Browse by Series:

Key Investigations in Advanced Colorectal Cancer

Insights from: Wells A. Messersmith, MD, FACP, University of Colorado Cancer Center
Published: Wednesday, Jun 20, 2018



Transcript: 

Wells A. Messersmith, MD, FACP: The key questions in advanced colorectal cancer have to do with novel therapeutics and biomarkers. In terms of novel therapeutics, there’s a lot of interest in immunotherapy. We know that in microsatellite-high colorectal cancer, which is a small subset, immunotherapy has benefit. The questions are, really, should we use 1 or 2 immunotherapies at a time, what are the best predictive markers in those patients, and, frankly, how long should we give them for? Is there a point where we can stop?

For the vast majority of patients, however—the microsatellite-stable patients—immunotherapy has not been effective, and so there’s a lot of interest in phase I and phase II trials to try to pick up combinations of immunotherapy that will turn microsatellite-stable colorectal cancer from a disease where immunotherapy has not been effective into a disease where it can be effective. Unfortunately, there was a press release recently regarding a combination that had some promise looking at a PD-L1 inhibitor and a MEK inhibitor. Unfortunately, that trial was not positive. I think the hunt will continue to try to find some type of immunotherapy combination that will be effective for microsatellite-stable colorectal cancer.

There’s also a lot of interest in biomarkers in terms of targeted therapies. For instance, can we use circulating tumor DNA from blood tests, which would, hopefully, represent the overall tumor burden in a patient, rather than biopsying one lesion or another, which is invasive, can have complications, and is more expensive? Can we just use a blood test to guide us in terms of what the best therapy would be? Finally, the other thing we’re seeing in 2018 is a sequencing question. Should we use drug A before drug B or drug B before drug A? What is the difference in outcome when we do those types of things?

Transcript Edited for Clarity 
Slider Left
Slider Right


Transcript: 

Wells A. Messersmith, MD, FACP: The key questions in advanced colorectal cancer have to do with novel therapeutics and biomarkers. In terms of novel therapeutics, there’s a lot of interest in immunotherapy. We know that in microsatellite-high colorectal cancer, which is a small subset, immunotherapy has benefit. The questions are, really, should we use 1 or 2 immunotherapies at a time, what are the best predictive markers in those patients, and, frankly, how long should we give them for? Is there a point where we can stop?

For the vast majority of patients, however—the microsatellite-stable patients—immunotherapy has not been effective, and so there’s a lot of interest in phase I and phase II trials to try to pick up combinations of immunotherapy that will turn microsatellite-stable colorectal cancer from a disease where immunotherapy has not been effective into a disease where it can be effective. Unfortunately, there was a press release recently regarding a combination that had some promise looking at a PD-L1 inhibitor and a MEK inhibitor. Unfortunately, that trial was not positive. I think the hunt will continue to try to find some type of immunotherapy combination that will be effective for microsatellite-stable colorectal cancer.

There’s also a lot of interest in biomarkers in terms of targeted therapies. For instance, can we use circulating tumor DNA from blood tests, which would, hopefully, represent the overall tumor burden in a patient, rather than biopsying one lesion or another, which is invasive, can have complications, and is more expensive? Can we just use a blood test to guide us in terms of what the best therapy would be? Finally, the other thing we’re seeing in 2018 is a sequencing question. Should we use drug A before drug B or drug B before drug A? What is the difference in outcome when we do those types of things?

Transcript Edited for Clarity 
View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Medical Crossfire®: Key Questions for the Use of Immunotherapy Throughout the Disease Continuum for NSCLC in an Era of Rapid DevelopmentSep 29, 20181.5
Provider and Caregiver Connection™: Addressing Patient Concerns While Managing GlioblastomaSep 29, 20182.0
Publication Bottom Border
Border Publication
x