Medscape InDiscussion: Colorectal Cancer Medscape

Are you using liquid biopsies in your practice? Join Drs Benjamin Schlechter and Pashtoon Kasi as they review the latest clinical applications of ctDNA and liquid biopsies in colorectal cancer.
Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1000089. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Colon Cancer https://emedicine.medscape.com/article/277496-overview
Using Circulating Tumor DNA in Colorectal Cancer: Current and Evolving Practices https://pubmed.ncbi.nlm.nih.gov/35839443/
Methylomics and Cancer: The Current State of Methylation Profiling and Marker Development for Clinical Care https://pubmed.ncbi.nlm.nih.gov/37840147/
Circulating Tumor DNA (ctDNA) for Informing Adjuvant Chemotherapy (ACT) in Stage II/III Colorectal Cancer (CRC): Interim Analysis of BESPOKE CRC Study https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.9
Molecular Residual Disease and Efficacy of Adjuvant Chemotherapy in Patients With Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/36646802/
CIRCULATE-Japan: Circulating Tumor DNA-Guided Adaptive Platform Trials to Refine Adjuvant Therapy for Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/33931919/
Minimal Residual Disease-Directed Adjuvant Therapy for Patients With Early-Stage Colon Cancer: CIRCULATE-US https://pubmed.ncbi.nlm.nih.gov/36260786/
Circulating Tumor DNA Analysis Guiding Adjuvant Therapy in Stage II Colon Cancer https://pubmed.ncbi.nlm.nih.gov/35657320/
Circulating Tumor DNA as a Predictive Biomarker in Adjuvant Chemotherapy for Patients With Stage 2a Colon Cancer (COBRA) https://pubmed.ncbi.nlm.nih.gov/33999346/
Clonal Hematopoiesis Detection in Patients With Cancer Using Cell-Free DNA Sequencing https://pubmed.ncbi.nlm.nih.gov/36989374/
Commercial ctDNA Assays for Minimal Residual Disease Detection of Solid Tumors https://pubmed.ncbi.nlm.nih.gov/34725800/
The PEGASUS Trial: Post-Surgical Liquid Biopsy-Guided Treatment of Stage III and High-Risk Stage II Colon Cancer Patients https://www.annalsofoncology.org/article/S0923-7534(23)04164-9/fulltext
Microsatellite Instability: A Review of What the Oncologist Should Know https://pubmed.ncbi.nlm.nih.gov/31956294/
Utility and Debate of Liquid Biopsy Assays in Surveillance Setting https://dailynews.ascopubs.org/do/utility-and-debate-liquid-biopsy-assays-surveillance-setting
Radioembolization With Chemotherapy for Colorectal Liver Metastases: A Randomized, Open-Label, International, Multicenter, Phase III Trial https://pubmed.ncbi.nlm.nih.gov/34541864/

Young-onset colorectal cancer is on the rise, challenging GI oncologists across the globe. Join Drs Benjamin Schlechter and Kimmie Ng as they share their expertise and experience.
Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1000090. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines https://pubmed.ncbi.nlm.nih.gov/36549470/
DNA Mutational Profiling in Patients With Colorectal Cancer Treated With Standard of Care Reveals Differences in Outcome and Racial Distribution of Mutations https://pubmed.ncbi.nlm.nih.gov/37992266/
Comprehensive Genomic Landscapes in Early and Later Onset Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/31243121/
Evaluation of Genomic Alterations in Early-Onset Versus Late-Onset Colorectal Cancer https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.3511
Young Onset Colorectal Cancer Patients Are Diagnosed With Advanced Disease After Multiple Misdiagnoses https://aacrjournals.org/cancerres/article/79/13_Supplement/3347/635227/Abstract-3347-Young-onset-colorectal-cancer
Association of Obesity With Risk of Early-Onset Colorectal Cancer Among Women https://pubmed.ncbi.nlm.nih.gov/30326010/
Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/30740587/
Sugar-Sweetened Beverage Intake in Adulthood and Adolescence and Risk of Early-Onset Colorectal Cancer Among Women https://pubmed.ncbi.nlm.nih.gov/33958435/
A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers https://pubmed.ncbi.nlm.nih.gov/34405229/
Survival in Young-Onset Metastatic Colorectal Cancer: Findings From Cancer and Leukemia Group B (Alliance)/SWOG 80405 https://pubmed.ncbi.nlm.nih.gov/34636852/
Overtreatment of Young Adults With Colon Cancer: More Intense Treatments With Unmatched Survival Gains https://pubmed.ncbi.nlm.nih.gov/25806815/

Join Drs Benjamin Schlechter and Cathy Eng as they discuss the treatments and clinical trials available for patients with refractory colorectal cancer.
Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1000091. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Randomized Trial of TAS-102 for Refractory Metastatic Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/25970050/
Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/37133585/
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Colon Cancer https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf
Regorafenib Monotherapy for Previously Treated Metastatic Colorectal Cancer (CORRECT): An International, Multicentre, Randomised, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/23177514/
Regorafenib Plus Best Supportive Care Versus Placebo Plus Best Supportive Care in Asian Patients With Previously Treated Metastatic Colorectal Cancer (CONCUR): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/25981818/
Regorafenib Dose-Optimisation in Patients With Refractory Metastatic Colorectal Cancer (ReDOS): A Randomised, Multicentre, Open-Label, Phase 2 Study https://pubmed.ncbi.nlm.nih.gov/31262657/
Preemptive Versus Reactive Topical Clobetasol for Regorafenib-Induced Hand-Foot Reactions: A Preplanned Analysis of the ReDOS Trial https://pubmed.ncbi.nlm.nih.gov/33604969/
Fruquintinib Versus Placebo in Patients With Refractory Metastatic Colorectal Cancer (FRESCO-2): An International, Multicentre, Randomised, Double-Blind, Phase 3 Study https://pubmed.ncbi.nlm.nih.gov/37331369/
Targeting KRAS in Cancer https://pubmed.ncbi.nlm.nih.gov/38637634/
Effect of Fruquintinib vs Placebo on Overall Survival in Patients With Previously Treated Metastatic Colorectal Cancer: The FRESCO Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/29946728/

Keep up to date on the newest research and clinical application of immunotherapy treatments in colorectal cancer with leading experts Dr Benjamin Schlechter and Marwan Fakih.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/986437). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Colorectal Cancer https://www.medscape.com/viewarticle/776784
Microsatellite Instability in Colorectal Cancer: Overview of Its Clinical Significance and Novel Perspectives https://pubmed.ncbi.nlm.nih.gov/30543589/
PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer https://pubmed.ncbi.nlm.nih.gov/35660797/
Dostarlimab: The Miracle Drug for the Treatment of Colorectal Cancer https://pubmed.ncbi.nlm.nih.gov/36060435/
Neoadjuvant Immunotherapy Leads to Pathological Responses in MMR-Proficient and MMR-Deficient Early-Stage Colon Cancers https://pubmed.ncbi.nlm.nih.gov/32251400/
Lynch Syndrome https://www.ncbi.nlm.nih.gov/books/NBK431096/
Optimal Management of Low Anterior Resection Syndrome: Colorectal Cancer (Update) https://pubmed.ncbi.nlm.nih.gov/32730011/
Pembrolizumab (Rx) https://reference.medscape.com/drug/keytruda-pembrolizumab-999962
Carcinomatosis https://www.cancer.gov/publications/dictionaries/cancer-terms/def/carcinomatosis
Association of Tumour Mutational Burden With Outcomes in Patients With Advanced Solid Tumours Treated With Pembrolizumab: Prospective Biomarker Analysis of the Multicohort, Open-Label, Phase 2 KEYNOTE-158 Study https://pubmed.ncbi.nlm.nih.gov/32919526/
Pembrolizumab Versus Chemotherapy for Microsatellite Instability-High or Mismatch Repair-Deficient Metastatic Colorectal Cancer (KEYNOTE-177): Final Analysis of a Randomised, Open-Label, Phase 3 Study https://pubmed.ncbi.nlm.nih.gov/35427471/
Circulating Tumor DNA Test May Help Guide GI Cancer Management https://www.medscape.com/viewarticle/982900
Durvalumab and Tremelimumab Combination Therapy Versus Durvalumab or Tremelimumab Monotherapy for Patients With Solid Tumors: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/32664183/
