3 new drugs to replace outdated colorectal chemo

3 new drugs to replace outdated colorectal chemo

Patients with metastatic colorectal cancer and a BRAF mutation should be given encorafenib, binimetinib and cetuximab rather than old-fashioned chemotherapy according to MD Anderson scientists announcing the results of a recent Phase III clinical trial.

In the trial, the median overall survival increased from 5.4 months to 9 months. A BRAF mutation occurs in approximately 15% of cases in colorectal cancer. The elements of the research took place simultaneously in more than 200 centres worldwide and the research was led by Professor Scott Kopetz at the MD Anderson Cancer Center in Texas.

Chris Woollams, former Oxford University Biochemist said, “Frankly, 5-FU which is regularly used for CRC in FOLFOX and FOLFIRI combinations, was given its FDA approval in 1956. It is quite ridiculous that with all the money spent on cancer research, we are still using it as the standard of care and have hitherto not come up with anything better or more targeted. The MD Anderson team need to be applauded.”

Kopetz is both a scientist and a doctor, and he is leader of the MD Anderson Colorectal 'Moon Shot' project. This aims, he says, to improve detection, monitoring and treatment of colorectal cancer which has such a poor history of treatment, agreeing with Woollams' comments. Kopetz is particularly looking at how immunotherapy drugs might impact colorectal cancer. He has already shown that another BRAF inhibitor vemurafenib can enhance standard treatments.

Woollams added, "Encorafenib is a BRAF inhibitor used with melanoma; binimetinib is an inhibitor of the MAPK tumour promoting pathway, and cetuximab is and EGFR inhibitor already used in the USA with colorectal cancer. All are really monoclonal antibodies targeting a genetic issue, but modern thinking is to call them immunotherapy drugs, which strictly speaking they aren't. It just makes them sound trendier!

Go to: Colorectal Cancer Overview

"Another interesting development is found in our coverage of the gut microbiome with colorectal cancer, and the finding that there are three different groups of pathogens at work, and there seems to be three different types of colorectal cancer, one associated with each. We wonder if these findings will figure in the Moon Shot program."

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