Gastrointestinal Cancer—Colorectal and Anal

Thierry Andre, Kai-Keen Shiu, Tae Won Kim, et al.
The study authors conclude, that 1st-line pembrolizumab vs chemotherapy for patients with MSI-H/dMMR mCRC provides statistically superior progression-free survival with fewer treatment-related adverse events and is associated with a trend toward reduced mortality (likely due to the high crossover rate from chemo to anti-PD1/PD-L1 therapies). The authors see pembrolizumab as a new standard-of-care in the 1st-line for patients with MSI-H/dMMR mCRC. Clinical trial information: NCT02563002
Akihito Tsuji, Hisatsugu Ohori, Tatsuro Yamaguchi, et al.
The study authors conclude, that the mFOLFOXIRI plus cetuximab has been shown to be significantly superior to the mFOLFOXIRI plus bevacizumab in terms ofdepth of response as the primary endpoint in first-line treatment for RAS wild-type mCRC. Clinical trial information: NCT02515734. Clinical trial information: UMIN000018217.
Sebastian Stintzing, Kathrin Heinrich, David Tougeron, et al.
The study authors conclude, that FIRE-4.5 is the first prospective and randomized study investigating the efficacy of FOLFOXIRI plus targeted therapy in the 1st-line treatment of BRAF V600E-mutant mCRC. FOLFOXIRI plus either bevacizumab or cetuximab have comparable efficacy with differential effects according to primary tumor sidedness. This supports the heterogeneity of BRAF V600E-mutant subpopulation of mCRC. Clinical trial information: NCT04034459
Dominik Paul Modest, Meinolf Karthaus, Stefan Frühauf, et al.
The study authors conclude, that In RAS WT mCRC, maintenance therapy with 5FU/LV+ panitumumab appears to be superior to 5FU/LV alone. Hence it should be regarded as the standard of care maintenance regimen following induction therapy with FOLFOX plus panitumumab. Clinical trial information: NCT01991873
Richard Adams, David Fisher, Janet Graham,  et al.
The study authors conclude that overall survival remains unaffected, despite strong evidence of prolongation of progression-free survival with maintenance therapy. FOCUS4-N provides additional evidence to support the use of treatment breaks as a safe management alternative for patients who are stable or responding well to 1st-line treatment for mCRC. In the interval after 16 weeks of combination therapy, Capecitabine without bevacizumab may be used to extend progression-free survival. Clinical trial information: ISRCTN#90061546.
Takayuki Yoshino, Maria Di Bartolomeo, Kanwal Pratap Singh Raghav, et al.
The study authors conclude, that Trastuzumab deruxteca  at 6.4 mg/kg Q3W showed promising activity and durability with longer-term FU in this pt population. There were no new safety signals observed. Interstitial lung disease continues to be recognized as an important identified risk. Therefore careful monitoring and intervention are important. Clinical trial information: NCT03384940
Andrea Sartore-Bianchi, Filippo Pietrantonio, Sara Lonardi, et al.
The study authors conclude, that liquid biopsy-driven rechallenge with anti-EGFR antibodies leads to further objective responses in one-third of patients. Genotyping tumor DNA in the blood can be effectively incorporated in the management of advanced CRCs. Clinical trial information: 2016-002597-12.
Yasutoshi Kuboki, Tetsuji Terazawa, Toshiki Masuishi, et al.
The study authors conclude, that FTD/TPI plus bevacizumab did not show non-inferiority to FOLFIRI or S-1 and irinotecan plus bevacizumab as 2nd-line treatment in patients with mCRC. Clinical trial information: jRCTs031180122.