Clinical colorectal cancer最新文献

{"title":"Trajectory for the Regulatory Approval of a Combination of Pertuzumab Plus Trastuzumab for Pre-treated HER2-positive Metastatic Colorectal Cancer Using Real-world Data","authors":"Yasutoshi Sakamoto ,&nbsp;Hideaki Bando ,&nbsp;Yoshiaki Nakamura ,&nbsp;Hiromi Hasegawa ,&nbsp;Takako Kuwaki ,&nbsp;Wataru Okamoto ,&nbsp;Hiroya Taniguchi ,&nbsp;Yoshihiro Aoyagi ,&nbsp;Izumi Miki ,&nbsp;Hiroshi Uchigata ,&nbsp;Naomi Kuramoto ,&nbsp;Nozomu Fuse ,&nbsp;Takayuki Yoshino ,&nbsp;Atsushi Ohtsu","doi":"10.1016/j.clcc.2022.10.003","DOIUrl":"10.1016/j.clcc.2022.10.003","url":null,"abstract":"<div><p><span>Utilizing real-world data (RWD) for effective clinical implementation is becoming more and more appealing as the cost of drug<span><span> development rises, especially for patients with rare diseases and rare molecular subtypes for whom conducting randomized controlled trials<span><span> is challenging. If a regulatory approval methodology based on RWD as an external control group can be established, drug development for rarer fractions can be accelerated by lowering costs and time, as well as reducing physical and emotional burdens on both patients and healthcare professionals. Since 2017, we have been prospectively collecting the clinical data of standard therapies </span>in patients with rare molecular fractions under the SCRUM-Japan Registry platform, which is a qualified registry utilized as external control data for regulatory submission. Based on the results of the phase II TRIUMPH study (UMIN000027887) and the extracted data from the SCRUM-Japan Registry, the pharmaceutical company submitted an application for </span></span>pertuzumab<span> and trastuzumab in patients with HER2-positive </span></span></span>metastatic colorectal cancer<span> in April 2021. Pertuzumab and trastuzumab were approved as expanded indications on March 28, 2022, as 6 cases out of 14 extracted from the SCRUM-Japan Registry were classified and utilized as “evaluation material” under the review process of the Pharmaceuticals and Medical Devices Agency (PMDA). Through the TRIUMPH study and the SCRUM-Japan Registry, we have paved the way for regulatory approval of RWD in Japan. In future, we must define the steps for constructing regulatory-grade registries and the method/process for utilizing RWD by accumulating case experiences.</span></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":"9146209","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":"Unusual dMMR Phenotype Locally Advanced Pancreatic Ductal Adenocarcinoma with Germline and Somatic BRCA2 Mutation in a Jehovah Witness Patient","authors":"Mehmet Sitki Copur ,&nbsp;Soe Min Tun ,&nbsp;Luciano Vargas ,&nbsp;Shaheed Merani ,&nbsp;Whitney Wedel ,&nbsp;Randy Duckert ,&nbsp;Adam Horn ,&nbsp;Nicholas Lintel ,&nbsp;Daniel Herold ,&nbsp;Swathi Lavudi","doi":"10.1016/j.clcc.2022.10.002","DOIUrl":"10.1016/j.clcc.2022.10.002","url":null,"abstract":"<div><p></p><ul><li><span>•</span><span><p>PDAC<span> is a genetically heterogenous disease with various molecular subtypes which may explain variations in treatment response. Genetic mutations and altered molecular pathways serve as targets in therapy and may improve outcomes.</span></p></span></li><li><span>•</span><span><p>Neoadjuvant systemic therapy with or without radiation followed by evaluation for surgery is an accepted treatment approach for locally advanced disease with the goal of enabling an R0 resection to achieve improved disease-free and overall survival.</p></span></li><li><span>•</span><span><p>In many cancers, including pancreatic cancer<span><span><span><span>, MSI is a predictive biomarker for response to </span>immunotherapy, and a </span>prognostic factor for survival. Treatment with neoadjuvant </span>chemoimmunotherapy in this group of patients usually leads to pathologic complete responses.</span></p></span></li><li><span>•</span><span><p><span>Although rare (15%), an unusual dMMR phenotype, evidenced by discordance between </span>IHC<span> staining of MMR proteins and next gen sequencing, do exist. In this group of patients available data show varying responses to immunotherapy ranging from complete, to partial responses to stable disease.</span></p></span></li><li><span>•</span><span><p>We present successful treatment outcome in a locally advanced PDAC case with dMMR and germline plus somatic BRCA2<span> mutation treated with available chemotherapy immunotherapy and targeted therapy options.