Published by Fight Colorectal Cancer (Fight CRC)

When you hear “clinical trial,” you might picture endless paperwork or doctors tracking tumor scans. But here’s what you might not know: patients—people just like you—are also in the room where decisions get made.

Through Fight CRC’s Research Advocacy Training & Support (RATS) program, survivors and caregivers are helping shape how studies are designed, who gets to join, and what outcomes really matter.

This is your behind-the-scenes look at how patient advocates are changing research—and why it matters for every colorectal cancer (CRC) patient.

Why This Matters if You’re a Patient

If you’re newly diagnosed, clinical trials might feel overwhelming. But here’s why patient advocacy makes a difference:

  • More Options. Advocates fight to make eligibility rules fairer, so more patients qualify.
  • Better Questions. Advocates push researchers to measure what matters—like fatigue, pain, and daily life—not just tumor shrinkage.
  • Fewer Barriers. Advocates flag real-world challenges like travel costs, early appointments, or financial stress.
Bottom line: trials designed with patients in mind are more realistic, humane, and doable.

What Advocacy Looks Like Behind the Scences

Fight CRC-trained advocates serve in places you might not expect:

  • IRBs (Institutional Review Boards): reviewing protocols to protect patients.
  • Federal panels: advising groups like FDA, PCORI, DoD PRCRP, and NCI.
  • Professional societies: influencing research priorities at ASCO and SWOG.
And they ask the questions you might ask yourself:
  • “Can families afford this?”
  • “Does this schedule actually work for patients?”
  • “Are we measuring both living longer and living better?”

Real Change in Action

So what does all this mean in real life? Thanks to patient advocates, trials are starting to look different, and better, for people with colorectal cancer:

  • More chances to participate. In the past, strict rules kept many patients out of trials. Advocates have pushed for broader criteria, so more people actually qualify.
  • Measuring what life feels like. Trials used to focus only on tumor size or survival. Now, many also track side effects like fatigue, pain, or how well you can do everyday activities—because those things matter too.
  • Support for the hidden costs. Trials are beginning to recognize that travel, hotel stays, and missed work add up. Advocates are raising these issues so more studies build in help, like financial counseling or travel assistance.
In other words: research isn’t just about the science anymore, it’s about making trials more doable, more humane, and more focused on what patients really need.

Research backs this up:

A Patient-Led Movement

As Fight CRC advocate Matthew DeAngelis shared:

“One thing I am excited to learn as a research advocate is how patient-advocates can influence the design of cutting-edge, practical, patient-centered clinical trials.”

Patients are no longer just trial participants. They’re leaders, partners, and innovators.

How You Can Get Involved

  • Learn about RATS. See how Fight CRC trains advocates to make an impact.
  • Ask your care team. Try: “Does this cancer center include patients on its research boards?”
  • Raise your voice. Every question you ask shapes research for the better.
At Fight CRC, we believe patients aren’t just part of the story, they’re helping write it.

In August 2018, I became a caregiver to my husband, Joe, who was diagnosed at age 47 with stage IIIb rectal cancer. I wish I had caregiver tips and advice at the time. But I didn’t. I was scrambling to get through each day.

Together with our three kids (then ages 15, 13, 11), we navigated the bumpy, icky, murky (and any other gross adjectives – feel free to add here) waters of colorectal cancer through diagnosis, chemo, radiation, surgery, NED declaration, and another surgery over the course of 13 months.

One thing I came through all of this with: No one fights alone. As a caregiver, I was extremely thankful to have a village support me.

Caregiving Isn’t Typically a Choice

maschke-captain-america-bobbleheadCaregiving isn’t a role I would have chosen, given the choice. Cancer is not a disease my husband would have chosen either. We were thrust into these positions, and in the words of Pat Summit, “It is what it is. But it will be what I make it.”

So, we tried to make each day “good.” Some days were harder than others to make “good.”

As a caregiver, I took my responsibility exceptionally seriously. That’s what makes being a caregiver so difficult. Caregivers typically “handle it” with everything. We step up and do what needs to be done. Whatever needs to be done always gets done. Even at the expense of our own physical and mental health.

In a world where everything has spun out of control, caregivers throw ourselves into caregiving with all of the intensity and passion in our souls. But then little is left to take care of ourselves.

Being a caregiver means we learn as we go. We do the best we can each day.

After Joe was diagnosed, I wished there was a list of things I “should” do as a caregiver. I felt like there were things I should have known, but I didn’t. So, here’s a list of my top 7 caregiving tips and advice. These things got me through one of the worst and most difficult years of my life.

1. Plan for What You Can Plan.

I created a binder with a tabs for each doctor (surgeon, oncologist, radiologist) where I would write questions we had as we went along, so I would remember them and ask questions at every appointment.

Don’t think “you’ll remember” everything when it’s time for appointments. You won’t.

I kept a spiral calendar book dedicated to treatment and procedures appointments, so I had everything in one place. I included a page with Joe’s prescription medications, as well as the medications making up his infusions.

Within this binder, Joe’s allergies were listed because with all we had going on, we didn’t need “one more thing.”

2. Don’t Google Anything Related to the Diagnosis.

Your loved one with colorectal cancer is one out of billions of people. Their doctors are on the case, and they are doing everything possible to cure your loved one and save their life. Trust the medical professionals and have faith in them.

While Google has answers, it doesn’t have all the answers. Google also doesn’t have all the specifics of your loved one’s diagnosis and specific particulars.

3. Ask for Time and Patience.

When Joe was diagnosed, it felt like someone smacked us across the backs of our heads with a board. Stunned is the best word to describe our reactions when we were told Joe had a tumor.

I wear my heart on my sleeve, and I am unable to hide or stuff emotions.

When people are “all mysterious and vague” on Facebook, I roll my eyes. I don’t want to be “that person.”

While I craved prayers, good thoughts, and good energy, and I wanted to share that we were going through “something big,” I wasn’t ready to share Joe’s diagnosis with my friends.

Honestly, it took me a good three weeks to tell people Joe had cancer.

