Clinical colorectal cancer最新文献

{"title":"Bowel Stenosis Following Immunotherapy in dMMR Colorectal Cancer: A Case Series","authors":"Ahmad Gebai ,&nbsp;Francine Aubin ,&nbsp;Martin Borduas ,&nbsp;Rasmy Loungnarath ,&nbsp;Frédéric Mercier ,&nbsp;Florence Perrault ,&nbsp;Frederic Lemay","doi":"10.1016/j.clcc.2025.12.002","DOIUrl":"10.1016/j.clcc.2025.12.002","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>The use of immune checkpoint inhibitors in the treatment of deficient mismatch repair (dMMR) colorectal cancers (CRC) has become standard in the metastatic setting and is emerging in the perioperative setting of locally advanced CRCs.</div></span></li><li><span>•</span><span><div>This article presents a case series of 5 patients who developed bowel stenosis following immunotherapy for metastatic or locally advanced colon cancers, an emerging and rare complication of immunotherapy.</div></span></li><li><span>•</span><span><div>Awareness of this complication should prompt a low threshold for imaging or endoscopic evaluation when immunotherapy-treated dMMR CRC patients complain of occlusive or subocclusive symptoms. Further studies are needed to identify potential risk factors leading to this complication and to establish monitoring guidelines of these patients.</div></span></li></ul></div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 291-296"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133779","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":"AZUR-4, a Phase 2, Open Label, Randomized Study of Neoadjuvant Dostarlimab Plus CAPEOX Versus CAPEOX in Previously Untreated T4N0 or Stage III Mismatch Repair Proficient/Microsatellite Stable Resectable Colon Cancer","authors":"Gertjan Rasschaert ,&nbsp;Allyson M. Peddle ,&nbsp;Sara Verbandt ,&nbsp;Sabine Tejpar ,&nbsp;Nicholas P. West ,&nbsp;Jenny Ross ,&nbsp;Julie Switzky ,&nbsp;Morad Marco Balas ,&nbsp;Ken Edwards ,&nbsp;Gabor Kari ,&nbsp;Sue Griffin ,&nbsp;Daniel N. Cohen ,&nbsp;Emily Hammatt ,&nbsp;Edmund K. Moon","doi":"10.1016/j.clcc.2026.03.001","DOIUrl":"10.1016/j.clcc.2026.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Recent evidence has suggested that neoadjuvant chemotherapy may provide clinical benefit for patients with locally advanced colon cancer. Immunotherapy may provide additive or synergistic effects when combined with chemotherapy. This study’s objective is to assess the efficacy, safety, and tolerability of neoadjuvant dostarlimab in combination with capecitabine-oxaliplatin (CAPEOX) versus CAPEOX in patients with T4N0 or stage III mismatch repair proficient/microsatellite stable (pMMR/MSS) resectable colon cancer.</div></div><div><h3>Methods</h3><div>AZUR-4 (NCT06567782) is a multicenter, phase 2, open-label, randomized (3:1 ratio) study of 120 patients across multiple countries. Eligible patients are aged ≥ 18 years with resectable pMMR/MSS colon adenocarcinoma with no prior treatment. Four cycles (21 days) of CAPEOX ± dostarlimab will be administered as neoadjuvant treatment. After completing neoadjuvant treatment, patients will undergo surgery 3 to 6 weeks later, with additional adjuvant chemotherapy administered after surgery at the investigator’s discretion; no additional dostarlimab will be administered. Primary endpoints are major pathological response, determined by local assessment, and safety. Secondary endpoints will assess the feasibility and pathological response to the regimen. Exploratory endpoints include biomarker readouts and pathological response rate in biomarker subsets.</div></div><div><h3>Conclusions</h3><div>AZUR-4 will evaluate the effect of neoadjuvant dostarlimab + CAPEOX in patients with previously untreated T4N0 or stage III pMMR/MSS resectable colon cancer, a population for whom improved treatments are urgently needed. The robust sampling and advanced analysis of pretreatment and posttreatment blood, tissue, and tumor samples planned for this trial should assist in elucidating immune profile analyses to support the discovery of novel predictive biomarkers in this population.