Advertisement

Advertisement

colorectal cancer

Frank A. Sinicrope, MD, on Adjuvant Treatment Strategies for Stage III dMMR Colon Cancer

Frank A. Sinicrope, MD, of Mayo Clinic Rochester, reviews findings from the randomized Alliance A021502/ATOMIC trial, which studied standard chemotherapy alone or combined with atezolizumab as adjuvant therapy for patients with stage III DNA mismatch repair–deficient (dMMR) colon cancer (LBA1).   

colorectal cancer

Elena Elez, MD, PhD, on Updated Survival Data From the BREAKWATER Trial

Elena Elez, MD, PhD, of Vall d’Hebron Institute of Oncology, presents updated overall survival data as well as progression-free survival data from the BREAKWATER trial of the first-line use of encorafenib, cetuximab, and mFOLFOX6 in BRAF V600E–mutant metastatic colorectal cancer (LBA3500). 

colorectal cancer

Heinz-Josef Lenz, MD, on MSI-H/dMMR Metastatic Colorectal Cancer: Expanded Analyses From CheckMate 8HW

Heinz-Josef Lenz, MD, of the University of Southern California Norris Comprehensive Cancer Center, reviews analyses from the CheckMate 8HW trial, which evaluated nivolumab plus ipilimumab vs chemotherapy or nivolumab monotherapy for microsatellite instability–high/mismatch repair–deficient (MSI-H/dMMR) metastatic colorectal cancer (Abstract 3501). 

colorectal cancer

Christopher M. Booth, MD, on a Structured Exercise Program for Patients With Colon Cancer

Christopher M. Booth, MD, of Queen’s University, reviews findings from the randomized phase III Canadian Cancer Trials Group (CCTG) CO.21 (CHALLENGE) trial, which evaluated the impact of a structured exercise program on disease-free survival in patients with stage III or high-risk stage II colon cancer (Abstract LBA3510). 

colorectal cancer

Anna Martling, MD, PhD, on the ALASCCA Trial in Colorectal Cancer

The randomized, double-blind, multicenter, placebo-controlled ALASCCA Trial screened 3,508 patients across 33 hospitals in Sweden, Denmark, Finland, and Norway for eligibility. They either had stage II or III colon cancer or stage I, II, or III rectal cancer. Ultimately, 626 patients continued on with the trial, including 419 with colon cancer, and 207 with rectal cancer. Anna Martling, MD, PhD, of Karolinska Institutet, and colleagues evaluated the impact of low-dose aspirin on recurrence in this patient population, especially those with PI3K pathway alterations (Abstract LBA125). 

colorectal cancer

Cathy Eng, MD, on the FRESCO-2 Study in Metastatic Colorectal Cancer

Cathy Eng, MD, of Vanderbilt-Ingram Cancer Center, reported on findings from the FRESCO-2 study, focusing on overall survival with fruquintinib vs placebo after adjusting for subsequent anticancer therapy in patients with refractory metastatic colorectal cancer (Abstract 171). Abstract 171, a poster, was presented at the 2025 ASCO Gastrointestinal Cancers Symposium by Sara Lonardi, MD, of Veneto Institute of Oncology IOV-IRCCS in Padova, Italy; Dr. Eng is the study's senior author.

colorectal cancer

Scott Kopetz, MD, PhD, FACP, on the BREAKWATER Study in BRAF V600–Mutant Metastatic Colorectal Cancer

The open-label, global, randomized phase III BREAKWATER study was an  analysis of first-line encorafenib plus cetuximab plus chemotherapy in patients with BRAF V600E–mutant metastatic colorectal cancer. Here, Scott Kopetz, MD, PhD, FACP, of The University of Texas MD Anderson Cancer Center, reports the primary analysis of objective response rate and the first interim analysis of overall survival (Abstract 16).

