Clinical colorectal cancer最新文献

{"title":"Plasma Cetuximab Concentrations Correlate With Survival in Patients With Advanced KRAS Wild Type Colorectal Cancer","authors":"Di Maria Jiang ,&nbsp;Shruti Parshad ,&nbsp;Luna Zhan ,&nbsp;Hao-Wen Sim ,&nbsp;Lillian L. Siu ,&nbsp;Geoffrey Liu ,&nbsp;Jeremy D. Shapiro ,&nbsp;Timothy J. Price ,&nbsp;Derek J. Jonker ,&nbsp;Christos S. Karapetis ,&nbsp;Andrew H. Strickland ,&nbsp;Wenjiang Zhang ,&nbsp;Mark Jeffery ,&nbsp;Dongsheng Tu ,&nbsp;Siobhan Ng ,&nbsp;Sabe Sabesan ,&nbsp;Jenny Shannon ,&nbsp;Amanda Townsend ,&nbsp;Chris J. O'Callaghan ,&nbsp;Eric X. Chen","doi":"10.1016/j.clcc.2023.08.006","DOIUrl":"10.1016/j.clcc.2023.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Cetuximab is a standard of care therapy for patients with RAS wild-type (WT) advanced colorectal cancer. Limited data suggest a wide variation in cetuximab plasma concentrations after standard dosing regimens. We correlated cetuximab plasma concentrations with survival and toxicity.</p></div><div><h3>Methods</h3><p>The CO. 20 study randomized patients with RAS WT advanced colorectal cancer in a 1:1 ratio to cetuximab 400 mg/m² intravenously followed by weekly maintenance of 250 mg/m², plus brivanib 800 mg orally daily or placebo. Blood samples obtained at week 5 precetuximab treatment were analyzed by ELISA. Patients were grouped into tertiles based on plasma cetuximab concentrations. Cetuximab concentration tertiles were correlated with survival outcomes and toxicity. Patient demographic and biochemical parameters were evaluated as co-variables.</p></div><div><h3>Results</h3><p>Week 5 plasma cetuximab concentrations were available for 591 patients (78.8%). The median overall survival (OS) was 11.4 months and 7.8 months for patients in the highest (T3) and lowest tertiles (T1) respectively. On multivariable analysis, plasma cetuximab concentration was associated with OS (HR 0.66, 95% confidence interval [CI]: 0.53-0.83, <em>P</em> &lt; .001, T3 vs. T1), and a trend towards progression-free survival (HR 0.82, 95% CI: 0.66-1.02, <em>P</em> = .07, T3 vs. T1). There was no association between cetuximab concentration and skin toxicity or diarrhea.</p></div><div><h3>Conclusion</h3><p>The standard cetuximab dosing regimen may not be optimal for all patients. Further pharmacokinetic studies are needed to optimize cetuximab dosing given the potential improvement in OS.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 4","pages":"Pages 457-463"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1533002823000841/pdfft?md5=e0a41a9a60e704490112f06409d6077d&pid=1-s2.0-S1533002823000841-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233316","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":"Stereotactic Body Radiotherapy for Management of Pulmonary Oligometastases in Stage IV Colorectal Cancer: A Perspective","authors":"Michael X. Fu ,&nbsp;Catarina Carvalho ,&nbsp;Bella Milan-Chhatrisha ,&nbsp;Nishita Gadi","doi":"10.1016/j.clcc.2023.09.001","DOIUrl":"10.1016/j.clcc.2023.09.001","url":null,"abstract":"<div><p><span>In pulmonary oligometastases from colorectal cancer (POM-CRC), metastasectomy<span><span> is the primarily recommended treatment. </span>Stereotactic body radiotherapy (SBRT) has been suggested as a viable alternative therapy. SBRT efficacy for POM-CRC is poorly delineated compared to selected non-CRC primaries. This perspective article aims to critically summarize the existing evidence regarding efficacy of SBRT in terms of overall survival (OS) and local control (LC), and factors modulating this, in the treatment of POM-CRC. Overall, reasonable LC and OS rates were observed. The wide range of expansions in planning target volume margins introduced variation in pretreatment protocols. Dose-fractionation schedules varied according to patient and tumor characteristics, though leverage of