Colorectal Cancer

Cancer in the proximal colon, the right part of the colon closest to the small intestine, has been increasing in African-American men since the mid-1990s.

A gene-based therapeutic cancer vaccine given along with standard chemotherapy produced tumor shrinkage in 6 of 11 evaluable patients with metastatic colorectal cancer. Results of the phase II trial

This photograph is from an upper gastrointestinal endoscopy on a 15-year-old male. He has a history of a total colectomy and is being evaluated for iron deficiency anemia. He denies abdominal pain, weight loss, and melena. He notes occasional bright red blood on the toilet paper but denies hematochezia.

A 72-year-old man is referred for evaluation of abnormal liver chemistries. He has a history of unresectable pancreatic cancer (adenocarcinoma of the head).

Interim results of a phase I/II trial of NV1020, an oncolytic herpes simplex virus (HSV), in refractory metastatic colorectal cancer patients are encouraging

Amgen is currently enrolling patients in a phase III study designed to evaluate the effectiveness of panitumumab (Vectibix) in combination with chemotherapy (FOLFIRI)

Nanoparticle albumin-bound (nab) rapamycin (ABI-009) showed antitumor activity in xeno-graft models of breast and colon cancer, according to investigators from Abraxis BioScience

Capsule endoscopy may eventually rival colonoscopy for the detection of colon polyps, according to the leaders of an ongoing clinical trial comparing the two technologies.

Integrins have direct effects in stimulating proliferation and preventing apoptosis in cancer cells and mediating proangiogenic interactions between endothelial cells and extracellular matrix. Alterations of expression of various integrins and their receptors have been observed in various cancers in which angiogenesis is known to play a role, including colorectal cancer. Inhibition of specific integrins might thus inhibit both direct effects of integrins on cancer cells and tumor angiogenesis. Inhibitory peptides and anti-integrin monoclonal antibodies are currently being investigated in clinical trials in patients with solid tumors, with early evidence suggesting clinical benefit in disease stabilization with use of an anti-αvβ3 antibody in the settings of colorectal cancer, renal cell carcinoma, and melanoma. Integrin inhibition alone and with other targeted therapeutic approaches should be further investigated in clinical trials in patients with colorectal cancer.

Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are often overexpressed in colorectal cancer and are associated with inferior outcomes. Based on successful randomized phase III trials, anti-EGFR and anti-VEGF therapeutics have entered clinical practice. Cetuximab (Erbitux), an EGFR-specific antibody, is currently approved in the United States in combination with irinotecan (Camptosar) for patients with metastatic colorectal cancer refractory to irinotecan or as a single agent for patients unable to tolerate irinotecan-based therapy. In retrospective analyses, patients with EGFR-expressing rectal cancer undergoing neoadjuvant radiation therapy had a significantly inferior disease-free survival and lower rates of achieving pathologic complete response. Based on the positive data in metastatic colorectal cancer and synergy with radiation therapy seen in preclinical models, there is a strong rationale to combine cetuximab with neoadjuvant radiation therapy and chemotherapy in rectal cancer. Bevacizumab (Avastin), a VEGF-specific antibody, was the first antiangiogenic agent to be approved in the United States for use in combination with standard chemotherapy in the first- and second-line of treatment in metastatic colorectal cancer. VEGF-targeted therapy may lead to indirect killing of cancer cells by damaging tumor blood vessels, and may increase the radiosensitivity of tumor-associated endothelial cells. VEGF blockade can also "normalize" tumor vasculature, thereby leading to greater tumor oxygenation and drug penetration. This review will address completed and ongoing trials that have established and continue to clarify the effects of these agents in rectal cancer.

In an ongoing phase I trial in patients with solid tumors and lymphomas, the small-molecule tumor vascular disrupting agent NPI-2358 (Nereus Pharmaceuticals, San Diego, California) was dose escalated without evidence of dose-limiting toxicity

FOLFOX4 given before and after resection of colorectal cancer liver metastases can significantly reduce the risk of recurrence, according to final data from the first study to test this approach.

"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.