A cancer diagnosis is bad enough. But then you throw in the word “rectal,” and it’s gone from bad to worse. If that’s even possible.

I can’t remember how long it took until I was able to say “rectal cancer.” I kept saying “colorectal cancer” at first. As if the word “colorectal” made the cancer “less gross.” Guess what? It didn’t.

For a while, I just said, “Joe has cancer.” Then I got the DMs asking “what kind?”

At that point, I still wasn’t comfortable saying “colorectal” much less “rectal.” I would simply say, “I am not ready to talk about that yet. Just please keep us in our prayers.” (Truly, I believe God knows where the cancer was located, so He didn’t need the specifics if people were praying for Joe.)

It felt incredibly invasive when people would ask, “What kind of cancer?”

To have the power and control in a situation – where I had no power and control –where I could just say, “I need time to get to that” was a gift.

4. Ask for Help.

So many people reached out when Joe was diagnosed. They asked, “How can I help?” I had no idea what I needed. “Prayers and positive thoughts” was my answer early on.

I knew Joe would need surgery down the line, and I held that “ask for help” card close to my heart.

One fear was that people would get sick of me asking for things. As a result, I waited until Joe’s surgery (a full 10 months later) and asked for help then – A LOT of help.

“Can you come to my house the day of Joe’s surgery (we arrived at the hospital at 5:30am), so that my kids don’t come home to an empty house?” Or “Can you help organize meals when Joe has his surgery? Just a few a week and just for a couple weeks. I don’t want people to be sick of us.”

Whether you need rides to help transport your kids or food on the table because you are too overwhelmed to shop, prep, and cook, people really do want to help you in any way they can. People want to be your village. They want to lighten your load.

Let them.

The nature of caregivers is that you have probably already paid this help forward to others in the past. Or you will in the future.

People helping each other out when they need it is part of what makes the world go round.

5. Ask the Medical Professionals.

I would grab scraps of paper and write down questions that came to me randomly during different times of day or night. At 8pm the night of Joe’s diagnosis, I my oncology nurse friend a DM that started, “Joe was diagnosed with rectal cancer today. Excuse my TMI. I don’t know where to start.”

She was the only person I was able to say that to the first days of diagnosis. Her “where you go matters,” response still hits me in the feels.

There was a part of me that flashed “close and convenient” ever so briefly. But in matters of the heart and health, we choose “the best.”

Find the best hands possible to treat your loved one.

7. Know That “This, Too, Shall Pass.”

Every day is not going to be as awful as what you are going through at this moment.

Keep the faith.

Stay positive.

When Joe was diagnosed, we began watching a new TV series and the doctor said, “It’s a good news kind of day!” I totally stole his line and I planned a “pallet party.”

This pallet party turned out to be one of my ways of self-care. I gathered with friends to paint. Cancer wasn’t the center of my universe for a few hours. It was glorious!

My custom pallet says, “It’s a good news kind of day!” I hung it in my kitchen for my daily reminder when I sit down to drink my coffee each day that for today, we were OK because we were sitting at the table having breakfast together.

For that reason alone, each day is a “Good news kind of day!”

Caregiving is the ultimate act of giving for those we love.

But caregivers also need to take time to care for yourselves. When you care for yourself, you know it’s going to be a “Good news kind of day.” Because you make it one.

Colorectal cancer and mental health are two topics that make people extremely uncomfortable to talk about, but there shouldn’t be shame or stigma attached to either. This month Maia and Manju discuss clinical trials promoting taking care of your mental health while dealing with colorectal cancer. The trials below span from using old-fashioned pen and paper to virtual reality to mindfulness.

Highlights:

  • There are many clinical trials happening to help alleviate stress.
  • Some trials are also looking at the impact of mental health on pain relief.
  • Clinical trials focused on Latino mental health are underway.

Resources

Clinical trials are critical to finding a cure for colorectal cancer. As an advocacy organization dedicated to supporting and empowering a community of patients, caregivers and families, Fight CRC has partnered with COLONTOWN to deliver a monthly blog series highlighting everything patients need to know about clinical trials and the best treatment options available.

More Fight CRC Resources

Stress or Pain Relief Trials

Maia, what are some clinical trials to help people feel stress relief or pain relief while they are being treated or have been treated for colorectal cancer?

Virtual Trial to Compare Two Digital Therapeutics as Interventions for Physical and Mental Health in People with Cancer (RESTORE)

NCT05227898

This trial is for stage I through stage III cancer patients with elevated anxiety symptoms. It is for those who are receiving systemic treatment or have received it within the past six months. Eligible patients from anywhere in the United States can enroll in it, since it is a virtual study – they will participate from home, without having to visit a clinic.

During 12 weeks, patients will receive access to one of the two apps, on their smartphone or tablet, and use it to complete 10 informational sessions, each approximately 60 minutes in length. The app also includes guided exercises and other interactive opportunities.

Expressive Writing for the Management of Stress in Cancer Survivors

NCT04776941

This clinical trial at MD Anderson evaluates the effect of expressive writing (EW) for the management of stress in cancer survivors. It is a virtual study, which enrolls adults with a diagnosis of any type of cancer who were diagnosed within the past three years.

These participants must be able to speak and read in English, and have access to a computer or smartphone with internet connection.

All of the patients complete questionnaires (which take more than 30 minutes) about their mood, health, and income at the start of the study, and at one, three, and six months. Half of the patients read brief neutral messages and write essays about neutral topics over 30 minutes (nonstop) once weekly, for three weeks. The other half of the patients read brief messages with positive content and write essays, too, in the same conditions, but about their own experiences.

Previous clinical trials support the use of expressive writing to improve quality of life in breast cancer survivors and favored improvements in cancer-related symptoms and fatigue levels in renal cell carcinoma.

The current study investigates the effect of expressive writing specifically related to stress and aims to find out if this approach is equally effective as virtual, not in-person intervention.

