Clinical colorectal cancer最新文献

{"title":"Fruquintinib or Regorafenib? A Weighted Toxicity Score Analysis to Facilitate Better Discussions on Toxicity and Benefits in Later-line Colorectal Cancer Treatment","authors":"Salvatore Corallo,&nbsp;Francesco Agustoni,&nbsp;Anna Pagani,&nbsp;Francesco Serra,&nbsp;Alessandra Ferrari,&nbsp;Nicola Personeni,&nbsp;Paolo Pedrazzoli,&nbsp;Chiara Citterio","doi":"10.1016/j.clcc.2026.05.002","DOIUrl":"10.1016/j.clcc.2026.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Regorafenib and fruquintinib are key treatment options for later-line therapy in metastatic colorectal cancer. In the absence of direct comparative studies, treatment selection frequently depends on safety profiles. The weighted toxicity score (WTS) was developed to summarize overall toxicity within a single arm of a randomized clinical trial, facilitating toxicity-benefit evaluations.</div></div><div><h3>Material and Methods</h3><div>In this analysis, WTS was applied to the CORRECT and FRESCO-2 trials. Adverse events (AEs) from both studies were analyzed, and toxicity burden was assessed by comparing WTS differences between trial arms. AEs were classified as either measurable or symptomatic, resulting in the calculation of measurable-WTS (M-WTS) and symptomatic-WTS (S-WTS). For a deeper characterization of treatment-attributable toxicities between the drugs, 3 additional metrics were employed: attributable fraction, which quantifies the proportion of each toxicity rate attributable to the study drug, risk difference, and toxicity incidence rate ratio (TIRR), which measures the frequency of each AE adjusted for toxicity likely related to the underlying disease.</div></div><div><h3>Results</h3><div>After adjustment for placebo-related toxicity, fruquintinib and regorafenib increased the toxicity burden by 97.8% and 85.1%, respectively. Regorafenib was associated with a greater increase in symptomatic toxicity, while fruquintinib was linked to a greater increase in measurable toxicities. Comparative TIRR analysis demonstrated that regorafenib was associated with a higher risk of dysphonia, oral mucositis, weight loss, and fever. In contrast, fruquintinib exceeded regorafenib in the risk of hand-foot skin reaction, transaminase elevation, constipation, and hypertension.</div></div><div><h3>Conclusion</h3><div>These findings may support clinicians in making more informed treatment decisions by distinguishing between drug-related toxicity and cancer-related effects.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 360-369.e3"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Quality of Life in Rectal Cancer Survivors Managed With Watch-and-Wait Versus Surgery","authors":"Sina Vatandoust,&nbsp;Luigi Sposato,&nbsp;David Wattchow,&nbsp;John Leung,&nbsp;Amitesh Roy,&nbsp;Dayan de Fontgalland,&nbsp;Bogda Koczwara,&nbsp;Gang Chen,&nbsp;Shahid Ullah,&nbsp;Michael Z. Michael,&nbsp;Christos S. Karapetis","doi":"10.1016/j.clcc.2026.05.006","DOIUrl":"10.1016/j.clcc.2026.05.006","url":null,"abstract":"<div><h3>Background</h3><div>A nonoperative (watch-and-wait) approach is increasingly accepted for patients with rectal cancer who achieve a complete clinical response to neoadjuvant treatment. This study aimed to investigate the effect of surgery—compared with a watch-and-wait strategy—on long-term quality of life among rectal cancer survivors following chemoradiotherapy.</div></div><div><h3>Patients and Methods</h3><div>This cross-sectional study included survivors of resectable rectal cancer treated with long-course chemoradiotherapy between 2011 and 2019 at Flinders Medical Centre, Australia. Participants were categorized as sustained watch-and-wait, surgery after regrowth, or standard surgery after chemoradiotherapy. Patient-reported outcome measures were collected by mail or during clinic visits. Primary multivariable analyses examined the effect of surgery on patient-reported outcomes. Linear regression models were adjusted for receipt of adjuvant chemotherapy, sex, age at assessment, tumor distance from the anal verge, comorbidity burden, and time from treatment completion.