Frank A. Sinicrope, MD, on Adjuvant Treatment Strategies for Stage III dMMR Colon Cancer
2025 ASCO Annual Meeting
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).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
ATOMIC was for patients with deficient mismatch repair stage 3 colon cancer. All of these patients had undergone a surgical resection with curative intent and all were found to have deficient mismatch repair tumors by immunohistochemistry. Patients were randomized 1 to 1 to FOLFOX chemotherapy plus atezolizumab given for six months, with the atezolizumab continued for an additional six months. This was compared to FOLFOX alone for six months. Atezolizumab, as we know, is an anti–PD-L1 antibody. The objective of this study was to see whether or not the immunotherapy would improve outcomes compared to chemotherapy alone. At the second interim analysis of this trial, with 75% of events, the trial was stopped. The results were reported out at a median follow-up of 37.2 months. The chemoimmunotherapy was associated with a hazard ratio of 0.5, indicating that there was a reduction in recurrence or death by 50% compared to the FOLFOX arm. So these are impressive results we regard as practice-changing, and I would comment that the treatments were well tolerated and not associated with really any adverse events that would not be expected with each of the agents. So we regard this treatment as a new standard of care for this patient population, and it really demonstrates that taking immunotherapy that we're commonly using in this population in the metastatic setting now can be moved to earlier-stage or stage 3 disease to benefit these patients also. So we think this is a very clinically meaningful result for patients, and we're very excited to continue to see if the guidelines will now be adopting this new regimen for our patients.
The ASCO Post Staff
Jamie E. Chaft, MD, FASCO, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, reviews results of the NeoADAURA trial, which looked at neoadjuvant osimertinib with or without chemotherapy vs chemotherapy alone in patients with resectable EGFR-mutated non–small cell lung cancer (NSCLC) (Abstract 8001).
The ASCO Post Staff
Andrew J. Armstrong, MD, MS, of Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University School of Medicine, discusses the 5-year overall survival analysis of the ARCHES trial, which investigated enzalutamide plus androgen-deprivation therapy in patients with metastatic hormone-sensitive prostate cancer (Abstract 5005).
The ASCO Post Staff
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).
The ASCO Post Staff
Asaf Maoz, MD, of Dana-Farber Cancer Institute/Mass General Brigham/Harvard Medical School, discusses the sensitivity of age and family history criteria for determining eligibility for pancreatic cancer surveillance among individuals with a hereditary risk for the malignancy (Abstract 10500).
The ASCO Post Staff
Gerhardt Attard, MD, PhD, of the Cancer Institute, University College London, presents findings from the phase III AMPLITUDE trial, which looked at the combination of niraparib and abiraterone acetate plus prednisone for patients with metastatic castration-sensitive prostate cancer with alterations in homologous recombination repair (HRR) genes (Abstract LBA5006).