Colorectal Cancer   

Questions discussed in this category



Would you approach with curative intent with locoregional treatment or systemic treatment alone?

The NCCN guidelines categorically recommend adjuvant XRT for a cT1-2N0 rectal adenocarcinoma upstaged to a pT3N0, yet there are multipl...

Is there a potential role for concurrent radiation therapy? What if the tumor is BRAF mutated?

And is it different when using pembrolizumab or a combination of ipilimumab/nivolumab?

Do you use the same high risk factors as adenocarcinoma when deciding on adjuvant treatment for early stage disease?

> 30s, female with metastatic colon cancer. Presented with a headache. Metastatic hemorrhagic mets per MRI 10/2022. Had radiation. Kras mutated, Br...

Would sidedness matter? Do you use ctDNA assays to evaluate for acquired RAS mutations to guide this decision?

Would you advocate for a targeted gene approach or a fully comprehensive NGS panel?

Specifically, would you consider either neoadjuvant or adjuvant immunotherapy in this setting, or only after recurrence?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

For example, portion is seen above and below the mesorectal fascia. Do you feel comfortable treating as colon cancer with surgery upfront?

Would you consider the BEACON regimen (i.e., encorafenib/binimetinib + cetuximab) in this setting?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice?

G1 neuropathy and G3 neutropenia were observed with cycle 12 FOLFOX + bev. Would you reintroduce oxali at a lower dose or switch to irinotecan+EGFRi ...

Of note - the tumor tissue biopsy NGS did not show KRAS or BRAF mutations. Microsatellite stable. Patient received first line FOLFOXIRI + Avastin .

This involves the primary site responding but progression with new bone marrow involvement with resulting cytopenias.

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

Benefit of oxaliplatin in patients >70 years of age is not proven and only 5FU/capecitabine in a MSI-H tumor is of questionable efficacy. What woul...

Would you use a small cell regimen over a more traditional FOLFOX-esque approach?

How would the sidedness of the tumor, BRAF, RAS,HER2 or MSI status affect your decision?

Would you use dual agent chemotherapy such as FOLFIRI, combination of chemo with biologic- IRI/Cetux or all 3 drugs simultaneously? How would sidednes...

Given that majority of benefit is derived from the capecitabine, would this be an acceptable option to decrease patient contact with the healthcare sy...

Would presence of features considered high risk in stage II sway your interpretation of the IDEA trial? 

In practice, does starting with chemoradiation followed by chemotherapy result in a significant delay in initiating chemotherapy or a patient's abilit...

The German trial included patients with tumors up to 16cm from the anal verge, while the Swedish trial update found no local control benefit for tumor...

The NCCN seems to make its recommendation based on extrapolation from colon cancer, but those patients are not treated with pre-op chemoRT.

Has the utility of BRAF in CRC expanded beyond guiding prognosis? Is there a role in non-metastatic CRC?

If a patient with stage II or III colon adenocarcinoma who presents to your clinic 12-16 weeks after surgical resection do you give adjuvant chemother...

The RTOG contouring atlas doesn't give a consensus on this issue.

Is there a change in approach over the past few years? Would there be a role for the 12-gene recurrence score?

Since some prior subset analyses have suggested that oxaliplatin may not improve outcomes of older patients with colon cancer in the adjuvant settin...

Does the recent Hopkins trial of pembrolizumab change your management of these patients?

In a lesion <2.5 cm from anal verge arising in a tubulovillous adenoma, does the data from Taylor, et. al. Red Journal 2001 apply? 

Should standard post operative radiation fields be used, treating up to the L5-S1 interspace? Or is it acceptable to treat a lower field, for ins...

In the past, I haven't seen great results in palliating the presacral area. The pain is excruciating for many patients. Is there an effective option f...


