Advancements in colon and rectal cancer treatments

Recent medical developments have introduced new approaches for the treatment and monitoring of rectal and colon cancers, specifically regarding immunotherapy and DNA monitoring.

The U.S. Food and Drug Administration approved atezolizumab (Tecentriq) combined with chemotherapy for the adjuvant treatment of patients aged 2 years and older with resected stage III mismatch repair deficient (dMMR) colon cancer. Based on the phase 3 ATOMIC trial, this regimen was shown to lower the risk of cancer recurrence or death by 50% compared to chemotherapy alone. For patients 12 years and older weighing at least 40 kg, the FDA also approved Tecentriq Hybreza, which is administered via subcutaneous injection.

In addition to immunotherapy advancements, research published in JCO Precision Oncology regarding the phase 2 CO. 28 trial explored using circulating tumor DNA (ctDNA) to guide surgical decisions for node-negative rectal cancer. The study indicated that monitoring ctDNA levels after chemotherapy can help determine the necessity of total mesorectal excision (TME), potentially helping to preserve bowel and sexual function by avoiding extensive surgery when ctDNA is no longer detectable.