Clinical Colorectal Cancer

Aflibercept-Based and Bevacizumab-Based Second Line Regimens in Patients with Metastatic Colorectal Cancer: Propensity Score Weighted-Analysis from a Multicenter Cohort
Lucchetti J, Angotti L, Parisi A, Basso M, Polito MG, Zoratto F, Di Giacomo E, Nitti D, Minelli A, Salvatore L, Calegari MA, Lo Prinzi F, Gemma D, Signorelli C, Veroli M, Anghelone A, Galbato Muscio L, Di Cocco B, Trombetta G, Morelli C, Schietroma F, Vincenzi B, Cortellini A and Tonini G
Both aflibercept and bevacizumab-based regimens are available II-line treatment options for patients with metastatic colorectal cancer (mCRC). However, no head-to-head trials established the optimal anti-angiogenic strategy for this setting.
Multidisciplinary Team Meeting Significantly Enhances Disease-Free Survival in Stage II-III Rectal Cancer
Jiang W, Dou X, Zhang N, Yu J, Zhao L and Yue J
Multidisciplinary team (MDT) meetings have been increasingly recognized for enhancing cancer treatment outcomes; however, their specific impact on stage II-III rectal cancer remains to be fully elucidated.
Lack of Hierarchical Survival Prognosis in AJCC Staging for Colon and Rectal Cancer-Implications for Future Summary Stage Classification
Bhutiani N, Hu CY, Palis B, Cotler J, Shi Q, Washington MK, Goldberg RM, Steele SR and Chang GJ
Current American Joint Committee on Cancer (AJCC) staging for colorectal cancer utilizes TNM framework groups disease based on extent and provides prognostic information, ideally with a hierarchical logic. We sought to evaluate survival as a function of stage within the 8 edition AJCC staging system for colon and rectal cancer.
Incidence and Outcomes of Patients With Mismatch Repair Deficient Rectal Cancer Operated in 2016: A Nationwide Cohort From The Netherlands
van Geffen EGM, Hogewoning CRC, Hazen SJA, Sluckin TC, Lange MM, Snaebjornsson P, Beets-Tan RGH, Marijnen CAM, Verhoef C, Chalabi M, Tanis PJ, Kusters M, Aukema TS and
Data regarding the incidence and outcomes of mismatch repair deficient (dMMR) rectal cancer is limited. This study characterizes dMMR rectal cancer patients, comparing response after neoadjuvant radiotherapy and oncological outcomes to mismatch repair proficient (pMMR) rectal cancer patients.
Exploring Early Kinetic Profiles of CEA, ctDNA and cfDNA in Patients With RAS-/BRAF-Mutated Metastatic Colorectal Cancer
Hamfjord J, Guren TK, Glimelius B, Sorbye H, Pfeiffer P, Dajani O, Lingjærde OC, Tveit KM, Spindler KG, Pallisgaard N and Kure EH
Patients with metastatic colorectal cancer (mCRC) respond differently to first-line chemotherapy. Early identification of patients with limited or no clinical benefit could prompt a timelier introduction of second-line therapy and potentially lead to improved overall outcomes. Carcinoembryonic antigen (CEA) is currently the only blood-based marker in clinical use for disease control monitoring in mCRC. Circulating cell-free DNA (cfDNA), including circulating tumor DNA (ctDNA) could become a useful surrogate for oncological outcomes.
AGITG MONARCC: A Randomized Phase 2 Study of Panitumumab Monotherapy and Panitumumab Plus 5-Fluorouracil as First-Line Therapy for Older Patients With RAS and BRAF Wild Type Metastatic Colorectal Cancer. A Study by the Australasian Gastro-Intestinal Trials Group (AGITG)
Burge ME, Espinoza D, Sjoquist KM, Siu DH, Mercieca-Bebber R, Chantrill LA, Karapetis CS, Steer CB, Yip S, Cuff J, Winata S, Tie J, Thaker DA, Srivastav R, Abdi E, Strickland A, Segelov E, Francesconi A, Price T, Ladwa R, Joubert W and Tebbutt NC
Panitumumab (pan) plus chemotherapy is a preferred first-line therapy for unresectable RAS and BRAF wild type metastatic colorectal cancer (mCRC). Older patients may not be suitable for combination regimens. We investigated 2 lower intensity pan-containing regimens.
SATB2 Expression Affects Chemotherapy Metabolism and Immune Checkpoint Gene Expression in Colorectal Cancer
Maguire B, Kisakol B, Prehn JHM and Burke JP
Special AT-rich binding protein-2 (SATB2) is a nuclear matrix associated protein regulating gene expression which is normally expressed in colonic tissue. Loss of SATB2 expression in colorectal cancer (CRC) has negative implications for prognosis and has been associated with chemotherapy resistance. Furthermore, recent evidence suggests SATB2 may influence immune checkpoint (IC) expression. We hypothesized that SATB2 expression may be associated with altered expression of chemotherapy resistance associated and IC genes.