colorectal cancer

Thierry André, MD, on First Results From CheckMate 8HW

Thierry André, MD, of Hôpital Saint-Antoine, presented first results from the ongoing phase III CheckMate 8HW trial comparing nivolumab plus ipilimumab vs nivolumab monotherapy for microsatellite instability–high/mismatch repair–deficient metastatic colorectal cancer (Abstract LBA143).

colorectal cancer

Aasma Shaukat, MD, MPH, on A Blood-Based Test for Colorectal Cancer Screening

Aasma Shaukat, MD, MPH, of NYU Langone, presented results from the PREEMPT CRC study, which evaluated the clinical performance of an investigational blood-based screening test for detecting molecular signals of advanced colorectal neoplasia in an average-risk population (Abstract 18).

colorectal cancer

Andrea Cercek, MD, on Rectal Cancer: Durable Complete Responses to PD-1 Blockade Alone

Andrea Cercek, MD, of Memorial Sloan Kettering Cancer Center, discusses expanded data on the durability of complete response to dostarlimab-gxly, a PD-1 single-agent therapy administered to patients with locally advanced mismatch repair–deficient rectal cancer. The drug yielded recurrence-free responses, lasting longer than a year, without the need for chemotherapy, radiation, or surgery (LBA3512).

colorectal cancer

Jeanne Tie, MD, MBChB, on Colon Cancer: New Data on ctDNA Guiding Adjuvant Therapy

Jeanne Tie, MD, MBChB, of Peter MacCallum Cancer Centre, discusses data on survival and updated 5-year results from the DYNAMIC trial, which supports a role for circulating tumor DNA (ctDNA) analysis, including serial sampling, in the management of patients with stage II colon cancer (Abstract 108).

colorectal cancer

Dominik P. Modest, MD, on Colorectal Cancer: Health-Related Quality-of-Life Findings From CodeBreaK 300

Dominik P. Modest, MD, of Charité-Universitätsmedizin Berlin, discusses phase III study findings showing sotorasib plus panitumumab vs trifluridine/tipiracil or regorafenib benefits patients with chemorefractory metastatic colorectal cancer in terms of improved clinical outcomes and better self-reported quality of life (Abstract 10).

colorectal cancer
pancreatic cancer

Jennifer Yon-Li Wo, MD, on Colorectal and Pancreatic Cancers: New Findings on SBRT With Ipilimumab and Nivolumab

Jennifer Yon-Li Wo, MD, of Massachusetts General Hospital, discusses the local failure rate of non-ablative hypofractionated radiation therapy in combination with the immune checkpoint inhibitors ipilimumab and nivolumab compared to ablative SBRT to treat metastatic microsatellite-stable colorectal and pancreatic cancers as a secondary analysis of four prospective trials. Dr. Wo and her team found that, despite using nearly half the radiation dose in those who received immunotherapy, there was no significant difference in local failure rates (Abstract 752).

colorectal cancer

Van K. Morris, MD, on Colon Cancer: ctDNA as a Predictive Biomarker

Van K. Morris, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II results on using circulating tumor DNA (ctDNA) as a predictive biomarker of adjuvant chemotherapy in patients with stage II colon cancer. During the trial, no improvement in ctDNA clearance was observed after 6 months of chemotherapy following resection of disease. Dr. Morris notes that future trials should account for evolving assay performance in patients with colorectal cancer (Abstract 5).

colorectal cancer

Second- and Third-Line Therapy for Metastatic Colorectal Cancer

This is Part 3 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss later-line treatment options for metastatic colorectal cancer. The patient is a 64-year-old male with metastatic ascending colon moderately differentiated adenocarcinoma. On CT scan, he has liver, lung, and retroperitoneal lymph node metastases. Molecular testing demonstrates proficient mismatch repair, HER2 IHC negative; a 100-gene next-generation sequencing panel demonstrates KRAS G13D, PIK3CA, CCND2, and ATM mutations. The patient has a good performance status and is initiated on FOLFOXIRI/bevacizumab with partial response, then develops disease progression on fluorouracil/bevacizumab maintenance therapy.   The faculty review the next steps for this patient and the importance of quality-of-life considerations when making treatment decisions. They also discuss the evolving third-line landscape, highlighting the recent SUNLIGHT trial that evaluated the addition of bevacizumab to TAS-102.

