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Studies show that rural populations experience greater cancer disparities across the cancer control continuum—from prevention and incidence to survivorship and mortality—compared with their urban counterparts. Those living in rural parts of the United States also tend to have lower cancer screening ...
Commercially available noninvasive screening tests for colorectal cancer—the fecal immunochemical test (FIT) and the Cologuard multitarget stool DNA test—are equally effective for screening patients with early-stage colorectal cancer. However, FIT costs about one-fifth of the multitarget stool DNA...
Patients with colorectal cancer who have certain clinical characteristics may benefit from more frequent chest imaging to help identify and target cancer that has metastasized to the lungs, according to a new study presented at the 2022 Scientific Forum of the American College of Surgeons Clinical...
Researchers have unmasked mutations in the RNF43 gene as predictive biomarkers of a response to treatment with anti-BRAF/EGFR combination therapy in patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer. Data showed that patients with tumors harboring loss-of-function...
S. M. Qasim Hussaini, MD, of the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, discusses findings from a nationwide study of the association between living in areas with discriminatory mortgage practices from the 1930s with present-day access to quality colon cancer care. The study underscores the importance of state- and federal-level practices on mortgage lending regulation and fair housing practices in determining equitable cancer risk, access to care, and outcomes (Abstract 69).
Populations in U.S. counties defined as more vulnerable based on social factors—including socioeconomic status and racial and ethnic minority status—may be significantly less likely to receive timely breast, cervical, and colorectal cancer screenings, according to a recent study published by Bauer...
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...
In an analysis of National Cancer Database data reported in JAMA Surgery, Nassoiy et al found that neoadjuvant chemoradiation therapy followed by surgery was associated with higher rates of R0 resection and improved survival vs other treatments in patients aged 80 and older undergoing surgery for...
Recent findings showed that historical housing discrimination may negatively affect contemporary care and outcomes for patients diagnosed with colon cancer, according to a study by Hussaini et al in the Journal of Clinical Oncology. The findings were also presented at the 2022 ASCO Quality Care...
Julien Taïeb, MD, PhD, of Paris Descartes University, discusses phase II results from the SAMCO-PRODIGE 54 trial, which shows the efficacy and safety of avelumab in the second-line treatment of patients with deficient DNA mismatch–repair microsatellite-instability metastatic colorectal cancer. According to Dr. Taïeb, the study indirectly suggests this population should be treated as soon as possible with an immune checkpoint inhibitor (Abstract LBA23).
Three-quarters of surveyed people preferred to do a fecal immunochemical test (FIT) rather than undergo a colonoscopy for their regular colorectal cancer screening, according to a new Cedars-Sinai study published by Makaroff et al in Clinical Gastroenterology and Hepatology. “One of the big issues...
Physical activity may be associated with improved outcomes for patients undergoing postoperative treatment for stage III colon cancer, according to findings from a new study out of Pennington Biomedical Research Center published by Brown et al in the Journal of Clinical Oncology. The study assessed ...
This is Part 4 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the management of microsatellite instability (MSI)-high rectal adenocarcinoma. The patient is a 62-year-old man with a large fungating nonobstructive tumor 6 cm from the anal verge, which is invading the mesorectum, and with enlarged mesorectal and superior hemorrhoidal lymph nodes. Immunohistochemistry reveals a dMMR tumor with loss of MLH1/PMS2, MLH1 promotor hypermethylation, and a BRAF V600E mutation. The faculty discuss next steps for this patient, including the current standard of care of trimodality therapy for locally advanced rectal adenocarcinoma, as well as ongoing trials that are evaluating the possibility of de-escalating trimodality therapy by omitting radiation or surgery.
This is Part 3 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the management of HER2-positive colorectal cancer. The patient is a 45-year-old man who presents to the clinic with diarrhea, constipation, and periodic blood in his stool over the past 6 months. Colonoscopy reveals a nonobstructing tumor 16 cm from the anal verge, and CT scans reveal bilateral liver metastases with a primary rectosigmoid cancer with bulky adenopathy, as well as nonspecific subcentimeter lung nodules. After starting a course of FOLFOXIRI and bevacizumab, next-generation sequencing reveals that the patient is HER2-positive. The faculty discuss the next steps for this patient in light of the recent MOUNTAINEER trial and discuss the role of HER2 positivity in colorectal cancer.
This is Part 2 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the role of neoadjuvant therapy in T4 colon cancer. The patient a 65-year-old woman who is diagnosed with a moderately differentiated adenocarcinoma with a partial mismatch repair mutation; flexible sigmoidoscopy reveals an ulcerating fungating lesion about 20 cm from the anal verge, and CT scans show no evidence of distant metastatic disease. The faculty discuss the next treatment options for this patient, given that patients with T4 tumors typically have higher risk of recurrence. Dr. Krishnamurthi reviews the findings of the FOxTROT and OPTICAL trials, which evaluated preoperative chemotherapy in T4 colon cancer. The faculty also discuss the potential role of preoperative immunotherapy for pMMR colon cancer.
