2025 ASCO update: Six big studies

The ASCO Annual Meeting, held May 30 to June 3 in Chicago, featured several important studies that could change how colorectal cancer is treated.

Exercise as Medicine

A landmark international trial involving nearly 900 stage II and stage III colon cancer patients found structured exercise reduces recurrence risk and boosts survival. Over eight years, patients in the study’s structured exercise program had a 28% lower risk of recurrent or new cancers developing than patients who only received health education materials. The findings mark a leap forward for lifestyle-based interventions.

Major Advancement for BRAF V600E Patients

Data from the phase III BREAKWATER trial show that combining encorafenib with cetuximab and mFOLFOX6 led to a 51% risk reduction in death compared to standard chemotherapy in patients with BRAF V600E–mutant metastatic CRC. The combination also limited disease progression by 47%. This powerful therapy is poised to become the new standard of care for BRAF V600E patients.

Immunotherapy After Surgery

The ATOMIC phase III trial examined the addition of atezolizumab to adjuvant mFOLFOX6 in stage III CRC patients with mismatch repair-deficient (dMMR) tumors. The combo delivered a marked improvement in disease‑free survival, cutting the risk of recurrence in half compared to chemo alone. The findings support atezolizumab + mFOLFOX6 as a new standard of care for patients with resected stage III dMMR colon cancer, replacing chemotherapy alone in this biomarker-defined population.

TRIPLETE Trial Offers Complicated Results

In metastatic CRC, the TRIPLETE study compared mFOLFIRINOX and panitumumab against mFOLFOX6 and panitumumab. Results showed improved overall survival with the intensified regimen, although response rates and progression-free survival weren’t significantly different. The increase in overall survival but higher treatment toxicity paints a complicated picture for oncologists, but the study could support using this stronger combination in selected patients.

Lifestyle and Diet Influence Outcomes

Another study confirmed that diets high in inflammatory foods — such as processed meats, refined carbs, and sugary drinks — are linked to worse survival in stage III colon cancer patients. Although diet didn’t change recurrence rates, it had a significant impact on overall survival.

Studying ctDNA to Tailor Treatment 

The DYNAMIC‑III trial evaluated ctDNA-guided adjuvant chemotherapy escalation (intensification) in stage III resected colon cancer. While ctDNA positivity can help predict patient outcomes, intensifying treatment based on ctDNA did not improve recurrence-free survival, suggesting further research is needed in ctDNA-positive patients.