Adjuvant treatment Colon Cancer

Size: px
Start display at page:

Download "Adjuvant treatment Colon Cancer"

Transcription

1 ESMO Preceptorship Colorectal Cancer, October 2016 Singapore Adjuvant treatment Colon Cancer Claus-Henning Köhne University Clinic for Onkology und Haematology Oldenburg, Germany

2 Aim of the lecture Adjuvant chemotherapy is indicated for stage III (N+) Capecitabine or (inf.) FU/LV are options for all patients FOLFOX / CapeOx options best for > 3 LN FOLFOX / CapeOx for patients < 70y, use with caution for pts > 70y Antibodies (EGFR, VEGF) are not indicated The decision for an adjuvant treatment should balance the risk of cancer mortality and that of comorbidities

3 5FU Increases OS and Cure in Stage III colon cancer patients Evidence in 13,793 Patients with Stage III 10.3% Moertel et al NEJM 1990 Sargent D, J Clin Oncol 2009

4 Stage III X-ACT: Overall Survival Capecitabine vs. 5-FU/FA Estimated probability Cape 2500mg/m² d1-14 Dose modifications in ~60% of patients 3-year Capecitabine (n=1004) 81.3% 5-FU/LV (n=983) 77.6% Years HR = 0.84 (95% CI: ) p=0.07 Twelves et al. NEJM 2005

5 MOSAIK Study Survival: Stage III infusional 5-FU/FA vs. FOLFOX p=0.029 Probability HR [95% CI] 4.4% Stage III 0.80 [ ] FOLFOX4 stage III LV5FU2 stage III Data cut-off: January Overall survival (months) De Gramont et al. ASCO 2007

6 Fluoropyrimidines ± Oxaliplatin Stage III HR for DFS P value DFS (%) HR for OS P value OS (%) MOSAIC (FOLFOX) 0.78 CI, 5 year % 58.9% vs 5 year 0.80 CI, 6 year % 68.7% vs 6 year NSABP C- 07 (FLOX) 0.78 CI, 5 year % 57.8% vs 5 year 0.85 CI, 5 year % 73.8% vs 5 year XELOXA (XELOX) 0.80 CI, 5 year % 62% vs 3 year 0.83 CI, 5 year % 74% vs. 77% (@ 5y) 1 André T, J Clin Oncol Yothers G, J Clin Oncol Haller D, J Clin Oncol Schmoll HJ, J Clin Oncol 2016

7 Fluoropyrimidines ± Oxaliplatin Stage III HR for DFS P value DFS (%) HR for OS P value OS (%) MOSAIC (FOLFOX) 0.78 CI, 5 year % 58.9% vs 5 year 0.80 CI, 6 year % 68.7% vs 6 year NSABP C- 07 (FLOX) 0.78 CI, 5 year % 57.8% vs 5 year 0.85 CI, 5 year % 73.8% vs 5 year XELOXA (XELOX) 0.80 CI, 5 year % 62% vs 3 year 0.83 CI, 5 year % 74% vs. 77% (@ 5y) X-ACT FU/FA bolus vs. Capecitabine 0.87 CI, 3y % 60.6% vs. 3y 0.84 CI: 0.69 p= % 77.6% vs. 1 André T, J Clin Oncol Yothers G, J Clin Oncol Haller D, J Clin Oncol Schmoll HJ, J Clin Oncol 2016

8 The achievements: Adjuvant chemotherapy for stage III colon cancer S u r v i v a l Years FOLFOX + 4% (Cape + 3%) FU/FA +15% Total ~ 20% 96% pts have no benefit from FOLFOX but > 40% persistent neurotoxicity Park et al. The Oncologist 2011

9 Adjuvant therapy with 5FU/Oxaliplatin in Colon Cancer Stage III pt3-4 N+ N 1-3 N > 3 Andre et al. JCO 2015

10 Clinical outcome from Oxaliplatin treatment in stage II/III colon cancer according to intrinsic subgroups (NASBP C-07) Nan Song et al. JAMAOncology 2016

11 ACHIEVE Trial Design Adjuvant Chemotherapy for colon cancer with HIgh EVidencE Curatively resected stage 3 colon cancer incl.rectosigmoid cancer PS0-1 R A N D O M I Z A T I O N 1:1 Arm 3: 3-month Ox-based therapy* Arm 6: 6-month Ox-based therapy* * mfolfox6 or XELOX at investigator s declaration before the randomization Primary endpoint: Relapse-free survival defined as time to colon cancer recurrence or death from any cause. Key secondary endpoints: DFS, time to treatment failure, overall survival, AEs related to treatment, completion rate of the study treatment, etc Stratification factors: primary site (colon vs. rectosigmoid vs. multiple), number of lymph nodes involved (1-3 vs. 4 or more), regimen (mfolfox6 or XELOX), age (< 70 years or > 70 years), and participating center.

12 International Duration Evaluation of Adjuvant Chemotherapy (IDEA) of adjuvant therapy with FOLFOX or XELOX 3 vs. 6 months in stage III colon cnacer Trial site Trial Group Planned accrual UK, Australia, New Zealand Denmark, Spain, Sweden, SCOT CACTUS, OCTO 4000 Italy TOSCA GISCAD 2500 France IDEA GERCOR, PRODIDGE 2000 US CALGB/SWOG 2500 Greece HORG HORG 1000 Japan ACHIEVE JFMC 1200 Total 6 trials 16 groups > Statistical design of non-inferiority 2 sided 95% CI HR < 1.2 DFS difference 3 years IDEA Committee: Andre, Iveson, Labianca, Meyerhardt, Souglakos, Yoshino, Paul, Sobrero, Taieb, Shileds, Ohtsu, Grothey, Sargent

13 ACHIEVE Non-Hematologic Aes Grade 3 or higher, n (%) (Grade 3 or higher) Arm 6 Arm 3 mfolfox6 XELOX Total mfolfox6 XELOX Total P Value Overall AE 76 (48) 196 (41) 272 (43) 56 (35) 128 (27) 184 (29) < Anorexia 2 (1) 25 (5) 27 (4) 4 (3) 24 (5) 28 (4) Diarrhea 1 (1) 26 (6) 27 (4) 3 (2) 27 (6) 30 (5) Nausea 1 (1) 14 (3) 15 (2) 2 (1) 14 (3) 16 (3) Vomiting 1 (1) 4 (1) 5 (1) 0 (0) 10 (2) 10 (2) HFS, Grade 2 or higher Neuropathy, Grade 2 or higher 4 (3) 70 (15) 74 (12) 2 (1) 35 (7) 37 (6) (36) 175 (37) 232 (37) 18 (11) 69 (14) 87 (14) < One treatment-related death due to duodenal perforation was observed in mfolfox6 in Arm 6.

