Sarah Cannon - April 25, 2022

Meredith Pelster, MD, MSCI, a medical oncologist and assistant director of gastrointestinal (GI) research at Sarah Cannon Research Institute, discusses the latest research developments in gastrointestinal cancer treatment.

Immunotherapy to treat microsatellite unstable colorectal cancer

“One of the biggest developments is the use of immunotherapy in treating microsatellite unstable colorectal cancer,” says Dr. Pelster. Microsatellite instability is a biomarker in colorectal cancer that is found in about 15% of cases. Immunotherapy works with the body’s immune system to destroy cancer cells, stop them from growing, or prevent them from spreading in the body.

“Now, patients with this type of colorectal cancer in a metastatic setting can be treated with immunotherapy rather than chemotherapy,” she says. “Immunotherapy is more effective and generally better tolerated than chemotherapy in this setting.”

Potential new treatments for colorectal cancer patients with KRAS gene mutations

One development that Dr. Pelster describes as “up and coming” and not yet FDA-approved is new therapies to help patients with KRAS gene mutations. “There are some patients with colorectal cancer who have mutations that we recently learned can be a target for drugs,” she says. “There are new therapies being developed that may give these patients further treatment options if clinical trials show they are safe and effective.”

Immunotherapy and targeted therapy research for GI cancer

Dr. Pelster says researchers are studying novel types of immunotherapy and targeted therapies that can address specific mutations in GI cancers. “The hope is to find treatments that are safe and effective and help patients live longer,” she says. “In biliary tract cancer, such as gallbladder cancer and cholangiocarcinoma, immunotherapy has been shown to be beneficial as a first-line treatment along with chemotherapy,” says Dr. Pelster. “It’s not yet FDA-approved, but this type of treatment has been shown to be effective and help patients live longer and better.”

Screenings for GI cancers

As researchers continue to study new and effective treatment options, paying attention to your health and getting regular colorectal cancer screenings is your best line of defense.

Currently, the only screening option for gastrointestinal cancer is colorectal cancer screening. Both men and women should begin colon cancer screenings at age 45, unless otherwise recommended by their doctor.

“If you have a family history of colorectal cancer, ask your primary care provider about the appropriate age to start screenings,” says Dr. Pelster.

She notes that at-home stool-based colon cancer screenings are a good option for those who don’t want to undergo a colonoscopy.

Sarah Cannon recommends consulting your physician if you are 45 years of age or older to determine the right screening test for you. Evidence-based options may include a colonoscopy at 10-year intervals or a Fecal Immunohistochemistry Test (FIT) annually.

It’s also important to listen to your body and see your primary care provider if you experience any of the following symptoms for more than a few days:

  • Unexpected weight loss
  • Changes in bowel habits, such as frequent constipation or diarrhea
  • Blood in your stool, which may look dark brown or black
  • Light-colored or greasy stools
  • Rectal bleeding with bright red blood
  • Narrowing of the stool
  • Persistent abdominal pain or cramping
  • Fatigue
  • Weakness
  • Poor appetite
  • Nausea
  • Feeling very full after a small meal
  • Heartburn or indigestion
  • Swelling in the abdomen
  • Vomiting with or without blood
  • Yellowing of the eyes and skin (jaundice)
  • Back pain
  • Itching
  • Dark urine
  • Fever

To learn more about GI cancer, visit Sarah Cannon’s blog, What you should know about GI cancers.  If you have questions about GI cancer, call askSARAH at 844-482-4812 or visit askSARAH online.