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Tailoring the colorectal cancer disease assessment to the treatment strategy
  1. Dustin A Deming1,2,3
  1. 1 Division of Hematology and Oncology, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
  2. 2 University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
  3. 3 Department of Oncology, McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, Wisconsin, USA
  1. Correspondence to Dr Dustin A Deming, Wisconsin Institutes for Medical Research, Madison, WI 53705, USA; ddeming{at}medicine.wisc.edu

https://doi.org/10.1136/gutjnl-2017-315394

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    The treatment options for metastatic colorectal cancer (CRC) continue to evolve with over 10 therapies now approved by the Food and Drug Administration for this indication. These include cytotoxic chemotherapeutics, biologics targeting vascular endothelial growth factor (VEGF) and epidermal growth factor receptor, and most recently the approval of the immunotherapeutic agents pembrolizumab and nivolumab for mismatch repair-deficient cancers. Additional agents targeting the BRAF mutant subtype of CRC are likely to be approved in the near future. This growing number of treatment options for patients increases the demand for accurate disease assessments to allow for further treatment in the setting of benefit, and also discontinuation or change in the treatment strategy in the setting of resistance.

    The Response Evaluation Criteria in Solid Tumors (RECIST v1.1)1 is the standard response criteria used in oncology clinical trials and is loosely followed in standard clinical practice. For CRC, this is most commonly done with oral and intravenous contrast enhanced CT imaging. These criteria use changes in the cross-sectional diameter to quantify whether cancers are …

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    Footnotes

    • Funding This project was supported by P30 CA014520 (Core Grant, University of Wisconsin Carbone Cancer Center).

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

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