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In an analysis of the German phase II PanaMa trial reported in the Journal of Clinical Oncology, Stahler et al evaluated consensus molecular subtypes as prognostic and predictive biomarkers in patients with RAS wild-type metastatic colorectal cancer receiving fluorouracil and leucovorin with or...
Researchers have discovered that the financial impact of an individual’s cancer diagnosis may also impact a partner’s health-related quality of life, according to a new study published by Ghazal et al in JAMA Network Open. “When you think of key developmental milestones young adults expect to...
In a study reported in JAMA Network Open, Kahi et al found no differences in all-cause or cancer-specific mortality among veterans in the Veterans Affairs (VA) health-care system with colonoscopy-detected colorectal cancer vs those with postcolonoscopy-diagnosed colorectal cancer. Study Details...
Midhun Malla, MD, of the West Virginia University Cancer Institute, discusses the molecular landscape of metastatic colorectal cancer and the development and approvals of targeted treatments. Dr. Malla also details the range of HER2-targeted therapeutic options and the approval of trastuzumab and tucatinib for HER2-amplified disease in the second-line setting or after. In addition, he discusses emerging therapies in refractory metastatic colorectal cancers followed by circulating tumor DNA–guided management of oligometastatic colorectal cancers using immune checkpoint inhibitors.
In a study reported in JAMA Oncology, En Cheng, MD, PhD, of Kaiser Permanente Northern California, Jeffrey Meyerhardt, MD, MPH, FASCO, of Dana-Farber Cancer Institute, and colleagues found that higher levels of inflammatory biomarkers measured after surgery but before starting chemotherapy were ...
March is widely recognized worldwide as Colorectal Cancer Awareness month. Several advocacy groups and professional organizations recognize Colorectal Cancer Awareness month by promoting screening for eligible individuals and working to increase awareness. Here, the Colorectal Cancer Alliance, an...
Colorectal cancer is the third most common cancer among men and women of all ages in the United States and is on track to be the leading cause of cancer death in adults younger than 50 by 2030. The alarming rise of colorectal cancer in people younger than age 50 prompted the U.S. Preventive...
According to the American Cancer Society, colorectal cancer is the third most commonly diagnosed cancer and the third most common cause of cancer-related death in both men and women in the United States. However, it ranks second in cancer-related deaths overall and is the leading cause of cancer...
Myriam Chalabi, MD, PhD, of The Netherlands Cancer Institute, discusses data from the NICHE-2 study, which confirms previously reported pathologic responses to short-term neoadjuvant nivolumab plus ipilimumab in patients with locally advanced mismatch repair–deficient colon cancer. Survival data suggest neoadjuvant immunotherapy may become standard of care and allow further exploration of organ-sparing approaches. (Abstract LBA7).
Researchers have found that postoperative physical activity was associated with improved disease-free survival among patients previously treated for stage III colorectal cancer, according to a novel study published by Brown et al in the British Journal of Sports Medicine. “With March being National ...
This is Part 3 of The Evolving Targeted Treatment Landscape for Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. John Strickler, Stacey A. Cohen, and Harshabad Singh discuss the first-line treatment of metastatic colon cancer. The patient is a 48-year-old man who presents to his primary care provider with bloody diarrhea. Colonoscopy reveals a nonobstructing sigmoid colon tumor, which pathology confirms as adenocarcinoma. CT of the chest, abdomen, and pelvis reveals a liver mass and multiple bilateral pulmonary nodules, and he is diagnosed with metastatic adenocarcinoma. His ECOG performance status score is 1, and he is started immediately on FOLFOX chemotherapy. Meanwhile, next-generation sequencing is ordered, which reveals APC and TP53 mutations, and wild-type KRAS, NRAS, and BRAF. The faculty discuss the myriad treatment options for this relatively young and fit patient with left-sided RAS wild-type metastatic colon cancer. They review the impact of tumor sidedness on decision making in the front-line setting, as well as the clinical implications of the recent phase III PARADIGM study.
