Cancers of the Colon, Rectum, and Anus

Studies presented in oral sessions with links to abstracts and conclusions cited from abstracts:

First author: Howard Hochster, MD

Abstract 552: Age distribution of tumor gene expression in patients with stage II/III colon cancer.

Conclusions: The etiology of the increase in both incidence and mortality from CRC in adults <55 y is poorly understood. Our findings suggest that colon cancer in younger patients is not biologically different from that in older patients, as measured by the Colon RS test in a large cohort referred for testing. As shown by this test in the GHI clinical laboratory experience, most patients with stage II/III colon cancer have low-risk disease, including patients <55 years. Our findings support a biology-driven approach to disease management of patients with stage II/III colon cancer regardless of age. This well-validated genomic assay may identify a group of younger patients for whom adjuvant chemotherapy might represent overtreatment.

J Clin Oncol 36, 2018 (suppl 4S; abstr 552)


First author: Thierry Andre, MD

Abstract 553: Nivolumab + ipilimumab combination in patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) metastatic colorectal cancer (mCRC): First report of the full cohort from CheckMate-142.

Conclusions: In the largest cohort of dMMR/MSI-H pts treated with an immunotherapy regimen, NIVO + IPI built on the efficacy reported with NIVO monotherapy, demonstrating enhanced clinical benefit and manageable safety, and may represent a new standard of care in pts with dMMR/MSI-H mCRC. Clinical trial information: NCT02060188

J Clin Oncol 36, 2018 (suppl 4S; abstr 553)


First author: Michael Overman, MD

Abstract 554: Nivolumab in patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) metastatic colorectal cancer (mCRC): Long-term survival according to prior line of treatment from CheckMate-142.

Conclusions: NIVO continued to provide clinically meaningful durable responses and long-term overall survival in pts with dMMR/MSI-H mCRC. Of note, CR rate increased with longer follow-up. No new safety signals were reported with long-term follow-up. Enhanced responses in pts with ≤ 2 SC regimens support ongoing evaluation of NIVO combinations in first-line setting. Clinical trial information: NCT02060188

J Clin Oncol 36, 2018 (suppl 4S; abstr 554)


First author: Oscar Murcia Sr., MD

Abstract 555: Genetic profile of polyps and risk of advanced metachronous lesions.

Conclusions: Presence of CIMP-H in polyps associates higher risk of subsequent AML and shorter interval to their development. Genetic profile of polyps emerges as useful tool for colonoscopy surveillance.

J Clin Oncol 36, 2018 (suppl 4S; abstr 555)


First author: Wen-Sy Tsai, MD, PhD

Abstract 556: Prospective clinical study of circulating tumor cells for colorectal cancer screening.

Conclusions: The study has demonstrated high accuracy for the detection of CRC using a novel CTC assay. It is the first study to show high sensitivity in the detection of precancerous colorectal lesions. The simple blood draw required can be easily integrated into a patient’s routine physical, increasing test compliance.

J Clin Oncol 36, 2018 (suppl 4S; abstr 556)


First author: Kohei Shitara, MD

Abstract 557: Reverce: Randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin, and irinotecan.

Conclusions: This was the first randomized study to compare the two therapeutic sequences of R and C for mCRC, suggesting R followed by C is the preferred sequence with median OS 17.4 vs. 11.6 months (HR 0.61; p=0.029). This is consistent across all subgroups including all RAS/BRAF wild-type patients. Comparable PFS1 and remarkable PFS2 improvement may lead to a longer OS in R-C sequence. PFS2 was longer with cetuximab (HR PFS1 0.97 and HR PFS2 0.29). Safety and QOL were comparable between the two arms with no unexpectedAE signals. Clinical trial information: UMIN000011294.

J Clin Oncol 36, 2018 (suppl 4S; abstr 557)


First author: Mark Saunders, MD, PhD

Abstract 558: SCOT: Tumor sidedness and the influence of chemotherapy duration on DFS.

Conclusions: This is the first study to show that unselected patients with R-sided tumours had a worse DFS compared to L-sided tumours. This implies that prognosis is influenced primarily by greater recurrence rather than the contributing factors that influence OS. Tumour sidedness did not impact on the 3-months vs. 6-months comparison in SCOT. Clinical trial information: ISRCTN59757862.

J Clin Oncol 36, 2018 (suppl 4S; abstr 558)


First author: Hilary Chan, BA

Abstract 559: Effect of physical activity trackers and daily text messages on quality-of-life in colorectal survivors (Smart Pace): A pilot randomized controlled trial.

Conclusions: A 12-week physical activity intervention using a Fitbit Flex™ and daily text messages may improve functional well-being among CRC survivors. Larger randomized studies are needed to definitively determine if a digital physical activity intervention improves functional well-being among CRC survivors, and if the improvement can be sustained over time. Clinical trial information: NCT02966054

J Clin Oncol 36, 2018 (suppl 4S; abstr 559)


First author: Johanna Bendell, MD

Abstract 560: A phase Ib study of safety and clinical activity of atezolizumab (A) and cobimetinib (C) in patients (pts) with metastatic colorectal cancer (mCRC).

Conclusions: The combination of atezolizumab + cobimetinib was tolerated in heavely pre-treated patients with locally advanced or metastatic CRC. 

With a median follow-up of 17 months, the median OS was 9.8 months and the 12-month OS rate was 43% in mCRC

- The 12-month OS compared favorably with the 12-month OS of 24% with regorafenib

- Durable responses were observed regardless of KRAS status and in patients with MSS tumors, populations with  a high unmet medical need.

The atezolizumab + cobimetinib combination represents the first potential immune-midifying combination for patients with MSS mCRC.

- Data from the confirmatory phase II study IMblaze370 (NCT02788279) are anticipated in 2018.

Clinical trial information: NCT01988896

J Clin Oncol 36, 2018 (suppl 4S; abstr 560)