Colorectal Cancer

As the new coronavirus disease 2019 creates problems internationally, health-wise and economically, it is also becoming a cause for concern throughout the oncology community.

In an interview with Targeted Oncology, Van K. Morris, MD, discussed a pooled analysis of the TRIBE trials to determine how oligometastatic disease status impacts treatment decisions. He also discussed advances in the field, including novel treatments that are emerging for advanced CRC.

In February 2020, the FDA gave indications to multiple therapies meant for treatment of solid tumor and hematologic malignancies. FDA action included 10 Priority Reviews, 2 Breakthrough Therapy designations, and 2 Fast Track designations.

Van K. Morris, MD, describes the novel treatments he is excited about in the treatment landscapes for colorectal and anal cancers right now.

To help clinicians cope with an increasing number of geriatric patients with cancer, the Association of Community Cancer Centers is addressing this problem with a 2-pronged approach that focuses on the delivery of care and diagnostic assessment.

The incidence of colorectal cancer is rising among people who are below 50 years of age, the colonoscopy screening age as recommended by the United States Preventive Service Task Force of the National Cancer Institute. To date, there is no research that can explain the rise which has led physicians to deliberation on whether the recommended screening age for colonoscopies should be lowered or left as is. During a debate at the 2020 Gastrointestinal Cancers Symposium, Uri Ladabaum, MD, and David S. Weinberg, MD, MSc, presented their stances on the topic.

In an interview with Targeted Oncology, Daniel H. Ahn, DO, discussed the phase Ib/II study of onvansertib plus FOLFIRI and bevacizumab for the treatment of patients with metastatic colorectal cancer  with a KRAS mutation.

Scott Kopetz, MD, PhD, discusses the results of the phase III BEACON CRC study, which was presented at the 2020 Gastrointestinal Cancers Symposium.

Maintenance of quality of life on patient-reported assessments was prolonged with encorafenib plus cetuximab with or without binimetinib, out-performing the standard of care in patients with <em>BRAF</em>&nbsp;V600E-mutant metastatic colorectal cancer.

The combination of regorafenib plus an oral fluoropyrimidine, TAS-102, as third-line treatment in patients with metastatic colorectal cancer, achieved a clinically meaningful disease control rate in the phase I dose-escalation trial REMETY, according to data presented at the 2020 Gastrointestinal Cancers Symposium.

Cetuximab plus mFOLFOX6 with the addition of avelumab resulted in an overall response rate of 81% in patients with RAS/BRAF-wildtype metastatic colorectal cancer, according to results of the phase II AVETUX study that were presented during the 2020 Gastrointestinal Cancers Symposium. But despite promising tumor responses, the trial missed its primary progression-free survival end point.

In an interview with&nbsp;Targeted Oncology, Richard Kim, MD, discussed the research from several trials that support the use of doublet and triplet regimens as treatment of patients with metastatic colorectal cancer harboring a&nbsp;BRAF&nbsp;mutation.

Integrating a geriatric assessment into the care of older adults who are receiving cancer treatment in communi&shy;ty oncology practices improves patient and caregiver satisfaction and encourages commu&shy;nication about aging-related concerns, accord&shy;ing to results of a clinical trial that enrolled 541 patients with advanced cancer.

Benjamin Weinberg, MD, discusses novel agents that may impact the treatment landscape for colorectal cancer once made available in the community setting.

The present and future benefits of telehealth in oncology can be observed through Tahoe For&shy;est Cancer Center and its affiliation with the UC Davis Cancer Center, use of other remote clinics, and participation in virtual tumor boards. Even though there are roadblocks to telehealth reaching more locations and more patients, the potential benefit warrants the time needed to get over those hurdles.

In an interview with&nbsp;Targeted Oncology&nbsp;at the 2019 Ruesch Center Symposium, Benjamin Weingberg, MD, shared key points from his discussion on mining the microbiome in patients with colorectal cancer and summarized the treatment landscape for patients with metastatic disease. He also discussed an upcoming basket trial that uses liquid biopsies to place patients on treatment plans that will be most effective for their individual needs.

Recent study results suggest that guideline recommendations for biomarker testing in metastatic colon cancer are not consistent with real-world care. A retrospective review of the COTA Real World Data database showed suboptimal adherence to testing guidelines for RAS, BRAF, and microsatellite instability (MSI)/mismatch repair deficiency in this patient population.

The FDA has accepted a supplemental new drug application for the combination of encorafenib and cetuximab for the treatment of patients with advanced&nbsp;BRAF&nbsp;V600E-mutant metastatic colorectal cancer, following 1 or 2 lines of therapy, Pfizer, Inc. reported in a press release.<br /> &nbsp;

Historically, colorectal cancer has been viewed as a common cancer among elderly patients. The average age at diagnosis of patients with colorectal cancer in the United States is 67 years,&nbsp;in which a screening colonoscopy remains the gold standard of care for prevention and is recommended for all individuals &gt;50 years of age.

New results from the KEYNOTE-164 trial have shown that patients with previously treated microsatellite instability-high DNA mismatch repair advanced or metastatic colorectal cancer who received pembrolizumab responded well to the drug.

A retrospective study has shown that only 40% of patients with metastatic colorectal cancer received biomarker testing prior to treatment, as recommended in the National Comprehensive Cancer Network guidelines. As a result, patients receive less effective therapies and experience serious adverse events, according to a press release from Guardant Health.

Benjamin Weinberg, MD, discusses&nbsp;his treatment decisions for patients with metastatic colorectal cancer and the role of cetuximab in this patient population.

In an interview with&nbsp;Targeted Oncology, Fr&eacute;d&eacute;ric Lehmann, MD, discussed the results for the alloSHRINK trial that were presented at the SITC 34^thAnnual Meeting. The allogenic CAR T-cell therapy, CYAD-101, in association with FOLFOX chemotherapy showed promising antitumor activity in patients with refractory mCRC.

Immotherapuetic agents have grown in popularity for treating mismatch repair&ndash;deficient (dMMR) metastatic colorectal cancer, becoming the standard of care in the second line, <strong>Howard Hochster, MD</strong>, told an audience at the 2019 Gastrointestinal Oncology Conference. Furthermore, ongoing clinical trials suggest that these agents may play a larger role in treating CRC going forward.

In patients whose solid<strong> </strong>tumors harbor a mutation in <em>KRAS </em>G12C, therapy with MRTX849 has produced promising responses and acceptable toxicity across 3 tumors types, according to data presented at the 2019 American Association for Cancer Research&ndash;National Cancer Institute&ndash;European Organization for Research and Treatment of Cancer International Conference on Molecular Targets and Cancer Therapeutics.