Gastrointestinal Cancers: mCRC (Issue 6)

Jennifer Wu, MD, discusses the issue of deficiencies in enzymes that fix mismatch repairs in colorectal cancer. Wu says targeting the cancer-specific enzymes which allow tumors to repair themselves could stop tumor growth in patients.

John Marshall, MD, discusses the individualization of treatment of patients with colorectal cancer (CRC).

A first-in-human phase I dose-escalation study followed by a small expansion cohort, both of which were conducted solely in Germany, set the stage for what would soon become the FDA-approved dose for regorafenib (Stivarga) of 160 mg/day.

"While adverse events across both populations were broadly similar, some did occur more frequently in patients with longer exposure, an observation that is possibly related to the longer duration in this subgroup," said Axel Grothey, MD.

Regorafenib offers a unique challenge in terms of AE management. AEs with regorafenib have been reported across several clinical trials, and more recently, a clinical case study demonstrated the utility of regorafenib in a "real world" scenario, adding further insight.

To gain further insight into TAS-102 and regorafenib, Targeted Oncology spoke with Tanios Bekaii-Saab, MD, on how he utilizes currently available data to provide optimal care for patients with chemorefractory CRC.

Many patients with metastatic colorectal cancer (CRC) will ultimately progress on standard first- and second-line therapy while maintaining a good performance status, placing importance on the optimal use of third-line treatments.

Carboplatin/paclitaxel-based chemoradiotherapy (CarPacRT) has sufficient activity to progress into phase II clinical trials as neoadjuvant treatment for patients with resectable esophageal cancer.

Cathy Eng, MD, FACP, medical oncologist, The University of Texas MD Anderson Cancer Center, discusses the combination of bevacizumab with FOLFOXIRI (irinotecan, oxaliplatin, fluorouracil, and folinate) as a treatment for patients with metastatic colorectal cancer (mCRC).