Anorectal melanoma is a rare malignant neoplasm that has a variable natural history and nonspecific presentation. A review by Hicks et al of 18 patients treated at Johns Hopkins Hospital between October 1991 and August 2012, finds that the cancer tends to be diagnosed at stage II or later and is...
As reported in the Journal of Clinical Oncology by O’Connell et al, the National Surgical Adjuvant Breast and Bowel Project (NSABP) Trial R-04 is assessing four chemotherapy regimens given concurrently with preoperative radiotherapy in order to help identify optimal treatment in patients with ...
In the noninferiority COREAN trial reported in The Lancet Oncology, Jeong et al found that laparoscopic surgery was associated with disease-free survival similar to that with open surgery for mid- or low-rectal cancer. Study Details In this open-label trial, 340 patients with cT3N0–2M0...
In a phase II feasibility study (MRC FOCUS3) reported in British Journal of Cancer, Maughan et al used KRAS and BRAF mutation status and topoisomerase-1 expression status to randomly assign patients with advanced colorectal cancer to molecular hypothesis–driven treatment or control treatment. ...
In a UK trial (EnROL) reported in the Journal of Clinical Oncology, Kennedy et al compared outcomes with open vs laparoscopic resection of colorectal cancer within a multimodality enhanced recovery program. Such programs are intended to improve all aspects of perioperative care and have been shown...
Geographic proximity to services has been identified as a potential barrier to cancer screening, and there is evidence of disparity in colorectal cancer outcomes between urban and rural U.S. residents. In a study reported in JAMA Surgery, Aboagye et al identified a significantly greater density of...
In a study reported in the Journal of Clinical Oncology, Fokas et al found that prospectively evaluated tumor regression grading was a significant prognostic factor for distant metastasis and disease-free survival after 132 months of follow-up in patients with locally advanced rectal carcinoma...
Nationwide data on mortality and morbidity from colorectal cancer resections in the aging population are lacking. In a study reported in JAMA Surgery, Jafari et al found that there has been an overall decrease in numbers of resections and improved in-hospital mortality in older patients, although...
In a study of health-care organization data reported in The New England Journal of Medicine, Corley et al assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent interval colorectal cancer and colorectal cancer...
In the open-label noninferiority phase III ASPECCT trial reported in The Lancet Oncology, Price et al found that anti-EGFR monoclonal antibody treatment with panitumumab (Vectibix) produced a noninferior overall survival outcome vs cetuximab (Erbitux) in patients with chemotherapy-refractory...
Surgery for liver metastasis from colorectal cancer is associated with overall survival of approximately 40% at 5 years, and progression-free survival is increased with the addition of oxaliplatin and fluorouracil (5-FU). The addition of cetuximab (Erbitux) to chemotherapy has produced a survival...
In a phase II study (COIN-B) reported in The Lancet Oncology, Wasan et al examined the addition of continuous or intermittent cetuximab (Erbitux) to intermittent chemotherapy in previously untreated advanced KRAS wild-type colorectal cancer. Continuous cetuximab appeared to be associated with...
In a phase II trial (PEAK) reported in the Journal of Clinical Oncology, Schwartzberg et al compared the EGFR inhibitor panitumumab (Vectibix) vs the VEGF-A inhibitor bevacizumab (Avastin) combined with modified fluorouracil, leucovorin, and oxaliplatin (FOLFOX6) in patients with previously...
In a cohort study reported in JAMA Internal Medicine, Reimers et al found that aspirin use was associated with a significant 47% reduction in mortality risk after diagnosis of colon cancer expressing HLA class I antigen. There was no difference in aspirin benefit according to strong or weak...
In a study reported in The New England Journal of Medicine, Imperiale et al found that a noninvasive, multitarget stool DNA test—including assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, β-actin, and hemoglobin—was significantly more sensitive but significantly less ...
