Key clinical point: The detection of circulating-tumor DNA (ctDNA) following curative surgery for colorectal cancer is an independent predictor for poor prognosis.

Major finding: The post-operative detection of ctDNA at the first liquid biopsy following surgery was associated with poor progression-free survival (hazard ratio [HR] 6.92; 95% CI 4.49-10.64) with the findings being consistent when stratified according to adjuvant chemotherapy use (adjuvant chemotherapy: HR 6.01, 95% CI 2.96-12.21; no adjuvant chemotherapy: HR 10.3; 95% CI 6.46-16.45) and disease extent (primary resection: HR 7.93; 95% CI 4.27-14.75; metastasectomy: HR 5.08; 95% CI 2.85-9.05).

Study details: The findings are from a meta-analysis of 37 studies including 3002 patients.

Disclosures: No funding source was declared. The authors declare no competing interests.

Source: Faulkner LG et al. The utility of ctDNA in detecting minimal residual disease following curative surgery in colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Nov 8). Doi: 10.1038/s41416-022-02017-9

Key clinical point: The detection of circulating-tumor DNA (ctDNA) following curative surgery for colorectal cancer is an independent predictor for poor prognosis.

Major finding: The post-operative detection of ctDNA at the first liquid biopsy following surgery was associated with poor progression-free survival (hazard ratio [HR] 6.92; 95% CI 4.49-10.64) with the findings being consistent when stratified according to adjuvant chemotherapy use (adjuvant chemotherapy: HR 6.01, 95% CI 2.96-12.21; no adjuvant chemotherapy: HR 10.3; 95% CI 6.46-16.45) and disease extent (primary resection: HR 7.93; 95% CI 4.27-14.75; metastasectomy: HR 5.08; 95% CI 2.85-9.05).

Study details: The findings are from a meta-analysis of 37 studies including 3002 patients.

Disclosures: No funding source was declared. The authors declare no competing interests.

Source: Faulkner LG et al. The utility of ctDNA in detecting minimal residual disease following curative surgery in colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Nov 8). Doi: 10.1038/s41416-022-02017-9

Key clinical point: The detection of circulating-tumor DNA (ctDNA) following curative surgery for colorectal cancer is an independent predictor for poor prognosis.

Major finding: The post-operative detection of ctDNA at the first liquid biopsy following surgery was associated with poor progression-free survival (hazard ratio [HR] 6.92; 95% CI 4.49-10.64) with the findings being consistent when stratified according to adjuvant chemotherapy use (adjuvant chemotherapy: HR 6.01, 95% CI 2.96-12.21; no adjuvant chemotherapy: HR 10.3; 95% CI 6.46-16.45) and disease extent (primary resection: HR 7.93; 95% CI 4.27-14.75; metastasectomy: HR 5.08; 95% CI 2.85-9.05).

Study details: The findings are from a meta-analysis of 37 studies including 3002 patients.

Disclosures: No funding source was declared. The authors declare no competing interests.

Source: Faulkner LG et al. The utility of ctDNA in detecting minimal residual disease following curative surgery in colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Nov 8). Doi: 10.1038/s41416-022-02017-9

Key clinical point: Total neoadjuvant therapy (TNT) vs neoadjuvant chemoradiotherapy (nCRT) was associated with improved pathological complete response (pCR), R0 resection, disease-free survival (DFS), and overall survival (OS) in patients with locally advanced rectal cancer (LARC) along with similar postoperative complications and no increase in distant metastasis and local recurrence.

Major finding: TNT vs nCRT was associated with higher rates of pCR (odds ratio [OR] 1.85; P < .0001), longer DFS (hazard ratio [HR] 0.80; P = .001), longer OS (HR 0.75; P = .002), a higher proportion of patients achieving R0 resection (OR 1.34; P = .02), and similar rates of chemoradiotherapy and surgical complications, with no increase in local recurrence or distant metastasis.

Study details: This meta-analysis of eight non-randomized and seven randomized controlled trials included 3579 patients, of which 1812 patients received TNT and 1767 received nCRT.

Disclosures: This study was funded by the Natural Science Foundation of Gansu Province, China,  and other sources. No conflicts of interest were declared.

