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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...
The percentage of American adults aged 50 to 75 who are up-to-date with recommended screening for colorectal cancer “increased from 54% in 2002 to 65% in 2010, primarily driven by increased use of colonoscopy,” according to data from the 2012 Behavioral Risk Factor Surveillance System survey....
The FIRE-3 study compared the two epidermal growth factor receptor (EGFR) antibodies, on top of chemotherapy, in the first-line treatment of metastatic colorectal cancer. A preplanned analysis of KRAS wild-type patients without RAS mutations, ie, “all-RAS wild-type,” showed overall survival to be...
Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, told attendees at the 2013 European Cancer Congress that in the management of metastatic colorectal cancer, it is time to expand KRAS testing to include more rare mutations. Until recently, KRAS status...
In a retrospective analysis of the randomized phase II EXPERT-C trial, TP53 emerged as a strong, independent predictive biomarker for the benefit of cetuximab (Eribitux) in MRI-defined high-risk, locally advanced rectal cancer, according to Francesco Sclafani, MD, of The Royal Marsden NHS...
For patients with operable rectal cancer, there is no clear role for adjuvant chemotherapy, according to an analysis of the PROCTOR and SCRIPT trials from the Dutch Colorectal Cancer Group. The findings were presented by Anne J. Breugom, MD, of Leiden University Medical Center in the Netherlands,...
Testing for codons 12 and 13 on the KRAS gene and BRAF testing can predict whether patients with colorectal cancer will respond to anti–epidermal growth factor receptor (EGFR) therapies. However, genetic alterations not captured by testing for KRAS codon 12 and 13 mutations may play an important...
This issue of The ASCO Post launches a Clinical Trials Resource Guide to increase awareness of NCI-funded phase I, II, and III clinical studies for your patients with advanced cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. The clinical...
Patients with metastatic colorectal cancer that harbors KRAS mutations in exon 2 and patients with other activating RAS mutations do not benefit from anti–epidermal growth factor receptor (EGFR) therapy and may in fact be harmed by it. In an analysis reported in The New England Journal of Medicine ...
It has been posited that aspirin treatment may reduce risk for colorectal cancer through inhibition of WNT/cadherin-associated protein β1 (CTNNB1, or β-catenin) signaling. In a study reported recently in the Journal of the National Cancer Institute, Nan et al investigated the potential role of the...
In a study reported in Journal of the National Cancer Institute, Kyrø and colleagues found that high levels of plasma alkylresorcinols, biomarkers of dietary whole-grain wheat and rye intake, were associated with reduced risk of distal colon cancer. The study involved prediagnostic plasma samples...
Fourteen years ago, when I was just 29, I was feeling weak and fatigued and had severe pain in my abdomen. I’d had these symptoms for about a year, but none of the several doctors I saw or any of the tests they performed could find the source of my problems. I even had one nurse practitioner tell...
In patients with metastatic colorectal cancer, maintenance treatment with capecitabine plus bevacizumab (Avastin) after induction treatment with capecitabine, oxaliplatin, and bevacizumab (CAPOX-B) significantly delayed disease progression, compared to observation, according to the final results of ...
More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....
As neoadjuvant therapy for rectal cancer, infusional fluorouracil (5-FU) and oral capecitabine achieve similar outcomes, and the addition of oxaliplatin confers no additional benefit, according to the mature results of the National Surgical Adjuvant Breast and Bowel Project (NSABP) R-04 trial,...
Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...
Analysis of a large cohort of patients with metastatic colorectal cancer who received chemotherapy at academic, private, and community-based oncology practices using the same chemotherapy order entry system showed that “bevacizumab has been more consistently integrated into treatment regimens than...
March is Colorectal Cancer Awareness Month, and the U.S. Department of Health and Human Services is committed to boosting public awareness about the importance of screening and treatment for colorectal cancer. Colorectal cancer poses the greatest risk to adults over age 50, and the U.S. Preventive...
In a study reported in the Journal of the National Cancer Institute, Ahn and colleagues found that decreased diversity of gut bacteria and differences in levels of specific bacteria were associated with significantly increased risk of colorectal cancer. The study involved measurement of 16S...
The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...
Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...
Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...
Contrary to emerging data from other studies, the regular use of aspirin was not associated with improved survival in patients with PIK3CA-mutant metastatic colorectal cancer in a study reported at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 Large Dataset “We did not validate...
Screening for colorectal cancer based on age alone may contribute to both underuse and overuse of colonoscopy, sigmoidoscopy, and fecal occult blood testing among older people, according to a study by investigators at the University of Michigan and the Veterans Affairs Center for Clinical...
Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...
In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary...
In a study of the roles of interleukin (IL)-17A and circulating tumor cells in colorectal cancer metastasis, Tseng and colleagues measured mesenteric circulating tumor cells according to colorectal cancer stage in patients and assessed the interaction of circulating tumor cells and IL-17A in a...
The tumor microenvironment contains a complex network of cytokines that contribute to the nature of intratumoral immune reactions. In a study reported in Science Translational Medicine, Mlecnik and colleagues assessed chromosomal gains and losses and expression of 59 cytokines and receptors and...
Although it is known that nuclear receptor peroxisome proliferator-activated receptor-δ/β (PPAR-d) is upregulated in colorectal cancer, the role of PPAR-d in tumorigenesis remains uncertain. In a study reported in Journal of the National Cancer Institute, Zuo and colleagues developed a mouse model...
The ASCO Cancer Research Committee recently convened four disease-specific working groups—in pancreas, breast, lung, and colon cancers—to “consider the design of future clinical trials that would produce results that are clinically meaningful to patients.” An ASCO perspective statement, reported in ...
Data from trials conducted mostly in the 1970s and 1980s established the paradigm that optimal treatment of rectal cancer requires a combination of radiation therapy, chemotherapy, and surgery.1 Virtually all of these trials, however, demonstrated that radiotherapy added only to the local control...
In a pilot study reported in the Journal of Clinical Oncology, Deborah Schrag, MD, MPH, and colleagues from Memorial Sloan Kettering Cancer Center, New York, assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with selective use of...
At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...
Chronic inflammation is implicated in the development of colorectal cancer, and the plasma inflammatory biomarker macrophage inhibitory cytokine-1 (MIC-1, GDF15) may have a direct role in tumorigenesis. As reported in Journal of the National Cancer Institute, Mehta and colleagues found that...
The U.S. Food and Drug Administration (FDA) has approved panitumumab (Vectibix) for use in combination with FOLFOX (fluorouracil, leucovorin, oxaliplatin) as first-line treatment in patients with wild-type KRAS (exon 2) metastatic colorectal cancer. This approval converts the accelerated...
Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...
Some evidence suggests that dual targeting of vascular endothelial growth factor (VEGF) and placental growth factor (which binds to VEGFR-1) might provide more effective antiangiogenic therapy. In a study reported in Molecular Cancer Therapeutics, Chiron and colleagues compared the antitumor...
Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...
I would like to congratulate Corley and his colleagues for their seminal work on the association between adenoma detection rate and risk of colorectal cancer, advanced colorectal cancer, and colorectal cancer mortality. The impact of their findings—reported in The New England Journal of Medicine1...
In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...
Data from the National Cancer Data Bank (2010–2011) suggest that 30% of patients with colorectal cancer who are eligible for adjuvant chemotherapy fail to receive it, but their odds increase by 30% when surgery is performed by laparoscopy, rather than laparotomy.1 “In this large national database...
New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...