Papers discussed in this category


International journal of radiation oncology, biology, physics, 2001-11-01

Radiat Oncol, 2014-12-23

Lancet (London, England), 2009-03-07

J. Clin. Oncol., 2012-06-01

Br J Surg, 2006-10-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-11-01

International journal of radiation oncology, biology, physics, 2014-03-15

Ann. Surg. Oncol., 2017 May 30

Ann. Oncol., 2019 Jun 13

Ann. Surg., 2007-11-01

Journal of cancer research and therapeutics, 2011

International journal of radiation oncology, biology, physics, 2012-04-01

J Can Assoc Radiol, 1975-09-01

Int. J. Radiat. Oncol. Biol. Phys., 1995-01-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-05-15

J. Clin. Oncol.,

Lancet Gastroenterol Hepatol, 2019 Jul 29

Diseases of the colon and rectum, 2008-08

JAMA oncology, 2018-06-14

J. Clin. Oncol., 2019 Oct 08

The New England journal of medicine, 1985-06-06

Cancer,

Eur J Surg Oncol,

Ann. Surg. Oncol., 2010 Sep 21

Clin Epidemiol, 2012 Nov 07

HPB : the official journal of the International Hepato Pancreato Biliary Association, 2016-03

Lancet Oncol., 2016-06-01

Nature, 2018-02-08

The Lancet. Oncology, 2019-04

Neuroendocrinology, 2019 Aug 21

Ann. Surg., 2019 Aug 30

Expert Opin Biol Ther, 2019 Mar 27

J. Clin. Oncol., 2019 Oct 14

Lancet Oncol., 2015 Aug 31

Lancet Oncol., 2020 Mar 09

JAMA, 2017-06-20

Annals of oncology : official journal of the European Society for Medical Oncology, 2017-08-01

Lancet Oncol, 2014 Jul 31

J Clin Oncol, 2022 Jun 06

J Clin Oncol, 2007 May 01

J. Clin. Oncol., 2003 Sep 08

N. Engl. J. Med.,

N Engl J Med, 2015 Jun 25

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-03-10

N. Engl. J. Med., 2019 Sep 30

J. Clin. Oncol., 2019 May 31

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-08-10

Nature, 2017-08-10

Oncogene, 2018 Mar 15

Clin Cancer Res, 2019 Sep 12

JCO Precis Oncol, 2019 Aug 05

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-11-01

N. Engl. J. Med.,

Br. J. Cancer,

Eur. J. Cancer, 2017-01-01

Int. J. Cancer, 2017 Jun 08

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-01-20

Lancet (London, England), 2007-12-15

Annals of surgery, 1999-07

Journal of the National Cancer Institute, 2000-03-01

Diseases of the colon and rectum, 2009-04

Radiother Oncol, 2012 Nov 28

J Gastrointest Oncol,

Radiat Oncol J, 2019 Jun 30

Radiat Oncol, 2019 Jan 16

Radiat Oncol, 2014 Jul 22

Radiat Oncol, 2016 Sep 05

British journal of cancer, 2011-02-01

Anticancer Res.,

Annals of surgical oncology, 2018-08

Biosci. Rep.,

J Natl Compr Canc Netw,

J Natl Compr Canc Netw,

Anticancer Res.,

Cancer, 2018-06-01

N. Engl. J. Med., 2019 Jun 02

Journal of the National Cancer Institute, 2018-11-01

J. Clin. Oncol., 2020 Jan 24

Invest New Drugs, 2012 Oct 09

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-07-10

Science translational medicine, 2016-07-06

JAMA oncology, 2019-05-09

JAMA oncology, 2019-05-09

J. Clin. Oncol., 2012 Aug 20

Gut, 2018 Feb 02

Lancet Oncol, 2020 Dec 07

Ann Oncol,

Lancet Oncol, 2021 Apr 13

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-07-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-10-01

Journal of the National Cancer Institute, 2012-02-08

Annals of oncology : official journal of the European Society for Medical Oncology, 2015-04

Cancers (Basel), 2021 Jan 15

ESMO Open,

J Clin Oncol,

JAMA oncology, 2018-09-01

Human pathology, 2019-06

Oncoimmunology, 2018

Pancreas, 2010-08

Annals of surgical oncology, 2006-03

Neuroendocrinology, 2012 Feb 15

Neuroendocrinology, 2015 Sep 10

Cancer cell, 2018-05-14

Annals of oncology : official journal of the European Society for Medical Oncology, 2019-07-01