Source: Zhang X et al. Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials. PLoS One. 2022;17(11):e0276599 (Nov 4). Doi: 10.1371/journal.pone.0276599

Key clinical point: Total neoadjuvant therapy (TNT) vs neoadjuvant chemoradiotherapy (nCRT) was associated with improved pathological complete response (pCR), R0 resection, disease-free survival (DFS), and overall survival (OS) in patients with locally advanced rectal cancer (LARC) along with similar postoperative complications and no increase in distant metastasis and local recurrence.

Major finding: TNT vs nCRT was associated with higher rates of pCR (odds ratio [OR] 1.85; P < .0001), longer DFS (hazard ratio [HR] 0.80; P = .001), longer OS (HR 0.75; P = .002), a higher proportion of patients achieving R0 resection (OR 1.34; P = .02), and similar rates of chemoradiotherapy and surgical complications, with no increase in local recurrence or distant metastasis.

Study details: This meta-analysis of eight non-randomized and seven randomized controlled trials included 3579 patients, of which 1812 patients received TNT and 1767 received nCRT.

Disclosures: This study was funded by the Natural Science Foundation of Gansu Province, China,  and other sources. No conflicts of interest were declared.

Source: Zhang X et al. Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials. PLoS One. 2022;17(11):e0276599 (Nov 4). Doi: 10.1371/journal.pone.0276599

Key clinical point: Total neoadjuvant therapy (TNT) vs neoadjuvant chemoradiotherapy (nCRT) was associated with improved pathological complete response (pCR), R0 resection, disease-free survival (DFS), and overall survival (OS) in patients with locally advanced rectal cancer (LARC) along with similar postoperative complications and no increase in distant metastasis and local recurrence.

Major finding: TNT vs nCRT was associated with higher rates of pCR (odds ratio [OR] 1.85; P < .0001), longer DFS (hazard ratio [HR] 0.80; P = .001), longer OS (HR 0.75; P = .002), a higher proportion of patients achieving R0 resection (OR 1.34; P = .02), and similar rates of chemoradiotherapy and surgical complications, with no increase in local recurrence or distant metastasis.

Study details: This meta-analysis of eight non-randomized and seven randomized controlled trials included 3579 patients, of which 1812 patients received TNT and 1767 received nCRT.

Disclosures: This study was funded by the Natural Science Foundation of Gansu Province, China,  and other sources. No conflicts of interest were declared.

Source: Zhang X et al. Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials. PLoS One. 2022;17(11):e0276599 (Nov 4). Doi: 10.1371/journal.pone.0276599

Key clinical point: Bone metastasis (BM) negatively affects survival in patients with colorectal cancer (CRC); however, triplet therapy (FOLFOXIRI)+bevacizumab maintained its survival advantage over doublet therapy (FOLFIRI/FOLFOX)+bevacizumab even in this prognostically unfavorable group.

Major finding: Overall, patients with vs without bone involvement at baseline reported shorter progression-free survival (PFS; hazard ratio [HR] 1.96; P < .001) and overall survival (OS; HR 2.04; P < .001), with survival after progression being poor among patients with vs without BM at the time of progression (HR 1.48; P = .002). The triplet+bevacizumab vs doublet+bevacizumab regimen provided survival advantage even in the presence of BM (PFS: HR 0.76; P < .001).

Study details: The data come from a pooled analysis of the TRIBE1 and TRIBE2 trials including 1187 patients with initially unresectable and previously untreated mCRC who received doublet or triplet chemotherapy plus bevacizumab.

Disclosures: No funding source was declared. Some authors declared serving as consultants, advisors, on speaker’s bureaus, or receiving research support from various sources.

Source: Dell'Aquila E et al. Bone metastases are associated with worse prognosis in patients affected by metastatic colorectal cancer treated with doublet or triplet chemotherapy plus bevacizumab: A subanalysis of the TRIBE and TRIBE2 trials. ESMO Open. 2022;7(6):100606 (Oct 31). Doi: 10.1016/j.esmoop.2022.100606

Key clinical point: Bone metastasis (BM) negatively affects survival in patients with colorectal cancer (CRC); however, triplet therapy (FOLFOXIRI)+bevacizumab maintained its survival advantage over doublet therapy (FOLFIRI/FOLFOX)+bevacizumab even in this prognostically unfavorable group.

Major finding: Overall, patients with vs without bone involvement at baseline reported shorter progression-free survival (PFS; hazard ratio [HR] 1.96; P < .001) and overall survival (OS; HR 2.04; P < .001), with survival after progression being poor among patients with vs without BM at the time of progression (HR 1.48; P = .002). The triplet+bevacizumab vs doublet+bevacizumab regimen provided survival advantage even in the presence of BM (PFS: HR 0.76; P < .001).