The researchers observe that the stress that most cancer survivors face “can be further exacerbated by social upheavals, such as the COVID-19 pandemic. For safety reasons, many patients are isolated with restricted access to in-person health care and reduced social interaction with family and friends. Together, with the economic uncertainties that come with this pandemic, these factors are likely to increase cancer survivors’ stress levels. Expressive writing may provide a medium through which cancer survivors confront stressors and find meaning in their experience.”

Virtual Reality for GI Cancer Pain to Improve Patient Reported Outcomes

NCT04907643

While the first trial listed involves mainly paper and pen, a really low-tech intervention, this study at Cedars-Sinai Medical Center (Los Angeles, CA) evaluates how a novel technology, virtual reality (VR), might help patients to manage gastrointestinal (GI) cancer pain.

Experiencing severe abdominal pain negatively affects physical, emotional, and social function, and overall quality of life for many cancer patients. Therapeutic use of VR has emerged as a promising and evidence-based treatment modality for management of cancer pain.

Users of VR wear a pair of goggles with a close-proximity screen in front of the eyes that creates a sensation of being transported into lifelike, 3D worlds. To date, VR has been limited to short-term clinical trials for cancer pain. In addition, limited research exists on theory-based VR modalities beyond mere distraction.

With the goal of effectively improving quality of life/easing pain with this intervention, this study will measure patient-reported outcomes (PROs) and opioid use among three groups of users.

All participants will be provided with a VR audio and visual headset that comes with an orientation-tracked controller, supports three degrees of freedom (3DOF) head tracking, has best-in-class optics, and a wide field of view. It does not require a smartphone or personal computer to operate. Participants will be asked to actively use the headset for four weeks on a daily basis, following the specific instructions for their assigned intervention: 1. Immersive skills-based VR therapy; 2. Immersive distraction VR therapy; and 3. Non-immersive sham VR using 2D videos displayed in a VR headset.

The skills-based treatment will use virtual healing environments to teach patients about meditation, breathing exercises, and pain management. The distraction treatment will use immersive videos that are designed to take the mind off of pain. The sham VR will use VR goggles, but patients will only watch a 2D video rather than a 3D, immersive experience.

Latino Mental Health Trials

Manju, what interesting mental health clinical trials do you want to share with us this month?

Mindfulness-Based Intervention for Latino Cancer Patients and Their Caregivers

NCT04870788

This 60 participant interventional clinical trial conducted at the MD Anderson Cancer Center develops effective and appropriate mindfulness-based interventions that help meet the needs of Latino cancer patients and their family caregivers. Mindfulness-based interventions focus on building awareness of thoughts, emotions/feelings, and sensations. This study may help improve mental well-being and reduce stress and anxiety associated with having cancer or with a family member’s cancer diagnosis. The primary objectives of the trial are to adapt a mindfulness-based intervention to improve psychological well-being in Latino patients with advanced cancer and their family caregivers, and to evaluate its feasibility in Latino patient-family caregiver dyads. The secondary objectives are to find out the effects of the adapted mindfulness techniques on patient and caregiver psychological distress, quality of life, and patient cancer symptoms, compared to a waitlist control.

In the study, patients with stage III or stage IV solid tumors and their caregivers will be randomized into one of two groups. In group one, patients and caregivers will receive mindfulness coaching for 60 minutes a week for four weeks. In group two patients and their caregivers will receive mindfulness coaching for 60 minutes a week for four weeks at 12 weeks after starting the study. Participants get a quality-of-life assessment and a questionnaire at six and 12 weeks.

Psychotherapy Intervention for Latinos With Adv Cancer

NCT04537936

The purpose of this 285 participant study is to adapt a counseling intervention called Meaning Centered Psychotherapy to make it culturally relevant for Latinos. This study will try to understand factors that affect Latino patients’ quality of life and how to improve it. Latinos often experience greater challenges due to cancer, yet few studies and interventions focus on this group of patients.

This project has five phases.

Phase one and phase two

The study team will work to understand the sources of meaning, hope, legacy, and identity in Latino patients with advanced cancer, and to explore Meaning Centered Psychotherapy to Latinos diagnosed with advanced cancer. Patients will be recruited from Memorial Sloan Kettering Cancer Center (MSKCC), and Lincoln Medical and Mental Health Center (LMC), a public hospital in a Latino-dense region. Eligible cancer patients will also be recruited through Dr. Gany’s Integrated Cancer Care Access Network (ICCAN) of MSKCC’s Immigrant Health and Cancer Disparities Service. ICCAN uses bilingual access facilitators to assist patients in identifying their needs.

Phase three

Mental health providers will be interviewed to find out what else may be helpful to patients.

Phase four

Patient interviews to learn about patient feedback.

Phase five

A randomized pilot study, which will collect preliminary data on the feasibility of recruitment, retention, adherence, and acceptability of the content of the intervention and key outcomes. This part will include 60 Spanish-speaking advanced cancer patients enrolled and randomized to the intervention or control arm, which is the enhanced usual care arm.

The primary outcome is measurement of spiritual well-being, and the secondary outcomes include measurement of depression, anxiety, hopelessness, and quality of life.

Stay Tuned

Once a month, Maia Walker and Manju George spend time unpacking important research trials, tips, and advice for our community. Be sure to subscribe to sign up with Fight CRC and join COLONTOWN’s online community to continue receiving the most relevant updates in the CRC world!

You can also follow Maia (@sassycell) and Manju (@manjuggm) to stay updated on research and trials and visit ClinicalTrials.gov for more information on trials.

HAI (hepatic artery infusion) pump therapy is a potential treatment option for patients diagnosed with stage IV colorectal cancer which has metastasized (spread) to the liver.

Colorectal cancer is the third most frequently diagnosed cancer in the United States among men and women, and when men and women are combined, it is the #2 cause of cancer death.

Ultimately, over 50% of patients diagnosed with CRC will develop liver metastasis.

Traditional chemotherapy is “systemic,” which means it is administered and distributed throughout the entire body. HAI pump therapy is different in that it delivers chemotherapy directly to the liver, providing up to 400 times greater drug concentration where it is needed. It accomplishes this by delivering chemotherapy to the hepatic artery, which supplies blood to the liver.

