Articles related to COLORECTAL CANCER (CRC)

Circulating tumor DNA (ctDNA)-based molecular residual disease (MRD) might be used to identify patients who would benefit more from standard-of-care adjuvant chemotherapy by accurately assessing recurrence-risk post-surgery and by evaluating adjuvant chemotherapy efficacy. This analysis from the GALAXY study, an observational study monitoring MRD, evaluates the association of ctDNA dynamics with a short-term clinical outcome and ACT efficacy.

Short-term radiotherapy with preoperative chemotherapy followed by surgery (total neoadjuvant therapy, TNT) was compared to standard long-term chemoradiotherapy in patients with locally advanced rectal cancer. At a median follow-up of 35.0 months, 3-year DFS was 64.5% and 62.3% in the TNT and CRT groups, respectively. There was no significant difference in metastasis-free survival or locoregional recurrence, but the TNT group had better 3-year overall survival than the CRT group (86.5% v 75.1%; P = .033). Treatment effects on DFS and overall survival were similar regardless of prognostic factors. The prevalence of acute grade III-V toxicities during preoperative treatment was 26.5% in the TNT group versus 12.6% in the CRT group (P < .001).

In a randomized clinical trial of 128 patients with refractory mCRC, the addition of the PD-L1 inhibitor atezolizumab to capecitabine and bevacizumab therapy resulted in marginally longer PFS vs the placebo comparator arm. However, the median improvement — 4.4 vs 3.6 months – was deemed not clinically relevant.

Studies suggest that G12C mutations occur in 3% to 8% of total colorectal cancer (CRC) cases and constitute 6% to 17% of KRAS mutations. Having a G12C mutation may be an adverse prognostic factor in mCRC, but confounding factors may be more responsible for differences in treatment outcomes than the G12C mutation itself. The two conflicting presentations at the ESMO World Congress on Gastrointestinal Cancer highlight the critical need to define the prognostic significance of the G12C mutation and the resulting treatment implications more precisely.

Using data from Swedish family cancer datasets to calculate standardized incidence ratios (SIRs) and the cumulative risk of invasive colorectal cancer (CRC) in first- and second-degree relatives of people with colorectal carcinoma in situ (CCIS) or invasive CRC, the Journal of the National Comprehensive Cancer Network (JNCCN) suggests that family history of CCIS should be considered similarly to family history of invasive CRC in risk stratification for earlier CRC screening.

The case reported is based on a 53-year-old woman who presented to her gastroenterologist with symptoms of bowel obstruction and right upper quadrant pain. Based on her age and excellent performance status, aggressive treatment with a triplet chemotherapy regimen of oxaliplatin, irinotecan, 5-fluorouracil, and leucovorin (FOLFOXIRI) in combination with the anti–vascular endothelial growth factor receptor antibody bevacizumab was begun.