BED</span></span>₁₀<span><span> in select studies enabled standardization. An association between SBRT dose and improved OS and LC was observed across multiple studies. Prognostic factors that were associated with improved LC included: fewer oligometastases, absence of extra-pulmonary metastases, primary </span>tumor histology<span>, and smaller gross tumor volume. Differences in SBRT modality and techniques over time further confounded results. Many studies included patients receiving additional systemic therapies; preprotocol and adjuvant chemotherapies were identified as prognostic factors for LC. SBRT compared with metastasectomy showed no differences in short-term OS and LC outcomes. In conclusion, SBRT is an efficacious treatment for POM-CRC, in terms of OS and LC. Heterogeneity in study design, particularly pertaining to dose protocols, patient selection, and additional therapies should be controlled for future randomized studies to further validate SBRT efficacy.</span></span></p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 4","pages":"Pages 402-410"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176272","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 Importance of Feasibility Assessment in the Design of ctDNA Guided Trials – Results From the OPTIPAL II Study","authors":"Louise Bach Callesen ,&nbsp;Anders Kindberg Boysen ,&nbsp;Christina Søs Auður Andersen ,&nbsp;Niels Pallisgaard ,&nbsp;Karen-Lise Garm Spindler","doi":"10.1016/j.clcc.2023.07.005","DOIUrl":"10.1016/j.clcc.2023.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Both quantitative and molecular changes in ctDNA can hold important information when treating metastatic colorectal cancer (mCRC), but its clinical utility is yet to be established. Before conducting a large-scale randomized trial, it is essential to test feasibility. This study investigates whether ctDNA is feasible for detecting patients who will benefit from treatment with epidermal growth factor receptor inhibitors and the prognostic value of circulating tumor DNA (ctDNA) response.</p></div><div><h3>Materials and methods</h3><p>Patients with mCRC, who were considered for systemic palliative treatment and were eligible for ctDNA analysis. Mutational testing on cell-free DNA (cfDNA) was done by ddPCR. ctDNA response from baseline to the third treatment cycle was evaluated in patients with detectable ctDNA at baseline. ctDNA maximum response was defined as undetectable ctDNA at the third treatment cycle, ctDNA partial response as any decrease in the ctDNA level, and ctDNA progression as any increase in the ctDNA level.</p></div><div><h3>Results</h3><p>Forty-nine patients were included. The time to test results for mutational testing on cfDNA was significantly shorter than on tumor tissue (<em>p</em> &lt; .001). Progression-free survival were 11.2 months (reference group), 7.5 months (HR = 10.7, <em>p</em>= .02), and 4.6 months (HR = 11.4, <em>p</em>= .02) in patients with ctDNA maximum response, partial response, and progression, respectively. Overall survival was 31.2 months (reference group), 15.2 months (HR = 4.1, <em>p</em>= .03), and 9.0 months (HR = 2.6, <em>p</em>= .03) in patients with ctDNA maximum response, partial response, and progression, respectively.</p></div><div><h3>Conclusion</h3><p>Pretreatment mutational testing on cfDNA in daily clinic is feasible and can be applied in randomized clinical trials evaluating the clinical utility of ctDNA. Early dynamics in ctDNA during systemic treatment hold prognostic value.