</span></p></span></li></ul></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":"9146692","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":"ROCKET: Phase II Randomized, Active-controlled, Multicenter Trial to Assess the Safety and Efficacy of RRx-001 + Irinotecan vs. Single-agent Regorafenib in Third/Fourth Line Colorectal Cancer","authors":"Tony R. Reid ,&nbsp;Nacer Abrouk ,&nbsp;Scott Caroen ,&nbsp;Bryan Oronsky ,&nbsp;Meaghan Stirn ,&nbsp;Christopher Larson ,&nbsp;Keola Beale ,&nbsp;Susan J. Knox ,&nbsp;George Fisher","doi":"10.1016/j.clcc.2022.11.003","DOIUrl":"10.1016/j.clcc.2022.11.003","url":null,"abstract":"<div><h3>Introduction</h3><p>RRx-001 is a novel cysteine-targeted alkylating agent that releases nitric oxide (NO). The primary biological activities of this hybrid molecule include macrophage repolarizing and vascular normalization. The purpose of this clinical trial (ROCKET) (NCT02096354) was to compare the safety and efficacy of the combination therapy RRx-001 + irinotecan vs. regorafenib in third/fourth line colorectal cancer that previously received treatment with irinotecan.</p></div><div><h3>Patients and Methods</h3><p>A total of 34 patients were randomized (24 to RRx-001 + irinotecan (RxI) and 10 to single-agent regorafenib (RegI)) and were the basis for the intention-to-treat analysis (ITT, comprising all 34 patients). RRx-001 treatment was administered as an up-to-2-month “primer” followed by irinotecan for patients randomized to the RRx-001 arm (24). The efficacy and safety data are presented for the 34 patients in the (ITT) efficacy analysis. Therapy consisted of intravenous administration of RRx-001 at 4 mg once weekly for up to 2 months, at which point RRx-001 was discontinued, followed by intravenous infusion of irinotecan at 180 mg/m² on day 1 in a 21-day cycle vs. 160 mg oral regorafenib daily for 3/4 weeks followed at progression, if applicable, by irinotecan 180 mg/m² on day 1 in a 21-day cycle. There were 3 patients (3/24 = 12.5%) with prior single agent irinotecan on the RRx-001 randomized arm and 2 (2/10 = 20%) on the regorafenib randomized arm. Numerous patients had irinotecan combination therapies prior to randomized treatment. There were 15 patients on RRx-001 arm that received irinotecan post-RRx-001 in the randomized trial. There were 5 PRs on RRx-001 plus irinotecan leading to an overall response of 20.8% (5/24). There were 37.5% (9/24) of RRx-001 randomized patients with KRAS mutant type while 60% (6/10) regorafenib randomized patients were of KRAS type mutant. There were only 4 patients with available QOL and Edmonton Symptom Assessment System, an insufficient sample size to allow for any meaningful analysis.</p></div><div><h3>Results</h3><p>Median patient follow-up was approximately 14.5 months (SD 4.5 months). Median overall survival was 8.6 months for RxI and 4.7 months for RegI. Median progression free survival was 6.1 months for RxI vs. 1.7 months for RegI (a statistically significant result, 2-sided log-rank test, <em>P</em> = .0030). The toxicity profile of RxI was substantially improved compared with RegI.</p></div><div><h3>Conclusion</h3><p>The results of this trial demonstrate improved efficacy of RxI compared with RegI in patients with metastatic colorectal cancer after previous treatment with irinotecan, and late-stage clinical development in this indication is planned on the strength of the observed “signal” accompanied by a sufficient safety profile.</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":"9159846","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":"Molecular Residual Disease-guided Adjuvant Treatment in Resected Colorectal Cancer: Focus on CIRCULATE-Japan","authors":"Seiya Sato ,&nbsp;Yoshiaki Nakamura ,&nbsp;Eiji Oki ,&nbsp;Takayuki Yoshino","doi":"10.1016/j.clcc.2022.12.001","DOIUrl":"10.1016/j.clcc.2022.12.001","url":null,"abstract":"<div><p>The body of evidence supporting the utility of the detection of molecular residual disease (MRD) in resected colorectal cancer (CRC) using circulating tumor DNA (ctDNA) analysis is rapidly growing. Furthermore, this evidence provides the rationale for escalation and de-escalation adjuvant chemotherapy (ACT) strategies using ctDNA MRD analysis. This has led to various randomized clinical trials, and CIRCULATE-Japan is one of the largest of these trial platforms. In this review, we provide an overview of the potential utility of ctDNA-based MRD detection for escalation and de-escalation ACT approaches. Furthermore, we highlight the feasibility using ctDNA clearance as a surrogate endpoint for ACT trials in patients with resected CRC, based on findings of the CIRCULATE-Japan project.