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 302-307.e3"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202448","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":"Phase II Study of Pembrolizumab Plus Capecitabine and Bevacizumab for Microsatellite Stable/Mismatch Repair-Proficient Metastatic Colorectal Cancer","authors":"Andrea Bocobo ,&nbsp;Julia Whitman ,&nbsp;Bridget P. Keenan ,&nbsp;Kelvin L. Koser ,&nbsp;Wesley A. Kidder ,&nbsp;Sorbarikor Piawah ,&nbsp;Katherine Van Loon ,&nbsp;Spencer C. Behr ,&nbsp;K. Pallav Kolli ,&nbsp;Xiaoying Chen ,&nbsp;Courtney Onodera ,&nbsp;Manjusha Pande ,&nbsp;Marin Pollak ,&nbsp;Renee Wang ,&nbsp;Joel Babdor ,&nbsp;Matthew H. Spitzer ,&nbsp;Li Zhang ,&nbsp;Lawrence Fong ,&nbsp;Chloe E. Atreya","doi":"10.1016/j.clcc.2026.02.003","DOIUrl":"10.1016/j.clcc.2026.02.003","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the safety, tolerability and preliminary efficacy of pembrolizumab in combination with capecitabine and bevacizumab in microsatellite stable (MSS) metastatic colorectal cancer (mCRC).</div></div><div><h3>Patients and Methods</h3><div>Patients with MSS/pMMR mCRC with stable or progressive disease on at least 1 prior fluoropyrimidine-based therapy received capecitabine 1000 mg/m² by mouth twice daily days 1 to 14, bevacizumab 7.5 mg/kg day 1, and pembrolizumab 200 mg day 1 every 3 weeks. The primary endpoint was overall response rate by RECIST 1.1. Secondary endpoints were safety, duration of response, progression-free survival (PFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Forty-four patients were enrolled between April 2018 and October 2021. Median follow up time was 9.3 months, while median time on treatment was 6 months. Overall response rate for 40 evaluable patients was 5% with median duration of response of 13.5 months. Median PFS was 4.1 months, and median OS was 10.1 months. Grade ≥ 3 treatment related adverse events occurred in 13 patients (30%); none were classified as immune-related. Grade 1 to 2 immune-related adverse events occurred in 8 patients (18%). Dose modifications occurred in 27 patients (61%), most commonly for palmar-plantar erythrodysesthesia. Single cell RNA sequencing on a subset of tumor biopsies demonstrated that the frequency of dendritic cells and tumor-infiltrating activated T cells correlated with time on treatment.</div></div><div><h3>Conclusions</h3><div>The combination of pembrolizumab with capecitabine and bevacizumab was tolerable with an expected toxicity profile in MSS/pMMR mCRC patients. The overall response rate of 5% did not meet the prespecified target of ≥ 15%; however, 55% patients remained on treatment &gt; 6 months.</div><div>ClinicalTrials.gov Identifier: clinicaltrials.gov: NCT03396926.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 271-282"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461526","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 Role of Systemic Chemotherapy to Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Patients With Appendiceal Cancers","authors":"Gagandeep Brar ,&nbsp;Dani Castillo ,&nbsp;Thinzar Lwin ,&nbsp;Mustafa Raoof ,&nbsp;Pashtoon Kasi ,&nbsp;Marwan Fakih ,&nbsp;S. Peter Wu","doi":"10.1016/j.clcc.2026.01.001","DOIUrl":"10.1016/j.clcc.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Appendiceal cancer frequently presents with peritoneal metastases. Cytoreductive surgery combined (CRS) with heated intraperitoneal chemotherapy (HIPEC) is currently standard practice for metastatic appendiceal cancer, particularly mucinous subtypes. However, the specific benefit of adding standard postoperative systemic chemotherapy, either alone or in addition to HIPEC, remains unclear.