Colonoscopy: The Key to Colon Cancer Survival
The study only included the roughly 60 percent of colon cancer patients whose tumors have the non-mutated KRAS gene that makes Erbitux more likely to be effective. Outcomes could have been influenced by differing access to therapies once initial treatment was over, Mayos Grothey said. Though he wasnt involved with the trial itself, Grothey will serve as chairman this weekend for a combined advisory board on the study for Erbitux partners Merck, Bristol-Myers Squibb Co. (BMY) and Eli Lilly & Co. (LLY) These results are intriguing, but an unexplained positive finding from a secondary endpoint will not influence U.S. practice patterns, Scott Kopetz, an associate professor of gastrointestinal medical oncology at the University of Texas MD Anderson Cancer Center, said in an e-mail. Switching Treatment About half the patients in each arm of the study switched to the opposite medicine — from Erbitux to Avastin, or vice versa — as a second treatment once their cancer had worsened, said Volker Heinemann, a professor of medical oncology at the Ludwig Maximilian University of Munich and lead author of the study. Full data on the treatment patients got once their cancer had worsened will be presented at the World Congress on Gastrointestinal Cancer in July, Heinemann said. The results show that doctors who treat patients with the unmutated KRAS gene should choose Erbitux over Avastin, Heinemann said. For the moment we have to remain at that conclusion, he said. We are going to wait for support from the larger study. For the moment that is a reasonable conclusion. Roche looks forward to seeing full details of the study presented at the conference later today, spokesman Daniel Grotzky said in an e-mail before the results were released. Avastin is the Basel, Switzerland-based companys third-biggest drug, with about $6 billion in sales last year.
By Brett Spiegel, Everyday Health Staff Writer WEDNESDAY, June, 19, 2013 If you’ve been putting off getting a colonoscopy cause you’re scared, lazy, suspicious of them, or just don’t think you need one, you may want to reconsider, and fast. Screening colonoscopies do in fact increase your chances of colon cancer survival, according to new research published today in JAMA Surgery. Researchers from Massachusetts General Hospital and Harvard Medical School in Boston reviewed 1,071 patients who underwent colon cancer surgery between 2004 and 2011. Of these patients, 217 had been diagnosed through screening colonoscopy. They found that patients who were not screened through colonoscopy had higher risk for more invasive tumors, nodal and metastatic disease, cancer recurrence, and death than those who were diagnosed through screening. Additionally, they also experienced shorter intervals of disease-free and survival episodes. “Patients with colon cancer identified on screening colonoscopy not only have lower-stage disease on presentation but also have better outcomes independent of their staging,” wrote the study authors. Considering the tremendous effect early diagnosis through screening has for the prognosis of patients, this further emphasizes the important role compliance to screening colonoscopy guidelines can play in prolonging longevity, improving quality of life, and reducing health care costs through early detection of colon cancer,” the study authors concluded. The U.S. Centers for Disease Control and Prevention reports that colon cancer is the second leading cause of death in the country with about 140,000 men and women diagnosed annually and more than 50,000 deaths. However, since their inception in 2000, colonscopies have been responsible for consistent decreases in rates of colon cancer death in the U.S., according to The National Cancer Institute Surveillance Epidemiology and End Results Database , with rates dropping by roughly 35 percent from 2002 to 2010.
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Colon Cancer Survival Has Family Link
The findings suggest that as yet unidentified genetic influences are associated with both an increased risk for developing colorectal cancer and an improved prognosis for surviving the disease, Jennifer A. Chan, MD, PhD, who led the study, tells WebMD. The study appears in tomorrow’s Journal of the American Medical Association. “This is reassuring for patients with a family history, but it could also be important for treatment,” says Chan, who is an instructor of medicine at Harvard Medical School. “If we are able to identify the factors associated with family risk and improved prognosis, this could help guide treatment decisions in the future.” Greater Risk, Better Survival As many as one in five colorectal cancer patients have a close family link to the disease, and having a first-degree relative such as a parent, sibling, or child with the cancer is associated with a twofold increase in risk. While it is clear that family history is an important risk factor for developing colorectal cancer, its influence on recurrence and survival are not well understood. In their effort to change this, Chan and colleagues from Harvard Medical School and the Dana-Farber Cancer Institute followed 1,087 patients with stage III colon cancer who were treated with surgery followed by chemotherapy. A total of 195 patients (18%) reported a history of colorectal cancer in one or more first-degree relatives. During an average of 5 1/2 years of follow up, 29% patients with a family history of the disease and 38% of patients with no family history either died of their disease or experienced disease recurrence. Patients with a family history were 26% less likely to have their disease recur than patients with no afflicted close family members. Screening Wasn’t a Factor Aggressive colorectal cancer screening is recommended for people with a family history of the disease. The American Cancer Society recommends earlier and more frequent screening for anyone with a first-degree relative who has had the disease, especially if that relative was diagnosed before age 60. Early screening saves lives, but it did not appear to be a factor in the improved survival among patients in this study, because all the patients had the same stage of advanced disease. The patients also had similar treatments, suggesting that genetic influences were the key to better survival.
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