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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...
According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who...
Elderly patients differ with respect to tolerance of therapy for colorectal cancer. In a study reported in Journal of Clinical Oncology, Thomas Aparicio, MD, PhD, of the University of Paris, and colleagues analyzed geriatric factors for potential association with severe toxicity, dose-intensity...
The largest-to-date and only prospective Spanish series of 549 patients who underwent surgical resection of lung metastases from colorectal carcinoma demonstrated a good postoperative recovery from the procedure. A further analysis on morbidity, the correlation between imaging studies and...
“The liver-first approach for patients with colorectal cancer with synchronous liver metastases is possible but is associated with a wide range of survival outcomes, despite protocol similarities between studies,” according to a review of four cohort studies identified by a literature search. “All...
The oncogenic microRNAs miR-21and miR-31 negatively regulate tumor-suppressor genes. Toiyama and colleagues conducted a series of studies to assess their potential as serum biomarkers in colorectal cancer. Screening in medium from two colorectal cancer cell lines and serum analysis in 12 patients...
Even before I had a colonoscopy to determine the cause of abdominal pains I had been having, I instinctively knew that the news wouldn’t be good. A colonoscopy and subsequent pathology report confirmed stage IIIC colorectal cancer. Because I was just 47 years old at the time of my diagnosis and had ...
As recently reported in Lancet Oncology by Martijn H.G.M. van der Pas, MD, of VU University Medical Center, Amsterdam, and colleagues, the phase III COLOR II trial has shown that laparoscopic surgery can produce similar safety outcomes, resection margins, and completeness of resection compared with ...
BRAF V600E mutations are associated with poor prognosis in colorectal cancer. A study by Coffee and colleagues examined PI3K/mTOR signaling in BRAF V600E colorectal cancer cell lines after BRAF inhibition as well as cell viability and apoptosis after combined BRAF and PI3K/mTOR inhibition. Western ...
In patients with advanced colorectal cancer, it remains unclear which biologic agent added to standard chemotherapy is best, even after a head-to-head comparison of two commonly used agents. In the phase III FIRE-3 trial, conducted by the German AIO CRC Study Group, the addition of cetuximab...
The latest clinical trial looking at combining vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibition in metastatic colorectal cancer adds little to our overall understanding of the mechanisms for optimizing selection of patients to receive such therapies....
The addition of a combination of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors to chemotherapy has not improved outcome in first-line treatment of advanced colorectal cancer. However, in early-phase evaluation, the addition of the investigational...
Evidence shows that diets high in red and processed meat are associated with an increased risk of colorectal cancer. In a study reported in the Journal of Clinical Oncology, Marjorie L. McCullough, ScD, Strategic Director of Nutritional Epidemiology, and colleagues from the Epidemiology Research...
The Colon Cancer Alliance has partnered with Bowel Cancer UK and the Colon Cancer Prevention Project to launch the international Never Too Young awareness campaign, addressing the rise in young-onset (younger than 50 years) colon cancer diagnoses and mortality rates. This global collaboration comes ...
The overuse of imaging in oncology workup and surveillance is a timely concern, as health-care dollars shrink and the risk for second malignancies becomes clearer. At this year’s ASCO Annual Meeting, several studies showed that although many routine imaging studies may be unnecessary, physicians...
For patients with unresectable metastatic colorectal cancer, maintenance treatment with capecitabine (Xeloda) and bevacizumab (Avastin) significantly delayed disease progression and improved overall survival in the phase III CAIRO3 study by the Dutch Colorectal Cancer Group. Miriam Koopman, MD,...
At the Best of ASCO Meeting in Los Angeles, Tony Reid, MD, PhD, Director of the Early Phase Clinical Research Program and Professor of Hematology/Oncology at the University of California, San Diego, reviewed important findings in metastatic colorectal cancer presented at the 2013 ASCO Annual...
The U.S. Food and Drug Administration (FDA) has approved the first generic version of capecitabine (Xeloda), an oral chemotherapy agent used in the treatment of metastatic colorectal cancer and breast cancers. Teva Pharmaceuticals USA has gained FDA approval to market generic capecitabine in 150...
As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...
Elderly patients are often underrepresented in clinical trials of metastatic colorectal cancer. In the phase III AVEX trial reported in The Lancet Oncology,1 David Cunningham, MD, of Royal Marsden Hospital in London and colleagues assessed the addition of bevacizumab (Avastin) to capecitabine in...
For the treatment of wild-type KRAS metastatic colorectal cancer in previously treated patients, a head-to-head comparison of the two antibodies—cetuximab (Erbitux) and panitumumab (Vectibix)—that target the epidermal growth factor receptor (EGFR) concluded that they convey similar overall survival ...
At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...
Colonoscopy and sigmoidoscopy have been shown to provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against proximal colon cancer, remain undefined. A study of long-term colorectal cancer incidence and mortality after lower endoscopy reported in ...
In general, we have come to think of mismatch repair–deficient colon cancer as having a more favorable prognosis, being less likely to metastasize to regional nodes or distant sites, and being resistant to fluoropyrimidines. Much of our data, however, come from trials combining stage II and III...
In an analysis reported in the Journal of Clinical Oncology, Frank A. Sinicrope, MD, of the Mayo Clinic and North Central Cancer Treatment Group (NCCTG), and colleagues investigated the association of deficient DNA mismatch repair with prognosis in patients with stage III colon cancer treated with...