</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":"9152880","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":"An Exploration of Trifluridine/Tipiracil Monotherapy and in Combination With Bevacizumab or Immune Checkpoint Inhibitors for Patients With Metastatic Colorectal Cancer: A Real-World Study","authors":"Caiyun Nie ,&nbsp;Weifeng Xu ,&nbsp;Beibei Chen ,&nbsp;Huifang Lv ,&nbsp;Jianzheng Wang ,&nbsp;Yingjun Liu ,&nbsp;Yunduan He ,&nbsp;Saiqi Wang ,&nbsp;Jing Zhao ,&nbsp;Xiaobing Chen","doi":"10.1016/j.clcc.2022.11.005","DOIUrl":"10.1016/j.clcc.2022.11.005","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Trifluridine/tipiracil (TAS-102) has achieved modest efficacy in the late-line treatment of </span>metastatic colorectal cancer. The present study aimed to explore the clinical efficacy and </span>drug toxicities of TAS-102 for patients with metastatic colorectal cancer in real-world clinical setting.</p></div><div><h3>Methods</h3><p><span><span>From October 2020 to February 2022, patients with metastatic colorectal cancer who failed from 2 or more lines of prior therapy and treated with TAS-102 monotherapy, in combination with </span>bevacizumab<span> or immune checkpoint inhibitors (ICIs) were analyzed. The evaluation indicators were </span></span>progression free survival (PFS), objective response rate , disease control rate (DCR), overall survival (OS) and drug toxicities.</p></div><div><h3>Results</h3><p>A total of 70 patients were enrolled. The objective response rate and DCR were 1.4% and 68.6%. The median PFS and OS were 6.0 (95% CI: 4.1-7.9) and 10.0 (95% CI: 8.3-11.7) months. Compared with TAS-102 monotherapy and TAS-102 plus ICIs, TAS-102 plus bevacizumab obtained superior DCR (75.9% vs. 50% vs. 40%, <em>P</em> = .047), PFS (6.3m vs. 3.0 m vs. 3.0 m, <em>P</em> = .041) and OS (12.0 m vs. 6.5 m vs. 6.0m, <em>P</em><span><span> = .013). Patients without prior regorafenib or </span>fruquintinib therapy obtained better median PFS (6.3 vs. 4.3 m, </span><em>P</em> = .031) and OS (NR vs. 9.0 m, <em>P</em><span><span> = .036). Other indicators, including age, tumor site, KRAS status and use of fluoropyrimidine as last regimen before TAS-102, did not affect the clinical efficacy of TAS-102. The most frequent adverse events were </span>leukopenia, neutropenia, anemia, fatigue, nausea, and vomiting.</span></p></div><div><h3>Conclusion</h3><p>In real-world clinical setting, TAS-102 showed consistent clinical efficacy and manageable safety with previous prospective clinical studies. Compared with monotherapy and TAS-102 plus ICIs, TAS-102 plus bevacizumab demonstrated better clinical efficacy for metastatic colorectal cancer.</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":"9153556","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":"Systemic Therapy for Pancreatic Neuroendocrine Tumors","authors":"Margaret Wheless ,&nbsp;Satya Das MD, MSCI","doi":"10.1016/j.clcc.2022.08.003","DOIUrl":"10.1016/j.clcc.2022.08.003","url":null,"abstract":"<div><p><span><span>Patients with metastatic or advanced pancreatic neuroendocrine tumors (NETs) carry poorer prognoses relative to patients with other </span>NETs<span> due to bulkier and often, more proliferative baseline disease. Patients with these tumors also possess more approved treatment options relative to patients with other NETs, making therapeutic sequencing nuanced. As such, defining optimal therapeutic sequencing and developing more potent cytoreductive treatments for patients are significant areas of research need in the field. Herein this review, we discuss the current systemic therapy landscape, our approach to therapeutic sequencing in the clinic and ongoing studies seeking to define optimal sequencing of systemic therapies, and novel therapeutics in development, for patients with pancreatic NETs. We limit the scope of this latter topic to agents with preclinical or clinical rationale over the last 8 years to provide a contemporary view of the </span></span>drug<span><span> development landscape and focus primarily on new types of peptide receptor<span> radionuclide therapy, anti-vascular endothelial growth factor </span></span>receptor tyrosine kinase<span> inhibitors and anti-vascular endothelial growth receptor tyrosine kinase inhibitor plus immunotherapy combinations.