Cabozantinib/Atezolizumab and the Future of Metastatic Colorectal Cancer Treatment: Thomas Abrams, MD

Thomas Abrams, MD.

Treatment options are limited for patients with metastatic colorectal cancer who have microsatellite-stable disease, which renders them ineligible for immune checkpoint inhibitor therapy. In a cohort of the COSMIC-021 trial, a team of researchers led by Dr. Thomas Abrams, Assistant Professor of Medicine at Harvard Medical School, investigated the efficacy of cabozantinib plus atezolizumab for this patient population. Dr. Abrams recently presented the trial's results at the 2022 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium. In this interview, he discusses the role that cabozantinib/atezolizumab may play for patients with metastatic colorectal cancer, particularly those with RAS wild-type disease, in the coming years.  

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Applying Precision Medicine in BRAF V600E-Mutant Metastatic Colorectal Cancer: Aparna Parikh, MD, MS, and Theresa Gillespie, PhD, MA, RN, FAAN

Oncology Data Advisor™ · Applying Precision Medicine in BRAF V600E-Mutant Metastatic Colorectal Cancer Colorectal cancer is the second leading cause of cancer death among men and women in the United States (ACS,2021). An estimated 149,500 new cases are diagnosed annually, and 52,980 people die of the disease (ACS, 2021). When detected and treated early at a localized stage, the 5-year survival rate is 90%. However, because colorectal cancer initially exhibits no symptoms and the use...

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Challenges and New Developments in Metastatic Colorectal Cancer With Tanios Bekaii-Saab, MD

Despite the many obstacles associated with treating and managing patients with metastatic colorectal cancer, the ongoing study of several novel agents has the potential to significantly improve the outcomes of these patients in the coming years. In this interview, Tanios Bekaii-Saab, MD, Professor of Medicine at the Mayo Clinic Cancer Center in Phoenix, Arizona, discusses strategies to optimize the management of metastatic colorectal cancer and the promising developments which may advance treatm...

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Treatment Options for Patients with Metastatic Colorectal Cancer: Jaffer A. Ajani, MD

Colorectal cancer is the third leading cause of cancer death among men and women in the United States. Each year, there are 149,500 new cases of colorectal cancer, and 52,980 people die from the disease. Treatment choice depends on many factors, including patient characteristics, tumor characteristics, molecular characteristics, and patient preferences. Approximately 21% of patients present with metastatic disease, which has a five-year survival rate of only 14%. Results from the CRYSTAL and PRI...

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Colorectal Cancer Surgery: Still Safe During the Pandemic

According to a new study, patients undergoing surgery for colorectal cancer experienced a low rate of COVID-19 infection during the postoperative period, suggesting that colorectal cancer surgery can be performed with minimal risks during the pandemic. "With the COVID-19 pandemic, the management of patients with cancer has been significantly impacted, from diagnosis to follow-up, leading to a proposal of treatment strategy adaptations," write the investigators of the COVID-GRECCAR study, led by ...

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For Patients With Metastatic Colorectal Cancer, Diet Does Not Improve Survival

Diet quality did not improve overall survival in patients with metastatic colorectal cancer (mCRC), according to a prospective cohort study published today in JAMA Network Open. The investigators, led by Erin Van Blarigan, Scd, Assistant Professor of Epidemiology & Biostatistics and of Urology at the University of California, San Francisco, evaluated the diet qualities of 1,284 patients with metastatic colorectal cancer from October 2005 to February 2012. The patients were enrolled into Canc...

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Cancer Overscreening in Older Adults: Jennifer L. Moss, PhD

According to a study recently published in JAMA Network Open, a high proportion of older adults with average cancer risk are overscreened for colorectal, cervical, and breast cancers after surpassing specified upper age limits recommended by the US Preventive Services Task Force (USPSTF). In this interview, Jennifer L. Moss, PhD, first author of the study, discusses the significance of these findings, explains the risks of overscreening, and shares advice for reducing overscreening among older a...

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Cancer Overscreening High Among Older Adults

Overscreening for colorectal, cervical, and breast cancer is prevalent among older adults in the United States, according to the results of a new study. While routine cancer screening for adults with average cancer risk is recommended by the US Preventive Services Task Force (USPSTF), it is recommended that screening be discontinued once individuals reach a specified upper age limit, defined as age 75 for colorectal cancer, age 65 for cervical cancer, and age 74 for breast cancer. However, many ...

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Hypertensive Medications and Reduced Colorectal Cancer Risk: Wai K. Leung, MD

In this interview, Wai K. Leung, MD, speaks with i3 Health about his research team's finding, recently published in Hypertension, that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are associated with a decreased risk of colorectal cancer within three years of colonoscopy. Dr. Leung discusses the significance of the study's results and shares potential reasons behind the link between ACE inhibitor and ARB use and reduced colorectal cancer risk. Can you c...

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Colorectal Cancer: Common Blood Pressure Medications May Reduce Risk

Taking angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) is associated with a decreased risk of colorectal cancer within three years of colonoscopy, according to the results of a new study. By inhibiting or blocking angiotensin, a protein that raises blood pressure by constricting the arteries, ACE inhibitors and ARBs treat heart disease, heart failure, and high blood pressure. Whether ACE inhibitors and ARBs can also play a role in cancer prevention, howeve...

