Van Morris, MD, assistant professor in the department of gastrointestinal medical oncology at The University of Texas MD Anderson Cancer Center, spoke about novel treatment strategies undergoing investigation for patients with colorectal and anal cancer at the 2020 Gastrointestinal Cancers Symposium, which was held January 23-25, in San Francisco, California.
Yeah, so I think in terms of novel treatment strategies, again I think there are multiple exciting clinical trials that are going on right now. There are trials looking at the role of surgical resection of traditionally unresectable disease in the oligometastatic setting, and there are also trials looking at the roles of definitive radiotherapy for 5 or fewer metastases in patients with what is traditionally considered unresectable metastatic colorectal cancer.
In terms of novel treatment approaches for patients with anal cancer that incorporate immunotherapy, I’m really excited about the NCI9673 trial, which is…a randomized phase II trial looking at patients with unresectable, treatment refractory, metastatic anal cancer randomizing them to either receive nivolumab (Opdivo) as a single agent, or nivolumab in combination with the anti-CTLA4 antibody ipilimumab (Yervoy).
But I think as well, another interesting trial is looking at patients with high-risk local/regional anal cancer, and this is the EA2165 trial that’s currently ongoing. Patients with either T3 or T4 primary tumors, or node positive non-metastatic disease undergo definitive standard-of-care chemoradiation and then are randomized either to standard of care, which would be observation, or 6 months of post-treatment anti-PD1 therapy with nivolumab. I think that this is a very important trial because it will help us to see if there is a role of moving immunotherapy into the local/regional space for patients with anal cancer.