Before you read: know your tumor biology: Many of the treatments below only work for specific tumor types. Your MSI/MMR status, BRAF mutation result, RAS status, and other biomarkers determine which findings apply to you. If you have not had comprehensive biomarker testing, ask your oncologist. 

1. BRAF V600E: A Targeted Combination with Landmark Survival 

Who this is for: Patients with BRAF V600E-mutated metastatic colorectal cancer (~8-10% of all CRC). 

About 8-10% of colorectal cancers carry a BRAF V600E mutation. This mutation is often linked with more aggressive disease, but it also creates a specific target for treatment. 

Ask your doctor: 

• “Does my tumor have a BRAF V600E mutation?” 

• “Am I eligible for the BREAKWATER combination as a first-line treatment?” 

• “Which chemotherapy backbone, such as FOLFOX or FOLFIRI, is the better fit for my health history?” 

2. MSI-H and dMMR: New Evidence on Combining Immunotherapy with Chemotherapy 

Who this is for: Patients with MSI-H (microsatellite instability-high) or dMMR (deficient mismatch repair) metastatic colorectal cancer (about 4-5% of metastatic cases). 

Pembrolizumab monotherapy (KEYNOTE-177, André et al., NEJM 2020) is the current FDA-approved standard for first-line MSI-H/dMMR metastatic CRC. This approach builds on earlier research demonstrating that mismatch repair-deficient tumors are uniquely sensitive to immune checkpoint blockade (Le et al., NEJM 2015). ASCO 2026 presented data examining whether adding chemotherapy and bevacizumab to immunotherapy could further improve outcomes, and whether that benefit is worth the added side effects. 

Ask your doctor: 

• “Is my tumor confirmed MSI-H or dMMR?” 

• “Based on my disease burden, would a more intensive combination approach make sense for me?” 

• “How do you weigh the COMMIT progression benefit against the safety data?” 

3. MSS Colorectal Cancer: Progress for the Majority 

Who this is for: The roughly 85% of colorectal cancer patients whose tumors are microsatellite stable (MSS or pMMR) and typically do not respond to standard immunotherapy. 

Standard immunotherapy alone usually does not work for MSS colorectal cancer. Research in this group focuses on combinations, using targeted therapy, radiation, or chemotherapy to create conditions where immune responses may be more likely. ASCO 2026 had several trials moving this approach forward. 

Ask your doctor: 

• “Has my tumor been fully tested, including BRAF, RAS, KRAS G12C, HER2, and NTRK?” 

• “Are there active trials for MSS colorectal cancer that fit my diagnosis and treatment history?” 

4. ctDNA Testing: A Blood Test That Could Guide Post-Surgery Decisions 

Who this is for: Primarily patients with stage II or III colon cancer who have had surgery and are deciding on next steps. 

After surgery, a key question is whether any cancer cells remain. Circulating tumor DNA (ctDNA) testing looks for fragments of cancer DNA in the bloodstream. A positive result after surgery suggests higher recurrence risk. A negative result suggests lower risk, although it does not guarantee cancer will not return. 

Supporting evidence: The DYNAMIC trial (Tie et al., NEJM 2022) showed ctDNA guidance reduced chemotherapy use from 28% to 15% of stage II patients without compromising recurrence-free survival. The GALAXY study (Nakamura et al., Nature Medicine 2024) found that ctDNA positivity after surgery was associated with dramatically worse disease-free survival (HR 11.99) and overall survival (HR 9.68). 

Ask your doctor: 

• “Am I a candidate for ctDNA testing given my stage and surgical outcome?” 

• “What would a positive or negative ctDNA result mean for my treatment plan?” 

5. GLP-1 Medications: An Emerging Signal in Colorectal Cancer 

Who this is for: Patients who have or may qualify for GLP-1 medications for diabetes, obesity, or cardiovascular risk. This is not a cancer treatment. 

GLP-1 medications were not developed as cancer treatments, but they have generated significant attention across cancer research this year. New findings presented at both ASCO GI and ASCO 2026 raised important questions about whether these medications could influence colorectal cancer risk, progression, or survivorship outcomes. While the evidence is still early, the level of interest from researchers and clinicians makes this an area worth watching.  

