How will the newest colorectal cancer trial results discussed at the 2026 ASCO GI Cancers Symposium in San Francisco impact patient care and therapeutic strategies? Medical oncologists Dr. Shruti Patel and Dr. Jun Gong dissect evidence from multiple practice-changing studies, translating complex data into practical recommendations.

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Timestamps

00:00 – Introduction
01:50 – BREAKWATER Trial for Metastatic CRC
11:31 – COMMIT Trial for Metastatic CRC dMMR
17:34 – STELLAR-303 Trial for Refractory CRC
26:03 – ALASCCA Trial on Adjuvant Low Dose Aspirin in CRC
31:29 – CHALLENGE Trial on Structured Exercise Programs
38:48 – ATOMIC Trial on Adjuvant Immunotherapy
44:34 – The Role of GLP-1s in CRC Prevention

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More about this episode

Dr. Patel and Dr. Gong cover key findings and takeaways from recent colorectal cancer studies, including BREAKWATER, COMMIT, STELLAR-303, ALASCCA, CHALLENGE, and ATOMIC.

BREAKWATER evaluates first-line targeted therapy combinations in BRAF V600E–mutant metastatic CRC, demonstrating improved response rates and progression-free survival with the addition of encorafenib-based regimens.

COMMIT investigates the role of immunotherapy with or without chemotherapy in dMMR metastatic CRC, helping clarify whether upfront chemotherapy adds benefit to checkpoint blockade in this population.
STELLAR-303 examines a novel therapeutic option in refractory CRC, comparing a new agent against standard therapies and showing modest survival benefit in heavily pretreated patients.

ALASCCA assesses the impact of adjuvant low-dose aspirin in biomarker-selected CRC patients, suggesting improved disease-free survival in patients with PI3K pathway alterations.

CHALLENGE evaluates structured exercise interventions in the post-treatment setting, demonstrating that increased physical activity is associated with improved disease-free survival and overall outcomes.
ATOMIC explores the addition of immunotherapy to standard adjuvant chemotherapy in resected dMMR CRC, supporting a potential shift toward incorporating checkpoint inhibitors in earlier-stage disease.

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Resources

BREAKWATER Trial Cohort 3 Study
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.13

COMMIT Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.14

STELLAR-303 Phase 3 Trial
https://pubmed.ncbi.nlm.nih.gov/41130252/

Immunotherapy Efficacy in Mismatch Repair-Proficient Colorectal Cancer Patients With and Without Liver Metastases
https://ascopubs.org/doi/10.1200/JCO-25-01044

ALASCCA Trial
https://clinicaltrials.gov/study/NCT02647099?tab=study
CHALLENGE Phase 3 Trial

https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA3510
Regular Physical Activity Can Help Manage CRC-Related Fatigue
https://dailynews.ascopubs.org/do/regular-physical-activity-can-help-manage-crc-related-fatigue

ATOMIC Phase 3 Trial
https://ascopubs.org/doi/10.1200/JCO.2025.43.17_suppl.LBA1

GLP-1 Receptor Agonist vs Aspiring for Primary Prevention of Colorectal Cancer
https://ascopubs.org/doi/10.1200/JCO.2026.44.2_suppl.18

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