</span></span></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":"9505134","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":"Single-Agent Neoadjuvant Immunotherapy With a PD-1 Antibody in Locally Advanced Mismatch Repair-Deficient or Microsatellite Instability-High Colorectal Cancer","authors":"Fengyun Pei ,&nbsp;Jingjing Wu ,&nbsp;Yandong Zhao ,&nbsp;Wan He ,&nbsp;Qijun Yao ,&nbsp;Meijin Huang ,&nbsp;Jun Huang","doi":"10.1016/j.clcc.2022.11.004","DOIUrl":"10.1016/j.clcc.2022.11.004","url":null,"abstract":"<div><h3>Background</h3><p>PD-1 blockade has been recommended as first-line therapy for nonresectable or metastatic mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) colorectal cancer (CRC). However, the safety and efficacy of neoadjuvant PD-1 blockade immunotherapy for locally advanced dMMR/MSI-H CRC remain unclear.</p></div><div><h3>Patients and Methods</h3><p>From June 2020 to June 2022, 11 locally advanced dMMR/MSI-H CRC patients treated at the Sixth Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) were enrolled. All patients received 6 sintilimab (Innovent, LTD) injections (200 mg/injection, every 3 weeks) before radical laparoscopic resection. The patient clinical and pathological data were analyzed retrospectively.</p></div><div><h3>Results</h3><p>dMMR was confirmed by immunohistochemistry for all patients. However, polymerase chain reaction (PCR) or next-generation sequencing confirmed MSI-H for only 90.9% (10/11) of the patients, while 1 patient had microsatellite stable (MSS) disease. After 6 injections of neoadjuvant anti-PD-1 therapy, 90.9% (10/11) of the patients (those confirmed to have dMMR and MSI-H disease) achieved pathological complete response (pCR). The other patient, who achieved major pathological response with residual tumor &lt;1%, had dMMR but MSS disease. No grade 3 or above immunotherapy-related adverse events occurred [Common Terminology Criteria for Adverse Events ; version 5.0]. Overall, 72.7% (8/11) of the patients had grade 1-2 immunotherapy-related adverse events . No operational mortality or complications occurred within 30 days after surgery.</p></div><div><h3>Conclusion</h3><p>Single-agent neoadjuvant PD-1 antibody immunotherapy was safe and effective in locally advanced dMMR/MSI-H CRC. Dual confirmation of MMR and MSI status by immunohistochemistry and next-generation sequencing or PCR is necessary for dMMR/MSI-H CRC patients before immunotherapy. The immunotherapy regimen used in this study deserves further validation in phase II and III clinical studies.</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":"9153543","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":"Systemic Therapy for Patients With Pancreatic Cancer: Current Approaches and Opportunities for Novel Avenues Toward Precision Medicine","authors":"Ruveyda Ayasun ,&nbsp;Turcin Saridogan ,&nbsp;Ola Gaber ,&nbsp;Ibrahim Halil Sahin","doi":"10.1016/j.clcc.2022.11.001","DOIUrl":"10.1016/j.clcc.2022.11.001","url":null,"abstract":"<div><p><span>Pancreatic ductal adenocarcinoma<span><span> (PDAC) has a dismal prognosis with a 5-year overall survival of 11%. The disease is usually diagnosed at advanced stages, and systemic chemotherapy is the standard-of-care treatment<span> for the majority of patients with PDAC. Although novel treatment options, such as targeted therapy and </span></span>immunotherapy<span>, have achieved substantial progress leading to practice-changing results, with FDA approvals for several solid tumors so far, the progress achieved for PDAC is relatively limited. Recent studies uncovered potential therapeutic targets for patients with PDAC, and potential therapeutic opportunities are currently being further examined. Herein, we review recent advances in systemic therapy regimens, including </span></span></span>cytotoxic agents<span>, targeted therapies, immunotherapy, and novel therapeutic options for managing patients with PDAC. We also elaborate on molecular profiling to guide treatment and existing therapeutic opportunities that may further advance the clinical care of patients with this devastating disease.</span></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":"9159351","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":"Stereotactic Ablative Radiation Therapy for Colorectal Liver Metastases","authors":"Ronan L McDermott ,&nbsp;Emma M Dunne ,&nbsp;Yizhou Zhao ,&nbsp;Alanah Bergman ,&nbsp;Mitchell CC Liu ,&nbsp;Devin Schellenberg ,&nbsp;Roy MK Ma","doi":"10.1016/j.clcc.2022.10.006","DOIUrl":"10.1016/j.clcc.2022.10.