</div></div><div><h3>Methods</h3><div>Using the National Cancer Database (NCDB) from 2018 to 2022, we identified 888 patients with appendiceal cancer (goblet cell/composite, signet-ring/diffuse, or adenocarcinoma) characterized by peritoneal metastases. Mucinous subtypes were excluded. All patients underwent cytoreductive surgery, and many underwent primary tumor resection concurrently. Patients were stratified based on initial systemic treatment received: no chemotherapy (<em>n</em> = 181), standard adjuvant chemotherapy (<em>n</em> = 415), perioperative chemotherapy (<em>n</em> = 62), HIPEC with additional systemic therapy (<em>n</em> = 122) or without additional systemic chemotherapy (<em>n</em> = 124). Survival outcomes were compared using Kaplan–Meier analysis and multivariable Cox regression, adjusting for age, sex, Charlson–Deyo comorbidity index and histologic subtype.</div></div><div><h3>Results</h3><div>With a median follow-up of 41 months, the 3-year overall survival was 20.2% for no chemotherapy, 25.3% for adjuvant chemotherapy, 39.3% for perioperative chemotherapy, and 58.4% for HIPEC without additional systemic therapy and 46.3% for HIPEC with additional systemic therapy. Compared to surgery alone, standard adjuvant chemotherapy reduced mortality risk by approximately 20% (HR 0.80; 95% CI, 0.60-1.07; <em>P</em> = .13), and HIPEC-based therapy reduced mortality risk by approximately 43% (HR 0.57; 95% CI, 0.40-0.81; <em>P</em> = .002), regardless of whether additional systemic therapy was received. Neither age, sex, nor specific histologic subtype independently influenced survival. A higher comorbidity burden (Charlson–Deyo ≥ 2) trended towards worse survival (HR 1.81; <em>P</em> = .05).</div></div><div><h3>Conclusions</h3><div>While prior literature suggests a role of systemic therapy in addition to cytoreductive surgery and HIPEC in treating peritoneal metastases from appendiceal cancers, our findings demonstrate that additional systemic chemotherapy, whether standard adjuvant or perioperative, is not associated with significantly improved survival outcomes compared to surgery and HIPEC alone. These results do not support the routine consideration of postoperative or perioperative systemic therapy for all patients undergoing cytoreductive surgery and HIPEC, irrespective of histologic subtype.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 209-215"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196273","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":"Phase Ib Study to Assess the Safety of Neoadjuvant Trifluridine/Tipiracil With Concurrent Radiation in Resectable Stage II/III Rectal Cancer: The FIERCE Study","authors":"Emerson Y. Chen ,&nbsp;Nima Nabavizadeh ,&nbsp;Nicholas D. Kendsersky ,&nbsp;Christopher Lessenich ,&nbsp;Daniel O. Herzig ,&nbsp;Elena Korngold ,&nbsp;Shaun M. Goodyear ,&nbsp;Hagen F. Kennecke ,&nbsp;Adel Kardosh ,&nbsp;Vassiliki Liana Tsikitis ,&nbsp;Kim C. Lu ,&nbsp;Sandy Fang ,&nbsp;Melissa Wong ,&nbsp;Guillaume Joe Pegna ,&nbsp;Flavio G. Rocha ,&nbsp;Skye C. Mayo ,&nbsp;Brian Brinkerhoff ,&nbsp;Erin Taber ,&nbsp;Brindha Rajagopalan ,&nbsp;Byung S. Park ,&nbsp;Charles D. Lopez","doi":"10.1016/j.clcc.2026.02.001","DOIUrl":"10.1016/j.clcc.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Trifluridine has demonstrated superior radio-sensitizing ability in vitro, and trifluridine/tipiracil (FTD/TPI) confers clinical benefit in metastatic colorectal cancer. The FIERCE trial (NCT04104139) sought to assess the safety of FTD/TPI as total neoadjuvant therapy (TNT) for rectal cancer.</div></div><div><h3>Methods</h3><div>Patients with stage II/III rectal adenocarcinoma at a single institution underwent chemo-radiation with FTD/TPI followed by oxaliplatin-based chemotherapy for 4 months. FTD/TPI was examined in cohorts of 3 patients at 3 dose levels (25 mg/m², 30 mg/m², and 35 mg/m²) until 18 were reached per Bayesian Optimal Interval design (BOIN). FTD/TPI was taken orally twice-daily for 5 days/week on weeks 1, 3, and 5 of radiation. Dose-limiting toxicity (DLT) was defined by relevant adverse events related to FTD/TPI. The primary endpoint was the proportion of DLT during chemo-radiation.