Clinical colorectal cancer最新文献

{"title":"Association of Circulating Tumor Cells and Tumor Molecular Profile With Clinical Outcomes in Patients With Previously Untreated Metastatic Colorectal Cancer: A Pooled Analysis of the Phase III VISNÚ-1 and Phase II VISNÚ-2 Randomized Trials","authors":"P. Jiménez-Fonseca ,&nbsp;J. Sastre ,&nbsp;P. García-Alfonso ,&nbsp;M.A. Gómez-España ,&nbsp;A. Salud ,&nbsp;S. Gil ,&nbsp;F. Rivera ,&nbsp;J.J. Reina ,&nbsp;G. Quintero ,&nbsp;M. Valladares-Ayerbes ,&nbsp;M.J. Safont ,&nbsp;A. La Casta ,&nbsp;L. Robles-Díaz ,&nbsp;B. García-Paredes ,&nbsp;R. López López ,&nbsp;M. Guillot ,&nbsp;J. Gallego ,&nbsp;V. Alonso-Orduña ,&nbsp;E. Diaz-Rubio ,&nbsp;E. Aranda","doi":"10.1016/j.clcc.2023.02.004","DOIUrl":"10.1016/j.clcc.2023.02.004","url":null,"abstract":"<div><h3>Background</h3><p><span>The bCTC count is a well-established prognostic biomarker in </span>mCRC, as well as in other tumor types. The aim of this analysis was to evaluate the prognostic/predictive role of the bCTC count (≥3 vs. &lt;3) in previously untreated mCRC.</p></div><div><h3>Patients and Methods</h3><p>The study involved 589 untreated mCRC patients included in the intention-to-treat population of 2 randomized clinical trials (phase III VISNU-1 [NCT01640405] and phase II VISNU-2 [NCT01640444] studies).</p></div><div><h3>Results</h3><p><span>Of the 589 patients, 349 (59.2%) had bCTC≥3 and 240 (40.7%) had bCTC&lt;3. Multivariate analysis<span> showed that the bCTC count is an independent prognostic factor for overall survival (OS) (HR 0.59, 95% CI 0.48-0.72; </span></span><em>P</em> = 0.000) and potential for progression-free survival (PFS) (<em>P</em><span> = 0.0549). Median OS was 32.9 and 19.5 months in patients with bCTC&lt;3 and bCTC≥3 (</span><em>P</em> &lt;0.001), respectively. This effect was also observed comparing OS in RASwt patients from both studies. Other prognostic factors were: ECOG-PS, primary tumor site, number of metastatic sites and surgery of the primary tumor. Median OS was lower for patients treated with anti-VEGF versus anti-EGFR (22.3 vs. 33.3 months, <em>P</em><span> &lt;0.0001) while there were no significant differences in PFS according to the targeted treatment received.</span></p></div><div><h3>Conclusion</h3><p>This post-hoc analysis of 2 randomized studies confirms the poor prognosis of patients with bCTC≥3 but this is not associated with other adverse independent prognostic factors such as RAS/BRAF mutations.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10048540","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 Value of Body Mass Index in Stage II/III Colon Cancer: Posthoc Analysis From the TOSCA Trial","authors":"Debora Basile ,&nbsp;Gerardo Rosati ,&nbsp;Francesca Bergamo ,&nbsp;Silvio Ken Garattini ,&nbsp;Maria Banzi ,&nbsp;Maria Zampino ,&nbsp;Silvia Bozzarelli ,&nbsp;Paolo Marchetti ,&nbsp;Fabio Galli ,&nbsp;Francesca Galli ,&nbsp;Raffaella Longarini ,&nbsp;Alberto Zaniboni ,&nbsp;Daris Ferrari ,&nbsp;Sabino De Placido ,&nbsp;Luca Giovanni Frassineti ,&nbsp;Mario Nicolini ,&nbsp;Saverio Cinieri ,&nbsp;Michele Priscindiaro ,&nbsp;Pina Ziranu ,&nbsp;Riccardo Caccialanza ,&nbsp;Giuseppe Aprile","doi":"10.1016/j.clcc.2023.01.004","DOIUrl":"10.1016/j.clcc.2023.01.004","url":null,"abstract":"<div><h3>Background</h3><p>High body mass index (BMI) plays a key role in the development of colon cancer (CC). Our post-hoc analysis from the TOSCA trial analyzed the association between BMI and survival outcomes in terms of relapse-free survival (RFS) and overall survival (OS) in stage II/III CC patients.</p></div><div><h3>Patients and methods</h3><p>Patients enrolled in the TOSCA trial between 2007-2013 with BMI data entered the study. The prognostic impact of BMI on survival outcomes was investigated through uni- and multivariable Cox regression analyses.