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 4","pages":"Pages 421-430.e1"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1533002823000646/pdfft?md5=a4efabfb35ea44f63ae0be8cc3a8eae0&pid=1-s2.0-S1533002823000646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10389343","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":"Anti-VEGF Therapy Possibly Extends Survival in Patients With Colorectal Brain Metastasis by Protecting Patients From Neurologic Disability","authors":"Chih-Wen Chen ,&nbsp;Tao-Shen Ou ,&nbsp;Wei-Shone Chen ,&nbsp;Jeng-Kai Jiang ,&nbsp;Shung-Haur Yang ,&nbsp;Huann-Sheng Wang ,&nbsp;Shih-Ching Chang ,&nbsp;Yuan-Tzu Lan ,&nbsp;Chun-Chi Lin ,&nbsp;Hung-Hsin Lin ,&nbsp;Sheng-Chieh Huang ,&nbsp;Hou-Hsuan Cheng ,&nbsp;Yi-Wen Yang ,&nbsp;Yu-Zu Lin ,&nbsp;Yee Chao ,&nbsp;Ling-Wei Wang ,&nbsp;Hao-Wei Teng","doi":"10.1016/j.clcc.2023.03.003","DOIUrl":"10.1016/j.clcc.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal brain metastases (CBMs) are rare with poor prognosis. There is still no standard systemic treatment for multiple or unresectable CBM. our study aimed to explore the impact of anti-VEGF therapy on overall survival, brain-specific disease control, and neurologic symptom burden in patients with CBM<em>.</em></p></div><div><h3>Methods</h3><p>A total of 65 patients with CBM under treatment were retrospectively enrolled and divided into anti-VEGF based systemic therapy or non–anti-VEGF based therapy. A total of 25 patients who received at least 3 cycles of anti-VEGF agent and 40 patients without anti-VEGF therapy were analyzed by endpoints of overall survival (OS), progression-free survival (PFS), intracranial PFS (iPFS) and neurogenic event-free survival (nEFS)<strong><em>.</em></strong> Gene expression in paired primary metastatic colorectal cancer (mCRC), liver, lung and brain metastasis from NCBI data was analyzed using top Gene Ontology (GO) and cBioPortal.</p></div><div><h3>Results</h3><p>Patients who treated with anti-VEGF therapy had significantly longer OS (19.5 vs. 5.5 months, <em>P</em> = .009), iPFS (14.6 vs. 4.1 months, <em>P</em> &lt; .001) and nEFS (17.6 vs. 4.4 months, <em>P</em> &lt; .001). Patients who received anti-VEGF therapy beyond any disease progression presented with superior OS (19.7 vs. 9.4 months, <em>P</em> = .039). Top GO and cBioPortal analysis revealed a stronger molecular function of angiogenesis in intracranial metastasis.</p></div><div><h3>Conclusions</h3><p>Anti-VEGF based systemic therapy showed favorable efficacy that was reflected in longer overall survival, iPFS and NEFS in patients with CBM.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 3","pages":"Pages 267-279"},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118402","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":"ShorTrip Trial: A Prospective, Multicentric Phase II Single-Arm Trial of Short-Course Radiotherapy Followed by Intensified Consolidation Chemotherapy With the Triplet FOLFOXIRI as Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer","authors":"Beatrice Borelli ,&nbsp;Veronica Conca ,&nbsp;Martina Carullo ,&nbsp;Aldo Sainato ,&nbsp;Roberto Mattioni ,&nbsp;Bruno Manfredi ,&nbsp;Riccardo Balestri ,&nbsp;Piero Buccianti ,&nbsp;Luca Morelli ,&nbsp;Piercarlo Rossi ,&nbsp;Paola Vagli ,&nbsp;Alessandra Anna Prete ,&nbsp;Frassineti Luca ,&nbsp;Federica Morano ,&nbsp;Samantha Di Donato ,&nbsp;Lisa Salvatore ,&nbsp;Carmelo Bengala ,&nbsp;Daniele Rossini ,&nbsp;Luca Boni ,&nbsp;Carlotta Antoniotti ,&nbsp;Roberto Moretto","doi":"10.1016/j.clcc.2023.06.002","DOIUrl":"10.1016/j.clcc.2023.06.002","url":null,"abstract":"<div><h3>Background</h3><p>In patients with locally advanced rectal cancer (LARC) treated with preoperative (chemo) radiotherapy and surgery, adjuvant chemotherapy is poorly feasible and its benefit is questionable. In the last years, several total neoadjuvant treatment (TNT) strategies, moving the adjuvant chemotherapy to the neoadjuvant setting, have been investigated with the aim of improving compliance to systemic chemotherapy, treating micrometastases earlier and then reducing distant recurrence.