</div></div><div><h3>Results</h3><div>Eighteen of 22 screened patients were evaluable after completing TNT. All patients had proficient mismatch repair and staged as cT3, of which 8 (44%) were node-negative and 10 (56%) were node-positive. Grade 3 neutropenia was observed in 4 (22%) patients during chemo-radiation, with 1 DLT occurring at 25 mg/m² and 1 at 35 mg/m². Using isotonic estimate of observed toxicity probability, the maximum tolerated dose of FTD/TPI was 35 mg/m² (PO, BID). At data cutoff, 10 (56%) patients entered into watch-and-wait surveillance, with 9 (50%) achieving clinical complete response.</div></div><div><h3>Conclusion</h3><div>FTD/TPI at 35 mg/m² on days 1 to 5, 15 to 19, and 29 to 33, is safe and feasible with concurrent radiation as TNT for rectal cancer and should be further studied to evaluate promising efficacy signal including organ preservation.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 249-257.e2"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358138","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":"Late-line Systemic Therapy in Metastatic Colorectal Cancer: A Narrative Review and Australian Expert Perspective","authors":"Matthew Burge ,&nbsp;Jeanne Tie ,&nbsp;Tharani Krishnan ,&nbsp;Amitesh Roy ,&nbsp;Lorraine Chantrill ,&nbsp;Niall C. Tebbutt ,&nbsp;Christos S. Karapetis ,&nbsp;Timothy Price","doi":"10.1016/j.clcc.2026.04.001","DOIUrl":"10.1016/j.clcc.2026.04.001","url":null,"abstract":"<div><div>Metastatic colorectal cancer (mCRC) remains a major clinical challenge, particularly for patients with disease progression after multiple lines of therapy. Advances in molecular profiling have transformed the therapeutic landscape, enabling personalized treatment selection and expanding third- and later-line options. Targeted therapies such as <em>BRAF</em> inhibitors, anti-HER2 agents, and <em>KRAS</em>^G12C inhibitors are utilized in patients whose tumors harbor specific molecular alterations, with their use increasingly being explored across various lines of therapy. Agents such as trifluridine/tipiracil, regorafenib, and fruquintinib offer additional benefit in heavily pretreated mCRC. The integration of broad molecular testing, including emerging rare biomarkers, further supports individualized management. Despite these developments, prognosis in late-line mCRC remains poor, underscoring the need for ongoing research and clinical trial participation. This review summarizes contemporary evidence supporting third- and later-line therapies, highlights key clinical trial data, and discusses practical considerations in treatment sequencing. Potential treatment algorithms designed to aid clinicians in the selection and sequencing of therapies for refractory mCRC are also proposed. Anticipated paradigm shifts with novel agents may further refine management strategies and improve outcomes for these patients. As the landscape evolves, ongoing multidisciplinary collaboration will be essential in optimizing both patient selection and therapy sequencing as new options become available.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 191-208"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936310","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":"Brain Metastasis From Anal Canal Squamous Cell Carcinoma: A Rare Case Report and Systematic Review","authors":"Miriam Tomaciello ,&nbsp;Mauro Palmieri ,&nbsp;Massimo Corsini ,&nbsp;Carolina Gentili ,&nbsp;Elisa Vitti ,&nbsp;Alessandro Al Giabri ,&nbsp;Francesca De Felice ,&nbsp;Franco Iafrate ,&nbsp;Cira Di Gioia ,&nbsp;Gabriele Di Bari-Bruno ,&nbsp;Luigi Valentino Berra ,&nbsp;Lucy Zaccaro ,&nbsp;Michelangelo Miccini ,&nbsp;Vincenzo Picone ,&nbsp;Antonio Santoro ,&nbsp;Giuseppe Minniti ,&nbsp;Alessandro Frati","doi":"10.1016/j.clcc.2026.01.005","DOIUrl":"10.1016/j.clcc.2026.01.005","url":null,"abstract":"<div><div>Anal canal squamous cell carcinoma (ACSCC) is a rare malignancy, accounting for approximately 2% of all colorectal cancers. Brain metastases originating from this primary site are exceedingly uncommon and scarcely documented. The aim of this study is to review the literature-reported