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VCU Massey Comprehensive Cancer Center and its NCI Community Oncology Research Program (NCORP) affiliates played a vital role in a phase III clinical trial that has established a new therapeutic standard for patients with stage III colon cancer with deficient DNA mismatch repair (dMMR).

Khalid Matin, M.D., a medical oncologist and Massey’s associate director of global oncology, as well as a research collaborator with the Alliance for Clinical Trials in Oncology (Alliance), helped author the findings, which were recently published in The New England Journal of Medicine. Khalid Matin, M.D., a medical oncologist and Massey’s associate director of global oncology, as well as a research collaborator with the Alliance for Clinical Trials in Oncology (Alliance), helped author the findings.

“This is the first randomized phase III study to show benefit with immunotherapy in the adjuvant treatment of dMMR colon cancer after surgery,” Matin reflected. “The findings show that immunotherapy can be safely added to chemotherapy and increase the likelihood of cancer cures.

“Being a part of innovative trials at Massey is critical so that our patients continue to benefit from access to novel therapies, and the collective data is enriched by their inclusion.”

Massey participated in the ATOMIC trial, the international phase III study that evaluated adjuvant treatment strategies for this specific patient group. Across its NCORP affiliates, including both the Virginia Cancer Institute and Centra Health in Lynchburg, several of the 712 enrolled patients were treated through Massey’s NCORP network.

“Our NCORP grant allows us to make treatment options more accessible to all Virginians,” said Terri Matson, executive director of clinical and translational research at Massey. “Participating in a clinical trial offers the potential of receiving tomorrow's treatment, today; and that was exactly the case for several patients, without whom we wouldn't be able to make treatment advances like this.”

The findings of the clinical trial showed that patients with stage III colon cancer with dMMR had significantly better outcomes when the immunotherapy drug atezolizumab was added to standard chemotherapy after surgery. Results found that treating patients with this approach lowered the risk of the cancer returning or causing death by 50%, with 86.3% of patients remaining disease-free at three years compared with 76.2% receiving chemotherapy alone.

"The results of this study represent a pivotal advancement for the treatment of non-metastatic dMMR colon cancer,” said Alliance Study Chair Frank A. Sinicrope, M.D., professor of oncology and clinical investigator of the Mayo Foundation at the Mayo Clinic Comprehensive Cancer Center. “The demonstrated improvement in outcomes supports a fundamental shift in how we approach adjuvant therapy for this molecular subgroup. These results provide compelling evidence that will inform and elevate the standard of care."

Colorectal cancer is a leading cause of cancer-related death worldwide. For patients with stage III colon cancer, the standard adjuvant treatment remains a combination of chemotherapy drugs that was established in the 1990s. The latest National Comprehensive Cancer Network (NCCN) guidelines now include the results of the ATOMIC trial and apply them to patients with stage II T4bN0 dMMR colon cancer (tumors that have grown outward locally but have not spread to lymph nodes or elsewhere) as well.

ATOMIC was sponsored by the National Cancer Institute (NCI), part of the National Institutes of Health, and led and conducted by the NCI-funded Alliance for Clinical Trials in Oncology with participation from the NCI-funded National Clinical Trials Network (NCTN) as part of a collaboration with Genentech, a member of the Roche Group, and the NCI through a Cooperative Research and Development Agreement (CRADA). The trial was also open in partnership with the German group Arbeitsgemeinschaft Internistische Onkologie (AIO). To learn more about the ATOMIC trial, visit ClinicalTrials.gov.

Written by: Bill Potter