</div></div><div><h3>Results</h3><div>Of 190 eligible participants approached, 78 were enrolled. Median age was 70 years; 33.3% were female. A total of 32 (41.0%) were in the watch-and-wait group, 8 (10.3%) had been managed with surgery due to regrowth after initial watch-and-wait, and 38 (48.7%) were in the standard surgery group. The comorbidity burden had a negative impact on quality of life (<em>P</em> &lt; .05). Surgery was independently associated with lower QLQ-C30 summary and social functioning scores (both <em>P</em> &lt; .05), and with higher pain, bowel-function, urinary, and embarrassment symptom scores (all <em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>Surgery was associated with worse quality of life, higher symptom burden, and poorer psychosocial outcomes. This study highlights the need for long-term symptom monitoring and personalized care in survivors of rectal cancer.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 379-386.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual CTLA-4/PD-1 Blockade Versus Anti–PD-1 in MSI-H Metastatic Colorectal Cancer: Early Survival Benefit and Exploratory Clinical Predictors","authors":"Lea Jehanno,&nbsp;Julie Henriques,&nbsp;Thomas Samaille,&nbsp;Camille Loisel,&nbsp;Baptiste Cervantes,&nbsp;Raphaël Colle,&nbsp;Dewi Vernerey,&nbsp;Thierry André,&nbsp;Romain Cohen","doi":"10.1016/j.clcc.2026.05.003","DOIUrl":"10.1016/j.clcc.2026.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICI) are standard for MSI-H/dMMR metastatic colorectal cancer (mCRC). We compared their efficacy and sought subgroups deriving greater benefit from ICI combination.</div></div><div><h3>Patients and Methods</h3><div>All patients with MSI/dMMR mCRC treated by anti-PD-1 ± anti-CTLA-4 in the prospective monocenter immunoMSI cohort were analyzed. Treatment choice followed trials availability and regulatory approvals. Main endpoints were progression-free survival (PFS, iRECIST) and overall survival (OS). Landmark analysis at 6 months, restricted mean survival time (τ = 7 years) and piecewise Cox models were used. Interactions were tested in a single Cox model including subgroup terms, treatment, and interaction terms.</div></div><div><h3>Results</h3><div>Among 210 patients, 97 received ICI combination and 113 monotherapy with anti–PD-1. Median follow-up was 4.4 years (4.1 combo; 5.4 mono). About 165 patients (78.5%) received ICI in second line or latter. Combination improved PFS (hazard ratios [HR] 0.48, 95% CI 0.31-0.76) and OS (HR 0.49, 0.29-0.84). RMST was 5.27 versus 3.91 years (+1.36 years, 0.55-2.17). Piecewise HRs showed an early benefit (0-6 months HR 0.32, 0.16-0.66) that attenuated thereafter. Objective responses were 78% versus 60%; progressive disease 5% versus 15%. Interactions were observed for sex (PFS HR 0.21 vs. 0.87 for females vs. males; <em>P</em>-interaction = .0067), liver metastases (0.30 vs. 0.79; 0.0479) and sidedness (0.27 vs. 0.64; 0.0922).</div></div><div><h3>Conclusion</h3><div>Dual CTLA-4/PD-1 blockade improved PFS and OS versus anti–PD-1 alone, driven by higher early response rates. Female sex, absence of liver metastases, and left-sided tumor location may predict greater benefit from combination.