Drug shows promise for subset of stage III colon cancer patients

August 28, 2014, American Gastroenterological Association

A subset of patients with stage III colon cancer had improved survival rates when treated with irinotecan-based therapy, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association.

When added to the standard chemotherapy —fluorouracil and leucovorin—adjuvant irinotecan therapy improved overall for patients with the CpG island methylator phenotype (CIMP). CIMP is seen in about 10 to 20 percent of colorectal cancers. Patients with CIMP-negative tumors, however, exhibited significant harm from the addition of irinotecan—overall survival was 68 percent compared with 78 percent for those receiving the standard treatment alone.

"Our results serve as an example that the molecular characterization of individual tumors may help to determine the most appropriate treatment for patients with ," said lead study author Stacey Shiovitz, MD, from the department of medicine, University of Washington, Seattle, WA, and the clinical research division of Fred Hutchinson Cancer Research Center, also in Seattle. "Based on our findings, identification of a 's CIMP status should play a greater role in the clinical setting."

Researchers analyzed data from patients with stage III colon cancer randomly assigned to groups given fluorouracil and leucovorin or adjuvant irinotecan after surgery, from April 1999 through April 2001. Patients were followed for eight years. Patients with CIMP-positive tumors demonstrated a trend toward improved overall survival when treated with irinotecan versus the standard treatment alone, 69 percent versus 56 percent, respectively. Results were most pronounced among patients with stage III CIMP-positive, mismatch repair intact (MMR-I) colon cancer.

No significant associations or interactions between CIMP and KRAS or BRAF mutations were observed, suggesting that the effectiveness of this treatment is not influenced by KRAS/BRAF mutation status.

"This analysis serves to increase our understanding of which subset of patients might benefit from irinotecan adjuvant therapy. This research is an important step in the medical community's work to classify tumors into groups that would result in optimized treatment strategies, thus delivering a higher level of personalized care to ," added Dr. Shiovitz.

Future studies are needed to better understand the origin of the CIMP phenotype and to test these findings in a larger subset.

Explore further: MM-398 added to standard treatment shows survival benefit in mets pancreatic cancer

More information: 1 Shiovitz et al. CpG Island Methylator Phenotype Is Associated With Response to Adjuvant Irinotecan-Based Therapy for Stage III Colon Cancer. Gastroenterology 2014: 147(3): 637-645. www.gastrojournal.org/article/ … (14)00657-X/abstract

Related Stories

MM-398 added to standard treatment shows survival benefit in mets pancreatic cancer

June 25, 2014
Adding the novel MM-398 to standard treatment for metastatic pancreatic cancer patients who have already received gemcitabine improves survival, researchers said at the ESMO 16th World Congress on Gastrointestinal Cancer ...

Smoking worsens outcomes with advanced colon cancer

April 6, 2013
(HealthDay)—Smoking is tied to significantly shorter disease-free survival (DFS) and time to recurrence (TTR) in patients undergoing treatment for stage III colon cancer, according to a study published April 1 in the Journal ...

Improved survival with TAS-102 in mets colorectal cancer refractory to standard therapies

June 28, 2014
The new combination agent TAS-102 is able to improve overall survival compared to placebo in patients whose metastatic colorectal cancer is refractory to standard therapies, researchers said at the ESMO 16th World Congress ...

Patients with metastatic colon cancer respond to new combination therapy

May 31, 2014
In an aggressive disease known for poor response rates, researchers from The University of Texas MD Anderson Cancer Center found patients with advanced colorectal cancer responded well to a combination therapy of the drugs ...

Study showed oxaliplatin improved colon cancer patient survival

January 20, 2012
Stage III colon cancer patients in the general population who receive adjuvant treatment for the disease have an improved rate of survival when oxaliplatin is added to 5-fluorouracil (5FU), according to a study published ...

Adding drug to chemotherapy following colon cancer surgery does not improve disease-free survival

April 3, 2012
Adding the drug cetuximab to a regimen of drugs used for the treatment of patients following surgery for stage III colon cancer did not result in improved disease-free survival, according to a study in the April 4 issue of ...

Recommended for you

Presurgical targeted therapy delays relapse of high-risk stage 3 melanoma

January 17, 2018
A pair of targeted therapies given before and after surgery for melanoma produced at least a six-fold increase in time to progression compared to standard-of-care surgery for patients with stage 3 disease, researchers at ...

Dulling cancer therapy's double-edged sword

January 17, 2018
Researchers have discovered that killing cancer cells can actually have the unintended effect of fueling the proliferation of residual, living cancer cells, ultimately leading to aggressive tumor progression.

Researchers develop swallowable test to detect pre-cancerous Barrett's esophagus

January 17, 2018
Investigators at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center have developed a simple, swallowable test for early detection of Barrett's esophagus that offers promise ...

Scientists zoom in to watch DNA code being read

January 17, 2018
Scientists have unveiled incredible images of how the DNA code is read and interpreted—revealing new detail about one of the fundamental processes of life.

T-cells engineered to outsmart tumors induce clinical responses in relapsed Hodgkin lymphoma

January 16, 2018
WASHINGTON-(Jan. 16, 2018)-Tumors have come up with ingenious strategies that enable them to evade detection and destruction by the immune system. So, a research team that includes Children's National Health System clinician-researchers ...

Researchers identify new treatment target for melanoma

January 16, 2018
Researchers in the Perelman School of Medicine at the University of Pennsylvania have identified a new therapeutic target for the treatment of melanoma. For decades, research has associated female sex and a history of previous ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.