14 Comparison Mosaik, Xeloxa, Archieve Planned Tx Duration % full planned cycles FL Mosaik FOLFOX Mayo Clinic / Roswell Park Xeloxa ARCHIVE 6 3 CapeOx FOLFOX CapeOX FOLFOX Cape/Ox 24 w 24 w 24/32 w 24 w 24 w 12 w 87% 75% 87% / 74% 69% 70% 59% 88% 86%

15 AEs by 5-FU Backbone (Grade 3 or higher) mfolfox6 XELOX Grade 3 or higher, n (%) n = 319 n = 958 Hematologic P Value Leukopenia 21 (7) 19 (2) Neutropenia 97 (30) 119 (12) < Thrombocytopenia 3 (1) 42 (4) Non-Hematologic Anorexia 6 (2) 49 (5) Diarrhea 4 (1) 53 (6) HFS, Grade 2 or higher 6 (2) 105 (11) < Neuropathy, Grade 2 or higher 75 (23.5) 244 (25.5) Note; One febrile neutropenia in XELOX group.

16 Adjuvant treatment with irinotecan - Negative experience (?) - Author: Saltz et al. Van Cutsem et al. Ychou et al. Group: CALGB PETACC 3 FNCLCC/FFCD Regimen: FU/FA vs. IFL LV5FU2 vs. FOLFIRI LV5FU2 vs. FOLFIRI Prinary end point: Survival DFS DFS Toxicity: > IFL +/- +/-

17 Bevacizumab for adjuvant therapy in Colon Cancer - negative data - NSABP C pts. stage II and III AVANT 3451 pts. stage II and III Allegra ASCO 2011 Allegra et al. JCO 2013 De Gramont et al. Lancet Oncol 2012

18 FOLFOX +/- Cetuximab in stage III colon cancer Albers et al. JAMA 2012 Taieb et al. Lancet Oncol 2014

19 PETACC-8 Subgroup Analysis Taieb et al. Lancet Oncol 2014

20 Elderly patients Treatment with FU plus LV or levamisol n= 3351 (15% > 70y) 7 trials Sargent et al. NEJM 2001

21 Pooled analysis of individual patient data (NSABP C-08, XELOXA, X-ACT, and AVANT) survival for age groups Haller et al. Ann Oncol 2015

22 Aim of the lecture Adjuvant chemotherapy is indicated for stage III (N+) Capecitabine or (inf.) FU/LV are options for all patients FOLFOX / CapeOx options best for > 3 LN FOLFOX / CapeOx for patients < 70y, use with caution for pts > 70y Antibodies (EGFR, VEGF) are not indicated The decision for an adjuvant treatment should balance the risk of cancer mortality and that of comorbidities

23 Stage II Small survival benefit (3%) with 5-FU No further improvement with FOLFOX?? Does a clinically defined high risk group benefit from FOLFOX (PFS)??

24 AJCC v Stage II 5yr rel OS (%) Stage III Gunderson et al, JCO 2009

25 Clinical Data in Stage II Colon Cancer Randomized trials: Stage II subsets Study N Arms 5y OS Intergroup FU/LV vs. Obs. 72% vs. 72% QUASAR 3238 FU vs. Obs. 80% vs. 77% IMPACT B FU vs. Obs. 82% vs. 80% QUASAR-1:superior OS with adjuvant therapy for stage II disease % Dukes B, 71% colon cancer n Deaths 5y survival p Chemo None Chemo No chemo Diff. 2.9% Years of follow-up Gray et al. Lancet 2007

26 SEER (Medicare) Database Patients > 65y Stage II and III n= Stage II No risk factor Stage III Stage II Any risk factor O Connor et al. JCO 2011

27 MOSAIK FOLFOX vs. FU/LV Overall survival all stage II patients p= % Probability HR [95% CI] Stage II 1.00 [ ] Stage III 0.80 [ ] FOLFOX4 stage II LV5FU2 stage II Data cut-off: January 2007 Overall survival (months) De Gramont et al. ASCO 2007

28 Updated MOSAIK data High Risk Stage II FOLFOX vs. FU/LV PFS OS 5 y DFS 6y OS N Pat HR P-value HR P-value high risk low risk Tournigant et al. JCO 2012

29 Patient groups in adjuvant Therapy No benefit cured Cured by surgery already T O X I C I T Y Jahre

30 Stage II Colon Cancer Are there subgroups that might benefit from adjuvant chemotherapy?

31 Patient Groups in Adjuvant Therapy Operation alone Operation plus Chemotherapy Chemotherapy without benefit Cured by chemotherapy Cured by operation already T O X I C I T Y Years

32 Mismatch Repair Deficiency (MMR-D): Unique Biological Subgroup of Colon Cancer IHC for MMR protein status MLH1+ MLH1- MSH2- MSH2+ Thus, IHC for MMR proteins and PCR for MSI detect two manifestations of the same tumor biology: MMR-D is synonymous with MSI-H MMR-P is synonymous with MSI-L/MSS Imai K, et al. Carcinogenesis. 2008;29: Umetani N, et al. Ann Surg Oncol. 2000;7: Rosen DG, et al. Mod Pathol. 2006;19: PCR on tumor DNA for MSI (microsatellite instability)

33 DFS by MMR status Stage II and III MSI is prognostic and predictive dmmr (MSI-H pmmr (MSI-L/MSS) Untreated 5Y DFS; p=.009 dmmr 80% pmmr 56% dmmr: deficient MMR pmmr: proficient MMR Treated 5Y DFS; p=.30 dmmr 70% pmmr 67% Sargent D J et al. JCO 2010;28:3219

34 Gray et al. JCO 2011 Paik et al. NEJM 2004 Gen-Expression Assay (OncoType Dx) CRC Stage II Breast Cancer N- HR +

35 Adjuvant! Online Prediction: Cancer and non-cancer related 5-year-Mortality Inprovement of cancer specific survival by 1.7% (FU) and 2.3% (FOLFOX) T3 NO MO T4 NO MO Assumption of Gill model

36 Algorithm for treatment decison in stage II colon cancer The decision for adjuvant therapy has to balances the risk of cancer and other competing risks Stage II colon cancer Age < 60y Advanced age or comorbidities pt4 pt3 pmmr / MSS dmmr / MSI-H Additional marker? Gen signature / mirna? Consider adj. CTx No adj. CTx

37 Conclusions Therapy < 70y > 70y Stage III 5FU/LV or Cape >3LN FOLFOX (FOLFOX) Stage II 5FU/LV or Cape? 5-FU/LV or Cape? - Low risk No adj CTx - High risk 5FU/LV or Cape? Biologicals currently no therapeutic option Gen signatures are prognostic, but predictive? The decision for adjuvant therapy has to balances the risk of cancer and other competing risks

38

Adjuvant therapy in older adults: controversies and challenges - Colorectal cancer -

