David H. Henry, MD, on Advances in Lung Cancer, Colorectal Cancer: Expert Perspective
David H. Henry, MD, of Pennsylvania Oncology Hematology Associates, outlines abstracts focusing on chemotherapy in locally advanced rectal cancer and immune-related toxicity, response to anti–PD-L1 blockade, and epacadostat plus pembrolizumab in lung cancer.
John Marshall, MD, and Qian Shi, PhD, on Colon Cancer: Results of the IDEA Trial
John Marshall, MD, of Georgetown University, and Qian Shi, PhD, of the Mayo Clinic, discuss study findings on shortening the duration of adjuvant oxaliplatin-based therapy, linked to neurotoxicity, for patients with stage III colon cancer. (Abstract LBA1)
FDA Approves Pembrolizumab for First Tissue/Site-Agnostic Indication
On May 23, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for adult and pediatric patients with unresectable or metastatic, microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) solid tumors that have progressed...
Expert Point of View: Manish Shah, MD and Daniel F. Hayes, MD, FACP, FASCO
Manish Shah, MD, Director of Gastrointestinal Oncology at NewYork-Presbyterian and Weill Cornell Medicine, was impressed with the findings of the two subanalyses of CALGB 89803. “The study found a 46% reduction in the risk of recurrence with two servings of tree nuts a week, and that’s more than ...
Tree Nut Consumption May Improve Outcomes in Stage III Colon Cancer
Tree nut consumption, as well as a generally healthy lifestyle, significantly reduced the risk of cancer recurrence and death in patients with stage III colon cancer treated in the Cancer and Leukemia Group B (CALGB) 89803 trial, researchers reported at the 2017 ASCO Annual Meeting. Two subanalyses ...
ASCO 2017: Impact of Patient Age on Molecular Alterations in Colorectal Tumors
Younger patients with colon cancer appear to have more than three times as many mutations in their tumors as older patients, which could lead to more effective treatment decisions, according to researchers at Georgetown Lombardi Comprehensive Cancer Center. In a new study, they found that tumor...
Axel Grothey, MD, on Colon Cancer: Results of the IDEA Collaboration
Axel Grothey, MD, of the Mayo Clinic Rochester, discusses study findings on shortening the duration of adjuvant oxaliplatin-based therapy, linked to neurotoxicity, for patients with stage III colon cancer. (Abstract LBA1)
Temidayo Fadelu, MD, on Colon Cancer: Results From the CALGB 89803 Trial
Temidayo Fadelu, MD, of Dana-Farber Cancer Institute, discusses study findings on nut consumption and survival in stage III colon cancer patients. Higher consumption of nuts may be associated with significantly reduced cancer recurrence and death in this group. (Abstract 3517)
ASCO 2017: The IDEA Collaboration: Global Study Sets New Risk-Based Standard to Personalize Chemotherapy for Colon Cancer After Surgery
After surgery for lymph node–positive colon cancer (stage III), some patients may need only half of the long-standing standard course of chemotherapy. In an analysis of 6 clinical trials with over 12,800 patients, 3 months of chemotherapy was nearly as effective as 6 months in patients with...
Erin Van Blarigan, ScD, on Colon Cancer: The Effect of Diet and Exercise, Results From CALGB 89803
Erin Van Blarigan, ScD, of the University of California, San Francisco, discusses the value of lifestyle recommendations from the American Cancer Society for people who have been diagnosed with colon cancer, including longer disease-free and overall survival. (Abstract 10006)
Non–V600 BRAF Mutations in Metastatic Colorectal Cancer
As reported by Jones et al in the Journal of Clinical Oncology, BRAF mutations occurring outside of codon 600 are found in a small proportion of cases of metastatic colorectal cancer and are associated with improved clinical outcome. Study Details The retrospective cohort study involved 9,643...
Expert Point of View: Patrick S. Sullivan, MD
”This was a great study and novel, asking what longer-term survivors with colon cancer are dying from—the toxicity of our treatment or population-risk illnesses?” commented session co-moderator, Patrick S. Sullivan, MD, Assistant Professor of Surgery and Chief Quality Officer, Division of Surgical ...
Common Causes of Death Predominate Among Long-Term Colorectal Cancer Survivors
Patients with colorectal cancer who survive at least 5 years are increasingly likely to die from causes that are common in the general population, highlighting the importance of screening and lifestyle modification, suggested a large cohort study conducted in California.1 The analysis of more than...
FDA Grants Accelerated Approval to Pembrolizumab for First Tissue/Site-Agnostic Indication
On May 23, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for adult and pediatric patients with unresectable or metastatic, microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) solid tumors that have progressed ...