</p></div><div><h3>Patients and Methods</h3><p>ShorTrip (NTC05253846) is a prospective, multicentre, single-arm phase II trial where 63 patients with LARC will be treated with short-course radiotherapy followed by intensified consolidation chemotherapy with FOLFOXIRI regimen and surgery. Primary endpoint is pCR. Among the first 11 patients who started consolidation chemotherapy, a preliminary safety analysis showed a high rate of grade 3 to 4 neutropenia (N = 7, 64%) during the first cycle of FOLFOXIRI. Therefore, the protocol has been emended with the recommendation to omit irinotecan during the first cycle of consolidation chemotherapy. After amendment, in a subsequent safety analysis focused on the first 9 patients treated with FOLFOX as first cycle and then with FOLFOXIRI, grade 3 to 4 neutropenia was reported in only one case during the second cycle.</p></div><div><h3>Aim of the study</h3><p>The aim of this study is to assess the safety and activity of a TNT strategy including SCRT, intensified consolidation treatment with FOLFOXIRI and delayed surgery. After protocol amendment, the treatment seems feasible without safety concern. Results are expected at the end of 2024.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 3","pages":"Pages 339-343.e3"},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10480328","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":"Differential Efficacy of Targeted Monoclonal Antibodies in Left-Sided Colon and Rectal Metastatic Cancers","authors":"Hiroyuki Kodama,&nbsp;Toshiki Masuishi,&nbsp;Munehiro Wakabayashi,&nbsp;Akinobu Nakata,&nbsp;Ryosuke Kumanishi,&nbsp;Taiko Nakazawa,&nbsp;Takatsugu Ogata,&nbsp;Yuki Matsubara,&nbsp;Kazunori Honda,&nbsp;Yukiya Narita,&nbsp;Hiroya Taniguchi,&nbsp;Shigenori Kadowaki,&nbsp;Masashi Ando,&nbsp;Kei Muro","doi":"10.1016/j.clcc.2023.05.002","DOIUrl":"10.1016/j.clcc.2023.05.002","url":null,"abstract":"<div><h3>Background</h3><p>The recommended first-line chemotherapy for <em>RAS/BRAF</em> wild-type metastatic colorectal cancer (mCRC) is bevacizumab (BEV)-containing therapy for right-sided colon cancer (R) and antiepidermal growth factor receptor antibody (anti-EGFR)-containing therapy for left-sided colon cancer (L) or rectal cancer (RE). However, anatomical or biological heterogeneity reportedly exists between L and RE. Therefore, we aimed to compare the efficacies of anti-EGFR and BEV therapies for L and RE, respectively.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed 265 patients with <em>KRAS (RAS</em>)/<em>BRAF</em> wild-type mCRC treated with fluoropyrimidine-based doublet chemotherapy plus anti-EGFR or BEV as the first-line treatment at a single institution. They were divided into 3 groups: R, L, and RE. Overall survival (OS), progression-free survival (PFS), objective response rate, and conversion surgery rate were analyzed.</p></div><div><h3>Results</h3><p>Forty-five patients had R (anti-EGFR/BEV: 6/39), 137 patients had L (45/92), and 83 patients had RE (25/58). In patients with R, both median (m) PFS and OS were superior with BEV therapy (mPFS, anti-EGFR vs. BEV: 8.7 vs. 13.0 months, hazard ratio [HR]: 3.90, <em>P</em> = .01; mOS, 17.1 vs. 33.9 months, HR: 1.54, <em>P</em> = .38). In patients with L, better mPFS and comparable mOS with anti-EGFR therapy were observed (mPFS, 20.0 vs. 13.4 months, HR: 0.68, <em>P</em> = .08; mOS, 44.8 vs. 36.0 months, HR: 0.87, <em>P</em> = .53), whereas, in patients with RE, comparable mPFS and worse mOS with anti-EGFR therapy were observed (mPFS, 17.2 vs. 17.8 months, HR: 1.08, <em>P</em> = .81; mOS, 29.1 vs. 42.2 months, HR: 1.53, <em>P</em> = .17).</p></div><div><h3>Conclusions</h3><p>Efficacies of anti-EGFR and BEV therapies may differ between patients with L and RE.