ASCO 2019: Targeted therapy, early-age onset, and chemotherapy

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Fight Colorectal Cancer (Fight CRC) was busy at this year’s conference meeting with leaders in the oncology field, engaging with research advocates, and convening the 7th meeting of the Fight CRC Immunotherapy (IO) Workgroup. Our team tracked the latest developments in research to share those findings with the colorectal cancer (CRC) community, translating what the research means for patients.

If you’ve been following along with the research from the 2019 American Society of Clinical Oncology’s (ASCO) annual conference, you may have noticed that it wasn’t quite the year for groundbreaking research in colon and rectal cancers. However, there were still some promising studies presented that could pave the way for the next big breakthrough.

What We’re Keeping an Eye On

Targeted Therapy

AMG-510: This year, results were presented on AMG-510 which showed a high response rate in both lung and colorectal cancers. AMG-510 targets a KRAS mutation also known as KRAS G12C, which occurs in approximately 3-5% of colon and rectal cancers. In this study, AMG-510 shrank tumors in half of the lung cancer patients enrolled and 13 out of 18 CRC patients had a stable response.

According to Dr.Chris Heery, Chief Medical Officer with Precision Biosciences, “The phase 1 clinical trial results using AMG-510 indicate a great step forward in targeting RAS and transcription factors in general. While the data on the clinical benefit is still early, it appears that the novel approach may be applicable to other transcription factors, including alternate mutations in RAS. This may provide a therapeutic path in many cancers, including metastatic colorectal cancer.”

Trials Affecting Early-Age Onset Colorectal Cancer (EAO CRC) Patients

STARTRK-NG: The STARTRK-NG trial enrolled 29 patients with central nervous tumors, neuroblastoma, and other solid tumors between the ages of 4.9 months and 20 years old. This trial found that entrectinib shrank tumors in all (11/11) of the patients with NTRK, ROS1, or ALK   solid tumors. In February 2019, the Federal Drug Administration (FDA) granted Priority Review for the drug entrectinib for the treatment of adult and pediatric patients with NTRK fusion-positive, locally advanced or metastatic solid tumors who have either progressed following prior therapies or as initial therapy when there are no acceptable standard therapies. This is another step to understand how biomarkers like NTRK can lead to improved treatment options.

Prolonged Rectal Bleeding: Researchers from the University of Colorado Cancer Center presented results on prolonged rectal bleeding before diagnosis in early-age onset colorectal cancer patients. Of 211 EAO CRC patients, over half of the patients had rectal bleeding prior to diagnosis and on average, it took 271.17 days to diagnose these cases with CRC. This research is important to lead to earlier diagnosis, earlier disease stage, and better outcomes for EAO CRC patients.

We had a chance to chat with Dr. Gurprataap Sandhu and Dr. Chris Lieu about this research. Check out their Facebook Live below!

Chemotherapy

FOxTROT Trial: The FOxTROT trial enrolled 1052 stage T3-4/N0-2/M0 colon cancer patients and found that neoadjuvant chemotherapy (patients received FOLFOX ahead of surgery) resulted in improved outcomes after surgery, downstaging, and fewer complications after surgery.

Phase III Study comparing FOLFOX + bevacizumab: Researchers enrolled 349 patients with metastatic colorectal cancer to compare FOLFOX+bevacizumab and FOLFOXIRI + bevacizumab as first-line treatment for those with three or more circulating tumor cells. Findings indicated that the progression-free survival was 12.4 months with  FOLFOXIRI + bevacizumab compared to 9.3 months with FOLFOX + bevacuizumab.

Leading research

It’s important to remember that breaking research doesn’t happen every year, and it doesn’t happen on its own. In order to advance the science, dedicated thought leaders have to ask the right questions, understand what previously has and hasn’t worked, and integrate the entire patient experience along the way.

To move the research ahead, Fight CRC convenes our workgroups at major conferences like ASCO, bringing together national and global experts to be the driving force in science and understand how the clinical research pipeline is developing. We’ve created innovative tools such as the Late-Stage MSS CRC Clinical Trial Finder to address clinical trial enrollment barriers and prioritize trials with the highest potential benefit for success for late-stage MSS patients. We train patients to be the most knowledgeable voice at the research table.

We also presented data on the Trial Finder at ASCO! Check out our poster here.

At the end of the day, we’re continuing to explore the research possibilities with leaders and patients in the community, with the goal to find the best treatment options possible for those with colorectal cancer.

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Following up from ASCO 2019, we hosted a webinar with HalioDx to break down the research around Immunoscore presented at the conference and to understand the potential clinical implications for a test like this.

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