OBR Daily Commentary - Colorectal

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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.

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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Metastatic Colorectal Cancer Patients Treated First-line With SIR-Spheres® Y-90 Resin Microspheres More Likely to Become Candidates for Potentially Curative Liver Surgery, REsect Study Shows

(Sirtex) May 24, 2017 - Adding selective internal radiation therapy (SIRT) with SIR-Spheres Y-90 resin microspheres to first-line FOLFOX-based chemotherapy was associated with a statistically significant gain in potentially curative liver resectability, an independent, international panel of expert liver surgeons has reported.

Howard S. Hochster, MD (Posted: June 01, 2017)

quotesReaders beware!! This is a "thought" experiment where a committee of hepatic surgeons decided on resectability of the hepatic metastases based on CT scans from the SIRTEX colon studies. It doesn't mean all the patients would be resectable (many may have occult extra-hepatic disease at time of surgery) and eligibility did NOT require liver only disease. Until actual resection data and survival statistics are presented, this should be regarded as an "in cerebro" experiment only.quotes

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Much Shorter Chemo Works For Many Colon Cancer Patients, Study Says

(Washington Post/To Your Health) June 4, 2017 - Many colon cancer patients can cut their chemotherapy regimen in half, improving their quality of life and reducing their chances of having debilitating side effects, according to a major international study released Sunday.

Howard S. Hochster, MD (Posted: June 05, 2017)

quotesThe combined analysis of more than 12000 patients in 6 randomize trial was intended to show a noninferiority of 3 months FOLFOX or CapeOX with 95% confidence. As it turned out the HR = 1.07 with 95%CI = 1.0 to 1.15 for the primary endpoint of 3 yr DFS (or 0.9% absolute difference). This means the we have 95% confidence that the shorter course may be equal as much as 1.8% worse at the most. It seems reasonable to assume these are as equal as possible to define. Also, across subsets of good risk (T3 or N1) 3 months was non-inferior. And CapeOX was more effective and non inferior across the board, though this was not a randomized assignment (physician choice in most studies). We can be comfortable that 3 months of CapeOX (and probably FOLFOX) is as good as 6 months treatment for good risk patients receiving adjuvant therapy. 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

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

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Ted Okon

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Thomas Marsland, MD

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William Harwin MD

Florida Cancer Specialists President and Managing Part...

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National Health Policy Expert...

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