Dr. Lenz on Later-Line Combo Approaches in CRC

Heinz-Josef Lenz, MD, FACP, professor of medicine; J. Terrence Lanni Chair in Gastrointestinal Cancer Research; and co-director of the University of Southern California (USC) Center for Molecular Pathway and Drug Discovery, at the USC Norris Comprehensive Cancer Center, discusses third-line treatment combination approaches in colorectal cancer (CRC).

Beyond the standard-of-care single-agent regorafenib (Stivarga) or single-agent TAS-102 (trifluridine/tipiracil; Lonsurf), very exciting developments with combination therapies in the third-line setting have been reported, says Lenz. One of the most exciting clinical trials presented during the 2019 ASCO Annual Meeting was a trial that examined the use of regorafenib plus nivolumab (Opdivo) in gastric and colon cancer. The data in patients with microsatellite-stable disease showed very promising response rates in CRC, at 36%, and gastric cancer, at 44%. Patients with gastric cancer who were previously progressed on immune-checkpoint inhibitors responded again to regorafenib, indicating that resistance to immune checkpoint therapy can be overcome. 

This is a very important mechanism of action that can be used to better understand the significance of anti-VEGF and immune checkpoint inhibitors are a very important new combination that can be and should be further explored, concludes Lenz.