Dual HER2 Targeting of HER2-Positive Metastatic Colorectal Cancer Shows Clinical Benefit
The combination of trastuzumab (Herceptin) plus lapatinib (Tykerb) achieved positive results in patients with heavily pretreated, HER2-positive metastatic colorectal cancer, according to the final results of the phase II HERACLES-A trial. This two-pronged, HER2-directed approach achieved clinical...
Expect Questions About Colorectal Cancer Among Younger Adults
Publicity surrounding a recent study showing a sharp increase in colorectal cancer among young people, even those in their 20s,1 may result in increased patient visits and questions. Among people aged 20 to 39, colon cancer rates have increased 1% to 2.4%, and rectal cancer rates have increased...
Increased Recognition of Colorectal Cancer in Young Adults, Even Those Aged 20 to 29, as Evidence Continues to Accumulate
The incidence of colorectal cancer continues to increase among young adults, with the sharpest increase among those aged 20 to 29, according to a recent article in the Journal of the National Cancer Institute.1 This trend has been called disturbing and ominous, but the widely reported results of...
AACR 2017: Minority Patients With Colorectal Cancer Report Higher Burden of Poor Quality-of-Life Than Whites
A study presented by Hildebrandt et al at the 2017 Annual Meeting of the American Association of Cancer Research (AACR; Abstract 990) revealed several findings about racial disparities in health-related quality of life among colorectal cancer patients. Hispanics and blacks had a higher burden of...
AACR 2017: Combination HER2-Targeted Therapy Effective in Heavily Pretreated HER2-Positive Colorectal Cancer
A combination of two HER2-targeted therapies, trastuzumab (Herceptin) and lapatinib (Tykerb), showed clinical benefit in patients with heavily pretreated HER2-positive metastatic colorectal cancer, according to final results from the phase II HERACLES clinical trial, presented by Siena et al at the ...
Reducing Debilitating Symptoms of Advanced Colorectal Cancer
In a phase III trial reported in The Lancet Oncology, Tamas Hickish, MD, of Poole Hospital NHS Foundation Trust, Dorset, England, and colleagues found that treatment with MABp1, an antibody that targets interleukin 1α and exhibits antitumor activity, was associated with improvement in the composite ...
Expert Point of View: Manish A. Shah, MD
Manish A. Shah, MD, Director of Gastrointestinal Oncology at NewYorkPresbyterian and Weill Cornell Medicine, commented that “the benefit seen in patients who regularly exercise is equal to or better than the benefit seen with some chemotherapy drugs,” although he cautioned that exercise in this...
Moderate Activity May Improve Overall and Progression-Free Survival in Patients With Metastatic Colorectal Cancer
Patients with metastatic colon cancer who exercise may live longer, according to an analysis of the CALGB/SWOG 80405 trial presented at the 2017 Gastrointestinal Cancers Symposium.1 According to the authors, this is the first study to demonstrate an association between physical activity and...
Novel Immunotherapeutic Vaccine Studied in Colorectal Cancer
Patients with advanced colorectal cancer mounted a robust response to an experimental vaccine and low-dose cyclophosphamide, and strong responses were associated with improvements in survival in a phase I/II clinical trial of modified vaccinia virus Ankara–5T4 (TroVax).1 Martin Scurr, PhD, of...
Clinical Trials Actively Recruiting Patients With Colorectal Cancer
Phase I Study Title: A Pilot Study of SGI-110 in Combination With an Allogeneic Colon Cancer Cell Vaccine and Cyclophosphamide in Metastatic Colorectal Cancer as Maintenance Therapy Study Type: Phase I/interventional/parallel assignment Study Sponsor and Collaborators: Sidney Kimmel Comprehensive...
Addition of Cetuximab to Chemoradiotherapy for Anal Carcinoma
In a phase II trial (Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group E3205) reported in the Journal of Clinical Oncology, Garg et al found that the addition of cetuximab (Erbitux) to definitive chemoradiotherapy appeared to reduce the rates of...
