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Colorectal Cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

Colorectal Cancer

Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile

“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...

Colorectal Cancer

Fam-Trastuzumab Deruxtecan-nxki Shows Benefit in Refractory Colorectal Cancer

Having recently gained approval in metastatic breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd) is now proving its worth in metastatic colorectal cancer, according to results of the phase II DESTINY-CRC01 study in patients with HER2-positive disease.1 T-DXd is an antibody-drug conjugate...

Colorectal Cancer

KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer

In an updated analysis of the pivotal phase III KEYNOTE-177 trial of pembrolizu-mab for microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to ...

Colorectal Cancer
COVID-19

Treating Colorectal Cancer in the Time of COVID-19

The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. In the spring of 2020, The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing...

Colorectal Cancer
Genomics/Genetics

KRAS Mutation Status May Predict Outcomes After Hepatic Arterial Infusion Pump Therapy for Unresectable Colorectal Liver Metastases

KRAS mutational status in patients with unresectable liver metastases from colorectal cancer predicts a worse response to hepatic arterial infusion (HAI) pump chemotherapy, according to research presented by Kolbeinsson et al at the Society of Surgical Oncology 2021 International Conference on...

Colorectal Cancer
Gastroesophageal Cancer

Circulating Hybrid Cells May Help to Monitor Treatment Response in Patients With Rectal and Esophageal Cancers

An analysis of 58 peripheral blood specimens from patients with rectal and esophageal cancers demonstrated that circulating hybrid cells may be a novel, noninvasive biomarker with potential for monitoring treatment response and disease progression to help guide decisions for further therapy,...

Colorectal Cancer
Survivorship

Use of Chemotherapy and Risk of Alzheimer’s Disease in Colorectal Cancer Survivors

In a retrospective cohort study reported in JCO Oncology Practice, Akushevich et al found that receipt of chemotherapy was associated with a reduced risk of Alzheimer’s disease in colorectal cancer survivors. As stated by the investigators, “Evidence on the nature of the relationship between...

Colorectal Cancer

Using CT Colonography as a Noninvasive Colorectal Cancer Screening Test for Advanced Neoplasia

According to a report published by Pickhardt et al in the American Journal of Roentgenology (AJR), compared with multitarget stool DNA and fecal immunochemical tests, computed tomography (CT) colonography using a polyp size threshold ≥ 10 mm most effectively targeted advanced neoplasia—preserving...

Colorectal Cancer

Complete Mesocolic Excision vs D2 Dissection in Patients Undergoing Laparoscopic Colectomy for Right-Sided Colon Cancer

In an analysis of early safety outcomes in a Chinese phase III trial (RELARC) reported in The Lancet Oncology, Xu et al found similar surgical complication rates with complete mesocolic excision vs D2 dissection in patients undergoing laparoscopic colectomy for right-sided colon cancer. The...

Colorectal Cancer

KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer

In an updated analysis of the pivotal phase III KEYNOTE-177 trial in microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to immunotherapy for...

Colorectal Cancer

Addition of Primary Tumor Resection to Chemotherapy for Asymptomatic Primary Colorectal Cancer Tumors and Synchronous Unresectable Metastases

In a Japanese phase III trial (JCOG1007; iPACS) reported in the Journal of Clinical Oncology, Kanemitsu et al found that the addition of primary tumor resection to chemotherapy did not improve overall survival vs chemotherapy alone in patients with asymptomatic primary colorectal cancer tumors and...

Colorectal Cancer

Expert Point of View: Michael J. Overman, MD

The study’s invited discussant, Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, said the findings of the study presented by Henriksen et al1 add to a convincing body of data showing that “the use of circulating...

Colorectal Cancer

Predicting Postoperative Recurrence in Stage I to III Colorectal Cancer With Circulating Tumor DNA

Patients with stage I to III colorectal cancer who have a high risk for recurrence may be identified by serial testing of circulating tumor DNA (ctDNA) after resection, according to a study in which ctDNA proved more reliable than carcinoembryonic antigen (CEA) surveillance or standard radiologic...

Colorectal Cancer

Delay in Time Between Abnormal At-Home Screening and Colonoscopy May Increase Colorectal Cancer Risk

At-home tests, which measure blood in stool as a potential marker for colon cancer, are often used for colorectal cancer screening. Usage of these tests has increased during the COVID-19 pandemic as patients try to avoid clinical visits. However, effectiveness of these screening tools, along with...

Colorectal Cancer

Study Shows Aspirin Use Before Diagnosis May Lower Colorectal Cancer Mortality

A recent study found that long-term aspirin use before a diagnosis of colorectal cancer may be associated with lower colorectal cancer–specific mortality. The report, published by Figueiredo et al in JNCI: The Journal of the National Cancer Institute, suggests that the findings for prediagnosis...