</p></div><div><h3>Results</h3><p>Overall, 1455 patients with stage II/III CC patients were included. The median follow-up was of 61.5 months; 16.1% of patients relapsed, 11.2% died and 19.5% patients relapsed or died. No impact of BMI on RFS was detected at univariate or multivariable analyses. By univariate analysis for OS, a significantly impact of a BMI &gt; 30 kg/m² was reported (HR [&gt;30 vs &lt;25] 1.57, 95% CI 1.00-2.47, <em>p</em> = 0.049; HR [&gt;30 vs &lt;30] 1.55, 95% CI 1.01-2.37, <em>p</em> = 0.045). Multivariable analyses did not confirm this data. In the subgroup of stage III patients, a negative survival impact of BMI was found in univariate and multivariable models both for RFS and for OS.</p></div><div><h3>Conclusions</h3><p>In our study, obesity with BMI &gt; 30 kg/m² was an independent prognostic factor for RFS and OS in CC patients treated with adjuvant chemotherapy, regardless of its duration (3 or 6 months). However, the prognostic impact of adiposity and body composition measurement should be considered to better classify patients with high visceral fat and refine their risk assessment.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9672894","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":"Colorectal Cancer Screening Disparities Among Race: A Zip Code Level Analysis","authors":"Carla Barberan Parraga ,&nbsp;Roshni Singh ,&nbsp;Rachel Lin ,&nbsp;Leonardo Tamariz ,&nbsp;Ana Palacio","doi":"10.1016/j.clcc.2023.01.001","DOIUrl":"10.1016/j.clcc.2023.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal cancer (CRC) screening can prevent disease by early identification. Existing disparities in CRC screening have been associated with factors including race, socioeconomic status, insurance, and even geography. Our study takes a deeper look into how social determinants related to zip code tabulation areas affect CRC screenings.</p></div><div><h3>Materials and Methods</h3><p>We conducted a retrospective cross-sectional study of CRC screenings by race at a zip code level, evaluating for impactful social determinant factors such as the social deprivation index (SDI). We used publicly available data from CDC 500 Cities Project (2016-2019), PLACES Project (2020), and the American Community Survey (2019). We conducted multivariate and confirmatory factor analyses among race, income, health insurance, check-up visits, and SDI.</p></div><div><h3>Results</h3><p>Increasing the tertile of SDI was associated with a higher likelihood of being Black or Hispanic, as well as decreased median household income (<em>P</em> &lt; .01). Lower rates of regular checkup visits were found in the third tertile of SDI (<em>P</em> &lt; .01). The multivariate analysis showed that being Black, Hispanic, lower income, being uninsured, lack of regular check-ups, and increased SDI were related to decreased CRC screening. In the confirmatory factor analysis, we found that SDI and access to insurance were the variables most related to decreased CRC screening.</p></div><div><h3>Conclusion</h3><p>Our results reveal the top 2 factors that impact a locality's CRC screening rates are the social deprivation index and access to health care. This data may help implement interventions targeting social barriers to further promote CRC screenings within disadvantaged communities and decrease overall mortality via early screening.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674399","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":"SCOT: Tumor Sidedness and the Influence of Adjuvant Chemotherapy Duration on Disease Free Survival (DFS)","authors":"Mark P. Saunders ,&nbsp;Rohan Iype ,&nbsp;Caroline Kelly ,&nbsp;Jana Crosby ,&nbsp;Rachel Kerr ,&nbsp;Andrea Harkin ,&nbsp;Karen Allan ,&nbsp;John McQueen ,&nbsp;Sarah R Pearson ,&nbsp;James Cassidy ,&nbsp;Louise C. Medley ,&nbsp;Sherif Raouf ,&nbsp;Mark Harrison ,&nbsp;Alison Brewster ,&nbsp;Charlotte Rees ,&nbsp;Richard Ellis ,&nbsp;Anne L. Thomas ,&nbsp;Mark Churn ,&nbsp;Timothy Iveson ,&nbsp;Noori Maka","doi":"10.1016/j.clcc.2023.02.005","DOIUrl":"10.1016/j.clcc.2023.02.005","url":null,"abstract":"<div><h3>Aim</h3><p>Patients with loco-regional right-sided colorectal tumors have a worse overall survival (OS). Here we investigate the difference in disease free survival (DFS) between colorectal patients with right and left sided tumors in the SCOT study.