Colorectal Cancer

Bevacizumab plus trifluridine/tipiracil demonstrated improved overall survival and progression-free survival vs TAS-102 alone as third-line treatment for patients with refractory metastatic colorectal cancer.

After a brief overview on first-line treatment options for patients with metastatic colorectal cancer, panelists highlight the role HER2 status plays in the selection of novel therapies.

A comprehensive discussion on the barriers to molecular testing in metastatic colorectal cancer, along with challenges in utilizing these tests in the real-world setting.

Panelists consider the potential role for circulating tumor DNA to inform the selection of therapy for patients with metastatic colorectal cancer.

A renewed focus on dismantling the barriers and closing gaps in care will aid in the mission to drive down the rate of cancer mortality and incidence across disease states.

Adding trilaciclib to FOLFOXIRI and bevacizumab led to statistically significant reductions in instances of severe neutropenia during induction and duration of severe neutropenia in cycles 1 to 4. However, the combination failed to improve antitumor activity vs placebo plus FOLFOXIRI/bevacizumab in patients with metastatic colorectal cancer.

Scott Kopetz, MD, discussed the key objectives of the phase 3 BREAKWATER trial being done in patients with BRAF V600E–mutated mCRC, the recently reported safety and efficacy data observed with encorafenib plus cetuximab and chemotherapy, and the importance of conducting biomarker research to further personalize treatment in these patients.

Investigators in the phase 2 SWOG S2107 trial are evaluating encorafenib plus cetuximab and nivolumab for patients with previously treated, microsatellite stable, unresectable, or metastatic colorectal cancer harboring a BRAF V600E mutation.

Shared insight on the value tissue and circulating tumor DNA respectively provide in molecular testing for patients with metastatic colorectal cancer.

Experts in metastatic colorectal cancer management highlight the role of molecular testing and testing modalities available in the academic and community settings.

For decades, resection of the primary tumor, either up front or after neoadjuvant therapy, has remained the standard of care for patients with early-stage (stage I-III) colorectal cancer. Recently, a plethora of data have been published that might change the current surgery-centered paradigm.

With 2 KRAS G12C inhibitors showing encouraging results in combination with anti-EGFR agents, there is a ray of hope for patients with recurrent colon cancer–a treatment that may offer patients the chance to make it to important milestones.

The safety and efficacy of a combination regimen comprised of XL092 and atezolizumab is being compared with that of regorafenib monotherapy in patients with microsatellite stable or microsatellite instability–low metastatic colorectal cancer who have progressed on or are intolerant to standard-of-care therapy.

The MOUNTAINEER-03 trial is designed to evaluate the efficacy of tucatinib and trastuzumab plus modified leucovorin calcium, fluorouracil, and oxaliplatin, compared with standard-of-care, first-line therapy for metastatic HER2-positive colorectal cancer.

John H. Strickler, MD, highlights key findings from the MOUNTAINEER trial and addresses the possibility of moving the combination up to the first line setting.

Six weeks of preoperative oxaliplatin-fluoropyrimidine chemotherapy did not increase perioperative morbidity in patients with radiologically staged T3-4, N0-2, M0 colon cancer, according to findings from the international phase 2/3 FOxTROT trial.

Jason Starr, DO, discusses the characterization of POLE/POLD1 mutations in colorectal adenocarcinoma.

Van K. Morris, MD, discusses the evaluation of circulating tumor as a predictive biomarker for the use of adjuvant chemotherapy in patients with low-risk, stage II colon cancer.

Joleen M. Hubbard, MD, discusses key survival data from the phase 1b study of the PolyPEPI1018 vaccine and the impact of these findings on continued investigations of this vaccine in metastatic colorectal cancer.

Thomas J. George, MD, FACP, discusses long-term data from the phase 2 NRG-GI002 trial of total neoadjuvant therapy in locally advanced rectal cancer.

Geneoscopy has submitted a premarket approval application to the FDA for a noninvasive, stool-based, at-home screening test to detect colorectal cancer and advanced adenomas in average-risk individuals.

The addition of mFOLFOX6 or FOLFIRI to the combination of encorafenib and cetuximab elicited encouraging antitumor activity and safety in patients with BRAF V600E-mutant metastatic colorectal cancer.

A novel Burning Rock patient-specific prognostic and potential therapeutic marker tracking approach demonstrated improved sensitivity in detecting circulating tumor DNA and identifying molecular residual disease compared with other approaches in patients with colorectal cancer following surgery.

Circulating tumor DNA could serve as an ideal biomarker to assess early response in patients with advanced colorectal cancer due to its short half-life compared with other tumor biomarkers, and it could enable the use of adaptive clinical study designs in the future.

The FDA has granted accelerated approval to tucatinib in combination with trastuzumab for adult patients with RAS wild-type, HER2-positive unresectable or metastatic colorectal cancer that has progressed after treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy.

John H. Strickler, MD, discusses the significance of the FDA approval of tucatinib plus trastuzumab in metastatic colorectal cancer.

The Signatera molecular residual disease test was able to detect patients with stage II to IV colorectal cancer who were at an increased risk for recurrence and predict which patients were most likely to benefit from adjuvant chemotherapy.

Tanios S. Bekaii-Saab, MD, FACP, expands on key data reported from the MOUNTAINEER trial, the potential effects of this regimen’s approval on the current treatment landscape, and the continued investigation of this and other targeted approaches in metastatic colorectal cancer.

Neoadjuvant treatment with anti–PD-1 inhibitors induced high rates of complete response and reduced recurrence rates, according to a retrospective analysis of patients with localized mismatch repair-deficient or microsatellite instability–high colorectal cancer.

Christina Wu, MD, discusses key targeted therapies under investigation in patients with colorectal cancer.