This is Part 1 of Updates in Colorectal Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Cathy Eng, Arvind Dasari, and Smitha Krishnamurthi discuss the role of circulating tumor DNA (ctDNA) in early-stage colon cancer. The patient is a 48-year-old woman with low-risk stage II colon cancer who underwent right hemicolectomy with no signs of metastasis. Immunohistochemistry revealed intact mismatch repair protein expression, and circulating tumor DNA was negative. She presents to the clinic asking about the best course of action after her surgery. The faculty discuss the role of ctDNA in guiding therapy in patients with low-risk colon cancer in light of the recent DYNAMIC, CIRCULATE-Japan, and GALAXY studies.
In a National Cancer Database analysis reported in JAMA Network Open, Brand et al found that patients with colon cancer who lived farther from their treatment facility and those with no insurance or Medicaid alone were more likely to present with advanced-stage disease. As stated by the...
In a circulating tumor DNA (ctDNA) substudy from the CALGB/SWOG-80405/Alliance trial reported in the Journal of Clinical Oncology, Kanwal Raghav, MD, MBBS, and colleagues found that first-line use of the anti-EGFR antibody cetuximab combined with chemotherapy was associated with only a small number ...
In a single-center retrospective study and a separate meta-analysis reported in The Lancet Oncology, Ecker et al found low correlations between recurrence-free survival and overall survival among patients undergoing resection of colorectal cancer liver metastases. As stated by the investigators,...
A new, large study led by researchers at the American Cancer Society (ACS) and The University of Texas MD Anderson Cancer Center showed the rising costs of cancer treatment led to increases in total costs of care, and when compounded with greater cost-sharing, increased out-of-pocket costs for...
In a retrospective cohort study reported in JAMA Oncology, Hagen F. Kennecke, MD, and colleagues found that among U.S. patients with clinical stage II/III rectal cancer diagnosed between 2006 and 2016 who received trimodality therapy, use of postoperative chemoradiation therapy (CRT) decreased and...
In a study reported in the Journal of Clinical Oncology by Topham et al, circulating tumor DNA (ctDNA) analysis indicated significantly increased frequencies of multiple potential EGFR inhibitor resistance alterations among patients with refractory metastatic colorectal cancer with vs without prior ...
A physician-scientist at City of Hope has identified a novel combination immunotherapy regimen—a triplet therapy consisting of regorafenib, ipilimumab, and nivolumab—that demonstrated significant response in patients with chemotherapy-resistant, microsatellite-stable metastatic colorectal cancer....
Researchers reported study results showing that fruquintinib, a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor receptors (VEGFR), significantly improved overall survival and progression-free survival in patients with refractory metastatic colorectal cancer. Findings...
Updated results from KRYSTAL-1, a multicohort phase I/II study, evaluating adagrasib—an investigational, highly selective, and potent oral small-molecule inhibitor of KRAS G12C—with or without cetuximab in patients with advanced colorectal cancer harboring a KRAS G12C mutation were presented by...
Marinde J.G. Bond, PhD Candidate, of the University Medical Center, Utrecht, discusses phase III findings from the CAIRO5 study of the Dutch Colorectal Cancer Group, the first such trial in defined subgroups of patients with initially unresectable colorectal cancer liver metastases and left-sided and RAS/BRAF V600E wild-type tumor. The study compared FOLFOX/FOLFIRI plus either bevacizumab or panitumumab (Abstract LBA21).
As reported in The Lancet Oncology, Kleppe et al have developed a risk stratification system using the DoMore-v1-CRC marker and pathologic staging markers that may permit many patients with stage II or III colorectal cancer to avoid adjuvant chemotherapy. As stated by the investigators, “The...
Ryan B. Corcoran, MD, PhD, commented on the C-800 study for The ASCO Post. Dr. Corcoran is the Mark J. Kusek Endowed Chair in Colorectal Cancer, Director of the Gastrointestinal Cancer Center Program and Scientific Director of the Termeer Center for Targeted Therapy, Massachusetts General Hospital...
Expanded data from the phase I C-800 study showed the immunotherapy combination of botensilimab and balstilimab appeared to be active in patients with microsatellite-stable (MSS) metastatic colorectal cancer. The findings were reported at the European Society for Medical Oncology (ESMO) World...
As reported in the Journal of Clinical Oncology by Hagen F. Kennecke, MD, MHA, and colleagues, the Canadian Cancer Trials Group phase II NEO trial has shown that 3 months of neoadjuvant chemotherapy resulted in tumor downstaging and avoidance of radical surgery in a high proportion of patients with ...
In a small phase II trial reported in The Lancet Oncology, Yamazaki et al found that the TGF-β type I receptor kinase inhibitor galunisertib appeared to show activity when added to neoadjuvant chemoradiation in previously untreated patients with locally advanced rectal cancer. As stated by the...
