While there weren’t new blockbuster announcements for colorectal cancer this year at the American Society for Clinical Oncology’s (ASCO) Annual Meeting, there was plenty of focus on making what we already have work better and on choosing the patients who will benefit the most from treatments, as well as those who might not be helped at all. (Note, many of these issues will be discussed in detail on our upcoming patient webinar.)

Highlights:

• While adding oxaliplatin to 5-FU improves five year survival slightly for stage II colon cancer, it increases side effects, particularly tingling and numbness in the feet.  An analysis of several NSABP trials found that two or three more stage II patients out of every 100 would be alive five years later if they were given oxaliplatin in addition to 5-FU than if they only got 5-FU.  Risk of cancer returning was similar with an absolute improvement of 3 to 5 percent, depending on risk factors.  Doctors and patients need to think about whether the small benefit is worth the risk of neuropathy that may become permanent.
• Two speakers at the Saturday colorectal cancer oral abstract session addressed adding oxaliplatin to 5-FU as part of pre-surgical chemoradiation treatment for rectal cancer.  NSABP R-04 found that oxaliplatin did not help increase complete response rates, avoid colostomies, or downstage cancers. It did increase diarrhea significantly. On the other hand, early results from a German trial did find an increase in complete responses with oxaliplatin, and they didn’t see worse side effects.
• In the PRIME phase III clinical trial, patients receiving their first treatment for advanced colorectal cancer who had normal or wild-type KRAS genes in their tumor did better when Vectibix® (panitumumab) was added to FOLFOX chemotherapy.  But those patients whose tumor KRAS was mutated actually did worse than patients who only got chemotherapy.
• Side effects, while difficult for patients, may predict better outcomes from treatment.  Patients who got capecitabine as part of pre-surgical chemoradiation and developed hand-foot syndrome had fewer recurrences three years later and better survival at five years.  In another study of breast, lung, and colorectal cancer, patients who got high blood pressure while on Avastin® (bevacizumab) lived longer and it took longer before their cancer got worse.

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On Monday, April 25th, Fight Colorectal Cancer held a free patient webinar that tackled the somewhat complex but fascinating topic of personalized medicine.

Personalized medicine is what the cancer community calls treatments that are tailored to each patient’s genetic makeup. It is the future of cancer care and in some cases, it is already making a big difference in the ways patients are treated.

You can learn about these cutting edge treatments and about emerging findings in an archive of the webinar below.

Our thanks to Carolyn Grande, CRNP, AOCNP for leading the discussion. She a phenomenal educator on this topic and a member of our Medical Advisory Board. She graciously donated her time to bring this information to patients.

Patients being treated for the first time with chemotherapy and Avastin® (bevacizumab) do worse if Vectibix™ (panitumumab) is added to their chemotherapy.  Median time until the cancer progresses is shorter, and they have more serious side effects.

KRAS status made no difference.  Both patients with wild-type and mutated KRAS in their tumors had worse outcomes when panitumumab was part of their treatment.

The research team recommends that Vectibix not be added to chemotherapy with Avastin to treat colorectal cancer that has spread. Read the rest of this entry »

Clarient Inc. announced the launch of a commercially available test for the BRAF mutation in colorectal cancer.  The test detects mutations in colorectal cancer tumor tissue.

In a recent study, patients with mutated BRAF did not respond to treatment with two drugs that block epidermal growth factor receptors (EGFR) — Erbitux® (cetuximab) and Vectibix™ (panitumumab).  Patients in the study all had normal, wild-type KRAS, another mutation that blocks response to Erbitux and Vectibix. Read the rest of this entry »

Nearly all patients who are treated with Vectibix™ (panitumumab) will develop an itchy skin rash that looks something like acne.  However, treating the rash preemptively  before it appears reduces its severity and lengthens the time before more serious rash appears.

During the STEPP (Skin Toxicity Evaluation Protocol with Panitumumab) trial, researchers randomized patients who were being treated with Vectibix to either preemptive skin rash management at the beginning of chemotherapy or reactive treatment once rash appeared.  After six weeks, 70 percent of patients treated preemptively had not developed grade 2 skin rash.  Sixty-two percent of the reactive group already had rash that was grade 2 or higher. Read the rest of this entry »