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In the phase III CheckMate 8HW trial, previously untreated patients with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) nonresectable or metastatic colorectal cancer derived significant benefit from an immunotherapy doublet, with nivolumab plus ipilimumab reducing the...
In a pooled analysis reported in the Journal of Clinical Oncology, Rahbari et al found that primary tumor resection before chemotherapy did not extend survival compared with upfront chemotherapy in patients with colon cancer and unresectable metastases. Study Details The study involved data from...
The established dual HER2 blockade of pertuzumab and trastuzumab may be an effective treatment for patients with several types of HER2-amplified cancers, according to a study published by Connolly et al in Clinical Cancer Research. Background HER2 receptors control how cells grow and divide. The...
Non-Hispanic Black patients with locally advanced rectal cancer may experience poorer treatment outcomes independent of the sociodemographic, clinical, and pathologic factors that often influence racial and ethnic disparities in this patient population, according to a recent study published by...
Investigators have found that U.S. individuals with a history of incarceration may have worse access to and receipt of breast cancer and colorectal cancer screenings compared with those without a history of incarceration, according to a recent study published by Zhao et al in JAMA Health Forum....
In a Dutch study reported in The Lancet Oncology, Wisse et al found that a multitarget fecal immunochemical test (mtFIT) improved detection of advanced adenomas vs standard FIT in colorectal cancer screening. The mtFIT used in the study measures hemoglobin, calprotectin, and serpin family F member...
Investigators may have identified colorectal cancer screening programs in Latin America, according to a recent systematic review and meta-analysis published by Montalvan-Sanchez et al in JAMA Network Open. Background Colorectal cancer—the second leading cause of cancer-related mortality...
In an analysis reported by Frei et al in The Lancet Oncology, multiplex immunofluorescence staining of tissue microarrays of samples from patients with stage II to III colorectal cancer showed that densities of CD8-positive and Foxp3-positive cells were associated with recurrence-free interval. As...
The novel COLOXIS machine learning model may accurately predict which patients with colon cancer are most likely to derive benefit from oxaliplatin, according to a recent study published by Chen et al in the Journal of Clinical Oncology. The findings could ultimately allow physicians to better...
Investigators discovered that overweight and obesity may be contributing to rising rates of colon cancer mortality in younger patients, according to a recent study published by Santucci et al in the Annals of Oncology. The findings represent the first time colon cancer mortality rates among younger ...
Dominik P. Modest, MD, of Charité-Universitätsmedizin Berlin, discusses phase III study findings showing sotorasib plus panitumumab vs trifluridine/tipiracil or regorafenib benefits patients with chemorefractory metastatic colorectal cancer in terms of improved clinical outcomes and better self-reported quality of life (Abstract 10).
Jennifer Yon-Li Wo, MD, of Massachusetts General Hospital, discusses the local failure rate of non-ablative hypofractionated radiation therapy in combination with the immune checkpoint inhibitors ipilimumab and nivolumab compared to ablative SBRT to treat metastatic microsatellite-stable colorectal and pancreatic cancers as a secondary analysis of four prospective trials. Dr. Wo and her team found that, despite using nearly half the radiation dose in those who received immunotherapy, there was no significant difference in local failure rates (Abstract 752).
Van K. Morris, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II results on using circulating tumor DNA (ctDNA) as a predictive biomarker of adjuvant chemotherapy in patients with stage II colon cancer. During the trial, no improvement in ctDNA clearance was observed after 6 months of chemotherapy following resection of disease. Dr. Morris notes that future trials should account for evolving assay performance in patients with colorectal cancer (Abstract 5).
Investigators have found that only a minority of patients with Lynch syndrome may be receiving aspirin as chemopreventive therapy, according to new findings presented by Singhal et al at the 2024 ASCO Gastrointestinal Cancers Symposium (Abstract 19). Background “[Patients] with Lynch syndrome are...
In the phase III CheckMate 8HW trial, previously untreated patients with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) metastatic colorectal cancer derived significant benefit from an immunotherapy doublet of nivolumab plus ipilimumab in the first-line setting, which...
Following surgery to remove a colorectal tumor, patients may have molecular measurable residual disease (MRD). Circulating tumor DNA (ctDNA), or liquid biopsy, may be used to detect molecular MRD in patients who underwent surgery for colorectal cancer and to determine whether they may benefit from...
The role of circulating tumor DNA (ctDNA), or liquid biopsy, as a predictive tool to guide and monitor cancer treatment remains unclear, after the first prospective randomized phase II trial evaluating clearance of ctDNA in patients with stage II colon cancer receiving adjuvant chemotherapy did not ...
