OBR Daily Commentary

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Study Examines 'Watch-And-Wait' Approach for People with Rectal Cancer

(St. Michael's Hospital [Toronto, Canada]) May 5, 2017 - In a paper published online today in The Lancet Gastroenterology & Hepatology, researchers conducted a systematic review and meta-analysis of 23 studies involving 867 patients with rectal cancer who adopted the “watch-and-wait” approach. Cancer returned in the rectum of only 15.7 per cent of these patients.

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Richard Goldberg, MD (Posted: May 05, 2017)

quotesThis is a very interesting study that opens the door to prospective investigation of a randomized trial of watch and wait strategy versus surgery in patients with low stage rectal cancers who have complete responses to chemotherapy and radiation. Identifying patients who can be spared the cost and toxicity of triple modality therapy with good outcomes is key.quotes

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A Survival 'Paradox' in Colon Cancer

(Medscape Medical News) Aug 5, 2016 - There is a "survival paradox" in colon cancer? patients with a lower-stage malignancy have poorer survival than patients with higher-stage disease? and a new study confirms the phenomenon.

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Richard Goldberg, MD (Posted: August 05, 2016)

quotesAdjuvant trials have shown the worse prognosis for T4 stage II tumors as compared to T2 and T3 stage IIIA (1-3 + nodes) for some time. Rather than representing a paradox this appears to highlight that staging is useful to give us a common currency for classifying tumors but is not necessarily the best predictor of outcomes. Staging is our attempt to impose an anatomical order on the chaos of cancer and yet it currently does not take biology as defined by molecular genetic and other drivers into account. The AJCC staging system is currently undergoing revision but will remain anatomically based for the next edition until there are more data to help refine the staging system through genomic analyses. The NCI is mounting a huge effort to extend genomic analyses in patients accrued to clinical trials in colon cancer and many other primary cancers to try to help refine our understanding of the interplay between biology and anatomy. quotes

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Oxaliplatin-Based Adjuvant Chemo for Stage III MMR CRC

(Medscape Medical News) July 22, 2016 - The largest study to date to focus on patients with colorectal cancer (CRC) with deficient DNA mismatch repair (dMMR) has found that adjuvant therapy with fluoropyrimidine combined with oxaliplatin (Eloxatin, Sanofi-Aventis), but not fluoropyrimidine alone, significantly improved disease-free survival when compared with surgery alone in patients with stage III disease.

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Richard Goldberg, MD (Posted: July 26, 2016)

quotesWhile there are some data for Stage II patients suggesting harm from 5-FU alone in MSI-H patients there has been little available to guide us in Stage III patients with MSI-H tumors. While this is retrospective data it does provide some evidence for using oxaliplatin in this setting that is corroborated by xenograft experiments. Even in patients with borderline PS trying a reduced dose of oxaliplatin initially seems like a reasonable strategy in patients who are getting adjuvant treatment for Stage III tumors and whose tumors are MSI-H. quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...