colorectal cancer

Second-Line Therapy for Metastatic Colorectal Cancer

This is Part 2 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss second-line treatment options for metastatic colorectal cancer. The patient is a 46-year-old female with locally advanced, poorly differentiated rectal adenocarcinoma who received neoadjuvant chemoradiation followed by resection, which revealed a ypT4N1 tumor. She received adjuvant FOLFOX for eight cycles; 5 months after completion of therapy, a restaging CT scan revealed more than 10 growing pulmonary nodules, all < 1 cm.   In the conversation that follows, the faculty discuss the many treatment options available in the second-line setting, the factors that impact decision-making, and the emerging role of HER2 amplification/overexpression as an actionable target in metastatic colorectal cancer.

colorectal cancer

Second-Line Therapy for Metastatic Colorectal Cancer

This is Part 2 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss second-line treatment options for metastatic colorectal cancer. The patient is a 46-year-old female with locally advanced, poorly differentiated rectal adenocarcinoma who received neoadjuvant chemoradiation followed by resection, which revealed a ypT4N1 tumor. She received adjuvant FOLFOX for eight cycles; 5 months after completion of therapy, a restaging CT scan revealed more than 10 growing pulmonary nodules, all < 1 cm.   In the conversation that follows, the faculty discuss the many treatment options available in the second-line setting, the factors that impact decision-making, and the emerging role of HER2 amplification/overexpression as an actionable target in metastatic colorectal cancer.

colorectal cancer

Front-Line Therapy for Metastatic Colorectal Cancer

This is Part 1 of New Directions in Metastatic Colorectal Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Michael Overman, Laura Goff, and Katrina Pedersen discuss front-line treatment options for metastatic colorectal cancer. The patient is a 77-year-old male with a history of resected prostate cancer who developed rectal bleeding. He had a colonoscopy in 2016 that revealed a transverse T3N1 adenocarcinoma that was subsequently resected. After four cycles of FOLFOX, he developed chest pain that led to a CT scan demonstrating left supraclavicular adenopathy. A biopsy is performed, and CT scan shows liver and adrenal metastases.   In the conversation that follows, the faculty discuss the next steps for this patient, the importance of mismatch repair testing in the decision-making process, and the role of monotherapy vs combination therapy.

colorectal cancer

Cathy Eng, MD, and Thejus Jayakrishnan, MD, on Colorectal Cancer: Metabolomic Differences in Young-Onset vs Average-Onset Disease

Cathy Eng, MD, of Vanderbilt-Ingram Cancer Center, and Thejus Jayakrishnan, MD, of the Cleveland Clinic Taussig Cancer Institute, discuss significant differences in the citrate cycle, a core pathway of cellular metabolism associated with colorectal cancer. Metabolomic differences impacted by environmental exposures (arginine biosynthesis and dietary red meat) were also noted, suggesting possible links with younger age of onset in this disease (Abstract 3510).

colorectal cancer

Smitha Krishnamurthi, MD, and Deb Schrag, MD, MPH, on Rectal Cancer: New Findings on Chemoradiation, Chemotherapy, and Excision

Smitha Krishnamurthi, MD, of the Cleveland Clinic, and Deb Schrag, MD, MPH, of Memorial Sloan Kettering Cancer Center, discuss phase III findings from the PROSPECT trial, which showed FOLFOX chemotherapy with selective use of radiation therapy and sensitizing fluoropyrimidine (5FUCRT) is noninferior to 5FUCRT for the neoadjuvant treatment of patients with locally advanced rectal cancer, prior to low anterior resection with total mesorectal excision (Abstract LBA2).

colorectal cancer

Cathy Eng, MD, and Lars Henrik Jensen, MD, PhD, on Locally Advanced Colon Cancer: Efficacy of Neoadjuvant Chemotherapy and Standard Treatment

