FDA Approves Nivolumab Plus Low-Dose Ipilimumab for Second-Line Treatment of MSI-H/dMMR Metastatic Colorectal Cancer
Today, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) plus low-dose ipilimumab (Yervoy) for the treatment of adult and pediatric patients aged 12 years and older with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR)...
Vitamin D Levels and Colorectal Cancer Risk
In a study reported in the Journal of the National Cancer Institute, McCullough et al found reduced risk for colorectal cancer with increasing levels of circulating 25-hydroxyvitamin D (25[OH]D). Study Details The study was an international pooling project using participant-level data from 17...
Colon Cancer Surgery and Resource Availability at Hospitals on Weekends and Holidays
The likelihood of severe complications after emergency colon cancer surgery is significantly higher over the weekend, according to a study published by Huijts et al in JNCCN – Journal of the National Comprehensive Cancer Network. The research was led by Perla Marang-van de Mheen, PhD, of the...
Dietary Insulin Load and Risk of Disease Recurrence in Stage III Colon Cancer
New research led by Dana-Farber Cancer Institute investigators suggests that patients treated for nonmetastatic colon cancer may sharply reduce the risk that the disease will return by following a diet low in carbohydrates and other foods that raise insulin levels. In a study published by...
AMA Plans Advocacy Outreach to Expand Colorectal Screening
Building on the efficacy of colorectal cancer screening, the American Medical Association (AMA) endorsed a plan at its Annual Meeting to work with physicians and payers to make the screening more available and affordable. Challenges with insurance coverage remain a barrier to colorectal cancer...
Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival
It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...
Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer
With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...
Surveillance Intensity Not Associated With Earlier Detection of Recurrence or Improved Survival in Patients With Colorectal Cancer
A national retrospective study led by researchers at The University of Texas MD Anderson Cancer Center found no association between intensity of posttreatment surveillance and detection of recurrence or overall survival (OS) in patients with stage I, II, or III colorectal cancer. Published by...
Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer
Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...
Young-Onset Colorectal Cancer Survivors, Patients, and Caregivers Asked to Participate in Third Annual Survey
The Colorectal Cancer Alliance has opened its third annual international survey of young-onset colorectal cancer patients, survivors, and caregivers, with the intent of learning about and tracking the medical and psychosocial experiences of this often overlooked group, which comprises 11% of...
Validation of the Consensus Immunoscore for Classification of Colon Cancer
As reported in The Lancet by Pagès et al, an international collaboration has validated the consensus Immunoscore for colon cancer as a predictive tool for recurrence of disease. Study Details An international consortium of 14 centers in 13 countries, led by the Society for Immunotherapy of ...
Howard S. Hochster, MD, on Colorectal Cancer: Results From the E7208 Trial
Howard S. Hochster, MD, of Rutgers-Cancer Institute of New Jersey, discusses study findings on irinotecan and cetuximab vs irinotecan, cetuximab, and ramucirumab as second-line therapy of advanced colorectal cancer following oxaliplatin and bevacizumab-based therapy (Abstract 3504).
Michael J. Overman, MD, and François Quenet, MD, on Colorectal Cancer: Results From the PRODIGE 7 Trial
Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and François Quenet, MD, of the Institut Régional du Cancer de Montpellier, discuss phase III study findings on hyperthermic intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis (Abstract LBA3503).
2018 ASCO: Hyperthermic Intraperitoneal Chemotherapy Does Not Add Benefit in Patients With Advanced Colorectal Cancer
A randomized phase III clinical trial showed that people with advanced colorectal cancer may not need a frequently considered component of treatment—heated chemotherapy delivered to the abdomen during surgery. There was no difference in survival between patients with metastases in the abdomen ...
2018 ASCO: Genomic Study Finds Lynch Syndrome Is Common Among Patients With MSI-High Tumors
A genomic study of more than 15,000 tumor samples showed that people who have tumors with high microsatellite instability (MSI-H)—a genomic marker associated with a large number of genetic mutations in the tumor—are more likely to have Lynch syndrome, a hereditary condition that...
