Colorectal Cancer

Clinical Approach for Left-Sided Metastatic Colorectal Cancer

Progression of Left-Sided Metastatic Colorectal Cancer

Even as immunotherapy grows more popular as a treatment for solid tumors, physicians are racing to identify patients with the molecular subtypes, rather than the disease, who will derive the most benefit.

Ulixertinib, a novel ERK1/2 inhibitor, demonstrated encouraging antitumor activity in patients with solid tumors harboring mutations in the MAPK/ERK pathway, according to the results of a phase I study published in <em>Cancer Discovery</em>.

Updated findings of the CheckMate-142 study presented by Michael J. Overman, MD, at the 2018 Gastrointestinal Cancers Symposium&nbsp;continued to support the use of nivolumab alone or in combination with ipilimumab for previously treated patients with DNA mismatch repair-deficient/microsatellite instability-high metastatic colorectal cancer.

Tanios Bekaii-Saab, MD, professor of medicine, Mayo Clinic, discusses a randomized phase II trial to evaluate dosing strategies for regorafenib (Stivarga) in patients with refractory metastatic colorectal cancer.

According to results reported at the 2018 Gastrointestinal Cancers Symposium, early&nbsp;signs of efficacy were seen with the&nbsp;investigational oral cancer stem cell pathway inhibitor napabucasin (BBI608) combined with the PD-1 inhibitor pembrolizumab (Keytruda) in the first 8 patients enrolled in a multicenter phase I/II trial of patients with metastatic colorectal cancer.

Superior overall survival was induced with sequencing regorafenib (Stivarga) before cetuximab (Erbitux) compared with the reverse sequence in patients with metastatic colorectal cancer following failure of standard chemotherapy, according to findings from the phase II&nbsp;REVERCE study presented at the 2018 Gastrointestinal Cancers Symposium.

According to 2 analyses presented at the 2018 Gastrointestinal Cancers Symposium, data from the CheckMate-142 study support the use of nivolumab (Opdivo) alone or in combination with ipilimumab (Yervoy) for the treatment of&nbsp;patients with previously treated DNA mismatch repair-deficient/microsatellite instability-high metastatic colorectal cancer.

According to findings reported during the 2018 Gastrointestinal Cancers Symposium, a weekly dose-escalation&nbsp;strategy of regorafenib (Stivarga) beginning at 80 mg and ending at 160 mg was found to be superior than the previously standard starting dose of 160 mg in patients with metastatic colorectal cancer.

A novel circulating tumor cell assay has demonstrated a high accuracy of up to 88% for detecting early-stage colorectal cancer, according to the results of a prospective study from Taiwan released ahead of a presentation at the 2018 Gastrointestinal Cancers Symposium in San Francisco, California. The study marks the first to show a high sensitivity for detecting precancerous lesions, as prior studies tended to identify later-stage CRCs.

Cathy Eng, MD, FACP, professor, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, discusses ongoing clinical trials in the <em>BRAF</em>-mutant colorectal cancer patient population.

John L. Marshall, MD,&nbsp;recaps some of the biggest CRC advancements of 2017, and explained what those successes mean for the treatment paradigm moving forward.

According to findings from the phase III TERRA trial published in the <em>Journal of Clinical Oncology, </em>previously treated Asian patients with metastatic colorectal cancer saw a significant survival benefit with TAS-102&nbsp;(trifluridine and tipiracil; Lonsurf) compared with placebo.

According to the results of the randomized phase III&nbsp;AXEPT clinical trial, a chemotherapy doublet has proved noninferior to treatment with standard FOLFIRI (folinic acid [leucovorin], fluorouracil [5-FU], and irinotecan) for patients with previously treated metastatic colorectal cancer (mCRC).¹

John L. Marshall, MD,&nbsp;chief, Division of Hematology/Oncology, Medstar Georgetown University Hospital, director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, discusses the progress that has been made with immunotherapy in the treatment of colorectal cancer.