Colorectal Cancer

The FDA recently released 5 new draft guidance documents that promote broader patient eligibility for cancer clinical trials. The policies encourage inclusion of certain individuals who were previously disqualified due to medical conditions or biological factors, including brain metastases, organ dysfunction, prior or concurrent malignancies, chronic infections, and age.

When bevacizumab was added to capecitabine plus irinotecan, the combined regimen was shown to be a safe and effective second-line treatment option for patients with metastatic colorectal cancer, according to findings from a phase II trial published recently in the International Journal of Clinical Oncology.

A cohort of cancer centers was selected to serve as models for identifying key strategies for racial and ethnic minority group engagement in clinical trials. On the basis of several qualifying criteria, such as sustained accrual of minorities into clinical cancer research, an established minority population ≥10% in the overall catchment, an established clinical trial infrastructure, and a formal community outreach program, the investigators identified 8 cancer centers for participation.

In a case-based-style discussion, Tanios S. Bekaii-Saab, MD, and Wells Messersmith, MD, reviewed the treatment of patients with colorectal cancer whose tumors express rare gene mutations or molecular signatures, such as <em>NTRK</em> fusions.

During a recent&nbsp;<em>Targeted Oncology&nbsp;</em>live case-based peer perspectives presentation, Tanios Bekaii-Saab, MD, discussed with a group of physicians the treatment options for patients with gastrointestinal cancers and the characteristics that influence his decision making. Bekaii-Saab explained his clinical decisions based on the case scenario of one patient with colorectal cancer and one with hepatocellular carcinoma.

Patients with colorectal cancer and liver metastases who&nbsp;underwent laparoscopic surgery had similar long-term rates of overall survival compared with patients who had open liver surgery,&nbsp;according to results of the randomized OSLO-COMET trial. These findings were&nbsp;presented in a press briefing during the 2019 ASCO Annual Meeting.

The combination of encorafenib, binimetinib, and cetuximab reduced the risk of death by 48% in patients wtih&nbsp;<em>BRAF</em> V600E-mutant metastatic colorectal cancer who have received up to 2 prior lines of therapy compared with cetuximab and irinotecan-containing regimens, according to the phase III BEACON CRC trial, which met both its primary endpoints.

Bassel El-Rayes, MD, discusses the key points physicians should consider when treating a patient with metastatic colorectal cancer.

Investigators on a first-in-human phase I trial found that antibody and T-cell responses were detected in a vaccine targeting&nbsp;GUCY2C, a commonly overexpressed protein in patients with early-stage colorectal cancer.<br /> &nbsp;

Scott Kopetz, MD, PhD, FACP, explains the biologic difference between left- and right-sided CRC and highlights recent research on tumor sidedness and its impact on clinical practice.

The combination of atezolizumab and cobimetinib failed to demonstrate a significant benefit compared with regorafenib in a phase III study of heavily pretreated patients with advanced colorectal cancer.

Michael J. Overman, MD,&nbsp;discusses the combination regimen of nivolumab and ipilimumab in metastatic colorectal cancer and highlights existing challenges that still need to be addressed in future research.

A retrospective study revealed an increase in the incidence of colorectal cancer in patients &lt;50 years across all income brackets and demographic groups, according to investigators from The University of Texas at Austin Dell Medical School. The findings were presented at the 2019 Gastrointestinal Cancers Symposium.

Although biomarker discovery has been a challenge in colorectal cancer, new findings suggest the presence of select polymorphisms may be promising in predicting treatment outcomes in patients with colorectal cancer.

Pashtoon M. Kasi, MD, MBBS, MS, discusses how genetic testing is underutilized in colorectal cancer, despite its ability to guide treatment dosing and adjustment based on the mutations or variations within a patient.

Before a community oncology practice considers getting involved in clinical trials research, there are many factorsto consider. Perhaps foremost is the fact that cancer clinical trials provide the evidence base for new advances in oncology.&nbsp;

Artificial intelligence has made inroads in many industries&mdash;banking, finance, security&mdash;but its adoption in healthcare has been lagging and real-world clinical implementation has yet to become a reality. Nonetheless, proponents say it is only a matter of time and pilot programs are starting to yield some practical results.&nbsp;

Pashtoon M. Kasi, MD, MBBS, MS, discusses the patient populations with colorectal cancer that are likely to benefit from immunotherapy treatment.

Wells A. Messersmith, MD, reviews key updates to the NCCN guidelines for the treatment of colorectal cancer.

The combination of FOLFOXIRI plus molecular targeted therapies, including bevacizumab, was effective as a first-line treatment in metastatic colorectal cancer, according to findings from a retrospective study recently published in <em>Oncotarget.</em>

The clinical practice guidelines for the treatment of patients with colorectal cancer have been updated by NCCN to include the combination of&nbsp;encorafenib plus binimetinib in addition to EGFR inhibition with either cetuximab or panitumumab as a Category 2a treatment recommendation for patients with <em>BRAF</em> V600E&ndash;mutant metastatic CRC, after 1 or 2 prior therapies for metastatic disease.

The healthcare community is still awaiting a response from the Centers for Medicare &amp; Medicaid Services to the opposition of the agency&rsquo;s proposal to substantially revise the Medicare Part D protected drug classes.