Colorectal Cancer
COVID-19
Issues in Oncology

Socially Distant Drive-by FluFIT Clinics May Increase Colorectal Cancer Screening Rates Among Black Patients During the COVID-19 Pandemic

Administering colorectal cancer screening kits through a socially distant drive-by flu vaccination clinic increased access to colorectal cancer screening among Black Americans, according to results presented by Washington et al at the AACR Virtual Meeting: COVID-19 and Cancer (Abstract S02-04)....

Colorectal Cancer

Hyperthermic Intraperitoneal Chemotherapy Plus Cytoreductive Surgery for Colorectal Cancer Metastases Does Not Improve Overall Survival

As reported in The Lancet Oncology by Quénet et al, the French phase III PRODIGE 7 trial has shown that the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery did not improve overall survival—and was associated with an increase in postoperative late...

Colorectal Cancer

Adjuvant Doublet Chemotherapy for High-Risk Stage II Colorectal Cancer: 3- or 6- Month Duration?

In an analysis of data from the IDEA collaboration reported in the Journal of Clinical Oncology, Timothy J. Iveson, MD, FRCP, and colleagues found that 3 months (vs 6 months) of adjuvant CAPOX (capecitabine and oxaliplatin) may be a potential treatment option for patients with high-risk colorectal...

Colorectal Cancer

New Clinical Calculator May Predict Recurrence Risk After Curative Colectomy for Colon Cancer

As reported in the Journal of Clinical Oncology, Weiser et al have developed a "third-generation" clinical calculator at Memorial Sloan Kettering Cancer Center (MSK), which incorporates molecular and clinicopathologic characteristics and provides an accurate prediction of disease recurrence...

Immunotherapy
Gastroesophageal Cancer
Gastrointestinal Cancer
Colorectal Cancer
Bladder Cancer
Skin Cancer
Sarcoma
Hepatobiliary Cancer

FDA Pipeline: Priority Reviews for Immunotherapies in Gastric Cancers, Anal Cancer

The U.S. Food and Drug Administration (FDA) recently granted Priority Review to nivolumab as either adjuvant or first-line therapy in several types of gastric cancers, as well as to a novel PD-1 inhibitor for locally advanced or metastatic squamous cell carcinoma of the anal canal. The FDA also...

Colorectal Cancer
Immunotherapy

Addition of Vemurafenib to Irinotecan/Cetuximab in Previously Treated Patients With BRAF V600E–Mutant Metastatic Colorectal Cancer

In a phase II trial (SWOG S1406) reported in the Journal of Clinical Oncology, Scott Kopetz, MD, PhD, and colleagues found that the addition of vemurafenib to irinotecan and cetuximab significantly improved progression-free survival in previously treated patients with BRAF V600E–mutant metastatic...

Colorectal Cancer

Duration of Adjuvant Chemotherapy Assessed in Stage III Colon Cancer

As reported in The Lancet Oncology by Thierry André, MD, of Sorbonne Université and Hôpital Saint Antoine, Paris, and colleagues, the prospective pooled analysis of six phase III trials in the IDEA collaboration has shown that noninferiority in overall survival for 3 vs 6 months of adjuvant...

Colorectal Cancer

High Recurrence-Free Survival Rates in Rectal Cancer After Clinical Complete Response to Neoadjuvant Chemoradiotherapy

In a study reported in The Lancet Oncology, Laura M. Fernandez, MD, of Champalimaud Foundation, Lisbon, and colleagues found high rates of conditional recurrence-free survival during watch-and-wait surveillance among patients with rectal cancer who maintained a clinical complete response to...

colorectal cancer

Tenna V. Henriksen, PhD Candidate, on Colorectal Cancer: Circulating Tumor DNA Analysis to Improve Treatment

Tenna V. Henriksen, PhD Candidate, of Aarhus University, discusses her findings on how circulating tumor DNA may help assess recurrence risk and the benefit of adjuvant therapy, and more quickly detect early relapse after treatment in patients with colorectal cancer (Abstract 11).

Genomics/Genetics
Colorectal Cancer
Lung Cancer

Prevalence of KRAS G12C Somatic Mutations by Cancer Type, Race, and Sex

In a study reported in a letter to the editor in The New England Journal of Medicine, Nassar et al identified the prevalence of the formerly “undruggable” KRAS G12C mutation across tumor types, race, and sex. As stated by the investigators, a recently reported early-phase clinical trial has shown...

