Clinical colorectal cancer最新文献

{"title":"What the Clinician Needs to Know About Laboratory Analyses of Circulating Tumor DNA","authors":"Cecilie Mondrup Jacobsen ,&nbsp;Luisa Matos do Canto ,&nbsp;Søren Kahns ,&nbsp;Torben Frøstrup Hansen ,&nbsp;Rikke Fredslund Andersen","doi":"10.1016/j.clcc.2025.01.003","DOIUrl":"10.1016/j.clcc.2025.01.003","url":null,"abstract":"<div><div>Liquid biopsies offer the possibility to evaluate cancer patients using noninvasive approaches. Circulating cell-free DNA (ccfDNA) is 1 of the most used and promising sources. Detecting tumor DNA among ccfDNA (ctDNA) can be used for early cancer detection, treatment response assessment, prognosis, and predictive evaluations. Providing analyses that can increase the quality of patient treatment is very much a joint effort between laboratory scientists and clinicians. With its use approaching clinical practice, it is important for clinicians to be familiar with the basic concepts and analyses behind ctDNA results in a similar way as laboratory scientists should have knowledge of the clinical needs to provide relevant analyses. In this Perspective, we describe the whole process of ctDNA analyses, from the preanalytical standards to reporting/analyzing results, and highlight some important factors that need to be addressed in the process of implementing them to clinical practice.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 109-119"},"PeriodicalIF":3.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434701","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":"Significant Alterations of Colorectal Cancer Care in the COVID-19 Pandemic With High Adherence to Quality Criteria in German Cancer Centers (CC) ‒ Data From the AIO CancerCOVID Consortium (AIO-YMO/KRK 520/ass)","authors":"Céline Lugnier ,&nbsp;Sarah Förster ,&nbsp;Sabine Sommerlatte ,&nbsp;Olaf Schoffer ,&nbsp;Jens Christmann ,&nbsp;Anna-Lena Kraeft ,&nbsp;Tobias Terzer ,&nbsp;Eleni Kourti ,&nbsp;Oliver Overheu ,&nbsp;Elena Schlageter ,&nbsp;Ira Ekmekciu ,&nbsp;Waldemar Uhl ,&nbsp;Christoph Biermann ,&nbsp;Lothar Müller ,&nbsp;Marianne Sinn ,&nbsp;Stefan Kasper-Virchow ,&nbsp;Dominik Modest ,&nbsp;Volker Heinemann ,&nbsp;Jochen Schmitt ,&nbsp;Jan Schildmann ,&nbsp;Anke Reinacher-Schick","doi":"10.1016/j.clcc.2025.01.001","DOIUrl":"10.1016/j.clcc.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) remains a leading cause of death despite notable advancements through guideline-based management. We present data on changes of CRC care during the COVID-19 pandemic in Germany.</div></div><div><h3>Methods</h3><div>Retrospective data from 22 AIO CCs and an academic Institute of Pathology compared the first (fw, 03-05.2020) and second wave (sw, 11-12.2020) of the pandemic with corresponding 2019 periods. Parameters were: number of cases diagnosed, age, sex, tumor stage, surgical procedures, quality criteria of CRC care (presentation in multidisciplinary tumor boards (MTB), psychological or social consultation), number of precancerous and malignant colorectal lesions (CRL). Data points were compared as mean values with confidence intervals estimated according to Clopper and Pearson (1934). Hypothesis tests were conducted using Poisson regression models that included interaction terms (year*sex or year*age over70). Statistical significance was considered at <em>P &lt; .</em>05.</div></div><div><h3>Results</h3><div>A total of 4316 cases diagnosed (AIO CC) revealed a substantial reduction (fw -20.58%; sw -23.48%). Hypothesis test showed a significant decline in incidence due to the fw and sw of the pandemic. Quality criteria of cancer care remained stable except for trial participation. Analysis from 60,695 CRL detected a decrease in precancerous (fw: -16 %/sw: -4 %) and malignant (fw: -18 %) lesions while malignant CRL increased in the sw (+8 %). Hypothesis test revealed a significant decline only for the fw 2020 and detected age &gt; 70 as independent risk factor in both waves.