As nations develop economically and adopt more Western diet and lifestyle, colorectal cancer increases.  In fact, the United States is the only nation in the world where colorectal cancer incidence rates are falling for both men and women.

Over the past 20 years, colorectal cancer rates have risen in 27 of 51 countries including Eastern Europe, most of Asia, and some South American countries.  Rates for men are rising faster than those for women. Read the rest of this entry »

Although adding Avastin® (bevacizumab) to FOLFOX chemotherapy showed an effect on reducing recurrences in people with stage II and III colon cancer one year after treatment began, the impact began to fade in the second year, and was completely gone at three years.

There was a transient benefit in the year during which Avastin was given every two weeks, with a 40 percent reduction in the risk of recurrence.  At the end of the first year patients who had been given Avastin had a 94.2 percent chance of being alive and cancer-free compared to 90.7 percent of patients who did get it.

However, at three years disease-free survival was 77.4 percent in the Avastin patients compared to 75.5 percent for those without it, a non-significant difference. Read the rest of this entry »

Researchers tried to push the envelope in treating rectal and anal cancer by adding new or different chemotherapy to standard chemoradiotherapy.  However, two trials in rectal cancer and one in anal cancer were not able to improve complete response rates for chemoradiation.  Adding extra chemotherapy after radiation was finished didn’t improve relapse-free survival for anal cancer either. Read the rest of this entry »

Several studies presented at ASCO looked a biomarkers that might predict cancer recurrence or patient survival in stage II and III colon cancer and whether patients could be chosen to receive chemotherapy based on those markers.  Of special interest was the hypothesis offered by two researchers from the PETACC-3 clinical trial that stage II and stage III may be very different biologically.  As Dr. Arnaud Roth said, “. . .in other words, could be different diseases.” Read the rest of this entry »

About 15 percent of people with stage III colon cancer may have fewer recurrences and better survival when they are treated with irinotecan. Although all stage III colon cancers don’t have an additional benefit when irinotecan is added to bolus 5-FU and leucovorin in a treatment called IFL, this smaller group does.

About 15 percent of colon cancers develop when damaged DNA is not repaired and mutated cells grow into malignant tumors.  So-called deficient mismatch repair (dMMR) tumors have features different from most colorectal cancer, including a better prognosis.  They also have a very poor response to 5-FU-based chemotherapy.

However, researchers studying tumor tissue from patients enrolled in a clinical trial comparing 5-FU and leucovorin alone to 5-FU, leucovorin, and irinotecan found that those with deficient mismatch repair tumors who received irinotecan had better disease-free survival and overall survival at five years than patients whose mismatch repair genes were working.  Those with dMMR on the 5-FU-only arm of the trial had no similar benefit. Read the rest of this entry »