This is Part 2 of The Evolving Targeted Treatment Landscape for Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. John Strickler, Stacey A. Cohen, and Harshabad Singh discuss the management of BRAF V600E–mutated colorectal cancer. The patient is a 40-year-old woman who presents to the ER with severe abdominal pain. CT scan of the chest, abdomen, and pelvis reveals a cecal mass with adjacent nodularity, abdominal lymphadenopathy, and multiple liver lesions consistent with metastatic disease. Colonoscopy demonstrates a nonobstructing mass in the ascending colon; pathology confirms adenocarcinoma, and biopsy of liver lesion confirms adenocarcinoma consistent with colorectal primary. Her performance status is limited due to severe abdominal pain related to her metastatic disease. The patient is started on FOLFOX plus bevacizumab, which results in an improvement in her pain and performance status. Next-generation sequencing reveals APC, SMAD4, and TP53 mutations, as well as a BRAF V600E mutation. The faculty discuss the treatment options for patients with aggressive BRAF V600E mutations, which are associated with poor prognosis and EGFR resistance, in both the first- and second-line setting. They also highlight importance of individualizing treatment based on a patient’s age, performance status, goals of treatment, and comorbidities.
This is Part 1 of The Evolving Targeted Treatment Landscape for Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. John Strickler, Stacey A. Cohen, and Harshabad Singh discuss the management of HER2-positive metastatic colorectal cancer. The patient is a 49-year-old man who presents to the ER with nausea, vomiting, and abdominal pain. A CT of the chest, abdomen, and pelvis reveals bowel obstruction, extensive hepatic metastases, and abdominal lymphadenopathy, and a partially obstructing mass in the sigmoid colon is found on colonoscopy. Next-generation sequencing is ordered, and the patient has APC and TP53 mutations, as well as an ERBB2 amplification. The faculty discuss potential next steps for a patient such as this, highlighting the role of HER2 amplification/overexpression in metastatic colorectal cancer, how the presence of brain metastases impacts treatment decisions, and treatment options for patients whose disease progresses on prior anti-HER2 therapies.
In a single-institution phase I trial reported in JAMA Oncology, Marwan Fakih, MD, and colleagues found that the combination of regorafenib, ipilimumab, and nivolumab showed evidence of activity in patients with microsatellite-stable metastatic colorectal cancer who did not have liver metastases....
On January 19, 2023, tucatinib was grated accelerated approval for use in combination with trastuzumab for RAS wild-type, HER2-positive unresectable or metastatic colorectal cancer that progressed following fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy.1 Supporting Efficacy...
In heavily pretreated patients with metastatic colorectal cancer who have microsatellite-stable tumors, the novel combination of the monoclonal antibodies botensilimab and balstilimab showed clinical activity, producing durable responses and an estimated 63% overall survival rate at 12 months,...
In a retrospective cohort study reported in JAMA Network Open, Saberzadeh-Ardestani et al found that first-line pembrolizumab was associated with clinically significant prolongation of survival outcomes in mostly older patients with mismatch repair–deficient (dMMR) metastatic colorectal cancer....
According to the American Cancer Society, colorectal cancer is the third most commonly diagnosed cancer and the third most common cause of cancer-related death in both men and women in the United States. However, it ranks second in cancer-related deaths overall, and is the leading cause of death in ...
The invited discussant of the SUNLIGHT trial, Dustin Deming, MD, the ACI/Schwenn Family Association Professor in the Division of Hematology, Medical Oncology, and Palliative Care and Director of JD Fluno Colorectal Cancer Precision Medicine at the University of Wisconsin, Madison, said the findings ...
In the open-label phase III SUNLIGHT trial, the addition of bevacizumab to trifluridine/tipiracil, also known as TAS-102, significantly improved overall survival in patients with metastatic treatment-refractory colorectal cancer,1 according to Josep Tabernero, MD, Head of the Department of Medical...
In the phase II ANCHOR CRC trial reported in the Journal of Clinical Oncology, Eric Van Cutsem, MD, PhD, and colleagues found that the combination of encorafenib, binimetinib, and cetuximab produced an objective response in nearly half of previously untreated patients with BRAF V600E–mutant...