As reported in the Journal of Clinical Oncology by Pinto et al, the Italian phase III ERMES trial showed that the addition of cetuximab maintenance to eight cycles of first-line FOLFIRI (fluorouracil, leucovorin, and irinotecan) plus cetuximab did not achieve noninferiority in terms of...
Investigators may have uncovered molecular evidence of racial disparities in the receipt of precision medicine, according to a recent study published by Yamada et al in npj Precision Oncology. Background Colorectal cancer is the third most common cancer type diagnosed in both male and female...
In the European CAMINO study reported in The Lancet Oncology, Görgec et al identified the likelihood of change in treatment plans with the addition of contrast-enhanced magnetic resonance imaging (MRI) in patients scheduled for local therapy for colorectal liver metastases on the basis of...
A novel vaccine may be effective at preventing relapse in patients with KRAS-mutated pancreatic and colorectal cancers, according to a recent study published by Pant et al in Nature Medicine. Background KRAS-mutated cancers make up about 25% of all solid tumors, including 90% of pancreatic cancer...
In a Dutch nationwide cross-sectional cohort study reported in JAMA Oncology, Hazen et al found that a reduced use of neoadjuvant radiotherapy as part of chemoradiotherapy was not associated with poorer outcomes in patients with non–locally advanced rectal cancer. As stated by the investigators,...
Robotic surgery may offer significant benefits over laparoscopic procedures in patients with colorectal cancer undergoing colectomies, according to a recent study published by Farah et al in the World Journal of Surgical Oncology. These findings suggest that a majority of patients receiving robotic ...
Next-generation sequencing may help better identify patients with cancer and mismatch repair deficiency who may benefit from immunotherapy, according to a recent study published by Farhat et al in Cancer Cell. The new findings indicated that treating more patients with immunotherapy may require...
Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, and the third-leading cause of cancer-related deaths. According to the American Cancer Society, in 2023, it is estimated that about 52,550 individuals died from the...
As reported in the Journal of Clinical Oncology by Innocenti et al, analysis of DNA mutational profiling in the phase III CALGB (Alliance)/SWOG 80405 trial of patients with metastatic colorectal cancer treated with bevacizumab or cetuximab with chemotherapy showed differences in outcome associated...
Glucagon-like peptide 1 (GLP-1) receptor agonists may be effective at reducing the risk of colorectal cancer in patients with a higher body mass index (BMI) and diabetes, according to a recent study published by Wang et al in JAMA Oncology. Background Obesity is a chronic health condition that...
Researchers have uncovered that the regular consumption of navy beans may help modulate markers linked to obesity and disease and improve the gut microbiome in colorectal cancer survivors, according to a novel study published by Zhang et al in eBioMedicine. Background Obesity, poor diet, and...
In a nationwide Danish cohort study reported in JAMA Oncology, Nors et al found the 5-year risk of recurrence after surgery for stage I to III colorectal cancer decreased over time and the time to recurrence was shorter with a more advanced disease stage. Study Details The study used the Danish...
In a European study reported in the Journal of Clinical Oncology, Heymer et al found that the risk of subsequent colorectal cancer was elevated among childhood cancer survivors who had undergone abdominopelvic radiotherapy. Study Details The study used data from the PanCareSurFup Study—a...
The combination of sotorasib and panitumumab significantly improved progression-free survival compared with standard treatment in patients with chemotherapy-refractory metastatic colorectal cancer with KRAS G12C mutations, the phase III CodeBreaK 300 trial has shown. The KRAS G12C inhibitor...
A high proportion of patients with colorectal cancer in Sub-Saharan Africa may receive no treatment or inadequate treatment, regardless of the disease’s curability, according to a recent study published by Hämmerl et al in JNCCN–Journal of the National Comprehensive Cancer Network. The new findings ...
A retrospective cohort study by Liu et al published in Cancer Epidemiology, Biomarkers & Prevention investigated the prevalence and reasons for an unsatisfactory fecal immunochemical test (FIT). Researchers found that over 10% of the tests used for routine colorectal cancer screening contained...
As reported in the Journal of Clinical Oncology by Zwanenburg et al, 5-year findings from the Dutch COLOPEC trial indicated that the addition of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) to systemic chemotherapy did not improve overall survival vs chemotherapy alone in patients...
In a study reported in the Journal of Clinical Oncology, Nogueira et al found that among U.S. Black and White patients with early-onset colorectal cancer, Black patients were more likely to receive poorer and less timely care. As stated by the investigators: “Young individuals racialized as Black...