Germline Cancer Susceptibility Mutations in Early-Onset Colorectal Cancer
In a study reported in JAMA Oncology, Pearlman et al found that 16% of patients with early-onset colorectal cancer had germline cancer susceptibility mutations, with a wide array of such mutations being identified. Heather Hampel, MS, CGC, of The Ohio State University Comprehensive Cancer Center,...
Nivolumab in Previously Treated Unresectable Metastatic Squamous Cell Carcinoma of the Anal Canal
In a phase II trial reported in The Lancet Oncology, Morris et al found that nivolumab (Opdivo) was active in previously treated unresectable metastatic squamous cell carcinoma of the anal canal. This malignancy is associated with human papillomavirus (HPV) infection, with the rationale for...
Study Finds Sharp Rise in Colon and Rectal Cancers in Young Adults
Although the overall incidence rate of colorectal cancer in the United States has been declining rapidly since the mid-1980s, the decrease has been in older adults. During this same period, incidence rates have been increasing sharply for adults younger than age 50, finds a study by the American...
Tailoring Treatment for Older Adults With Colorectal Cancer
Nearly 60% of colorectal cancer cases are diagnosed in patients ≥ 65 years, with a median age at diagnosis of 68 years,1 but this population makes up only 34% of clinical trial participants.2 In addition, the older adults enrolled on clinical trials are traditionally the most-fit older adults....
ASCO-SITC Clinical Immuno-Oncology Symposium: Utility of Biomarkers for Predicting Colorectal Cancer Survival Depends on Tumor Location
A large population-based study suggests that the utility of particular types of tumor-infiltrating lymphocytes (TILs) to predict colorectal cancer survival depends on where the tumor originates in the body. Although prior research has shown an association between high TIL density and longer...
Optimal Time to Assess Response After Chemoradiotherapy in Anal Squamous Cell Carcinoma
In a post hoc analysis of the UK ACT II trial reported in The Lancet Oncology, Glynne-Jones et al found that the best time to assess for complete response to chemoradiotherapy in patients with anal squamous cell carcinoma is at approximately 26 weeks from the start of treatment. In the ACT II...
Expert Point of View: Philip B. Paty, MD
Philip B. Paty, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center, New York, commented on the findings for The ASCO Post. Dr. Paty is leading studies of surveillance at his own institution, which is not part of the International Watch & Wait Database. Consistency of Outcomes...
‘Watch-and-Wait’ Strategy Does Not Compromise Survival in Selected Patients With Rectal Cancer
A “watch-and-wait” approach to treating rectal cancer patients with complete responses to chemoradiotherapy resulted in a 3-year survival rate of 91%, which is similar to historic survival rates after surgical resection, according to an analysis of the International Watch & Wait Database.1 For ...
Expert Point of View: Frank Sinicrope, MD
Frank Sinicrope, MD, Professor of Medicine and Oncology at the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that anti–programmed cell death protein 1 (anti–PD-1) agents “have already changed the landscape” of metastatic colorectal cancer. “We are currently treating microsatellite...
CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer
With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...
ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers for Evaluation of Colorectal Cancer
As reported in the Journal of Clinical Oncology by Antonia Sepulveda, MD, PhD, of Columbia University, and colleagues, a joint guideline on the use of molecular biomarkers for evaluation of colorectal cancer has been developed by an expert panel from the American Society for Clinical Pathology...
Most Patients Undergoing Elective Colorectal Surgery Receive Inadequate Bowel Preparation to Prevent Postoperative Complications
In the largest study of its kind to date, researchers from Fox Chase Cancer Center and the Lewis Katz School of Medicine at Temple University confirmed that oral antibiotics combined with mechanical bowel preparation were more effective at preventing surgical site infections...
ASCP/CAP/AMP/ASCO Clinical Practice Guideline Focuses on Molecular Biomarker Testing for Patients With Colorectal Cancer
A new, evidenced-based clinical practice guideline on molecular biomarker testing for patients with colorectal cancer identifies opportunities for improving patient outcomes. The American Society for Clinical Pathology (ASCP), the College of American Pathologists (CAP), the Association for...
‘Collateral Lethality’ May Offer New Therapeutic Approach to Cancers of the Pancreas, Stomach, and Colon
Cancer cells often delete genes that normally suppress tumor formation. These deletions also may extend to neighboring genes, an event known as “collateral lethality,” which may create new options for the development of therapies for several cancers. Scientists at The University of Texas MD...