cases of brain metastases from ACSCC and to supplement this analysis with the description of a clinical case. A systematic review of the literature was conducted in accordance with PRISMA guidelines to identify published cases of brain metastases from ACSCC. The clinical and therapeutic features of these cases were analyzed. In addition, we present a rare case of a 74-year-old woman with a primary diagnosis of HPV-negative ACSCC with an isolated brain metastasis occurring 20 months after completion of definitive chemoradiotherapy. She underwent craniotomy with gross total resection of the mass and adjuvant stereotactic radiotherapy to the tumor bed. Overall, 4 papers were included. Prognosis following cerebral dissemination is generally poor, ranged from 3 months to 8 years. Management is predominantly palliative, with the goal of symptom relief. But recent advances in therapeutic strategies are contributing to improved long-term survival in these patients. Concerning our case report, a personalized approach was adopted. Six months after neurosurgery and adjuvant stereotactic radiotherapy, the patient was in good general condition with no new or progressive neurological symptoms, indicating effective control of cerebral disease. The patient is currently alive and receiving active treatment. This systematic review highlights the importance of prompt brain metastasis diagnosis and of a multimodal treatment approach––including surgery, radiotherapy and systemic therapy––to significantly enhance both prognosis and quality of life in affected patients. Clarifying biological pathways is essential for developing targeted therapies and advancing precision oncology in ACSCC. A multinational approach could help address this issue and potentially determine if treatment intensification is necessary.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 173-180"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222298","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":"Successful Encorafenib and Cetuximab Re-Challenge Combined With Nivolumab in BRAF V600E Mutated, Mismatch-Repair-Proficient Metastatic Colorectal Cancer – A Case Report From the AGMT mCRC Registry","authors":"Iason Theodorou ,&nbsp;Ronald Heregger ,&nbsp;Richard Greil ,&nbsp;Lukas Weiss ,&nbsp;Florian Huemer","doi":"10.1016/j.clcc.2026.01.004","DOIUrl":"10.1016/j.clcc.2026.01.004","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>BRAF V600E mutated, MSS mCRC often proves refractory to palliative chemotherapy.</div></span></li><li><span>•</span><span><div>Re-challenge with encorafenib + cetuximab may be a therapeutic option in BRAF V600E mutated, MSS mCRC.</div></span></li><li><span>•</span><span><div>The effect of the addition of nivolumab to encorafenib and cetuximab re-challenge necessitates further investigation.</div></span></li></ul></div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 297-301"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198395","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":"Trends and Disparities in the Receipt of Treatment for Colon Cancer in Older Adults in Alberta, Canada","authors":"Abisola A. Adegbulugbe ,&nbsp;Philip Q. Ding ,&nbsp;Chantelle Carbonell ,&nbsp;Dylan E. O’Sullivan ,&nbsp;Winson Y. Cheung","doi":"10.1016/j.clcc.2025.09.006","DOIUrl":"10.1016/j.clcc.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Adults aged ≥ 70 years represent approximately half of all patients diagnosed with colon cancer, but undertreatment in this population persists. Recent guidelines have aimed to reduce age-related biases in the treatment of colon cancer. We evaluated the age-related disparities in the receipt of curative-intent surgical and medical treatment of colon cancer, and their changes over time.