</p></div><div><h3>Methods</h3><p>The SCOT study showed 3-months of oxaliplatin-containing adjuvant chemotherapy (OxFp) is non-inferior to 6-months for patients with stage III and high-risk stage II colorectal cancer. We divided the cohort into patients with left and right sided tumors, and evaluated the effect on DFS and the principle 3 versus 6-months analysis.</p></div><div><h3>Results</h3><p>6088 patients with Stage III/high risk Stage II colorectal cancers were randomized between 27^th March 2008 and 29^th November 2013 from 244 centers internationally. In February 2017 (3-years FU) information on sidedness was available for 3309 patients (1238 R-sided, 2071 L-sided). Patients with right-sided tumors had a significantly worse DFS (3-year DFS right: 73.3% (se = 1.3%), left: 80.2% (se = 0.9%) HR 1.423 (95% CI 1.237-1.637; <em>P</em> &lt; .0001). Adjusting for T and N-stage reduced the HR to 1.230 (95% CI 1.066-1.420, <em>P</em> = .005). The data did not suggest that sidedness affected the impact of chemotherapy duration on 3-year DFS (R: HR 1.024 [0.831-1.261], L: HR 0.944 [0.783-1.139]). Test for heterogeneity, <em>P</em> = .571. Further sub-set analysis was limited due to cohort size.</p></div><div><h3>Conclusions</h3><p>This is the first study to show that unselected patients with right-sided tumors had a worse DFS compared to left-sided tumors. Tumor sidedness did not impact upon the 3-months versus 6-months comparison in SCOT.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674436","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":"Patterns of Care for Patients With Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy at Predominately Academic Centers between 2016-2020: An NCDB Analysis","authors":"Jason Liu ,&nbsp;Colton Ladbury ,&nbsp;Scott Glaser ,&nbsp;Marwan Fakih ,&nbsp;Andreas M. Kaiser ,&nbsp;Yi-Jen Chen ,&nbsp;Terence M. Williams ,&nbsp;Arya Amini","doi":"10.1016/j.clcc.2023.01.005","DOIUrl":"10.1016/j.clcc.2023.01.005","url":null,"abstract":"<div><p><span><span>Total neoadjuvant therapy<span> (TNT) has emerged as the preferred approach for locally advanced rectal cancer (LARC), defined as T3/4 or any T with N+ disease. Our objective was to (1) determine the proportion of patients with LARC receiving TNT over time, (2) determine the most common method in which TNT is being delivered, and (3) determine what factors are associated with a greater likelihood of receiving TNT in the United States. Retrospective data was obtained from the National Cancer Database (NCDB) for patients diagnosed with rectal cancer between 2016 and 2020. Patients were excluded if they had M1 disease, T1-2 N0 disease, incomplete staging information, nonadenocarcinoma histology, received RT to a nonrectum site, or received a nondefinitive RT dose. Data were analyzed using </span></span>linear regression, χ</span>²<span> test, and binary logistic regression. Of the 26,375 patients included, most patients were treated at an academic facility (94.6%). Five thousand three (19.0%) patients received TNT, and 21,372 (81.0%) patients did not receive TNT. The proportion of patients receiving TNT increased significantly over time, from 6.1% in 2016 to 34.6% in 2020 (slope = 7.36, 95% CI 4.58-10.15, R</span>² = 0.96, <em>P</em><span> = .040). The most common TNT regimen was multiagent chemotherapy followed by long-course chemoradiation (73.2% of cases from 2016-2020). There was a significant increase in utilization of short-course RT as part of TNT from 2.8% in 2016 to 13.7% in 2020 (slope = 2.74, 95% CI 0.37-5.11, R</span>² = 0.82, <em>P</em> = .035). Factors associated with a lower likelihood of TNT usage included age &gt;65, female gender, Black race, and T3 N0 disease. TNT use in the United States has increased significantly from 2016-2020, with approximately 34.6% of patients with LARC receiving TNT in 2020. The observed trend appears to be in line with the recent National Comprehensive Cancer Network guidelines recommending TNT as the preferred approach.