Adjuvant therapy in older adults: controversies and challenges - Colorectal cancer - International Society of Geriatric Oncology Lisbon October 23 rd 25t h 2014 Adjuvant therapy in older adults: controversies and challenges - Colorectal cancer - Claus-Henning Köhne Klinik für Onkologie

More information

Adjuvant/neoadjuvant systemic treatment of colorectal cancer

Adjuvant/neoadjuvant systemic treatment of colorectal cancer 5th ESO-ESMO Eastern Europe and Balkan Region Masterclass in Medical Oncology Belgrade, June 19 th 2018 Adjuvant/neoadjuvant systemic treatment of colorectal cancer Carlotta Antoniotti Polo Oncologico

More information

Adjuvant therapies for large bowel cancer Wasantha Rathnayake, MD

Adjuvant therapies for large bowel cancer Wasantha Rathnayake, MD LEADING ARTICLE Adjuvant therapies for large bowel cancer Wasantha Rathnayake, MD Consultant Clinical Oncologist, National Cancer Institute, Maharagama, Sri Lanka. Key words: Large bowel; Cancer; Adjuvant

More information

S u p p o r t e d b y a n i n d e p e n d e n t E d u c a t i o n a l G r a n t f r o m B a y e r

S u p p o r t e d b y a n i n d e p e n d e n t E d u c a t i o n a l G r a n t f r o m B a y e r EXPERTS KNOWLEDGE SHARE with Prof. Köhne, Dr. Modest and Dr. Vecchione Madrid (Spain) Sunday September 10 th 2017 S u p p o r t e d b y a n i n d e p e n d e n t E d u c a t i o n a l G r a n t f r o m

More information

Disclosures. Clinical and molecular features to guide adjuvant therapy. Personalized Medicine - Decision Tools -

Disclosures. Clinical and molecular features to guide adjuvant therapy. Personalized Medicine - Decision Tools - Disclosures Clinical and molecular features to guide adjuvant therapy Daniel Sargent Professor of Biostatistics & Oncology Mayo Clinic Consulting activities Amgen Pfizer Roche/Genentech Sanofi-Aventis

More information

Is There a New Standard of Care for Adjuvant Therapy in Colon Cancer? When is 3 Months Enough?

Is There a New Standard of Care for Adjuvant Therapy in Colon Cancer? When is 3 Months Enough? Is There a New Standard of Care for Adjuvant Therapy in Colon Cancer? When is 3 Months Enough? Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA 1 Disclosure Ad Board: Genentech Honorarium:

More information

Optimal adjuvant therapy for colon cancer is FOLFOX for 6 cycles YES

Optimal adjuvant therapy for colon cancer is FOLFOX for 6 cycles YES Optimal adjuvant therapy for colon cancer is FOLFOX for 6 cycles YES Bassel F. El-Rayes 1 Background Standard of care for resected stage III colon cancer is six months of adjuvant oxaliplatin-based therapy

More information

Progress and Challenges in the Adjuvant Treatment of Stage II & III Colon Cancer

Progress and Challenges in the Adjuvant Treatment of Stage II & III Colon Cancer Progress and Challenges in the Adjuvant Treatment of Stage II & III Colon Cancer Professor Eva Segelov Monash Health and Monash University (with thanks to A/P Jeremy Shapiro) Melbourne, Australia Apr 2017

More information

Hot Topic in tema di neoplasie del Colon: Durata ottimale della chemioterapia adiuvante nei tumori del Colon

Hot Topic in tema di neoplasie del Colon: Durata ottimale della chemioterapia adiuvante nei tumori del Colon Convegno Nazionale AIOM Giovani 2018 News in Oncology Hot Topic in tema di neoplasie del Colon: Durata ottimale della chemioterapia adiuvante nei tumori del Colon Daniele Rossini U.O. di Oncologia Medica

More information

Adjuvant treatment for stage II and III Colon Cancer. Ramon Salazar Catalan Institute of Oncology

Adjuvant treatment for stage II and III Colon Cancer. Ramon Salazar Catalan Institute of Oncology Adjuvant treatment for stage II and III Colon Cancer Ramon Salazar Catalan Institute of Oncology Disclosures R. Salazar has served in a consultant or advisory role for Amgen, Merck Serono, Taihoo, MSD,

More information

Where are we in 2013?

Where are we in 2013? The Use of Gene Profile Testing in the Adjuvant Therapy of Stages II & III Colon Cancer: Where are we in 2013? Howard S. Hochster, MD Professor of Medicine, Yale School of Medicine Associate Director,

More information

The International Duration Evaluation of Adjuvant Chemotherapy study: implications for clinical practice

The International Duration Evaluation of Adjuvant Chemotherapy study: implications for clinical practice Editorial The International Duration Evaluation of Adjuvant Chemotherapy study: implications for clinical practice Marwan Fakih Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive

More information

Chemotherapy for resectable liver mets: Options and Issues. Herbert Hurwitz Duke University Medical Center Durham, North Carolina, USA

Chemotherapy for resectable liver mets: Options and Issues. Herbert Hurwitz Duke University Medical Center Durham, North Carolina, USA Chemotherapy for resectable liver mets: Options and Issues Herbert Hurwitz Duke University Medical Center Durham, North Carolina, USA Chemotherapy regimens in 1 st line mcrc Standard FOLFOX-Bev FOLFIRI-Bev

More information

Adjuvant treatment for stage III colon cancer

Adjuvant treatment for stage III colon cancer ESMO Preceptorship Programme Rectal cancer Singapur November 2017 Adjuvant treatment for stage III colon cancer Andrés Cervantes Disclosures Consulting and advisory services, speaking or writing engagements,

More information

Advances in Chemotherapy of Colorectal Cancer

Advances in Chemotherapy of Colorectal Cancer Advances in Chemotherapy of Colorectal Cancer Richard M. Goldberg Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Disease Settings Adjuvant Therapy MOSAIC, FOLFOX Andre

More information

Does it matter which chemotherapy regimen you partner with the biologic agents?