</div></div><div><h3>Conclusion</h3><div>We detected substantial alterations in cancer care during the pandemic, including detected precancerous CRL. CCs showed high resilience in quality criteria for CRC care.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 218-230"},"PeriodicalIF":3.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451119","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":"The Impact of a Multidisciplinary Tumor Board (MDTB) in the Management of Colorectal Cancer (CRC)","authors":"Francesco Schietroma ,&nbsp;Maria Bensi ,&nbsp;Maria Alessandra Calegari ,&nbsp;Carmelo Pozzo ,&nbsp;Michele Basso ,&nbsp;Giustina Valente ,&nbsp;Giulia Caira ,&nbsp;Giovanni Trovato ,&nbsp;Alexia Spring ,&nbsp;Viria Beccia ,&nbsp;Anna Ceccarelli ,&nbsp;Serena Perazzo ,&nbsp;Laura Chiofalo ,&nbsp;Brunella Barbaro ,&nbsp;Giulia Tatulli ,&nbsp;Sergio Alfieri ,&nbsp;Davide De Sio ,&nbsp;Laura Lorenzon ,&nbsp;Roberto Persiani ,&nbsp;Filippo Lococo ,&nbsp;Lisa Salvatore","doi":"10.1016/j.clcc.2025.01.002","DOIUrl":"10.1016/j.clcc.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>The management of colorectal cancer (CRC) is a complex process. Defining the disease burden, assessing the radiological response and identifying the right time for surgery or other locoregional treatments are crucial factors which can require the involvement of a multidisciplinary tumor board (MDTB) comprising several specialists. This study investigates the impact of MDTB on management of CRC in our institution.</div></div><div><h3>Methods</h3><div>We retrospectively assessed all cases discussed by our MDTB between September 2019 and April 2023. In particular, we collected data concerning radiology, surgery and radiotherapy indication before and after MDTB meetings. The primary endpoint was the overall rate of discrepancy between pre- and post-discussion evaluations.</div></div><div><h3>Results</h3><div>Our analysis involved 1150 cases. Median age was 64 years (16-90), 629 patients (54.7%) were male and 915 (79.5%) had metastatic disease at the time of the relevant MDTB discussion. After the meetings, 325 treatment decisions were modified, producing an overall discrepancy rate of 28.3%. In particular: (1) of 648 cases discussed for radiological assessment, 156 decisions (24.1%) were altered after a central imaging review; (2) of 327 cases considered for surgical approach, treatment strategy changed in 118 (36.1%); and (3) of the 160 cases discussed regarding radiotherapy, the treatment strategy changed in 51 of them (31.9%).</div></div><div><h3>Conclusions</h3><div>Our analysis shows significant discrepancies between the radiology and locoregional evaluations from both before and after the MDTB meetings. Our results highlight that the discussions of a MDTB can considerably change the management of CRC, maximizing the treatment strategy.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 231-238"},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076509","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":"Aflibercept-Based and Bevacizumab-Based Second Line Regimens in Patients with Metastatic Colorectal Cancer: Propensity Score Weighted-Analysis from a Multicenter Cohort","authors":"Jessica Lucchetti ,&nbsp;Lorenzo Angotti ,&nbsp;Alessandro Parisi ,&nbsp;Michele Basso ,&nbsp;Mariam Grazia Polito ,&nbsp;Federica Zoratto ,&nbsp;Emanuela Di Giacomo ,&nbsp;Daniele Nitti ,&nbsp;Alessandro Minelli ,&nbsp;Lisa Salvatore ,&nbsp;Maria Alessandra Calegari ,&nbsp;Federica Lo Prinzi ,&nbsp;Donatello Gemma ,&nbsp;Carlo Signorelli ,&nbsp;Margherita Veroli ,&nbsp;Annunziato Anghelone ,&nbsp;Luca Galbato Muscio ,&nbsp;Barbara Di Cocco ,&nbsp;Giorgio Trombetta ,&nbsp;Cristina Morelli ,&nbsp;Giuseppe Tonini","doi":"10.1016/j.clcc.2024.12.007","DOIUrl":"10.1016/j.clcc.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Both aflibercept and bevacizumab-based regimens are available II-line treatment options for patients with metastatic colorectal cancer (mCRC). However, no head-to-head trials established the optimal anti-angiogenic strategy for this setting.