Clinical colorectal cancer最新文献

{"title":"Salvage Treatment of Recurrent or Persistent Anal Squamous Cell Carcinoma: The Role of Multi-modality Therapy","authors":"Ethan P. Damron ,&nbsp;Jordan McDonald ,&nbsp;Michael K. Rooney ,&nbsp;Prajnan Das ,&nbsp;Ethan B. Ludmir ,&nbsp;Bruce D. Minsky ,&nbsp;Craig Messick ,&nbsp;George J. Chang ,&nbsp;Van K. Morris ,&nbsp;Emma B. Holliday","doi":"10.1016/j.clcc.2023.12.002","DOIUrl":"10.1016/j.clcc.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><p>The standard treatment for recurrent or persistent anal squamous cell carcinoma is surgical salvage, but disease control and survival are suboptimal.</p></div><div><h3>Patients/Methods</h3><p>Patients treated for recurrent or persistent anal squamous cell carcinoma at our institution from 2002 to 2022 were included. Patients were classified by type of salvage treatment received: surgery alone vs. reirradiation followed by surgery and by whether they received intraoperative radiation at the time of surgery. Clinical and pathologic variables were collected and assessed for association with risk of second local recurrence and death from any cause.</p></div><div><h3>Results</h3><p>Sixty four patients were included; 55(85.9%) were treated with surgery alone and 9 (14.1%) were treated with reirradiation followed by surgery. Median (IQR) follow up from the time of salvage treatment was 40.0 (20.3-68.0) months. The 3-year cumulative incidence of second local recurrence (95% CI) after salvage surgery was 36% (24%-48%); 39% (26%-52%) for patients treated with surgery alone and 15% (0.46%-51%) for patients treated with reirradiation followed by surgery. Factors associated with increased second local recurrence after salvage surgery included a locoregional recurrence, lymphovascular space invasion and positive surgical margins. The 3-year overall survival (95% CI) after salvage surgery was 70% (59%-83%); 68% (7%-56%) after surgery alone and 89% (10.5%-70.6%) after reirradiation followed by surgery. Factors associated with worse overall survival included male sex, a larger recurrent tumor and positive surgical margins.</p></div><div><h3>Conclusions</h3><p>Approximately 60% of patients achieved pelvic control after salvage therapy for recurrent or persistent anal squamous cell carcinoma. Although receipt of reirradiation and intraoperative radiation were not associated with improved second local recurrence or overall survival in our cohort, patients with positive surgical margins and lymphovascular space invasion on surgical pathology had higher rates of pelvic recurrence after salvage surgery and may benefit from escalated salvage therapy.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687733","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":"Cost-Effectiveness of the New Combination Trifluridine/Tipiracil Plus Bevacizumab for the Third-Line Treatment for Metastatic Colorectal Cancer in Italy","authors":"Jacopo Giuliani ,&nbsp;Beatrice Mantoan ,&nbsp;Daniela Mangiola ,&nbsp;Marco Muraro ,&nbsp;Giuseppe Napoli ,&nbsp;Marina Tommasi ,&nbsp;Francesco Fiorica ,&nbsp;Marta Mandarà","doi":"10.1016/j.clcc.2023.10.005","DOIUrl":"10.1016/j.clcc.2023.10.005","url":null,"abstract":"","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489981","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":"Propensity-Score Matched Analysis of Survival Outcomes of Adjuvant Therapy in Stage II-III Signet-Ring Cell Carcinoma of the Colon","authors":"Sameh Hany Emile ,&nbsp;Nir Horesh ,&nbsp;Zoe Garoufalia ,&nbsp;Rachel Gefen ,&nbsp;Victor Strassmann ,&nbsp;Steven D. Wexner","doi":"10.1016/j.clcc.2023.10.006","DOIUrl":"10.1016/j.clcc.2023.10.006","url":null,"abstract":"<div><h3>Background</h3><p><span>Colonic signet ring cell carcinoma (SRCC) is a </span>mucinous adenocarcinoma subtype often associated with poor prognosis. This study assessed the survival benefits of adjuvant therapy after curative resection of stage II-III colonic SRCC.</p></div><div><h3>Methods</h3><p>This was a retrospective analysis of outcomes of adjuvant therapy in colonic SRCC using National Cancer Database (2010-2019) data. Patients who received adjuvant therapy were matched to those who did not use the nearest neighbor propensity-score matching. The primary outcome was 5-year overall survival (OS).