Colorectal Cancer

"In patients with metastatic colorectal cancer (mCRC), the number of circulating tumor cells (CTCs) before and after initiation of treatment is a significant independent predictor of progression-free survival and overall survival," Neal J. Meropol, MD, reported

Patients with stage III colon cancer who have undergone surgery and chemotherapy with curative intent may have a higher risk of relapse and death if they follow a predominantly "Western" diet

Monoclonal antibodies to the epidermal growth factor receptor (EGFR) are among the promising novel targeted therapies being explored in colorectal cancer. Two such agents that inhibit EGFR signaling by interfering with ligand-binding are cetuximab (Erbitux) and panitumumab (Vectibix). This review will address the use of cetuximab and panitumumab in chemotherapy-refractory colorectal cancer as well as in front-line therapy for the disease, consider predictors of response and resistance, and outline comparisons between these agents.

The US Food and Drug Administration (FDA) has accepted, for filing and priority review, the New Drug Application (NDA) for Bristol-Myers Squibb's investigational compound ixabepilone, an epothilone B analog.

Monoclonal antibodies to the epidermal growth factor receptor (EGFR) are among the promising novel targeted therapies being explored in colorectal cancer. Two such agents that inhibit EGFR signaling by interfering with ligand-binding are cetuximab (Erbitux) and panitumumab (Vectibix). This review will address the use of cetuximab and panitumumab in chemotherapy-refractory colorectal cancer as well as in front-line therapy for the disease, consider predictors of response and resistance, and outline comparisons between these agents.

Monoclonal antibodies to the epidermal growth factor receptor (EGFR) are among the promising novel targeted therapies being explored in colorectal cancer. Two such agents that inhibit EGFR signaling by interfering with ligand-binding are cetuximab (Erbitux) and panitumumab (Vectibix). This review will address the use of cetuximab and panitumumab in chemotherapy-refractory colorectal cancer as well as in front-line therapy for the disease, consider predictors of response and resistance, and outline comparisons between these agents.

People who have had adenomas removed during colonoscopy are returning for surveillance colonoscopies more frequently than recommended by current guidelines

With up to 23 years of follow-up data on thousands of participants in the National Polyp Study (NPS), it is clear that colonoscopy with removal of polyps produces "a substantial, long-term reduction in colorectal cancer (CRC) mortality,"

For the past few decades, optical colonoscopy has been the gold standard in colon cancer screening. However, recent studies have shown that virtual colonoscopy may be the safest and most cost-effective colon cancer screening method available. Cancer Care & Economics (CC&E) recently spoke with Abraham H. Dachman, MD, professor of radiology at the University of Chicago Hospitals.

The third-generation epothilone KOS-1803 may optimize tumor penetration while limiting exposure to other tissues

The currently available therapies for colorectal cancer have led to a significant increase in survival, but the majority of patients with advanced disease progress and eventually die of their disease. This is a particularly frustrating scenario when a patient experiences a complete remission, only to recur with refractory disease.

This year's plenary presentations at the American Society of Clinical Oncology annual meeting, held in Chicago on June 1-5, addressed a variety of issues in five major cancer types.

A new study has determined that virtual colonoscopy that ignores lesions smaller than 6 mm provides the most cost-effective screening tool for colorectal cancer.

After controlling for socioeconomic status (SES) and treatment, African-Americans have only a marginally increased risk of death from colorectal cancer, according to a meta-analysis.

The identification of biomarkers to aid in patient selection for treatment with agents targeting epidermal growth factor receptor (EGFR) has become a high-priority research goal.

Both chemoembolization and radioembolization are safe and confer a similar survival benefit of about 7 to 8 months in patients with liver-dominant metastases of colorectal cancer in the salvage setting

In colorectal cancer patients progressing after second- and third-line therapies, cetuximab (Erbitux) is an option that may prolong progression-free and overall survival, according to phase III studies presented at the American Association for Cancer Research 2007 centennial annual meeting.

In a move more than 2 years in the making, a National Quality Forum (NQF) recently endorsed the first nationally recognized hospital-based performance measures for quality of care for breast and colorectal cancer.

Over the past decade, new cytotoxic and biologic therapies beyond the old standard-of-care, biomodulated fluorouracil (5-FU), have become available for the treatment of metastatic colorectal cancer (mCRC). The introductions of irinotecan (Camptosar), oxaliplatin (Eloxatin), and bevacizumab (Avastin) have prolonged survival, but the optimal use of these new therapies remains to be determined. Issues remain regarding management of toxicities, treatment of elderly patients or those with poor performance status, and the duration of treatment with front-line therapy. This article reviews recent and ongoing studies of newer therapies in an effort to determine the best use of these drugs in the treatment of mCRC. Current data support the front-line use of bevacizumab added to either 5-FU/leucovorin alone or 5-FU/leucovorin in combination with oxaliplatin (FOLFOX/bevacizumab) or irinotecan (FOLFIRI/bevacizumab). If oxaliplatin is used in first-line therapy, oxaliplatin should be discontinued before the development of severe neurotoxicity and be reintroduced or replaced with irinotecan on disease progression. Definitive conclusions on the sequence and duration of front-line therapy and the most effective strategy to ameliorate toxicity await results of ongoing prospective clinical trials.

