Randall F. Holcombe, MD, professor, Chief Medical Officer, Cancer, Mount Sinai Health System, discusses key takeaways for a practicing oncologist regarding the stool DNA test for colon cancer.

A colonoscopy provides more information than the stool DNA test, Holcombe says, and allows for the visualization and removal of polyps. The stool DNA test is simple and may prompt patients who are reluctant to undergo colonoscopy to proceed with the exam.

The greatest relevance for the stool DNA test, Holcombe says, is most likely for a gastroenterologist or practicing care physician. Oncologists do interact with patients’ families, however, so they are able to encourage members to get screened for colon cancer.

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Dr. Holcombe on the Utility of Stool DNA Test for Colon Cancer

Randall F. Holcombe, MD, Associate Director for Clinical Affairs and Director of Gastrointestinal Medical Oncology for the Division of Hematology/Oncology at the Tisch Cancer Institute at Mount Sinai Medical Center, speaks about the use of aflibercept in patients with metastatic colorectal cancer.

Aflibercept is a vascular endothelial growth factor (VEGF) trap and works in a similar way to bevacizumab (Avastin) to block blood vessel formation in tumors. Aflibercept is currently approved for use in the second-line in combination with 5-fluorouracil, leucovorin, irinotecan (FOLFIRI) in patients with mCRC.

The phase III VELOUR trial showed the survival benefit of aflibercept compared to placebo. The median overall survival was 12.06 months in the placebo plus FOLFIRI arm vs 13.50 months in the aflibercept plus FOLFIRI arm (

 = .0032; HR=0.82 [95.34% CI: 0.71 to 0.94]).

Aflibercept and bevacizumab have not been compared head-to-head, which makes aflibercept's role less clear, Holcombe says. It will take time and research to determine where aflibercept fits into the treatment regimen of mCRC.

Randall F. Holcombe, MD, Tisch Cancer Institute at Mount Sinai Medical Center, speaks about the use of aflibercept in patients with metastatic colorectal cancer.

Dr. Holcombe Discusses Aflibercept for mCRC

Randall F. Holcombe, MD, Associate Director for Clinical Affairs and Director of Gastrointestinal Medical Oncology for the Division of Hematology/Oncology at the Tisch Cancer Institute at Mount Sinai Medical Center, discusses the oral multikinase inhibitor regorafenib (Stivarga) for patients with metastatic colorectal cancer (mCRC).

Holcombe notes that the FDA recently approved regorafenib for patients with treatment refractory mCRC. In general, these patients have exhausted all available treatment options, including chemotherapy and biologic agents, such as bevacizumab and EGFR-targeted therapies for patients with 

Regorafenib was approved based on results from the randomized, placebo-controlled, phase III CORRECT trial. In the trial, median overall survival with regorafenib was 6.4 months and progression-free survival was 1.9 months, when compared to placebo.

Holcombe believes this agent will be very useful for patients with good performance status, since progression on all other therapies is common.

Randall F. Holcombe, MD, from  the Tisch Cancer Institute at Mount Sinai Medical Center, discusses the oral multikinase inhibitor regorafenib for patients with metastatic colorectal cancer.

Randall F. Holcombe, MD

Articles

Dr. Holcombe on the Utility of Stool DNA Test for Colon Cancer

Dr. Holcombe Discusses Aflibercept for mCRC

Dr. Holcombe on Regorafenib for Colorectal Cancer