</p></div><div><h3>Results</h3><p><span>The unmatched cohort included 3530 patients. Patients who received adjuvant therapy were significantly younger, more often male, and more often had Charlson scores 0-1, left-sided cancers, stage III disease, lymphovascular invasion<span>, and perineural invasion. The matched cohort included 958 patients (53.6% female); 479 received adjuvant therapy and 479 did not. Adjuvant therapy was associated with longer mean OS (39.9 vs. 29.2 months; </span></span><em>P</em> &lt; .001)<strong>.</strong> Survival benefit of adjuvant therapy was evident in stage III disease (37.5 vs. 24.7 months; <em>P</em><span> &lt; .001), right-sided colon cancer (40.2 vs. 27.7 months; </span><em>P</em><span> &lt; .001), and transverse colon cancer (40.6 vs. 31.1 months; </span><em>P</em> = .002), but not stage II disease (52.1 vs. 53.1 months; <em>P</em> = .694) or left-sided colon cancer (35.8 vs. 32.6 months; <em>P</em> = .417). Independent predictors of improved OS were adjuvant therapy (HR: 0.539; <em>P</em><span> &lt; .001), laparoscopic surgery (HR: 0.829; </span><em>P</em> = .001), robotic-assisted surgery (HR: 0.63; <em>P</em> = .007), and number of harvested lymph nodes (HR: 0.976; <em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Adjuvant therapy was associated with improved OS in stage III, right-sided, and transverse colon SRCC. The survival benefit of adjuvant therapy in stage II and left-sided colon SRCC was limited.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136093804","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":"Real-World Safety and Effectiveness of a Bevacizumab Biosimilar (ABP 215) in Metastatic Colorectal Cancer Patients in Canada","authors":"Winson Y. Cheung ,&nbsp;Setareh Samimi ,&nbsp;Kim Ma ,&nbsp;Gregory John Knight ,&nbsp;Shaqil Kassam ,&nbsp;Bruce Colwell ,&nbsp;Annie Beaudoin ,&nbsp;Mark David Vincent ,&nbsp;Mateya Trinkaus ,&nbsp;Alain Filion ,&nbsp;Katerine Marquis ,&nbsp;Hatim Karachiwala ,&nbsp;Timothy Asmis ,&nbsp;Lucas Sideris ,&nbsp;Rajvi J. Wani ,&nbsp;Elaine Ngan ,&nbsp;Naila Inam ,&nbsp;Yinhao Du ,&nbsp;Leyla Nunez ,&nbsp;Maria Eberg ,&nbsp;Carlye Cirone Morris","doi":"10.1016/j.clcc.2023.10.007","DOIUrl":"10.1016/j.clcc.2023.10.007","url":null,"abstract":"<div><h3>Background</h3><p>ABP 215 is a biosimilar to the reference product, bevacizumab, and was one of the first biosimilars approved by Health Canada for the first-line treatment of metastatic colorectal cancer (mCRC). This study aimed to address gaps in real-world evidence (RWE) including patient characteristics, treatment safety (primary objective), and effectiveness (secondary objective) for first-line ABP 215 therapy in Canadian patients with mCRC.</p></div><div><h3>Materials and Methods</h3><p>Retrospective data were collected in 2 waves, at least 1 year (Wave 1) or 2 years (Wave 2) after commercial availability of ABP 215 at each participating site.</p></div><div><h3>Results</h3><p>A total of 75 patients from Wave 1 and 164 patients from Wave 2 treated with a minimum of 1 cycle of ABP 215 were included. At least one safety event of interest (EOI) was recorded for 34.7% of Wave 1 and 42.7% of Wave 2 patients. The median progression free survival (PFS) for Wave 1 and 2 patients were 9.47 (95% confidence interval [CI]: 6.71, 11.90) and 21.38 (95% CI: 15.82, not estimable) months, respectively. Median overall survival was not estimable for Wave 1 and was 26.45 months for Wave 2.</p></div><div><h3>Conclusion</h3><p>The safety and effectiveness of ABP 215 observed in this real-world study were comparable to clinical trial findings and to other RWE with longer PFS in the current study.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1533002823000944/pdfft?md5=c5b19261efb6c944060160487270dab5&pid=1-s2.0-S1533002823000944-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160579","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":"Adjuvant Chemotherapy for Older Patients With Stage III Colorectal Cancer: A Real-World Analysis of Treatment Recommendations, Treatment Administered and Impact on Cancer Recurrence","authors":"Oliver Piercey ,&nbsp;Hui-Li Wong ,&nbsp;Clara Leung ,&nbsp;Yat Hang To ,&nbsp;Valerie Heong ,&nbsp;Margaret Lee ,&nbsp;Jeanne Tie ,&nbsp;Malcolm Steel ,&nbsp;Justin M. Yeung ,&nbsp;Jacob McCormick ,&nbsp;Peter Gibbs ,&nbsp;Rachel Wong","doi":"10.1016/j.clcc.2024.01.001","DOIUrl":"10.1016/j.clcc.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><p><span>A substantial proportion of patients with stage III colorectal cancer (CRC) are older than 70 years. Optimal adjuvant chemotherapy (AC) for older patients (OP) continues to be debated, with subgroup analyses of randomized trials not demonstrating a survival benefit from the addition of </span>oxaliplatin<span><span> to a fluoropyrimidine </span>backbone.