Organ Preservation After Immune Checkpoint Inhibition for Locally Advanced Rectal Cancer
Claeys C, Billiet A, Haustermans K, Wolthuis A, Bislenghi G, D'Hoore A, Dresen R, Rasschaert G, Van Cutsem E, Van Herpe F and Dekervel J
Oncological Outcomes From Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Colorectal Cancer Peritoneal Metastases
Tinsley N, O'Dwyer ST, Nagaraju R, Braun M, Mullamitha S, Kamposioras K, Marti FEM, Saunders M, Clouston H, Selvasekar C, Wild J, Wilson M, Renehan A, Aziz O and Barriuso J
Cytoreductive surgery (CRS) is effective for colorectal cancer peritoneal metastases (CRPM) at increasing overall survival (OS) compared to systemic anticancer treatment (SACT) alone. The addition of Oxaliplatin heated intraperitoneal chemotherapy (HIPEC) has been shown in a randomized controlled trial to result in increased complications without significant OS benefit. This study evaluates outcomes for CRPM patients undergoing CRS+HIPEC with Oxaliplatin (Ox) 368mg/m (30 min), versus Mitomycin C (MMC) 35mg/m (90min).  METHODS: A prospective CRPM real-world database was used to collect outcomes for patients undergoing CRS+HIPEC at a single center. OS, recurrence-free (RFS), peritoneal RFS (PeRFS) were compared amongst all patients with histologically proven CRPM, those with completeness of cytoreduction (CC) score =0/1, and those with CC score=0/1 who were SACT naïve.  RESULTS: Between April 2005 and April 2021, 409 patients underwent CRS+HIPEC: 271 (66%) had MMC, 138 (34%) Ox. Of these, 395 (97%) had histologically confirmed CRPM, 336 (85%) achieved CC=0/1, 188 (47%) were SACT naïve; median OS =39.5, 44.4, and 47.2 months respectively. MMC versus Ox median OS in CC0/1=43.7 (95% CI 35.9-48.3) versus 50.1 (39.7-70.2) months, P = .28; Median OS in SACT naïve=45.7 (39.4-65.9) versus 59.9 (38.3-82.0) months, P = .31; multivariable analysis for CC0/1, SACT naïve patients showed Ox was comparable to MMC: HR=0.90, (0.64-1.27) P = .55 versus HR=0.88, (0.53-1.44) P = .60, respectively. Ox resulted in a significantly improved PeRFS in CC0/1 patients (MMC=9.0 versus Ox=12.6months, P = .01). A multivariable model for PeRFS showed a HR=0.63, (0.43-0.95), P = .03 for Ox.  CONCLUSION: This study suggests a role for Ox HIPEC in CRPM which should be explored further in clinical trials.
Impact of Treatment With Trifluridine/Tipiracil in Combination With Bevacizumab on Health-Related Quality of Life and Performance Status in Refractory Metastatic Colorectal Cancer: An Analysis of the Phase III SUNLIGHT Trial
Taieb J, Fakih M, Tabernero J, Ciardiello F, Van Cutsem E, Soler G, Calleja E, Barboux V, Roby L, Amellal N and Prager GW
The efficacy of trifluridine/tipiracil (FTD/TPI) + bevacizumab compared to FTD/TPI for treatment of refractory metastatic colorectal cancer (mCRC) was demonstrated in the SUNLIGHT trial. This analysis of SUNLIGHT investigated the impact of treatment with FTD/TPI + bevacizumab on patient quality of life (QoL) and Eastern Cooperative Oncology Group performance status (ECOG PS).
Rectosigmoid Junction Cancer; The Role of Preoperative and Postoperative Radiation With Novel Nomogram in Predicting Survival in the United States
Khan M, Chandasir A, Yasinzai AQK, Robinson J, Khan I, Jogezai ZH, Wali A, Jain H, Iqbal A, Sohail AH and Ullah A
There is controversy and limited data the management of rectosigmoid junction cancer (RSJC), especially the role of radiation. We aim to investigate the role of preoperative and postoperative radiation in RSJC and whether this cancer should be treated as a colon cancer or as a rectal cancer.
Efficacy and Safety of KH903 Plus FOLFIRI as a Second-Line Treatment in Unresectable Recurrent or Metastatic Colorectal Cancer: A Randomized Phase 2 Study
Li J, Ba YI, Lin R, Ke X, Yin X, Ying J, Cheng Y, Xu N, Xu J, Shen Y, Zhou J, Wang J, Qian X, Wu R, Zhang Y and Shen L
Patients with recurrent or metastatic advanced colorectal cancer (mCRC) often face the clinical dilemma as this unresectable disease is continuously progressing and endangering the patients' lives. In the current study, we explored the clinical feasibility of KH903 in combination with FOLFIRI chemotherapy as a new clinical indication for mCRC.
Outcomes of Elderly Patients With Node-Positive Colon Cancer: A Multicenter Population-Based Cohort Study
Pinter C, Sharma S, Abid A, Ahmed O, Le D, Kanthan R, Kanthan SC, Gill D, Chalchal H and Ahmed S
In this large population-based cohort study, we examined the prognostic significance of various clinical, pathological, and contextual variables for their correlation with survival in elderly patients with stage III colon cancer.
