Persons with colorectal cancer that has spread from the colon or rectum to other parts of the body often undergo chemotherapy with a combination of drugs to alleviate the symptoms of disease and prolong survival time. Now, researchers presenting their findings at the May 2000 American Society of Clinical Oncology annual meeting report that a novel new biologic therapy, a monoclonal antibody called rhuMAb VEGF, may enhance the effectiveness of chemotherapy with fluorouracil and leucovorin in treating this disease.

Cancers of the colon and rectum, sometimes referred to together as colorectal cancer, are characterized by the presence of cancerous tumors in the colon or rectum, each part of the body’s digestive system. Treatment options may include surgery, chemotherapy, radiation therapy, and/or biologic therapy, depending on the

stage of cancer (extent of disease at diagnosis). For cancer that originated in the colon or rectum and then spread to other parts of the body (called

metastatic disease), surgery followed by chemotherapy with fluorouracil and leucovorin is often used to relieve the symptoms of disease and prolong survival time. The drug fluorouracil fights the cancer cells, while the agent leucovorin works to protect healthy cells from being damaged by the fluorouracil, producing responses in 14 to 33% of patients. However, researchers continue to develop and study new drugs and drug combinations, including biologic therapies, with the hope of providing more effective treatment options for persons with metastatic colorectal cancer.

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A substance in the body, called vascular endothelial growth factor (VEGF), plays a crucial role in the progression of cancer by stimulating the new growth of blood vessels. In essence, VEGF stimulates the body to provide a blood supply for a newly developing cancer. Researchers have developed a type of antibody, a recombinant humanized monoclonal antibody called rhuMAb VEGF, that inhibits the effects of VEGF in the body. This monoclonal antibody has now been studied in persons with metastatic colorectal cancer.

Researchers assigned 104 persons with metastatic colorectal cancer to receive treatment with either fluorouracil and leucovorin alone or fluorouracil, leucovorin, and rhuMAb VEGF. Twenty-one percent of those receiving the chemotherapy alone had a response to treatment, compared with 34% of those who also received the rhuMAb VEGF. The average time it took for the cancer to begin growing again (called time to progression) was 5.4 months in those receiving the chemotherapy alone and 6.8 to 7.3 months in those also receiving the rhuMAb VEGF.

These findings suggest that adding rhuMAb VEGF to chemotherapy regimens may improve response rates and prolong time to progression for persons with colorectal cancer. Persons with this type of disease may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which rhuMAb VEGF (combined with chemotherapy) or other promising new treatment is being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com (www.411cancer.com). (Proceedings of the American Society of Clinical Oncology Thirty-Sixth Annual Meeting, Vol 19, Abstract 939, p242a, 2000)

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