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The combination of the BRAF inhibitor encorafenib with cetuximab and nivolumab produced responses in 50% of patients and disease control in 96% of patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer in a phase I/II trial reported at the 2022 ASCO Gastrointestinal...
For the treatment of metastatic colorectal cancer in patients unfit for intensive chemotherapy, trifluridine/tipiracil plus bevacizumab as first-line therapy was no more effective than capecitabine plus bevacizumab, investigators from the phase III SOLSTICE trial reported in a European Society for...
Weight loss for adults, particularly those who are overweight or obese, may reduce their risk of developing a type of polyp that may lead to colorectal cancer, according to a new study published by He et al in JNCI Cancer Spectrum. Losing weight from early to late adulthood (up to the mid-70s)—at...
Romain Cohen, MD, PhD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results of the GERCOR NIPICOL study, which suggests nivolumab plus ipilimumab at a fixed duration of 1 year continued to show durable activity in patients with chemoresistant microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer after 3 years of follow-up. Dr. Cohen points out there is now some question as to whether all patients need 2 years of therapy (Abstract 13).
Melissa Amy Lumish, MD, of Memorial Sloan Kettering Cancer Center, discusses new findings showing a 100% complete response rate to PD-1 blockade alone among the first 11 patients with locally advanced mismatch repair–deficient rectal cancer treated with this approach. None of the patients required chemoradiation or surgery, thus avoiding their attendant morbidities, and so PD-1 blockade may represent a new treatment paradigm. Follow-up on the durability of response is needed (Abstract 16).
Van K. Morris, MD, of The University of Texas MD Anderson Cancer Center, discusses phase I/II data suggesting that encorafenib plus cetuximab and nivolumab is safe and well tolerated for patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer (Abstract 12).
A new risk score may aid in identifying men and women younger than 50 who are most likely to develop a cancer of the colon or rectum, an international study published by Archaumbault et al in the Journal of the National Cancer Institute showed. More About Scoring The score—a number between 0 and...
Gabriel A. Brooks, MPH, MD, of the Norris Cotton Cancer Center, discusses key studies that, when synthesized, suggest the benefits of oxaliplatin may be less than often assumed. The toxicities are well described (especially neuropathy), and the agent should be used cautiously and sparingly beyond the third month of adjuvant treatment for patients with colon cancer and in the elderly or frail with metastatic disease.
Colorectal cancer is the second most common cause of death in the United States. In 2020, approximately 148,000 people were diagnosed with the disease, and 53,200 people died from it, including 17,930 cases and 3,640 deaths in individuals younger than age 50. According to the American Cancer...
Afsaneh Barzi, MD, PhD, of City of Hope Comprehensive Cancer Center and AccessHope, discusses results from a phase I/II study of regorafenib and pembrolizumab in refractory microsatellite-stable colorectal cancer. Although the trial did not meet its primary endpoint, the median overall survival is “provocative,” says Dr. Barzi. An analysis of biomarkers to identify patients with a longer duration of benefit is ongoing (Abstract 15).
Heinz-Josef Lenz, MD, of USC Norris Comprehensive Cancer Center, discusses phase II results from the CheckMate 9X8 study, which compared nivolumab plus fluorouracil/leucovorin/oxaliplatin (mFOLFOX6) and bevacizumab vs mFOLFOX6 and bevacizumab in the first-line treatment of metastatic colorectal cancer. A subgroup of patients may benefit from adding nivolumab to the standard of care in this setting (Abstract 8).
In a study reported in the Journal of Clinical Oncology, Cheng et al found that the addition of patient-reported diet and lifestyle factors to prediction models based on clinical and pathologic characteristics improved predictions of disease recurrence and mortality among patients with stage III...
Mehmet Altan, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from a phase Ib dose-escalation study, which showed early evidence of activity for NKTR-255, an investigational IL-15 receptor agonist, plus cetuximab in patients with solid tumors. Treatment appeared to lead to expansion and proliferation of NK and CD8+ cells (Abstract 957).
In a study published in the journal Gastroenterology, Trivedi et al described an increase in early-onset colorectal cancer and precancerous polyps, based on a large, nationally representative study of patients younger than 50 who underwent colonoscopy. It was the first large-scale study to look at...
A team of researchers has revealed some of the mechanisms by which polyps develop into colorectal cancer, setting the framework for improved surveillance for the disease. Their study, published by Chen et al in the journal Cell, describes findings using a single-cell transcriptomic and imaging...
