Dr. Morris on Optimizing CRC Treatment Based on Oligometastatic Status

Van K. Morris, MD, assistant professor, Department of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, discusses his research around treatment for patients with unresectable colorectal cancer (CRC), in an interview during the 2020 Gastrointestinal Cancers Symposium.

A pooled analysis evaluated the outcomes of patients with surgically unresectable CRC who were treated in the phase II TRIBE and phase III TRIBE-2 studies with chemotherapy plus bevacizumab (Avastin). The investigators set out to determine whether or not the oligometastatic status of patients was indicative of response, and whether it could aid in deciding which patients should be given doublet or triplet cytotoxic chemotherapy, says Morris.

Results showed that patients with oligometastatic disease had better survival outcomes than those with nonoligometastatic disease. Interestingly, when investigators looked at patients with oligometastatic disease versus those with nonoligometastatic disease and analyzed how they fared when they received 2 cytotoxic agents versus 3 cytotoxic agents, no difference in survival outcomes was observed between the 2 groups, adds Morris. Based on these findings, oligometastatic status is not a good determinant of whether to give doublet or triplet cytotoxic chemotherapy to patients with unresectable CRC.

The investigators also looked at the roles of locoregional therapy in patients with unresectable metastatic CRC. Data showed that a significant proportion of the patients who either had oligometastatic disease or nonoligometastatic disease were able to undergo the treatment. However, those with oligometastatic disease were more likely to be able to withstand more local regional therapies, concludes Morris.

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