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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 ...
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...