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 321-331.e8"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Liver Metastases and KRAS Mutations in Patients With Metastatic Colorectal Cancer: A Pooled Analysis of Third-Line Placebo-Controlled Trials From the ARCAD CRC Database","authors":"Thomas Samaille,&nbsp;Morteza Raeisi,&nbsp;Romain Cohen,&nbsp;Qian Shi,&nbsp;Takayuki Yoshino,&nbsp;John R. Zalcberg,&nbsp;Richard Adams,&nbsp;Chiara Cremolini,&nbsp;Axel Grothey,&nbsp;Robert J. Mayer,&nbsp;Benoist Chibaudel,&nbsp;Aimery de Gramont,&nbsp;Thierry André","doi":"10.1016/j.clcc.2026.05.007","DOIUrl":"10.1016/j.clcc.2026.05.007","url":null,"abstract":"<div><h3>Background</h3><div>KRAS mutations in metastatic colorectal cancer (mCRC) are a factor of poor prognosis, partly because of associated resistance to anti-EGFR therapies. Liver metastases (LM) were also described as a factor of poor prognosis. This study aims to compare the outcomes of patients treated in third-line setting with placebo or Trifluridine/Tipiracil or regorafenib (TToR) and to assess the impact of LM and KRAS mutations on prognosis.</div></div><div><h3>Methods</h3><div>Data were pooled from five placebo-controlled randomized trials of the ARCAD CRC database (CORRECT, RECOURSE, CONCUR, TERRA, and J003). Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier estimates and adjusted Cox models. Interaction tests were conducted to evaluate the combined effects of LM and KRAS mutations.</div></div><div><h3>Results</h3><div>The study included 2,207 patients: 1,464 treated with TToR and 743 with placebo. A total of 73% had LM and 51% had KRAS mutations. Patients with LM had significantly lower OS and PFS compared to those without LM in both TToR (HR = 0.48 for OS; HR = 0.55 for PFS) and placebo groups (HR = 0.49 for OS; HR = 0.58 for PFS). Patients with KRAS mutations had worse OS compared to wild-type KRAS in TToR-treated patients (HR = 1.18), but not in placebo-treated patients (HR = 1.03). Interaction tests were not significant between LM and KRAS status in both TToR and placebo groups.</div></div><div><h3>Conclusions</h3><div>In patients with refractory mCRC, LM are a major poor prognosis factor, while KRAS mutations have no clinically relevant additive impact. These results underline the importance to stratify clinical trials on liver metastases rather than on RAS status in latter lines.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 387-395.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Polyps in Colon Capsule Endoscopy and Impact of Colonic Transit Time","authors":"Ola Selnes,&nbsp;Lea Østergaard Hansen,&nbsp;Benedicte Schelde-Olesen,&nbsp;Thomas Bjørsum-Meyer,&nbsp;Lasse Kaalby,&nbsp;Anastasios Koulaouzidis,&nbsp;Gunnar Baatrup,&nbsp;Ulrik Deding,&nbsp;CareForColon2015 study group","doi":"10.1016/j.clcc.2026.04.002","DOIUrl":"10.1016/j.clcc.2026.04.002","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Colon capsule endoscopy (CCE) is a noninvasive technique for colon evaluation. Although previous research has demonstrated high accuracy of CCE in detecting polyps, the impact of colonic transit time (CTT) on polyp detection remains unclear. We aimed to identify the lowest acceptable CTT for an optimal polyp detection rate (PDR).</div></div><div><h3>Methods</h3><div>This study analyzed data from colorectal cancer screening participants with complete CCE examinations, as part of the CareForColon2015 trial. A multivariate logistic regression model was employed to investigate the relationship between CTT and PDR.</div></div><div><h3>Results</h3><div>Among the 2,031 participants who underwent CCE, 1,266 (62.3%) were eligible for analysis. CTTs ≤ 20 minutes were significantly associated with lower PDR for polyps of any size (OR 0.36, 95% CI 0.22; 0.59, <em>P</em> &lt; .001) and polyps &gt; 5 mm (OR 0.54, 95% CI 0.34; 0.85, <em>P</em> = .007) compared to a CTT of &gt; 60 minutes. A nonsignificant trend was observed for CTTs 21-40 minutes and PDR for polyps &gt; 5 mm (OR 0.68, 95% CI 0.46; 1.01, <em>P</em> = .053). No significant differences in PDR for polyps &gt; 9 mm was found across the CTT categories. A sensitivity analysis with size-adjusted polyps revealed no significant differences in PDR for polyps &gt; 5 mm across CTT categories.