Minimally Invasive Surgery, Targeted Therapies Offer Options for CRC

Advances in minimally invasive surgery have reached the highest level in the history of surgery, according to Alessio Pigazzi, MD, PhD, FACS, FASCRS.

CancerNetwork^® spoke with Pigazzi, executive medical director of Surgical Services, the vice chair of Clinical Network Surgery in the Department of Surgery, and clinical professor in the division of Colorectal Surgery at City of Hope Orange County, about his recent appointment as executive medical director at the institution. The appointment comes 20 years after Pigazzi performed the first robot-assisted tumor removal for rectal cancer. Pigazzi also highlighted recent surgical and medical oncology developments in the colorectal cancer field.

Pigazzi emphasized the advances in minimally invasive surgeries for colorectal cancers, particularly the level of technical expertise, while expressing a need for more trained surgeons to utilize the available technology to perform these surgeries. Specifically, he highlighted the ability of minimally invasive surgery technology to facilitate difficult procedures while reducing recovery times and improving patient outcomes.

Additionally, Pigazzi described the ongoing development of targeted therapies for colorectal cancers. In contrast with standard chemotherapy agents indiscriminately attacking healthy and malignant cells and potentially resulting in adverse effects, modalities such as immunotherapy may help the treatment paradigm evolve over time.

Transcript:

On the surgical side, the advances in minimally invasive surgery have now reached a peak; the highest level in the history of surgery. The level of technical expertise and the tools available have never been as good as they are now. There is still a lot of work to do, mostly in terms of training more surgeons, but we do have tools available that are amazing in terms of being able to do the most difficult procedures in a minimally invasive way, therefore ensuring optimal recovery and patient outcomes.

On the medical oncology side—and that is very important because we are really working together on every case—we are making strides constantly with the use of targeted therapies. These therapies are usually specifically designed molecules that hit specific molecular pathways present in a specific tumor instead of giving the standard chemotherapy, which destroys good cells and bad cells indiscriminately and has a lot of [adverse] effects. One classic example of this that has received quite a bit of attention in the media is the use of immunotherapy for certain types of tumors. This paradigm will continue to evolve in the future, and I am sure that the next 20 years will be extremely exciting in this field.

Reference

City of Hope Orange County appoints Alessio Pigazzi, M.D., Ph.D., as executive medical director, colorectal surgery. News release. City of Hope Orange County. August 20, 2024. Accessed September 4, 2024. https://tinyurl.com/yf4p8np3