Does it matter which chemotherapy regimen you partner with the biologic agents? Does it matter which chemotherapy regimen you partner with the biologic agents? Yes, it does matter! Axel Grothey Disclosures Research Funding to MAYO Clinic Genentech Bayer Eisai Pfizer Imclone Potential

More information

Toxicity by Age Group. Old Factor 1: Age. Disclosures. Predicting survival in metastatic colorectal cancer. Personalized Medicine - Decision Tools -

Toxicity by Age Group. Old Factor 1: Age. Disclosures. Predicting survival in metastatic colorectal cancer. Personalized Medicine - Decision Tools - Disclosures Predicting survival in metastatic colorectal cancer Daniel Sargent, PhD Mayo Clinic Consulting activities Amgen Pfizer Roche/Genentech Sanofi-Aventis Genomic Health Personalized Medicine -

More information

First line treatment in metastatic colorectal cancer

First line treatment in metastatic colorectal cancer First line treatment in metastatic colorectal cancer Claus-Henning Köhne University Clinic Onkology and Haematology North West German Cancer Center (NWTZ) A non authorised version of ESMO guidelines was

More information

Management of early rectal cancer: Any role for adjuvant chemotherapy

Management of early rectal cancer: Any role for adjuvant chemotherapy Management of early rectal cancer: Any role for adjuvant chemotherapy Andrés Cervantes Professor of Medicine CURRENTS CONCEPTS IN RECTAL CANCER DIAGNOSIS AND THERAPY TME surgery Optimal staging by MRI

More information

Forum of Clinical Oncology

Forum of Clinical Oncology HeSMO 5(2) 2014 1 7 DOI: 10.2478/fco-2014-0006 Forum of Clinical Oncology Projecting Event-Based Analysis Dates in Clinical Trials: An Illustration Based on the International Duration Evaluation of Adjuvant

More information

Retrospective analysis of the effect of CAPOX and mfolfox6 dose intensity on survival in colorectal patients in the adjuvant setting

Retrospective analysis of the effect of CAPOX and mfolfox6 dose intensity on survival in colorectal patients in the adjuvant setting ORIGINAL ARTICLE CAPOX AND mfolfox6 DOSE INTENSITY AND CLINICAL OUTCOMES IN STAGE III CRC, Mamo et al. Retrospective analysis of the effect of CAPOX and mfolfox6 dose intensity on survival in colorectal

More information

Targeted Therapies in Metastatic Colorectal Cancer: An Update

Targeted Therapies in Metastatic Colorectal Cancer: An Update Targeted Therapies in Metastatic Colorectal Cancer: An Update ASCO 2007: Targeted Therapies in Metastatic Colorectal Cancer: An Update Bevacizumab is effective in combination with XELOX or FOLFOX-4 Bevacizumab

More information

Adjuvant chemotherapy for high-risk stage II and stage III colon cancer: timing of initiation and optimal duration

Adjuvant chemotherapy for high-risk stage II and stage III colon cancer: timing of initiation and optimal duration JBUON 2018; 23(3): 568-573 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com REVIEW ARTICLE Adjuvant chemotherapy for high-risk stage II and stage III colon cancer:

More information

Chemotherapy options and outcomes in older adult patients with colorectal cancer

Chemotherapy options and outcomes in older adult patients with colorectal cancer Critical Reviews in Oncology/Hematology 72 (2009) 155 169 Chemotherapy options and outcomes in older adult patients with colorectal cancer Muhammad W. Saif a,, Stuart M. Lichtman b a Yale University School

More information

Development of Conventional Chemotherapy in mcrc BSC vs. Chemo, Biochemical modulation, Oral fluoropyrimidines, Developmentof combination chemotherapy

Development of Conventional Chemotherapy in mcrc BSC vs. Chemo, Biochemical modulation, Oral fluoropyrimidines, Developmentof combination chemotherapy ESMO Preceptorship Colorectal Cancer Colorectal ESMO Cancer Preceptorship Valencia May Program 20-21st 2016 Prague May 22-23rd 2014 Development of Conventional Chemotherapy in mcrc BSC vs. Chemo, Biochemical

More information

ADJUVANT CHEMOTHERAPY FOR RECTAL CANCER

ADJUVANT CHEMOTHERAPY FOR RECTAL CANCER ESMO Preceptorship Programme Colorectal Cancer Barcelona November, 25-26, 2016 ADJUVANT CHEMOTHERAPY FOR RECTAL CANCER Andrés Cervantes Professor of Medicine OLD APPROACH TO RECTAL CANCER Surgical resection

More information

Adjuvant therapy in colon cancer: which treatment in 2005?

Adjuvant therapy in colon cancer: which treatment in 2005? Annals of Oncology 16 (Supplement 4): iv69 iv73, 2005 doi:10.1093/annonc/mdi911 Adjuvant therapy in colon cancer: which treatment in 2005? F. Di Costanzo* & L. Doni Medical Oncology Unit, Department of

More information

Chemotherapy of colon cancers

Chemotherapy of colon cancers Chemotherapy of colon cancers Stage distribution Stage I : 15% T 1,2 NO Stage IV: 20 25% M+ Stage II : 20 30% T3,4 NO Stage III N+: 30 40% clinical stages I, II, or III colon cancer are at risk for having

More information

COLORECTAL CANCER. Bert H. O Neil, MD Jackie and Joseph Cusick Professor of Oncology Director, GI Malignancies and Phase I Program

COLORECTAL CANCER. Bert H. O Neil, MD Jackie and Joseph Cusick Professor of Oncology Director, GI Malignancies and Phase I Program COLORECTAL CANCER Bert H. O Neil, MD Jackie and Joseph Cusick Professor of Oncology Director, GI Malignancies and Phase I Program Rectal Cancer Adjuvant therapy No single study specific to rectal cancer

More information

The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters.

The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters. The IDEA (International Duration Evaluation of Adjuvant Chemotherapy) Collaboration: Prospective Combined Analysis of Phase III Trials Investigating Duration of Adjuvant Therapy with the FOLFOX (FOLFOX4

More information

High risk stage II colon cancer

High risk stage II colon cancer High risk stage II colon cancer Joel Gingerich, MD, FRCPC Assistant Professor Medical Oncologist University of Manitoba CancerCare Manitoba Disclaimer No conflict of interests 16 October 2010 Overview

More information

Colorectal Cancer Update Dr. Barb Melosky

Colorectal Cancer Update Dr. Barb Melosky Colorectal Cancer Update 2017 Dr. Barb Melosky bmelosky@bccancer.bc.ca Disclosure Research Support/P.I. Honoraria/Advisory Board Bayer Roche, Amgen, Bayer, Lilly Objectives 1) Demonstrate knowledge of

More information

SIOG CRC Guidelines D Papamichael MB BS FRCP Cyprus Oncology Centre SIOG 2014 Special SIOG Guidelines Session

SIOG CRC Guidelines D Papamichael MB BS FRCP Cyprus Oncology Centre SIOG 2014 Special SIOG Guidelines Session SIOG CRC Guidelines D Papamichael MB BS FRCP Cyprus Oncology Centre SIOG 2014 Special SIOG Guidelines Session Lisbon October 25 th Outline Background Surgery in older adults Adjuvant therapy - Single agent

More information

Progress towards an individualized approach to therapy: colorectal cancer

Progress towards an individualized approach to therapy: colorectal cancer Progress towards an individualized approach to therapy: colorectal cancer Alan P. Venook, M.D. University of California, SF GIST: PET change after 4 weeks imatinib Multiple liver and upper abdominal 18

More information

Cetuximab with Chemotherapy as Treatment for Stage III Colon or Metastatic Colorectal Cancer