</div></div><div><h3>Conclusions</h3><div>CTTs of ≤ 20 min are correlated with lower PDR for polyps of any size and those exceeding &gt; 5 mm, but not for polyps &gt; 9 mm. After size-adjustments of polyps, detection rates of clinically significant polyps were deemed CTT independent.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 332-339"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordant Dynamics Between Absolute ctDNA and Tumor Fraction During Treatment Monitoring in Metastatic Colorectal Cancer: Evidence of a Dilution Phenomenon","authors":"Yuji Takayama,&nbsp;Kosuke Ichida,&nbsp;Taro Fukui,&nbsp;Nao Kakizawa,&nbsp;Fumiaki Watanabe,&nbsp;Koichi Suzuki,&nbsp;Toshiki Rikiyama","doi":"10.1016/j.clcc.2026.05.001","DOIUrl":"10.1016/j.clcc.2026.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Circulating tumor DNA (ctDNA) is a promising biomarker for monitoring metastatic colorectal cancer. Tumor fraction, defined as the proportion of tumor-derived DNA within total circulating cell-free DNA (cfDNA), has been used as a quantitative measure of tumor-derived DNA burden. However, because tumor fraction is a relative metric, its relationship with absolute ctDNA dynamics remains unclear.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective longitudinal study of patients with metastatic colorectal cancer harboring RAS or BRAF mutations who underwent systemic therapy with serial ctDNA monitoring. Plasma samples were analyzed using droplet digital PCR to quantify absolute ctDNA, expressed as mutant copies/mL of plasma, and tumor fraction. Longitudinal dynamics were assessed by comparing each sample with the preceding measurement. Dilution was defined as increased absolute ctDNA, with fold change ≥ 1.5 and increase ≥ 313 mutant copies/mL of plasma, accompanied by decreased tumor fraction.</div></div><div><h3>Results</h3><div>Fifty-five patients with 246 evaluable plasma samples were included. Among 120 samples with preceding measurements, 7 dilution events were identified in 5 patients, occurring predominantly during progressive disease. Although absolute ctDNA and tumor fraction increased concordantly at the population level during progression, individual-level analyses revealed discordant dynamics in which absolute ctDNA increased while tumor fraction decreased. Higher absolute ctDNA levels were associated with dilution in mixed-effects logistic regression analysis (odds ratio, 3.25; 95% CI, 1.16-9.15; <em>P</em> = 0.025).</div></div><div><h3>Conclusion</h3><div>Tumor fraction may decrease despite increasing tumor-derived ctDNA during treatment monitoring. Simultaneous evaluation of absolute ctDNA and tumor fraction may improve interpretation of ctDNA dynamics in metastatic colorectal cancer.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 352-359.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Double Down: Dual Immunotherapy as the Best Bet for Treatment of Microsatellite Instability-High Metastatic Colorectal Cancer","authors":"Mir Lim,&nbsp;Van Morris","doi":"10.1016/j.clcc.2026.07.003","DOIUrl":"10.1016/j.clcc.2026.07.003","url":null,"abstract":"","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 309-310"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant Bevacizumab and Chemoradiotherapy for Locally Advanced Rectal Cancer: Long-Term Outcomes of a Multicentre Study","authors":"Ilaria Prata,&nbsp;Iris D. Nagtegaal,&nbsp;Geke Hospers,&nbsp;Johannes H.W. de Wilt,&nbsp;Cristina Graham Martinez,&nbsp;Stefan A.J. Hutschemaekers,&nbsp;Steven Vanhoutvin,&nbsp;Annemieke Cats,&nbsp;Corrie A.M. Marijnen","doi":"10.1016/j.clcc.2026.06.002","DOIUrl":"10.1016/j.clcc.2026.