Colon cancer has undergone significant changes and has seen increasing treatment options. With more and more drugs available and approved for colon cancer we are facing difficult decisions deciding what is the right treatment at the right time.

For patients with newly diagnosed colon cancer we have two chemotherapeutic regimens: a combination of infusional 5-FU with irinotecan (FOLFIRI) or with oxaliplatin (FOLFOX). Both regimens have shown similar efficacy and similar extent of toxicity however there are differences in the quality of toxicity.  More often FOLFOX has to be stopped because of its neurotoxicity than because it stopped working. Read the rest of this entry »

Sorry but today I am also getting into new and very difficult data to discuss but wanted to give it a shot since you may surf the Net and come across data which are shown to be negative leading to some stress if you are on similar or same therapy.

I attended the European Meeting for Medical Oncology in Berlin two weeks ago, and some new data were presented. Let’s start with the good news which is consistent with all the data we have. In a large randomized phase III trial called CRYSTAL comparing FOLFIRI with or without Erbitux® (cetuximab), the data showed that in patients with wild-type KRAS response rate went up to 60% and time to tumor progression increased about 30% but, so far no overall survival benefit was shown.  The trial was criticized for that. Read the rest of this entry »

We have just published our study on colon cancer clinical outcomes in women versus men. The facts that premenopausal women are protected against developing colon cancer and that postmenopausal women who take hormonal replacement therapy have reduced risk for colon cancer suggest that female hormones are protective. This can be very confusing since estrogen replacement therapy is not recommended for breast cancer patients. Read the rest of this entry »

You may have heard the exciting data on PARP inhibitors for patients with mutations in the BRCA genes reported at ASCO 2009. Patients who carry these mutations are deficient in DNA repair which makes them very sensitive to PARP inhibitors which play a significant role in DNA repair.

Why does that matter for colon cancer? Well, the genetic predisposition HNPCC is caused by another DNA repair deficiency linked to mutations in MLH1, MSH2, MSH6, PMS1 and PMS2. The landmark sign for mismatch repair deficiency is microsatellite instability also called MSI. Read the rest of this entry »

A recent study suggested that patients with colon cancer lived longer when taking aspirin.

Aspirin is a very interesting drug which has showed to reduce the risk of cardiovascular disease and colon cancer risk and is a great pain reliever. The mechanism of action is the inhibition of an enzyme called COX-2. Read the rest of this entry »