</div></div><div><h3>Methods</h3><div>We launched a multicenter, retrospective, observational study to assess and compare clinical efficacy of II-line treatments for patients with mCRC. Patients with <em>KRAS/NRAS/BRAF</em>-wild type and <em>KRAS/NRAS</em> mutant tumors were also analyzed separately.</div></div><div><h3>Findings</h3><div>348 patients were included, of whom 153 and 195 were treated with bevacizumab- and aflibercept-based regimens, respectively. Patients treated with aflibercept showed an increased risk of death (corrected [co]-HR 1.92, 95 %CI: 1.37–2.68), of disease progression/death (co-HR 1.43, 95 %CI: 1.12–1.82) and a decreased objective response rate (ORR) (21.5 % vs 34.7 %, p=0.007) in comparison to bevacizumab. Patients treated with II-line bevacizumab were more frequently treated in the third line setting after disease progression (91.1 % vs 68.5 %, p&lt;0.0001). In the <em>KRAS/NRAS</em> mutant cohort, treatment with bevacizumab was associated with longer overall survival (OS) (18.0 months vs 12.5 months, p=0.0069), but similar progression free survival (PFS) (p=0.32) and ORR (p=0.57). In the <em>KRAS/NRAS, BRAF</em> wild type cohort, patients treated with bevacizumab achieved longer OS (20.2 months vs 10.6 months, p=0.013), PFS (8.4 months vs 3.7 months, p=0.0002), and higher ORR (48.6 % vs 15.0 %, p=0.0016), compared to those treated with aflibercept. The results were independently confirmed with inverse probability of treatment weighting and with fixed multivariable Cox-regressions.</div></div><div><h3>Conclusion</h3><div>These findings support the use of bevacizumab-based over aflibercept-based regimens as II-line treatment in mCRC, especially in <em>KRAS/NRAS</em> and <em>BRAF</em> wild type tumors.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 207-217.e5"},"PeriodicalIF":3.3,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044044","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":"Multidisciplinary Team Meeting Significantly Enhances Disease-Free Survival in Stage II-III Rectal Cancer","authors":"Wenheng Jiang ,&nbsp;Xue Dou ,&nbsp;Nan Zhang ,&nbsp;Jinming Yu ,&nbsp;Lei Zhao ,&nbsp;Jinbo Yue","doi":"10.1016/j.clcc.2024.12.006","DOIUrl":"10.1016/j.clcc.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary team (MDT) meetings have been increasingly recognized for enhancing cancer treatment outcomes; however, their specific impact on stage II-III rectal cancer remains to be fully elucidated.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study investigated the influence of MDT meeting on disease-free survival (DFS) and overall survival (OS) in patients with stage II-III rectal cancer. Propensity score matching (PSM) was used to minimize selection bias. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare DFS and OS between groups.</div></div><div><h3>Results</h3><div>A total of 502 patients were included, with 176 whose cases were discussed in MDT meetings and 326 who did not undergo MDT discussions. After PSM, 173 patients were matched in each group. The MDT group exhibited a significantly improved DFS compared to the non-MDT group, both before PSM (HR = 0.618, <em>P</em> = .037) and after PSM (HR = 0.545, <em>P</em> = .012). Subgroup analysis indicated notable benefits of MDT discussions for patients with T3 to 4 tumors, low to mid tumor locations, and node-positive tumors. While there was a trend towards improved OS in the MDT group, this did not reach statistical significance. More MDT group patients received MRI staging and neoadjuvant therapy compared to non-MDT group.</div></div><div><h3>Conclusions</h3><div>Discussion in MDT meetings is associated with improved DFS in stage II-III rectal cancer, particularly among patients with locally advanced, low to mid rectal cancer. These findings underscore the importance of incorporating MDT discussions into routine clinical practice to optimize outcomes for rectal cancer patients.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 198-206.e5"},"PeriodicalIF":3.