Cetuximab with Chemotherapy as Treatment for Stage III Colon or Metastatic Colorectal Cancer Cetuximab with Chemotherapy as Treatment for Stage III Colon or Metastatic Colorectal Cancer Cetuximab with Chemotherapy (CT) as First-Line Treatment for Metastatic Colorectal Cancer (mcrc): Analysis of

More information

Konzepte bei der Therapie des metastasierten kolorektalen Karzinoms

Konzepte bei der Therapie des metastasierten kolorektalen Karzinoms 21. Ärzte Fortbildungskurs in Klinischer Onkologie 24.-26. Februar 2011 Kantonspital St. Gallen / Schweiz Konzepte bei der Therapie des metastasierten kolorektalen Karzinoms Claus-Henning Köhne Klinik

More information

Adjuvant Chemotherapy

Adjuvant Chemotherapy State-of-the-art: standard of care for resectable NSCLC Adjuvant Chemotherapy JY DOUILLARD MD PhD Professor of Medical Oncology Integrated Centers of Oncology R Gauducheau University of Nantes France Adjuvant

More information

Unresectable or boarderline resectable disease

Unresectable or boarderline resectable disease ESMO Preceptorship Colorectal Cancer Nov 2016 Barcelona Unresectable or boarderline resectable disease Claus-Henning Köhne Klinik für Onkologie und Hämatologie North West German Cancer Center (NWTZ) Learning

More information

BRAF Testing In The Elderly: Same As in Younger Patients?

BRAF Testing In The Elderly: Same As in Younger Patients? EGFR, K-RAS, K BRAF Testing In The Elderly: Same As in Younger Patients? Nadine Jackson McCleary MD MPH Gastrointestinal Oncology Dana-Farber/Harvard Cancer Care Boston, MA, USA Outline Colorectal cancer

More information

National Surgical Adjuvant Breast and Bowel Project (NSABP) Foundation Annual Progress Report: 2009 Formula Grant

National Surgical Adjuvant Breast and Bowel Project (NSABP) Foundation Annual Progress Report: 2009 Formula Grant National Surgical Adjuvant Breast and Bowel Project (NSABP) Foundation Annual Progress Report: 2009 Formula Grant Reporting Period July 1, 2012 June 30, 2013 Formula Grant Overview The National Surgical

More information

Management of Advanced Colorectal Cancer in Older Patients

Management of Advanced Colorectal Cancer in Older Patients Review Article [1] April 15, 2005 By Stuart M. Lichtman, MD, FACP [2] Many elderly individuals have substantial life expectancy, even in the setting of significant illness. There is evidence to indicate

More information

Best of ASCO 2009 / GI

Best of ASCO 2009 / GI Best of ASCO 2009 / GI Santa Monica, CA J. Randolph Hecht, M.D. Professor of Clinical Medicine Director, UCLA GI Oncology Program David Geffen School of Medicine at UCLA Financial Disclosures I have no

More information

Lindsay A. Renfro, Daniel J. Sargent. Statistics in Oncology Clinical Trials

Lindsay A. Renfro, Daniel J. Sargent. Statistics in Oncology Clinical Trials Page 1 of 11 Editor s note: The special column Statistics in Oncology Clinical Trials is dedicated to providing state-of-the-art review or perspectives of statistical issues in oncology clinical trials.

More information

Unresectable or boarderline resectable (Groupp 1) chemotherpy +/- targeted agents

Unresectable or boarderline resectable (Groupp 1) chemotherpy +/- targeted agents ESMO Preceptorship Program 27.-28. March Singapore Unresectable or boarderline resectable (Groupp 1) chemotherpy +/- targeted agents Claus-Henning Köhne Klinik für Onkologie und Hämatologie North West

More information

Il paziente anziano con malattia oncologica avanzata: il tumore del colon-retto

Il paziente anziano con malattia oncologica avanzata: il tumore del colon-retto Milano 05.10.2018 Il paziente anziano con malattia oncologica avanzata: il tumore del colon-retto Salvatore Corallo U.O.C. Oncologia Medica IRCCS Istituto Nazionale dei Tumori Milano CRC in elderly patients

More information

Understanding predictive and prognostic markers

Understanding predictive and prognostic markers Understanding predictive and prognostic markers Professor Aimery de Gramont Chairman of ARCAD Foundation and GERCOR, Paris FRANCE Understanding predictive and prognostic markers Aimery de Gramont Prognostic

More information

Managing mcrc Across Disease Continuum: Front-Line Therapy and Treatment Beyond Progression

Managing mcrc Across Disease Continuum: Front-Line Therapy and Treatment Beyond Progression Managing mcrc Across Disease Continuum: Front-Line Therapy and Treatment Beyond Progression Guillermo Méndez, MD Sección Oncología Hospital de Gastroenterología Bonorino Udaondo Carlos B. Udaondo y Fundación

More information

MOSAIC study: Actualization of Overall Survival (OS) with 10 years follow up and evaluation of BRAF by GERCOR and MOSAIC investigators

MOSAIC study: Actualization of Overall Survival (OS) with 10 years follow up and evaluation of BRAF by GERCOR and MOSAIC investigators MOSAIC study: Actualization of Overall Survival (OS) with 10 years follow up and evaluation of BRAF by GERCOR and MOSAIC investigators Thierry André, Armand de Gramont, Benoist Chibaudel, Annemilaï Raballand,

More information

State of the Art: Colorectal Cancer Liver Metastasis Dr. Iain Tan

State of the Art: Colorectal Cancer Liver Metastasis Dr. Iain Tan State of the Art: Colorectal Cancer Liver Metastasis Dr. Iain Tan Consultant GI Medical Oncologist National Cancer Centre Singapore Clinician Scientist, Genome Institute of Singapore OS (%) Overall survival

More information

Adjuvant chemotherapy outcomes in patients over 65 years with early stage colorectal carcinoma

Adjuvant chemotherapy outcomes in patients over 65 years with early stage colorectal carcinoma JBUON 2014; 19(4): 906-912 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Adjuvant chemotherapy outcomes in patients over 65 years with early

More information

Adjuvant Chemotherapy for Rectal Cancer: Are we making progress?

Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Hagen Kennecke, MD, MHA, FRCPC Division Of Medical Oncology British Columbia Cancer Agency October 25, 2008 Objectives Review milestones

More information

ASCO 2017 updates in Colorectal and Gastric Cancers. May Cho, M.D.