Three independent research teams asked whether GLP-1 receptor agonists like semaglutide, liraglutide, or dulaglutide might affect colorectal cancer risk or outcomes. None of these studies proves the medications work as cancer treatment. But taken together, they are interesting enough to study further, but they should not change cancer care on their own.  

Important: These are observational studies showing associations, not proof of benefit. A 2025 meta-analysis (Zhong et al., BMC Gastroenterology 2025) found mixed results depending on the comparison group. Do not start these medications based on cancer concerns alone. 

Ask your doctor: 

• “Do I have a medical reason, such as diabetes, obesity, or cardiovascular risk, to consider a GLP-1 medication?” 

• “If I am already on one, how might it interact with my cancer treatment?” 

Additional Studies Worth Knowing 

These studies may matter for specific patient groups. Some results are mature, while others are early or ongoing, so the right takeaway is to ask whether any of these questions apply to your diagnosis, biomarkers, and treatment history. 

The Bottom Line 

ASCO 2026 was not defined by a single headline. Instead, it highlighted meaningful progress across the colorectal cancer continuum. 

Researchers reported a new standard of care for patients with BRAF V600E-mutated metastatic colorectal cancer, new questions about how best to intensify treatment for selected MSI-H/dMMR tumors, continued efforts to expand immunotherapy strategies for MSS disease, and growing evidence supporting ctDNA-guided treatment decisions after surgery, and emerging research exploring the connections between metabolic health, survivorship, and colorectal cancer outcomes.  

These results do not replace a conversation with your oncologist. But they can help you ask better questions. 

Know your biomarkers. Ask about clinical trials. Talk about quality of life, not just tumor response. And remember: you do not have to navigate this alone. Fight CRC is here to help you understand your options, ask informed questions, and advocate for the care you deserve. 

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Fight CRC Resources 

References 

1a.  Elez et al. NEJM 2025. https://doi.org/10.1056/NEJMoa2501912  

1b.  Kopetz et al. Nature Medicine 2025. https://doi.org/10.1038/s41591-024-03443-3  

1c.  Kopetz et al. ASCO 2026, Abstract LBA3503. NCT04607421.  

2a.  Rocha Lima, Overman et al. ASCO 2026, Abstract 14. NCT02997228.  

2b.  André et al. NEJM 2020. https://doi.org/10.1056/NEJMoa2017699 

2c.  Le et al. NEJM 2015. https://doi.org/10.1056/NEJMoa1500596  

3a.  Morris VK II et al. ASCO 2026, Abstract 3504. SWOG S2107. 

3b.  Bai et al. ASCO 2026, Abstract LBA3515. mRCAT-III. 

4a.  Folprecht, ASCO 2026, Abstract LBA3500. NCT04089631. 

4b.  Tie et al. NEJM 2022. https://doi.org/10.1056/NEJMoa2200075 

4c.  Nakamura et al. Nature Medicine 2024. https://doi.org/10.1038/s41591-024-03254-6 

5a.  Jones et al. ASCO GI 2026, Abstract 18. 

5b.  Arya et al. ASCO GI 2026, Abstract 83. 

5c.  Orland et al. ASCO 2026, Abstract 3143.  

6a. Pietrantonio et al. ASCO 2026, Abstract 3511. CodeBreaK 300. 

6b. EPISODE-III. ASCO 2026, Abstract LBA3508. 

6c. PUMP trial. ASCO 2026, Abstract LBA3506. 

6d. Salazar et al. ASCO 2026, Abstract 3512. CR-SEQUENCE. 

6e. Lenz et al. ASCO 2026, Abstract 3510. CRDF-004. 

6f. Xu et al. ASCO 2026, Abstract LBA3509. 

Medical disclaimer: This blog is for informational purposes only and does not constitute medical advice. Study results may not apply to every patient. Always consult your oncologist before making any treatment decisions. Fight CRC is a patient advocacy organization, not a medical provider. 