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2017 Guidelines In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology®, covering 8 tumor types. Guidelines are now published for more than 60 tumor types and...
Racial Differences in Risk of Interval Colorectal Cancer
A population-based cohort study by Fedewa et al investigating whether the risk for interval colorectal cancer—defined as cancer that develops after a negative colonoscopy result but before the next recommended screening—varies by race or ethnicity has found that black patients face a...
ASCO 2017: Chance of Colon Cancer Recurrence Nearly Cut in Half in Patients Who Consume Nuts
An observational study of 826 patients with stage III colon cancer showed that those who consumed 2 ounces or more of nuts per week had a 42% lower chance of cancer recurrence and 57% lower chance of death than those who did not eat nuts. A secondary analysis revealed the benefit of nut consumption ...
ASCO 2017: Healthy Lifestyle After Colon Cancer Diagnosis Helps Extend Survival
A study of 992 patients with stage III colon cancer found that those who reported a healthy lifestyle during and following adjuvant treatment had a 42% lower chance of death and a trend for lower chance of cancer recurrence than those who had less healthy lifestyles. The study will be presented by...
Surveillance and Colorectal Cancer Risk in Patients With Intermediate-Risk Adenomas
A UK retrospective study showed that colonoscopic surveillance was associated with a reduced risk of colorectal cancer among patients with removal of intermediate-risk adenomas. The study was reported in The Lancet Oncology by Atkin et al. Study Details The study involved routine lower...
Delaying Colonoscopy for 9 Months or More After Positive Fecal Screening Test May Increase Risk of Colorectal Cancer
The risk of colorectal cancer increased significantly when colonoscopy was delayed by more than 9 months following a positive fecal screening test, according to a large Kaiser Permanente study published by Rutter et al in the Journal of the American Medical Association. “With this study, we...
Tumor CD274 (PD-L1) Expression and Survival With Aspirin Use in Colorectal Cancer
According to a study reported by Hamada et al in the Journal of Clinical Oncology, postdiagnosis aspirin use was associated with improved survival vs nonuse among patients with colorectal cancer who have lower, but not higher, tumor levels of CD274 (programmed cell death 1 ligand 1; PD-L1). Study...
Perioperative Hepatic Arterial Infusion Pump Chemotherapy After Resection of Colorectal Liver Metastases
A propensity score analysis in a prospectively maintained database at Memorial Sloan Kettering Cancer Center (MSKCC) has shown that use of perioperative hepatic arterial infusion pump chemotherapy after complete resection of colorectal liver metastases is associated with a marked improvement in...
Nomogram for Early Mortality in Metastatic Colorectal Cancer
As reported in the Journal of Clinical Oncology, Renfro et al have derived a nomogram for predicting early mortality in metastatic colorectal cancer using data from more than 20,000 patients in the ARCAD (Aide et Recherche en Cancérologie Digestive) database. Study Details The analysis...
Long-Term Outcome With Combined-Modality vs Systemic Treatment for Unresectable Colorectal Liver Metastases
The long-term follow-up of a phase II trial reported by Ruers et al in the Journal of the National Cancer Institute showed a 42% reduced risk of death among patients with colorectal liver metastases receiving aggressive local treatment plus systemic therapy vs systemic therapy alone. Study Details ...
Long-Term Outcome With Combined-Modality vs Systemic Treatment for Unresectable Colorectal Liver Metastases
The long-term follow-up of a phase II trial reported by Ruers et al in Journal of the National Cancer Institute showed a 42% reduced risk of death among patients with colorectal liver metastases receiving aggressive local treatment plus systemic therapy vs systemic therapy alone. Study Details...
Expert Point of View: Kelly M. McMasters, MD, PhD
“Several gene-expression profiles have been evaluated to predict prognosis in colorectal cancer, but none have become widely accepted or U.S. Food and Drug Administration–approved. This has important implications for deciding which patients may benefit from adjuvant chemotherapy,” commented...
Machine Learning Model Predicts Colorectal Cancer Recurrence
A machine learning model that uses a set or ensemble of algorithms has good accuracy for predicting colorectal cancer recurrence, investigators reported during a plenary session at the 2017 Society of Surgical Oncology (SSO) Annual Cancer Symposium.1 Persistent key questions in managing early...
Expert Point of View: Rodrigo Dienstmann, MD
“This is one of the most beautiful stories we have in translational precision oncology research in colorectal cancer. We have robust preclinical data, rigorous molecular diagnosis, and successful clinical results,” said formal discussant of this trial, Rodrigo Dienstmann, MD, of Vall D’Hebron...
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...
