Clinical advances in treating colorectal cancer

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Published: 10 Sep 2017
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Prof Michael Geißler - Klinikum Esslingen, Esslingen am Neckar, Germany

Prof Geißler speaks with ecancer at ESMO 2017 about recent trials in treating colorectal cancer presented at the congress.

He notes the Prodige 18 trial of bevacizumab and the Tricolore trial of combination therapy as stand-out presentations.

Prof Geißler also spoke about his work in the VOLFI trial of triplet therapy for CRC, here.

ecancer's filming has been kindly supported by Amgen through the ECMS Foundation. ecancer is editorially independent and there is no influence over content.

There were no presentations really changing our clinical practice. Maybe the PRODIGE 18 trial was interesting. Here it was demonstrated that in the second line situation after first line bevacizumab the treatment beyond progression with bev with switching the chemo backbone was superior to switching to cetuximab as a biological agent. For me this was not surprising because there was some evidence from other smaller trials, this trial was also pretty small, that EGFR antibodies may not work very well after VEGF first line. Therefore, in my opinion and also in the majority of the German oncologists, they support the recommendation that in left-sided colorectal cancer the primary treatment should be with an anti-EGFR antibody. Here they have the best action, here we have very long survival benefits which are superior to bevacizumab and we know that bev after EGFR treatments in the second and third line situation is active. This was supporting some clinical practice.

Then, for me, it was interesting the TRICOLORE trial. It’s not clinical practice changing, it’s hypothesis generating, but to perform neoadjuvant chemotherapy, not in rectal cancer but in colon cancer, is an interesting concept because we know from different tumours that the early delivery of systemic chemotherapy usually improves overall survival compared to surgery alone but these data were too early.