</div></div><div><h3>Methods</h3><div>This was a population-based cohort study of adult patients diagnosed with colon adenocarcinoma between 2010 and 2018 in Alberta, Canada. Surgery receipt was assessed in patients with stage I-III disease, while systemic therapy receipt was assessed in stage III to IV disease. Patients were stratified by age at diagnosis (&lt; 70 and ≥ 70 years). Cox proportional hazard models were used to evaluate interactions between age and treatment status, and their associations with cancer-specific survival (CSS). Time trends associated with treatment receipt were identified with multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the 10,838 patients included, 48% were aged ≥ 70 years. For surgery recipients, 5-year CSS was 0.90 (95% CI, 0.88-0.91) and 0.79 (95% CI, 0.77-0.80) for patients &lt; 70 and patients ≥ 70 years of age respectively. Systemic therapy recipients aged &lt; 70 years had a 5-year CSS of 0.57 (95% CI, 0.55-0.60), while individuals aged ≥ 70 years had a 5-year CSS of 0.51 (95% CI, 0.49-0.55). The association between treatment receipt and CSS was independent of age for both treatment modalities (<em>P</em> = .17). Treatment receipt trends remained consistent between 2010 and 2018.</div></div><div><h3>Conclusion</h3><div>Despite evolving practice guidelines and non-age-dependent survival benefits, disparities persist in the receipt of treatment for older adults with colon adenocarcinoma.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 33-42"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423664","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":"Does Tumor Sidedness Matter After Curative Surgery in Colorectal Cancer? A Retrospective Cohort Study on Recurrence Patterns and Post Recurrence Survival","authors":"Fernando Mendoza-Moreno ,&nbsp;Manuel Díez-Alonso ,&nbsp;Belén Matías-García ,&nbsp;Enrique Ovejero-Merino ,&nbsp;Héctor Aguado López ,&nbsp;Cristina Vera-Mansilla ,&nbsp;Lucía Diego-García ,&nbsp;Beatriz Castro-Catalán ,&nbsp;Alberto Vilar-Tabanera ,&nbsp;Rubén Jiménez-Martín ,&nbsp;Raúl Díaz-Pedrero ,&nbsp;Miguel A. Ortega ,&nbsp;Melchor Alvarez-Mon ,&nbsp;Alberto Gutiérrez-Calvo","doi":"10.1016/j.clcc.2025.10.006","DOIUrl":"10.1016/j.clcc.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic and predictive relevance of primary tumor sideness in colorectal cancer (CRC) has garnered growing interest. While clinical and molecular differences between right-sided (RS), left-sided (LS) and rectal (RT) tumors are well established in metastatic disease, their impact in non-metastatic, surgically treated patients remains less clear. This study aims to evaluate whether tumor location influences recurrence patterns and post-recurrence survival (PRS) following curative-intent resection for CRC. Patients and Methods We conducted a retrospective cohort study including 1,425 patients with histologically confirmed stage I-III colorectal adenocarcinoma who underwent R0 resection.</div></div><div><h3>Results</h3><div>Tumor recurrence was observed in 22.4% of patients. However, recurrence site differed significantly by tumor location: RS tumors were more likely to develop peritoneal metastases (9.5% vs. 6.6% LS and 5.3% RT; p=0.044), whereas RT tumors had a higher incidence of pulmonary metastases (12.4% vs. 6.3% RS and 7.4% LS; p=0.004). PRS differed markedly: 36-month PRS was 21% for RS, 41% for LS, and 32% for RT (p=0.005). Multivariate analysis confirmed primary tumor location as an independent prognostic factor for PRS. RS tumors conferred a significantly higher risk of death post-recurrence compared to LS and RT tumors. Although tumor sidedness does not appear to influence overall recurrence rates after curative resection, it is associated with distinct metastatic patterns and significantly worse post-recurrence outcomes.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need to incorporate tumor location into prognostic stratification and post-surgical surveillance strategies in CRC. Personalized follow-up protocols, based on tumor biology and recurrence risk, may improve long-term outcomes.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 87-96"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552402","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}