KRAS G12C–mutated colorectal cancer represents 3% to 4% of metastatic colorectal cancers. Like other KRAS-mutated metastatic colorectal cancers, this group of patients represents a patient population with an unmet need, with limited options beyond two lines of therapy. In contrast to other KRAS...
In a phase I/II trial (KRYSTAL-1) reported in The New England Journal of Medicine, Rona Yaeger, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues found that the KRAS G12C inhibitor adagrasib showed activity alone and in combination with cetuximab in heavily pretreated patients ...
Investigators have revealed that individuals who react defensively to an invitation for colorectal cancer screening may be less likely to take part, according to a new study published by Clarke et al in Cancer. Background Colorectal cancer is one of the most treatable cancer types—especially if...
In a Dutch study reported in JAMA Oncology, Geurts et al found a dose-response relationship between radiotherapy and risk of colorectal cancer among survivors of Hodgkin lymphoma, with the risk being increased with increasing procarbazine dose. Study Details The nested case-control study included...
As reported in the Journal of Clinical Oncology by Morton et al, the European phase III FOxTROT trial has shown that neoadjuvant plus adjuvant oxaliplatin/fluoropyrimidine resulted in a reduced risk of residual disease or disease recurrence vs adjuvant oxaliplatin/fluoropyrimidine in patients with...
In a study reported in JAMA Oncology, Cheng et al found that higher levels of inflammatory biomarkers measured after surgery—but before receipt of chemotherapy—were associated with poorer outcomes in patients with stage III colon cancer enrolled in the CALGB/SWOG 80702 trial of adjuvant...
In one of the first clinical trials combining immunotherapy and targeted therapy for patients with BRAF V600E–mutated colorectal cancer, researchers discovered that a combination regimen of dabrafenib, trametinib, and spartalizumab resulted in long-lasting responses. The study findings published by ...
Julien Taïeb, MD, PhD, of Hôpital Européen Georges Pompidou, Université Paris-Cité, discusses the clinical implications of new phase III findings from the SUNLIGHT study, which showed that trifluridine and tipiracil (FTD/TPI) plus bevacizumab resulted in improved outcomes compared with FTD/TPI alone in patients with refractory metastatic colorectal cancer. This three-drug regimen may represent a new standard of care for patients whose cancer has progressed despite two lines of therapy (Abstract 4).
Many individuals considering screening for colorectal cancer may want information on their personal risk when making decisions about screening—such as whether to select an at-home stool-based test or colonoscopy. Investigators evaluated five online colorectal cancer risk calculators to determine...
In a retrospective, observational case series study reported in JAMA Oncology, Emile et al identified changes in the stage at diagnosis, treatments, and outcomes in U.S. patients with rectal adenocarcinoma diagnosed between 2004 and 2019. Study Details The study used National Cancer Database data...
Josep Tabernero, MD, PhD, of Spain’s Vall d’Hebron Institute of Oncology, discusses phase III findings from the SUNLIGHT study, which showed that trifluridine and tipiracil (FTD/TPI) plus bevacizumab resulted in improved outcomes compared with FTD/TPI alone in patients with refractory metastatic colorectal cancer. Improvements in survival occurred irrespective of tumor sidedness, RAS mutational status, and receipt of prior bevacizumab. This three-drug regimen may represent a new standard of care for patients whose cancer has progressed after two lines of therapy (Abstract 4).
A combination of the next-generation immunotherapies botensilimab and balstilimab showed clinical activity in treating patients with refractory metastatic microsatellite-stable (MSS) colorectal cancer, according to new findings presented by El-Khoueiry et al at the 2023 ASCO Gastrointestinal...
On January 19, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the kinase inhibitor tucatinib (Tukysa) in combination with the monoclonal antibody trastuzumab for RAS wild-type, HER2-positive, unresectable or metastatic colorectal cancer that has progressed following...
