Gastrointestinal Cancer

In this review we discuss the current treatment options in metastatic colon cancer, with a special focus on biologic agents and how molecular understanding guides treatment decisions.

It was originally hoped that the presence of mutations in KRAS and other related genes would provide an easy answer as to whether to administer anti-EGFR antibody therapy to a given metastatic colorectal cancer patient. However, in nature nothing is simple, and there are a number of issues that practicing clinicians should be made aware of.

Progress in the area of targeted therapies for colorectal cancer has come slowly and with some difficulty.

In this interview, we discuss the current state of pancreatic cancer management, and look toward trials to further define the best course of treatment for this deadly disease.

Patients with heavily pretreated metastatic gastrointestinal stromal tumors were able to tolerate combined treatment with the pan-deacetylase inhibitor panobinostat and imatinib, according to the results of a small phase I study.

As part of our coverage of the 2014 ASCO GI Symposium, we highlight some of the most interesting trials presented at this year's meeting.

A phase II trial showed that patients with advanced gastrointestinal stromal tumors had a marginal response to pazopanib when assigned to the treatment after two or more failed therapies.

The combination of two anticancer vaccines demonstrated improved survival compared to a single vaccine in patients with advanced pancreatic cancer, a particularly difficult to treat tumor type with few therapy options.

Adding ramucirumab to paclitaxel significantly increased survival in patients with metastatic gastric cancer whose disease had progressed on first-line therapy.

Results of a small study indicate that patients with gastrointestinal stromal tumors had increased activity of Src, but unlike in other tumors, it may be associated with longer overall survival.

Completion of 6 cycles of adjuvant chemotherapy, rather than time of initiation, was an independent prognostic factor after resection of pancreatic adenocarcinoma, according to results taken from the phase III European Study Group for Pancreatic Cancer-3.

After 2 decades of disappointing phase III trials and years of single-agent gemcitabine therapy, the pancreatic cancer community is relieved to expand the front-line armamentarium in patients with mPAC. Here we evaluate the current landscape and ask some provocative questions about response rate, dosing, and predictive markers.

All improvements in outcomes for patients with metastatic pancreatic adenocarcinoma have occurred with the use of cytotoxic agents, which will probably remain the mainstay of treatment for advanced pancreatic adenocarcinoma.

Gemcitabine monotherapy has been the standard of care for patients with metastatic pancreatic cancer for several decades. Despite recent advances in various chemotherapeutic regimens and in the development of targeted therapies, metastatic pancreatic cancer remains highly resistant to chemotherapy.

In light of two recent positive clinical trials for advanced pancreatic cancer, we are currently facing an interesting situation that those of us who treat this disease have not had to deal with previously: what to do with this expanding array of choices?

Researchers have developed a new online risk assessment tool that can accurately estimate an individual’s risk of developing colorectal cancer.

Researchers have identified a potential new method for treating pancreatic cancer, using calcium to overload pancreatic cancer cells and, thus, induce cell death in cancerous cells while sparing healthy cells.

In a new study using mice, researchers show that targeting the protein BMI-1 in colorectal cancer can eliminate the self-renewing cell population and lead to long-term inhibition of tumor growth.

A decreased diversity of gut microbiota was associated with an increased risk of colorectal cancer, according to the results of a new study.

Patients who exhibited certain clusters of symptoms after undergoing surgery for esophageal cancer were at an increased risk for mortality, according to the results of a prospective Swedish cohort study.

Trends in pancreatic mortality have gone in opposite directions for blacks and whites during the last few decades, a pattern which cannot be explained by known risk factors, according to researchers from the American Cancer Society.

Researchers at Kaiser Permanente were able to achieve complete histopathologic response in more than 40% of initially unresectable patients with pancreatic adenocarcinoma who underwent prolonged preoperative chemotherapy and were subsequently able to undergo surgical resection.

In this podcast, we discuss whether all male colorectal cancer patients over the age of 60 should be screened for prostate cancer.

The surgical strategies of “classic, reversed, or combined” resection of colorectal cancer and colorectal liver metastases have to be tailored to a specific patient, and all three strategies have a role in the treatment of stage IV colorectal cancer today.

There is limited data available to guide decision making in the management of colorectal liver metastases. Despite a trend toward increased use of perioperative chemotherapy, others have questioned the role of this approach in patients with solitary lesions and a longer disease-free interval.

In a good percentage of patients who have oligometastatic disease confined to a single organ-usually the liver-complete metastasectomy can result in cure. However, once the decision to pursue surgery is made, there remain a number of issues that must be addressed in order to ensure the best possible outcome.

Patients with a high body mass index prior to being diagnosed with pancreatic cancer had reduced survival from the disease and were more likely to present with late-stage cancer, according to the results of a recently published study.

The two drug combination of cetuximab plus brivanib alaninate worsened quality of life and did not improve overall survival in patients with KRAS wild-type metastatic colorectal cancer.

No difference in overall survival was seen for surgery with or without FOLFOX4 in patients with initially resectable liver metastases from colorectal cancer, according to the results of a new study.

We discuss colorectal cancer screening with two gastroenterologists, including results from two recently published studies showing long-term effects of screening.