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Two presentations given at the American Association for Cancer Research (AACR) Annual Meeting 2022 focused on promising strategies for making breakthrough immunotherapies work for more patients. Both studies report findings from clinical trials that advance a novel immunotherapy platform in...
Maria Elena Martinez, PhD, MPH, of the University of California, San Diego Moores Cancer Center, provides an overview of the key components of the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science program, challenges posed by the COVID-19 pandemic, and opportunities for overcoming these challenges. Although screening and follow-up may reduce the incidence of and mortality from colorectal cancer, these disparities persist in medically underserved populations (Abstract SY30).
Reid M. Ness, MD, MPH, of Vanderbilt-Ingram Cancer Center, discusses significant updates to the NCCN Clinical Practice Guidelines in Oncology for colorectal cancer screening: lowering the age from 50 to 45 for the initiation of average-risk screening for all combinations of race, ethnicity, and sex; and extending the surveillance interval from 5 to 7–10 years following the identification of one to two low-risk adenomas.
Tumor budding is an emerging prognostic biomarker in colon cancer and currently influences decision-making in patients with pT1 and stage II colon cancer. In stage III colon cancer, its prognostic impact has been limited to small and retrospective cohorts. In a post hoc analysis of the IDEA-France...
In a German study reported in JAMA Oncology, Li et al found that assessment of risk of colorectal cancer based on cumulative lifetime excess weight may be more accurate than risk indicated by single body mass index (BMI) measurements. As stated by the investigators, “Excess weight is associated...
In the Chinese phase III STELLAR trial reported in the Journal of Clinical Oncology, Jin et al found that preoperative short-term radiotherapy followed by chemotherapy was not inferior in 3-year disease-free survival vs a standard schedule of long-term chemoradiotherapy in patients with locally...
For patients with stage III colon cancer, early discontinuation of adjuvant chemotherapy leads to worse outcomes—but early discontinuation of oxaliplatin did not. These findings, which came from an analysis of the large ACCENT and IDEA clinical trials databases, were presented at the 2022 ASCO...
The combination of encorafenib, cetuximab, and nivolumab produced responses in 50% of patients and disease control in 96% of patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer in a phase I/II trial reported at the 2022 ASCO Gastrointestinal Cancers Symposium. The...
Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...
The phase II GERCOR NIPICOL study evaluated 1 year of treatment with nivolumab plus ipilimumab in patients with chemotherapy-resistant metastatic colorectal cancer whose tumors were microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR). With this shortened treatment duration,...
In a prespecified analysis of the phase II CodeBreaK100 trial reported in The Lancet Oncology, Marwan Fakih, MD, and colleagues found that the KRAS G12C protein inhibitor sotorasib showed modest activity in patients with previously treated KRAS G12C–mutant colorectal cancer.1 Study Details The...
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,...
As reported in The Lancet Oncology by Thierry Conroy, MD, and colleagues, the French phase III UNICANCER-PRODIGE 23 trial has shown that intensification of preoperative therapy with FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, fluorouracil [5-FU]) prior to chemoradiotherapy resulted in...
In an Italian phase II study (MAYA) reported in the Journal of Clinical Oncology, Morano et al found that patients with microsatellite-stable (MSS) and O6-methylguanine–DNA methyltransferase (MGMT)-silenced metastatic colorectal cancer without disease progression on temozolomide derived benefit...
Gabriel A. Brooks, MPH, MD, Associate Professor of Medicine, Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, was invited to discuss the results of the ACCENT/IDEA database analysis of early treatment discontinuation in stage III colon cancer.1 Although the results confirm the...
For patients with stage III colon cancer, early discontinuation of adjuvant chemotherapy leads to worse outcomes—but early discontinuation of oxaliplatin did not. These findings, which came from an analysis of the large ACCENT and IDEA clinical trials databases, were presented at the 2022 ASCO...
About 5 years ago, I began experiencing some digestive issues that I initially blamed on the stress from coping with my mother’s diagnosis of Alzheimer’s disease. But after 2 weeks of unrelenting symptoms, including abdominal pain, a change in my bowel habits, and rectal bleeding, I saw my primary...
Christopher Willett, MD, Professor and Chair of the Department of Radiation Oncology at Duke University in Durham, North Carolina, shared his thoughts on the findings of the study by Lumish et al1 with The ASCO Post. He first noted the shift in recent years toward total neoadjuvant therapy in the...