Investigators discovered that PD-1 inhibition prior to surgery may be effective for patients with localized mismatch repair–deficient or microsatellite instability–high (dMMR/MSI-H) colorectal cancer, according to a study published by Xiao et al in JNCCN–Journal of the National Comprehensive Cancer ...
In the phase I/II KRYSTAL-1 trial reported in The New England Journal of Medicine, Rona Yaeger, MD, and colleagues found that the KRAS G12C inhibitor adagrasib showed activity alone and in combination with cetuximab in heavily pretreated patients with metastatic colorectal cancer and mutated KRAS...
In a study reported in the Journal of Clinical Oncology, Damgacioglu et al found that squamous cell carcinoma of the anus incidence and mortality rates increased in men and women aged ≥ 50 years at diagnosis between 2001 to 2005 and 2014 to 2018, with increases concentrated in Midwestern and...
A new ASCO guideline on the management of advanced colorectal cancer summarizes the latest treatments supported by quality data that could expand oncologists’ armamentarium and potentially improve survival outcomes.1 “[Colorectal cancer] remains the second-leading class of cancer deaths among men ...
In a U.S. cross-sectional study reported in JAMA Oncology, Oakes et al found that as of December 2021, breast, cervical, and colorectal cancer screening rates remained below pre–COVID-19 pandemic levels, despite initial rebounds in some rates. Reduced screening rates were accompanied by reduced...
In an analysis from the phase III CALGB (Alliance)/SWOG 80702 trial of adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) for patients with stage III colon cancer reported in the Journal of Clinical Oncology, Lee et al found that longer duration of oxaliplatin treatment was associated with ...
Researchers have discovered that patients with type 2 diabetes who develop cancer are more likely to be diagnosed with advanced disease if they do not undergo routine screenings, according to a new study published by Jansana et al in the European Journal of Cancer. The new findings were also...
Colorectal cancer ranks third among cancer deaths in both men and women in the United States, with an estimated 150,000 new cases and 52,000 deaths anticipated in 2022.1 Colorectal cancer rates have declined by approximately 2% per year from 2014 to 2018 in people older than age 50, which is...
After examining the impact of exercise on the gut microbiome of patients with cancer and reporting a positive association, researchers discovered that regular physical activity may extend the survival of patients with colorectal cancer, according to a new study published by Himbert et al in the...
New findings revealed that overall cancer mortality among American Indian and Alaska Native patients was 18% higher than among White patients despite similar cancer incidence, according to a new study published by Kratzer et al in CA: A Cancer Journal for Clinicians. The findings included the first ...
In a pooled analysis reported in the Journal of Clinical Oncology, Gallois et al found that early discontinuation of adjuvant oxaliplatin/fluoropyrimidine regimens—consisting of FOLFOX (infusional fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin)—was associated...
As reported in a letter published in The New England Journal of Medicine by Papke et al, data from a prospective biopsy screening program at a large gastrointestinal pathology group indicate that approximately 3% of rectal adenocarcinomas are mismatch repair (MMR)-deficient. Study Background As...
HUTCHMED (China) Limited recently announced that the global phase III FRESCO-2 trial evaluating the investigational use of the anti–vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor fruquintinib met its primary endpoint of overall survival in patients with advanced, refractory...
In a pragmatic trial reported in The New England Journal of Medicine, Bretthauer et al, on behalf of the Nordic-European Initiative on Colorectal Cancer (NordICC) Study Group, found a reduced risk of colorectal cancer diagnosis but no significant reduction in disease-specific mortality among...
Treatment with neoadjuvant immunotherapy in colon cancer resulted in major pathologic responses in 95% of patients, NICHE-2 investigators reported at the European Society for Medical Oncology (ESMO) Congress 2022.1 Additionally, after 4 weeks of nivolumab plus ipilimumab, 67% of patients with...
Colorectal cancer ranks third among cancer deaths in both men and women in the United States, with an estimated 106,000 new cases and 52,000 deaths anticipated in 2022.1 Colorectal cancer rates have declined by approximately 2% per year from 2014 to 2018 in people over the age of 50 years, which is ...