In a study reported in the Journal of Clinical Oncology, Rosmarin et al assessed the association of reported fluorouracil (5-FU) toxicity genetic markers with occurrence of capecitabine toxicity of grade ≥ 3 in the QUASAR2 trial in colorectal cancer and with occurrence of capecitabine and 5-FU...
It is known that chronic inflammation plays a role in the development of colorectal cancer. In a study reported in the Journal of the National Cancer Institute, Mehta et al evaluated the association of the novel plasma inflammatory biomarker macrophage inhibitory cytokine-1 (MIC-1; growth...
In a study reported in The Lancet Oncology, Gralnek et al found that full-spectrum endoscopic colonoscopy had a lower adenoma miss rate compared with standard forward-viewing colonoscopy. Study Details In the study, performed at three sites in Israel, one in the Netherlands, and two in the United ...
In a study reported in the Journal of Clinical Oncology, van Ryn et al assessed patient-reported quality of care among patients with colorectal cancer in the Veterans Affairs health-care system. The investigators found significant gaps in patient-centered quality of supportive care, but also found...
Individuals at increased familial risk of colorectal cancer have poor adherence to colonoscopy screening recommendations, especially those in rural and other geographically underserved populations. In a study (Family CARE trial) reported in the Journal of Clinical Oncology, Kinney et al found that...
In a study (FACS trial) reported in JAMA, Primrose et al compared outcomes with intensive follow-up with carcinoembryonic antigen measurement (CEA), computed tomography (CT), both, or minimum follow-up after curative surgery for primary colorectal cancer. Intensive strategies resulted in a...
As reported in The Lancet Oncology by Bosset et al, long-term results of the European Organisaton for Research and Treatment of Cancer (EORTC) trial 22921 indicate that adjuvant fluorouracil (5-FU)-based chemotherapy after preoperative radiotherapy with or without chemotherapy does not affect...
Neoadjuvant chemoradiotherapy delays administration of optimal chemotherapy in stage II to III rectal cancer. In a pilot study reported in the Journal of Clinical Oncology, Schrag et al assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with...
Preclinical data suggest a role of angiotensin II in colorectal cancer. In a study reported in the Journal of the National Cancer Institute, Makar et al assessed whether use of angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) treatment for hypertension was...
It has been posited that aspirin treatment may reduce risk for colorectal cancer through inhibition of WNT/cadherin-associated protein β1 (CTNNB1, or β-catenin) signaling. In a study reported in the Journal of the National Cancer Institute, Nan et al investigated the potential role of the ...
In a phase III N08CB/Alliance trial reported in the Journal of Clinical Oncology, Loprinzi et al assessed whether calcium and magnesium treatment reduced oxaliplatin-related neurotoxicity in patients with colon cancer receiving adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin). They found ...
In a study reported in the Journal of Clinical Oncology, Taylor et al evaluated the ability of preoperative high-resolution magnetic resonance imaging (MRI) assessment of circumferential resection margin to predict outcome in patients with rectal cancer. They found that MRI assessment was...
Black patients with metastatic colorectal cancer have been found to have poorer survival than white patients. In a study reported in Journal of the National Cancer Institute, Simpson et al found that black patients were less likely to have specialist consultations and to receive multimodality...
ASCO has policy and procedures for endorsing clinical practice guidelines developed by other professional organizations. As reported in the Journal of Clinical Oncology by Meyerhardt et al of the ASCO Clinical Practice Guidelines Committee, ASCO has endorsed the Cancer Care Ontario (CCO)...
In a study reported in Journal of the National Cancer Institute, Shuji Ogino, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical School, and colleagues from the Alliance for Clinical Trials in Oncology evaluated the association of PIK3CA mutations with outcome in patients with stage III...
In a study reported in Journal of Clinical Oncology, Greg Yothers, PhD, of the National Surgical Adjuvant Breast and Bowel Project (NSABP) Biostatistical Center and the University of Pittsburgh Graduate School of Public Health, and colleagues assessed performance of the 12-gene colon cancer...