How HAI Pump Placement Works

HAI pump surgery is a minor procedure that places the port in the abdomen just below the skin, somewhat like a port that is used for traditional chemotherapy. The pump is then filled with the drug being used to treat the tumors in the liver, slowly delivering medication at a constant rate.  

The pump is powered by body heat and refilled every two weeks during active treatment. The pump can be filled with an inactive fluid during treatment breaks. 

Benefits of HAI Pump Therapy for Liver Metastases

For patients with mets to the liver that cannot be surgically removed, HAI pump therapy may be an option to help prevent the tumors from growing, and in some cases even shrinking them, which may prolong survival and help them become a surgery candidate.  

For patients that have had their tumors surgically removed, HAI therapy may help prevent new tumors from forming and may prolong survival. 

Possible Side Effects of HAI Pump Therapy

No therapy is without side effects, including HAI therapy. However, patients generally report fewer chemotherapy related side effects when compared to traditional systemic chemotherapy. Possible side effects include: 

  • Nausea 
  • Vomiting 
  • Diarrhea 
  • Elevated liver enzymes 

It is important to follow all instructions given by your provider. While you can remain active with an HAI pump, you should rough physical activity that may damage the pump. You should also avoid scuba diving, and be careful to avoid activites that may increase your body temperature, such as using a hot tub, during active treatment, as this can alter the medication flow rate. 

How to Receive HAI Pump Chemotherapy

HAI therapy is administered by a physician specially trained to do so. There are several centers across the U.S. now offering this treatment option. After placement of the pump, the pump will be managed by the provider, who will refill the pump and decide on a course of treatment. 

Success Stories with HAI Pump Therapy

“My experience with the Hepatic Artery Infusion (HAI) pump was truly life-changing—and, without question, life-saving. From the moment it was implanted, I not only remained cancer-free, but I was able to fully live my life in ways I never imagined possible during cancer treatment. I continued running, working out, and staying active. One of the greatest advantages of the HAI pump was the absence of the debilitating systemic side effects I experienced with traditional chemotherapy. The treatment targeted my liver directly, which meant my other organs were spared from the harmful effects of chemotherapy. That fact proved critical to my survival. A year later, I unexpectedly went into liver failure due to biliary inflammation. Because the rest of my body had been spared from chemo-related damage, I was strong and healthy enough to undergo a living donor liver transplant. The HAI pump quite literally became the bridge that kept me cancer-free and in peak enough condition to qualify for groundbreaking transplant research at Cleveland Clinic. Now, nearly nine years later, I have no lingering complications from the pump or the treatment, aside from a small hernia that will be repaired soon. The HAI pump didn’t just save my life—it gave me back my life while I was fighting for it.”

Carole Motycka, Stage IV Survivor

Next steps

If you have colorectal cancer with metastasis to the liver, HAI therapy may be an available treatment option. Talk to your oncologist to learn more.  

Fight Colorectal Cancer has received funding from Intera Oncology (now part of Boston Scientific), the producers of HAI Therapy, in the form of unrestricted educational grants. We maintain ultimate authority over website content and the content written in this article. 

Intera Logo Purple 300x157

By Elsa Lankford, Fight CRC Research Advocacy Trainings and Support (RATS) Program Member & Clinical Trial Curator

If you’re living with or caring for someone with microsatellite stable (MSS) stage IV colorectal cancer, you’ve probably heard this frustrating line before:
Immunotherapy doesn’t work for MSS.”

That’s been the reality for years. While immunotherapy has made a huge difference for a small group of patients with MSI-high colorectal cancer, the vast majority —over 95%—are MSS. And they’ve had very few options once standard treatments stop working.

But some exciting new research presented at the ESMO GI 2025 conference is giving reason to hope.

What’s New: A Promising Combo Called Botensilimab + Balstilimab

At the conference, a group of respected researchers—including Dr. Benjamin Schlechter from Dana-Farber—shared results from a clinical trial testing an immunotherapy combination:

  • Botensilimab (Bot): a newer kind of checkpoint inhibitor that helps kickstart the immune system
  • Balstilimab (Bal): a checkpoint inhibitor that helps keep that immune response going

Together, they aim to turn “cold” tumors, like most MSS tumors, into “hot” ones that the immune system can recognize and attack.

The researchers looked at patients who had already been through many treatments. Some were on their third, fourth, or even fifth line of therapy. Many had already tried chemotherapy like regorafenib or TAS-102, and some had even tried other immunotherapies.

Who was in the trial?

Here’s a simple snapshot of the patients in this study:

  • 123 total patients with MSS colorectal cancer
  • All had no active liver metastases, which can help immunotherapy work better
  • About 30% had tried four or more treatments
  • Around 15–30% had already tried immunotherapy
  • None had high tumor mutation burden (TMB), which sometimes helps immunotherapy work better

These were patients who were running out of options—and looking for hope.

What Did the Results Show?

The results were surprisingly encouraging for a group of patients who’ve often been told “there’s nothing left.”

  • 20% of patients had their tumors shrink by at least 30%
    • That’s 1 in 5 people seeing a meaningful response.
    • 3 people had a complete response (tumors disappeared), including one person in the most heavily treated group
  • 50% of patients had stable disease
    • That means their cancer didn’t shrink, but it also didn’t grow
  • About 70% of patients got some form of disease control
  • For those who responded, the benefit lasted a long time—over 16 months
  • Median overall survival was almost 21 months—even in patients who had already been through 4 or more treatments

For MSS colorectal cancer patients, these results are some of the most promising seen with immunotherapy.

Side Effects

All cancer treatments come with side effects, and this one is no different. But overall, they were manageable:

  • About 6 in 10 patients had some side effects related to the immune system
  • The most common side effect was diarrhea or colitis (inflammation of the colon)
  • About 3 in 10 patients had more serious side effects (grade 3)
  • Only one person had a very serious (grade 4) side effect
  • No one died from treatment-related side effects

The more serious side effects were seen more often with higher doses. Doctors are learning more about how to manage this as the trials continue.