Over the past decade, new cytotoxic and biologic therapies beyond the old standard-of-care, biomodulated fluorouracil (5-FU), have become available for the treatment of metastatic colorectal cancer (mCRC). The introductions of irinotecan (Camptosar), oxaliplatin (Eloxatin), and bevacizumab (Avastin) have prolonged survival, but the optimal use of these new therapies remains to be determined. Issues remain regarding management of toxicities, treatment of elderly patients or those with poor performance status, and the duration of treatment with front-line therapy. This article reviews recent and ongoing studies of newer therapies in an effort to determine the best use of these drugs in the treatment of mCRC. Current data support the front-line use of bevacizumab added to either 5-FU/leucovorin alone or 5-FU/leucovorin in combination with oxaliplatin (FOLFOX/bevacizumab) or irinotecan (FOLFIRI/bevacizumab). If oxaliplatin is used in first-line therapy, oxaliplatin should be discontinued before the development of severe neurotoxicity and be reintroduced or replaced with irinotecan on disease progression. Definitive conclusions on the sequence and duration of front-line therapy and the most effective strategy to ameliorate toxicity await results of ongoing prospective clinical trials.

Over the past decade, new cytotoxic and biologic therapies beyond the old standard-of-care, biomodulated fluorouracil (5-FU), have become available for the treatment of metastatic colorectal cancer (mCRC). The introductions of irinotecan (Camptosar), oxaliplatin (Eloxatin), and bevacizumab (Avastin) have prolonged survival, but the optimal use of these new therapies remains to be determined. Issues remain regarding management of toxicities, treatment of elderly patients or those with poor performance status, and the duration of treatment with front-line therapy. This article reviews recent and ongoing studies of newer therapies in an effort to determine the best use of these drugs in the treatment of mCRC. Current data support the front-line use of bevacizumab added to either 5-FU/leucovorin alone or 5-FU/leucovorin in combination with oxaliplatin (FOLFOX/bevacizumab) or irinotecan (FOLFIRI/bevacizumab). If oxaliplatin is used in first-line therapy, oxaliplatin should be discontinued before the development of severe neurotoxicity and be reintroduced or replaced with irinotecan on disease progression. Definitive conclusions on the sequence and duration of front-line therapy and the most effective strategy to ameliorate toxicity await results of ongoing prospective clinical trials.

In patients with colorectal cancer, a 'hand-in' approach to laparoscopic surgery—hand-assisted laparoscopic surgery (HALS)—may yield benefits beyond those of traditional laparoscopic techniques, particularly reduced operation time.

The Jay Monahan Center for Gastrointestinal Health at New York-Presbyterian Hospital/Weill Cornell Medical Center is teaming up with New York City's taxi drivers to remind New Yorkers and visitors to the city to get screened for colon cancer.

A new way to select for further testing those people who are at risk for Lynch syndrome may increase detection of the disorder, also known as hereditary nonpolyposis colorectal cancer (HNPCC). The syndrome, which predisposes people to developing colorectal cancer at a young age, is caused by germline mutations in DNA mismatch repair (MMR) genes.

Better communication is needed between oncologists and their patients regarding the benefits and risks of adjuvant therapy

Preliminary findings from Italian researchers show that adding oxaliplatin (Eloxatin) to preoperative chemoradiotherapy (CRT) for rectal cancer is feasible and safe, and does not adversely affect the ability to carry out subsequent surgery.

About 6% of colorectal cancers are caused by genetic mutations associated with hereditary colorectal cancer syndromes. The most common hereditary cancer syndromes nurses are likely to encounter include hereditary nonpolyposis colon cancer or Lynch syndrome, familial adenomatous polyposis, attenuated familial adenomatous polyposis, and MYH polyposis. Current colorectal cancer recommendations for risk management, screening, and surveillance are complex and based on level of colorectal cancer risk and whether an individual carries a genetic mutation associated with a hereditary colorectal cancer syndrome. Caring for patients with hereditary colorectal cancer syndromes requires nurses to understand how to identify individuals and families at risk for hereditary colorectal cancer, refer to appropriate resources, and provide accurate information regarding screening, surveillance, and management. Nurses play a critical role in assessing colorectal cancer risk, obtaining an accurate family history of cancer, and providing information concerning appropriate cancer screening and surveillance.

The monoclonal antibody bevacizumab (Avastin) is likely to have a variety of uses in cancer treatment but also carries with it risks that require careful monitoring by oncology nursing staff

ImClone Systems and Bristol-Myers Squibb have announced that a phase III study of cetuximab (Erbitux) plus FOLFIRI (an irinotecan-based chemotherapy regimen) met the primary endpoint of increasing median duration of progression-free survival (PFS) over FOLFIRI alone in patients with previously untreated metastatic colorectal cancer.

British researchers have developed a vaccine that stimulates colorectal cancer patients' immune systems to fight cancerous cells. In a clinical trial of 67 patients, investigators at the University of Nottingham observed that when the vaccines were administered before and after surgery to remove cancerous tumors, they helped stimulated immune cell production in up to 70% of patients. These results were published in a recent issue of Clinical Cancer Research.