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ColoPrint, an 18-gene expression profile assay for patients with early-stage colon cancer, accurately stratifies patients by recurrence risk and identifies a subset who can be adequately treated by surgery alone, investigators reported at the 2012 Gastrointestinal Cancers Symposium.1 According to...
The results of the CORRECT trial created some degree of “buzz” at the 2012 Gastrointestinal Cancers Symposium, with experts predicting that regorafenib will become FDA-approved and have strong clinical utility. While numerically, the benefit appeared small, “There is a real difference with this...
The novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease progression in an international phase III trial presented at the 2012 Gastrointestinal Cancers...
Recent studies have shown that interleukin-8 (IL-8) and its receptors CXCR1 and CXCR2 are significantly upregulated in colorectal cancer tumors and their microenvironment and act as regulators of proliferation, angiogenesis, and metastasis. Ning and colleagues from the University of Southern...
Three new studies have added data to the growing evidence that low-dose, daily aspirin helps prevent colorectal cancer and other malignancies and may be useful in preventing metastases as well.1-3 Coming on the heels of other recent studies, the results appear to strengthen the case for using...
Bayer HealthCare announced that it has submitted a New Drug Application (NDA) to the FDA seeking approval for the oral multikinase inhibitor regorafenib for the treatment of patients with metastatic colorectal cancer. The submission is based on the results of the pivotal, global phase III CORRECT...
Sanofi and Regeneron Pharmaceuticals, Inc, recently announced that the FDA has granted Priority Review of the Biologics License Application (BLA) for the investigational agent aflibercept (Zaltrap) concentrate for solution for infusion in combination with irinotecan/fluoropyrimidine–based...
Over the past 2 decades, we have seen a substantial increase in the 5-year survival of patients with stage II and III colon cancer, marking an evolving oncologic success story. However, in the postoperative setting, the value of regular CT screening to monitor for recurrence has been greeted with...
Because few people over 75 participate in clinical trials, it is unknown whether adjuvant chemotherapy could benefit this population. Faced with this gap in clinical trial evidence, researchers reviewed data from 5,489 patients ≥ 75 years with stage III colon cancer. The review suggests that...
Oxaliplatin/fluoropyrimidine–based adjuvant therapy is of benefit in patients with resected stage II/III colon cancer, but the ability to predict risk of toxicity could improve care by permitting individualization of treatment. Ana Custodio, MD, and colleagues from GEMCAD (Grupo Español...
Bayer HealthCare and Onyx Pharmaceuticals announced that the FDA has granted priority review designation to Bayer HealthCare’s New Drug Application (NDA) filed end of April 2012 for the oral multikinase inhibitor regorafenib, for the treatment of patients with metastatic colorectal cancer whose...
The FDA has granted approval to cetuximab (Erbitux) for use in combination with FOLFIRI (irinotecan, fluorouracil, leucovorin) for first-line treatment of patients with KRAS mutation–negative (wild-type), EGFR-expressing metastatic colorectal cancer as determined by FDA-approved tests for this use. ...
A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...
In a study highlighted at a press briefing during the 2012 ASCO Annual Meeting, German investigators reported that prolonging treatment with bevacizumab (Avastin) beyond disease progression extends overall survival in patients with metastatic colorectal cancer.1 Patients received bevacizumab plus...
The FDA has approved sodium picosulfate, magnesium oxide, and citric acid (Prepopik) to help cleanse the colon in adults preparing for colonoscopy, Ferring Pharmaceuticals announced. The new solution is a low-volume, dual-acting stimulant and osmotic laxative. The FDA approval is based on data from ...
The FDA has approved ziv-aflibercept (Zaltrap) for use in combination with a FOLFIRI (leucovorin, fluorouracil, irinotecan) chemotherapy regimen to treat adults with colorectal cancer. Ziv-aflibercept is an angiogenesis inhibitor that inhibits the blood supply to tumors. It is intended for patients ...
Patients with surgically unresectable metastatic colon cancer and an asymptomatic intact primary tumor can be spared initial noncurative resection of their intact primary tumor, National Surgical Adjuvant Breast and Bowel Project (NSABP) C-10 trial investigators reported in the Journal of Clinical...
Escalating the dose of cetuximab (Erbitux) among patients with metastatic colorectal cancer who developed no or mild skin reactions on standard-dose cetuximab plus irinotecan “seemed to lead to an increase in response rate” as well as in the disease-control rate, according to a phase I/II study...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication In July 2012, cetuximab (Erbitux) was approved for use...
Key colorectal cancer studies presented at this year’s ASCO Annual Meeting are changing the treatment landscape in this disease, according to Michael Overman, MD, of The University of Texas MD Anderson Cancer Center, who reviewed the data at the Best of ASCO San Diego meeting. The mix included...
The FDA recently approved regorafenib (Stivarga) to treat patients with metastatic colorectal cancer that has progressed after treatment. Regorafenib is a multikinase inhibitor that blocks several enzymes that promote cancer growth. The drug was reviewed under the FDA’s priority review program that ...
Patients who have had colorectal cancer and who are carriers of the DNA mismatch repair gene mutations that cause Lynch syndrome “have an increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers,” according to a study ...
Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Patients who have received standard...
Even at the eight cancer centers participating in the National Comprehensive Cancer Network (NCCN) Colorectal Cancer Outcomes project, a “sizable minority” of patients with stage II/III rectal cancer treated with curative intent neoadjuvant chemoradiotherapy did not complete postoperative...
On January 23, 2013, the FDA approved bevacizumab (Avastin) for use in combination with fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy for the treatment of patients with metastatic colorectal cancer whose disease has progressed on a first-line bevacizumab-containing...
Treatment of colorectal cancer is complicated by the potential difference in molecular profiles between the primary tumor and metastases. Miranda and colleagues from the Humanitas Clinical and Research Center in Milan, Italy, recently assessed the presence of molecular heterogeneity during...
Two recent study reports in colorectal cancer explored new data on genetic precursors to the disease and outcome predictors once treatment is initiated. New Genetic Links to Colorectal Cancer Are Identified Investigators from Vanderbilt-Ingram Cancer Center, Nashville, and colleagues in China,...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On January 23, 2013, bevacizumab (Avastin) was approved...
To support all of our valuable programs for patients and physicians, the Conquer Cancer Foundation of the American Society of Clinical Oncology partners with organizations of every size and scale, and every partnership has a lasting impact. Recently, the Foundation began working with a new...
In patients with KRAS wild-type metastatic colorectal cancer, outcomes were comparable whether patients received the epidermal growth factor receptor (EGFR) inhibitor panitumumab (Vectibix) or the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). This was shown both in the...
For the treatment of metastatic colorectal cancer, better outcomes were achieved when bevacizumab (Avastin) was added to FOLFOXIRI (leucovorin, fluorouracil [5-FU], oxaliplatin, irinotecan), rather than FOLFIRI (leucovorin, 5-FU, irinotecan), in the phase III TRIBE trial conducted at 35 Italian...
A survey of Veterans Affairs (VA) medical centers recently reported by Nancy L. Keating, MD, MPH, and colleagues at Harvard Medical School in the Journal of the National Cancer Institute showed that the presence of multidisciplinary tumor boards had little association with rates of recommended...
Deregulation of oncogenic signaling pathways was used to molecularly subclassify colorectal cancers into clinically relevant subgroups with both prognostic and predictive implications, in a study from the Duke Institute for Genome Sciences and Policy in Durham, North Carolina.1 “There is a need to...
An increasing body mass index (BMI) was associated with a higher risk for colorectal cancer with a specific molecular characteristic, and inversely, physical activity was linked to a decreased risk for that same cancer, according to data published in Cancer Research,1 a journal of the American...
The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...
After six recurrences of colorectal cancer, the chances it will recur again are high. But if I concentrate on that, I couldn’t live my life. In retrospect, I should have paid attention sooner to the abdominal pain I was experiencing and not dismiss it as a simple case of gas. But at age 47 and with ...
In elderly patients with treatment-naive metastatic colorectal cancer, a trend toward a survival benefit was observed for bevacizumab (Avastin) plus capecitabine (Xeloda) in the international phase III AVEX trial, which was presented at the 2013 Gastrointestinal Cancers Symposium by David...
Colorectal cancer that is microsatellite stable but chromosomally unstable is characterized by poor prognosis and remains largely intractable at the metastatic stage. Mutational analysis has shown that the mixed lineage kinase 4 (MLK4) protein kinase is frequently mutated in microsatellite-stable...
The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the...
The companion UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) trials compared computed tomographic (CT) colonography with barium enema and colonoscopy in patients with symptoms suggestive of colon cancer. As recently reported by the SIGGAR investigators in The...
Intrinsic molecular subtyping in breast cancer has become clinically applicable, and the same could be happening for gastrointestinal tumors, according to an international study reported at the 2013 Gastrointestinal Cancers Symposium in San Francisco.1 While recent efforts have yielded prognostic...
Some 5% to 10% of patients with colorectal cancer harbor the BRAF mutation, placing them at risk for poor treatment response and worse outcomes. The ASCO Post interviewed S. Gail Eckhardt, MD, an expert in this area who is Professor and Head of the Division of Medical Oncology at the University of...
The Colon Cancer Challenge Foundation (CCCF) and the Society of Surgical Oncology (SSO) named Karen Lo, MD, a surgical resident at the University of Colorado, as recipient of third annual Colorectal Cancer Research Scholar Award. The award was presented at the SSO Annual Cancer Symposium held...
In the March 1 issue of The ASCO Post, the article on page 2, “Outcomes Comparable for Panitumumab and Bevacizumab in Metastatic Colorectal Cancer,” contained an inaccuracy about the FDA-approved indications of bevacizumab (Avastin) in colorectal cancer. Specifically, the article noted that...
A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...
In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with...
As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...
Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to...
As reported by Alan P. Venook, MD, Professor of Medicine (Hematology/Oncology) at the University of California, San Francisco, and colleagues in Journal of Clinical Oncology, a 12-gene recurrence score (Oncotype DX Colon Cancer Assay) was shown to predict recurrence in stage II colon cancer in a...