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Latest & greatest articles for colorectal cancer
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regorafenib in the third-line setting.IMblaze 370 is a multicentre, open-label, phase 3, randomised, controlled trial, done at 73 academic medical centres and community oncology practices in 11 countries. Patients aged at least 18 years with unresectable locally advanced or metastatic colorectalcancer, baseline Eastern Cooperative Oncology Group performance status of 0-1, and disease progression on or intolerance to at least two previous systemic chemotherapy regimens were enrolled. We used permuted (...) Atezolizumab with or without cobimetinib versus regorafenib in previously treated metastatic colorectalcancer (IMblaze370): a multicentre, open-label, phase 3, randomised, controlled trial Microsatellite-stable metastatic colorectalcancer is typically unresponsive to immunotherapy. This phase 3 study was designed to assess atezolizumab plus cobimetinib in metastatic colorectalcancer. Here, we report the comparison of atezolizumab plus cobimetinib or atezolizumab monotherapy versus
Towards risk-stratified colorectalcancer screening. Adding risk factors to the fecal immunochemical test: Evidence, evolution and expectations With increasing incidence and mortality, colorectalcancer (CRC) is a growing health problem worldwide. An effective way to address CRC is by screening for fecal (occult) blood by the fecal immunochemical test (FIT). However, there is room for improvement since precursor lesions and CRC bleed intermittent and can therefore be missed by the FIT (false
Comparison of Universal Versus Age-Restricted Screening of ColorectalTumors for Lynch Syndrome Using Mismatch Repair Immunohistochemistry: A Cohort Study. Guidelines recommend screening all patients with newly diagnosed colorectalcancer (CRC) for Lynch syndrome (LS). However, the efficiency of universal LS screening in elderly populations has not been well studied.To compare the performance of age-restricted and universal LS screening using reflex mismatch repair (MMR) immunohistochemistry (...) (IHC) of CRC tumors.Retrospective cohort study.A large, diverse, community-based health care system.3891 persons with newly diagnosed CRC who had LS screening between 2011 and 2016.Diagnostic yield of different LS screening strategies.Sixty-three LS cases (diagnostic yield, 1.62%) were identified by universal screening, with only 5 (7.9%) detected after age 70 years and 1 (1.6%) detected after age 80 years. When all patients with CRC who had universal screening were used as the denominator, 58 LS
Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III ColonCancer: ASCO Clinical Practice Guideline To develop recommendations for duration of adjuvant chemotherapy with a fluoropyrimidine and oxaliplatin for patients with completely resected stage III coloncancer based on the results of trials of 3 months compared with 6 months of treatment.ASCO convened an Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review (...) of evidence by the Expert Panel.Pooled data from the six International Duration Evaluation of Adjuvant Chemotherapy (IDEA) Collaboration randomized controlled trials comprise the evidence base for these guideline recommendations.The recommendations for therapy duration apply to patients with completely resected stage III coloncancer who are being offered adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine. Recommendations are informed by the findings of a recent pooled analysis of clinical
Effect of a Single Aspirin Dose Prior to Fecal Immunochemical Testing on Test Sensitivity for Detecting Advanced ColorectalNeoplasms: A Randomized Clinical Trial. Fecal immunochemical tests for hemoglobin are widely used for colorectalcancer (CRC) screening. Observational studies suggested that sensitivity of fecal immunochemical tests for detecting advanced neoplasms could be increased by acetylsalicylic acid (aspirin), especially among men.To evaluate the potential to increase sensitivity (...) containing 300 mg of aspirin (n = 1208) or placebo (n = 1214) 2 days before fecal sampling for fecal immunochemical test.The primary outcome was sensitivity of a quantitative fecal immunochemical test at 2 predefined cutoffs (10.2 and 17-μg Hb/g stool) for detecting advanced neoplasms (colorectalcancer or advanced adenoma).Among 2422 randomized patients (mean [SD] age, 59.6 [7.9] years; 1219, 50%, men), 2134 were included in the analysis (78% for primary screening colonoscopy, 22% for diagnostic