Study details: The data come from a pooled analysis of the TRIBE1 and TRIBE2 trials including 1187 patients with initially unresectable and previously untreated mCRC who received doublet or triplet chemotherapy plus bevacizumab.

Disclosures: No funding source was declared. Some authors declared serving as consultants, advisors, on speaker’s bureaus, or receiving research support from various sources.

Source: Dell'Aquila E et al. Bone metastases are associated with worse prognosis in patients affected by metastatic colorectal cancer treated with doublet or triplet chemotherapy plus bevacizumab: A subanalysis of the TRIBE and TRIBE2 trials. ESMO Open. 2022;7(6):100606 (Oct 31). Doi: 10.1016/j.esmoop.2022.100606

Key clinical point: Bone metastasis (BM) negatively affects survival in patients with colorectal cancer (CRC); however, triplet therapy (FOLFOXIRI)+bevacizumab maintained its survival advantage over doublet therapy (FOLFIRI/FOLFOX)+bevacizumab even in this prognostically unfavorable group.

Major finding: Overall, patients with vs without bone involvement at baseline reported shorter progression-free survival (PFS; hazard ratio [HR] 1.96; P < .001) and overall survival (OS; HR 2.04; P < .001), with survival after progression being poor among patients with vs without BM at the time of progression (HR 1.48; P = .002). The triplet+bevacizumab vs doublet+bevacizumab regimen provided survival advantage even in the presence of BM (PFS: HR 0.76; P < .001).

Study details: The data come from a pooled analysis of the TRIBE1 and TRIBE2 trials including 1187 patients with initially unresectable and previously untreated mCRC who received doublet or triplet chemotherapy plus bevacizumab.

Disclosures: No funding source was declared. Some authors declared serving as consultants, advisors, on speaker’s bureaus, or receiving research support from various sources.

Source: Dell'Aquila E et al. Bone metastases are associated with worse prognosis in patients affected by metastatic colorectal cancer treated with doublet or triplet chemotherapy plus bevacizumab: A subanalysis of the TRIBE and TRIBE2 trials. ESMO Open. 2022;7(6):100606 (Oct 31). Doi: 10.1016/j.esmoop.2022.100606

Key clinical point: This meta-analysis demonstrated that the elevated pretreatment neutrophil-to-lymphocyte ratio (NLR) was correlated with poor long-term survival in patients with colorectal cancer (CRC) liver metastasis, including those who underwent surgery.

Major finding: Higher NLR was associated with poor overall survival (OS; hazard ratio [HR] 1.95; P < .01) and disease-free survival (DFS; HR 1.80; P < .01), and normal vs elevated NLR was associated with a better OS among patients who underwent surgery (HR 1.95; P < .01). The 5-year OS and DFS rates were higher in patients with normal vs high NLR (both P < .01).

Study details: The data come from a meta-analysis of 14 retrospective studies including 2974 participants.

Disclosures: This study was supported by the Startup Fund for Scientific Research, Fujian Medical University, China. No conflicts of interest were declared.

Source: Lin N et al. Prognostic value of neutrophil-to-lymphocyte ratio in colorectal cancer liver metastasis: A meta-analysis of results from multivariate analysis. Int J Surg. 2022;107:106959 (Oct 17). Doi: 10.1016/j.ijsu.2022.106959

Key clinical point: This meta-analysis demonstrated that the elevated pretreatment neutrophil-to-lymphocyte ratio (NLR) was correlated with poor long-term survival in patients with colorectal cancer (CRC) liver metastasis, including those who underwent surgery.

Major finding: Higher NLR was associated with poor overall survival (OS; hazard ratio [HR] 1.95; P < .01) and disease-free survival (DFS; HR 1.80; P < .01), and normal vs elevated NLR was associated with a better OS among patients who underwent surgery (HR 1.95; P < .01). The 5-year OS and DFS rates were higher in patients with normal vs high NLR (both P < .01).

Study details: The data come from a meta-analysis of 14 retrospective studies including 2974 participants.

Disclosures: This study was supported by the Startup Fund for Scientific Research, Fujian Medical University, China. No conflicts of interest were declared.

