What changed: Colorectal cancer

When this page itself was last checked or edited.

Colorectal cancer screening in average-risk adults aged 45 and older

Primary endpoint (sustained cCR at 12 months) met; rates pending congress presentation.

A milestone in how this cancer is treated.

A milestone in how this cancer is treated.

Breakthrough Therapy designation, dMMR locally advanced rectal cancer (organ preservation)

Breakthrough Device designation for Shield multi-cancer (MCD)

With nivolumab first-line MSI-H/dMMR colorectal cancer (CheckMate 8HW)

KRAS G12C colorectal cancer with panitumumab (CodeBreaK 300)

With sotorasib for KRAS G12C mCRC (CodeBreaK 300)

KRAS G12C mCRC with sotorasib

KRAS G12C colorectal cancer with panitumumab

3-year recurrence HR 0.

3-year DFS 86.

OS 30.

DFS HR 0.

A milestone in how this cancer is treated.

Medicare coverage under the blood-based CRC screening NCD

PMA approval: first blood test for primary colorectal cancer screening (ECLIPSE)

KRAS G12C colorectal cancer with cetuximab (accelerated)

FDA advisory committee votes favourably

KRAS G12C colorectal cancer with cetuximab

Colorectal cancer screening in average-risk adults aged 45 and older

Colorectal cancer screening, average-risk adults ≥45

Sensitivity 93.

First-line PFS 54.

Sensitivity 83.

Placebo-adjusted weight gain 2.

A milestone in how this cancer is treated.

A milestone in how this cancer is treated.

FRESCO-2

HER2+ RAS wild-type metastatic colorectal cancer with trastuzumab (MOUNTAINEER, accelerated)

Refractory mCRC after fluoropyrimidine, oxaliplatin, irinotecan, anti-VEGF, and anti-EGFR if appropriate

Companion diagnostic for cetuximab and panitumumab (KRAS/NRAS wild-type colorectal cancer) with tumour-profiling claims

GALAXY: ctDNA+ post-op HR for recurrence ~10; ALTAIR: DFS endpoint not met.

PFS HR 0.

ORR 37.

OS 7.

Fewer severe complications and faster recovery with prehabilitation; surgery not delayed.

OS 10.

A milestone in how this cancer is treated.

Chemotherapy use 15% vs 28% with non-inferior RFS.

Phase 2 ORR 38.

pCR 68%, major pathologic response 95%; 3-year DFS 100%.

10-year colorectal cancer risk 0.

OS 37.

A milestone in how this cancer is treated.

Organ preservation without surgery (Cercek, NEJM); panitumumab beats bevacizumab in left-sided disease; ctDNA-guided de-escalation.

FOCUS4-C: adavosertib improved progression-free survival in RAS and TP53 co-mutated tumours (hazard ratio 0.

3-year disease-free survival 76% vs 69% (hazard ratio 0.

Medicare coverage (MolDX) for stage II-III colorectal cancer

therascreen BRAF V600E: encorafenib plus cetuximab in colorectal cancer

PFS 16.

3-year disease-related treatment failure 23.

Continuous cohort reporting: positive signals for pembrolizumab in high tumour mutational burden cancers and trastuzumab plus pertuzumab in ERBB2-amplified colorectal cancer; palbociclib in CDKN2A-altered lung cancer and several other matches were negative.

A milestone in how this cancer is treated.

5-year OS 42.

Refractory mCRC (FRESCO)

Response in 23 percent of the first 230 patients; trastuzumab plus pertuzumab gave a 32 percent response rate in HER2-amplified colorectal cancer, now a guideline option; atezolizumab activity rose with tumour mutational burden.

A milestone in how this cancer is treated.

A milestone in how this cancer is treated.

Based on KEYNOTE-016/164 and others; dMMR CRC becomes the model immunotherapy-responsive GI tumour.

Refractory metastatic colorectal cancer

CMS1-4 classification; RECOURSE establishes TAS-102 in refractory disease.

First-line with FOLFOX in RAS wild-type (PRIME)

Colorectal cancer screening in average-risk adults aged 50 and older (later 45 and older)

First-line RAS wild-type mCRC with FOLFOX

Sensitivity 92.

FIRE-3 and CALGB 80405 subgroups show anti-EGFR benefit only in left-sided RAS wild-type tumours.

Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI

Metastatic colorectal cancer, previously treated

therascreen KRAS: cetuximab and panitumumab eligibility in metastatic colorectal cancer

Metastatic colorectal cancer resistant to or progressing after oxaliplatin, with FOLFIRI

Advanced gastric cancer with cisplatin; metastatic colorectal cancer intolerant of other fluoropyrimidines added 2022 (Teysuno)

CRYSTAL KRAS-WT OS 23.

Retrospective CRYSTAL/OPUS analyses; first negative predictive biomarker in CRC; RAS testing becomes mandatory.

Accelerated approval, refractory mCRC

EGFR-expressing mCRC after chemotherapy (later RAS wild-type)

First-line metastatic colorectal cancer with 5-FU chemotherapy

EGFR-expressing metastatic colorectal cancer (later restricted to RAS wild-type)

5-year local recurrence 6% (preoperative) vs 13% (postoperative); overall survival unchanged.

A milestone in how this cancer is treated.

First anti-angiogenic and first anti-EGFR antibodies; MOSAIC establishes adjuvant FOLFOX.

Metastatic colorectal cancer with 5-FU/LV

Colorectal, gastric and breast cancer

FOLFIRI and FOLFOX double median metastatic survival from ~12 to ~20 months.

Gastric cancer; later colorectal, head and neck, lung, pancreatic, biliary and breast cancer (TS-1)

Metastatic breast cancer after anthracycline and taxane; later adjuvant and metastatic colorectal cancer, rectal chemoradiotherapy

Metastatic colorectal cancer after 5-FU; first line with 5-FU/LV 2000

Metastatic colorectal cancer

Adjuvant 5-FU/levamisole shown to improve survival in stage III (1990); MSH2/MLH1 cloned 1993.

APC → KRAS → TP53 model of colorectal tumorigenesis defines the genetic paradigm of cancer.

Colorectal, breast, gastric and pancreatic adenocarcinoma

Heidelberger; still the backbone of colorectal chemotherapy 70 years later.