Colorectal Cancer

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to “reflect, renew, and reignite” in order to create a more resilient oncology team for the community.

Among patients with advanced solid tumors associated with <em>NTRK</em> gene fusions, more than half had responses to&nbsp;the small-molecule inhibitor entrectinib, according to an integrated analysis of 3 clinical trials presented at the 2018 ESMO Annual Congress.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

Cathy Eng, MD, discusses how the PRODIGE 7 trial, though negative, provided valuable evidence to the field for treatment of patients with metastatic colorectal cancer with peritoneal carcinomatosis.

Axel Grothey, MD, recently shared the treatment considerations and decisions he makes when treating patients with colon cancer. Grothey, a medical oncologist at the West Cancer Center, explained how he would treat these patients based on case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives presentation.

Pontchartrain Cancer Center was founded in 2005 to serve an area of Louisiana that lacked the necessary resources for cancer care. This community cancer center, with 2 locations in Southeast Louisiana, accommodates any patient to walk through its doors, filling a major unmet need for the community in this rural area.

Ronit Yarden, PhD, MHSA, has joined the Colorectal Cancer Alliance as its new director of medical affairs, where she will work to develop the organization&rsquo;s funding initiatives and act as liaison to its medical scientific advisory committee with the goal of promoting patient education and disease prevention.

Scott Kopetz, MD, PhD, FACP, discusses recent data in <em>BRAF</em>-mutant colorectal cancer and the importance of molecular subtyping.

Adding selective internal radiation therapy to chemotherapy improved overall survival by 5 months compared with &nbsp;chemotherapy alone for patients with liver-only or liver-dominant right-sided primary metastatic colorectal cancer, according to results from a post hoc analysis of 2 randomized, controlled trials.

Two oncologists from the Winship Cancer Institute of Emory University reviewed data for and against the use of chemotherapy for patients with resectable colorectal cancer liver metastases. Mehmet Akce, MD, spoke in favor of chemotherapy, while Shishir K. Maithel, MD, argued against it.

According to findings from the&nbsp;phase IIIb CONSIGN trial, now published in <em>The Oncologist</em>, safety and efficacy findings&nbsp;for regorafenib in patients with previously treated metastatic colorectal cancer were consistent with previous phase III results.

Tanios Bekaii-Saab, MD,&nbsp;shares his insights on the results from the ReDOS trial, as well as the IMblaze370 trial for patients with mCRC

Checkpoint inhibitors have provided practice-changing therapeutic targets for clinicians by regulating host immune response. The treatment landscape in colorectal cancer has significantly changed as a result, but more research is necessary for certain subtypes, particularly the microsatellite stable patient population.

Scott Kopetz, MD, PhD, FACP, associate professor, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the importance of molecular testing in 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&nbsp;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&nbsp; 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&rsquo;s needs before making a treatment decision.&nbsp;

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;