Colorectal or bowel cancer is a cancer that begins in the large bowel and is the fourth most common cancer in the UK. Metastatic/advanced colorectal cancer, or Stage IV, occurs when the cancer has spread to another part of the body; this is most commonly to the liver. A small proportion of colorectal cancer cases develop due to deficiencies in a repair mechanism for DNA; this may contribute to an increase in potential faulty (mutated) DNA. A high rate of this mutation is known as high microsatellite instability or mismatch repair deficient. These subsets of patients may have outcomes which are worse than those observed in the overall metastatic colorectal cancer population.
The most common treatment options for advanced colorectal cancer in the UK is surgery, radiotherapy and chemotherapy. Pembrolizumab is a type of immunotherapy that is delivered intravenously by a drip and that works by targeting specific proteins that stimulate an immune response attacking the cancer cells. It increases the body’s natural ability to identify and kill cancer cells. If licenced, pembrolizumab will offer an additional first line treatment option for patients with advanced colorectal cancer and prolong the time without cancer progression and overall survival.
Ixazomib citrate is a novel oral medicinal product that is already licensed in the UK for the treatment of MM in patients who have received at least one prior therapy (in combination with lenalidomide and dexamethasone). Ixazomib citrate offers the potential advantage over similar medicines in its class of being more effective in its anticancer activity, less toxic (reduced side effects) and more convenient to administer (through its weekly oral dosing). If approved as maintenance therapy following stem cell transplant in newly diagnosed MM patients, ixazomib citrate has the potential to improve the success rates of treatment by improving progression free survival and overall survival as well as presenting a more convenient way of administration that allows long term administration and improvement of patients’ quality of life.