What is the Best Treatment in the Neoadjuvant Setting for Rectal Cancer?

At ASCO a number of studies showed the efficacy data of combining 5-FU or Xeloda with oxaliplatin in combination with radiation therapy in patients with rectal cancer. Continue reading…

Posted by Heinz-Josef Lenz, MD on June 30th, 2009
Posted in: From the Desk of Dr. Lenz | 2 Comments »
Tags: chemoradiation, rectal cancer

Dr. Lenz: Genetic Signature Not Helpful to Predict Recurrence in Clinical Practice

At ASCO 2009 Dr. David Kerr from the United Kingdom presented data on a genetic signature which is associated with tumor recurrence in stage II colon cancer. However these data are not even close to being clinically meaningful.

These data have been discussed by Kate Murphy. However I wanted to follow up with the significance of the data. To increase the risk of recurrence from 12% to 22% is not in any way or form helpful in the clinic, particularly because this outcome is independent of treatment effect. Continue reading…

Posted by Heinz-Josef Lenz, MD on June 25th, 2009
Posted in: From the Desk of Dr. Lenz | No Comments »
Tags: ASCO 2009, genetic signature, recurrence risk

Colorectal Cancers Associated with Urological Cancers

A recent study by Dr. Rubin from the University of Chicago evaluated over 180,000 patients with urological cancers such as renal pelvis and ureteral cancers and over 350,000 with colorectal cancer.

It is known that families with a genetic predisposition to colon cancer known as HNPCC (hereditary colorectal cancers) are at higher risk to develop additional cancers such as upper gastrointestinal cancers, ovarian and endometrium cancers but also renal cancers. This is one of the first and largest studies to connect colorectal and urological cancers. Continue reading…

Posted by Heinz-Josef Lenz, MD on June 17th, 2009
Posted in: From the Desk of Dr. Lenz | No Comments »
Tags: colorectal cancer risk, urological cancer

MSI in Stage II Colon Cancer: Chemotherapy or Not?

Some of the most interesting data presented at ASCO was the data on MSI and 18qLOH in a European clinical trial.

Last year at ASCO, Dr. Daniel Sargent presented new data that patients with stage II disease with microsatellite instability do not only not benefit from 5-FU, but they may be harmed, and it was recommended to test for MSI in all stage II colon cancer patients and in the presence of MSI-high not to give 5-FU. For stage III colon cancer that was not the case.

This year, the PETACC-3 clinical trial was analyzed for MSI and did not show the same the same findings. It seems that chemotherapy does not harm these patients, and they may benefit. Continue reading…

Posted by Heinz-Josef Lenz, MD on June 8th, 2009
Posted in: From the Desk of Dr. Lenz | 2 Comments »
Tags: 18qLOH, ASCO 2009, MSI, personalized medicine

Avastin in Stage II and III Colon Cancer

In the plenary session at ASCO this year there was a presentation of a large NASBP trial which tested whether the addition of Avastin® (bevacizumab) to 6 months of FOLFOX would decrease tumor recurrence.

The data suggested that there was no benefit with the addition of Avastin, which was given not only for 6 months along with chemotherapy but 6 months in addition to FOLFOX for a total of 12 months. Continue reading…

Posted by Heinz-Josef Lenz, MD on June 7th, 2009
Posted in: From the Desk of Dr. Lenz | 5 Comments »
Tags: adjuvant chemotherapy, ASCO 2009, Avastin