In a 5-year follow-up of the phase II OPRA trial reported in the Journal of Clinical Oncology, Verheij et al found that many patients receiving total neoadjuvant therapy for rectal adenocarcinoma remained free of the need for total mesorectal excision. Study Details In the U.S. multicenter trial,...
Investigators have found that Black patients with early-onset colorectal cancer in the United States may receive worse and less timely, guideline-concordant care than White patients, according to a recent study published by Nogueira et al in the Journal of Clinical Oncology. Background “Colorectal...
On November 8, the U.S. Food and Drug Administration (FDA) approved fruquintinib (Fruzaqla) for adult patients with metastatic colorectal cancer who received prior fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy; an anti-VEGF therapy; and—if their disease is RAS wild-type and it...
I’ve been contending with health issues since I was 12, when I was diagnosed with Crohn’s disease. As I began my early 30s, I was feeling the healthiest of my life. I was working out 5 days a week and attributed sudden weight loss and fatigue to weight training and high-intensity Zumba classes....
Researchers have found that presenting older patients with personalized information regarding the benefits and harms of colorectal cancer screenings may reduce unnecessary screenings, according to a recent study published by Saini et al in JAMA Internal Medicine. Background Colorectal cancer...
Investigators have found that U.S. adult patients with prior insurance coverage disruptions may be less likely to receive guideline-concordant and past-year cancer screenings compared with those with continuous coverage, according to new findings presented by Shi et al at the 2023 ASCO Quality Care ...
The phase III CodeBreaK 300 trial showed that sotorasib plus panitumumab improved progression-free survival vs standard care in patients with KRAS G12C–mutated refractory metastatic colorectal cancer. Findings were presented at the European Society for Medical Oncology (ESMO) Congress 2023 (LBA10)...
Researchers have identified significant variations in the gut microbiome of patients with precancerous colorectal lesions, suggesting a potential correlation between gut bacteria and the onset of precancerous lesions and colorectal cancer, according to new findings presented by Gacesa et al at...
Intensive local-regional tumor debulking in addition to standard palliative chemotherapy may not impact the overall quality of life of patients with metastatic colorectal cancer, according to a novel study published by Bakkerus et al in JNCCN–Journal of the National Comprehensive Cancer Network....
In an international validation study reported in the Journal of Clinical Oncology, El Sissy et al found that the Immunoscore biopsy was capable of distinguishing risk of disease recurrence in patients with rectal cancer treated with a watch-and-wait strategy. As stated by the investigators, “No...
There have been demonstrated differences in tumor cell metabolism between right-sided and left-sided colorectal tumors, which could explain the differences observed in their clinical behavior, especially in metastatic disease. Now, new research has found that patients with right-sided colorectal...
Regular and intense aerobic exercise may be effective at reducing the risk of colorectal cancer in patients with Lynch syndrome by improving the immune system's ability to detect and remove potentially harmful cells, according to a novel study published by Deng et al in Clinical Cancer Research....
According to the American Cancer Society, colorectal cancer is the second-leading cause of cancer-related death in the United States. In 2023, the disease is expected to cause an estimated 52,550 deaths. Studies show that receiving a clinician recommendation is the strongest and most consistent...
This is Part 3 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss later-line treatment options for metastatic colorectal cancer. The patient is a 64-year-old male with metastatic ascending colon moderately differentiated adenocarcinoma. On CT scan, he has liver, lung, and retroperitoneal lymph node metastases. Molecular testing demonstrates proficient mismatch repair, HER2 IHC negative; a 100-gene next-generation sequencing panel demonstrates KRAS G13D, PIK3CA, CCND2, and ATM mutations. The patient has a good performance status and is initiated on FOLFOXIRI/bevacizumab with partial response, then develops disease progression on fluorouracil/bevacizumab maintenance therapy. The faculty review the next steps for this patient and the importance of quality-of-life considerations when making treatment decisions. They also discuss the evolving third-line landscape, highlighting the recent SUNLIGHT trial that evaluated the addition of bevacizumab to TAS-102.
This is Part 2 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss second-line treatment options for metastatic colorectal cancer. The patient is a 46-year-old female with locally advanced, poorly differentiated rectal adenocarcinoma who received neoadjuvant chemoradiation followed by resection, which revealed a ypT4N1 tumor. She received adjuvant FOLFOX for eight cycles; 5 months after completion of therapy, a restaging CT scan revealed more than 10 growing pulmonary nodules, all < 1 cm. In the conversation that follows, the faculty discuss the many treatment options available in the second-line setting, the factors that impact decision-making, and the emerging role of HER2 amplification/overexpression as an actionable target in metastatic colorectal cancer.