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Stereotactic Ablative Radiation Therapy (SABR) is a therapeutic option for patients with inoperable oligometastatic colorectal carcinoma (CRC). Given the scarcity of prospective data on outcomes of SABR for metastatic CRC, this study aims to review SABR outcomes and determine predictive factors of local control (LC) and survival in patients with liver metastases from CRC.</p></div><div><h3>Materials and Methods</h3><p>A retrospective review of SABR for CRC liver metastases between 2011 and 2019 was undertaken. Endpoints included LC, overall survival (OS), progression-free survival (PFS) and time to restarting systemic therapy. Univariate (UVA) and multivariable analyses (MVA) were performed to identify predictive factors.</p></div><div><h3>Results</h3><p>Forty-eight patients were identified. The total number of tumors treated was 58. Median follow-up was 26.6 months. LC at 1, 2 and 3 years was 92.7%, 80.0%, and 61.2% respectively. Median time to local failure was 40.0 months (95% CI 31.8-76.1 months). Median OS was 31.9 months (95% CI 20.6-40.0 months). OS at 1, 2, and 3 years was 79.2%, 61.7%, and 44.9% respectively. Thirty-three patients (69%) restarted systemic therapy after completion of SABR. Median time to restarting chemotherapy was 11.0 months (95% CI 7.1-17.6 months). Systemic therapy free survival at 1, 2, and 3 years was 45.7%, 29.6%, and 22.6% respectively. On MVA, inferior LC was influenced by GTV volume ≥40 cm³ (HR: 3.805, 95% CI 1.376-10.521, <em>P</em> = .01) and PTV D100% BED &lt;100 Gy₁₀ (HR 2.971, 95% CI 1.110-7.953; <em>P</em> = .03). Inferior OS was associated with PTV volume ≥200 cm³ (HR 5.679, 95% CI 2.339-13.755; <em>P</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>SABR is an effective therapeutic option for selected patients with CRC liver metastases providing acceptable LC within the first 2 years. In many cases, it provides meaningful chemotherapy-free intervals. Higher biological effective doses are required to enhance LC.</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":"9151268","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":"Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer","authors":"Hyun Gu Lee ,&nbsp;Chan Wook Kim ,&nbsp;Jong Keon Jang ,&nbsp;Seong Ho Park ,&nbsp;Young Il Kim ,&nbsp;Jong Lyul Lee ,&nbsp;Yong Sik Yoon ,&nbsp;In Ja Park ,&nbsp;Seok-Byung Lim ,&nbsp;Chang Sik Yu ,&nbsp;Jin Cheon Kim","doi":"10.1016/j.clcc.2022.10.005","DOIUrl":"10.1016/j.clcc.2022.10.005","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Extramural venous invasion (EMVI) is a poor prognostic factor in </span>rectal cancer. Recent advances in magnetic resonance imaging (MRI) allow for the detection of EMVI before surgery. This study aimed to analyze the correlations between MRI-detected EMVI (MR-EMVI) and pathologic parameters </span>in patients with rectal cancer.</p></div><div><h3>Materials and Methods</h3><p>This study retrospectively analyzed 721 patients who underwent radical resection<span> for locally advanced rectal cancer between 2018 and 2019 at the Asan Medical center. All patients underwent an MRI before surgery. The lesions of patients who received neoadjuvant chemoradiation therapy (CRT) were evaluated by MRI before and after the neoadjuvant CRT.</span></p></div><div><h3>Results</h3><p><span>Of the 721 patients, 118 (16.4%) showed a positive MR-EMVI, which significantly correlated with advanced pathologic T-category and N-category, extranodal extension, poor differentiation, lymphatic invasion, venous invasion, and perineural invasion. In addition, MR-EMVI was an independent factor for predicting the pathologic nodal status (OR 3.476, 95% CI, 2.186-5.527, </span><em>P</em><span> &lt; .001). Patients with a positive MR-EMVI had a sensitivity of 28.0% and specificity of 91.9% for predicting regional lymph node metastasis, whereas the MR-N category had a sensitivity of 88.7% and specificity of 30.6%. Patients whose MR-EMVI changed from positive to negative after neoadjuvant CRT had no significant differences in pathologic parameters except for lymphatic invasion with patients who were negative before and after neoadjuvant CRT.</span></p></div><div><h3>Conclusion</h3><p>MR-EMVI correlated with aggressive pathologic features, which indicated a poor prognosis. MR-EMVI may be a complementary imaging biomarker for predicting nodal status and evaluating tumor response to neoadjuvant CRT.</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":"9505705","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}