Gastrointestinal Cancer
Colorectal Cancer
Gastroesophageal Cancer

Anti–PD-1 Therapy Dostarlimab for dMMR Gastrointestinal Cancers: Safety and Efficacy Examined

Dostarlimab, a monoclonal antibody targeting PD-1, showed strong and durable antitumor activity in patients with mismatch repair–deficient (dMMR) gastrointestinal tumors in the phase I GARNET study, reported Thierry André, MD, of Sorbonne Université and Hôpital Saint Antoine, Paris, and colleagues...

colorectal cancer
immunotherapy

Kai-Keen Shiu, MD, PhD, on Colorectal Cancer: Pembrolizumab vs Chemotherapy for Microsatellite Instability–High Disease

Kai-Keen Shiu, MD, PhD, of the University College Hospital NHS Foundation Trust - London, discusses an interim analysis of PFS 2 results (defined as time from random assignment to progression on the next line of therapy or death) from the phase III KEYNOTE-177 trial. This study has already shown that first-line pembrolizumab provides a clinically meaningful and statistically significant improvement in PFS compared with chemotherapy in patients with microsatellite instability–high metastatic colorectal cancer (Abstract 6).

colorectal cancer

Romain Cohen, MD, PhD, on Colon Cancer: Prognostic Value of Tumor Deposits

Romain Cohen, MD, PhD, of the Mayo Clinic and Sorbonne University, discusses a post-hoc analysis of phase III results from the CALGB/SWOG 80702 study, which showed that adding the number of tumor deposits, a negative prognostic factor, to the count of lymph node metastases may improve the accuracy of TNM staging (Abstract 10).

Colorectal Cancer

Postsurgical Disease Recurrence in Stage I to III Colorectal Cancer May Be Predicted by ctDNA

Patients with stage I to III colorectal cancer and a high risk for disease recurrence may be identified by serial testing of circulating tumor DNA (ctDNA) after resection, according to a study in which ctDNA was more reliable than carcinoembryonic antigen (CEA) surveillance or standard radiologic...

Colorectal Cancer

Study Finds Artificial Intelligence May Help to Identify New Risk Factors for Early-Onset Colorectal Cancer

Electronic health record–based artificial intelligence may help uncover new risk factors in the development of early-onset colorectal cancer, according to study findings presented by Parker et al at the AACR Virtual Special Conference: Artificial Intelligence, Diagnosis, and Imaging (Abstract...

Colorectal Cancer

Adding Oxaliplatin to Fluoropyrimidine for Patients With Stage III Colon Cancer and Microsatellite Instability

In a pooled analysis reported in the Journal of Clinical Oncology, Cohen et al found that the addition of oxaliplatin to fluoropyrimidine was associated with improved overall and disease-free survival in patients with stage III colon cancer with microsatellite instability (MSI). They also found the ...

Breast Cancer
Gynecologic Cancers
Colorectal Cancer

Rates of Eligible People Missing Timely Cancer Screenings: A Canadian Analysis

New research published by Abdel-Rahman in JNCCN—Journal of the National Comprehensive Cancer Network found more than one-third of eligible people miss timely screening tests for colorectal cancer, and at least one-quarter appear to miss timely screening tests for breast and cervical cancers....

Colorectal Cancer

Total Neoadjuvant Therapy vs Standard Therapy for Locally Advanced Rectal Cancer

In a systematic review and meta-analysis reported in JAMA Network Open, Kasi et al found that total neoadjuvant therapy was associated with improved pathologic complete response rates vs standard therapy with neoadjuvant concurrent chemoradiotherapy plus adjuvant chemotherapy in patients with...

Colorectal Cancer

Final Overall Survival Results of the IDEA Collaboration: 3 vs 6 Months of Adjuvant Chemotherapy for Stage III Colon Cancer

Thierry André, MD, and colleagues reported the prospective pooled analysis of six phase III trials in the IDEA collaboration in The Lancet Oncology. The analysis showed that noninferiority in overall survival for 3 vs 6 months of adjuvant chemotherapy was not established in patients with stage III...

Colorectal Cancer

Intensity of Active Surveillance in Patients With Rectal Cancer Managed With a Watch-and-Wait Approach

In a study reported in The Lancet Oncology, Fernandez et al found high rates of conditional recurrence-free survival during watch-and-wait surveillance among patients with rectal cancer who maintained clinical complete response to neoadjuvant chemotherapy for 1, 3, or 5 years. Study Details In the...

Colorectal Cancer

Study Reports Highly Skilled Surgeons Significantly Reduce Death From Colon Cancer

To improve long-term survival odds, individuals with early-stage colon cancer should have their surgery performed by highly skilled surgeons. In a study that used video assessment, surgeons with highly ranked skills gave their patients a 69% lower risk of dying at 5 years as compared with their...

Colorectal Cancer

Pembrolizumab Improves Progression-Free Survival vs Chemotherapy in First-Line Treatment of Microsatellite Instability–High Advanced Colorectal Cancer

As reported in The New England Journal of Medicine by Thierry André, MD, of Sorbonne Université and Hôpital Saint Antoine, Paris, and colleagues, the second interim analysis of the phase III KEYNOTE-177 trial has shown significantly prolonged progression-free survival with pembrolizumab vs...