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10048515","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":"Optimizing Screening for Colorectal Cancer: An Algorithm Combining Fecal Immunochemical Test, Blood-Based Cancer-Associated Proteins and Demographics to Reduce Colonoscopy Burden","authors":"Mathias M. Petersen ,&nbsp;Jakob Kleif ,&nbsp;Lars N. Jørgensen ,&nbsp;Jakob W. Hendel ,&nbsp;Jakob B. Seidelin ,&nbsp;Mogens R. Madsen ,&nbsp;Jesper Vilandt ,&nbsp;Søren Brandsborg ,&nbsp;Jørn S. Rasmussen ,&nbsp;Lars M. Andersen ,&nbsp;Ali Khalid ,&nbsp;Linnea Ferm ,&nbsp;Susan H. Gawel ,&nbsp;Frans Martens ,&nbsp;Berit Andersen ,&nbsp;Morten Rasmussen ,&nbsp;Gerard J. Davis ,&nbsp;Ib J. Christensen ,&nbsp;Christina Therkildsen","doi":"10.1016/j.clcc.2023.02.001","DOIUrl":"10.1016/j.clcc.2023.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Fecal Immunochemical Test (FIT) is widely used in population-based screening for colorectal cancer (CRC). This had led to major challenges regarding colonoscopy capacity. Methods to maintain high sensitivity without compromising the colonoscopy capacity are needed. This study investigates an algorithm that combines FIT result, blood-based biomarkers associated with CRC, and individual demographics, to triage subjects sent for colonoscopy among a FIT positive (FIT⁺) screening population and thereby reduce the colonoscopy burden.</p></div><div><h3>Materials and methods</h3><p>From the Danish National Colorectal Cancer Screening Program, 4048 FIT⁺ (≥100 ng/mL Hemoglobin) subjects were included and analyzed for a panel of 9 cancer-associated biomarkers using the ARCHITECT <em>i</em>2000. Two algorithms were developed: 1) a predefined algorithm based on clinically available biomarkers: FIT, age, CEA, hsCRP and Ferritin; and 2) an exploratory algorithm adding additional biomarkers: TIMP-1, Pepsinogen-2, HE4, CyFra21-1, Galectin-3, B2M and sex to the predefined algorithm. The diagnostic performances for discriminating subjects with or without CRC in the 2 models were benchmarked against the FIT alone using logistic regression modeling.</p></div><div><h3>Results</h3><p>The discrimination of CRC showed an area under the curve (AUC) of 73.7 (70.5-76.9) for the predefined model, 75.3 (72.1-78.4) for the exploratory model, and 68.9 (65.5-72.2) for FIT alone. Both models performed significantly better (<em>P</em> &lt; .001) than the FIT model. The models were benchmarked vs. FIT at cutoffs of 100, 200, 300, 400, and 500 ng/mL Hemoglobin using corresponding numbers of true positives and false positives. All performance metrics were improved at all cutoffs.</p></div><div><h3>Conclusion</h3><p>A screening algorithm including a combination of FIT result, blood-based biomarkers and demographics outperforms FIT in discriminating subjects with or without CRC in a screening population with FIT results above 100 ng/mL Hemoglobin.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9728330","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 Immunotherapy in Esophageal and Gastric Cancer","authors":"Hans Dedecker ,&nbsp;Laure-Anne Teuwen ,&nbsp;Timon Vandamme ,&nbsp;Andreas Domen ,&nbsp;Hans Prenen","doi":"10.1016/j.clcc.2023.03.001","DOIUrl":"10.1016/j.clcc.2023.03.001","url":null,"abstract":"<div><p><span><span>Upper gastrointestinal tract tumors<span><span> historically have a poor prognosis. The decision to treat esophageal or gastric cancers by surgery, radiotherapy, systemic therapy, or a combination of these treatment modalities should always be discussed multidisciplinary. The introduction of </span>immunotherapy has drastically transformed the treatment landscape of multiple solid </span></span>malignancies. Emerging data from early and late phase </span>clinical trials<span> suggests that the use of immunotherapies that target immune checkpoint proteins such as PD-1/PD-L1 result in superior overall survival in advanced, metastatic, or recurrent esophageal and gastric cancer, whether or not with specific molecular characteristics such as PD-L1 expression level or microsatellite instability. This review offers an overview of the most recent advances in the field of immunotherapy treatment in esophageal and gastric cancer.