ASCO 2017 updates in Colorectal and Gastric Cancers. May Cho, M.D. ASCO 2017 updates in Colorectal and Gastric Cancers May Cho, M.D. Relevant financial relationships in the past twelve months by presenter or spouse/partner: None The speaker will directly disclosure the

More information

Clinical interpretation and validity of trials: when do they become practice changing

Clinical interpretation and validity of trials: when do they become practice changing Clinical interpretation and validity of trials: when do they become practice changing Alberto Sobrero Oncologia Medica 1 Ospedale Policlinico San Martino Genova Italy Clinical trials: the 5 phases and

More information

ADJUVANT AND NEOADJUVANT MANAGEMENT OF COLORECTAL CANCER

ADJUVANT AND NEOADJUVANT MANAGEMENT OF COLORECTAL CANCER gastrointestinal tract and abdomen ADJUVANT AND NEOADJUVANT MANAGEMENT OF COLORECTAL CANCER Christina E. Bailey, MD, MSCI, Eduardo Vilar, MD, PhD, and Y. Nancy You, MD, MHSc In 2013, colorectal cancer

More information

ADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS. Andrés Cervantes. Professor of Medicine

ADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS. Andrés Cervantes. Professor of Medicine ADVANCED COLORECTAL CANCER: UNRESECTABLE OR BORDERLINE RESECTABLE (GROUP 1) CHEMOTHERAPY +/- TARGETED AGENTS Andrés Cervantes Professor of Medicine 1995 One option Advances in the treatment of mcrc 2000

More information

Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastatic colorectal cancer: a large-scale Phase II study (OPUS)

Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastatic colorectal cancer: a large-scale Phase II study (OPUS) Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastatic colorectal cancer: a large-scale Phase II study (OPUS) C Bokemeyer, E Staroslawska, A Makhson, I Bondarenko, JT Hartmann,

More information

/m 2 Oxaliplatin 85 1 Q2W 1-3 Leucovorin Q2W 5-FU Q2W 5-FU Q2W

/m 2 Oxaliplatin 85 1 Q2W 1-3 Leucovorin Q2W 5-FU Q2W 5-FU Q2W 癌症診療指引33 Adjuvant therapy of colon cancer mfolfox6 Oxaliplatin 85 1 Q2W 1-3 FOLFOX4 Oxaliplatin 85 1 Q2W 9 Leucovorin 200 1-2 Q2W 5-FU 400 1-2 Q2W 5-FU 600 1-2 Q2W FLOX Oxaliplatin 85 1,15,29 Q8W 4 Leucovorin

More information

Third Line and Beyond: Management of Refractory Colorectal Cancer

Third Line and Beyond: Management of Refractory Colorectal Cancer Third Line and Beyond: Management of Refractory Colorectal Cancer George A. Fisher MD PhD Stanford University 1 Overview Defining the chemo refractory and intolerant Agents approved in 3 rd line setting

More information

Treating Liver Limited or Oligometastatic CRC

Treating Liver Limited or Oligometastatic CRC ESMO Preceptorship Colorectal Cancer Nov 2016 Barcelona Treating Liver Limited or Oligometastatic CRC Claus-Henning Köhne Klinik für Onkologie und Hämatologie North West German Cancer Center (NWTZ) Learning

More information

DALLA CAPECITABINA AL TAS 102

DALLA CAPECITABINA AL TAS 102 DALLA CAPECITABINA AL TAS 102 Milano 29 settembre 2016 LE PROSPETTIVE NELLA RICERCA Armando Santoro Humanitas Cancer Center THE 1,2.AND 3 LINE CHEMOTHERAPY IN CRC M BEVACIZUMAB AFLIBERCET RAS wt RAS mu

More information

Jonathan Dickinson, LCL Xeloda

Jonathan Dickinson, LCL Xeloda Xeloda A blockbuster in the making Jonathan Dickinson, LCL Xeloda Xeloda unique tumor-activated mechanism Delivering more cancer-killing agent straight into cancer Highly effective comparable efficacy

More information

Terapia neoadyuvante en cáncer de recto Estado del arte Mauricio Lema Medina MD Clínica de Oncología Astorga / Clínica SOMA - Medellín, Colombia

Terapia neoadyuvante en cáncer de recto Estado del arte Mauricio Lema Medina MD Clínica de Oncología Astorga / Clínica SOMA - Medellín, Colombia Terapia neoadyuvante en cáncer de recto Estado del arte Mauricio Lema Medina MD Clínica de Oncología Astorga / Clínica SOMA - Medellín, Colombia Temario Generalidades Adyuvancia en colon y recto FU / Capecitabina

More information

Conflicts of Interest GI Malignancies: An Update on Current Treatment Options

Conflicts of Interest GI Malignancies: An Update on Current Treatment Options Conflicts of Interest GI Malignancies: An Update on Current Treatment Options Nothing to disclose Trevor McKibbin, PharmD, MS, BCOP Clinical Specialist, Hematology/Oncology Winship Cancer Institute of

More information

The role of Maintenance treatment Appropriate endpoints according to ESMO consensus

The role of Maintenance treatment Appropriate endpoints according to ESMO consensus ESMO Preceptorship Programme Colorectal Cancer Singapore-October 20-22 2016 JY Douillard, MD, PhD, CMO ESMO The role of Maintenance treatment Appropriate endpoints according to ESMO consensus MAINTENANCE

More information

MSI and other molecular markers: how useful are they? Daniela E. Aust, Institute for Pathology, University Hospital Dresden, Germany

MSI and other molecular markers: how useful are they? Daniela E. Aust, Institute for Pathology, University Hospital Dresden, Germany MSI and other molecular markers: how useful are they? Daniela E. Aust, Institute for Pathology, University Hospital Dresden, Germany Disclosure slide I Member of advisory boards for AMGEN, ROCHE I Speaker

More information

trial update clinical

trial update clinical clinical trial update by John W. Mucenski, BS, PharmD, Director of Pharmacy Operations, UMPC Cancer Centers In order to provide the most up-to-date and efficacious care to their patients, oncologists must

More information

INMUNOTERAPIA EN CANCER COLORRECTAL METASTASICO. CCRm MSI-H NUEVO ESTANDAR EN PRIMERA LINEA Y/O PRETRATADOS?

INMUNOTERAPIA EN CANCER COLORRECTAL METASTASICO. CCRm MSI-H NUEVO ESTANDAR EN PRIMERA LINEA Y/O PRETRATADOS? INMUNOTERAPIA EN CANCER COLORRECTAL METASTASICO CCRm MSI-H NUEVO ESTANDAR EN PRIMERA LINEA Y/O PRETRATADOS? V. Alonso Servicio de Oncologia Medica H. U. Miguel Servet Zaragoza MSI-H mcrc Clinical and Pathological

More information

Tobias Engel Ayer Botrel 1,2*, Luciana Gontijo de Oliveira Clark 1, Luciano Paladini 1 and Otávio Augusto C. Clark 1

Tobias Engel Ayer Botrel 1,2*, Luciana Gontijo de Oliveira Clark 1, Luciano Paladini 1 and Otávio Augusto C. Clark 1 Botrel et al. BMC Cancer (2016) 16:677 DOI 10.1186/s12885-016-2734-y RESEARCH ARTICLE Open Access Efficacy and safety of bevacizumab plus chemotherapy compared to chemotherapy alone in previously untreated

