Colon Cancer

Capsule Endoscopy

Capsule Endoscopy(CE) is a procedure in which a capsule with a miniature camera is swallowed and it transmits images as it goes through the gastrointestinal tract. It has advantages and disadvantages. While easier on the patient, it does not allow for a biopsy, and if it shows a suspicious findings, full endoscopyto perform a biopsy will still be required. A recent European guideline says that patients at high risk for CRC, because of symptoms or

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Weekly 5 FU

Fluoropyrimidine (5-fluorouracil [5-FU] is the oldest chemotherapy drug for colon cancer and it is usually given with leucovorin [LV]. , It has a long history of its use for colorectal metastatic cancer and support from many older papers. Unfortunately, the issue ofweekly versus every three weeks schedule for 5FU.leukovorin has not been resolved, and with the appearance of many new drugs, has receded into the past and is no longer of actual importance

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Gemzar for colon and rectal cancer

Gemzar( gemcitabine) has been tested for colon and recatl cancer. A 1992 study found that Gemcitabine did not demonstrate activity against advanced colorectal adenocarcinoma. ON teh other hand,a much later study found that Gemcitabine has a modest activity in heavily pre-treated colorectal cancer patients and may be an option in good performance status patients. There are a number of reports and ongoing studies of gemcitabine in combination for

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Sprycel for treating colon and rectal cancer

Dasatinib, also known as Sprycel, is a cancer drug produced by Bristol-Myers Squibb and sold under the trade name Sprycel. It is a drug that is approved by the FDA for chronic myelogenous leukemia. It has certain boplogical efects that raised the hope that it might be able to affect colon cancer. Unfortunately, thus far one phase II trial(Nautiyal et al) showed that Dasatinib is inactive in previously treated metastatic colorectal patients patients.

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Colovantage test

ColoVantage is a new test available from Quest. Although it is a screening test, Quest says that it is not meant to be a substitute for colonoscopy. It was approved by NY State in March of 2011. It  detects circulating methylated DNA from the SEPT9 gene, which is involved in cell frowth and cell cycle control. A case-control study performed at Quest Diagnostics showed that the ColoVantage test is 70% sensitive for colorectal cacner detection at

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PET for possibly recurring colon cancer

After definitive treatmetn of colon cancer, patients are followed with CEA levels. When they begin to rise, a recurrence is suspected. PET is being more frequenlty used to detect and identify recurrence in this situation. More recently NCCN has been more supportive of PET in this setting. It used to support PET only in the situation of rising CEA and no identified recurrence for localization of disease recurrence in patients with rising CEA level

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Xeloda and irinotecan for second or later lines in colorectal cancer

The issue that we will discuss is Xeliri (Xeloda and irinotecan) in second or later line of therapy. It is a tempting regimen because Xeldoa is an generally effective drug for colorectal cancer and it is oral.  We start by pointing out that there are now six different classes of drugs with significant antitumor activity in colon cancer: Fluoropyrimidine (5-fluorouracil [5-FU] which is usually given with leucovorin [LV], capecitabine, tegafur plus

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Afinitor for colon cancer

Afinitor is a new exciting drug that is approved for breast and kidney cancer and other conditions. Evidence for using Afinitor for colorectal cancer is weak - one small trial with weak results. There is some evidence from this trial ( Altomare et al) reported in ASCO 2012 that some colorectal cancer patients whose tumors had gotten worse on all standard treatments can benefit from a combination of Afinitor® (everolimus) and Avastin® (bevacizumab).

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Posttreatment surveillance after hepatic metastases resection for colorectal cancer

Since the appearance of effective new drugs for colorectal cancer and more aggressive surgical approaches to resecting isolated metastases, many patients who had metastatic cancer are now free of disease for an extended period of time. There are few guidelines on how to follow such patients it is fairly new situation and there are no mature studies. For high risk non-metastatic colon cancer, NCCN guidelines recommend annual CT of chest, abdomen

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Zaltrap: A new drug for colon cancer

Zaltrap was approved by the FDA in the beginning of August 2012. It is also known as aflibercept, VEGF trap or, when used for macular degeneration, Eylea.  By binding to and inhibiting vessel growth(angiogenic) growth factors, aflibercept inhibits tumor vessel production and supply. Aflibercept has demonstrated efficacy in treating metastatic colorectal cancer in a recent randomized Phase III trial. The approval for colon cancer was based on a phase

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