Although the incidence and mortality rates in colorectal cancer have dropped by 3.6% each year from 2007 to 2016 for people aged 55 and older—mainly because of increased colorectal cancer screening, advances in therapy, and reductions in smoking—these rates have increased by 2% each year during the ...
Throughout my adolescence and early adulthood, I had been plagued with digestive issues, including bouts of gastritis and constipation, which seemed normal for me and wasn’t too concerning. But by the time I turned 30, in 2015, the acid reflux I had been experiencing became so frequent and...
Women who live in urban areas and those residing in rural areas are screened for breast cancer at similar rates, but rural women are screened for colorectal cancer at significantly lower rates than their urban counterparts, research published by Shete et al in JAMA Network Open showed. The...
Although research so far has failed to uncover the root causes of the development of young-onset colorectal cancer, what is certain is that although colorectal cancer rates are declining in older adults, they are on a steady rise in people younger than age 50, especially those between the ages of...
Despite the availability of several effective screening tests, colorectal cancer screening rates remain below national goals. Although colonoscopy is the most often recommended screening method, a new study has found that the preferences of primary care clinicians have shifted toward noninvasive...
In a prespecified analysis of the phase II CodeBreaK100 trial reported in The Lancet Oncology, Marwan Fakih, MD, and colleagues found that the KRAS G12C protein inhibitor sotorasib showed modest activity in patients with previously treated KRAS G12C–mutant colorectal cancer. Study Details The...
Updating its 2016 recommendation on the use of aspirin to prevent cardiovascular disease and colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement. It noted the potential harms of daily aspirin, with the most serious being bleeding in the...
In a study reported in the Journal of Clinical Oncology, Pan et al found that overall survival was poorer among patients with metastatic right-sided vs left-sided colorectal cancer with TP53 mutations, driven by poorer outcomes in those with non–gain-of-function mutations, and that gain-of-function ...
In a study reported in JAMA Network Open, Montminy et al found that the incidence of colorectal adenocarcinoma in people aged 40 to 49 years in the United States has increased in White individuals and remained stable in Black individuals between 2000 and 2017, with incidence rates being equivalent...
Long-term results of a German phase II trial (CAO/ARO/AIO-12) reported in JAMA Oncology by Fokas et al showed similar disease outcomes, chronic toxicity, and quality of life with chemoradiotherapy before vs after chemotherapy in the total neoadjuvant treatment of patients with locally advanced...
In an analysis of data from the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) database reported in the Journal of Clinical Oncology, Fontana et al found a greater risk of relapse and cancer-specific mortality after adjuvant fluoropyrimidine/oxaliplatin chemotherapy in patients...
The U.S. Multisociety Task Force on Colorectal Cancer—representing the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy—has updated its colorectal cancer screening recommendations, which were last published...
Even though patients with metastatic colorectal cancer younger than age 50 tend to be more fit and receive more intensive treatment than older patients, survival for both groups is roughly the same, according to a study published by Lipsyc-Sharf et al in the Journal of the National Cancer...
The novel WEE1 inhibitor adavosertib, given after induction chemotherapy, yielded a 65% reduction in the risk of disease progression or death compared with active monitoring in patients with metastatic colorectal cancer and TP53/RAS mutations, according to the randomized phase II FOCUS4-C trial....
“KRAS G12C inhibitors as monotherapy yield a relatively low overall response rate, but when you combine them with an EGFR [epidermal growth factor receptor] inhibitor, the response rate is nearly double,” said Federica Di Nicolantonio, MD, PhD, Professor of Oncology at the University of Turin in...
Adagrasib, a covalent inhibitor of KRAS G12C, combined with cetuximab, showed activity in patients with metastatic colorectal cancer in the phase I/II KRYSTAL-1 trial, as presented during a Presidential Symposium at the European Society for Medical Oncology (ESMO) Congress 2021 by Jared Weiss, MD,...
The U.S. Food and Drug Administration (FDA) has granted approval of a new indication for the EGFR inhibitor cetuximab (Erbitux) in combination with encorafenib (Braftovi) for the treatment of adults with metastatic colorectal cancer and a BRAF V600E mutation, as detected by an FDA-approved test,...
As reported in the Journal of Clinical Oncology by Heinz-Josef Lenz, MD, and colleagues, in the phase II CheckMate 142 trial, first-line treatment with nivolumab plus low-dose ipilimumab produced a high rate of durable responses in a cohort of patients who had received no prior treatment for...
Filippo Pietrantonio, MD, and Federica Morano, MD, both of the Istituto Nazionale dei Tumori, discuss results from the MAYA trial, which provided proof of concept that temozolomide-induced hypermutation may be exploited to achieve durable responses to low-dose ipilimumab plus nivolumab in patients with microsatellite stable metastatic colorectal cancer (Abstract 383O).