</span></p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9728821","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":"Patient-reported Bowel Function and Bowel-related Quality of Life After Pelvic Radiation for Rectal Adenocarcinoma: The Impact of Radiation Fractionation and Surgical Resection","authors":"Michael K. Rooney ,&nbsp;Brian De ,&nbsp;Kelsey Corrigan ,&nbsp;Grace L. Smith ,&nbsp;Cullen Taniguchi ,&nbsp;Bruce D. Minsky ,&nbsp;Ethan B. Ludmir ,&nbsp;Eugene J. Koay ,&nbsp;Prajnan Das ,&nbsp;Albert C. Koong ,&nbsp;Oliver Peacock ,&nbsp;George Chang ,&nbsp;Y. Nancy You ,&nbsp;Van K. Morris ,&nbsp;Graciela Nogueras-González ,&nbsp;Emma B. Holliday","doi":"10.1016/j.clcc.2023.02.003","DOIUrl":"10.1016/j.clcc.2023.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Multimodality treatment for locally advanced </span>rectal cancer (LARC) can include long-course radiotherapy (LCRT) or short course radiotherapy (SCRT). Nonoperative management is increasingly pursued for those achieving a complete clinical response. Data regarding long-term function and quality-of-life (QOL) are limited.</p></div><div><h3>Methods</h3><p><span><span>Patients with LARC treated with radiotherapy from 2016 to 2020 completed the Functional Assessment of Cancer Therapy- General (FACT-G7), the Low Anterior Resection Syndrome Score (LARS) and the </span>Fecal Incontinence QOL Scale (FIQOL). Univariate and multivariable </span>linear regression analyses identified associations between clinical variables including radiation fractionation and the use of surgery versus non-operative management.</p></div><div><h3>Results</h3><p>Of 204 patients surveyed, 124 (60.8%) responded. Median (interquartile range) time from radiation to survey completion was 30.1 (18.3-43) months. Seventy-nine (63.7%) respondents received LCRT, and 45 (36.3%) received SCRT; 101 (81.5%) respondents underwent surgery, and 23 (18.5%) pursued nonoperative management. There were no differences in LARS, FIQoL or FACT-G7 between patients receiving LCRT versus SCRT. On multivariable analysis, only nonoperative management was associated with lower LARS score signifying less bowel dysfunction. Nonoperative management and female sex were associated with a higher FIQoL score signifying less disruption and distress from fecal incontinence issues. Finally, lower BMI at the time of radiation, female sex, and higher FIQoL score were associated with higher FACT-G7 scores signifying better overall QOL.</p></div><div><h3>Conclusions</h3><p>These results suggest long-term patient-reported bowel function and QOL may be similar for individuals receiving SCRT and LCRT for the treatment of LARC, but nonoperative management may lead to improved bowel function and QOL.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10030906","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":"Sarcopenia is Associated With Oncological Prognosis and the Incidence of Secondary Cancer in Patients With Middle/Lower Rectal Cancer","authors":"Shinya Abe,&nbsp;Hiroaki Nozawa,&nbsp;Kazuhito Sasaki,&nbsp;Koji Murono,&nbsp;Shigenobu Emoto,&nbsp;Yuichiro Yokoyama,&nbsp;Hiroyuki Matsuzaki,&nbsp;Yuzo Nagai,&nbsp;Yuichiro Yoshioka,&nbsp;Takahide Shinagawa,&nbsp;Hirofumi Sonoda,&nbsp;Soichiro Ishihara","doi":"10.1016/j.clcc.2022.10.001","DOIUrl":"10.1016/j.clcc.2022.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>This study evaluated the clinical implications of sarcopenia<span> for patients with rectal cancer according to cancer progression.</span></p></div><div><h3>Summary Background Data</h3><p>The negative impact of body composition on long-term outcome has been demonstrated for various malignancies.</p></div><div><h3>Methods</h3><p><span><span>We retrospectively reviewed 708 patients with rectal cancer who underwent curative resection at our institution between 2003 and 2020. Factors contributing to long-term outcomes and the incidence of secondary cancer (ISC) were analyzed. </span>Psoas muscle<span> mass index (PMI) was assessed using preoperative computed tomography. Sarcopenia was defined using the PMI cut-off values for Asian adults (6.36 cm</span></span>²/m² for males and 3.92 cm2/m2 for females).