Colorectal Cancer

No one doubts that molecular testing has rapidly improved care for patients with colorectal cancer, Stanley R. Hamilton, MD, told his audience at the 2nd Annual International Congress on Oncology Pathology.

Results from a prospective study involving 15,045 tumor samples that underwent next-generation sequencing using MSK-IMPACT and microsatellite-instability testing demonstrate that MSI-high and DNA mismatch-repair deficient tumors are predictive of Lynch syndrome across all tumor types. The results suggest that LS-associated cancers may be more heterogeneous than previously suspected.

John L. Marshall, MD, chief of the  Division of Hematology/Oncology at Medstar Georgetown University Hospital, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, discusses the use of chemotherapy in patients with colorectal or other gastrointestinal cancers. He also highlights the importance of understanding each individual patient’s needs before making a treatment decision. 

The triplet combination of&nbsp;the BRAF inhibitor encorafenib, the MEK inhibitor binimetinib, and the EGFR inhibitor cetuximab has been granted a breakthrough therapy designation by the FDA for the&nbsp;treatment of patients with <em>BRAF</em> V600E&ndash;mutant metastatic colorectal cancer following 1 or 2 prior lines of treatment in the metastatic setting.&nbsp;The designation will expedite the development and review of the novel triplet in this setting.

The FDA issued several approvals in July, including in colorectal cancer, breast cancer, prostate cancer, and acute myeloid leukemia.&nbsp;Here&rsquo;s a look back on the FDA happenings for the month of July 2018.

Richard Kim, MD, recently shared his treatment considerations and decisions he makes when treating patients with hepatocellular carcinoma and colorectal cancer. Kim explained his treatment decisions based on 2 gastrointestinal case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives program.

An accelerated approval has been granted by the FDA for the combination of nivolumab plus ipilimumab for the treatment of both adult and pediatric patients, over the age of 12 years, with microsatellite instability-high or mismatch repair deficient metastatic colorectal cancer, following progression on treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.&nbsp;

Consistent benefits and safety were seen with TAS-102&nbsp;(trifluridine/tipiracil; Lonsurf) in a real-world treatment setting for patients with&nbsp;refractory metastatic colorectal cancer, according to preliminary data from the phase IIIb open-label PRECONNECT trial.&nbsp;

A strategy of escalating regorafenib from 80 mg to 160 mg per day was superior to starting at a dose of 160 mg per day in patients with refractory metastatic colorectal cancer, according to results from the regorafenib dose optimization study presented at the 2018 World Congress on GI.

According to findings from the&nbsp;IMblaze370 study, atezolizumab alone or in combination with cobimetinib did not demonstrate superior overall survival when compared with regorafenib for the treatment of&nbsp;patients with chemorefractory metastatic colorectal cancer. Findings from the study were presented at the 2018 World Congress on Gastrointestinal Cancer.

Treatment with&nbsp;trifluridine/tipiracil combined with bevacizumab improved&nbsp;progression-free survival over capecitabine plus bevacizumab in patients with&nbsp;metastatic colorectal cancer who are not eligible for chemotherapy or surgical resection,&nbsp;according to findings presented at the 20th World Conference of Gastrointestinal Cancer.&nbsp;<br /> &nbsp;

Bert H. O&rsquo;Neil, MD, recently shared his considerations for treatment when treating patients with gastrointestinal cancers. O&rsquo;Neil reviewed how he would treat patients with colon cancer and patients with hepatocellular carcinoma based on case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives presentation.<br /> &nbsp;

Things are looking up in the world of adjuvant therapy for patients with gastrointestinal cancers, according to Diane Reidy-Lagunes, MD.&nbsp;During her presentation, Reidy-Lagunes outlined the current state-of-the-art in GI cancer care, with findings from pivotal studies in gastric, pancreatic, biliary, and colorectal cancers.

The Hutchinson Institute for Cancer Outcomes Research released the first Community Care Cancer in Washington State: Quality and Cost Report to provide transparency for patients and health providers, establishing a more value-based care model.

Todd Yezefski, MD, a senior fellow in the Clinical Research Division at the Fred Hutchinson Cancer Research Center, discusses the results of a trial investigating cost and outcome differences in patients with metastatic colorectal cancer in the United States and Canada. Specifically, he looked at patients in Washington and British Columbia. This data was presented at the 2018 ASCO Annual Meeting.

In patients with&nbsp;peritoneal carcinomatosis undergoing surgery, the addition of heated chemotherapy to the abdomen during surgery did not provide a survival benefit, data&nbsp;from a phase III study presented at the 2018 ASCO Annual Meeting, in Chicago, Illinois, showed.