Primary Tumor Resection in Patients with Incurable Localized or Metastatic ColorectalCancer: A Systematic Review and Meta-analysis To assess the impact of primary tumor resection (PTR) on survival and morbidity in incurable colorectal cancer.Systematic literature review and meta-analysis to compare PTR versus primary tumor intact (PTI).Seventy-seven studies were included, reporting on 159,991 participants (94,745 PTR; 65,246 PTI). PTR improved overall survival (hazard ratio [HR] 0.59, P (...) < 0.0001; mean difference [MD] 7.27 months, P < 0.0001), cancer-specific survival (HR 0.47, MD 10.80), and progression-free survival (HR 0.76, MD 1.67). Overall survival remained significantly improved during subgroup analysis of asymptomatic patients (HR 0.69, MD 3.86), elderly patients (HR 0.46, MD 7.71), patients diagnosed after 2000 (HR 0.62, MD 7.29), patients with colon (HR 0.58, MD 6.31) or rectal (HR 0.54, MD 6.88) primary tumor, patients undergoing resection of primary tumor versus non
, and developed for health professionals practising in an Australian health care setting. This publication reflects the views of the authors and not necessarily the views of the Australian Government. Cite this guideline Cancer Council Australia Colorectal Referring to the largebowel, comprising the colon and rectum. Cancer Guidelines Working Party. Clinical practice guidelines for the prevention, early detection and management of colorectalcancer. Sydney: Cancer Council Australia. [Version URL: , cited (...) Clinical practice guidelines for the prevention, early detection and management of colorectalcancer Clinical practice guidelines for the prevention, early detection and management of colorectalcancer - Cancer Guidelines Wiki Skip Links Personal tools Search Navigation Cancer Council guidelines Methodology Hosted cancer guidelines Adolescents and Young Adult (AYA) guidelines Prevention Policies Social links Page actions The guideline recommendations were approved by the Chief Executive Officer
Effect of High-Dose vs Standard-Dose Vitamin D3 Supplementation on Progression-Free Survival Among Patients With Advanced or Metastatic ColorectalCancer: The SUNSHINE Randomized Clinical Trial In observational studies, higher plasma 25-hydroxyvitamin D (25[OH]D) levels have been associated with improved survival in metastatic colorectalcancer (CRC).To determine if high-dose vitamin D3 added to standard chemotherapy improves outcomes in patients with metastatic CRC.Double-blind phase 2 (...) randomized clinical trial of 139 patients with advanced or metastatic CRC conducted at 11 US academic and community cancer centers from March 2012 through November 2016 (database lock: September 2018).mFOLFOX6 plus bevacizumab chemotherapy every 2 weeks and either high-dose vitamin D3 (n = 69) or standard-dose vitamin D3 (n = 70) daily until disease progression, intolerable toxicity, or withdrawal of consent.The primary end point was progression-free survival (PFS) assessed by the log-rank test
Effect of Vitamin D Supplementation on Relapse-Free Survival Among Patients With Digestive Tract Cancers: The AMATERASU Randomized Clinical Trial. Randomized clinical trials of vitamin D supplementation for secondary prevention in patients with cancer are needed, given positive results of observational studies.To determine whether postoperative vitamin D3 supplementation can improve survival of patients with digestive tract cancers overall and in subgroups stratified by 25-hydroxyvitamin D (25 (...) [OH]D) levels.The AMATERASU trial, a randomized, double-blind, placebo-controlled trial conducted at a single university hospital in Japan. Enrollment began in January 2010 and follow-up was completed in February 2018. Patients aged 30 to 90 years with cancers of the digestive tract from the esophagus to the rectum, stages I to III, were recruited. Of 439 eligible patients, 15 declined and 7 were excluded after operation.Patients were randomized to receive oral supplemental capsules of vitamin D