As reported in JAMA Surgery by van der Kruijssen et al, 60-day post–random assignment mortality results in the Danish/Dutch phase III CAIRO4 trial showed higher rates of mortality in patients with metastatic colorectal cancer who received primary tumor resection plus systemic treatment vs those...
In an Italian retrospective cohort study reported in JAMA Surgery, Deidda et al found that a longer vs shorter delay to surgery among patients with locally advanced rectal cancer with minor or no pathologic response to neoadjuvant chemoradiotherapy was associated with significantly poorer overall...
Jenny F. Seligmann, MBChB, PhD, of the University of Leeds, discusses phase II findings that suggest adavosertib improved progression-free survival, compared with active monitoring, by inhibiting the WEE1 kinase in patients with RAS- and TP53-mutant metastatic colorectal cancer. In the trial, adavosertib’s activity tended to be even greater in left-sided tumors (Abstract 382O).
In the phase III EPOCH trial reported in the Journal of Clinical Oncology, Mary F. Mulcahy, MD, and colleagues found that the addition of transarterial yttrium-90 radioembolization (TARE) to second-line chemotherapy significantly prolonged progression-free survival and hepatic progression–free...
In the German phase II PANAMA trial reported in the Journal of Clinical Oncology, Modest et al found that the addition of the monoclonal antibody panitumumab to fluorouracil (5-FU)/leucovorin maintenance therapy improved progression-free survival in patients with RAS wild-type metastatic colorectal ...
As reported in the Journal of Clinical Oncology by Seligmann et al, the phase II FOCUS4-C trial has shown activity of the WEE1 kinase inhibitor adavosertib in patients with TP53- and RAS-mutant metastatic colorectal cancer with disease control after first-line chemotherapy. As state by the...
The U.S. Food and Drug Administration (FDA) has granted approval of a new indication for cetuximab (Erbitux) in combination with encorafenib (Braftovi) for the treatment of adult patients with metastatic colorectal cancer and a BRAF V600E mutation, as detected by an FDA-approved test, after prior...
In the Japanese phase II/III JCOG0603 trial reported in the Journal of Clinical Oncology, Kanemitsu et al found that the addition of adjuvant mFOLFOX6 (fluorouracil, leucovorin, and oxaliplatin) to hepatectomy improved disease-free survival in patients with liver-only metastatic colorectal cancer;...
In the FOCUS4-N trial reported in the Journal of Clinical Oncology, Adams et al found that capecitabine maintenance improved progression-free—but not overall—survival vs active monitoring in patients with stable disease or objective response after first-line therapy for metastatic colorectal...
The phase II ANCHOR CRC study, the largest prospective study of BRAF inhibitor–based therapy as first-line treatment of metastatic colorectal cancer, has met its primary endpoint, with 47.8% of patients with metastatic colorectal cancer responding to first-line treatment with encorafenib,...
In a French study reported in JAMA Network Open, Thierry et al found that tumor burden (assessed as plasma circulating tumor DNA [ctDNA]) was significantly higher among patients with newly diagnosed metastatic colorectal cancer screened for a clinical trial after vs before the first COVID-19...
In a study reported in JAMA Network Open, Fleming et al found that low skeletal muscle area and high visceral-to-total fat ratio were associated with increased expression of proinflammatory cytokines and VEGF as well as worse 5-year outcomes in patients with nonmetastatic colon cancer. Study...
Infants whose mothers were obese during pregnancy may have a heightened risk of developing colorectal cancer later in life, according to new research published by Murphy et al in the journal Gut. Obesity is already a well-established risk factor for colorectal cancer, and several studies suggest...
The measurement of circulating tumor DNA (ctDNA) is changing the way gastrointestinal cancers are managed, according to Bassel F. El-Rayes, MD, Professor and Vice Chair for Clinical Research in the Department of Hematology and Oncology, Emory University, and Associate Cancer Center Director,...
Cancer is a leading cause of mortality in patients with mental illnesses. Although individuals with mental illnesses are equally as vulnerable to cancer as the general population, they are at a much higher risk of cancer-related mortality. Owing to a lack of early screening in most cases, such...
Commonly used blood pressure drugs may improve survival for patients with colorectal cancer, a recent study published by Balkrishnan et al in Cancer Medicine suggests. After reviewing outcomes of almost 14,000 patients with colorectal cancer, researchers determined that angiotensin-converting...