Colorectal Cancer

A Continuum of Care for Metastatic CRC

Manish A. Shah, MD, discusses the HERACLES clinical trial, which explored treatment with trastuzumab (Herceptin) and lapatinib (Tykerb) in patients with HER2-amplified metastatic colorectal cancer.

The PD-1 inhibitor nivolumab showed single-agent activity in previously treated patients with squamous cell carcinoma of the anal canal, resulting in an overall response rate of 24.3%.

Manish Shah, MD, discusses ongoing efforts to understand the distinction between early-onset CRC and traditional CRC.

The combination of trastuzumab (Herceptin) and lapatinib (Tykerb) resulted in a 30% objective response rate (ORR) in heavily pretreated patients with HER2-positive metastatic colorectal cancer (mCRC), suggesting a new targeted therapy strategy for later lines of treatment that supports testing for the aberration.

Treatment Options for Metastatic CRC

The impact of the recent findings regarding tumor sidedness in patients with metastatic colorectal cancer are potentially practice-changing, with data demonstrating that patients with right-sided tumors have a poorer prognosis than those with left-sided tumors. In addition, sidedness could be clinically relevant as a predictive biomarker of response to standard frontline treatments.

Brian Hemphill, MD, provides insight on some of the challenges currently being faced in GI malignancies—specifically, colorectal cancer, pancreatic cancer, and gastic cancer—and how molecular profiles of tumors will dramatically change outcomes for these patients.

Michael J. Overman, MD, medical oncologist, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses updated results from the CheckMate-142 trial, which investigated nivolumab alone or in combination with ipilimumab in patients with DNA mismatch repair deficient/microsatellite instability high metastatic colorectal cancer. 

Arturo Loaiza-Bonilla, MD,&nbsp;the potential role of <em>BRAF</em> and <em>CTNNB1</em> mutations in the survival difference between CRC patients with left- and right-sided tumors.

Ali Maawy, MD, and Patrick M. Boland, MD, provide a brief review of the immune environment of colorectal cancer (CRC) and recently reported studies of immunotherapy in CRC.

John L. Marshall, MD, chief, Division of Hematology and Oncology, Medstar Georgetown University Hospital, discusses the current state of liver-directed therapy in metastatic colorectal cancer.&nbsp;

The results of a randomized trial showed patients with advanced colorectal cancer had a modest gain in progression-free survival with the addition of irinotecan to standard chemotherapy plus an angiogenesis inhibitor as induction therapy.

The latest clinical trial data strongly support anti&ndash;PD-1 therapy as the new second-line treatment standard for patients with microsatellite instability-high metastatic colorectal cancer, says Michael J. Overman, MD.<br /> &nbsp;

An immunotherapy-containing regimen was well-tolerated and had a manageable safety profile in patients with microsatellite-high metastatic colorectal cancer, according to results of a preliminary clinical evaluation presented at the 2017 Gastrointestinal Cancers Symposium<span style="font-size:10.8333px">.</span>

As many as one-third of patients with treatment-resistant colorectal cancer attained objective responses with the stemness inhibitor napabucasin plus FOLFIRI chemotherapy with or without bevacizumab.

Patients receiving the same diagnosis, colorectal cancer with synchronous peritoneal metastases (PM), were offered different treatments that led to dramatically different outcomes based upon the institution in which they were diagnosed.