</span></p></div><div><h3>Patients and Methods</h3><p>We analyzed the multisite Australian ACCORD registry, which prospectively collects patient, tumor and treatment data along with long term clinical follow-up. We compared OP (≥70) with stage III CRC to younger patients ([YP] &lt;70), including the proportion recommended AC and any reasons for not prescribing AC. AC administration, regimen choice, completion rates, and survival outcomes were also examined.</p></div><div><h3>Results</h3><p>One thousand five hundred twelve patients enrolled in the ACCORD registry from 2005 to 2018 were included. Median follow-up was 57.0 months. Compared to the 827 YP, the 685 OP were less likely to be offered AC (71.5% vs. 96.5%, <em>P</em> &lt; .0001) and when offered, were more likely to decline treatment (15.1% vs. 2.8%, <em>P</em> &lt; .0001). Ultimately, 60.0% of OP and 93.7% of YP received AC (<em>P</em> &lt; .0001). OP were less likely to receive oxaliplatin (27.5% vs. 84.7%, <em>P</em> &lt; .0001) and to complete AC (75.9% vs. 85.7%, <em>P</em> &lt; .0001). The probability of remaining recurrence-free was significantly higher in OP who received AC compared to those not treated (HR 0.73, <em>P</em> = .04) but not significantly improved with the addition of oxaliplatin (HR 0.75, <em>P</em> = .18).</p></div><div><h3>Conclusion</h3><p>OP were less likely than YP to receive AC. Receipt of AC reduced recurrences in OP, supporting its use, although no significant benefit was observed from the addition of oxaliplatin.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139464766","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":"Efficacy of Pyrotinib With/Without Trastuzumab in Treatment-Refractory, HER2-Positive Metastatic Colorectal Cancer: Result From a Prospective Observational Study","authors":"Haojie Zhou ,&nbsp;Minzhi Lv ,&nbsp;Wei Li ,&nbsp;Yan Wang ,&nbsp;Jing Wu ,&nbsp;Qing Liu ,&nbsp;Tianshu Liu ,&nbsp;Yuehong Cui ,&nbsp;Qian Li","doi":"10.1016/j.clcc.2023.10.008","DOIUrl":"10.1016/j.clcc.2023.10.008","url":null,"abstract":"<div><h3>Background</h3><p><span>Human epidermal growth factor<span> receptor 2 (HER2) is a promising therapeutic target in metastatic colorectal cancer (mCRC). This study was to evaluate the efficacy and safety of pyrotinib alone or pyrotinib with </span></span>trastuzumab<span> in patients with HER2-positive mCRC.</span></p></div><div><h3>Patients and Methods</h3><p><span><span>In this prospective observational study, patients with HER2 positive, Ras Sarcoma </span>Viral Oncogene<span> Homolog (RAS) wild type mCRC who received at least one standard treatment of palliative chemotherapy were enrolled. Patients were treated with oral pyrotinib alone or pyrotinib with trastuzumab. The primary endpoint was </span></span>progression free survival (PFS), and the secondary endpoints were overall survival (OS), confirmed objective response rate (ORR), and safety. This trial is registered with chitcr.org, number ChiCTR2100046381.</p></div><div><h3>Results</h3><p>From February 15, 2021, to January 10, 2023, 32 patients were enrolled in this study. Twenty (62.5%) patients were treated with pyrotinib, while 12 (37.5%) received pyrotinib and trastuzumab. As of June 24, 2023, with a median follow-up of 11.0 months, the median PFS was 5.7 months (95%CI 4.5-10.2), while OS was not evaluable (NE), ORR and disease control rate (DCR were 34.4% and 87.5%. Patients’ PFS in the pyrotinib plus trastuzumab subgroup and pyrotinib monotherapy<span> group were 8.6 and 5.5 months, OS was not evaluable (NE) and 10.9 months, ORR was 50.0% and 25.0%, respectively. Most treatment-related adverse events (TRAEs) were grade 1-2, diarrhea was the most frequent TRAE (81.3%, 26/32). Grade 3 TRAEs occurred in 11 patients: 9 for diarrhea, 1 for nausea, and 1 for oral mucositis.</span></p></div><div><h3>Conclusion</h3><p>Pyrotinib with or without trastuzumab showed promising anti-tumor activity and acceptable toxicities in treatment-refractory, HER2-positive mCRC.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138525574","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":"Prognostic Impact of Primary Tumor Sidedness in Stage III Colorectal Cancer: Real-World Evidence from a Brazilian Cohort","authors":"Bruno Medonça Protásio ,&nbsp;Tiago Biachi de Castria ,&nbsp;Renato Natalino ,&nbsp;Flávia R. Mangone ,&nbsp;Daniel Fernandes Saragiotto ,&nbsp;Jorge Sabbaga ,&nbsp;Paulo M. Hoff ,&nbsp;Roger Chammas","doi":"10.1016/j.clcc.2023.12.001","DOIUrl":"10.1016/j.clcc.