Cathy Eng, MD, of Vanderbilt-Ingram Cancer Center, and Lars Henrik Jensen, MD, PhD, of the Danish Colorectal Cancer Center South and the University Hospital of Southern Denmark, discuss phase III results from the Scandinavian NeoCol trial, which showed that neoadjuvant chemotherapy is not superior to standard upfront surgery in terms of disease-free and overall survival in patients with colon cancer, although there are certain circumstances when this approach may have more favorable outcomes (Abstract LBA3503).

colorectal cancer

Thierry Conroy, MD, on Rectal Cancer: Long-Term Results on mFOLFIRINOX vs Preoperative Chemoradiation Therapy

Thierry Conroy, MD, of the Institut de Cancérologie de Lorraine, discusses phase III findings from the PRODIGE 23 trial, showing that neoadjuvant chemotherapy with mFOLFIRINOX followed by chemoradiotherapy, surgery, and adjuvant chemotherapy improved all outcomes, including overall survival, in patients with locally advanced rectal cancer compared with standard chemoradiotherapy, surgery, and adjuvant chemotherapy (Abstract LBA3504).

colorectal cancer

Sebastian Stintzing, MD, on Colorectal Cancer: Influence of Liquid Biopsy in First-Line Combination Treatment

Sebastian Stintzing, MD, of the Charité Universitätsmedizin Berlin, discusses results from the phase III FIRE-4 study, which showed that liquid biopsy is clinically relevant in verifying mutational status in patients with metastatic colorectal cancer and is efficacious in first-line treatment of FOLFIRI and cetuximab for patients with RAS wild-type disease (Abstract 3507).

supportive care
symptom management
breast cancer
colorectal cancer

Lindsay L. Peterson, MD, on Exercise and Cancer Outcomes

Lindsay L. Peterson, MD, of the Washington University, St. Louis, discusses the value of physical activity in improving cancer prognosis, especially for patients with breast or colon cancer. Aerobic exercises and resistance training are recommended during and after treatment. Exercise may help inhibit tumor growth, improve quality of life by decreasing fatigue and anxiety, build muscle mass, increase physical function, and reduce surgical complications and treatment delays.

solid tumors
colorectal cancer

Midhun Malla, MD, on Metastatic Colorectal Cancer: Treatment Updates

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.

colorectal cancer

Myriam Chalabi, MD, PhD, on Colon Cancer: New Findings on Neoadjuvant Immune Checkpoint Inhibition

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).

colorectal cancer

First-Line Therapy of Metastatic Colon Cancer

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.

colorectal cancer
genomics/genetics

BRAF V600E–Mutated Colon Cancer

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.

colorectal cancer

HER2-Positive Metastatic Colorectal Cancer

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.

colorectal cancer

Julien Taïeb, MD, PhD, on Treating Colorectal Cancer With Trifluridine and Tipiracil Plus Bevacizumab

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).

colorectal cancer

Josep Tabernero, MD, PhD, on Colorectal Cancer: Recent Data on Treatment With Trifluridine and Tipiracil Plus Bevacizumab

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).

colorectal cancer

S.M. Qasim Hussaini, MD, on Colon Cancer Treatment Outcomes and Historical Housing Discrimination

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).

colorectal cancer
immunotherapy

Julien Taïeb, MD, PhD, on Colorectal Cancer: Recent Findings on Avelumab vs Standard Second-Line Chemotherapy

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).

colorectal cancer

MSI-High Rectal Adenocarcinoma

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.

colorectal cancer

HER2-Positive Colorectal Cancer

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.

colorectal cancer

Role of Neoadjuvant Therapy in T4 Colon 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.

colorectal cancer

Role of Circulating Tumor DNA in Early-Stage 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.

colorectal cancer

Marinde J.G. Bond, PhD Candidate, on Colorectal Liver Metastases: FOLFOX/FOLFIRI, Bevacizumab, and Panitumumab

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).  