Why This Matters

If you or your loved one has MSS colorectal cancer and has already tried multiple treatments, this trial offers something rare—hope.

These results show that immunotherapy might finally be on the horizon for MSS patients, especially those without active liver metastases. Even stable disease gives patients time: time to enter another trial, explore a new option, or even return to a treatment that may now work better because the immune system has been “revved up.”

What’s Next?

Because the early results were so strong, the drug maker (Agenus) plans to start a Phase 3 trial by the end of 2025. This larger trial could bring botensilimab + balstilimab one step closer to FDA approval.

Right now, this drug combo is only available in clinical trials. But trials are open, and there may be one that’s a match for you or someone you care for.

You can search for trials using this combo on the Fight CRC Clinical Trial Finder: https://fightcolorectalcancer.org/resource/trial-results/?drug%5B0%5D=botensilimab

A Personal Note from a Care Partner

My name is Elsa, and I’ve been a caregiver, trial curator, and proud member of Fight CRC’s Research Advocacy Trainings and Support (RATS) Program for several years.

This trial stood out—not just for the science, but because it represents real progress for patients who’ve had very few options. I’ve seen firsthand how much every extra month, every slowed scan, every new option matters to patients and their families.

This is why research matters. This is why funding matters. And this is why we advocate.

Learn More

Poster from ESMO GI 2025:
Download PDF

Trial Registration – NCT03860272:
ClinicalTrials.gov listing

Background on MSS and TMB:
Yaeger, R., et al. (2018). Clinical Cancer Research, 24(19), 4691–4703.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087857/

Honestly, you can’t watch TV or scroll Instagram without seeing a commercial about Ozempic®, Wegovy®, Mounjaro® or a compounded semaglutide right now.

These drugs were developed to manage type 2 diabetes but they are used for much more. Nowadays, they are the center of many conversations around weight loss, and more recently, cancer prevention and care.

After a recent work trip, I realized the cancer community is talking about GLP-1s A LOT, so I decided to look into it! I love this part of my job: I get to follow the science, stay curious, and make sure you’re empowered with the facts.

I started reading the emerging research and what it could mean for colorectal cancer patients. If medications that are being used to manage diabetes can also help reduce that risk or improve cancer treatment outcomes, that’s a big deal!

What is a GLP-1?

For starters, GLP-1 is short for glucagon-like peptide 1 (GLP-1) agonists. These drugs mimic a natural hormone that helps control blood sugar, reduce appetite, and slow digestion. GLP-1 agonists are available via prescription, and they are usually administered by injection. The doses and how often you take the drug depends on the patient.

GLP-1s and Cancer

Here’s what the research community has published on GLP-1s and cancer-related topics.

GLP-1s and Colonoscopy Prep

Recent research has shown that GLP-1 drugs may affect colonoscopy effectiveness, especially when it comes to bowel prep and the quality of how well a GI can see your colon during the colonoscopy.

Why It Matters:

  • GLP-1s slow gastric emptying, which is a helpful feature for blood sugar control, but a potential obstacle for colonoscopy prep. Patients using GLP-1s may experience incomplete or inadequate prep, which can reduce the visibility of polyps and lead to repeat procedures.
  • A 2024 study in the Journal of Clinical Medicine found that polyp detection rates were lower in patients who used GLP-1s without adjusting their prep protocol.  Singh et al., 2024
  • In ScienceDirect, experts recommended patients pause GLP-1 meds one or two days before a colonoscopy, and some centers are adjusting prep regimens accordingly.

TIP: If you’re taking a GLP-1 and are due for a colonoscopy, talk with your GI doctor about prep adjustments to ensure you have an empty colon for your colonoscopy.

Do GLP-1s or Metformin Influence Cancer Treatment?

Beyond screening, a smaller but growing body of research is exploring how GLP-1s might affect treatment outcomes for colorectal cancer patients.

This is all still very early, but the findings are cautiously optimistic.

What We’re Learning:

  • A 2022 article in Frontiers in Pharmacology showed that in lab models (not in real people yet), GLP-1s have been shown to inhibit tumor-promoting pathways, such as PI3K/AKT/mTOR, potentially slowing cancer cell growth.
  • Gut Journal reported that GLP-1s may reduce chemotherapy side effects like mucositis. A 2013 study found protective effects on intestinal tissue, which could support better treatment tolerance.
  • A 2024 study in the Journal of Thoracic Oncology analyzed GLP-1 drug use in people newly diagnosed with type 2 diabetes and studied their lung cancer risk. The findings highlighted broader relevance to obesity-related cancers—including colon and rectal cancers. Researchers suggested GLP-1s may reduce inflammation and tumor progression in metabolically vulnerable patients.
  • A 2025 review in the Journal of Clinical Medicine took a comprehensive look at Metformin’s role across cancers, including colorectal and bladder cancer. The review reinforced Metformin’s anti-inflammatory, insulin-modulating mechanisms and its possible use in cancer prevention and progression control.

We know that people with type 2 diabetes have a higher risk for CRC, so if medications that manage diabetes can also help reduce colorectal cancer risk, or improve treatment outcomes, that’s a big deal.

Key Takeaways

It is important to remember that GLP-1s are not a replacement or current treatment for colorectal cancer.

For patients managing both diabetes and colorectal cancer, they may offer metabolic and, potentially, added benefits. Make sure you talk to your oncologist.

For patients on GLP-1s

Share this information with your care team, especially before a colonoscopy.

For providers

Be proactive in adjusting prep strategies if your patient is on a GLP-1, especially if they are having a colonoscopy.

Why This Matters

A lot of cancer patients are dealing with health-related issues beyond their cancer diagnosis, from navigating diabetes or struggling with weight gain. We can’t help but be curious about how GLP-1s impact someone’s risk for cancer or cancer treatment.

We also need to remember to deal with the whole person.