Potential Suboptimal Use of Guideline-Endorsed Genomic Testing in Non–Small Cell Lung and Colorectal Cancers
In a study reported in the Journal of Oncology Practice, Gray et al found that many medical oncologists did not use genomic testing endorsed by guidelines in place in 2012 and 2013 in patients with non–small cell lung cancer (NSCLC) and colorectal cancer. The study involved a survey of U.S....
Expert Point of View: Frank A. Sinicrope, MD
Frank A. Sinicrope, MD, Professor of Medicine and Oncology at the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that the regimen of irinotecan/cetuximab (Erbitux)/vemurafenib (Zelboraf) could be an important approach to treating this challenging tumor subtype. “BRAF-mutated tumors have a...
Dual Inhibition Proves Effective for BRAF-Mutated Colorectal Tumors
In patients with metastatic colorectal cancer who have mutations in BRAF V600, the addition of the BRAF inhibitor vemurafenib (Zelboraf) to cetuximab (Erbitux) and irinotecan significantly improved progression-free survival, results of the phase II Southwest Oncology Group (SWOG) 1406 trial have...
Postmenopausal Normal-Weight Women With Poor Metabolic Health May Have Higher Risk for Colorectal Cancer
Few studies have explored the association between metabolic phenotype and colorectal cancer incidence in normal-weight individuals. Now, a study comparing the risk of colorectal cancer in normal-weight postmenopausal women with a metabolically unhealthy phenotype vs those with a metabolically...
Cynthia L. Sears, MD, on Colon Cancer: Keynote Lecture
Cynthia L. Sears, MD, of Johns Hopkins University School of Medicine, summarizes her keynote talk on microbes, microbiota, and colon cancer. Next-generation sequencing combined with biologic studies suggests that most colorectal cancer cases have specific microbiome associations.
Brendan J. Guercio, MD, on Colorectal Cancer and Physical Activity: Impact on Survival
Brendan J. Guercio, MD, of the Dana-Farber Cancer Institute, discusses results from a study of patients with metastatic colorectal cancer who took part in weekly physical activity and its impact on their disease progression and overall survival (Abstract 659).
Cornelis van de Velde, MD, PhD, on Rectal Cancer: A Database Update
Cornelis van de Velde, MD, PhD, of Leiden University Medical Center, discusses the International Watch & Wait database, established to track evidence on organ-preserving strategies in patients with rectal cancer (Abstract 521). For More Information: www.IWWD.org
Michael J. Overman, MD, on Colorectal Cancer: Updated Results From CheckMate 142
Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, discusses study findings on nivolumab alone or in combination with ipilimumab in patients with DNA mismatch repair–deficient/microsatellite instability high metastatic colorectal cancer (Abstract 519).
Cathy Eng, MD, on Anal Squamous Cell Cancer: Management Strategies
Cathy Eng, MD, of The University of Texas MD Anderson Cancer Center, discusses management approaches to anal cancer, including the current standard of care, as well as novel approaches for locally advanced and metastatic disease.
Scott Kopetz, MD, on Colorectal Cancer: Results of the SWOG 1406 Trial
Scott Kopetz, MD, of The University of Texas MD Anderson Cancer Center, discusses study findings on irinotecan and cetuximab with or without vemurafenib in BRAF-mutant metastatic colorectal cancer (Abstract 520).
2017 GI Cancers Symposium: Less Than Half of Recommended Adults Screened for Lynch Syndrome
A team of researchers at Fox Chase Cancer Center found that, despite the recommendation of screening guidelines, less than half of adults younger than 50 years old who have colorectal cancer are being screened for Lynch syndrome, a genetic anomaly that increases the risk of colorectal and several...
Novel Antibody May Reduce Debilitating Symptoms in Patients With Advanced Colorectal Cancer
In a phase III trial reported in The Lancet Oncology, Hickish et al found that treatment with MABp1, an antibody that targets interleukin 1α and exhibits antitumor activity, was associated with improvement in the composite outcome of stabilizing/improving lean body mass and debilitating...
