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 years tend to be more fit and receive more intensive treatment than older patients, both groups survive for roughly the same amount of time, according to a study published by Lipsyc-Sharf et al in the Journal of the National ...
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 lockdown ...
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,...
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 Molecular 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 molecular 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...