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018322","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":"SATB2 Expression Affects Chemotherapy Metabolism and Immune Checkpoint Gene Expression in Colorectal Cancer","authors":"Barry Maguire ,&nbsp;Batuhan Kisakol ,&nbsp;Jochen H.M. Prehn ,&nbsp;John P. Burke","doi":"10.1016/j.clcc.2024.12.004","DOIUrl":"10.1016/j.clcc.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Special AT-rich binding protein-2 (SATB2) is a nuclear matrix associated protein regulating gene expression which is normally expressed in colonic tissue. Loss of SATB2 expression in colorectal cancer (CRC) has negative implications for prognosis and has been associated with chemotherapy resistance. Furthermore, recent evidence suggests SATB2 may influence immune checkpoint (IC) expression. We hypothesized that SATB2 expression may be associated with altered expression of chemotherapy resistance associated and IC genes.</div></div><div><h3>Methods</h3><div>Clinicopathologic and gene expression data were extracted from The Cancer Genome Atlas PanCancer Atlas. SATB2 expression was compared by clinicopathologic characteristic and by using multivariate regression analysis to explore associations with chemotherapy and IC gene expression.</div></div><div><h3>Results</h3><div>About 553 patients were included for analysis. Lower quartile SATB2 expression was associated with worse disease specific survival (<em>P</em> = .04). MSI (<em>P</em> &lt; .001) and mucinous (<em>P</em> &lt; .001) tumors were associated with reduced SATB2 expression independently. SATB2 varied by consensus molecular subtype (<em>P</em> &lt; .001) and was lowest in CMS1. On multivariate analysis, SATB2 was negatively associated with 5-FU related metabolism genes, while more complex but significant relationships were seen with oxaliplatin and irinotecan related genes. Low SATB2 expression was associated with increased expression of PD-1, PD-L1, TIM-3 and CTLA-4 IC genes.</div></div><div><h3>Conclusion</h3><div>The positive prognostic influence of SATB2 expression is reaffirmed in this study. This effect may be explained by the negative association between SATB2 and 5-FU-resistance related gene expression. Enhanced IC gene expression in SATB2 low cases suggests a potential role for IC inhibition in this setting, but further study is required.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 129-134.e7"},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967478","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":"Organ Preservation After Immune Checkpoint Inhibition for Locally Advanced Rectal Cancer","authors":"Charlotte Claeys ,&nbsp;Antoon Billiet ,&nbsp;Karin Haustermans ,&nbsp;Albert Wolthuis ,&nbsp;Gabriele Bislenghi ,&nbsp;André D'Hoore ,&nbsp;Raphaëla Dresen ,&nbsp;Gertjan Rasschaert ,&nbsp;Eric Van Cutsem ,&nbsp;Filip Van Herpe ,&nbsp;Jeroen Dekervel","doi":"10.1016/j.clcc.2024.12.005","DOIUrl":"10.1016/j.clcc.2024.12.005","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Immune checkpoint inhibition (ICI) targeting PD-1 (programmed cell death protein 1) is the standard treatment for metastatic microsatellite instable (MSI-H)/mismatch repair deficient (dMMR) colorectal cancer, producing long-lasting responses. Emerging evidence suggests an important role for neoadjuvant ICI in local and locoregional disease, especially in anatomical regions associated with high surgical morbidity.</div></span></li><li><span>•</span><span><div>We report single-center data of the clinical course and outcome of 6 eligible patients with dMMR locally advanced rectal cancer (LARC) treated with off-label ICI as part of their initial treatment.</div></span></li><li><span>•</span><span><div>Meaningful clinical responses were noted in all evaluable patients. Four patients had a complete clinical response, followed by active surveillance. Two patients had a partial response and underwent surgery. After a median follow-up of 25.8 months, no local or distant recurrences were noted.</div></span></li><li><span>•</span><span><div>The role of immunotherapy in dMMR LARC is promising, although more prospective clinical trials with a longer follow-up are required.