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Neoadjuvant treatment for locally advanced rectal cancer (LARC) evolves rapidly, and targeted agents could play a relevant role.</div></div><div><h3>Patients and Methods</h3><div>In the phase II RAX study, we investigated the efficacy and safety of neoadjuvant chemoradiotherapy (CRT, 25 × 2 Gy with twice daily 825 mg/m² capecitabine) combined with bevacizumab (5 mg/kg, day: 14, 1, 15, 29 of CRT) followed by surgery. Patients with cT4 tumors, cT3 within 5 cm from the anal verge, or high cT3 within 2 mm of the mesorectal fascia (MRF) were included. Safety was presented in terms of number of toxicity failures, according to protocolized criteria based on expected toxicity of CRT and bevacizumab, and severe adverse events. Histopathological response was described in terms of extent (according to Mandard’s Tumor Regression Grade) and pattern (shrinkage vs. fragmentation). Efficacy outcomes were histopathological response, incidence of locoregional recurrences (LRR) and distant metastases (DM), disease-free (DFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>We included 35 patients; 66% were male with a median age of 61 years (range, 25-77). About 71% of tumors involved the MRF at baseline, 56% were cT4, and 71% were cN+. Eight patients developed toxicity failures (3 bowel perforations, 2 pulmonary embolisms, 2 bleedings, and 1 anal mucositis requiring surgery). These toxicity failures exceeded the predefined stopping rules and led to study termination after 35 patients. Pathological complete response was observed in 4 patients, and 1 was ypT0N1 (total 15%), and 5 more achieved a major response (TRG1). Ten-year incidences of LRR and DM were 6% (95% confidence interval [CI], 0%-13%) and 31% (95% CI, 16%-47%), respectively; both DFS and OS were 60% (95% CI, 44%-76%).</div></div><div><h3>Conclusion</h3><div>Neoadjuvant CRT with concomitant bevacizumab results in high DFS and OS after long follow-up, but with concerning numbers of early toxicity failures. Incorporating bevacizumab into neoadjuvant treatment of LARC, possibly in combination with novel therapeutic strategies, may result in promising long-term oncological outcomes and deserves further investigation.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 403-413.e2"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a Domestic Chinese Robotic Surgical System in Radical Resection Combined With Lateral Lymph Node Dissection for Low Rectal Cancer: A Retrospective Study","authors":"Feng Zheng,&nbsp;Aihe Sun,&nbsp;Peng Zhai,&nbsp;Zhongming Bao,&nbsp;Yongjun Jiang","doi":"10.1016/j.clcc.2026.07.002","DOIUrl":"10.1016/j.clcc.2026.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Lateral lymph node dissection (LLND) in low rectal cancer is technically demanding due to the narrow pelvis and risk of nerve injury. Robotic surgery may improve visualization and precision, but evidence on domestic Chinese robotic systems for this procedure is limited. This study compared the safety and short-term outcomes of the KangDuo Surgical Robot-01 (KD-SR-01) robotic system with conventional laparoscopic surgery in patients undergoing radical resection with LLND.</div></div><div><h3>Patients and Methods</h3><div>This retrospective single-center study included 278 patients with low rectal cancer who underwent radical resection plus LLND from June 2022 to June 2025. Patients were divided into robotic (n = 120, KangDuo KD-SR-01) and laparoscopic (n = 158) groups. Perioperative, pathological, postoperative, and short-term oncological outcomes were compared.