The post ASCO 2026: What the Latest Colorectal Cancer Research Means for You  appeared first on Fight Colorectal Cancer.

Front Immunol. 2026 May 19;17:1809281. doi: 10.3389/fimmu.2026.1809281. eCollection 2026.

ABSTRACT

INTRODUCTION: Lynch syndrome (LS) is a hereditary cancer syndrome that increases risk for colorectal and other cancers. We hypothesize that vaccines against tumor-associated antigens CEA, MUC1, and brachyury, simultaneously delivered in an adenovirus serotype-5 vector (Tri-Ad5) combined with the immune-enhancing IL-15 receptor superagonist nogapendekin-alfa-inbakicept (NAI) will reduce the incidence of colorectal neoplasms in LS carriers.

METHODS: In this ongoing phase IIB double-blind placebo-controlled trial, two open-label safety phases (SPs) assessed safety of Tri-Ad5 alone (SP1, n=10) and with added NAI (SP2, n=10). A randomized controlled trial (RCT) follows the SPs. After baseline colonoscopy, vaccine dosing occurs at weeks 0, 4 and 8; Tri-Ad5 alone in SP1 and Tri-Ad5 plus NAI in SP2, with identical boosters at Week 52. The RCT phase participants (n=138) were randomized to receive Tri-Ad5 plus NAI or placebo. All participants complete colonoscopy at Weeks 52 and 104 for assessment of the primary endpoint: cumulative colorectal neoplasm incidence. Secondary endpoints include safety, tolerability, and immunogenicity.

RESULTS: All 20 SP participants (median age 57.5 (range 42-75), 70% female, 15% minority) received all prime and booster series. SP1 participants reported 139 adverse events (AEs) and SP2 participants reported 178. AEs were predominantly grade 1; no treatment-related serious adverse events (SAEs) occurred. The most common treatment-related AEs were reactogenic events including grade 3 rash (without skin necrosis or breakdown) at NAI injection site (100% of SP2 participants). The RCT phase (n=138) recently completed accrual.

DISCUSSION: In LS carriers without active cancer, the combination of Tri-Ad5 + NAI was well-tolerated; the RCT phase is ongoing.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/, identifier NCT05419011.

PMID:42238576 | PMC:PMC13226594 | DOI:10.3389/fimmu.2026.1809281

The post Design and preliminary report of a randomized phase IIb clinical trial of multitargeted recombinant adenovirus 5 vaccines against CEA, MUC1, and brachyury (Tri-Ad5) and the IL-15 receptor superagonist nogapendekin alfa inbakicept in Lynch syndrome (TRIAD5-Plus): the first cross-network trial of the Cancer Prevention Clinical Trials Network (CP-CTNet) appeared first on Fight Colorectal Cancer.

Clin Gastroenterol Hepatol. 2026 Jun 2:S1542-3565(26)00402-7. doi: 10.1016/j.cgh.2026.05.022. Online ahead of print.

NO ABSTRACT

PMID:42235869 | DOI:10.1016/j.cgh.2026.05.022

The post Birth Cohort Effects on Colorectal Cancer Onset in Lynch Syndrome appeared first on Fight Colorectal Cancer.

JCO Oncol Pract. 2026 May 29:OP2600098. doi: 10.1200/OP-26-00098. Online ahead of print.

ABSTRACT

PURPOSE: In metastatic colorectal cancer (mCRC), testing for mismatch repair deficiency (dMMR) can identify patients who will benefit from immune checkpoint inhibitors (ICIs). Communication regarding molecular testing and ICI is challenging, with studies demonstrating that oncologists have varied knowledge of genomic testing and frequently use technical jargon, and patient understanding is poor. We aimed to characterize discussions of molecular testing and ICIs to identify effective communication strategies.

METHODS: We conducted an observational qualitative study from 2022 to 2023. We recruited US medical oncologists who treat colon cancer. Oncologists participated in recorded telehealth encounters with standardized patients with dMMR mCRC who were referred to discuss treatment. NVivo QSR 14 was used for transcription and code identification via content analysis.

