Tag Archives: metastatic colorectal cancer

Adding Erbitux to First Line Chemotherapy Helps Advanced Colorectal Cancer Patients with Wild Type KRAS

Does adding Erbitux to chemotherapy help people whose colorectal cancer has spread beyond the colon or rectum to distant body sites? The answer is yes, according to a pooled analysis of two large randomized clinical trials comparing chemotherapy alone to chemotherapy plus Erbitux® (cetuximab).  However, benefits depend on whether or not patient tumors have mutations of two genes, KRAS and BRAF. Previous studies have shown that only patients with normal or wild type KRAS get any benefit from EGFR inhibitors Erbitux or Vectibix™ (panitumumab) so a combined analysis of the CRYSTAL and OPUS studies looked only a outcomes in KRAS wild type tumors.  In addition, the research team studied the

Young People with Advanced Colorectal Cancer Do As Well with Chemotherapy as Older Patients

When colorectal cancer spreads to other parts of the body, young people under 50 who get chemotherapy benefit as much as those who are older. With drug combinations, there is no difference between those under 50 and those who are 50 and older in responding to chemotherapy, how long it takes before cancer gets worse, or in survival time.

Early Tumor Shrinkage Points to Good Erbitux Outcomes

Patients with advanced colorectal cancer whose tumors have gotten smaller six weeks after starting treatment with Erbitux had a much longer time before their cancer got worse and almost twice the overall survival as patients whose tumors didn’t shrink. Patients in the BOND study had already gotten worse on standard chemotherapy and were receiving either Erbitux® (cetuximab) alone or in combination with irinotecan.  CT scans  for about a third of them showed at least a 10 percent decrease in the size of their tumors six weeks into treatment.

Primary Colorectal Tumors Can Be Safely Left in Place

When cancer has spread beyond the colon or rectum, the primary colorectal tumor can safely be left in place with only rare complications. Surgeons at Memorial Sloan Kettering Cancer Center in New York followed 233 patients who began chemotherapy without surgery to remove their primary colon or rectal tumor. Almost 90 percent never had a problem with their tumor that needed intervention with surgery, radiation, or a stent. Only 7 percent required emergency surgery.

Almost There: Colon Cancer Clinical Trial Needs Six More Patients

NSABP C-10 needs only six more patients to complete enrollment and prepare to answer the question: Is it safe and effective to leave a primary tumor without symptoms in the colon or rectum and proceed directly to chemotherapy in patients with colon cancer that has spread to distant organs where it cannot be surgically removed, The trial has already enrolled 84 of the 90 patients with metastatic colon cancer needed. All patients in the study will be treated with FOLFOX (oxaliplatin, leucovorin, and continuous infusion 5-FU) and Avastin® (bevacizumab) every two weeks for as long as their cancer doesn’t get worse and they are able to tolerate side effects.  

Intense Combination Chemotherapy Enables Surgery for Initially Unresectable Colorectal Mets

Treated with a combination of three chemotherapy drugs, 1 in 5 patients whose colorectal cancer had spread too far for surgery were able to have operations to remove metastatic tumors.  After five years, a third of them were alive with no sign of cancer. Doctors in Italy treated 200 stage IV patients with a combination of 5-FU, oxaliplatin, and irinotecan (FOLFOXIRI) during three different clinical trials.  While all three drugs are commonly used to treat colorectal cancer, they are not usually used at the same time.  Initially, all of the patients had cancer that had spread beyond the possibility of having it removed surgically.

NCCN Updates Guidelines to Include KRAS Testing

The National Comprehensive Cancer Network (NCCN) has updated their Clinical Practice Guidelines in Oncology for Colon Cancer to include testing tumors from patients with metastatic colon cancer for the KRAS gene.  The Guidelines also now say that cetuximab (Erbitux®) and panitumumab (Vectibix™) should only be given to patients whose tumors have normal (wild-type) KRAS.

Continuing Avastin Beyond Initial Cancer Progression Improves Survival Time

Continuing Avastin® (bevacizumab) beyond the time when advanced colorectal cancer gets worse helps patients, according to new study reports.  Patients who continued to receive Avastin with a new chemotherapy regimen after their cancer first progressed lived almost 12 months longer than patients who got more chemo but stopped Avastin.  Both groups did better than those who had no further treatment at all. BRiTE (Bevacizumab Regimens: Investigation of Treatment Effects and Safety) observed progress of three groups of patients when their cancer got worse after their first chemotherapy treatments.  All patients had Avastin as part of the first chemo, some continued it beyond that first cancer progression.

Hypertension Clue to Better Outcomes with Avastin

Patients who developed hypertension with Avastin® (bevacizumab) had better response to treatment for colorectal cancer.  More had tumors shrink, and it took significantly longer for their cancer to get worse. In a small Italian study, researchers measured blood pressure in 39 patients receiving Avastin along with irinotecan and 5-FU for the initial treatment of colorectal cancer.  Eight patients (20 percent) experienced grade 2 or 3 hypertension.

Stents Can Manage Colon Obstruction Effectively

Self-expanding metal stents can help patients with an obstruction from advanced colon cancer avoid surgery. When a large tumor blocks the left side of the colon, surgeons can remove the tumor or put in a stent to move bowel contents around the obstruction.  According to a recent study, patients live as long with either technique but spend less time in the hospital and have fewer complications with stents.