In a small study of patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, treatment with the anti–PD-1 agent dostarlimab-gxly alone led to a clinical complete response rate of 100%. The findings of this study from Memorial Sloan Kettering Cancer Center (MSK) were reported...
Benoit Rousseau, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, called the findings of the phase II GERCOR NIPICOL trial “interesting and convincing.” Long-term follow-up showed the 3-year progression-free survival rate to be 70% after just 1 total year of treatment with nivolumab...
The phase II GERCOR NIPICOL study evaluated 1 year of treatment with nivolumab plus ipilimumab in patients with chemotherapy-resistant metastatic colorectal cancer whose tumors were microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR). With this shortened treatment duration,...
Updates of phase II studies evaluating fam-trastuzumab deruxtecan-nxki (T-DXd) in gastrointestinal cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium, continuing to offer support for the antibody-drug conjugate in these malignancies. In HER2-expressing gastric cancer, T-DXd...
Researchers at City of Hope published data pointing to the limitations of a popular liquid biopsy that is used to detect the recurrence of colorectal cancer in patients who who have undergone surgical resection. The findings were published in JAMA Network Open by Marwan Fakih, MD, and colleagues....
In a prospective cohort study reported in JAMA Network Open, Erin L. Van Blarigan, ScD, and colleagues found that higher intake of unprocessed red meat or processed meat was not associated with poorer recurrence-free or overall survival in patients with stage III colon cancer. As stated by the...
A new meta-analysis adds to evidence that taller adults may be more likely than shorter ones to develop colorectal cancer or colon polyps that can later become malignant. While the association between taller height and colorectal cancer has been previously investigated, researchers from Johns...
In an analysis reported in a letter to the editor in The New England Journal of Medicine, Doubeni et al found that a sustained Kaiser Permanente Northern California (KPNC) colorectal cancer screening initiative resulted in increased screening, increased identification of colorectal cancer, and a...
The use of circulating tumor DNA (ctDNA) assays in early-stage colorectal cancer is highly prognostic for recurrence and may help identify patients who could benefit from adjuvant chemotherapy, according to findings from the GALAXY trial, presented at the 2022 ASCO Gastrointestinal Cancers...
ASCO has published updated guidance on the use of adjuvant therapy in the management of stage II colon cancer, providing clinicians with a newer evidence-based framework that can be used in shared decision-making with patients.1 Need for Updated Guidance “How to approach patients with stage II...
The combination of the BRAF inhibitor encorafenib with cetuximab and nivolumab produced responses in 50% of patients and disease control in 96% of patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer in a phase I/II trial reported at the 2022 ASCO Gastrointestinal...
For the treatment of metastatic colorectal cancer in patients unfit for intensive chemotherapy, trifluridine/tipiracil plus bevacizumab as first-line therapy was no more effective than capecitabine plus bevacizumab, investigators from the phase III SOLSTICE trial reported in a European Society for...
Weight loss for adults, particularly those who are overweight or obese, may reduce their risk of developing a type of polyp that may lead to colorectal cancer, according to a new study published by He et al in JNCI Cancer Spectrum. Losing weight from early to late adulthood (up to the mid-70s)—at...
Romain Cohen, MD, PhD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results of the GERCOR NIPICOL study, which suggests nivolumab plus ipilimumab at a fixed duration of 1 year continued to show durable activity in patients with chemoresistant microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer after 3 years of follow-up. Dr. Cohen points out there is now some question as to whether all patients need 2 years of therapy (Abstract 13).
Melissa Amy Lumish, MD, of Memorial Sloan Kettering Cancer Center, discusses new findings showing a 100% complete response rate to PD-1 blockade alone among the first 11 patients with locally advanced mismatch repair–deficient rectal cancer treated with this approach. None of the patients required chemoradiation or surgery, thus avoiding their attendant morbidities, and so PD-1 blockade may represent a new treatment paradigm. Follow-up on the durability of response is needed (Abstract 16).
Van K. Morris, MD, of The University of Texas MD Anderson Cancer Center, discusses phase I/II data suggesting that encorafenib plus cetuximab and nivolumab is safe and well tolerated for patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer (Abstract 12).