American Cancer Society Updates Colorectal Cancer Screening Guideline
An updated American Cancer Society guideline now says colorectal cancer screening should begin at age 45 for people at average risk, based in part on data showing rates of colorectal cancer are increasing in young and middle-aged populations. The updated recommendations were published by Wolf et al ...
Risk of Recurrence in Stage III Colon Cancer According to RAS- and BRAF-Mutation Status
In a study in the PETACC-8 trial population reported in JAMA Oncology, Julien Taieb, MD, PhD, of the Université Paris Descartes, and colleagues found that the risk of recurrence in patients with stage III colon cancer differed for the primary tumor location according to RAS- and BRAF-mutation...
BRAF Mutations, Survival, and Recurrence in Patients Undergoing Surgery for Colorectal Cancer Liver Metastases
In a study reported in JAMA Surgery, Margonis et al found that presence of a BRAF V600E mutation was associated with higher risk of recurrence and poorer overall survival among patients undergoing surgical resection of liver metastases from colorectal cancer. Study Details The cohort study...
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...
GAME Score for Patients With Metastatic Colorectal Cancer
Surgical oncologists at the Johns Hopkins University School of Medicine may have developed an improved scoring system for predicting survival in people with colorectal cancers that have metastasized to the liver. According to the researchers, the system, called the Genetic and Morphological...
Profile of ERBB2/ERBB3-Mutant Colorectal Cancer
In a study reported in the Journal of the National Cancer Institute, Loree et al found that ERBB2/ERBB3 mutations in colorectal cancer are associated with microsatellite instability and PIK3CA mutation. Study Details The study involved retrospective analysis of 419 patients from The University of ...
Survival Analysis for Adjuvant Chemotherapy vs Observation After Pathologic Complete Response and Resection in Rectal Cancer
In a propensity-score matching analysis reported in JAMA Oncology, Polanco et al found that adjuvant chemotherapy was associated with a survival benefit vs observation among patients with locally advanced rectal cancer who underwent resection after pathologic complete response following neoadjuvant ...
Adjuvant FOLFOX or CAPOX for 3 or 6 Months in Stage II or III Colon Cancer
As reported in the Journal of Clinical Oncology by Sobrero et al, the Italian phase III TOSCA trial did not demonstrate noninferiority of 3 vs 6 months of adjuvant CAPOX (capecitabine plus oxaliplatin) or FOLFOX (fluorouracil, leucovorin, and oxaliplatin) in relapse-free survival in stage II or...
Following Nutrition and Exercise Guidelines May Prolong Survival in Stage III Colon Cancer
A diet high in whole grains, fruits, and vegetables—along with exercise and maintaining a healthy body weight—can improve the 5-year survival rate for patients with stage III colorectal cancer, according to a new report published by Van Blarigan et al in JAMA Oncology. The findings...
Nut Consumption in Patients With Stage III Colon Cancer
People with stage III colon cancer who regularly eat tree nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology.1 Study Findings The study followed 826 participants in the...
Adjuvant Chemotherapy Duration in Stage III Colon Cancer
In a preplanned pooled analysis of phase III trials reported in The New England Journal of Medicine, Grothey et al did not establish noninferiority of 3 vs 6 months of adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin) in disease-free survival in...
Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer
In a retrospective cohort study reported in JAMA Oncology, Cercek et al found evidence supporting the use of total neoadjuvant therapy as an effective option in locally advanced rectal cancer. Study Details The study involved data on 811 patients presenting with locally advanced rectal cancer (T3 ...
Expert Point of View: Timothy Gilligan, MD, MSc
“IN THE PAST, patients were often told to rest and reduce their physical activity during treatment, but we now know that exercise is both safe and beneficial,” said Timothy Gilligan, MD, MSc, moderator of a presscast where these results were presented prior to the Cancer Survivorship Symposium....