2017 GI Cancers Symposium: Watch-and-Wait Approach for Rectal Cancer Appears an Option for More Patients
Real-world data from a large observational study suggests that omitting surgery in strictly selected patients with a clinical complete response does not compromise outcomes in rectal cancer. The 3-year survival rate among patients who received “watch-and-wait” care after initial cancer...
2017 GI Cancers Symposium: Physical Activity May Be Linked to Longer Survival in Advanced Colorectal Cancer
A new analysis of the CALGB 80405 (Alliance) trial suggests that people with metastatic colorectal cancer who are more physically active fare better than those who are less active. In a large clinical trial, patients who at the time of starting chemotherapy reported engaging in physical activity...
Has the Affordable Care Act Reduced Socioeconomic Disparities in Cancer Screening?
Out-of-pocket expenditures are thought to be a significant barrier to receiving cancer preventive services, especially for individuals of lower socioeconomic status. A new study published by Cooper et al in Cancer looked at how the Affordable Care Act (ACA), which eliminated such out-of-pocket...
Germline Cancer Susceptibility Mutations in Early-Onset Colorectal Cancer
In a study reported in JAMA Oncology, Pearlman et al found that 16% of patients with early-onset colorectal cancer had germline cancer susceptibility mutations, with a wide array of such mutations being identified. The study involved 450 patients diagnosed with colorectal cancer at age < 50...
Colonoscopy Screening in Older Adults
A large population-based observational study by Xabier García-Albéniz, MD, PhD, of the Harvard T.H. Chan School of Public Health, and colleagues evaluating the effectiveness and safety of screening colonoscopy for the prevention of colorectal cancer in people aged 70 to 74 and 75 to 79 has found...
T-Cell Transfer Therapy Targets Mutant KRAS in Metastatic Colorectal Cancer
In a case report in The New England Journal of Medicine, Tran et al at the National Cancer Institute describe response to adoptive transfer of ex vivo expanded tumor-infiltrating lymphocytes containing T cells targeting personalized cancer neoepitopes in a patient with lung metastases from...
At ESMO 2016, Many Phase III Trials Fail to Meet Primary Endpoints
The 2016 European Society for Medical Oncology (ESMO) Congress revealed many important positive findings from key trials in a number of tumor types, but many highly anticipated phase III trials in advanced disease failed to meet their primary endpoints. The ASCO Post has summarized several of these ...
Blocking ADAM17 Protein May Help to Circumvent Resistance to Cetuximab in Bowel Cancer
Blocking a molecule may bypass bowel cancer's defense against the drug cetuximab, according to new research presented by Weir et al at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool, United Kingdom. Cetuximab is used to treat advanced bowel cancer, and just under half ...
New Blood Test for Colorectal Cancer Recurrence: Twice as Sensitive as CEA Test
In a new report published by Young et al in Cancer Medicine,1 a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard-of-care...
Study Shows International Trends in Anal Cancer Incidence Rates
A new American Cancer Society study finds that incidence of anal cancer has been increasing in women or in both men and women in 13 of 18 countries studied, particularly in the Americas, Northern/Western Europe, and Australia. The authors say population-based preventive measures, including human...
New Blood Test for Colorectal Cancer Recurrence Is Twice as Sensitive as CEA Test
In a new report published by Young et al in Cancer Medicine, a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer (CRC) recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard of...
Effect of Isolated Peritoneal and Nonperitoneal Metastasis and Metastatic Sites on Survival in Patients With Colorectal Cancer
Overall survival was poorer with isolated peritoneal metastasis in colorectal cancer vs other isolated sites of metastasis in patients receiving first-line systemic therapy but similar to that in patients with peritoneal plus another metastatic site and in patients with at least two nonperitoneal...
ESMO 2016: Longer Interval Between Preoperative Chemoradiotherapy and Surgery Urged in Locally Advanced Rectal Cancer
A longer waiting interval from the end of preoperative chemoradiotherapy to surgery increases the rate of pathologic complete response and yields a higher proportion of patients achieving tumor downstaging in patients with locally advanced rectal cancer, according to new findings from a...