RESULTS: The study included 107 oncologists at 42 institutions across 27 US states who were contacted via email, and 21 (20%) participated. The median age was 41 years, 43% were female, and 33% were non-White. Average encounter duration was 44 minutes 5 seconds. The conversation structure was similar, but descriptions differed. MMR was described using variable terms, most commonly mutation (8/21) and protein loss (8/21). Almost all (20/21) oncologists discussed ICI, and over half (11/20) explained the mechanism. A minority of oncologists (5/21) reported response rates to immunotherapy (30%-70%) and informed of severe side effects. Oncologists uncommonly discussed next-generation sequencing (6/21), while over half (13/21) discussed germline testing.

CONCLUSION: This nationwide sample of oncologists used variable descriptions when discussing MMR and ICI, as evidenced by the use of technical jargon and inconsistent inclusion of key topics, including the likelihood of response and severe adverse events. The use of a structured framework could help oncologists communicate key information to patients more effectively.

PMID:42214055 | DOI:10.1200/OP-26-00098

The post Evaluating Oncologists’ Communication Strategies Regarding Molecular Testing and Immunotherapy appeared first on Fight Colorectal Cancer.

Am Soc Clin Oncol Educ Book. 2026 Jun;46(3):e516572. doi: 10.1200/EDBK-26-516572. Epub 2026 May 28.

ABSTRACT

Squamous cell carcinoma of the anal canal (SCAC) is a rare, human papillomavirus-driven malignancy with a rising global incidence and an increasingly dynamic therapeutic landscape. This review summarizes recent advances and current evidence in the management of SCAC, with a focus on immunotherapy, systemic treatment strategies, and optimization of curative-intent approaches. For locally advanced SCAC, concurrent chemoradiotherapy with fluorouracil and mitomycin C remains the standard of care, on the basis of multiple randomized trials demonstrating improved disease control and organ preservation compared with radiotherapy alone. These studies also show that treatment intensification with alternative chemotherapy, induction therapy, or radiation dose escalation does not improve outcomes. Given the curative intent, maintaining quality of life is a key consideration, and current studies are evaluating radiation dose optimization to reduce treatment-related toxicity, as well as the integration of immunotherapy to improve treatment efficacy. In metastatic SCAC, the combination of carboplatin and paclitaxel is the established first-line chemotherapy backbone. The addition of the PD-1 inhibitor retifanlimab to chemotherapy has demonstrated improved clinical outcomes and is now a preferred first-line approach. In the treatment-refractory setting, anti-PD-1 monotherapy provides modest response rates and remains a standard option for immunotherapy-naïve patients. Together, these findings summarize the current evidence base guiding the management of SCAC.

PMID:42208017 | DOI:10.1200/EDBK-26-516572

The post Updates on Management of Anal Cancer: A New Era Has Begun appeared first on Fight Colorectal Cancer.

Cell Host Microbe. 2026 May 27:S1931-3128(26)00177-0. doi: 10.1016/j.chom.2026.05.001. Online ahead of print.

ABSTRACT

Although the gut microbiome is implicated in colorectal cancer (CRC), microbiome and metabolome alterations along the adenoma-carcinoma sequence remain unclear. Here, we profile stool metagenomes obtained from 354 women 12.1 ± 4.8 years following adenoma resection and from their 1:1-matched controls, as well as stool metabolomes from 184 pairs. Metagenomic profiles are compared with those from 14 independent CRC case-control studies. Microbial composition differs between adenoma cases and controls and agrees with CRC-associated alterations (Pearson’s rho = 0.26, p < 0.0001). Thirty-one microbes, including Faecalibacterium prausnitzii and Flavonifractor plautii, are altered in both conditions and correlate with lifestyle factors. Thirty metabolites and 7 sub-pathways, particularly sphingolipids, are associated with adenomas. Adenomas also exhibit disease-specific microbe-metabolite associations, including those between Bilophila wadsworthia and alanine-containing dipeptides. These findings reveal gut microbial and metabolomic alterations detectable years after adenoma resection, supporting the presence of an altered microbiome along the adenoma-CRC continuum.