More information

CHEMOTHERAPY FOR COLON CANCER OUTLINE OF TODAY S TALK. Colon Cancer Epidemiology 11/6/2012 GATRA/GCCR FALL CONFERENCE NOVEMBER 14 16, 2012

CHEMOTHERAPY FOR COLON CANCER OUTLINE OF TODAY S TALK. Colon Cancer Epidemiology 11/6/2012 GATRA/GCCR FALL CONFERENCE NOVEMBER 14 16, 2012 CHEMOTHERAPY FOR COLON CANCER JONATHAN C. BENDER,MD MEDICAL DIRECTOR OF PIEDMONT FAYETTE CANCER CENTER OUTLINE OF TODAY S TALK 1. Overview of Colon Cancer in the US 2. Colon Cancer staging and risks of

More information

Current Status of Adjuvant Therapy for Colorectal Cancer

Current Status of Adjuvant Therapy for Colorectal Cancer Review Article [1] May 01, 2004 By Michael J. O connell, MD [2] Adjuvant therapy with chemotherapy and/or radiation therapy in addition to surgery improves outcome for patients with high-risk carcinomas

More information

Treatment of the elderly metastatic colorectal cancer patient: SIOG Recommendations

Treatment of the elderly metastatic colorectal cancer patient: SIOG Recommendations Treatment of the elderly metastatic colorectal cancer patient: SIOG Recommendations D Papamichael MB BS FRCP On behalf of the SIOG CRC in the Elderly Task Force Madrid 10/11/07 8 th Meeting of the International

More information

Immunotherapy for dmmr metastatic colorectal cancer. Prof.dr. Kees Punt Dept. Medical Oncology AUMC

Immunotherapy for dmmr metastatic colorectal cancer. Prof.dr. Kees Punt Dept. Medical Oncology AUMC Immunotherapy for dmmr metastatic colorectal cancer Prof.dr. Kees Punt Dept. Medical Oncology AUMC Active specific immunotherapy (ASI) in stage II-III colon cancer Vaccination with autologous tumor + BCG

More information

RESEARCH ARTICLE. Joanne Chiu 1, Vikki Tang 1, Roland Leung 1, Hilda Wong 1, Kin Wah Chu 2, Jensen Poon 3, Richard J Epstein 4, Thomas Yau 1,3,5 *

RESEARCH ARTICLE. Joanne Chiu 1, Vikki Tang 1, Roland Leung 1, Hilda Wong 1, Kin Wah Chu 2, Jensen Poon 3, Richard J Epstein 4, Thomas Yau 1,3,5 * DOI:http://dx.doi.org/10.7314/APJCP.2013.14.11.6585 Adjuvant XELOX in Asian Patients with Colorectal Cancer RESEARCH ARTICLE Efficacy and Tolerability of Adjuvant Oral Capecitabine plus Intravenous Oxaliplatin

More information

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509. Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

More information

journal of medicine The new england Duration of Adjuvant Chemotherapy for Stage III Colon Cancer abstract

journal of medicine The new england Duration of Adjuvant Chemotherapy for Stage III Colon Cancer abstract The new england journal of medicine established in 1812 March 29, 2018 vol. 378 no. 13 Duration of Adjuvant Chemotherapy for Stage III Colon Cancer A. Grothey, A.F. Sobrero, A.F. Shields, T. Yoshino, J.

More information

Ashita Waterston Beatson West of Scotland Cancer Centre

Ashita Waterston Beatson West of Scotland Cancer Centre Ashita Waterston Beatson West of Scotland Cancer Centre Aim of treatment Scheduling and choice of treatments are dictated by aim: Down staging for resectability: upfront intensive Prolong survival: combination

More information

Rob Glynne-Jones Mount Vernon Cancer Centre

Rob Glynne-Jones Mount Vernon Cancer Centre ESMO Preceptorship Programme Colorectal Cancer Barcelona October 2017 State of the art: Radio- /chemotherapy for rectal cancer Rob Glynne-Jones Mount Vernon Cancer Centre My Disclosures: last 5 years Speaker:

More information

THE ROLE OF PREDICTIVE AND PROGNOSTIC MARKERS IN COLORECTAL CANCER

THE ROLE OF PREDICTIVE AND PROGNOSTIC MARKERS IN COLORECTAL CANCER THE ROLE OF PREDICTIVE AND PROGNOSTIC MARKERS IN COLORECTAL CANCER Cathy Eng, M.D., F.A.C.P. Associate Professor Associate Medical Director, Colorectal Center Dept of GI Medical Oncology November 5, 2010

More information

Colon Cancer Molecular Target Agents

Colon Cancer Molecular Target Agents Colon Cancer Molecular Target Agents Ci Caio Max SR S. Rocha Lima, M.D. MD Professor of Medicine CDi CoDiretor Cl Colorectal tlheptobiliary, Pancreatic SDG, and Phase I Unit University of Miami & Silvester

More information

Review of the ESMO consensus conference on metastatic colorectal cancer Basic strategies and groups. Chemotherapy and targeted agents in 1st line

Review of the ESMO consensus conference on metastatic colorectal cancer Basic strategies and groups. Chemotherapy and targeted agents in 1st line ESMO Preceptorship Programme Colorectal Cancer Valencia, 18th May 2018 Review of the ESMO consensus conference on metastatic colorectal cancer Basic strategies and groups Chemotherapy and targeted agents

More information

療指引 34 Adjuvant Therapy of Colon Cancer

療指引 34 Adjuvant Therapy of Colon Cancer 療指引 34 Adjuvant Therapy of Colon Cancer mfolfox6 Oxaliplatin 85 1 Q2W 1~3, 10 FLOX Oxaliplatin 85 1,15,29 Q8W 4 Leucovorin 500 1,8,15,22,29,35 Q8W 5-FU 500 1,8,15,22,29,35 Q8W Capecitabine Capecitabine

More information

What s New in Colon Cancer? Therapy over the last decade

What s New in Colon Cancer? Therapy over the last decade What s New in Colon Cancer? 9/19/2014 Michael McNamara, MD Therapy over the last decade Cytotoxic chemotherapy - 5FU ( Mayo, Roswell, Infusional) - Xeloda (01 ) - Oxaliplatin (02 ) - Irinotecan (96 ) Anti-

More information

Adjuvant Treatment of Colorectal Cancer

Adjuvant Treatment of Colorectal Cancer Adjuvant Treatment of Colorectal Cancer Adjuvant Treatment of Colorectal Cancer Brian M. Wolpin, MD; Jeffrey A. Meyerhardt, MD, MPH; Harvey J. Mamon, MD, PhD; Robert J. Mayer, MD Dr. Wolpin is Instructor

More information

Case 1 Metastatic Pancreatic Adenocarcinoma: What Therapy Should I Select First?