Lancet Oncol, 2020 Sep 10

JAMA Oncol,

Cancer Discov, 2020 Nov 02

J Gastrointest Oncol,

Hum Mutat,

International journal of radiation oncology, biology, physics, 2011-01-01

International journal of radiation oncology, biology, physics, 1989-02

Int J Radiat Oncol Biol Phys,

Curr Health Sci J, 2018 Jan 05

Clin Cancer Res, 2020 Mar 6

N Engl J Med,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002-12-01

BJS open, 2021 Nov 09

PLoS One, 2021 Mar 26

Eur J Surg Oncol, 2021 Jul 31

BMJ Open, 2021 Sep 24

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-03-10

N Engl J Med, 2018 Mar 29

J Clin Oncol, 2020 Dec 23

Nat Med, 2020 Apr 06

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-10-10

JAMA oncology, 2018-03-01

J Clin Oncol, 2015 Nov 02

J Natl Cancer Inst, 2016 Feb 01

N Engl J Med, 2022 Jun 05

N Engl J Med, 2022 Jun 04

Journal of gastrointestinal oncology, 2017-12

Pract Radiat Oncol, 2022 May 05

JCO precision oncology, 2022 Jul

Pract Radiat Oncol, 2020 Oct 21

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007-06-01

Cancer, 2007-08-01

Journal of gastrointestinal oncology, 2017-12

Cardiooncology, 2019

Cardiol Clin, 2019 Aug 26

JACC CardioOncol, 2021 Mar 16

The New England journal of medicine, 2013-10-31

Lancet, 2021 Jun 05

Eur J Cancer, 2018 Aug 24

NEJM Evidence, 2022 Jun 1

Clinics in colon and rectal surgery, 2019-05

N Engl J Med, 2022 Nov 03

J Gastrointest Oncol, 2020 Feb

Front Oncol, 2023 Feb 02

JAMA Oncol, 2019 Mar 01

Nat Med, 2022 Aug 01

Br J Cancer, 2020 Aug 31

Target Oncol, 2021 Oct 31

JAMA Oncol, 2021 Oct 01

Ann Oncol, 2019 Feb 01

Lancet Oncol, 2020 Jan 31

Nat Med, 2023 Jan 16

Cancer Sci, 2021 Jun 07

J Natl Cancer Inst, 2021 Feb 01

J Clin Oncol, 2021 Oct 12

Nat Cancer, 2020 Aug 03

Cancers (Basel), 2021 Feb 21

J Neurooncol, 2017 Nov 23

Annals of surgery, 2006-12

Annals of surgical oncology, 2013-07

Annals of surgical oncology, 2010-01

Diseases of the colon and rectum, 1999-09

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-09-10

Dermatol Pract Concept, 2019 Jan 31

Clin Cancer Res, 2013 Jul 05

N Engl J Med, 2023 Jun 04

Lancet Oncol, 2021 May 04

Lancet Oncol, 2023 Jun 02

Oncology (Williston Park), 2022 Feb 08

Insights Imaging, 2018 Nov 14

JAMA, 2021 Feb 16

Lancet Oncol., 2011 May 17

Lancet (London, England), 2009-03-07

Ann Surg, 2011 Apr

JAMA Oncol, 2019 Jul 01

J Clin Oncol, 2023 Jun 19

Clinical cancer research : an official journal of the American Association for Cancer Research, 2008-01-15

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2013 Jan 29

Journal of geriatric oncology, 2020 Jun 21

Medical oncology (Northwood, London, England), 2018 May 31

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 Jan 09

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 May 15

Nature communications, 2023 Jun 07

Diseases of the colon and rectum, 1993-01

Cancer, 1976 Apr

Annals of oncology : official journal of the European Society for Medical Oncology, 2011 Apr 29

Digestion, 2018 Jun 05

British journal of cancer, 2016 Mar 15

Nature medicine, 2008-09

Annals of oncology : official journal of the European Society for Medical Oncology, 2017-06-01

The Cochrane database of systematic reviews, 2015 Dec 10

Japanese journal of clinical oncology, 2002 Feb

British journal of cancer, 2019 Apr 24