PMID:42202778 | DOI:10.1016/j.chom.2026.05.001

The post Long-lasting gut microbiome and fecal metabolome alterations after colorectal adenoma removal and their relationship to colorectal cancer appeared first on Fight Colorectal Cancer.

Am J Prev Med. 2026 May 25:108365. doi: 10.1016/j.amepre.2026.108365. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate colorectal cancer screening uptake in an academic setting after updated guidelines to initiate screening at age 45 years, focusing on differences between adults aged 45-49 years and 50-75 years, and by sociodemographic characteristics.

METHODS: This was a retrospective cohort of insured, average risk adults aged 45-75 years receiving care in the University of California San Diego Health System between 2021 and 2023. Electronic health records were used to capture colorectal cancer screening uptake and modality, individual-level sociodemographic factors, and linkage to ZIP code-level social vulnerability measures. Colorectal cancer screening adherence was measured by calendar year and compared between ages 45-49 years and 50-75 years using multivariable Poisson regression with robust standard errors.

RESULTS: Adults aged 45-49 years experienced increased screening adherence from 20% in 2021 to 46% in 2023. Their screening adherence likelihood were lower than adults aged 50-75 years across all years (2021 adjusted prevalence ratio [aPR]=0.27, 95% CI=0.25, 0.29; 2022 aPR=0.45, 95% CI=0.43, 0.48; 2023 aPR=0.59, 95% CI= 0.56, 0.62). Colonoscopy was the primary screening modality, though adults aged 45-49 years increased stool-based testing from 3% in 2021 to 9% in 2023. All racial and ethnic groups showed increased screening adherence from 2021 to 2023, leaving existing screening disparities unchanged.

CONCLUSIONS: Adults aged 45-49 years had lower colorectal cancer screening adherence likelihood than adults aged 50-75 years and had increasing interest in stool-based test modalities between 2021 and 2023. Despite concerns guideline changes could increase screening disparities, colorectal cancer screening adherence increased across all racial and ethnic groups, though gaps between groups did not change. The findings highlight screening promotion successes at one academic center, while emphasizing the need for focused interventions to continue minimizing disparities and improving adherence.

PMID:42201273 | DOI:10.1016/j.amepre.2026.108365

The post Colorectal Cancer Screening Uptake Across Age Groups in an Academic Health System appeared first on Fight Colorectal Cancer.

J Med Internet Res. 2026 Mar 31. doi: 10.2196/87037. Online ahead of print.

ABSTRACT

BACKGROUND: The use of web-based approaches to identify, recruit, enroll, survey, and interview health-related research participants has increased over time, with rapid acceleration since the COVID-19 pandemic. These approaches can make research more accessible to a broader population, but also increase the risk of fraudulent or imposter participants infiltrating research studies. While this threat has been discussed extensively in quantitative survey research, less has been reported in qualitative and mixed-methods studies.

OBJECTIVE: Our primary objectives are to identify recurring patterns of fraudulent study participation and to offer strategies for identification, remediation, and reporting.

METHODS: Encounters with fraudulent or imposter individuals during recruitment, enrollment, survey distribution, data collection, and focus group sessions in two multi-site qualitative and mixed methods research studies are presented. Content from both studies was analyzed to identify common themes to develop strategies for prevention and remediation.

RESULTS: Investigators across two multi-site studies observed several indicators of suspected fraudulent activity, including large response volumes over a short period, highly repetitive email addresses, higher-than-expected proportions of phone numbers with area codes outside the study area, and unusual email/phone responses using atypical language and phrasing. Several imposter or fraudulent individuals disrupted online focus group sessions. To mitigate these issues, both studies implemented remediation strategies including enhanced screening procedures at baseline, cross-checking of survey responses, and additional identity verification methods prior to participation. Studies took various actions to address these experiences, including notifying the institutional review board, recruitment platforms, and funders.