</div></span></li></ul></div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 320-324"},"PeriodicalIF":3.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967367","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":"AGITG MONARCC: A Randomized Phase 2 Study of Panitumumab Monotherapy and Panitumumab Plus 5-Fluorouracil as First-Line Therapy for Older Patients With RAS and BRAF Wild Type Metastatic Colorectal Cancer. A Study by the Australasian Gastro-Intestinal Trials Group (AGITG)","authors":"Matthew E. Burge ,&nbsp;David Espinoza ,&nbsp;Katrin Marie Sjoquist ,&nbsp;Derrick Ho Siu ,&nbsp;Rebecca Mercieca-Bebber ,&nbsp;Lorraine A. Chantrill ,&nbsp;Christos Stelios Karapetis ,&nbsp;Christopher B. Steer ,&nbsp;Sonia Yip ,&nbsp;Jeff Cuff ,&nbsp;Stephanie Winata ,&nbsp;Jeanne Tie ,&nbsp;Darshit Arunbhai Thaker ,&nbsp;Ratnesh Srivastav ,&nbsp;Ehtesham Abdi ,&nbsp;Andrew Strickland ,&nbsp;Eva Segelov ,&nbsp;Alessandra Francesconi ,&nbsp;Timothy Price ,&nbsp;Rahul Ladwa ,&nbsp;Niall C. Tebbutt","doi":"10.1016/j.clcc.2024.11.003","DOIUrl":"10.1016/j.clcc.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Panitumumab (pan) plus chemotherapy is a preferred first-line therapy for unresectable RAS and BRAF wild type metastatic colorectal cancer (mCRC). Older patients may not be suitable for combination regimens. We investigated 2 lower intensity pan-containing regimens.</div></div><div><h3>Methods</h3><div>Prospective, noncomparative, randomized (1:1) phase 2 study of pan alone (Arm A) or pan plus FU (Arm B). Previously untreated mCRC were ≥70 years; RAS/BRAF wild type. Primary endpoint: 6-month progression-free survival (PFS). Secondary endpoints included: overall survival (OS), response rate (RR), feasibility of geriatric assessments and overall treatment utility (OTU)—a composite measure based on radiological response, clinical progress, toxicity and patient-reported treatment worth. Planned sample size was 40 patients per arm.</div></div><div><h3>Results</h3><div>36 patients (Arm A n <em>=</em> 19, Arm B n <em>=</em> 17) were randomized between June 2018 and June 2021. Median age was 79 and 80 years respectively. 6-month PFS 63% (95% CI 38%-80%) arm A 82% (95%CI 55%-94%) Arm B. Median OS 21 months Arm A (95%CI 13-31) 28 (95%CI 14-39) months Arm B. RR 47% and 65% Arms A and B respectively. Baseline comprehensive geriatric assessments were completed in &gt;80% of patients. At week 16, OTU was categorized as good in 92% (Arm A) and 90% (Arm B). No unexpected adverse events were seen.</div></div><div><h3>Conclusions</h3><div>Six-month PFS in both arms was consistent with that achieved with FU/bev, whilst the rate was numerically higher for Arm B. Baseline comprehensive geriatric assessments were feasible and OTU was high. Both treatment arms might be suitable in appropriately selected patients.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 120-128"},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960182","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":"Oncological Outcomes From Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colorectal Cancer Peritoneal Metastases","authors":"Nadina Tinsley ,&nbsp;Sarah T. O'Dwyer ,&nbsp;Raghavendar Nagaraju ,&nbsp;Michael Braun ,&nbsp;Saifee Mullamitha ,&nbsp;Konstantinos Kamposioras ,&nbsp;F.E. Marti Marti ,&nbsp;Mark Saunders ,&nbsp;Hamish Clouston ,&nbsp;Chelliah Selvasekar ,&nbsp;Jonathan Wild ,&nbsp;Malcolm Wilson ,&nbsp;Andrew Renehan ,&nbsp;Omer Aziz ,&nbsp;Jorge Barriuso","doi":"10.1016/j.clcc.2024.12.001","DOIUrl":"10.1016/j.clcc.