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Targeted Treatment in Colorectal Cancer: New Mechanisms and Agents and the Role of Clinical Trials in Practice
Released May 2012

Proceedings from a CME symposium held at the 2012 Gastrointestinal Cancers Symposium. Featuring perspectives from Drs Dirk Arnold, Cathy Eng, George A Fisher, J Randolph Hecht and John L Marshall. (Video Program)

CE Disclosures and Faculty Information


    This activity has been designed to meet the educational needs of medical oncologists and other healthcare providers involved in the treatment of colorectal cancer (CRC).


    Cancer of the colon and rectum is the fourth most frequently diagnosed cancer and the second leading cause of death among all neoplasms in the United States. In 2011, it is estimated that 101,340 new cases of colon cancer and approximately 39,870 cases of rectal cancer will have occurred, representing a decline during the past several years thought to be related to improvements in detection and treatment.

    Current therapeutic management of CRC is dependent on tumor stage at the time of initial diagnosis, status of surgical margins (R0, R1, R2), patient performance status, age, prior treatment exposure and sites of metastasis for those with disease recurrence or de novo advanced cancer. Although these variables are helpful in guiding selection of treatment, the introduction of novel biomarkers, genomic signatures and molecular-targeted systemic agents has significantly refined the clinical algorithm, such that individualized therapeutic approaches have become standard. This rapid paradigm shift presents a challenge to practicing oncologists who must grapple with the presentation of ambiguous data sets and their immediate effects on treatment decisions. To bridge the gap between research and patient care, these proceedings from a CME symposium at the 2012 Gastrointestinal Cancers Symposium use the perspectives of clinical investigators to apply evidence-based concepts to routine practice. By providing access to the latest research developments and expert opinions on the disease, this activity will assist medical oncologists and other healthcare providers in the formulation of up-to-date clinical management strategies for CRC.


    • Critically evaluate data from pivotal clinical trials integrating novel molecular therapeutic agents into the treatment of CRC, and communicate the scientific and patient-level advantages of each.
    • Communicate the benefits and risks of existing and emerging anti-VEGF biologic therapies.
    • Describe the unique research and development challenges associated with identification of effective dosing, scheduling and duration of novel targeted agents.
    • Evaluate the safety and tolerability of novel targeted compounds under investigation for the treatment of CRC, and identify evidence-based strategies to manage side effects associated with these agents.
    • Discuss the integral role of clinical trial participation in maximizing cancer treatment advances, and counsel appropriately selected patients on the relevance and availability of ongoing research studies.


    CME credit is no longer available for this issue


    CME credit is no longer available for this issue


    This CME activity consists of a video component. The participant should watch the video.

    CME credit is no longer available for this issue


    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Dirk Arnold, MD
    Director, Hubertus Wald Tumor Center
    University Cancer Center Hamburg
    University Hospital Eppendorf
    Hamburg, Germany

    Advisory Committee and Speakers Bureau: Amgen Inc, Merck Serono, Roche Laboratories Inc, Sanofi; Consulting Agreement: Bayer HealthCare Pharmaceuticals; Paid Research: Roche Laboratories Inc.

    Cathy Eng, MD
    Associate Professor
    Associate Medical Director, Colorectal Center
    Department of Gastrointestinal Medical Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee: Genentech, A Member of the Roche Group; Data and Safety Monitoring Board: GlaxoSmithKline.

    George A Fisher, MD, PhD
    Associate Professor of Medicine
    Director, Cancer Clinical Trials Office
    Stanford University School of Medicine
    Stanford, California

    Paid Research: Bristol-Myers Squibb Company, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Sanofi.

    J Randolph Hecht, MD

    Professor of Clinical Medicine
    Director, UCLA GI Oncology Program
    Division of Hematology/Oncology
    Department of Medicine
    UCLA School of Medicine
    Los Angeles, California

    Advisory Committee: Halozyme Therapeutics, Morphotek Inc; Paid Research: Amgen Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

    John L Marshall, MD
    Chief, Hematology and Oncology
    Director, Ruesch Center for the Cure of GI Cancers
    Lombardi Comprehensive Cancer Center
    Georgetown University
    Washington, DC

    Advisory Committee: Amgen Inc, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology; Data and Safety Monitoring Board: Daiichi Sankyo Inc; Paid Research and Speakers Bureau: Amgen Inc, Genentech BioOncology.

    MODERATORDr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: Abbott Laboratories, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Bayer HealthCare Pharmaceuticals/Onyx Pharmaceuticals Inc, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Cephalon Inc, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Genentech BioOncology, Genomic Health Inc, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Incyte Corporation, Lilly USA LLC, Medivation Inc, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva Pharmaceuticals.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by an educational grant from Regeneron Pharmaceuticals and Sanofi.

    Hardware/Software Requirements:
    An Internet connection that is at least 28.8 Kbps
    A monitor set to 1280 x 1024 pixels or more
    Netscape 7.x or newer, Internet Explorer 5.x or newer, or Firefox
    Macromedia Flash plug-in 6.0 or greater
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: May 2012
    Expiration date: May 2013

Acknowledge and close

Watch videos
(WiFi is recommended for best performance)
Introduction: Dr Love
Module 1:
Dr Marshall
Colorectal Cancer Biology and Pathways
Module 2:
Dr Hecht
Anti-Angiogenic Strategies
Module 3:
Dr Arnold
R&D of Novel Agents: Aflibercept as an Example
Module 4:
Dr Eng
Novel Approaches to Targeting the EGFR Pathway
Module 5:
Dr Fisher
Benefits and Challenges with Phase I/II Research