Case 1 Metastatic Pancreatic Adenocarcinoma: What Therapy Should I Select First? Case 1 Metastatic Pancreatic Adenocarcinoma: What Therapy Should I Select First? Marc Peeters, MD, PhD Head of the Oncology Department Antwerp University Hospital Antwerp, Belgium marc.peeters@uza.be 71-year-old

More information

ADJUVANT CHEMOTHERAPY...

ADJUVANT CHEMOTHERAPY... Colorectal Pathway Board: Non-Surgical Oncology Guidelines October 2015 Organization» Table of Contents ADJUVANT CHEMOTHERAPY... 2 DUKES C/ TNM STAGE 3... 2 DUKES B/ TNM STAGE 2... 3 LOCALLY ADVANCED

More information

Colorectal cancer Chapelle, J Clin Oncol, 2010

Colorectal cancer Chapelle, J Clin Oncol, 2010 Colorectal cancer Chapelle, J Clin Oncol, 2010 Early-Stage Colorectal cancer: Microsatellite instability, multigene assay & emerging molecular strategy Asit Paul, MD, PhD 11/24/15 Mr. X: A 50 yo asymptomatic

More information

NOVITA IN TEMA DI TERAPIA DEL CARCINOMA DEL COLON-RETTO

NOVITA IN TEMA DI TERAPIA DEL CARCINOMA DEL COLON-RETTO Congresso AIOM Giovani Perugia, 9 luglio 2016 NOVITA IN TEMA DI TERAPIA DEL CARCINOMA DEL COLON-RETTO Carlotta Antoniotti Polo Oncologico Azienda Ospedaliero-Universitaria Pisana Università di Pisa What

More information

2/20/14& Medical Management of Colon and Rectal Cancer: An Overview. Outline / Learning Objectives. How common is colon cancer?

2/20/14& Medical Management of Colon and Rectal Cancer: An Overview. Outline / Learning Objectives. How common is colon cancer? Medical Management of Colon and Rectal Cancer: An Overview Jonathan Grim, MD, PhD VA Puget Sound Health Care System Fred Hutchinson Cancer Research Center UW Medicine Outline / Learning Objectives Epidemiology

More information

Roche setting the standards of cancer care Oncology Event for Investors, June 19

Roche setting the standards of cancer care Oncology Event for Investors, June 19 Roche setting the standards of cancer care Oncology Event for Investors, June 19 Kapil Dhingra, VP Medical Science Developing a drug to the standard of care Superior clinical benefit, resources and time

More information

ADVANCES IN COLON CANCER

ADVANCES IN COLON CANCER ADVANCES IN COLON CANCER Peter T. Silberstein, M.D., FACP Professor, Creighton University Chief Hematology/Oncology UNIVERSAL SCREENING FOR LYNCH SYNDROME OF ALL PATIENTS WITH COLON CANCER ADOPTED BY CHI

More information

Adjuvant Therapy for Stage II Colon Cancer: Prognostic and Predictive Markers

Adjuvant Therapy for Stage II Colon Cancer: Prognostic and Predictive Markers 927 Original Article Adjuvant Therapy for Stage II Colon Cancer: Prognostic and Predictive Markers Brian Vicuna, MD, and Al B. Benson III, MD, Chicago, Illinois Key Words Stage II, colon cancer, treatment,

More information

What s New? Dr. Barbara Melosky

What s New? Dr. Barbara Melosky Metastatic Colorectal o Carcinoma a What s New? Dr. Barbara Melosky Objectives Review any recent changes regarding treatment t t options for mcrc Discuss the common and expected toxicities of treatment

More information

How Old is Too Old for Chemotherapy in Early C olon Colon Cancer: Role of Geriatric Assessments Winson Y. Cheung, MD, MPH, FRCPC

How Old is Too Old for Chemotherapy in Early C olon Colon Cancer: Role of Geriatric Assessments Winson Y. Cheung, MD, MPH, FRCPC How Old is Too Old for Chemotherapy in Early Colon Cancer: Role of Geriatric Assessments Winson Y. Cheung, MD, MPH, FRCPC British Columbia Cancer Agency - Vancouver CAGPO - October 20, 2013 1 About Me

More information

Colorectal cancer in the adjuvant setting: perspectives on treatment and the role of prognostic factors

Colorectal cancer in the adjuvant setting: perspectives on treatment and the role of prognostic factors Symposium article Annals of Oncology 14 (Supplement 2): ii25 ii29, 2003 DOI: 10.1093/annonc/mdg725 Colorectal cancer in the adjuvant setting: perspectives on treatment and the role of prognostic factors

More information

Κίκα Πλοιαρχοπούλου. Παθολόγος Ογκολόγος Ευρωκλινική Αθηνών

Κίκα Πλοιαρχοπούλου. Παθολόγος Ογκολόγος Ευρωκλινική Αθηνών Κίκα Πλοιαρχοπούλου Παθολόγος Ογκολόγος Ευρωκλινική Αθηνών Time (months) Survival outcomes in mcrc have progressively improved over the past two decades Treatment options for many patients Multidisciplinary

More information

Objectives. Briefly summarize the current state of colorectal cancer

Objectives. Briefly summarize the current state of colorectal cancer Disclaimer I do not have any financial conflicts to disclose. I will not be promoting any service or product. This presentation is not meant to offer medical advice and is not intended to establish a standard

More information

Therapy for Metastatic Colorectal Cancer

Therapy for Metastatic Colorectal Cancer Therapy for Metastatic Colorectal Cancer Richard M. Goldberg Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Learning Objectives Key

More information

Therapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer

Therapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer Therapeutic Options for Patients with BRAF-mutant Metastatic Colorectal Cancer Axel Grothey, M.D., Professor of Oncology, Clinical and Translational Science Division of Medical Oncology Mayo Clinic, Rochester,

More information

Adjuvant therapy in pancreatic cancer Monotherapy for whom? JL VAN LAETHEM, MD,PhD

Adjuvant therapy in pancreatic cancer Monotherapy for whom? JL VAN LAETHEM, MD,PhD Adjuvant therapy in pancreatic cancer Monotherapy for whom? JL VAN LAETHEM, MD,PhD Efficacy Parameters in adjuvant monochemotherapy Randomized studies in resectable PDAC Regimen DFS HR (p) OS HR (p) 5-yr-OS

More information

METASTATIC COLORECTAL CANCER: TUMOR MUTATIONAL ANALYSIS AND ITS IMPACT ON CHEMOTHERAPY SUMA SATTI, MD

METASTATIC COLORECTAL CANCER: TUMOR MUTATIONAL ANALYSIS AND ITS IMPACT ON CHEMOTHERAPY SUMA SATTI, MD METASTATIC COLORECTAL CANCER: TUMOR MUTATIONAL ANALYSIS AND ITS IMPACT ON CHEMOTHERAPY SUMA SATTI, MD INTRODUCTION Second leading cause of cancer related death in the United States. 136,830 cases in 2014

More information