colorectal cancer
genomics/genetics

Michael J. Overman, MD, and Smitha Krishnamurthi, MD, on RAS Wild-Type Metastatic Colorectal Cancer: Refining Treatment Strategy

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Smitha Krishnamurthi, MD, of the Cleveland Clinic, review three abstracts, all of which enrolled patients with newly diagnosed RAS and BRAF wild-type metastatic colorectal cancer with left-sided primary tumors. The discussion centers on what the study results indicate about the use of an EGFR therapy and weighing the risk to quality of life from rash, in particular (Abstracts LBA3503, LBA3504, LBA3505).

colorectal cancer

Michael J. Overman, MD, and Jeanne Tie, MBChB, MD, on Colon Cancer: Guiding Adjuvant Chemotherapy With ctDNA

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Jeanne Tie, MBChB, MD, of Peter MacCallum Cancer Centre, discuss results from the DYNAMIC trial, in which a circulating tumor DNA (ctDNA)-guided approach reduced the use of adjuvant chemotherapy without compromising recurrence-free survival in patients with stage II colon cancer (Abstract LBA100).

colorectal cancer

Smitha S. Krishnamurthi, MD, on Colorectal Cancer: Treatment Updates

Smitha S. Krishnamurthi, MD, of the Cleveland Clinic Taussig Cancer Institute, discusses prognostic assays for localized colon cancer, the potential clinical uses and current limitations of prognostic assays for stage II to III disease, and checkpoint inhibitor therapy for metastatic colorectal cancer.

colorectal cancer
covid-19

Maria Elena Martinez, PhD, MPH, on Colorectal Cancer Screening in Underserved Populations: COVID, Silver Linings, and Challenges Ahead

Maria Elena Martinez, PhD, MPH, of the University of California, San Diego Moores Cancer Center, provides an overview of the key components of the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science program, challenges posed by the COVID-19 pandemic, and opportunities for overcoming these challenges. Although screening and follow-up may reduce the incidence of and mortality from colorectal cancer, these disparities persist in medically underserved populations (Abstract SY30).

colorectal cancer

Reid M. Ness, MD, MPH, on Colorectal Cancer: Updates in Screening Recommendations

Reid M. Ness, MD, MPH, of Vanderbilt-Ingram Cancer Center, discusses significant updates to the NCCN Clinical Practice Guidelines in Oncology for colorectal cancer screening: lowering the age from 50 to 45 for the initiation of average-risk screening for all combinations of race, ethnicity, and sex; and extending the surveillance interval from 5 to 7–10 years following the identification of one to two low-risk adenomas.

colorectal cancer
immunotherapy

Romain Cohen, MD, PhD, on Metastatic Colorectal Cancer: Long-Term Follow-up on Nivolumab Plus Ipilimumab

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).

colorectal cancer
immunotherapy

Melissa Amy Lumish, MD, on Rectal Cancer: PD-1 Blockade for Mismatch Repair–Deficient Disease

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).

colorectal cancer
immunotherapy
genomics/genetics

Van K. Morris, MD, on Metastatic Colorectal Cancer: Early Trial Results on Encorafenib, Cetuximab, and Nivolumab

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).

colorectal cancer

Gabriel A. Brooks, MPH, MD, on Colorectal Cancer: Expert Perspective on the Need to Deintensify Oxaliplatin

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
immunotherapy

Afsaneh Barzi, MD, PhD, on Colorectal Cancer: Early Data on Regorafenib and Pembrolizumab

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).

colorectal cancer
immunotherapy

Heinz-Josef Lenz, MD, on Colorectal Cancer: Update From the CheckMate 9X8 Trial on Nivolumab, mFOLFOX6, and Bevacizumab

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).

immunotherapy
solid tumors
colorectal cancer
head and neck cancer

Mehmet Altan, MD, on Solid Tumors: Interim Safety and Efficacy Results on NKTR-255 Plus Cetuximab

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).

Advertisement

Advertisement

Advertisement