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Showing 151 - 196Study Finds Anorectal Melanoma Is Diagnosed at Later Stages and Is Often Misdiagnosed
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...
No Differences in Surgical Outcomes With Four Different Chemotherapy Regimens Plus Preoperative Radiotherapy in Rectal Cancer
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 ...
Korean Trial Shows Similar Disease-Free Survival With Laparoscopic vs Open Surgery in Mid- or Low-Rectal Cancer After Neoadjuvant Chemoradiotherapy
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...
Phase II Feasibility Study Tests Four Molecular-Based Hypotheses in Advanced Colorectal Cancer
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. ...
No Difference in Postsurgery Fatigue With Laparoscopic vs Open Surgery for Colorectal Cancer With Enhanced Recovery Program
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...
Lower Densities of Gastroenterologists, General Surgeons, and Radiation Oncologists in Rural vs Urban U.S. Counties
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...
Tumor Regression Grading After Preoperative Chemoradiotherapy for Rectal Carcinoma Predicts Distant Metastasis Risk and Disease-Free Survival
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...
Study Shows Decreasing Numbers of Colorectal Cancer Resections and Improved In-Hospital Mortality in Older Patients
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...
Colonoscopy Adenoma Detection Rate Is Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality
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...
Panitumumab Not Inferior to Cetuximab in Overall Survival in Chemotherapy-Refractory Wild-Type KRAS Metastatic 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...
Worse Progression-Free Survival With Addition of Cetuximab to Chemotherapy in Patients With Resectable Colorectal Liver Metastasis
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...
Phase II Study Suggests Promise of Intermittent Chemotherapy Plus Continuous Cetuximab in Advanced KRAS Wild-Type Colorectal Cancer
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...
Similar Progression-Free Survival With Panitumumab vs Bevacizumab Plus Modified FOLFOX6 in Wild-Type KRAS Exon 2 Metastatic Colorectal Cancer
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...
HLA Class I Antigen Expression Predicts Overall Survival Benefit With Aspirin Use in Colon Cancer
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...
Stool Multitarget DNA Test More Sensitive, But Less Specific Than Fecal Immunochemical Test for Colorectal Cancer Screening in Persons at Average Risk
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 ...
Only Small Number of Genetic Markers Show Association With Capecitabine Toxicity in Colorectal Cancer
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...
Higher Macrophage Inhibitory Cytokine-1 Levels Associated With Increased Risk of Colorectal Cancer
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...
Lower Adenoma Miss Rate With Full-Spectrum vs Standard Forward-Viewing Colonoscopy
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 ...
Coordination of Care Improves Patient-Reported Quality of Supportive Care Among Patients With Colorectal Cancer
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...
Telephone-Based Intervention Improves Colorectal Cancer Screening in At-Risk Relatives of Patients With Colorectal Cancer
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...
Intensive Follow-up Increases Surgical Treatment of Recurrence With Curative Intent in Colorectal Cancer
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...
No Survival Benefit of Adjuvant 5-FU–Based Chemotherapy After Neoadjuvant Radiotherapy or Chemoradiation for Resectable Rectal Cancer
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...
Pilot Study Shows Promise of Neoadjuvant Chemotherapy Without Routine Radiotherapy in Patients With Locally Advanced Rectal Cancer
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...
Long-Term/High-Dose Use of ACE Inhibitors Associated With Reduced Colorectal Cancer Risk in Hypertensive Subjects
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...
Protective Effect of Aspirin for Colorectal Cancer Is Associated With rs6983267 T Allele
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 ...
No Benefit of Calcium/Magnesium in Preventing Oxaliplatin-Induced Sensory Neurotoxicity in Patients With Colon Cancer
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 ...
Preoperative MRI Assessment of Circumferential Resection Margin Predicts Survival and Local Recurrence in Rectal Cancer
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...
Reduced Specialist Consultation and Multimodality Therapy May Account for Poorer Survival in Black Patients With Metastatic Colorectal Cancer
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 Endorses Cancer Care Ontario Guideline for Follow-up in Colorectal Cancer Survivors
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)...
PIK3CA Mutation Fails to Predict Outcome of Irinotecan-Based Therapy in Stage III Colon Cancer
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...
12-Gene Recurrence Score Independently Predicts Recurrence in Patients With Stage II/III Colon Cancer
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...
MicroRNA Signature Predicts Risk of Recurrence After Surgery for Stage II 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 ...
Increased Use of Local Excision to Treat Early-Stage Rectal Cancer
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...
Most Gastroenterologists and Endoscopy Nurses Prefer Propofol Over Moderate Sedation in Screening Colonoscopies, but Would Pay Little Extra for It
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...
Perioperative FOLFOX4 Does Not Improve Overall Survival vs Surgery Alone in Patients With Resectable Liver Metastases From Colorectal Cancer
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...
PIK3CA Mutation Predictive of Relapse-Free Survival Benefit of Aspirin in Colorectal Cancer
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 Associated With Reduction in Overall, Distal, and Proximal Colorectal Cancer Incidence and Mortality
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 ...
Deficient DNA Mismatch Repair Associated With Favorable Prognosis in Proximal Tumors in Stage III Colon Cancer Patients Receiving Adjuvant FOLFOX
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...
Widespread Contraindicated Use of Bevacizumab in Elderly Patients
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 ...
Presence of RAS Mutations in Metastatic Colorectal Cancer Predictive of Negative Response to Panitumumab/FOLFOX4 Treatment
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,...
Addition of Bevacizumab to Capecitabine Improves Progression-Free Survival in Elderly Patients with Previously Untreated Metastatic Colorectal Cancer
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...
Combined Microsatellite Instability and BRAF Status a Potential Marker of Risk Stratification in Colorectal Cancer
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...
High Prediagnosis Red Meat Consumption Associated with Increased All-cause Mortality in Patients with Colorectal Cancer
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...
Volumetric Growth Rate of Small Colorectal Polyps on CT Colonography May Be Useful Risk Marker
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...
Chemotherapy-induced Neuropathy Has Long-term Effect on Colorectal Cancer Survivors
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...
Impact of Age on Efficacy of Newer Adjuvant Therapies in Patients with Stage II/III Colon Cancer
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...
