Researchers reported a number of important findings in colorectal cancer treatment at the 2019 Annual Meeting of the American Society of Clinical Oncology:

“Circulating tumor DNA” analysis being researched as tool in colorectal cancer

Colorectal tumors can shed tiny bits of DNA, which then circulate throughout the body. Researchers are seeking to learn how analysis of this “circulating tumor DNA” (ctDNA) can help detect, diagnose and treat colorectal cancer.

What Patients Need to Know

While the research is at an early stage, analysis of ctDNA has the potential for a number of uses in colorectal cancer. One potential use is checking the blood for ctDNA after surgery, to see if any disease remains in the body. This analysis would allow doctors to be more certain about which patients would benefit from post-surgery chemotherapy.

Duration of post-surgery chemotherapy regimens evaluated in high-risk stage II colon cancer

As a treatment for high-risk stage II colon cancer, the results of a recent analysis suggest that three months of CAPOX (capecitabine plus oxaliplatin) given after surgery may be as effective as six months of CAPOX and result in less toxicity.

The analysis was conducted by the IDEA (International Duration Evaluation of Adjuvant Chemotherapy) Collaboration.

What Patients Need to Know

There were no significant differences in the five-year recurrence rate for patients who received either three or six months of treatment with CAPOX, which is given in pill form. However, the analysis showed that six months of intravenous treatment with FOLFOX (folinic acid, fluorouracil and oxaliplatin) was more effective than three months of FOLFOX treatment.

Up-front chemotherapy evaluated in treatment of colon cancer

The standard of care for resectable (surgically operable) stage I, II or III colon cancer is to remove the tumor with surgery, followed by treatment with chemotherapy for between three and six months.

The international FOxTROT trial evaluated whether colon cancer patients could benefit from six weeks of up-front (neoadjuvant) chemotherapy, followed by surgery and 18 weeks of chemotherapy.

What Patients Need to Know

Although the results were not conclusive, researchers found a promising trend toward fewer cancer recurrences over a two-year period in patients who received chemotherapy before surgery.

Chemotherapy regimen FOLFOXIRI evaluated as first-line approach for metastatic colorectal cancer

In the treatment of unresectable (inoperable) metastatic colorectal cancer, the phase III TRIBE2 trial showed the clinical superiority of FOLFOXIRI plus the targeted therapy bevacizumab, as compared with sequential treatment with FOLFOX plus bevacizumab followed by FOLFIRI plus bevacizumab.

The results were consistent with the results of the TRIBE trial and support the use of FOLFOXIRI plus bevacizumab as a first-line (initial) approach in the treatment of unresectable metastatic colorectal cancer

What Patients Need to Know

FOLFOXIRI, FOLFOX and FOLFIRI are all chemotherapy regimens. FOLFOXIRI consists of folinic acid, 5-fluorouracil, oxaliplatin and irinotecan. FOLFOX is FOLFOXIRI without irinotecan, and FOLFIRI is FOLFOXIRI without oxaliplatin