Four Years Posttreatment, Exercise Improves Physical Activity Levels, Reduces Fatigue in Patients With Breast and Colon Cancers
IN PATIENTS WITH breast and colon cancers, a physical exercise intervention conducted during adjuvant chemotherapy improved total physical activity levels 4 years after treatment, with a trend toward less fatigue, according to a follow-up study from the randomized multicenter PACT study, presented...
Modified XELIRI vs FOLFIRI as Second-Line Treatment for Metastatic Colorectal Cancer
In an Asian phase III noninferiority trial (AXEPT) reported in The Lancet Oncology, Xu et al found that modified XELIRI (mXELIRI, capecitabine plus irinotecan) was noninferior in overall survival vs standard FOLFIRI (leucovorin, fluorouracil, and irinotecan), both given with or without bevacizumab...
FDA Accepts sBLA for Nivolumab Plus Ipilimumab in Previously Treated MSI-H or dMMR Metastatic Colorectal Cancer
On March 27, the U.S. Food and Drug Administration (FDA) accepted a supplemental biologics license application (sBLA) for nivolumab (Opdivo) in combination with ipilimumab (Yervoy) for the treatment of adults with microsatellite instability–high (MSI-H) or mismatch repair deficient...
Duration of Adjuvant Oxaliplatin-Based Therapy for Stage III Colon Cancer
“At Microphone 1” is an occasional column written by Steven E. Vogl, MD, of the Bronx, New York. When he is not in his clinic, he can generally be found at major oncology meetings and often at the microphone, where he stands ready with critical questions for presenters of new data. The opinions...
Long-Term Risk of Cardiovascular Disease Increased Among Colorectal Cancer Survivors
COMPARED TO the general population, the risk of cardiovascular disease among colorectal cancer survivors was significantly increased more than 10 years after their cancer diagnosis, according to research presented by David Baraghoshi, MSTAT candidate, of the Huntsman Cancer Institute at the...
Alan P. Venook, MD, on Selecting Treatment for Advanced Colorectal Cancer
Alan P. Venook, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses which biomarkers to order and when, the role of checkpoint inhibitors, and chemotherapy choices.
Support, Inform Patients With ASCO Resources
Stock your practice with ASCO resources for your patients. Visit ASCO’s patient information website, Cancer.Net, for a newly updated comprehensive guide to colorectal cancer at cancer.net/colorectal and a shorter, one-page colorectal cancer fact sheet. Copies can be purchased from the ASCO...
Triplet Therapy Poses a Triple Threat to BRAF-Mutated Colorectal Cancers
Triplet therapy that inhibits the BRAF, MEK, and epidermal growth factor receptor (EGFR) pathways appears promising in BRAF-mutated colorectal cancer, a malignancy that typically does not respond to BRAF inhibition alone. Early results from the BEACON CRC study showed a 48% response rate and an...
Studies Explore Colon Tumor Sidedness, Lung Radiation Dose in Esophageal Cancer, Pembrolizumab in Liver Cancer, and More
Along with full coverage of key presentations from the 2018 Gastrointestinal Cancers Symposium, The ASCO Post brings our readers this additional news roundup. Side Matters in Colon Cancer One of the studies included in the global IDEA trial, which compared 3 vs 6 months of adjuvant chemotherapy in ...
Study Finds Patients Using an iPad App to Self-Order Tests Doubled Colon Cancer Screening Rates
According to the American Cancer Society (ACS), colorectal cancer (CRC) is the third most commonly diagnosed cancer in the United States and the second leading cause of death from cancer. Projections by the ACS show that, this year, about 50,630 people will die from the disease. However, studies...
EXPERT POINT OF VIEW: Wafik S. El-Deiry, MD, PhD, FACP
WAFIK S. EL-DEIRY, MD, PhD, FACP, Deputy Cancer Center Director for Translational Research, and Co-Leader of the Molecular Therapeutics Program at Fox Chase Cancer Center, Philadelphia, shared his thoughts on these findings with The ASCO Post. In essence, Dr. El-Deiry suggested the comparison does ...
