Opportunities on the horizon for the management of early colon cancer

Daan G Knapen; Jacco J de Haan; Rudolf S N Fehrmann; Elisabeth G E de Vries; Derk Jan A de Groot

doi:10.1016/j.critrevonc.2023.103918

Opportunities on the horizon for the management of early colon cancer

Daan G Knapen, Jacco J de Haan, Rudolf S N Fehrmann, Elisabeth G E de Vries, Derk Jan A de Groot^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

There is a clear unmet need to improve early colon cancer management. This review encompasses the current systemic treatment landscape and summarises novel and pivotal trials. The Immunoscore and circulating tumour DNA (ctDNA) are studied to evaluate which patients should receive no, 3, or 6 months of adjuvant treatment. Several trials also test escalating treatment strategies for non-cleared ctDNA following standard adjuvant chemotherapy. Advances made in treating patients with metastatic colon cancer are now being translated to the early colon cancer setting. Two ongoing RCTs study immune checkpoint inhibitors (ICI) in patients with microsatellite instable high (MSI-H) early colon cancer as adjuvant treatment. Neo-adjuvant treatment is being studied in several ongoing RCTs as well. The complete response rate in patients with MSI-H tumours following ICI in neoadjuvant trials has potential organ-sparing implications.

Original language	English
Article number	103918
Number of pages	8
Journal	Critical Reviews in Oncology/Hematology
Volume	183
DOIs	https://doi.org/10.1016/j.critrevonc.2023.103918
Publication status	Published - Mar-2023

Keywords

Humans
Colonic Neoplasms/genetics
Rectal Neoplasms
Chemotherapy, Adjuvant
Microsatellite Instability

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title = "Opportunities on the horizon for the management of early colon cancer",

abstract = "There is a clear unmet need to improve early colon cancer management. This review encompasses the current systemic treatment landscape and summarises novel and pivotal trials. The Immunoscore and circulating tumour DNA (ctDNA) are studied to evaluate which patients should receive no, 3, or 6 months of adjuvant treatment. Several trials also test escalating treatment strategies for non-cleared ctDNA following standard adjuvant chemotherapy. Advances made in treating patients with metastatic colon cancer are now being translated to the early colon cancer setting. Two ongoing RCTs study immune checkpoint inhibitors (ICI) in patients with microsatellite instable high (MSI-H) early colon cancer as adjuvant treatment. Neo-adjuvant treatment is being studied in several ongoing RCTs as well. The complete response rate in patients with MSI-H tumours following ICI in neoadjuvant trials has potential organ-sparing implications.",

keywords = "Humans, Colonic Neoplasms/genetics, Rectal Neoplasms, Chemotherapy, Adjuvant, Microsatellite Instability",

author = "Knapen, {Daan G} and {de Haan}, {Jacco J} and Fehrmann, {Rudolf S N} and {de Vries}, {Elisabeth G E} and {de Groot}, {Derk Jan A}",

year = "2023",

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doi = "10.1016/j.critrevonc.2023.103918",

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AU - Knapen, Daan G

AU - de Haan, Jacco J

AU - Fehrmann, Rudolf S N

AU - de Vries, Elisabeth G E

AU - de Groot, Derk Jan A

PY - 2023/3

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AB - There is a clear unmet need to improve early colon cancer management. This review encompasses the current systemic treatment landscape and summarises novel and pivotal trials. The Immunoscore and circulating tumour DNA (ctDNA) are studied to evaluate which patients should receive no, 3, or 6 months of adjuvant treatment. Several trials also test escalating treatment strategies for non-cleared ctDNA following standard adjuvant chemotherapy. Advances made in treating patients with metastatic colon cancer are now being translated to the early colon cancer setting. Two ongoing RCTs study immune checkpoint inhibitors (ICI) in patients with microsatellite instable high (MSI-H) early colon cancer as adjuvant treatment. Neo-adjuvant treatment is being studied in several ongoing RCTs as well. The complete response rate in patients with MSI-H tumours following ICI in neoadjuvant trials has potential organ-sparing implications.

KW - Humans

KW - Colonic Neoplasms/genetics

KW - Rectal Neoplasms

KW - Chemotherapy, Adjuvant

KW - Microsatellite Instability

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