Novel Modalities Yield New Era for Surgical Oncology in CRC

EP: 1.Laparoscopy Yields Increased Surgical Outcomes in Colorectal Cancer

EP: 2.Addressing the Growing Colorectal Cancer Incidence in Younger Populations

EP: 3.Neoadjuvant Treatment Has Potential in Select CRC Populations

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EP: 4.Novel Modalities Yield New Era for Surgical Oncology in CRC

EP: 5.Leveraging Surgical Oncology Advances in Colorectal Cancer Care

New treatment modalities such as immunotherapy have made it a “very exciting time” to be a surgical oncologist in the colorectal cancer (CRC) field, according to Gregory Charak, MD.

Charak, a board-certified colorectal surgeon at Palisades Medical Center and Hackensack University Medical Center of Hackensack Meridian Health, spoke with CancerNetwork^® at John Theurer Cancer Center about novel therapy strategies that have the potential to impact the standard of care in CRC.

Specifically, Charak described immunotherapy as an “elegant” strategy for treating this patient population compared with employing cytotoxic agents or more invasive surgical techniques. He stated that it would be “exciting” to learn how to apply immunotherapy to a greater proportion of tumors.

According to findings published by Cancer Research Institute, administering immunotherapy to patients with CRC may especially demonstrate efficacy in those with microsatellite instability–high (MSI-H) disease.¹ Previously approved agents in this drug class include the monoclonal antibody panitumumab (Vectibix), which the FDA approved in June 2017 for use in combination with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) as frontline therapy for those with RAS wild-type metastatic CRC.²

Other types of immunotherapy in CRC include checkpoint inhibitors such as pembrolizumab (Keytruda), which the FDA approved in June 2020 for use as first-line treatment for patients with unresectable or metastatic disease that is MSI-H or mismatch repair deficient (dMMR).³ Additionally, nivolumab (Opdivo) was granted an accelerated approval for MSI-H or dMMR CRC in July 2017.⁴ The FDA also granted accelerated approval to ipilimumab (Yervoy) in combination with nivolumab for MSI-H or dMMR metastatic CRC in July 2018.⁵

Transcript:

It’s a very exciting time to be a surgical oncologist. [There are] tremendous new treatment modalities coming down the pike. Immunotherapy, in particular, is extremely exciting because it’s such an elegant way to treat cancer: to harness and augment the body’s own defense system to eliminate a cancer rather than using cytotoxic chemicals or invasive surgery. It’s a beautiful thing. If we can get it to apply to more and more tumors and figure out how to make it work, it couldn’t be more exciting.

References

1. Immunotherapy for colorectal cancer: how is immunotherapy for colorectal cancer changing the outlook for patients? Cancer Research Institute. Accessed April 25, 2024. https://tinyurl.com/r8unsewn
2. FDA approves Vectibix® (Panitumumab) for use in wild-type RAS metastatic colorectal cancer. News release. Amgen. June 29, 2017. Accessed April 25, 2024. https://tinyurl.com/5d6pb8nr
3. FDA approves pembrolizumab for first-line treatment of MSI-H/dMMR colorectal cancer. News release. FDA. June 29, 2020. Accessed April 25, 2024. https://tinyurl.com/47bzbpv4
4. FDA grants nivolumab accelerated approval for MSI-H or dMMR colorectal cancer. News release. FDA. July 31, 2017. Accessed April 25, 2024. https://tinyurl.com/43szkuuy
5. FDA grants accelerated approval to ipilimumab for MSI-H or dMMR metastatic colorectal cancer. News release. FDA. July 10, 2018. Accessed April 25, 2024. https://tinyurl.com/yc8m2vfw