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 3","pages":"Pages 298-306"},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114109","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":"Revisiting the Radical Radiotherapy-Radiochemotherapy Results in Anal Canal Cancers: (TROD Gastrointestinal Group Study 02-005)","authors":"Sule Karabulut GUL ,&nbsp;Huseyin Tepetam ,&nbsp;Ferah Yildiz ,&nbsp;Ilhami Er ,&nbsp;Didem Colpan Oksuz ,&nbsp;Murtaza Parvizi ,&nbsp;Ayse Sevgi Ozden ,&nbsp;Zumre Arican Alicikus ,&nbsp;Sezin Yuce Sari ,&nbsp;Omar Alomari ,&nbsp;Ilknur Bilkay Gorken","doi":"10.1016/j.clcc.2023.05.004","DOIUrl":"10.1016/j.clcc.2023.05.004","url":null,"abstract":"<div><h3>Background and Aim</h3><p>This study aimed to determine treatment outcomes and factors affecting prognosis in patients diagnosed with anal canal cancer who received radical radiotherapy (RT) or radiotherapy combined with chemotherapy (CT-RT) in radiation oncology centers in Turkey and compare the results with literature.</p></div><div><h3>Material and Method</h3><p>The study included 193 patients with anal canal cancer reported between 1995 and 2019, of which 162 had complete data. The study was conducted in 11 radiation oncology centers, and a joint database was shared among them. Patients received radiotherapy doses of 45 Gy to 60 Gy. Data analysis was done using SPSS for Windows version 20.</p></div><div><h3>Results</h3><p>Median follow-up was 48.51 months (2-214). All patients received radiotherapy, and 140 (86.4%) received concurrent chemotherapy. Radiotherapy doses of 50.4 Gy to 60 Gy were administered to 74 patients (45.7%) using 2-dimensional-3-dimensional (2D-3D) conformal therapy and 70 patients (43.2%) using intensity modulated radiotherapy technique (IMRT). Acute phase hematologic toxicity was observed in 62 patients (38.3%), and nonhematologic toxicity in 123 patients (75.9%). The 5-year overall survival (OS) rate was 75.1% and disease-specific survival (DSS) rate was 76.4%. OS without colostomy was achieved in 79,8 % at 5 years, and complete response in 112 patients (69.1%). OS rate was significantly higher in 142 patients with positive response (<em>P</em> &lt; .000) and 112 with complete response (<em>P</em> &lt; .000). Anemia (<em>P</em> &lt; .002), local progression, and systemic progression (<em>P</em> &lt; .000) resulted in lower OS (<em>P</em> &lt; .002). In univariate analysis, factors affecting OS rate were: gender, age, stage, lymph node status, T stage, RT treatment duration, and treatment planning with PET fusion, which were found to be statistically significant. Completing radiotherapy in less than 45 days, concurrent chemotherapy, and continued administration of mitomycin and 5 FU as chemotherapy had a significant positive effect on overall survival. OS rate was higher in patients receiving RT dose of 58 Gy or less and undergoing IMRT planning in radiotherapy. IMRT was associated with lower acute and late side effects.</p></div><div><h3>Conclusion</h3><p>Radiochemotherapy is the primary treatment for anal canal cancer and advanced radiotherapy techniques may increase survival by reducing side effects and improving treatment continuation. Higher treatment doses require further investigation. The efficacy of treatment can be improved by including patients treated with modern radiotherapy techniques in multicenter prospective studies using new and more effective chemotherapy and immunotherapy agents.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 3","pages":"Pages 318-326"},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118921","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":"Effect of High-Versus Low-Frequency of Abdominopelvic Computed Tomography Follow-Up Testing on Overall Survival in Patients With Stage II Or III Colon Cancer","authors":"Jeongseok Jeon ,&nbsp;Da Bin Lee ,&nbsp;Sang Joon Shin ,&nbsp;Dai Hoon Han ,&nbsp;Jee Suk Chang ,&nbsp;Yoon Dae Han ,&nbsp;Hyunwook Kim ,&nbsp;Joon Seok Lim ,&nbsp;Han Sang Kim ,&nbsp;Joong Bae Ahn","doi":"10.1016/j.clcc.2023.05.003","DOIUrl":"10.1016/j.clcc.2023.05.003","url":null,"abstract":"<div><h3>Background</h3><p>Intensive surveillance of colon cancer by using the abdominopelvic computed tomography (AP-CT) is common in real world practice; however, it is still unclear whether high-frequency surveillance using AP-CT in patients with these risk factors is superior to that in the low-frequency surveillance.