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Published recently in a supplement to European Oncology & Haematology Review, the peer-reviewed journal from touchONCOLOGY, an article by James Gilbart and Axel Grothey emphasises that both metastatic colorectal cancer (mCRC) and hepatocellular cancer (HCC) are complex diseases. During progression, they frequently become refractory to treatment and patients are likely to receive a series of different chemotherapy regimens. The multikinase inhibitors (MKIs) have considerable potential in mCRC and HCC treatment and can extend overall and disease-free survival in advanced disease. Clinical experience of some of the newer MKIs in mCRC and HCC is, however, limited. The phase III CORRECT (n=760) and CONCUR (n=204) trials showed that in patients who failed with previous therapy, overall survival (OS) and progression-free survival (PFS) were significantly increased with the MKI, regorafenib compared with placebo (both given with best supportive care). Similar findings were reported in the CONSIGN trial (n=2,872) that assessed regorafenib efficacy in real-world mCRC patients. In CORRECT and CONCUR the objective response rate was low (1-4%) but stable disease was achieved in much greater proportions (40-47%). This indicates that the suitability of some therapeutic goals may need to change after disease progression. Studies have also indicated the potential of biomarkers such as carcinoembryonic antigen, carbohydrate antigen 19-9 and the consensus molecular subtype in identifying patients who are more suitable for MKI treatment. Results of the RESOURCE study (n=573) show that regorafenib significantly improves OS, PFS and time to progression in HCC compared with placebo. These positive benefits are in contrast to the negative results of many previous trials of other treatments in HCC. Greater use of MKIs, alternating them with other therapies, expanded guidelines for managing disease progression and the identification of biomarkers are likely to improve the otherwise bleak prospects and outcomes in mCRC and HCC. This article reports presentations given at a satellite symposium convened at the European Society for Medical Oncology 18th World Congress on Gastrointestinal Cancer, Barcelona 2nd July 2016.
The full peer-reviewed, open-access article is available here:
Disclosure: James Gilbart is an employee of Touch Medical Media. The Mayo Clinic Foundation received grants and honoraria for activities conducted by Axel Grothey from Bayer, Genentech, Taiho, Eli-Lilly, Amgen, BMS, Eisai and Boston Biomedicals. This article reports the proceedings of a sponsored satellite symposium held at the European Society for Medical Oncology 18th World Congress on Gastrointestinal Cancer and, as such, has not been subject to this journal's usual peer-review process. The report was reviewed for scientific accuracy by the symposium speakers and Editorial Board before publication.
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