</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups. After 1:1 propensity score matching (119 pairs), the robotic group showed significantly shorter total operation time (238.7 ± 45.9 vs. 304.1 ± 58.9 minutes, <em>P</em> &lt; .001), shorter LLND time (86.5 ± 23.2 vs. 121.1 ± 27.2 minutes, <em>P</em> &lt; .001), lower blood loss (134.5 ± 52.3 vs. 351.8 ± 183.2 mL, <em>P</em> &lt; .001), and higher lateral lymph node yield (7.87 ± 2.19 vs. 5.87 ± 2.34, <em>P</em> &lt; .001) compared with the laparoscopic group. These advantages persisted in the matched cohort. Robotic surgery was also associated with, borderline lower overall complication rate (<em>P</em> = .047), and nominally lower sexual dysfunction (<em>P</em> = .047). Pathological outcomes and DFS (log-rank <em>P</em> = .163) were comparable.</div></div><div><h3>Conclusion</h3><div>The domestic KangDuo KD-SR-01 robotic system is safe and feasible for radical resection with LLND in low rectal cancer. It provides significant perioperative and functional benefits compared to laparoscopy without compromising short-term oncological results.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 422-430"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matching-Adjusted Indirect Comparison of Sotorasib Plus Panitumumab Versus Trifluridine/Tipiracil Plus Bevacizumab in Chemorefractory Metastatic Colorectal Cancer","authors":"Lisa Salvatore,&nbsp;Marwan Fakih,&nbsp;Yasutoshi Kuboki,&nbsp;David S. Hong,&nbsp;Dominik Paul Modest,&nbsp;Julien Taieb,&nbsp;Timothy Jay Price,&nbsp;Chiara Cremolini,&nbsp;Istvan Matyas Majer,&nbsp;Marko Rehn,&nbsp;Emily Chan,&nbsp;Ziyan Chen,&nbsp;Qui Tran,&nbsp;Filippo Pietrantonio","doi":"10.1016/j.clcc.2026.04.003","DOIUrl":"10.1016/j.clcc.2026.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Sotorasib 960 mg plus panitumumab (soto960+pani) was investigated in chemorefractory <em>KRAS</em> G12C-mutated metastatic colorectal cancer (mCRC) in the phase 3 CodeBreaK 300 and phase 1b CodeBreaK 101 studies. In CodeBreaK 300, soto960+pani significantly improved progression-free survival (PFS) versus investigator’s choice therapy (trifluridine/tipiracil [T/T] or regorafenib). The phase 3 SUNLIGHT study evaluated T/T plus bevacizumab (T/T+bev) in patients with unselected refractory mCRC and found longer survival times with T/T+bev than T/T monotherapy. Matching-adjusted indirect treatment comparisons (MAIC) were performed to compare the efficacy and safety of soto960+pani with new standard-of-care T/T+bev treatment.</div></div><div><h3>Materials and Methods</h3><div>Clinical outcomes and adverse events (AEs) from CodeBreaK 300 and 101 (for soto960+pani) were compared with those from SUNLIGHT (for T/T+bev). By reweighting individual patient-level data from the pooled CodeBreaK studies, differences in baseline characteristics were adjusted. Odds ratios (ORs) were estimated for objective response rates; hazard ratios (HRs) were used for PFS and overall survival (OS).</div></div><div><h3>Results</h3><div>From a pool of 93 patients, the effective sample size of soto960+pani with matched characteristics was 29 patients. Soto960+pani increased the likelihood of treatment response, with an adjusted OR of 5.7 (95% CI, 2.6-12.8) versus T/T+bev. HR for PFS was 0.77 (95% CI, 0.47-1.25); HR for OS was 0.44 (95% CI, 0.22-0.87), suggesting a survival benefit favoring soto960+pani. Grade ≥ 3 AEs occurred in 58% and 72% of soto960+pani-treated and T/T+bev-treated patients, respectively.</div></div><div><h3>Conclusion</h3><div>In this MAIC analysis, soto960+pani demonstrated statistically significant improvement in response rates and OS in patients with chemorefractory <em>KRAS</em> G12C-mutated mCRC.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 3","pages":"Pages 340-351.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}