</p></div><div><h3>Patients and Methods</h3><p>We retrospectively reviewed 1803 patients with stage II-III colon cancer receiving curative surgery between January 1, 2005 to December 31, 2015. We evaluated the average scan-to-scan intervals of postoperative AP-CT testing and assigned patients with an interval of 5 to 8 and 9 to 13 months to the high-frequency (HF) and low-frequency (LF) groups, respectively. The cutoff value of preoperative and postoperative CEA levels was 5 ng/mL. We also applied propensity score matching (PSM) and inverse probability of treatment weighting to adjust clinicopathologic differences between the 2 groups.</p></div><div><h3>Results</h3><p>We matched 1:1 for each surveillance group yielding a cohort of 776 matched patients. After PSM, Baseline demographics were overall well balanced between 2 groups. Stage III (OR, 2.00; 95% Confidence interval [CI], 1.21-3.30) and postoperative CEA elevation (OR, 2.30; 95% CI, 1.08-4.92) were independent risk factors of recurrence in multivariate analyses. Patient in the HF group had more surgery plus chemo- or radiotherapy as postrecurrence treatment than patient in the LF group (46.2% vs. 23.1%, <em>P</em> = .017). This trend was retained after PSM, although it is not significant (44.4% vs. 23.1%, <em>P</em> = .060). However, survival outcomes of high-frequency AP-CT surveillance were not superior to those of low-frequency surveillance in all subgroups, including stage III (HR 0.99, 95% CI 0.40-2.47) and postoperative CEA elevation (HR 1.36, 95% CI 0.45-4.11).</p></div><div><h3>Conclusion</h3><p>High-frequency AP-CT testing is associated with a higher proportion of surgery plus chemo- or radiotherapy as postrecurrence treatment, without improvement in 5-year overall survival.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 3","pages":"Pages 307-317"},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118907","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":"Improving Outcome of Selected Patients With Non-Resectable Hepatic Metastases From Colorectal Cancer With Liver Transplantation: A Prospective Parallel Trial (COLT trial)","authors":"Carlo Sposito ,&nbsp;Filippo Pietrantonio ,&nbsp;Marianna Maspero ,&nbsp;Fabrizio Di Benedetto ,&nbsp;Marco Vivarelli ,&nbsp;Giuseppe Tisone ,&nbsp;Luciano De Carlis ,&nbsp;Renato Romagnoli ,&nbsp;Salvatore Gruttadauria ,&nbsp;Michele Colledan ,&nbsp;Salvatore Agnes ,&nbsp;Giuseppe Ettorre ,&nbsp;Umberto Baccarani ,&nbsp;Guido Torzilli ,&nbsp;Stefano Di Sandro ,&nbsp;Domenico Pinelli ,&nbsp;Lucio Caccamo ,&nbsp;Andrea Sartore Bianchi ,&nbsp;Carlo Spreafico ,&nbsp;Valter Torri ,&nbsp;Vincenzo Mazzaferro","doi":"10.1016/j.clcc.2023.01.003","DOIUrl":"10.1016/j.clcc.2023.01.003","url":null,"abstract":"<div><h3>Background</h3><p>Patients with unresectable Colorectal Liver Metastases (CLM) receiving palliative chemotherapy have a 5-year overall survival (OS) of less than 30%. Liver transplantation (LT) can improve OS up to 60%-83% (SECA-I and SECA-II trials). The aim of the study is to assess the efficacy of LT in liver-only metastatic CRC compared with a matched cohort of patients included in a phase III trial on triplet chemotherapy + antiEGFR.</p></div><div><h3>Patients and Methods</h3><p>The COLT trial is an investigator-driven, multicenter, non-randomized, open-label, controlled, prospective, parallel trial (ClinicalTrials.gov NCT03803436). Hyperselected patients with liver-limited unresectable CLM, <em>RAS</em> and <em>BRAF</em> wild-type and curatively removed primary colon cancer are included. The observed post-transplant outcomes will be prospectively compared 1:5 with those obtained in a matched cohort from the TRIPLETE trial (NCT03231722).