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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.
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.
This is Part 1 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 front-line treatment options for metastatic colorectal cancer. The patient is a 77-year-old male with a history of resected prostate cancer who developed rectal bleeding. He had a colonoscopy in 2016 that revealed a transverse T3N1 adenocarcinoma that was subsequently resected. After four cycles of FOLFOX, he developed chest pain that led to a CT scan demonstrating left supraclavicular adenopathy. A biopsy is performed, and CT scan shows liver and adrenal metastases. In the conversation that follows, the faculty discuss the next steps for this patient, the importance of mismatch repair testing in the decision-making process, and the role of monotherapy vs combination therapy.
ASCO EXPERT Peter Paul Yu, MD, FACP, FASCO, commented on these GALAXY trial findings. He noted the results of this current study and others planned will establish the role of circulating tumor DNA (ctDNA) monitoring for risk of recurrence and guidance for adjuvant therapy. Dr. Yu is...
Postoperative molecular residual disease detected by circulating tumor DNA (ctDNA) at 4 weeks after resection has emerged as the strongest prognostic risk factor for disease-free survival in patients with resected colorectal cancer. This finding was observed regardless of BRAF V600E status and...
On August 2, 2023, the fixed combination of trifluridine, a nucleoside metabolic inhibitor, and tipiracil, a thymidine phosphorylase inhibitor, was approved for use with bevacizumab for metastatic colorectal cancer previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based...
In the final analysis of the phase III LEAP-017 study, the combination of lenvatinib plus pembrolizumab failed to improve outcomes over the standard of care in previously treated patients with metastatic colorectal cancer that lacked high microsatellite instability or mismatch repair deficiency...
Cholesterol-lowering statins may reduce colorectal cancer incidence and mortality in patients with ulcerative colitis, according to a recent study published by Sun et al in eClinicalMedicine. The findings also suggested that statin use may be associated with a lower risk of all-cause mortality in...
Researchers have identified new strategies to help physicians predict which patients with advanced colorectal cancer may benefit from immunotherapy, according to a recent study published by Saberzadeh-Ardestani et al in Clinical Cancer Research. The findings demonstrate the potential of using...
In a Canadian retrospective cohort study reported in JAMA Network Open, Castelo et al found that a greater interval between date of presentation and treatment initiation was not associated with an increased risk of poorer survival among patients with colorectal cancer diagnosed before age 50. The...
In the French phase II SAMCO-PRODIGE 54 trial reported in JAMA Oncology, Julien Taïeb, MD, PhD, and colleagues found that second-line avelumab improved progression-free survival vs standard chemotherapy in patients with mismatch repair–deficient and/or microsatellite instability (dMMR/MSI)...