A new risk score may aid in identifying men and women younger than 50 who are most likely to develop a cancer of the colon or rectum, an international study published by Archaumbault et al in the Journal of the National Cancer Institute showed. More About Scoring The score—a number between 0 and...
Gabriel A. Brooks, MPH, MD, of the Norris Cotton Cancer Center, discusses key studies that, when synthesized, suggest the benefits of oxaliplatin may be less than often assumed. The toxicities are well described (especially neuropathy), and the agent should be used cautiously and sparingly beyond the third month of adjuvant treatment for patients with colon cancer and in the elderly or frail with metastatic disease.
Colorectal cancer is the second most common cause of death in the United States. In 2020, approximately 148,000 people were diagnosed with the disease, and 53,200 people died from it, including 17,930 cases and 3,640 deaths in individuals younger than age 50. According to the American Cancer...
Afsaneh Barzi, MD, PhD, of City of Hope Comprehensive Cancer Center and AccessHope, discusses results from a phase I/II study of regorafenib and pembrolizumab in refractory microsatellite-stable colorectal cancer. Although the trial did not meet its primary endpoint, the median overall survival is “provocative,” says Dr. Barzi. An analysis of biomarkers to identify patients with a longer duration of benefit is ongoing (Abstract 15).
Heinz-Josef Lenz, MD, of USC Norris Comprehensive Cancer Center, discusses phase II results from the CheckMate 9X8 study, which compared nivolumab plus fluorouracil/leucovorin/oxaliplatin (mFOLFOX6) and bevacizumab vs mFOLFOX6 and bevacizumab in the first-line treatment of metastatic colorectal cancer. A subgroup of patients may benefit from adding nivolumab to the standard of care in this setting (Abstract 8).
In a study reported in the Journal of Clinical Oncology, Cheng et al found that the addition of patient-reported diet and lifestyle factors to prediction models based on clinical and pathologic characteristics improved predictions of disease recurrence and mortality among patients with stage III...
Mehmet Altan, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from a phase Ib dose-escalation study, which showed early evidence of activity for NKTR-255, an investigational IL-15 receptor agonist, plus cetuximab in patients with solid tumors. Treatment appeared to lead to expansion and proliferation of NK and CD8+ cells (Abstract 957).
In a study published in the journal Gastroenterology, Trivedi et al described an increase in early-onset colorectal cancer and precancerous polyps, based on a large, nationally representative study of patients younger than 50 who underwent colonoscopy. It was the first large-scale study to look at...
A team of researchers has revealed some of the mechanisms by which polyps develop into colorectal cancer, setting the framework for improved surveillance for the disease. Their study, published by Chen et al in the journal Cell, describes findings using a single-cell transcriptomic and imaging...
Although the incidence and mortality rates in colorectal cancer have dropped by 3.6% each year from 2007 to 2016 for people aged 55 and older—mainly because of increased colorectal cancer screening, advances in therapy, and reductions in smoking—these rates have increased by 2% each year during the ...
Throughout my adolescence and early adulthood, I had been plagued with digestive issues, including bouts of gastritis and constipation, which seemed normal for me and wasn’t too concerning. But by the time I turned 30, in 2015, the acid reflux I had been experiencing became so frequent and...
Women who live in urban areas and those residing in rural areas are screened for breast cancer at similar rates, but rural women are screened for colorectal cancer at significantly lower rates than their urban counterparts, research published by Shete et al in JAMA Network Open showed. The...
Although research so far has failed to uncover the root causes of the development of young-onset colorectal cancer, what is certain is that although colorectal cancer rates are declining in older adults, they are on a steady rise in people younger than age 50, especially those between the ages of...
Despite the availability of several effective screening tests, colorectal cancer screening rates remain below national goals. Although colonoscopy is the most often recommended screening method, a new study has found that the preferences of primary care clinicians have shifted toward noninvasive...
In a prespecified analysis of the phase II CodeBreaK100 trial reported in The Lancet Oncology, Marwan Fakih, MD, and colleagues found that the KRAS G12C protein inhibitor sotorasib showed modest activity in patients with previously treated KRAS G12C–mutant colorectal cancer. Study Details The...
Updating its 2016 recommendation on the use of aspirin to prevent cardiovascular disease and colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement. It noted the potential harms of daily aspirin, with the most serious being bleeding in the...