Small Study Evaluates Treatment Sequencing in Patients With Metastatic Colorectal Cancer
THE OPTIMAL treatment sequence for two approved agents in metastatic colorectal cancer may be regorafenib (Stivarga) before cetuximab (Erbitux), according to results from the small randomized Japanese REVERCE trial presented at the 2018 Gastrointestinal Cancers Symposium.1 Giving regorafenib...
Investigational Genomic Tool Identifies Consensus Molecular Subtype of Colon Tumor and May Predict Risk of Recurrence
AN INVESTIGATIONAL TOOL called ColotypeR classifies colon cancers by molecular subtype and creates a subtype-specific risk of recurrence, according to research. Developers of the tool say it will be able to guide treatment decisions. Colon cancer is highly heterogeneous in prognosis and response to ...
Study Finds Colorectal Cancer Screenings Vary Widely Throughout the United States
A study examining prevalence estimates of colorectal cancer screening at the county level in the United States has found that the country is far behind reaching the goal of screening 80% of adults aged 50 and older for colorectal cancer by 2018, which is supported by the National Colorectal Cancer...
Nut Consumption in Patients With Stage III Colon Cancer
People with stage III colon cancer who regularly eat nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology. Findings The study followed 826 participants in the CALGB...
David Baraghoshi, on Colorectal Cancer and Cardiovascular Disease Risk
David Baraghoshi, of the Huntsman Cancer Institute at the University of Utah, discusses an assessment of cardiovascular risk more than 10 years after diagnosis for colorectal cancer survivors compared with a cancer-free general population cohort (Abstract 113).
Use of Circulating Tumor Cells to Detect Colorectal Cancer and Adenomas
Circulating tumor cells (CTCs) in the blood had an accuracy of up to 88% in detecting colorectal cancer and 84% in identifying adenomas, in a study from Taiwan presented at the 2018 Gastrointestinal Cancers Symposium by Wen-Sy Tsai, MD, of Linkou Chang Gung Memorial Hospital in Taipei.1 “The study ...
Combination Immunotherapy in DNA Mismatch Repair–Deficient/Microsatellite Instability–High Metastatic Colorectal Cancer
As reported in the Journal of Clinical Oncology by Overman et al, findings in the nivolumab (Opdivo) plus ipilimumab (Yervoy) cohort of the CheckMate-142 study indicate a high response rate and durable responses with the combination in previously treated patients with DNA mismatch...
2018 SURVIVORSHIP: Exercising During Chemotherapy for Breast or Colon Cancer Has Long-Term Benefits
A follow-up study to a randomized clinical trial reveals that exercising during adjuvant chemotherapy helps people engage in more physical activity years later. Four years later, people with breast or colon cancer who had participated in an 18-week exercise program while receiving chemotherapy...
EXPERT POINT OF VIEW: Zsofia Kinga Stadler, MD
DISCUSSANT ZSOFIA KINGA STADLER, MD, of Memorial Sloan Kettering Cancer Center, found the nivolumab (Opdivo)/ipilimumab (Yervoy) combination results very encouraging but was also impressed with the monotherapy arm. Both approaches are significant advances in treatment, she said. “The treatment of ...
Nivolumab Plus Ipilimumab Improves Outcomes in Metastatic Colorectal Cancer
IN THE FIRST REPORT of the full cohort of CheckMate-142, nivolumab (Opdivo) plus ipilimumab (Yervoy) led to a 1-year overall survival rate of 85% in previously treated patients with metastatic colorectal cancer who have DNA mismatch repair–deficient (dMMR) or microsatellite instability–high...
Is There a Benefit of Maintenance Bevacizumab During Chemotherapy-Free Intervals in Metastatic Colorectal Cancer?
As reported by Aparicio et al in the Journal of Clinical Oncology, a French phase III trial (PRODIGE 9) showed no benefit of maintenance bevacizumab (Avastin) during postinduction chemotherapy-free intervals in metastatic colorectal cancer. Study Details In the open-label trial, 491 patients from ...
