Could you benefit from newer colorectal cancer treatments?

By Miles J. Varn, M.D., Chief Medical Officer at PinnacleCare

When you exclude skin cancer, colorectal cancer is the third most common type of cancer diagnosed in both men and women in the U.S. The American Cancer Society projects 95,520 new cases of colon cancer and 39,910 new cases of rectal cancer in 2017.

If you or a loved one has been diagnosed with colorectal cancer, your physician will recommend a treatment plan based on the stage and location of the cancer. With any cancer diagnosis, it’s wise to seek a second opinion on both your diagnosis and the suggested treatment. A second opinion can either confirm or change your diagnosis. It may also suggest other treatment options that may be more appropriate or effective for your particular cancer.

What are the treatment options for colorectal cancer?

The current gold standard of treatment for colorectal cancer is usually surgery, sometimes preceded by chemotherapy to shrink the tumors and make them easier to remove surgically. You may want to also talk to your doctor to find out if some newer approaches to treating colorectal cancer, including treatments currently in clinical trials, may be an appropriate option for you.

Newer treatment options include:

• Targeted therapy: There are a number of drugs that target specific proteins that help tumors grow. Some, such as bevacizumab (Avastin), ramucirumab (Cyramza), which was recently FDA-approved for the treatment of late stage, metastatic colon cancer, and ziv-aflibercept (Zaltrap), target the proteins that help tumors form the blood vessels they need to get nutrients. Others, including cetuximab (Erbitux) and panitumumab (Vectibix), target a protein called epidermal growth factor receptor (EGFR) that promotes tumor growth. The kinase inhibitor regorafenib (Stivarga), which is used to treat advanced colorectal cancer, also blocks certain proteins that help tumors grow.
• Immunotherapy: This treatment approach uses the body’s immune system to attack cancer cells. Most immunotherapy treatments for colorectal cancer are still in the clinical trial stage. One type of immunotherapy drug is the immune checkpoint inhibitor. Some cancer cells use the molecules on immune cells to protect themselves from being attacked by the body’s immune system. These drugs counteract that action so that the immune system can kill the cancer cells. Pembrolizumab (Keytruda) and nivolumab (Opdivo), which are approved to treat other types of cancer, are currently being studied to discover if they are effective for the treatment of colorectal cancer. Researchers are also working on vaccines that enhance the immune system so it can combat the cancer cells.
• New chemotherapy approaches: For colorectal cancer that has recurred and spread to the lining and organs of the abdominal cavity, researchers are studying a new approach of delivering chemotherapy drugs. The process is called hyperthermic intraperitoneal chemotherapy (HIPEC). After surgeons remove as much of the cancer in the abdominal cavity as they can, the area is directly bathed in heated chemotherapy drugs, delivering the treatment directly to the cancer cells.

Talk with your physician to learn more about all the treatment options available to you. A personal health advisor can also help you learn more about the complete spectrum of treatment options for colorectal cancer, as well as help you find experienced physicians and clinical trials of new treatments.