I want our community to feel empowered and grounded in science (not just commercials) as we advocate for ourselves to live heathy lives and feel confident in our bodies.

References

  1. Singh, S., Chandan, S., Dahiya, D. S., et al. (2024). Impact of GLP-1 receptor agonists in gastrointestinal endoscopy. Journal of Clinical Medicine, 13(18), 5627. https://www.mdpi.com/2077-0383/13/18/5627
  2. Chiu, Y.-T., Chen, Y.-T., Lee, F.-J., et al. (2025). Impact of GLP-1 receptor agonists on colonoscopy quality: a meta-analysis. Digestive and Liver Disease. https://www.sciencedirect.com/science/article/pii/S1590865825002804
  3. Tong, G., Peng, T., Chen, Y., et al. (2022). Effects of GLP-1 receptor agonists on biological behavior of colorectal cancer cells. Frontiers in Pharmacology, 13, 901559. https://www.frontiersin.org/articles/10.3389/fphar.2022.901559/full
  4. Kissow, H., Hartmann, B., Holst, J. J., et al. (2013). GLP-1 as a treatment for chemotherapy-induced mucositis. Gut, 62(12), 1724–1733. https://gut.bmj.com/content/62/12/1724.short
  5. Nomiyama, T., & Yanase, T. (2016). GLP-1 receptor agonist as treatment for cancer and diabetes. Expert Rev Endocrinol Metab. https://www.tandfonline.com/doi/abs/10.1080/17446651.2016.1191349

Twenty-nine leading patient advocacy groups and healthcare organizations joined together to applaud the United States Supreme Court’s decision in Kennedy v. Braidwood Management to uphold the constitutionality of the United States Preventive Services Task Force (USPSTF) and in turn the provision of the Affordable Care Act that requires most private insurers cover recommended services without cost sharing, including colorectal cancer screening.

Colorectal cancer is the second leading cause of cancer-related death in the United States, with rates currently rising in younger adults. Many Americans have been provided with no-cost screening for colorectal cancer for more than 15 years, and it has proven to be a lifesaving tool to reduce mortality, and for some, prevent cancer altogether.

Between 2010 and 2016, eliminating cost sharing was associated with a 17% drop in colorectal cancer incidence, meaning this coverage prevented approximately 65,000+ of the 290,000 deaths that would have otherwise occurred. This is tremendous progress, but more work remains. Still far too many Americans die each year of colorectal cancer.

The Court’s decision is a win for Americans and for public health, but continued access to timely colorectal cancer screening is critical. We urge the Administration to continue to uphold and build on the rigorous, data-driven work of the Task Force and ensure that it keeps up with scientific innovation to protect patient access to the full continuum of effective colorectal cancer screening.

Signed by the Colorectal Cancer Screening Policy Workgroup, including:

  • AliveandKick’n
  • Alliance for Women’s Health and Prevention
  • American Cancer Society
  • American Cancer Society Cancer Action Network
  • American College of Gastroenterology
  • American Gastroenterological Association
  • American Society for Gastrointestinal Endoscopy
  • American Society of Colon & Rectal Surgeons
  • Big Mike’s Bottom Line
  • Braintree Laboratories
  • California Colorectal Cancer Coalition
  • Cheeky Charity
  • Collaborative Group of the Americas on Inherited Gastrointestinal Cancer
  • Colon Cancer Coalition | Get Your Rear in Gear
  • Colon Cancer Prevention Project
  • Colon Cancer Stars
  • Colorectal Cancer Alliance
  • Exact Sciences
  • Fight Colorectal Cancer
  • FORCE: Facing Our Risk of Cancer Empowered
  • Freenome
  • Geneoscopy
  • Georgia Center for Oncology Research and Education
  • GH Foundation
  • Guardant Health
  • Nevada Cancer Coalition
  • PALTOWN Development Foundation/COLONTOWN
  • Prevent Cancer Foundation
  • The Gloria Borges WunderGlo Foundation

To Secretary Kennedy:

On behalf of the colorectal cancer community including patients, families, researchers, and healthcare providers across the nation, we write to emphasize the concerns you raised in your recent appearances before both the House Appropriations Committee and the Senate Health, Education, Labor and Pension (HELP) Committee, about the sharp rise in early onset colorectal cancer (EOCRC). Once considered a disease primarily affecting older adults, colorectal cancer is now increasingly diagnosed in individuals under the age of 50. This trend is alarming and demands immediate federal attention and investment.

As you continue to spotlight rising cancer rates in younger Americans, we urge a clear distinction between pediatric and early-onset colorectal cancer, both concerning, but biologically and clinically distinct.

Pediatric colorectal cancer, diagnosed in individuals under 18, is rare, estimated at 150 to 200 cases per year in the U.S. These cases often present at advanced stages and require pediatric-specific research and care protocols.

EOCRC affects adults under 50 and is increasing at an alarming rate, growing 1–2% annually since the mid-1990s. In 2023, colorectal cancer became the leading cause of cancer death in men under 50 and the second in women. More than 19,500 Americans under 50 were expected to be diagnosed last year alone.

Both trends underscore the urgent need to invest in understanding why this is happening. Sustained federal investment in research is critical. We need to identify the drivers of EOCRC to develop effective prevention and treatment strategies. We share your goal of addressing our nation’s food supply and addressing chronic diseases as obesity and certain dietary habits have been among the variety of potential factors linked to the rise in EOCRC. Proposed cuts to research funding and staffing threaten to halt progress and undermine years of advancement.

In the HELP Committee hearing, Senator Patty Murray shared about a young stage IV colorectal cancer patient named Natalie attempting to access an NIH clinical trial. Natalie’s journey illustrates not only the systemic challenges patients already face when accessing clinical trials, but also the devastating impact that cuts to federal research funding and staff have on patient care. We cannot afford to go backward. We hope to work with you to expand trial access so patients like Natalie can benefit from the best available science.

