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Colorectal Cancer Awareness Month – Hope on the Horizon
Linh Alejandro, PharmD, is a Medical Affairs Director leading GI cancers strategy at Mirati. A clinical oncology pharmacist by training, she is passionate about improving lives of patients with cancer and educating patients, caregivers and healthcare professionals. Linh obtained her doctorate in pharmacy at University of California, San Francisco and completed clinical oncology residences at City of Hope and Memorial Sloan Kettering Cancer Center. She began her career working in direct patient care in the oncology clinic for nearly 10 years before transitioning to industry. Linh also serves as a volunteer faculty member at UCSD Skaggs School of Pharmacy and is the program director for the UCSD-Mirati PharmD Medical Affairs Fellowship Program.
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In recognition of Colorectal Cancer Awareness Month in the month of March, Linh Alejandro, Director of Medical Affairs Strategy interviewed Rona Yaeger, MD, of Memorial Sloan Kettering to elevate education and research on this devastating disease.
Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in men and women in the United States, according to the American Cancer Society. While the incidence rate of colorectal cancer has dropped overall since the mid-1980’s, the average age of diagnosis is getting younger (American Cancer Society 2023).
Q: Why were you motivated to focus your professional efforts on treating colorectal cancer?
A: I am interested in the science of how cancers develop. Colorectal cancer was one of the first cancers where the genetic steps for cancer development were mapped out, as polyps could be removed and analyzed. Beyond my scientific interest, I find the close relationship oncologists develop with patients, often spanning over years, especially rewarding. This is particularly true for colorectal cancer, where treatment of advanced disease requires consideration of local interventions, such as surgery or ablations where possible, and sequencing multiple treatments.
Q: During this colorectal cancer awareness month, what do you think is important for people living with colorectal cancer to know?
A: It’s important for everyone to be aware of the rising incidence of colorectal cancer among young people. While we don’t understand the cause, colorectal cancer is rising rapidly among people in their 30’s and 40’s, particularly low colon or rectal tumors. Symptoms such as change in bowel habits or rectal bleeding that persist should be evaluated. Many of our young patients describe feeling that something wasn’t right for a while and their difficulty getting a colonoscopy. With increased awareness that even young people can get colorectal cancer, there’s hope that we will catch these cancers earlier, when they are more curable.
Q: Do you have any perspectives to offer other physicians treating colorectal cancer?
A: I have been fortunate to be involved in recent clinical trials of targeted therapies against BRAF V600E and KRASG12C mutated colorectal cancers. I have learned from this experience that it is important to consider both the mutation and the cancer type. Matched therapies can lead to dramatic responses in patients who have a specific mutation in their cancer. But these treatments can’t be applied the same across cancers, so physicians need to think of both factors, particularly for colorectal cancer, where combination therapy can be needed to sufficiently block the target.
Q: Looking at the horizon of colorectal cancer clinical research, is there anything exciting that gives you hope?
A: We’ve seen in past years that colorectal cancer can be a particularly challenging disease for which to develop new therapies; targeted therapies and immunotherapies that showed high efficacy in other cancers were not effective against colorectal cancer. We are now in an exciting time with many targeted therapy combinations and immunotherapy combinations being tested and advancing quickly in clinical trials. I am hopeful that there will be new treatments for patients with advanced colorectal cancer in the near future.
Q: Are there any resources you recommend to people living with colorectal cancer or their caregivers?
A: Patient networks on social media, such as COLONTOWN or KRAS Kickers, provide support and help patients and their families navigate treatments and clinical trials. Organizations such as ASCO have patient resources that can also provide information on disease-specific treatment options and what to expect with treatment. I have found that patients are now very well-informed and that information can be empowering.
Key Statistics for Colorectal Cancer American Cancer Society. 2023.