Episode # 82 • 22 Sept 2026
Advances in Perioperative Colorectal Cancer Management
How much of perioperative colorectal cancer management has changed in just one year, and what does it mean for patient care? On this episode of BackTable Tumor Board, Dr. Jun Gong is joined by Dr. Ibrahim Sahin and Dr. Alexandra Gangi to review the latest practice-changing data in colon and rectal cancer. They discuss observation versus maintenance immunotherapy in MSI-high disease, the CHALLENGE trial's surprising results on exercise and disease-free survival, and the evolving role of ctDNA and local therapies after liver metastasis resection.
Timestamps
00:00 - Introduction
05:29 - Monotherapy, Doublet, and Treatment Duration
10:35 - CHALLENGE Trial and Exercise After Surgery
16:18 - Adjuvant Immunotherapy and Liver Metastases
23:39 - ctDNA and Molecular Residual Disease
29:44 - Case: Unresectable Liver Metastases and HAI Pump
39:17 - Closing Thoughts
Resources
- CHALLENGE Trial: Structured Exercise after Adjuvant Chemotherapy for Colon Cancer
- ATOMIC Trial (Alliance A021502): Atezolizumab plus FOLFOX for Stage III Mismatch Repair Deficient Colon Cancer
- Phase 2 LAVA-CRLM Trial: Microwave Ablation versus SBRT for Colorectal Liver Metastases
- COLLISION Trial: Thermal Ablation versus Surgical Resection of Small-Size Colorectal Liver Metastases
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More about this episode
The conversation also covers adjuvant immunotherapy duration, comparing microwave ablation with SBRT, and how molecular residual disease (MRD) can guide post-resection decisions. They walk through a complex case of liver metastases, highlight the use of hepatic arterial infusion pumps, and discuss the future of transplant for unresectable disease. The discussion closes with practical advice on patient selection, multidisciplinary care, and the ongoing need for consensus as new therapies and biomarkers emerge.
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