FOLFOXIRI/Bevacizumab Plus Nivolumab as First-Line Treatment in Metastatic Colorectal Cancer RAS/BRAF Mutated: Safety Run-In of Phase II NIVACOR Trial https://pubmed.ncbi.nlm.nih.gov/34970487/
Use of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: Initial Results From the Pembrolizumab Arm of a Phase 2 Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/34196693/
Regorafenib, Ipilimumab, and Nivolumab for Patients With Microsatellite Stable Colorectal Cancer and Disease Progression With Prior Chemotherapy: A Phase 1 Nonrandomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/36892833/
Regorafenib Plus Nivolumab in Patients With Advanced Gastric or Colorectal Cancer: An Open-Label, Dose-Escalation, and Dose-Expansion Phase Ib Trial (REGONIVO, EPOC1603) https://pubmed.ncbi.nlm.nih.gov/32343640/
Regorafenib Plus Nivolumab in Patients With Mismatch Repair-Proficient/Microsatellite Stable Metastatic Colorectal Cancer: A Single-Arm, Open-Label, Multicentre Phase 2 Study https://pubmed.ncbi.nlm.nih.gov/37090438/
CTLA-4 Cytotoxic T-Lymphocyte Associated Protein 4 [Homo sapiens (human)] https://www.ncbi.nlm.nih.gov/gene/1493
iRECIST: Guidelines for Response Criteria for Use in Trials Testing Immunotherapeutics https://pubmed.ncbi.nlm.nih.gov/28271869/
Fc-Engineered Anti-CTLA-4 Monoclonal Antibody in Advanced Cancer https://clinicaltrials.gov/ct2/show/NCT03860272
A Study of Botensilimab and Balstilimab for the Treatment of Colorectal Cancer https://clinicaltrials.gov/ct2/show/NCT05608044

When you see an older adult with colorectal cancer, how do you fit your care to their needs? Join Dr Benjamin Schlechter and geriatric medical oncology expert Dr Nadine McCleary for clinical pearls.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988970). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Colorectal Cancer https://www.medscape.com/viewarticle/776784
Comprehensive Geriatric Assessment--A Guide for the Non-specialist https://pubmed.ncbi.nlm.nih.gov/24118661/
Comprehensive Geriatric Assessment for Older Patients With Cancer https://pubmed.ncbi.nlm.nih.gov/17488980/
Performance Status Assessment by Using ECOG (Eastern Cooperative Oncology Group) Score for Cancer Patients by Oncology Healthcare Professionals https://pubmed.ncbi.nlm.nih.gov/31616281/
NCCN Guidelines https://www.nccn.org/guidelines/category_1
ePrognosis https://eprognosis.ucsf.edu/
Duration of Adjuvant Chemotherapy for Stage III Colon Cancer https://pubmed.ncbi.nlm.nih.gov/29590544/
Oxaliplatin https://www.cancer.gov/publications/dictionaries/cancer-drug/def/oxaliplatin
Colon Cancer Staging https://emedicine.medscape.com/article/2006674-overview
Survival Following Recurrence in Stage II and III Colon Cancer: Findings From the ACCENT Data Set https://pubmed.ncbi.nlm.nih.gov/18467725/
Oxaliplatin Combined With Weekly Bolus Fluorouracil and Leucovorin as Surgical Adjuvant Chemotherapy for Stage II and III Colon Cancer: Results From NSABP C-07 https://pubmed.ncbi.nlm.nih.gov/17470851/
Oxaliplatin, Fluorouracil, and Leucovorin as Adjuvant Treatment for Colon Cancer https://pubmed.ncbi.nlm.nih.gov/15175436/
Colon Cancer Medication https://emedicine.medscape.com/article/277496-medication
Capecitabine https://www.cancer.gov/publications/dictionaries/cancer-drug/def/capecitabine
The ARCAD Advanced Colorectal Cancer Database--Open for Business https://pubmed.ncbi.nlm.nih.gov/22104572/
Effect of Adjuvant Chemotherapy on Survival of Patients With Stage III Colon Cancer Diagnosed After Age 75 Years https://pubmed.ncbi.nlm.nih.gov/22665536/
FOLFOX and FOLFIRI Use in Stage IV Colon Cancer: Analysis of SEER-Medicare Data https://pubmed.ncbi.nlm.nih.gov/30878317/
Alliance for Clinical Trials in Oncology https://www.allianceforclinicaltrialsinoncology.org/main/