In a multinational study using artificial intelligence (AI), investigators developed an algorithm to improve the prediction of colorectal cancer recurrence. Study results were published by Pai et al in Gastroenterology. QuantCRC Rish K. Pai, MD, PhD, a pathologist at Mayo Clinic in Arizona and...
As reported in the Journal of Clinical Oncology by Brown et al, a prospective cohort study nested within the phase III CALGB/SWOG 80702/Alliance trial showed that greater volumes of physical activity in patients receiving adjuvant therapy for stage III colon cancer were associated with significant...
Researchers from the Mayo Clinic Comprehensive Cancer Center and the Mayo Clinic Center for Individualized Medicine are studying the rare genetic condition called familial adenomatous polyposis, looking for potential ways to prevent colorectal cancer in the general population at an earlier, more...
In a study reported in The Lancet Oncology, Aggarwal et al identified the impact of several models of centralization of specialist cancer services in England, using rectal cancer surgery as an example. As stated by the investigators, “Centralization of specialist cancer services is occurring in...
In the phase II MOUNTAINEER trial, tucatinib in combination with trastuzumab produced durable responses in patients with previously treated HER2-positive metastatic colorectal cancer. The late-breaking data were presented at the European Society for Medical Oncology (ESMO) World Congress on...
The pivotal global phase III FRESCO-2 trial evaluating the investigational use of fruquintinib met its primary endpoint of overall survival in patients with advanced, refractory metastatic colorectal cancer. The U.S. Food and Drug Administration (FDA) granted Fast Track designation for the...
In a Korean phase III noninferiority trial (KCSG CO09-07) reported in the Journal of Clinical Oncology, Kim et al found noninferiority in disease-free survival and reduced risk of neuropathy for adjuvant therapy with 3 vs 6 months of oxaliplatin plus 6 months of fluoropyrimidine treatment in...
The invited discussant of the CAIRO5 presentation at the 2022 ASCO Annual Meeting was Cathy Eng, MD, FACP, FASCO, Professor of Medicine, Hematology, and Oncology at Vanderbilt-Ingram Cancer Center, Nashville. Dr. Eng explained the key questions being asked by the investigators. “If you have a...
In the phase III CAIRO5 study, conducted by the Dutch Colorectal Cancer Group, triplet vs doublet chemotherapy plus bevacizumab significantly increased progression-free survival, response rate, and the rate of R0/R1 resections, with and without ablation, in patients with initially unresectable...
The use of postoperative circulating tumor DNA (ctDNA) in stage II colon cancer spared many patients the need for adjuvant chemotherapy without compromising recurrence-free survival, according to the phase II DYNAMIC study.1 “The strategy of using ctDNA results to inform treatment almost halved...
In patients with RAS/BRAF wild-type metastatic colorectal cancer, FOLFIRI (fluorouracil, leucovorin, irinotecan) plus panitumumab can be given intermittently rather than continuously, without compromising outcomes, according to the results of the IMPROVE study presented at the 2022 ASCO Annual...
In a retrospective cohort study reported in JAMA, Schottinger et al found that patients treated by physicians with higher adenoma detection rates on colonoscopies negative for cancer had a lower risk of postcolonoscopy colorectal cancer and death from colorectal cancer. Study Details The study...
The invited discussant of PARADIGM, Chiara Cremolini, MD, PhD, Professor of Medical Oncology at the University of Pisa, Italy, said the findings prospectively confirm the superior benefit of FOLFOX (fluorouracil, leucovorin, oxaliplatin) paired with panitumumab rather than bevacizumab in RAS...
The preferred targeted therapy for left-sided RAS wild-type metastatic colorectal cancer, in combination with standard chemotherapy, is panitumumab, not bevacizumab, based on a head-to-head comparison in the phase III PARADIGM trial. Panitumumab plus chemotherapy yielded the longest overall...
In 2020, nearly 150,000 Americans, mostly those aged 50 and older, were diagnosed with colorectal cancer. However, about 18,000 of those individuals were younger than age 50. And while colorectal cancer rates have decreased for people over age 50, they have been increasing by 51% since 1994 for...
Investigators at the American Cancer Society presented results of several studies during poster sessions at the 2022 ASCO Annual Meeting. Summaries of a few of these studies are provided here. COVID-19 and Cancer Mortality According to a new study led by researchers at the American Cancer Society,...
The study’s invited discussant was Kimmie Ng, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Co-Director of the Colon and Rectal Cancer Center at Dana-Farber Cancer Institute, Boston. “Neoadjuvant dostarlimab-gxly for 6 months represents a promising new treatment for...
In a study of 18 patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, 6 months of neoadjuvant treatment with the anti–PD-1 agent dostarlimab-gxly alone led to clinical complete responses in 100% of the study’s first 14 patients.1 These results were presented at the 2022...
In the phase III ANCHOR study reported in The New England Journal of Medicine, Palefsky et al found that treatment of high-grade squamous intraepithelial lesions was successful in preventing anal cancer vs active monitoring in persons infected with HIV. Study Details In the multicenter trial, 4,446 ...