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Family History-Based Colorectal Cancer Screening: Samir Gupta, MD

Colorectal cancer rates in younger adults are currently rising, and those with a family history of the disease face an even greater risk. Samir Gupta, MD, Chief of the Gastrointestinal (GI) Section of the San Diego Veterans Affairs Healthcare System, recently spoke with i3 Health about his research team's finding, now published in Cancer, that only 25% of patients between the ages of 40 to 49 who were diagnosed with colorectal cancer as a result of screening met the family history-based early sc...

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Encorafenib/Cetuximab for BRAF V600E–Mutant Metastatic Colorectal Cancer: Scott Kopetz, MD, PhD, FACP

After patients with metastatic colorectal cancer who have a BRAF V600E mutation stop responding to first-line treatment, they have a median survival of only four to six months. These patients now have a new option in a combination therapy consisting of encorafenib (Braftovi®, Array BioPharma) and cetuximab (Erbitux®, Lilly), which was approved by the FDA earlier this month for adults with previously treated BRAF V600E-mutated metastatic colorectal cancer. In this interview with i3 Health, Scott ...

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Family History-Based Screening Improves Colorectal Cancer Detection

In individuals with a family history of colorectal cancer, early screening improves detection, leading to a better prognosis in younger patients with this condition. Colorectal cancer rates in adults under the age of 50 are currently on the rise, and individuals with a family history of the disease face an even higher risk than the general population. Several societies, including the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiol...

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Encorafenib/Cetuximab Approved: Metastatic Colorectal Cancer With BRAF V600E Mutations

​The FDA has now approved encorafenib (Braftovi®, Array BioPharma) in combination with cetuximab (Erbitux®, Lilly) for adults with previously treated metastatic colorectal cancer (CRC) with a BRAF V600E mutation, as detected by an FDA-approved test. "Patients with metastatic colorectal cancer with the BRAF V600E mutation have a poor prognosis, with a median overall survival of 4 to 6 months after failure of initial therapy," write Scott Kopetz, MD, PhD, FACP, and colleagues in their publica...

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RNF43 Variation and Cetuximab Efficacy in Metastatic Colorectal Cancer: Francesca Battaglin, MD

​In metastatic colorectal cancer, there has been a concerted effort to identify biomarkers that can predict the efficacy of existing treatments and support the development of new targeted therapies. As part of these efforts, Francesca Battaglin, MD, and colleagues investigated the association between cetuximab efficacy and gene expression levels and genetic variants in the R-Spondin/RNF43 complex. For their analysis, the researchers used genomic DNA from blood samples of participants in the phas...

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BRAF V600E-Mutant Colorectal Cancer: Triplet and Doublet Therapies Improve Quality of Life

An updated analysis of a phase 3 trial reports that encorafenib/cetuximab, alone or in combination with binimetinib, improves quality of life compared with the current standard of care in patients with BRAF V600E-mutant metastatic colorectal cancer whose disease progressed after one or two prior therapies. The BEACON CRC study, the results of which were published in the New England Journal of Medicine in October, investigated the efficacies of encorafenib/cetuximab/binimetinib (triplet therapy) ...

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Incidence of Cardiotoxicity Induced by 5-FU and Capecitabine in Colorectal Cancer Patients

Fluoropyrimidines, such as 5-fluorouracil (5-FU) and capecitabine, are standards of care in treating gastrointestinal cancers, breast cancer, and head and neck cancers. However, both 5-FU and capecitabine can potentially induce cardiotoxicity that presents as acute coronary syndromes. A team of researchers led by Anne Dyhl-Polk, PhD of the Department of Oncology at the Herlev-Gentofte Hospital in Copenhagen, Denmark, set out to compare the incidence of cardiotoxicity caused by 5-FU and capecitab...

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Continued Induction, Maintenance, or Observation: Which Is Most Effective for Metastatic Colorectal Cancer?

For patients with metastatic colorectal cancer, the standard treatment is induction combination chemotherapy with a targeted agent. However, clinical trials that involved patients either continuing cytotoxic therapy until disease progression or observation have shown inconsistent efficacy results. To close this gap, a systematic review and network meta-analysis was conducted and revealed that continued induction therapy until progression offered no survival benefit compared with maintenance fluo...

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Triplet Therapy for BRAF V600E-Mutated Metastatic Colorectal Cancer

In metastatic colorectal cancer, the BRAF V600E mutation, which affects around 10% of patients, portends a poor outcome. Initial standard chemotherapy often fails, and after it does, patients survive for a median of only 4 to 6 months. A phase 3 trial reports a significant improvement in overall survival with two different treatments: a triplet therapy consisting of encorafenib (BraftoviTM, Array BioPharma), binimetinib (MektoviTM, Array BioPharma), and cetuximab (Erbitux®, Eli Lilly); and ...

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Novel Treatments for High-Risk Rectal Adenocarcinoma: Carlos Fernández-Martos, MD

​Carlos Fernández-Martos, MD, and colleagues recently reported that in patients with high-risk, locally advanced rectal adenocarcinoma, adding aflibercept (Zaltrap®, Regeneron Pharmaceuticals, Inc.) to a modified schedule of fluorouracil/leucovorin/oxaliplatin (FOLFOX6) followed by standard chemoradiotherapy and total mesorectal excision surgery increased treatment efficacy, producing a higher complete pathologic response rate. In this interview with i3 Health, Dr. Fernández-Martos discusses the...

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