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Beyond the Guidelines: Clinical Investigators Provide Their Perspectives on Current Strategies and Ongoing Research in the Management of Cancers of the Colon and Rectum
Released March 2013

Proceedings from Part 1 of a 2-part satellite symposia series during the 2013 Gastrointestinal Cancers Symposium. Including perspectives from Drs Howard S Hochster, John L Marshall, Eric Van Cutsem, Richard M Goldberg and Josep Tabernero. (Video Program)

CE Disclosures and Faculty Information

    This activity is intended for medical oncologists, hematology-oncology fellows, surgeons and other healthcare providers involved in the treatment of gastrointestinal cancers.

    Cancer of the colon and rectum is the fourth most frequently diagnosed cancer and the second most common cause of death among all neoplasms in the United States, accounting for approximately 9% of all cancer deaths. In the year 2012 it was estimated that 103,170 new cases of colon cancer and 40,290 new cases of rectal cancer were documented in the United States. Current therapeutic management of colorectal cancer (CRC) is dependent on tumor stage at the time of initial diagnosis, status of surgical margins, 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, multigene signatures and molecular-targeted systemic agents has significantly refined the clinical algorithm such that individualized therapeutic approaches have become the standard. This rapid paradigm shift presents a challenge to practicing oncologists who must grapple with the presentation of ambiguous data sets and their immediate impact on treatment decisions.

    These proceedings from a CME symposium held during the 2013 Gastrointestinal Cancers Symposium use the perspectives of renowned experts in the field of CRC to explore the self-described practice patterns of 25 gastrointestinal cancer clinical investigators and the supporting research database in a number of commonly encountered clinical situations. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, hematology-oncology fellows, surgeons and other healthcare providers with the formulation of up-to-date clinical management strategies for CRC.


    • Apply the results of emerging clinical research to the best-practice management of cancers originating within the colon and rectum.
    • Counsel patients with Stage II colon cancer about their individual risk of recurrence based on clinical, pathologic and genomic biomarkers, and consider adjuvant therapeutic options based on this information.
    • Effectively apply the results of practice-changing clinical research in the selection and sequencing of biologic agents alone or in combination with chemotherapy for patients with metastatic CRC (mCRC).
    • Develop an evidence-based algorithm for the prevention and amelioration of side effects associated with chemotherapeutic and biologic agents used in the management of mCRC.
    • Individualize local and systemic treatment for patients with mCRC that is isolated to the liver.
    • Identify ongoing clinical trials evaluating innovative investigational approaches for CRC, and obtain consent from appropriate patients for study participation.

    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    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:

    Howard S Hochster, MD
    Associate Director (Clinical Research)
    Yale Cancer Center
    Professor of Medicine
    Yale School of Medicine
    New Haven, Connecticut

    Advisory Committee: Genentech BioOncology, Genomic Health Inc, Roche Laboratories Inc, Sanofi; Speakers Bureau: Genomic Health 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, Daiichi Sankyo Inc, Genentech BioOncology; Consulting Agreements: Amgen Inc, Bayer HealthCare Pharmaceuticals, Daiichi Sankyo Inc, Genentech BioOncology; Paid Research: Abbott Laboratories, Genentech BioOncology; Speakers Bureau: Amgen Inc, Genentech BioOncology.

    Eric Van Cutsem, MD, PhD
    Professor of Medicine
    Digestive Oncology
    University Hospital Gasthuisberg/Leuven
    Leuven, Belgium

    Contracted Research: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Merck Serono, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi.

    Richard M Goldberg, MD
    Professor of Medicine
    OSUCCC-James Cancer Hospital and
    Richard J Solove Research Institute
    Klotz Family Chair in Cancer Research
    The Ohio State University
    Columbus, Ohio

    Advisory Committee: Sanofi; Consulting Agreements: Lilly USA LLC, Pfizer Inc; Contracted Research: Bayer HealthCare Pharmaceuticals, Sanofi; Speakers Bureau: Fresenius Kabi AG, Yakult Pharmaceutical Industry CO LTD.

    Josep Tabernero, MD
    Head, Medical Oncology Department
    Vall d’Hebron University Hospital
    Vall d’Hebron Institute of Oncology
    Barcelona, Spain

    Consulting Agreements: Amgen Inc, Bristol-Myers Squibb Company, Genentech BioOncology, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Merck, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, Sanofi; Speakers Bureau: Amgen Inc, Merck, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi.

    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: AbbVie Inc, Algeta US, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly USA LLC, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva Oncology.

    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 educational grants from Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech BioOncology, Genomic Health Inc, Lilly USA LLC, Onyx Pharmaceuticals Inc, Regeneron Pharmaceuticals and Sanofi.

    Hardware/Software Requirements:

    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio
    A high-speed Internet connection

Acknowledge and close

Watch video
(WiFi is recommended for best performance):

Introduction: Dr Love
Module 1:
Dr Hochster –
Adjuvant Therapy
Module 2:
Dr Marshall –
Bev Beyond Progression
Module 3:
Prof Van Cutsem –
Aflibercept and CRC
Module 4:
Dr Goldberg –
Regorafenib, Other Novel Agents
Module 5:
Dr Tabernero –
Optimal Therapy CRC w/ Liver Mets