Source: Lin N et al. Prognostic value of neutrophil-to-lymphocyte ratio in colorectal cancer liver metastasis: A meta-analysis of results from multivariate analysis. Int J Surg. 2022;107:106959 (Oct 17). Doi: 10.1016/j.ijsu.2022.106959

Key clinical point: This meta-analysis demonstrated that the elevated pretreatment neutrophil-to-lymphocyte ratio (NLR) was correlated with poor long-term survival in patients with colorectal cancer (CRC) liver metastasis, including those who underwent surgery.

Major finding: Higher NLR was associated with poor overall survival (OS; hazard ratio [HR] 1.95; P < .01) and disease-free survival (DFS; HR 1.80; P < .01), and normal vs elevated NLR was associated with a better OS among patients who underwent surgery (HR 1.95; P < .01). The 5-year OS and DFS rates were higher in patients with normal vs high NLR (both P < .01).

Study details: The data come from a meta-analysis of 14 retrospective studies including 2974 participants.

Disclosures: This study was supported by the Startup Fund for Scientific Research, Fujian Medical University, China. No conflicts of interest were declared.

Source: Lin N et al. Prognostic value of neutrophil-to-lymphocyte ratio in colorectal cancer liver metastasis: A meta-analysis of results from multivariate analysis. Int J Surg. 2022;107:106959 (Oct 17). Doi: 10.1016/j.ijsu.2022.106959

Key clinical point: An early severe postoperative inflammatory response increased the risk for recurrence in patients with colorectal cancer (CRC) who underwent curative surgery, with the recurrence hazard being early and persistently higher in patients with high vs low C-reactive protein (CRP) levels.

Major finding: High vs low CRP levels was a significant predictor of worse 5-year RFS (adjusted hazard ratio 2.21; P < .001) with the hazard function peak being higher and earlier in the high (peak rate 0.0142; peak months 5.6) vs low (peak rate 0.0073; peak months 8.4) CRP group.

Study details: The data come from a retrospective study including 422 patients with stage I-IV CRC who underwent curative surgery and were followed for 5 years after surgery.

Disclosures: This study did not report the source of funding. No conflicts of interest were declared.

Source: Nakamura Y et al. Impact of severe postoperative inflammatory response on recurrence after curative resection of colorectal cancer. Int J Colorectal Dis. 2022;37(11):2375-2386 (Oct 24). Doi: 10.1007/s00384-022-04271-y

Key clinical point: An early severe postoperative inflammatory response increased the risk for recurrence in patients with colorectal cancer (CRC) who underwent curative surgery, with the recurrence hazard being early and persistently higher in patients with high vs low C-reactive protein (CRP) levels.

Major finding: High vs low CRP levels was a significant predictor of worse 5-year RFS (adjusted hazard ratio 2.21; P < .001) with the hazard function peak being higher and earlier in the high (peak rate 0.0142; peak months 5.6) vs low (peak rate 0.0073; peak months 8.4) CRP group.

Study details: The data come from a retrospective study including 422 patients with stage I-IV CRC who underwent curative surgery and were followed for 5 years after surgery.

Disclosures: This study did not report the source of funding. No conflicts of interest were declared.

Source: Nakamura Y et al. Impact of severe postoperative inflammatory response on recurrence after curative resection of colorectal cancer. Int J Colorectal Dis. 2022;37(11):2375-2386 (Oct 24). Doi: 10.1007/s00384-022-04271-y

Key clinical point: An early severe postoperative inflammatory response increased the risk for recurrence in patients with colorectal cancer (CRC) who underwent curative surgery, with the recurrence hazard being early and persistently higher in patients with high vs low C-reactive protein (CRP) levels.

Major finding: High vs low CRP levels was a significant predictor of worse 5-year RFS (adjusted hazard ratio 2.21; P < .001) with the hazard function peak being higher and earlier in the high (peak rate 0.0142; peak months 5.6) vs low (peak rate 0.0073; peak months 8.4) CRP group.

Study details: The data come from a retrospective study including 422 patients with stage I-IV CRC who underwent curative surgery and were followed for 5 years after surgery.

Disclosures: This study did not report the source of funding. No conflicts of interest were declared.

Source: Nakamura Y et al. Impact of severe postoperative inflammatory response on recurrence after curative resection of colorectal cancer. Int J Colorectal Dis. 2022;37(11):2375-2386 (Oct 24). Doi: 10.1007/s00384-022-04271-y

Key clinical point: Exposure to fluoropyrimidine-based adjuvant chemotherapy increased the risk for incident cardiovascular disease (CVD) in patients with high-risk stage II-III colorectal cancer (CRC) without preexisting CVD, highlighting the importance of cardiovascular risk monitoring.