</p></div><div><h3>Results</h3><p>Primary endpoint is to compare the 3 and 5-years OS of patients enrolled in the COLT trial with COLT-eligible population enrolled in the TRIPLETE trial. An expected gain in OS of 40% at 5-years is predicted for the COLT population (the expected OS at 5-years in COLT vs. TRIPLETE is 70% vs. 30%). Secondary endpoints are to compare the 5-years disease-free survival and to assess the safety of LT (Dindo-Clavien Classification and the Comprehensive Complication Index).</p></div><div><h3>Conclusion</h3><p>LT offers the longest OS reported in selected patients with CLM. Improving the selection strategies can give patients a 5-year OS similar to other indications for LT and a better outcome than those undergoing chemotherapy alone.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 2","pages":"Pages 250-255"},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9672382","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":"Incidence of Disease Recurrence in Patients With Colon and Upper Rectum Adenocarcinoma Stage II and III Receiving Adjuvant Capecitabine Monotherapy: Do Number of Chemotherapy Cycles and Relative Dose Intensity of the Drug Play a Role?","authors":"Joseph Sgouros ,&nbsp;Stefania Gkoura ,&nbsp;Nikolaos Spathas ,&nbsp;Fotios Tzoudas ,&nbsp;Konstantinos Karampinos ,&nbsp;Nikolaos Miaris ,&nbsp;Anastasios Visvikis ,&nbsp;Nick Dessypris ,&nbsp;Davide Mauri ,&nbsp;Gerasimos Aravantinos ,&nbsp;Ilias Theodoropoulos ,&nbsp;George Stamoulis ,&nbsp;Epaminondas Samantas","doi":"10.1016/j.clcc.2023.02.007","DOIUrl":"10.1016/j.clcc.2023.02.007","url":null,"abstract":"<div><h3>Introduction/Background</h3><p>Adjuvant capecitabine<span><span> monotherapy is an option for colon and upper </span>rectum adenocarcinoma patients, providing they have stage II disease with an intermediate risk of recurrence, or stage III but they are above 70’s or they have comorbidities. We wanted to examine whether the number of chemotherapy cycles and the relative dose intensity (RDI) of capecitabine monotherapy in the adjuvant setting are affecting disease recurrence.</span></p></div><div><h3>Patients and Methods</h3><p>We included patients with completely resected stage II and III colon and upper rectum cancer<span> who received adjuvant capecitabine monotherapy, from 2003 until May 2020. Patients with early relapse, i.e. during chemotherapy or within 6 months after the completion of adjuvant chemotherapy<span>, and those with rectal cancer who received radiotherapy were excluded. Patients were divided into 3 groups based on the number of chemotherapy cycles received and the RDI. Group A included patients with ≤4 cycles of chemotherapy, group B patients with &gt;4 cycles of chemotherapy and RDI ≤80%, and group C patients with &gt;4 cycles of chemotherapy and RDI &gt;80%. Study’s endpoint, was recurrence free survival (RFS).</span></span></p></div><div><h3>Results</h3><p>Two hundred twenty six patients with stage II and III disease (164 and 62 respectively) were included. Sixteen, 166 and 44 were included in groups A, B and C respectively. After a median follow-up of 41 months, 21 patients (9,3%) had relapsed. Patients belonging to group C were found to have a trend for lower relapse rate compared to patients belonging to group A or group B.</p></div><div><h3>Conclusion</h3><p>Number of adjuvant capecitabine cycles and RDI might play a role in RFS in patients with stage II and III colon and upper rectum adenocarcinoma.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 2","pages":"Pages 238-244"},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674437","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}