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Primary tumor sidedness (PTS) is an independent prognostic factor </span>in patients<span> with metastatic colorectal cancer (CRC), with a worse prognosis for right-sided tumors. There are limited data on the prognostic impact of PTS in stage III CRC. The main objective of this study was to analyze the prognostic impact of PTS in stage III CRC.</span></p></div><div><h3>Patients and Methods</h3><p><span><span>A retrospective and uni-institutional cohort study<span> was performed in an oncology reference center. Patients with stage III CRC treated with a 5-fluorouracil and oxaliplatin-based </span></span>chemotherapy regimen (mFLOX regimen) from October 2007 to February 2013 were included. The primary outcome was the probability of overall survival (OS) at 5 years stratified by PTS. Secondary outcomes were the probability of disease-free survival (DFS) at 5 years and an analysis of the prognostic impact of clinical and molecular biomarkers. Kaplan‒Meier curves were used, and </span>Cox models were used to evaluate prognostic factors associated with OS and DFS.</p></div><div><h3>Results</h3><p><span>Overall, 265 patients were evaluated. Transverse colon tumors, multicentric tumors, and undetermined primary subsites were excluded, resulting in 234 patients classified according to PTS: 95 with right sidedness (40.6%) and 139 with left sidedness (59.4%). The median follow-up time was 66 months [interquartile range (IQR): 39-81]. The 5-year OS probabilities for right-sided and left-sided tumors were 67% (95% CI: 58%-77%) and 82% (75%-89%), respectively [hazard ratio (HR): 2.02, 95% CI: 1.18-3.46; </span><em>P</em> = .010]. The 5-year probabilities of DFS for right-sided and left-sided tumors were 58% (49%-69%) and 65% (58%-74%), respectively (HR: 1.29, 0.84-1.97; <em>P</em> = 0.248).</p></div><div><h3>Conclusion</h3><p>These data suggest that there may be a worse prognosis (inferior OS at 5 years) for resected right-sided stage III CRC patients treated in the real world. However, these data need to be confirmed by prospective studies with a larger number of participants.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138560722","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 Immunotherapy With Ipilimumab Plus Nivolumab in Mismatch Repair Deficient/Microsatellite Instability-High Colorectal Cancer: A Preliminary Report of Case Series","authors":"Tao Pan ,&nbsp;Hui Yang ,&nbsp;Wu-yi Wang ,&nbsp;Yuan-yi Rui ,&nbsp;Zi-jian Deng ,&nbsp;Yung-chang Chen ,&nbsp;Chao Liu ,&nbsp;Hai Hu","doi":"10.1016/j.clcc.2024.01.002","DOIUrl":"10.1016/j.clcc.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Although ipilimumab<span> plus nivolumab<span><span> have significantly improved the survival of metastatic colorectal cancer (CRC) with </span>mismatch repair deficient (dMMR) /microsatellite instability-high (MSI-H), the data on neoadjuvant setting is limited.</span></span></p></div><div><h3>Patients and Methods</h3><p>We enrolled 11 patients with advanced dMMR/MSI-H CRC. 10 patients were locally advanced and 1 was metastatic. Ten patients were treated with 1 dose of ipilimumab (1 mg/kg) and 2 doses of nivolumab (3 mg/kg), and 1 patient was treated with 1 dose of ipilimumab (1 mg/kg) and 2 doses of nivolumab (3 mg/kg) with 2 cycles. All the patients underwent surgery after immunotherapy. The aim of the study was to evaluate the safety and short-term efficacy of this strategy.</p></div><div><h3>Results</h3><p><span>Pathologic responses were observed in 11/11 (100%) dMMR/MSI-H tumors, with 9/11 (81.8%) achieving complete responses. Among these 9 cases with complete responses, 1 achieved a radiological noncomplete response after treatment with 1 dose of ipilimumab (1 mg/kg) and 2 doses of nivolumab (3 mg/kg), so another cycle of treatment with 1 dose of ipilimumab (1 mg/kg) and 2 doses of nivolumab (3 mg/kg) was administered, followed by surgery. The postoperative pathological evaluation was a complete response. Seven patients (63.6%) developed grade I/II adverse events. No patients developed grade III/IV adverse events or </span>postoperative complications.