Major finding: Patients with CRC receiving fluoropyrimidine-based adjuvant chemotherapy had a nearly 2-fold higher risk for CVD compared with control individuals without cancer (adjusted cause-specific hazard ratio 2.11; P < .001).

Study details: The data come from a population-based study including 1037 patients with high-risk stage II-III CRC treated with radical surgery followed by adjuvant chemotherapy, of which 102 patients received fluoropyrimidine-based adjuvant chemotherapy, and 5078 control individuals without cancer or a CVD history.

Disclosures: This study was supported by El Instituto de Salud Carlos III, Spain. The authors declared no conflicts of interest.

Source: Lee SF et al. Incident cardiovascular diseases among survivors of high-risk stage II-III colorectal cancer: A cluster-wide cohort study. J Natl Compr Canc Netw. 2022;20(10):1125-1133.e10 (Oct). Doi: 10.6004/jnccn.2022.7042

Key clinical point: Exposure to fluoropyrimidine-based adjuvant chemotherapy increased the risk for incident cardiovascular disease (CVD) in patients with high-risk stage II-III colorectal cancer (CRC) without preexisting CVD, highlighting the importance of cardiovascular risk monitoring.

Major finding: Patients with CRC receiving fluoropyrimidine-based adjuvant chemotherapy had a nearly 2-fold higher risk for CVD compared with control individuals without cancer (adjusted cause-specific hazard ratio 2.11; P < .001).

Study details: The data come from a population-based study including 1037 patients with high-risk stage II-III CRC treated with radical surgery followed by adjuvant chemotherapy, of which 102 patients received fluoropyrimidine-based adjuvant chemotherapy, and 5078 control individuals without cancer or a CVD history.

Disclosures: This study was supported by El Instituto de Salud Carlos III, Spain. The authors declared no conflicts of interest.

Source: Lee SF et al. Incident cardiovascular diseases among survivors of high-risk stage II-III colorectal cancer: A cluster-wide cohort study. J Natl Compr Canc Netw. 2022;20(10):1125-1133.e10 (Oct). Doi: 10.6004/jnccn.2022.7042

Key clinical point: Exposure to fluoropyrimidine-based adjuvant chemotherapy increased the risk for incident cardiovascular disease (CVD) in patients with high-risk stage II-III colorectal cancer (CRC) without preexisting CVD, highlighting the importance of cardiovascular risk monitoring.

Major finding: Patients with CRC receiving fluoropyrimidine-based adjuvant chemotherapy had a nearly 2-fold higher risk for CVD compared with control individuals without cancer (adjusted cause-specific hazard ratio 2.11; P < .001).

Study details: The data come from a population-based study including 1037 patients with high-risk stage II-III CRC treated with radical surgery followed by adjuvant chemotherapy, of which 102 patients received fluoropyrimidine-based adjuvant chemotherapy, and 5078 control individuals without cancer or a CVD history.

Disclosures: This study was supported by El Instituto de Salud Carlos III, Spain. The authors declared no conflicts of interest.

Source: Lee SF et al. Incident cardiovascular diseases among survivors of high-risk stage II-III colorectal cancer: A cluster-wide cohort study. J Natl Compr Canc Netw. 2022;20(10):1125-1133.e10 (Oct). Doi: 10.6004/jnccn.2022.7042

Key clinical point: The presence of synchronous ovarian metastases was not associated with a reduced 3-year overall survival (OS) in females with stage IV colorectal cancer (CRC).

Major finding: The 3-year OS rate was not significantly different between patients with vs without ovarian metastases (6.8% vs 8.0%; P = .607), with the median OS not being significantly different among patients with vs without ovarian metastases (adjusted hazard ratio 0.81; 95% CI 0.61-1.09).

Study details: The data come from a propensity score-matched analysis including 5253 female patients with stage IV CRC who received systemic therapy with palliative intent, of which 159 women with ovarian metastases were propensity matched with 159 women without ovarian metastases.

Disclosures: No information on funding source was available. No conflicts of interest were declared.

