Amy Early in Clinic

Medical Therapy for Colorectal Tumors

Medical therapies use drugs or other substances to kill cancer cells or slow their growth. These are called systemic therapies, because the medications travel throughout the body via the blood to find and attack cancer cells.

Your personalized treatment plan, based on your cancer’s stage and other characteristics specific to your cancer, may include one or more of the following approaches.

Chemotherapy

Chemotherapy kills cancer cells by interrupting and preventing rapidly-dividing cells (like cancer cells) from growing and multiplying. Unfortunately, other rapidly-dividing cells in the body, such as those in the hair follicles and digestive tract, may also be harmed and cause side effects such as nausea and hair loss. The chemotherapy drugs used to treat colorectal cancer include capecitabine, fluorouracil, irinotecan and oxaliplatin.

Other agents, such as leucovorin calcium and levoleucovorin, may help boost the effectiveness of 5-FU. These drugs are often given together in combination regimens such as:

  • 5-FU/LV (Fluorouracil, leucovorin)
  • FOLFOX (5-FU, oxaliplatin, leucovorin)
  • FOLFIRI (5-FU, irinotecan, leucovorin)
  • CAPOX (capecitabine, oxaliplatin)

Targeted therapies

Targeted therapy fights cancer by interfering with specific molecules that contribute to the growth, spread and progression of cancer. These molecular targets, found only in cancer cells and not in healthy ones, may be a hormone, protein, a receptor on the cancer cell, or specific mutant form of a protein. Some targeted therapies inhibit the tumor’s ability to generate the new blood vessels necessary to feed it, thereby diminishing the cancer cell’s nutrient supply.

Because these therapies are able to home in on only the cancer cells, they tend to present fewer side effects than chemotherapy. Some targeted therapies for colorectal cancer include bevacizumab, cetuximab, panitumumab, aflibercept and regorafenib. Drugs like bevacizumab and cetuximab are usually combined with chemotherapy.

Immunotherapy

Immunotherapy is a new class of cancer treatment that uses substances to harness the innate power of your own immune system to fight cancer. Cancer is able to develop and grow in part because the cancer cells have adapted so they can hide from the immune system. Some immunotherapies can mark the cancer cells, unmasking them and triggering the body’s immune response. Other therapies boost the immune system to work better against the cancer by engineering or multiplying the body’s natural fighting cells, like T-cells.

Microsatellite testing specifically tests your tumor to learn whether it has a high number of microsatellites, which are short, repeated sequences of DNA. Tumors with high microsatellite instability (MSI-H) respond well to immunotherapy with drugs such as pembrolizumab, nivolumab, and ipilimumab. For tumors with less microsatellite instability (MSI), the benefit of immunotherapy is unclear.

The Roswell Park Advantage

Most importantly, we test colorectal tumors using two panels developed at Roswell Park to determine which therapies or clinical trials offer you the very best option, based on:

Tumor Genetic Profile. OmniSeq Comprehensive tests the tumor’s DNA to identify genetic alterations that are actionable, meaning there is a drug or anti-cancer agent available that targets that particular genetic mutation. This test looks at 144 genes for abnormalities, and patients are matched with a targeted therapy, or a clinical trial that offers a new agent, that is specific for their tumor.

Unique immune system features. OmniSeq Immune Report Card examines multiple biomarkers to learn of unique abnormalities of a patient’s immune system and predict which immunotherapies would provoke the best response.