s invited discussant, Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, said the findings of the study presented by Henriksen et al1 add to a convincing body of data showing that “the use of circulating...
Predicting Postoperative Recurrence in Stage I to III Colorectal Cancer With Circulating Tumor DNA
Patients with stage I to III colorectal cancer who have a high risk for recurrence may be identified by serial testing of circulating tumor DNA (ctDNA) after resection, according to a study in which ctDNA proved more reliable than carcinoembryonic antigen (CEA) surveillance or standard radiologic...
Delay in Time Between Abnormal At-Home Screening and Colonoscopy May Increase Colorectal Cancer Risk
At-home tests, which measure blood in stool as a potential marker for colon cancer, are often used for colorectal cancer screening. Usage of these tests has increased during the COVID-19 pandemic as patients try to avoid clinical visits. However, effectiveness of these screening tools, along with...