Source: van der Meer R et al. A propensity score-matched analysis of oncological outcome after systemic therapy for stage IV colorectal cancer: Impact of synchronous ovarian metastases. Int J Cancer. 2022 (Oct 17). Doi: 10.1002/ijc.343205

Key clinical point: The presence of synchronous ovarian metastases was not associated with a reduced 3-year overall survival (OS) in females with stage IV colorectal cancer (CRC).

Major finding: The 3-year OS rate was not significantly different between patients with vs without ovarian metastases (6.8% vs 8.0%; P = .607), with the median OS not being significantly different among patients with vs without ovarian metastases (adjusted hazard ratio 0.81; 95% CI 0.61-1.09).

Study details: The data come from a propensity score-matched analysis including 5253 female patients with stage IV CRC who received systemic therapy with palliative intent, of which 159 women with ovarian metastases were propensity matched with 159 women without ovarian metastases.

Disclosures: No information on funding source was available. No conflicts of interest were declared.

Source: van der Meer R et al. A propensity score-matched analysis of oncological outcome after systemic therapy for stage IV colorectal cancer: Impact of synchronous ovarian metastases. Int J Cancer. 2022 (Oct 17). Doi: 10.1002/ijc.343205

Key clinical point: The presence of synchronous ovarian metastases was not associated with a reduced 3-year overall survival (OS) in females with stage IV colorectal cancer (CRC).

Major finding: The 3-year OS rate was not significantly different between patients with vs without ovarian metastases (6.8% vs 8.0%; P = .607), with the median OS not being significantly different among patients with vs without ovarian metastases (adjusted hazard ratio 0.81; 95% CI 0.61-1.09).

Study details: The data come from a propensity score-matched analysis including 5253 female patients with stage IV CRC who received systemic therapy with palliative intent, of which 159 women with ovarian metastases were propensity matched with 159 women without ovarian metastases.

Disclosures: No information on funding source was available. No conflicts of interest were declared.

Source: van der Meer R et al. A propensity score-matched analysis of oncological outcome after systemic therapy for stage IV colorectal cancer: Impact of synchronous ovarian metastases. Int J Cancer. 2022 (Oct 17). Doi: 10.1002/ijc.343205

Key clinical point: The combination of CXD101 and nivolumab at full individual doses was effective and well tolerated as a third-line and above treatment for patients with late-stage microsatellite stable colorectal cancer (MSS CRC).

Major finding: CXD101 and nivolumab combination was well tolerated, with neutropenia (18%) and anemia (7%) being the most common grade 3-4 adverse events. The median progression-free survival and overall survival were 2.1 (95% CI 1.4-3.9) and 7.0 (95% CI 5.13-10.22) months, respectively, with an immune disease control rate of 48% and an immune objective response rate of 9%.

Study details: The data comes from a phase 1b/2 trial including 55 heavily pretreated patients with biopsy-confirmed MSS CRC who received oral CXD101 and intravenous nivolumab.

Disclosures: The trial was supported by Celleron Therapeutics. This study was funded by The Oxford NIHR Comprehensive Biomedical Research Centre and a Cancer Research UK Advanced Clinician Scientist Fellowship. Some authors declared being employees of or holding shares or share options in Celleron Therapeutics.

Source: Saunders MP et al. CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): A multicentre, open-label, single-arm, phase II trial. ESMO Open. 2022;7(6):100594 (Oct 27). Doi: 10.1016/j.esmoop.2022.100594

Key clinical point: The combination of CXD101 and nivolumab at full individual doses was effective and well tolerated as a third-line and above treatment for patients with late-stage microsatellite stable colorectal cancer (MSS CRC).

Major finding: CXD101 and nivolumab combination was well tolerated, with neutropenia (18%) and anemia (7%) being the most common grade 3-4 adverse events. The median progression-free survival and overall survival were 2.1 (95% CI 1.4-3.9) and 7.0 (95% CI 5.13-10.22) months, respectively, with an immune disease control rate of 48% and an immune objective response rate of 9%.

Study details: The data comes from a phase 1b/2 trial including 55 heavily pretreated patients with biopsy-confirmed MSS CRC who received oral CXD101 and intravenous nivolumab.

Disclosures: The trial was supported by Celleron Therapeutics. This study was funded by The Oxford NIHR Comprehensive Biomedical Research Centre and a Cancer Research UK Advanced Clinician Scientist Fellowship. Some authors declared being employees of or holding shares or share options in Celleron Therapeutics.

