ASCO Focuses on Personalized Medicine for Colorectal Cancer

Update from 2008 ASCO Meeting in Chicago

Some thoughts from Kate Murphy. . .

We’ve known for a long time that cancer isn’t one disease and that colorectal cancer isn’t one disease either.  Too often the only way to know if a treatment would work for a patient was to give it to them and wait.  Meanwhile, the patients struggled through side effects, not knowing if the treatment was going to really help or not.  And — even worse — lost valuable time that might have been spent with a more effective therapy.

Probably the most important theme at ASCO this year for colorectal cancer is that we now have real tools to target the right therapy to the right patient.

On Sunday at the Plenary Session — the big meeting for everyone where the most important cancer breakthroughs are discussed — Dr. Eric Van Cutsem presented the results of the Crystal trial with a special focus on KRAS. Crystal randomized patients who had not be treated for metastatic colorectal cancer before to FOLFIRI or FOLFIRI plus Erbitux® (cetuximab).

KRAS is a gene that contributes to the division of cancer cells and the growth of tumors.  In about 35 to 40 percent of colorectal cancer patients, it is mutated. Other patients don’t have this mutation, and their KRAS is normal or wild type. While patients with wild type KRAS benefit when Erbitux is added to FOLFIRI, patients with mutated KRAS don’t.  They have no better response or progression-free survival.  Testing tumors for KRAS mutations before beginning treatment with Erbitux avoids futile treatment with its unnecessary side effects and disappointments.

Other research discussed on Saturday also showed that people with KRAS mutations just don’t benefit from Erbitux or Vectibix™ treatment, either in first-line treatment with FOLFOX or in later therapy.

The good news is that people with no mutation in KRAS (wild type) may have better outcomes than we previously thought.  Overall results from the CRYSTAL trial included both people with mutated and wild type KRAS.  But when just wild type patients were analyzed, there was better response and progression-free survival. Dr. Van Cutsem urged that patients be tested for KRAS before deciding on treatment for metastatic colorectal cancer.

In the morning, I met with several researchers who had colorectal cancer posters for discussion.  Posters provide more detailed information about research being presented at ASCO than the brief abstracts.

A break at lunchtime gave me a chance to sit with other C3 staff and board members behind the C3 booth in the Exhibit Hall.  Judi Sohn, Vice President for Operations, maintains the booth and provides information about C3′s work to people attending ASCO.  She cheerfully hands out Cover Your Butt bracelets and C3 flyers and newsletters and answers questions.

Another long day . . . but one with important breakthroughs for people with colon and rectal cancer.