It is also important to note that the rising trends in EOCRC are occurring even as overall incidence in older populations has declined due to screening efforts. Colorectal cancer is one of the few cancers that can be prevented with timely screening. Screening for colorectal cancer can prevent cancer by removing polyps before they develop into cancer and prevent death by finding cancer earlier when it is more responsive to treatment. In 2021, in response to the increase in EOCRC, the U.S. Preventive Services Task Force lowered the recommended screening age for average risk patients from 50 to 45. This change helped millions more people have access to life-saving colorectal cancer screening.

Additionally, programs like the CDC’s Colorectal Cancer Control Program (CRCCP) are critical to help increase colorectal cancer screening rates in communities most in need. The CRCCP works with local clinics and health systems that serve populations with low colorectal cancer screening rates. From 2015-2024, clinics that participated in CRCCP for at least two years saw improvements in their screening outcomes. When looking at their most recent year of participation, clinics reported a 20% increase in the proportion of patients up to date with CRC screening rates. From 2009-2020, the CRCCP was associated with 806 less CRC diagnoses (primarily late-stage cancers) and averted 392 CRC deaths.

We have made important progress in colorectal cancer research and screening, but there is still much more work to be done. We urge you to lead efforts at HHS to:

Increase federal funding and support for colorectal cancer research, particularly into early-age onset colorectal cancer;Support and fund screening programs such as the CRCCP that have proven to be effective in increasing screening for this preventable disease;Ensure continued affordable and equitable access to colorectal cancer screening, including no-cost coverage for all USPSTF-recommended tests starting at age 45.

Thank you for your attention to this critical challenge. We stand ready to serve as a resource to you and your staff and look forward to working together to change the course of this disease.

Sincerely,

  • AliveandKick’n
  • American Cancer Society Cancer Action Network
  • American College of Gastroenterology
  • American Gastroenterological Association
  • American Society for Gastrointestinal Endoscopy
  • American Society of Colon & Rectal Surgeons
  • Association of Black Gastroenterologists and Hepatologists (ABGH)
  • Big Mike’s Bottom Line
  • California Colorectal Cancer Coalition
  • CancerCare
  • Cancer Support Community
  • Cheeky Charity
  • Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC)
  • Colon Cancer Coalition | Get Your Rear in Gear
  • Colon Cancer Prevention Project
  • Colon Cancer Stars
  • Colorectal Cancer Alliance
  • Colorectal Cancer Equity Foundation
  • CoxHealth Foundation
  • Digestive Disease National Coalition
  • Fight Colorectal Cancer
  • Georgia Center for Oncology Research and Education
  • GH Foundation
  • GI Cancers Alliance
  • Global Colon Cancer Association
  • Hitting Cancer Below the Belt
  • Missouri Colorectal Cancer Roundtable (MCCRT)
  • Nevada Cancer Coalition
  • PALTOWN Development Foundation/COLONTOWN
  • Prevent Cancer Foundation
  • Raymond Foundation
  • Tell 5 Friends Foundation
  • The Blue Hat Foundation
  • The Gloria Borges WunderGlo Foundation
  • United Ostomy Associations of America

Tumor testing, genomic testing, biomarker testing – these are all complicated names for the same thing. Regardless of how you refer to it, biomarker testing plays an important role in personalizing your cancer treatment, and advancements continue to be made as research into biomarker directed therapy continues.

We talked with several survivors about how biomarker testing impacted their treatment options and want to share their first-hand experiences with you, so you know you’re not alone.

Phuong Gallagher

KRAS, BRAF, HER2 NEGATIVE AND MSS/PMM

2024 Tribute Phuong Gallagher 2

However, in a testament to the rapid pace of change in treatment options, she is now able to participate in an immunotherapy clinical trial, despite her KRAS mutation.

“Testing for biomarkers should not be “one and done.” Time and treatments can alter your biomarkers, so you will want to ensure that you have the most accurate information available when making major treatment decisions.”

Wenora Johnson

MSI-H, MSH2 MUTATION

Wenorajohnson300

Looking on the bright side, Wenora notes “…the positive side of MSI-H tumors is that they tend to have better prognosis and may respond to immune checkpoint inhibitors.” Wenora also notes that biomarker testing plays a critical role in her ongoing monitoring and risk management to ensure early detection of recurrences or other cancers associated with her Lynch syndrome.

“Biomarkers are powerful tools that may help doctors understand your cancer better and guide your treatment, but they don’t define you or your journey. While they may seem overwhelming at first, they’re here to give you more personalized, effective care and open up treatment options that are right for you.”

Amy Jensen

RAS wild type, RAF mutated, MSI stable, BRAF mutation D594G, APC and TP53 mutated

“Ask your doctor if they tested your biomarkers, and if they haven’t, ask if they can! Ask what your biomarkers mean to you. Even with what I know about biomarkers, it is still confusing!”

Tim McDonald

MSS, KRAS, BRAF, and NRAS wild types

Tim McDonald 300x225

Tim also eventually received a liver transplant during his course of treatment, and notes that “having MSS (microsatellite stable) made it more likely that he would be a strong candidate (for a transplant).”

How do you take the next step?

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Thank you to our sponsors for supporting our biomarker education!

Breakthroughs, Trends, and Emerging Ideas

Every year, the American Society of Clinical Oncology (ASCO) Annual Meeting brings groundbreaking research to the forefront — and this year is no exception. At ASCO 2025, several clinical trials offer renewed hope for those impacted by colorectal cancer (CRC). From first-in-class therapies to smarter, more targeted treatment strategies, the future of CRC care is being shaped in real time. Here’s a roundup of some of the most exciting CRC trials in progress that caught our attention.

