S. Gail Eckhardt, MD

S. Gail Eckhardt, MD, professor and head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center, discusses the role of regorafenib in colorectal cancer.

Regorafenib is a great option for community physicians who do not have access to clinical trials

The approval of regorafenib gives physicians a level of activity to improve upon but is only an incremental improvement for patients

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S. Gail Eckhardt, MD, discusses the role of regorafenib in colorectal cancer.

The Role of Regorafenib in Colorectal Cancer

S. Gail Eckhardt, MD, professor and head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center, discusses the role of angiogenesis inhibitors for the treatment of metastatic colorectal cancer (mCRC), following the approval of aflibercept.

Eckhardt notes that she has not administered aflibercept, not because of bias, but rather due to a lack of a formal comparison to bevacizumab. Both agents possess a unique toxicity profile in addition to the toxicity associated with the chemotherapy that is co-administered, Eckhardt notes. As such, new side effect management techniques would be required in this space.

Without a formal comparison to bevacizumab, Eckhardt remains unsure where to position aflibercept in the treatment sequence for patients with mCRC. There is evidence that bevacizumab works beyond progression, Eckhardt notes, but it remains unclear if aflibercept possesses these same properties. However, clinical trials have shown that aflibercept is effective following bevacizumab and may be an ideal choice as a second-line treatment.

There are data suggesting that agents inhibiting angiogenesis can be moved around in the sequence during the treatment of renal cell carcinoma, Eckhardt points out. However, this approach has not been examined for patients with colorectal cancer.

A formal comparison between aflibercept and bevacizumab is lacking, leaving physicians unsure where to position aflibercept in the treatment sequence for patients with mCRC

There is evidence that bevacizumab works beyond progression, but it remains unclear if aflibercept possesses these same properties

Clinical trials have shown that aflibercept is effective following bevacizumab and may be an ideal choice as a second-line treatment

S. Gail Eckhardt, MD, discusses the role of angiogenesis inhibitors for the treatment of metastatic colorectal cancer (mCRC), following the approval of aflibercept.
 

Angiogenesis Inhibitors in mCRC

S. Gail Eckhardt, MD, Professor and Head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center, discusses the wnt pathway and its role in colorectal cancer.

Eckhardt says the wnt pathway is highly mutated in colorectal cancer and has been linked to the regulation of the adenomatous polyposis coli (APC) gene and stem cells.

In addition to being a target to treat colorectal cancer, Echkardt says, the wnt pathway is also an area of interest in pancreatic cancer because of the stem cell component.

As the wnt pathway is redundant and complex, Eckhardt says, a combination approach could be most beneficial.

In pancreatic cancer, chemotherapy would be used to de-bulk a tumor before a stem cell targeted wnt inhibitor is administered, Eckhardt says. In colorectal cancer, the MEK pathway and the wnt pathway are both targeted.

The wnt pathway is highly mutated in colorectal cancer and has been linked to the regulation of the APC gene.

Since the wnt pathway is very redundant and complex, a combination approach is used when targeting the pathway.

S. Gail Eckhardt, MD | Authors

Articles

The Role of Regorafenib in Colorectal Cancer

Angiogenesis Inhibitors in mCRC

The Wnt Pathway and its Role in Colorectal Cancer