Colorectal Cancer

My Life of Service to Other Cancer Survivors

Six months before my diagnosis of metastatic colorectal cancer, in 2016, at age 38, I told my mom, “I feel like I’m dying.” Even though more than 10 specialists I had seen over the previous 8 years for unexplained bouts of abdominal pain and bloating, fatigue, and constipation kept assuring me that ...

Colorectal Cancer

Radiotherapy and Chemotherapy Before Total Mesorectal Excision for Locally Advanced Rectal Cancer: Comparison of Regimens

As reported in The Lancet Oncology by Bahadoer et al, the phase III RAPIDO trial has shown improved 3-year disease-related treatment failure with preoperative short-course radiotherapy followed by chemotherapy and total mesorectal excision (TME) vs preoperative chemoradiotherapy, TME, and optional...

Colorectal Cancer
Immunotherapy

Pembrolizumab vs Chemotherapy in First-Line Treatment of Microsatellite Instability–High Advanced Colorectal Cancer: KEYNOTE-177 Trial

As reported in The New England Journal of Medicine, the second interim analysis of the phase III KEYNOTE-177 trial has shown significantly prolonged progression-free survival with pembrolizumab vs fluorouracil (5-FU)-based chemotherapy as first-line treatment of patients with advanced...

Colorectal Cancer

Statins Reduced Risk of Colorectal Cancer in Meta-analysis

A systematic meta-analysis has shown that statin users had a significantly reduced risk of colorectal cancer. The study included patients with and without inflammatory bowel disease, which is associated with an increased risk of this type of cancer. The largest chemopreventive effect was observed...

Colorectal Cancer

ESMO Asia 2020: Performance of Immunoscore in Asian Patients With Early-Stage Colon Cancer

The Immunoscore assay can assess the risk of disease recurrence in Asian patients with early-stage colon cancer and may be used together with TNM classification to guide clinical decision-making, according to findings presented at the European Society for Medical Oncology (ESMO) Asia Virtual...

Colorectal Cancer

U.S. Multisociety Task Force on Colorectal Cancer Offers Management Strategies for Malignant Colorectal Polyps

Early identification and removal of cancerous colorectal polyps are critical to preventing the progression of colorectal cancer and improving survival rates. The U.S. Multisociety Task Force on Colorectal Cancer has released new guidance for endoscopists on how to assess colorectal lesions for...

Colorectal Cancer

Effect of Anterior Approach vs Conventional Hepatectomy in Resection of Colorectal Liver Metastases on Intraoperative Tumor Cell Dissemination

In a German single-institution study reported in JAMA Surgery, Rahbari et al found that the anterior approach to the resection of colorectal liver metastases was not associated with a reduction in the detection of intraoperative circulating tumor cells vs conventional hepatectomy. As stated by the...

Colorectal Cancer

Addition of Irinotecan to Neoadjuvant Capecitabine Chemoradiation Guided by UGT1A1 Genotype in Locally Advanced Rectal Cancer

In a Chinese phase III trial reported in the Journal of Clinical Oncology, Zhu et al found that the addition of irinotecan to neoadjuvant capecitabine chemoradiation (CapIriRT)—with irinotecan dosing guided by UGT1A1 genotype—followed by capecitabine/irinotecan (XELIRI) significantly improved...

Colorectal Cancer

Surgical Technical Skill and Long-Term Survival After Surgery for Colon Cancer

In a study reported as a research letter in JAMA Oncology, Brajcich et al found that higher-rated surgical technical skill was associated with significantly improved long-term survival in patients undergoing surgery for colon cancer.  Study Details In the study, surgeons were recruited from the...

Legislation
Breast Cancer
Colorectal Cancer
Lung Cancer

Medicaid Expansion Associated With Decreased Mortality in Patients With Newly Diagnosed Breast, Colorectal, and Lung Cancers

In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major types of cancer are significantly lower than in states that have not expanded their Medicaid, according to findings from a new study published by Miranda B. Lam, MD, MBA, and ...

Colorectal Cancer

After Surgery for Colorectal Cancer, Intensive Monitoring of Little Benefit: PRODIGE 13

Is intensive monitoring of patients after curative colorectal cancer resection warranted? Not necessarily, according to the findings of PRODIGE 13, reported at the European Society for Medical Oncology (ESMO) Virtual Congress 2020.1 “After curative surgery, the addition of CEA [carcinoembryonic...

Colorectal Cancer

Should Patients With a Complete Response to Neoadjuvant Chemoradiation for Rectal Cancer Also Undergo Surgery?

A nonsurgical treatment option for rectal cancer that preserves quality of life may be safe for selected patients, according to a new study comparing it with standard surgical treatment. These findings were published by Beard et al in the Journal of the American College of Surgeons and were...

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