Cancer and Aging Research Group https://www.mycarg.org/
Effect of Duration of Adjuvant Chemotherapy for Patients With Stage III Colon Cancer (IDEA Collaboration): Final Results From a Prospective, Pooled Analysis of Six Randomised, Phase 3 Trials https://pubmed.ncbi.nlm.nih.gov/33271092/
Should Capecitabine Replace Infusional Fluorouracil and Leucovorin When Combined With Oxaliplatin in Metastatic Colorectal Cancer? https://ascopubs.org/doi/full/10.1200/JCO.2007.11.6582
Metastatic Colorectal Cancer Outcomes by Age Among ARCAD First- and Second-Line Clinical Trials | JNCI Cancer Spectrum | Oxford Academic (oup.com) https://academic.oup.com/jncics/article/6/2/pkac014/6537541

Join Drs Benjamin Schlechter and Harvey Mamon as they discuss treatment options for patients with stage II and III rectal cancer based on new data from the most recent clinical trial results.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988971). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Colon Cancer https://emedicine.medscape.com/article/277496-overview
Colon Cancer Staging https://emedicine.medscape.com/article/2006674-overview
Signal Transduction https://www.cancer.gov/publications/dictionaries/cancer-terms/def/signal-transduction
Preoperative Treatment of Locally Advanced Rectal Cancer https://pubmed.ncbi.nlm.nih.gov/37272534/
Neoadjuvant Chemotherapy Without Routine Use of Radiation Therapy for Patients With Locally Advanced Rectal Cancer: A Pilot Trial https://pubmed.ncbi.nlm.nih.gov/24419115/
FOLFOX Regimen https://www.cancer.gov/publications/dictionaries/cancer-terms/def/folfox-regimen
Cancer Therapy Evaluation Program https://ctep.cancer.gov/
Common Terminology Criteria for Adverse Events (CTCAE) v5.0 https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf
Patient-Reported Outcomes During and After Treatment for Locally Advanced Rectal Cancer in the PROSPECT Trial (Alliance N1048) https://pubmed.ncbi.nlm.nih.gov/37270691/
Abdominoperineal Resection https://www.ncbi.nlm.nih.gov/books/NBK574568/
The Circumferential Resection Margin Is a Prognostic Predictor in Colon Cancer https://pubmed.ncbi.nlm.nih.gov/32670875/
Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy https://pubmed.ncbi.nlm.nih.gov/35483010/
Total Neoadjuvant Therapy (TNT) Versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/33987952/
Testing the Addition of an Anti-Cancer Drug, Irinotecan, to the Standard Chemotherapy Treatment (FOLFOX) After Long-Course Radiation Therapy for Advanced-Stage Rectal Cancers to Improve the Rate of Complete Response and Long-Term Rates of Organ Preservation (JANUS) https://classic.clinicaltrials.gov/ct2/show/NCT05610163
Factors Influencing Downstaging After Neoadjuvant Long-Course Chemoradiotherapy in Rectal Carcinoma https://pubmed.ncbi.nlm.nih.gov/35545701/
Carcinoembryonic Antigen https://www.ncbi.nlm.nih.gov/books/NBK578172/
Short-Course Radiotherapy Followed by Chemotherapy Before Total Mesorectal Excision (TME) Versus Preoperative Chemoradiotherapy, TME, and Optional Adjuvant Chemotherapy in Locally Advanced Rectal Cancer (RAPIDO): A Randomised, Open-Label, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/33301740/
Neoadjuvant Chemotherapy With FOLFIRINOX and Preoperative Chemoradiotherapy for Patients With Locally Advanced Rectal Cancer (UNICANCER-PRODIGE 23): A Multicentre, Randomised, Open-Label, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/33862000/
FOLFIRINOX Regimen https://www.cancer.gov/publications/dictionaries/cancer-terms/def/folfirinox-regimen
Locoregional Failure During and After Short-Course Radiotherapy Followed by Chemotherapy and Surgery Compared to Long-Course Chemoradiotherapy and Surgery - A Five-Year Follow-Up of the RAPIDO Trial https://pubmed.ncbi.nlm.nih.gov/36661037/