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Cytoreductive surgery (CRS) is effective for colorectal cancer peritoneal metastases (CRPM) at increasing overall survival (OS) compared to systemic anticancer treatment (SACT) alone. The addition of Oxaliplatin heated intraperitoneal chemotherapy (HIPEC) has been shown in a randomized controlled trial to result in increased complications without significant OS benefit. This study evaluates outcomes for CRPM patients undergoing CRS+HIPEC with Oxaliplatin (Ox) 368mg/m² (30 min), versus Mitomycin C (MMC) 35mg/m² (90min). </div></div><div><h3>Methods</h3><div>A prospective CRPM real-world database was used to collect outcomes for patients undergoing CRS+HIPEC at a single center. OS, recurrence-free (RFS), peritoneal RFS (PeRFS) were compared amongst all patients with histologically proven CRPM, those with completeness of cytoreduction (CC) score =0/1, and those with CC score=0/1 who were SACT naïve. </div></div><div><h3>Results</h3><div>Between April 2005 and April 2021, 409 patients underwent CRS+HIPEC: 271 (66%) had MMC, 138 (34%) Ox. Of these, 395 (97%) had histologically confirmed CRPM, 336 (85%) achieved CC=0/1, 188 (47%) were SACT naïve; median OS =39.5, 44.4, and 47.2 months respectively. MMC versus Ox median OS in CC0/1=43.7 (95% CI 35.9-48.3) versus 50.1 (39.7-70.2) months, <em>P = .</em>28; Median OS in SACT naïve=45.7 (39.4-65.9) versus 59.9 (38.3-82.0) months, <em>P = .</em>31; multivariable analysis for CC0/1, SACT naïve patients showed Ox was comparable to MMC: HR=0.90, (0.64-1.27) <em>P = .</em>55 versus HR=0.88, (0.53-1.44) <em>P = .</em>60, respectively. Ox resulted in a significantly improved PeRFS in CC0/1 patients (MMC=9.0 versus Ox=12.6months, <em>P = .</em>01). A multivariable model for PeRFS showed a HR=0.63, (0.43-0.95), <em>P = .</em>03 for Ox. </div></div><div><h3>Conclusion</h3><div>This study suggests a role for Ox HIPEC in CRPM which should be explored further in clinical trials.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 166-179"},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973824","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":"Impact of Treatment With Trifluridine/Tipiracil in Combination With Bevacizumab on Health-Related Quality of Life and Performance Status in Refractory Metastatic Colorectal Cancer: An Analysis of the Phase III SUNLIGHT Trial","authors":"Julien Taieb ,&nbsp;Marwan Fakih ,&nbsp;Josep Tabernero ,&nbsp;Fortunato Ciardiello ,&nbsp;Eric Van Cutsem ,&nbsp;Gemma Soler ,&nbsp;Elizabeth Calleja ,&nbsp;Valentine Barboux ,&nbsp;Lucas Roby ,&nbsp;Nadia Amellal ,&nbsp;Gerald W. Prager","doi":"10.1016/j.clcc.2024.12.002","DOIUrl":"10.1016/j.clcc.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of trifluridine/tipiracil (FTD/TPI) + bevacizumab compared to FTD/TPI for treatment of refractory metastatic colorectal cancer (mCRC) was demonstrated in the SUNLIGHT trial. This analysis of SUNLIGHT investigated the impact of treatment with FTD/TPI + bevacizumab on patient quality of life (QoL) and Eastern Cooperative Oncology Group performance status (ECOG PS).</div></div><div><h3>Methods</h3><div>Questionnaires (EORTC QLQ-C30 and EQ-5D-5L) and ECOG PS assessments were conducted at baseline and on Day 1 of each treatment cycle. Time to definitive deterioration (TTDD) of QoL and time to ECOG PS worsening between treatment arms was assessed. A repeated-measures mixed-effects model was used to compare changes in QoL and ECOG PS from baseline. Kaplan–Meier and Cox regression methods were used to assess TTDD of QoL, time to ECOG PS worsening to ≥ 2, and overall survival (OS) and progression-free survival (PFS) in patients maintaining an ECOG PS of 0-1.</div></div><div><h3>Results</h3><div>Both treatment arms showed similar QoL scores from baseline to cycle 6, with no clinically relevant change over time. Patients receiving FTD/TPI + bevacizumab had a longer TTDD of QoL than patients receiving FTD/TPI, as well as longer time to ECOG PS worsening. In patients with maintained ECOG PS, median OS and PFS was prolonged in the FTD/TPI + bevacizumab arm compared to the FTD/TPI arm.</div></div><div><h3>Conclusion</h3><div>This analysis of SUNLIGHT showed that patients treated with FTD/TPI + bevacizumab had no clinically relevant changes in QoL, and prolonged TTDD and time to ECOG PS worsening, compared to patients treated with FTD/TPI.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 180-187.e4"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018319","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}