Early Detection for ColorectalCancer Resource-Stratified Guideline Early Detection for ColorectalCancer: ASCO Resource-Stratified Guideline | Journal of Global Oncology Search in: Menu Article Tools SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JGO.18.00213 Journal of Global Oncology - published online before print February 25, 2019 PMID: Early Detection for ColorectalCancer: ASCO Resource-Stratified Guideline , MD, MBA 1 (...) Lumpur, Malaysia 10 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico 11 Shahid Beheshti University, Tehran, Iran 12 Columbia Asia Hospitals, Bangalore, India, and Weill Cornell Medical College, New York, NY 13 New York-Presbyterian/Weill Cornell Medical Center, New York, NY 14 Makati Medical Center, Makati, Philippines 15 Homerton University Hospital Foundation Trust, BowelDisease Research Foundation, London, United Kingdom 16 The University of Puerto Rico
Treatment of Patients with Early-Stage ColorectalCancer Resource-Stratified Guideline Treatment of Patients With Early-Stage ColorectalCancer: ASCO Resource-Stratified Guideline | Journal of Global Oncology Search in: Menu Article Tools SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JGO.18.00214 Journal of Global Oncology - published online before print February 25, 2019 PMID: Treatment of Patients With Early-Stage (...) ColorectalCancer: ASCO Resource-Stratified Guideline , MD, MPH 1 x Ainhoa Costas-Chavarri ; , MD 2 3 x Govind Nandakumar ; , MSPH 4 x Sarah Temin ; , MD, MBA 5 x Gilberto Lopes ; , MD, PhD 6 x Andres Cervantes ; , MD, PhD 7 8 x Marcia Cruz Correa ; , MD 9 x Rena Engineer ; , MD, PhD 10 x Chisato Hamashima ; , MD 11 x Gwo Fuang Ho ; , MD 12 x Fidel David Huitzil ; , MD 13 x Mona Malekzadeh Moghani ; , MD 14 x Ala I. Sharara ; , PhD 15 x Mariana C. Stern ; , MD 16 x Catherine Teh ; , MD 12 x Sara E
Lymphocyte-C-reactive Protein Ratio as Promising New Marker for Predicting Surgical and Oncological Outcomes in ColorectalCancer MINI: In the present study, we systemically and comprehensively evaluated the prognostic significance of a combination of inflammatory factors using preoperative blood examination, and focused on the potential feasibility of our newly developed lymphocyte-CRP ratio (LCR) as a prognostic biomarker in CRC patients. We have firstly identified that a combination (...) of lymphocytic counts along with CRP levels, which we defined as LCR, is a more reliable indicator of poor prognosis compared with other combinations of inflammatory markers, in CRC patients. Furthermore, preoperative LCR could also identify CRC patients who are at higher risk for postoperative infectious complications.Systemic inflammation via host-tumor interactions is currently recognized as a hallmark of cancer. The aim of this study was to evaluate the prognostic value of various combinations
Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study No standard adjuvant treatment currently is recommended in localized biliary tract cancer (BTC) after surgical resection. We aimed to assess whether gemcitabine and oxaliplatin chemotherapy (GEMOX) would increase relapse-free survival (RFS) while maintaining health-related quality of life (HRQOL) in patients who undergo resection.We
The Impact of Preoperative Immune Modulating Nutrition on Outcomes in Patients Undergoing Surgery for GastrointestinalCancer: A Systematic Review and Meta-analysis To define the influence of preoperative immune modulating nutrition (IMN) on postoperative outcomes in patients undergoing surgery for gastrointestinal cancer.Although studies have shown that perioperative IMN may reduce postoperative infectious complications, many of these have included patients with benign and malignantdisease (...) using RevMan v5.3 software.Sixteen studies reporting on 1387 patients (715 IMN group, 672 control group) were included. Six of the included studies reported on a mixed population of patients undergoing all gastrointestinalcancer surgery. Of the remaining, 4 investigated IMN in colorectalcancer surgery, 2 in pancreatic surgery, and another 2 in patients undergoing surgery for gastric cancer. There was 1 study each on liver and esophageal cancer. The formulation of nutrition used in all studies
