From Oncology Net Guide Metastatic Colorectal Cancer Resource Guide

The Online Oncologist

Colon Cancer Treatment Plan and Summary Resources

This section of the ASCO Website includes several downloadable, customizable templates for medical oncologists treating colon cancer patients. There is a “Colon Cancer Adjuvant Treatment Plan and Summary” and a “Colon Cancer Survivorship Plan.” The former includes a plan component, to be completed before chemotherapy is administered, and a summary to be completed following administration. The latter is a modifiable document that provides a customized plan for colon cancer survivorship care based on ASCO’s guidelines, and it can be added as a third page to the “Colon Cancer Treatment Plan and Summary” template. All forms are available in Microsoft Word and Excel formats.

Management of potentially resectable colorectal cancer liver metastases

Resection and the role of systemic chemotherapy for hepatic metastases are the primary subjects of this data review. The information is broken down into major topics, such as biopsy confirmation, surgical resection, neoadjuvant chemotherapy, local options for incompletely resected metastatic disease, timing of hepatectomy in patients presenting with metastases, and therapy after resection of liver metastases. Although the information is presented as one lengthy article, a navigation bar on the side allows users to quickly jump to the topic or subtopic of their choosing. In addition, subscribers have access to related data and charts that are hyperlinked throughout the article. The material on the site is reviewed and updated regularly, and much of it is backed by statistics and facts cited from over 100 unique sources.

Webcast

Genetic influences in response to EGFR for metastatic colorectal cancer

In this Webcast from the AACR 100th Annual Meeting 2009, hosted on ecancer.tv, Frederica Di Nicolantonio, PharmD, PhD, Laboratory of Molecular Genetics, Institute for Cancer Research and Treatment, University of Turin Medical School, Italy, discusses how BRAF, PIK3CA, and KRAS mutations and loss of PTEN expression impair response to EGFR-targeted therapies in metastatic colorectal cancer.

The Educated Patient

Colorectal Cancer Coalition (C3)

Momentum

The C3 Website features an abundance of information for patients, including updates on the latest colorectal cancer research, treatment advances, and policy and advocacy news. It also has a patient information section that reviews diagnosis and treatment, coping and support, and survivorship. Heinz-Josef Lenz, MD, a colorectal cancer expert, regularly contributes articles to the Website that cover subjects such as managing symptoms and side effects, understanding genetics, knowing about clinical trials, and more. The site has a medical review network that checks and updates the site regularly to ensure its accuracy. Patients who require greater support can use the C3 Answer Line, which allows patients to communicate directly with a member of C3 via telephone or e-mail. Patients can also sign up to receive C3’s magazine, , and download any back-issues.

Colon Cancer Alliance (CCA)

The CCA is a large organization dedicated to ending colorectal cancer through patient advocacy. Its Website has sections detailing numerous aspects of colorectal cancer, such as risk factors, diagnosis, treatment, staging, and screening. In addition to educating patients, the site has a section dedicated to caregivers, covering issues such as quality of life, how to help a loved one, avoiding financial troubles, and end of life matters. Other useful tools include an FAQ section, where patients and caregivers alike may find answers to key questions.

Online CME

Innovations in chemotherapy for metastatic colorectal cancer: An update of recent clinical trials

Credits: 1.00

Fee: None

Expires: October 24, 2010

Upon completing this activity, participants should be able to use evolving treatments in metastatic colorectal cancer based on key data from recent clinical trials, prescribe biologic agents in combination with chemotherapy, and use strategies (eg, “stop and go”’ dosing) that may aid patients with metastatic colorectal cancer receive optimal therapy while minimizing the toxicity of treatment.

Combining targeted therapies for metastatic colon cancer is not beneficial

Credits: 0.25

Fee: None

Expires: February 5, 2010

Upon completing this activity, which involves reading a short news article and answering two multiple-choice questions, participants will be able to list the standard cytotoxic drugs used to treat metastatic colorectal cancer, and evaluate the addition of cetuximab to capecitabine, oxaliplatin, and bevacizumab as a first-line treatment.

eArticles

The following are links to full articles available online that address various topics related to metastatic colorectal cancer.

Title: Vascular endothelial growth factor plus epidermal growth factor receptor dual targeted therapy in metastatic colorectal cancer: synergy or antagonism?

Author: John L. Marshall

Journal of Clinical Oncology

Publication:

Date: December 2009

Title: Significance of circulating tumor cells detected by the CellSearch System in patients with metastatic breast, colorectal, and prostate cancer

Authors: M. Craig Miller, Gerald V. Doyle, and Leon W. M. M. Terstappen

Journal of Clinical Oncology

Publication:

Date: December 2009

Title: UGT1A1 gene polymorphism: impact on toxicity and efficacy of irinotecan-based regimens in metastatic colorectal cancer

Authors: Christoph Schulz, Volker Heinemann, Andreas Schalhorn, et al

Publication: World Journal of Gastroenterology

Date: October 2009

Title: Multi-determinants analysis of molecular alterations for predicting clinical benefit to EGFR-targeted monoclonal antibodies in colorectal cancer

Authors: Andrea Sartore-Bianchi, Federica Di Nicolantonio, Michele Nichelatti, et al

Publication: PLoS One

Date: October 2009

Clinical Trials

Chemotherapy and internal radiation in treating patients with colorectal cancer that has spread to the liver

Study Type: Interventional

Age/Sex Requirements: 18 years+ (None)

Sponsor: Goshen Health System

ClinicalTrials.gov Identifier: NCT00408551

Purpose: The goal of this phase II interventional trial is to study how well chemotherapy combined with internal radiation works in patients with colorectal cancer that has metastasized to the liver. Primary measures include tumor response based on CEA level, RECIST criteria, and PET scanning, as well as hepatic toxicity. Secondary measures are the therapeutic efficacy based on time from selective internal radiation therapy to in-liver disease progression and on the proportion of patients who achieve down-staging after chemo-selective internal radiation therapy.

Sunitinib and capecitabine for first-line colon cancer

Study Type: Interventional

Age/Sex Requirements: 18 years+ (None)

Sponsors: Georgetown University, Pfizer

Purpose: This clinical trial is for patients with metastatic colorectal cancer who have yet to be treated with chemotherapy. The study will assess the efficacy of capecitabine in combination with sunitinib in improving progression-free survival, and will measure toxicity, overall survival, and objective response in these patients.

Panitumumab combination study with AMG 102 or AMG 479 in wild-type KRAS mCRC

Study Type: Interventional

Age/Sex Requirements: 18 years+ (none)

Sponsors: Amgen

ClinicalTrials.gov Identifier: NCT00788957

Purpose: To evaluate the safety and efficacy of AMG 102 or AMG 479 in combination with panitumumab versus panitumumab alone in subjects with metastatic colorectal cancer with wild-type KRAS tumors. The primary outcome measure for the phase I part of the study will be “subject incidence of selected adverse events and laboratory abnormalities.” The phase II portion will examine incidence of objective response.

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