</p></div><div><h3>Results</h3><p><span>Sarcopenia was identified in 306 patients (43.2%). Sarcopenia was associated with advanced age, low body mass index<span>, smoking history, and advanced T-stage. Multivariate analysis<span> showed sarcopenia was an independent poor prognostic factor for OS (HR 1.71; </span></span></span><em>P</em> = .0102) and cancer-specific survival (HR 1.64; <em>P</em><span> = .0490). Patients with sarcopenia had significantly higher mortality due to cancer-related death in stages III and IV, whereas non-rectal cancer-related death, including secondary cancer, was markedly increased in stage 0-II sarcopenic rectal patients. Five-year cumulative ISC in patients<span> with and without sarcopenia was 11.8% and 5.9%, respectively. Multivariate analysis revealed that sarcopenia was an independent predictive factor for ISC (HR 2.05; </span></span><em>P</em> = .0063).</p></div><div><h3>Conclusions</h3><p>Sarcopenia helps predict survival outcomes and cause of death according to cancer stage for patients with middle/lower rectal cancer who underwent radical surgery. Furthermore, sarcopenia increased the development of secondary cancer in those patients.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9152361","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":"Napabucasin Plus FOLFIRI in Patients With Previously Treated Metastatic Colorectal Cancer: Results From the Open-Label, Randomized Phase III CanStem303C Study","authors":"Manish A. Shah ,&nbsp;Takayuki Yoshino ,&nbsp;Niall C. Tebbutt ,&nbsp;Axel Grothey ,&nbsp;Josep Tabernero ,&nbsp;Rui-Hua Xu ,&nbsp;Andres Cervantes ,&nbsp;Sang Cheul Oh ,&nbsp;Kensei Yamaguchi ,&nbsp;Marwan Fakih ,&nbsp;Alfredo Falcone ,&nbsp;Christina Wu ,&nbsp;Vi K. Chiu ,&nbsp;Jiri Tomasek ,&nbsp;Johanna Bendell ,&nbsp;Marilyn Fontaine ,&nbsp;Matthew Hitron ,&nbsp;Bo Xu ,&nbsp;Julien Taieb ,&nbsp;Eric Van Cutsem","doi":"10.1016/j.clcc.2022.11.002","DOIUrl":"10.1016/j.clcc.2022.11.002","url":null,"abstract":"<div><h3>Purpose</h3><p><span><span>Napabucasin is an investigational, orally administered </span>reactive oxygen species generator bioactivated by intracellular antioxidant NAD(P)H:quinone oxidoreductase 1 that has been evaluated in various </span>solid tumors<span><span>, including metastatic colorectal cancer (mCRC). Phosphorylated </span>signal transducer and activator of transcription 3 (pSTAT3) is hypothesized to predict response in napabucasin-treated patients with mCRC.</span></p></div><div><h3>Patient and Methods</h3><p><span><span><span>In the multi-center, open-label, phase III CanStem303C (NCT02753127) study, adults with histologically confirmed mCRC that progressed on first-line fluoropyrimidine plus </span>oxaliplatin ± </span>bevacizumab were randomized to twice-daily napabucasin plus FOLFIRI (napabucasin) or FOLFIRI alone (control). The primary endpoint was overall survival (OS) in the general study population and </span>in patients with pSTAT3-positive tumors (biomarker-positive).</p></div><div><h3>Results</h3><p>In the general study population (napabucasin, n = 624; control, n = 629), median OS was 14.3 months for napabucasin and 13.8 months for control (hazard ratio [HR], 0.976, one-sided <em>P</em> = .74). Overall, 44% of patients were biomarker-positive (napabucasin, n = 275; control, n = 272). In the biomarker-positive population, median OS was 13.2 months for napabucasin and 12.1 months for control (HR, 0.969; one-sided <em>P</em> &gt; .99). In the control arm, median OS was shorter for biomarker-positive versus biomarker negative patients (12.1 vs. 18.5 months; HR, 1.518; nominal 2-sided <em>P</em><span> = .0002). The most common treatment-emergent adverse events (TEAEs) were diarrhea (napabucasin, 84.6%; control, 53.9%), nausea (60.5%, 50.5%), vomiting (41.2%, 29.3%), and abdominal pain (41.0%, 25.2%). Grade ≥3 TEAEs occurred in 73.8% of napabucasin-treated and 66.7% of control-treated patients, most commonly diarrhea (21.2%, 7.0%), neutrophil count decreased (13.7%, 19.2%), and neutropenia (13.3%, 15.2%). Safety was similar in biomarker-positive patients.</span></p></div><div><h3>Conclusion</h3><p>In patients with previously treated mCRC, adding napabucasin to FOLFIRI did not improve OS. Results from the control arm indicate that pSTAT3 is an adverse prognostic factor in mCRC.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9522261","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}