in a multicentre, open-label RCT in six centres in the Netherlands. Patients with colorectalcancer scheduled for elective curative surgery with a primary anastomosis were eligible. Oral colistin, tobramycin and amphotericin B were administered to patients in the SDD group to decontaminate the digestive tract. Both treatment and control group received intravenous cefazolin and metronidazole for perioperative prophylaxis. Mechanical bowel preparation was given for left-sided colectomies, sigmoid and anterior (...) Randomized clinical trial of selective decontamination of the digestive tract in elective colorectalcancer surgery (SELECT trial) Infectious complications and anastomotic leakage affect approximately 30 per cent of patients after colorectalcancer surgery. The aim of this multicentre randomized trial was to investigate whether selective decontamination of the digestive tract (SDD) reduces these complications of elective colorectalcancer surgery.The effectiveness of SDD was evaluated
Participation and Ease of Use in ColorectalCancer Screening: A Comparison of 2 Fecal Immunochemical Tests The impact of fecal immunochemical test (FIT)-based colorectalcancer (CRC) screening on disease incidence and mortality is affected by participation, which might be influenced by ease of use of the FIT. We compared the participation rates and ease of use of 2 different FITs in a CRC screening program.There were two study designs within the Dutch CRC screening program. In a paired cohort
Aspirin Use to Prevent Cardiovascular Disease and ColorectalCancer 1 Aspirin Use to Prevent Cardiovascular Disease and ColorectalCancer Interim Guidance from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group October 5, 2018 Three randomized clinical trials (ARRIVE 1 , ASCEND 2 , and ASPREE 3 ) recently published results on aspirin use in patients without known Atherosclerotic Cardiovascular Disease (ASCVD). The studies looked at benefits including (...) daily. • There is no recommendation for or against aspirin therapy in adults aged < 50 or = 60 years. • Exclude adults with increased risk of bleeding. This includes those with a history of gastrointestinal (GI) bleeding, GI ulcers, intracranial bleed, bleeding disorders, renal failure, severe liver disease, thrombocytopenia, or using NSAIDS daily, or other medicine to prevent blood clots. The recommendations above reflect a change from initiate to consider in adults aged 50-59 years with 10-year
Familial colorectalcancer risk in half siblings and siblings: nationwide cohort study. To explore the risk of colorectalcancer in family members of patients with colorectalcancer, with an emphasis on subtypes of second degree relatives, especially half siblings, which were lacking in the literature.Ambidirectional cohort study.Nationwide Swedish Family Cancer Data (record linkage).All people residing in Sweden and born after 1931, with their biological parents, totalling >16 million (...) individuals (follow-up: 1958-2015); of those with clear genealogy, 173 796 developed colorectal cancer.Lifetime (0-79 years) cumulative risk and standardised incidence ratio of colorectalcancer among first degree relatives and second degree relatives.The overall lifetime cumulative risk of colorectalcancer in siblings of patients was 7%, which represents a 1.7-fold (95% confidence interval 1.6 to 1.7; n=2089) increase over the risk in those without any family history of colorectalcancer. A similarly
Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for ColorectalCancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564-2575. . Centers for Disease Control and Prevention. National Health Interview Survey. Available at: . Published March 1, 2014. Accessed June 21, 2018. .National Cancer Institute. SEER Cancer Statistics Fact sheets: Colon and Rectum Cancer. Available at: .Published September, 2014. Accessed June 21, 2018 (...) will continue to improve, and blood tests for CRC are in development. Research and one blood test, Epi pro Colon, was approved by the FDA in 2016. However, it is not currently recommended by the USPSTF. As this area of research develops, it is important that physicians remain aware of all the currently available USPTSF-approved screening modalities. “One size fits all” may not be the most effective cancer screening approach for all patients. Studies have shown that colonoscopy may be avoided by large