CONCLUSIONS: This multi-site study identified multiple ways that imposter or fraudulent participants can pose a significant and evolving threat to the integrity of qualitative and mixed methods. These types of fraudulent actors can distort data and undermine research credibility. Lessons learned highlight the importance of real-time recruitment and enrollment analysis and the need for transparent reporting. Addressing this issue will require a comprehensive approach to prevent and address fraudulent study participation that includes collaboration with multiple stakeholders, and the broader research community to effectively address this issue.

PMID:42189056 | DOI:10.2196/87037

The post Fraudulent and Imposter Participants in Qualitative Research: Experiences from Two Multi-Site Studies appeared first on Fight Colorectal Cancer.

J Med Screen. 2026 May 19:9691413261449911. doi: 10.1177/09691413261449911. Online ahead of print.

ABSTRACT

Fecal immunochemical testing (FIT) screens for colorectal cancer (CRC) through detection of hemoglobin. Specimens without a collection date are a common source of test cancellation. We implemented a quality improvement intervention to improve collection date documentation and screening completion using a pre-post design. Within a large US Veterans Affairs (VA) CRC screening trial, we modified the FIT return envelope instructions, including a field for collection date documentation on the envelope. Preintervention 6654/7083 FIT kits (93.9%) were received with a collection date compared to 3069/3105 (98.8%) postintervention (p < .00001). Preintervention, 35.2% of kits without a date were received within 15 days of original outbound mailing of the kit from VA, thereby allowing testing in 95.4% of all kits received. Postintervention, 44.4% of undated kits were received within 15 days of mailing from the VA, allowing for testing of 98.8% of all kits (p < .00001 compared to preintervention). The intervention was associated with an absolute 3.5% (95% CI: 2.8%-4.1%) increase in testable kits, thereby reducing the proportion of individuals requiring retesting from 4.6% to 1.2%. This no-cost, targeted intervention was associated with a significantly increased proportion of individuals successfully completing screening. Programs using FIT should consider implementation of this no-cost intervention to enhance program effectiveness.

PMID:42154016 | DOI:10.1177/09691413261449911

The post No-cost envelope modification improves fecal immunochemical test laboratory acceptance in a US Veterans Affairs colorectal cancer screening trial appeared first on Fight Colorectal Cancer.

Cancer Epidemiol Biomarkers Prev. 2026 May 14. doi: 10.1158/1055-9965.EPI-25-1836. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a leading global health burden and has been linked to chronic diseases, including cancer. Chronic stress may promote colorectal carcinogenesis via hormonal, immune, and metabolic abnormalities. Evidence for depression and colorectal cancer (CRC) is inconsistent, and data on colorectal polyps are limited.

METHODS: We prospectively followed 91,383 women from the Nurses’ Health Study II (1993-2019) for CRC analyses, and 62,237 women (1993-2017) for adenoma and serrated polyp analyses. Depression was defined as a Mental Health Index-5 score ≤ 52, antidepressant use, or physician-diagnosed depression. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) for CRC while logistic regression estimated odds ratios (ORs) for adenomas and serrated polyps.

RESULTS: Over 2.36 million person-years of follow-up, 474 CRC cases were documented. Depression was modestly associated with lower risk of CRC (HR=0.76, 95% CI: 0.59-0.97) and colon, but not rectal cancer. Among 62,237 women undergoing lower endoscopy over 24 years, 4,104 conventional adenomas and 4,563 serrated polyps were documented. Depression was modestly inversely associated with overall and large conventional adenomas (OR = 0.76, 95% CI: 0.63-0.92). No consistent association was observed with serrated polyps in primary models, although some sensitivity analyses suggested possible positive associations.

CONCLUSIONS: Depression was inversely associated with CRC and large conventional adenomas. Associations with serrated polyps were not evident in primary models but varied across sensitivity analyses, requiring further study.

IMPACT: These findings suggest potential differences across colorectal neoplastic pathways, indicate that the relationship between depression and colorectal carcinogenesis may be more complex than previously appreciated.

PMID:42132476 | DOI:10.1158/1055-9965.EPI-25-1836

The post Association between depression and risk of colorectal cancer and polyps: A prospective cohort study from Nurses’ Health Study II appeared first on Fight Colorectal Cancer.