FOG-001: Targeting the “Undruggable” in CRC

  • Trial Basics: Recruiting, phase 1/ 2 trial (NCT05919264)
  • What’s new: FOG-001 is a first-in-class direct β-catenin inhibitor, targeting a pathway long considered undruggable — the Wnt/β-catenin signaling cascade, which drives tumor growth in many CRC cases.
  • Why it matters: This is the first drug of its kind in the clinic, aiming to intercept a key mechanism of cancer progression.
  • Who it’s for: Patients with locally advanced or metastatic microsatellite stable (MSS) CRC, as well as other solid tumors.
  • Learn more: Abstract TPS3169

Two-in-One Immunotherapy Breakthrough: DSP107 Targets CD47 & 4‑1BB to Fight MSS mCRC

  • Trial Basics: Active, no longer recruiting phase 1/2 clinical trial (NCT04440735)
  • What’s new: DSP107 is a bi-specific fusion protein targeting CD47 on cancer cells and 41BB on immune cells, helping the immune system find and fight cancer cells.
  • Why it matters: This first-in-class drug could offer a much-needed immunotherapy option for MSS mCRC – a cancer type that is typically resistant to current immunotherapy treatments.
  • Who it’s for: Patients with MSS mCRC, as well as other solid tumors.
  • Learn more: Abstract 3517

Temab-A (ABBV-400): Smart Targeting for Refractory mCRC

  • Trial Basics: Recruiting, phase 3 clinical trial (NCT06614192)
  • What’s new: Temab-A is an antibody-drug conjugate (ADC) designed to precisely target c-Met–positive tumors — essentially delivering chemo directly to the cancer like a guided missile.
  • Why it matters: This trial pits Temab-A against a current standard regimen (trifluridine/tipiracil (LONSURF)+ bevacizumab), offering new hope for those with treatment-resistant (refractory) metastatic CRC (mCRC).
  • Who it’s for: Patients with high c-Met expression and refractory mCRC.
  • Learn more: Abstract TPS3635

From Metastatic to Early Stage: ATOMIC Trials PD‑L1 Blockade in Stage III dMMR Colon Cancer

  • Trial Basics: Phase 3 clinical trial (NCT02912559)
  • What’s new: The ATOMIC clinical trial is set to determine whether adding atezolizumab, an immunotherapy, to combination chemotherapy can improve outcomes for patients with stage III mismatch repair-deficient (dMMR) colon cancer.
  • Why it matters: This trial compares adjuvant FOLFOX chemotherapy with or without atezolizumab, offering new hope for patients with stage III dMMR colon cancer by potentially reducing recurrence and improving cure rates in a biomarker-defined, high-risk early-stage population.
  • Learn more: Abstract LBA1

ERASur Trial: Aggressive Local Treatment for Limited Metastases

  • Trial Basics: Recruiting, phase 3 clinical trial (NCT05673148)
  • What’s new: The ERASur trial explores total ablative therapy — including radiation, ablation, and surgery — for patients with limited metastatic CRC.
  • Why it matters: This “curative intent” strategy may shift how we treat oligometastatic CRC, emphasizing local control of disease even in metastatic settings.
  • Learn more: Abstract TPS3634
  • Read more about this trial from Fight CRC and ERASur principal investigator (PI), Dr. Eric Miller, a GI radiation oncologist at The Ohio State University Comprehensive Cancer Center, here!

FruBLOOM Trial: Real-World Biomarker Research

  • Trial Basics: Observational/Translational
  • What’s new: This study gathers real-world evidence and aims to identify biomarkers for fruquintinib use in metastatic CRC.
  • Why it matters: Biomarker research is key to personalizing CRC care. Fruquintinib was recently approved, and this trial will help guide its future use.
  • Learn more: Abstract TPS3637

Re‑Deploying an Old Ally: ASAC Trials Low-Dose Aspirin for Secondary Prevention in CRCLM

  • Trial Basics: Phase 3, placebo-controlled clinical trial (NCT03326791)
  • What’s new: The ASAC trial is investigating whether low-dose aspirin can improve disease-free survival in patients treated for colorectal cancer liver metastases (CRCLM).
  • Why it matters: If proven beneficial, aspirin could be an inexpensive, well-tolerated, and easily accessible option for secondary prevention of CRCLM.
  • Learn more: Abstract LBA3511

ctDNA & Liquid Biopsy in CRC: From Detection to Action

  • Trials to watch:
    • VALENTINO Trial: Evaluates low-pass whole methylome sequencing as a noninvasive method for monitoring metastatic CRC. (Abstract 3552)
    • ꞵ-CORRECT Study: Investigates the relationship between circulating tumor DNA (ctDNA) and recurrence risk in stage II-IV CRC. (Abstract 3590)
  • Why it matters: These studies could make blood-based testing a routine tool for early relapse detection, leading to faster interventions and more personalized treatment strategies.

New Approaches to Immunotherapy and Targeted Therapy

Several ASCO 2025 trials explored innovative combinations of immunotherapy and targeted therapy. Notable mentions include:
  • Second-generation KRAS G12C inhibitor: Combining olomorasib and cetuximab in advanced KRAS G12C-mutant CRC (Abstract 3507)
  • SPARKLE-L: Combining stereotactic body radiation therapy (SBRT) with a PD-1 inhibitor in unresectable CRC liver metastases. (Abstract TPS3639)
  • GCC19CART Study: First-in-human study of a CAR T-cell therapy in mCRC. (Abstract 3581)
  • Phase 1b Vaccine Trial: Using a mutant KRAS peptide vaccine + dual checkpoint inhibitors in MMR-proficient CRC. (Abstract TPS2698)
These trials are pushing the boundaries of immunotherapy in colorectal cancer — especially for patients previously considered ineligible for such treatments.

What This Means for the CRC Community

The ASCO 2025 lineup shows that innovation in colorectal cancer research is accelerating — with therapies that are:
  • More precise and biomarker-driven
  • Designed for treatment-resistant or metastatic disease
  • Focused on patient-centered outcomes like quality of life, minimal toxicity, and early detection
At Fight CRC, we’re inspired by the momentum and remain committed to keeping the community informed, empowered, and engaged. Stay tuned for updates as these trials progress — and as always, talk to your doctor about whether a clinical trial might be right for you. Join the movement. Share this post. Let’s fight CRC together. #FightCRC #ASCO25 #ColorectalCancer #ClinicalTrials #CancerResearch #HopeInProgress #Immunotherapy #PrecisionMedicine
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