Source: Saunders MP et al. CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): A multicentre, open-label, single-arm, phase II trial. ESMO Open. 2022;7(6):100594 (Oct 27). Doi: 10.1016/j.esmoop.2022.100594

Key clinical point: The combination of CXD101 and nivolumab at full individual doses was effective and well tolerated as a third-line and above treatment for patients with late-stage microsatellite stable colorectal cancer (MSS CRC).

Major finding: CXD101 and nivolumab combination was well tolerated, with neutropenia (18%) and anemia (7%) being the most common grade 3-4 adverse events. The median progression-free survival and overall survival were 2.1 (95% CI 1.4-3.9) and 7.0 (95% CI 5.13-10.22) months, respectively, with an immune disease control rate of 48% and an immune objective response rate of 9%.

Study details: The data comes from a phase 1b/2 trial including 55 heavily pretreated patients with biopsy-confirmed MSS CRC who received oral CXD101 and intravenous nivolumab.

Disclosures: The trial was supported by Celleron Therapeutics. This study was funded by The Oxford NIHR Comprehensive Biomedical Research Centre and a Cancer Research UK Advanced Clinician Scientist Fellowship. Some authors declared being employees of or holding shares or share options in Celleron Therapeutics.

Source: Saunders MP et al. CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): A multicentre, open-label, single-arm, phase II trial. ESMO Open. 2022;7(6):100594 (Oct 27). Doi: 10.1016/j.esmoop.2022.100594

Key clinical point: Patients with stage III colon cancer (CC) who received >50% of the planned 6-month oxaliplatin-based chemotherapy may discontinue oxaliplatin and continue fluoropyrimidine in case of clinically relevant neurotoxicity.

Major finding: Discontinuation of all treatment (DT) vs no DT was independently associated with worse 3-year disease-free survival (DFS, adjusted hazard ratio [aHR] 1.61; P < .001) and 5-year overall survival (OS aHR, 1.73; P < .001), but discontinuation of oxaliplatin had no effect on 3-year DFS (P = .3) and 5-year OS (P = .1). However, patients receiving <50% vs 100% of the planned oxaliplatin cycles had poorer DFS (aHR 1.34; 95% CI 1.10-1.64) and OS (aHR 1.61; 95% CI 1.29-2.01).

Study details: This pooled analysis of 11 adjuvant trials included patients with stage III CC who were to receive 6 months of infusional fluorouracil+leucovorin+oxaliplatin or capecitabine+oxaliplatin.

Disclosures: No funding source was declared. Some authors declared employment, stock, or other ownership interest in or receiving research support, speakers' fee, or consultancy fees from various sources.

Source: Gallois C et al. Prognostic impact of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer: An ACCENT/IDEA pooled analysis of 11 adjuvant trials. J Clin Oncol. 2022 (Oct 28). Doi: 10.1200/JCO.21.02726

Key clinical point: Patients with stage III colon cancer (CC) who received >50% of the planned 6-month oxaliplatin-based chemotherapy may discontinue oxaliplatin and continue fluoropyrimidine in case of clinically relevant neurotoxicity.

Major finding: Discontinuation of all treatment (DT) vs no DT was independently associated with worse 3-year disease-free survival (DFS, adjusted hazard ratio [aHR] 1.61; P < .001) and 5-year overall survival (OS aHR, 1.73; P < .001), but discontinuation of oxaliplatin had no effect on 3-year DFS (P = .3) and 5-year OS (P = .1). However, patients receiving <50% vs 100% of the planned oxaliplatin cycles had poorer DFS (aHR 1.34; 95% CI 1.10-1.64) and OS (aHR 1.61; 95% CI 1.29-2.01).

Study details: This pooled analysis of 11 adjuvant trials included patients with stage III CC who were to receive 6 months of infusional fluorouracil+leucovorin+oxaliplatin or capecitabine+oxaliplatin.

Disclosures: No funding source was declared. Some authors declared employment, stock, or other ownership interest in or receiving research support, speakers' fee, or consultancy fees from various sources.

Source: Gallois C et al. Prognostic impact of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer: An ACCENT/IDEA pooled analysis of 11 adjuvant trials. J Clin Oncol. 2022 (Oct 28). Doi: 10.1200/JCO.21.02726

Key clinical point: Patients with stage III colon cancer (CC) who received >50% of the planned 6-month oxaliplatin-based chemotherapy may discontinue oxaliplatin and continue fluoropyrimidine in case of clinically relevant neurotoxicity.