</p></div><div><h3>Conclusion</h3><p>Neoadjuvant immunotherapy with ipilimumab plus nivolumab induced tumor regression with a major clinical and pathological response in advanced dMMR/MSI-H CRC. Notably, patients do not achieve a complete response to neoadjuvant immunotherapy, additional neoadjuvant immunotherapy may offer benefits. Further research is needed to assess the long-term efficacy of this strategy.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506388","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":"Clinical Management of Gastrointestinal and Liver Toxicities of Immune Checkpoint Inhibitors","authors":"Kevin Mok ,&nbsp;Claudia Wu ,&nbsp;Stephen Chan ,&nbsp;Grace Wong ,&nbsp;Vincent Wai-Sun Wong ,&nbsp;Brigette Ma ,&nbsp;Rashid Lui","doi":"10.1016/j.clcc.2023.12.003","DOIUrl":"10.1016/j.clcc.2023.12.003","url":null,"abstract":"<div><p><span><span>Immune checkpoint inhibitors<span> have transformed the treatment paradigm for various types of cancer. Nonetheless, with the utilization of these groundbreaking treatments, immune-related adverse events (irAEs) are increasingly encountered. Colonic and hepatic involvement are among the most frequently encountered irAEs. Drug-induced side effects, infectious causes, and tumor-related </span></span>symptoms<span><span> are the key differentials for irAE complications. Potential risk factors for the development of irAEs include combination use of immune checkpoint inhibitors, past development of irAEs with other immunotherapy<span> treatments, certain concomitant drugs, and a pre-existing personal or family history of autoimmune illness such as </span></span>inflammatory bowel disease. The importance of early recognition, timely and proper management cannot be understated, as there are profound clinical implications on the overall cancer treatment plan and prognosis once these adverse events occur. Herein, we cover the clinical management of the well-established gastrointestinal irAEs of </span></span>enterocolitis and hepatitis, and also provide an overview of several other emerging entities.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138687834","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":"Effectiveness of Biologic Agents Among Hispanic Patients With Metastatic Colorectal Cancer","authors":"Riya Patel ,&nbsp;Abdissa Negassa ,&nbsp;Seda S. Tolu ,&nbsp;Ana Acuna-Villaorduna ,&nbsp;Sanjay Goel","doi":"10.1016/j.clcc.2023.10.001","DOIUrl":"10.1016/j.clcc.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Randomized clinical trials<span> have defined the survival advantage with the addition of biologic drugs to chemotherapy in patients with </span></span>metastatic colorectal cancer (mCRC). Under representation of Hispanics contributes to poorly defined outcomes in this group. We aim to determine whether the real-world benefit of biologics extends to Hispanics using a comparative effectiveness research approach.</p></div><div><h3>Methods</h3><p><span>This retrospective cohort study<span> included all treatment centers contributing to SEER registry with available claims in the SEER-Medicare linked database (2001-2011) and 2 hospitals (2004-2016) catering to minorities. Metastatic CRC patients were </span></span><em>classified as receiving chemotherapy or biochemotherapy (CT plus biologics; if initiated within 3 months of chemotherapy).</em><span> The primary outcome was overall survival (OS) among the Hispanic patients calculated from time of administration of first dose of chemotherapy to death or last follow-up. A weighted Cox regression model was used to assess differences in survival.</span></p></div><div><h3>Results</h3><p>We identified 182 Hispanic patients with mCRC from the Patient Entitlement and Diagnosis Summary (PEDSF) file (n = 101) and hospital database (n = 81). Overall, 52% were women and 72% received biologics. The median OS was 11.3 and 17.0 months in chemotherapy and biochemotherapy group, respectively. Biochemotherapy offered a survival benefit compared with chemotherapy alone, with an average hazard rate reduction of 39% (95% CI 6%-60%, <em>p</em> = .0236) using inverse probability of treatment weighting (IPTW) based analysis.</p></div><div><h3>Conclusion</h3><p>In this cohort of Hispanic patients with mCRC, biochemotherapy was associated with longer survival. Clinicians may offer biochemotherapy therapy to all patients regardless of race/ethnicity to maximize clinical benefit.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71430253","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}