Use of combined biomarkers analysis to predict response to chemotherapy in colorectal cancer: A single-institution feasibility study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11074-11074
Author(s):  
J. Rodriguez-Pascual ◽  
E. Garcia ◽  
F. Lopez-Rios ◽  
A. Cubillo ◽  
I. Diaz-Padilla ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Treatment Options ◽  
Molecular Targets ◽  
Individual Case ◽  
Single Institution ◽  
First Line ◽  
Egfr Amplification ◽  
Response To Chemotherapy ◽  
Predict Treatment Response ◽  
Line Chemotherapy

11074 Background: Treatment options for patients (pts) with colorectal cancer (CRC) have increased in the last years. However, there are no validated prospective molecular markers in CRC to select which agents are better to treat any individual case. The aim of this study was to determine the feasibility of developing an implementing a biomarker panel to guide treatment selection in this setting. Methods: Colorectal cancer tumors were prospectively analyzed with a predefined set of 11 molecular targets, including: KRas and PI3K mutations, EGFR amplification (FISH), and ERCC-1, TS, TP expression by IHC. Clinical characteristics and response to chemotherapy were registered. To establish the utility of this panel, we determine as congruent-treatment if the panel predict the best treatment in patients with more of 1 chemotherapy line and no-congruent-treatment if do not. Results: A total of 84 patients were studied. Only 6 % required a repeated biopsy to obtain sufficient tumor for marker analysis. In 81 % of patients was feasible to study almost 8/11 targets. There were 29 pts (39%) with KRas mutant CRC; 3 pts with PI3K mutations (4%, all of them with KRas mutation); and 2 patients with EGFR amplification. ERCC-1 was positive in 5/78 (6.4%) and TS was positive in 47%. None of 54 pts had TP positivity. Clinical floow up was available in 66 pts (44 males, median age 59, 93% ECOG 0–1). Nineteen patients had early CRC; 23 with metastatic CRC treated with a first line chemotherapy and 24 with advanced CRC treated with 2 or more prior regimens. In this last group for whom the response to multiple agents is known, the panel predictive the most effective treatment in 14 of 24 cases. Conclusions: This targeted-therapy-panel is feasible to implement and should be explore to predict treatment response to CRC . No significant financial relationships to disclose.

Supporting Treatment Decision Making in Advanced Cancer: A Randomized Trial of a Decision Aid for Patients With Advanced Colorectal Cancer Considering Chemotherapy

2011 ◽  
Vol 29 (15) ◽  
pp. 2077-2084 ◽  
Author(s):  
Natasha B. Leighl ◽  
Heather L. Shepherd ◽  
Phyllis N. Butow ◽  
Stephen J. Clarke ◽  
Margaret McJannett ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Randomized Trial ◽  
Advanced Cancer ◽  
Decision Aid ◽  
Advanced Colorectal Cancer ◽  
Treatment Options ◽  
Decisional Conflict ◽  
First Line ◽  
Line Chemotherapy

Purpose Decision making in advanced cancer is increasingly complex. We developed a decision aid (DA) for patients with advanced colorectal cancer who are considering first-line chemotherapy and reviewing treatment options, prognostic information, and toxicities. We examined its impact on patient understanding, treatment decisions, decisional conflict, decision making, consultation satisfaction, anxiety, and quality of life by using a randomized trial design. Patients and Methods In all, 207 patients with colorectal cancer who were considering first-line chemotherapy for metastatic disease were randomly assigned to receive a standard medical oncology consultation or a consultation in which the DA (take-home booklet with audio recording, reviewed by an oncologist) was used. Participants completed questionnaires postconsultation, postdecision, and 1 month later. Results In this study, 100 patients were randomly assigned to the control arm, and 107 received the DA. Median age of the sample was 62 years, 58% were male, 89% had a performance status of 0 or 1, and 36% had received prior adjuvant chemotherapy. Patients receiving the DA demonstrated a greater increase in understanding of prognosis, options, and benefits, with higher overall understanding (P < .001). Decisional conflict, treatment decisions, and achievement of involvement preferences were similar between the groups. Anxiety was similar across groups and decreased over time. Most patients were confident in a decision during the first consultation; 74% chose chemotherapy, 7% supportive care alone, and 10% observation. Conclusion This randomized trial of a decision aid in advanced cancer showed that its use in advanced colorectal cancer improved patient understanding of prognosis, treatment options, risks, and benefits without increasing anxiety. DAs can improve informed consent and can be tested through randomized trials even in the advanced cancer setting.

Maintenance therapy following first-line chemotherapy in metastatic colorectal cancer: toxicity and efficacy—single-institution experience

2014 ◽  
Vol 32 (1) ◽  
Author(s):  
Mikahil Fedyanin ◽  
Alexey Tryakin ◽  
Anna Vybarava ◽  
Dzhennet Chekini ◽  
Ilya Pokataev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Maintenance Therapy ◽  
Metastatic Colorectal Cancer ◽  
Single Institution ◽  
First Line ◽  
Line Chemotherapy

scholarly journals Molecular Targets and Novel Therapeutic Avenues in Soft-Tissue Sarcoma

2020 ◽  
Vol 27 (11) ◽  
pp. 34-40 ◽  
Author(s):  
A. Elkrief ◽  
T. Alcindor
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Metastatic Disease ◽  
Treatment Options ◽  
Molecular Targets ◽  
First Line ◽  
Standard Chemotherapy ◽  
Disease Outcomes ◽  
Rare Tumours ◽  
Line Chemotherapy

Soft-tissue sarcoma (sts) represents a heterogeneous group of rare tumours, and a significant number of affected patients will develop metastatic disease. Outcomes in the population with metastatic disease are generally poor, especially after progression on standard chemotherapy. The advent of personalized medicine has permitted oncologists to offer targeted treatment, thus addressing the limited treatment options and poor prognosis after progression on first-line chemotherapy. In this review, we delineate the existing data and therapeutic successes with respect to existing and emerging molecular targets in sts and options for immunotherapy in sts. Our review also summarizes emerging clinical trials that are currently recruiting patients.

scholarly journals Patient profiles as an aim to optimize selection in the second line setting: the role of aflibercept

2021 ◽  
Author(s):  
B. González Astorga ◽  
F. Salvà Ballabrera ◽  
E. Aranda Aguilar ◽  
E. Élez Fernández ◽  
P. García-Alfonso ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Therapeutic Option ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Effective Therapeutic Option ◽  
Line Setting ◽  
First Line Treatment

AbstractColorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient’s profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.

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