Major finding: Discontinuation of all treatment (DT) vs no DT was independently associated with worse 3-year disease-free survival (DFS, adjusted hazard ratio [aHR] 1.61; P < .001) and 5-year overall survival (OS aHR, 1.73; P < .001), but discontinuation of oxaliplatin had no effect on 3-year DFS (P = .3) and 5-year OS (P = .1). However, patients receiving <50% vs 100% of the planned oxaliplatin cycles had poorer DFS (aHR 1.34; 95% CI 1.10-1.64) and OS (aHR 1.61; 95% CI 1.29-2.01).

Study details: This pooled analysis of 11 adjuvant trials included patients with stage III CC who were to receive 6 months of infusional fluorouracil+leucovorin+oxaliplatin or capecitabine+oxaliplatin.

Disclosures: No funding source was declared. Some authors declared employment, stock, or other ownership interest in or receiving research support, speakers' fee, or consultancy fees from various sources.

Source: Gallois C et al. Prognostic impact of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer: An ACCENT/IDEA pooled analysis of 11 adjuvant trials. J Clin Oncol. 2022 (Oct 28). Doi: 10.1200/JCO.21.02726

Key clinical point: Participants invited to undergo a single screening colonoscopy had a modestly reduced risk for colorectal cancer (CRC) at 10 years than those who were assigned to no screening.

Major finding: At 10 years, the real-world risk for CRC was 18% lower among participants who were invited vs not invited to undergo screening colonoscopy (risk ratio 0.82; 95% CI 0.70-0.93), with the number needed to invite to undergo screening to prevent 1 case of CRC within 10 years being 455 (95% CI 270-1,429).

Study details: The findings are 10-year follow-up results of the NordICC trial including 84,585 participants who were randomly assigned to receive (invited group; n = 28,220) or not receive (usual-care group; n = 56,365) an invitation to undergo a single screening colonoscopy.

Disclosures: This study was funded by the Research Council of Norway, Nordic Cancer Union, and others. Some authors declared serving as expert witnesses or consultants for or receiving research support, speakers' fees, or consultancy fees from various sources.

Source: Bretthauer M et al. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387(17):1547-1556 (Oct 27). Doi: 10.1056/NEJMoa2208375

Key clinical point: Participants invited to undergo a single screening colonoscopy had a modestly reduced risk for colorectal cancer (CRC) at 10 years than those who were assigned to no screening.

Major finding: At 10 years, the real-world risk for CRC was 18% lower among participants who were invited vs not invited to undergo screening colonoscopy (risk ratio 0.82; 95% CI 0.70-0.93), with the number needed to invite to undergo screening to prevent 1 case of CRC within 10 years being 455 (95% CI 270-1,429).

Study details: The findings are 10-year follow-up results of the NordICC trial including 84,585 participants who were randomly assigned to receive (invited group; n = 28,220) or not receive (usual-care group; n = 56,365) an invitation to undergo a single screening colonoscopy.

Disclosures: This study was funded by the Research Council of Norway, Nordic Cancer Union, and others. Some authors declared serving as expert witnesses or consultants for or receiving research support, speakers' fees, or consultancy fees from various sources.

Source: Bretthauer M et al. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387(17):1547-1556 (Oct 27). Doi: 10.1056/NEJMoa2208375

Key clinical point: Participants invited to undergo a single screening colonoscopy had a modestly reduced risk for colorectal cancer (CRC) at 10 years than those who were assigned to no screening.

Major finding: At 10 years, the real-world risk for CRC was 18% lower among participants who were invited vs not invited to undergo screening colonoscopy (risk ratio 0.82; 95% CI 0.70-0.93), with the number needed to invite to undergo screening to prevent 1 case of CRC within 10 years being 455 (95% CI 270-1,429).

Study details: The findings are 10-year follow-up results of the NordICC trial including 84,585 participants who were randomly assigned to receive (invited group; n = 28,220) or not receive (usual-care group; n = 56,365) an invitation to undergo a single screening colonoscopy.

Disclosures: This study was funded by the Research Council of Norway, Nordic Cancer Union, and others. Some authors declared serving as expert witnesses or consultants for or receiving research support, speakers' fees, or consultancy fees from various sources.

Source: Bretthauer M et al. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387(17):1547-1556 (Oct 27). Doi: 10.1056/NEJMoa2208375