In a study reported in The Lancet Oncology, Jia-Xing Zhang, MD, of Sun Yat-sen University, and colleagues identified a six-microRNA (miRNA) signature that predicted risk of recurrence after surgery for stage II colon cancer and that may help to identify patients most likely to benefit from adjuvant ...
Recommended treatment for most stage I rectal cancers is total mesorectal excision. However, local excision is considered an alternative for T1 tumors that are < 30% of the bowel circumference, < 3 cm in size, mobile, well to moderately differentiated, and lack lymphovascular invasion in...
Propofol is increasingly being used for sedation in screening colonoscopies in low-risk patients. In the United States, propofol can be administered only by an anesthesiologist, which can raise the cost of the procedure by $600 to $2,000. In a study reported in a research letter in JAMA Internal...
Previously reported results of the phase III EORTC intergroup 40983 trial showed that perioperative chemotherapy with FOLFOX4 (leucovorin, fluorouracil [5-FU], and oxaliplatin) increased progression-free survival compared with surgery alone in patients with initially resectable liver metastases...
Although nonsteroidal anti-inflammatory drugs such as aspirin have been shown to be protective against colorectal cancer and are associated with reduced disease recurrence and improved outcome, they are also associated with toxicities that limit their use in therapy. Recent data suggest that the...
Colonoscopy and sigmoidoscopy have been shown to provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against proximal colon cancer, remain undefined. A study of long-term colorectal cancer incidence and mortality after lower endoscopy reported in ...
In an analysis reported in Journal of Clinical Oncology, Frank A. Sinicrope, MD, of the Mayo Clinic and North Central Cancer Treatment Group (NCCTG), and colleagues investigated the association of deficient DNA mismatch repair with prognosis in patients with stage III colon cancer treated with...
In a study reported in Journal of Clinical Oncology, Dawn L. Hershman, MD, MS, of Columbia University, and colleagues assessed the use of bevacizumab in older patients with metastatic breast, lung, or colon cancer. They found that bevacizumab (Avastin) was contraindicated in approximately one-third ...
Patients with metastatic colorectal cancer that harbors KRAS mutations in exon 2 do not benefit from anti-EGFR therapy. However, other activating RAS mutations may predict poorer outcome with anti-EGFR therapy. In an analysis reported in The New England Journal of Medicine by Jean-Yves Douillard,...
Elderly patients are often underrepresented in clinical trials of metastatic colorectal cancer. In a phase III study (AVEX trial) reported in The Lancet Oncology, David Cunningham, MD, of Royal Marsden Hospital in London and colleagues assessed the addition of bevacizumab (Avastin) to capecitabine...
In a study reported in Journal of the National Cancer Institute, Paul Lochhead, MBChB,MRCP, of the Dana-Farber Cancer Institute and Harvard Medical School, and colleagues analyzed the association of microsatellite instability and BRAF status subgroups with survival in patients with colorectal...
There is evidence that diets high in red and processed meat are associated with increased risk of colorectal cancer. In a study reported in Journal of Clinical Oncology, Marjorie L. McCullough, ScD, and colleagues from the Epidemiology Research Program of the American Cancer Society examined the...
The growth rates and clinical importance of small colorectal polyps have not been well established. In a study reported in Lancet Oncology, Perry J. Pickhardt, MD, of the University of Wisconsin School of Medicine and Public Health, and colleagues found that volumetric growth rate on computed...
In a study reported in Journal of Clinical Oncology, Floortje Mols, PhD, of the Center of Research on Psychology in Somatic Diseases, Tilburg University, and colleagues assessed the prevalence and severity of chemotherapy-induced neuropathy and its affect on health-related quality of life in...
Available data suggest that patients with stage II/III colon cancer receive similar benefit from intravenous fluorouracil (5-FU) adjuvant therapy regardless of age. Combination regimens and oral fluoropyrimidine therapy are now standard treatments in this setting. Nadine J. McCleary, MD, MPH, and...