Long-Term Outcomes in Patients With Locally Advanced Rectal Cancer Following R1 Resection After Either Induction Chemotherapy and Chemoradiotherapy or Chemoradiotherapy Alone
Hein Nordvig E, Bergliot Grønbæk GM, Khalid Al-Uboody Z, Lykke J, Hagen Vasehus Schou J and Østergaard Poulsen L
Total neoadjuvant treatment (TNT) with induction chemotherapy (ICT) followed by chemoradiotherapy (CRT) has improved long-term outcomes for patients with locally advanced rectal cancer (LARC). However, long-term outcomes have not been investigated for patients with incomplete (R1) resection separately. This study investigates overall survival (OS), disease-free survival (DFS) and local and distant recurrence rates in patients with R1 resection after preoperative treatment with ICT and CRT or CRT.
Initial Assessment of Resectability of Colorectal Cancer Liver Metastases Versus Clinical Outcome
Kim GY, Jalali A, Gard G, Yeung JM, Chau H, Gately L, Houli N, Jones IT, Kosmider S, Lee B, Lee M, Nott L, Shapiro JD, Tie J, Thomson B, To YH, Wong V, Wong R, Dunn C, Johns J and Gibbs P
Surgery improves long-term survival for resectable, liver-only metastatic colorectal cancer (mCRC). With no consensus definition of "resectable" disease, decisions regarding resectability are reliant on the expertise and judgement of the treating clinician working in consultation with a multidisciplinary team (MDT). This study examines the clinical outcome versus initial assessment of resectability in an Australian population with mCRC.
Neoadjuvant Treatment With Regorafenib and Capecitabine Combined With Radiotherapy in Locally Advanced Rectal Cancer: A Multicenter Phase Ib Trial (RECAP)-SAKK 41/16
Bastian S, Joerger M, Holer L, Bärtschi D, Guckenberger M, Jochum W, Koeberle D, Siebenhüner AR, Wicki A, Berger MD, Winterhalder RC, Largiadèr CR, Löffler M, Mosna-Firlejczyk K, Maranta AF, Pestalozzi BC, Csajka C, von Moos R and
The multi tyrosine kinase inhibitor regorafenib is active in metastatic colorectal cancer. Improvement in clinical outcome by adding regorafenib to long-course chemoradiotherapy (LcCRT) was investigated in molecularly undefined LARC.
Different Metabolic Associations of Hepatitis C With Colon and Rectal Cancers: A 9-Year Nationwide Population-Based Cohort Study
Chen CW, Shan Cheng J, Chen TH, Kuo CJ, Ku HP, Chien RN and Chang ML
Whether HCV infection is associated with colorectal cancer (CRC) development remains inconclusive.
Rationale and Design of the COPERNIC Trial: A Study of On-treatment ctDNA Changes in Chemo-refractory Colorectal Cancer Patients
Assaf I, Bregni G, Anthoine G, Aparicio T, Artru P, Abdelghani MB, Buyse M, Chibaudel B, Coart E, Diaz M, Evrard C, Geboes K, Ghiringhelli F, Puleo F, Raimbourg J, Vandamme T, Van den Eynde M, Hendlisz A and Sclafani F
Evidence suggests that ctDNA may be a reliable biomarker to monitor metastatic colorectal cancer (CRC) evolution. Nevertheless, evidence on the potential of liquid biopsy in this setting is still low quality, mostly consisting of retrospective studies.
Fruquintinib-Associated Posterior Reversible Encephalopathy Syndrome in a Patient With Multiply Metastatic Rectal Cancer
Ledet CB, Sener U, Johnson DR, Ku K and Halfdanarson TR
Prognostic Impact of Para-Aortic Lymph Node Dissection in Colorectal Cancer Patients Suspected of Para-Aortic Lymph Node Metastasis: A Retrospective Cohort Study
Zhou Y, Xie X, Chen X, Tang Q, Cai Z, Zou Y, Yu Z and Chen Y
Para-aortic lymph node metastasis (PALNM) is a rare occurrence in colorectal cancer (CRC), and the high risk of radical lymphadenectomy leads to persistent debate about the best treatment strategy. This study aims to evaluate the predictor for PALNM and the clinical value of para-aortic lymph node dissection (PALND) in CRC patients with radiologically suspected synchronous PALNM.
A National Cancer Database Analysis of the Characteristics and Outcome of Colon Cancer According to Type of Preexisting Adenoma
Emile SH, Horesh N, Strassmann V, Garoufalia Z, Gefen R, Zhou P and Wexner SD
The vast majority of colon cancers occur in pre-existing adenomas. Little is known about the impact of adenoma type on behavior and outcome of subsequent carcinomas. The present study aimed to assess characteristics, behavior, and outcome of colon adenocarcinoma based on histologic type of pre-existing adenoma.