A rapid, saliva-based test for COVID-19 could enable testing, diagnosis, and prescribing to take place in a single office visit by immediately confirming whether a patient has the infection and needs to be treated, researchers say. The test has sparked commercial interest and earned additional funding from the Canadian government.

The test uses a DNA aptamer – a short, synthetic oligonucleotide that binds to a specific molecular target – that shows high affinity for the SARS-CoV-2 spike protein and its variants. The approach “can be rapidly adapted to different threats,” as well, Leyla Soleymani, PhD, an associate professor of engineering physics at McMaster University, Hamilton, Ontario, Canada, told this news organization. Her team invented the approach.
 

Adaptable to other pathogens

Current gold-standard COVID-19 tests are based on reverse transcription-polymerase chain reaction (RT-PCR), which are sensitive but costly, complicated, and require waiting at least a couple of days for results, according to Dr. Soleymani and colleagues. Rapid nucleic acid and antigen tests have only “moderate” sensitivity and specificity, particularly when viral loads are low. None have been shown to work well with saliva samples.

By contrast, the new test “uses a reader and test cartridges, similar to the glucose reader,” said Dr. Soleymani, who is also Canada Research chair in Miniaturized Biomedical Devices. A small sample of saliva is added to a chemical reagent and inserted into the reader, which is attached to a smartphone. Once commercialized, the point-of-care test is expected to be performed quickly in a physician’s office or in a clinic.

“The same reader can be applied to a variety of infectious diseases or infection panels by developing new cartridges,” Dr. Soleymani explained. “Noroviruses and bacteria such as C. difficile are on our list” to examine next.What’s more, she added, “this test is ideally positioned for settings where access to centralized labs is not possible, such as less developed countries.”

The team’s recent studies seem to support the promise. A study published last year in the international edition of Angewandte Chemie documents the development of the test, which at that point could detect wild-type SARS-CoV-2 and its Alpha and Delta variants in unprocessed saliva samples in 10 minutes with 80.5% sensitivity and 100% specificity.

This study was followed in January 2022 by a paper in Chemistry showing that the device also detected Alpha, Gamma, Epsilon, Kappa, and Omicron variants, demonstrating its potential for recognizing rapidly evolving targets such as those found in SARS-CoV-2.

In another demonstration of its versatility, the technology was recently adapted and successfully detected animal viruses from saliva samples.
 

Commercial and government funding

The findings prompted Zentek, an intellectual property development and commercialization company in Guelph, Ont., to license the technology, with plans to invest more than $1 million in the next 5 years to scale up production of the test components and adapt the technology for other forms of infection.

Furthermore, the collaborative efforts required to develop the test and move it forward gained funding from Canada’s Natural Sciences and Engineering Research Council, which is investing nearly $1.5 million in the form of two grants: $1 million to further streamline the technology development in preparation for the next pandemic and $488,440 (including $140,000 from Zentek) to get the current test to market as quickly as possible.

Meanwhile, Dr. Soleymani is urging clinicians “to be open to nontraditional diagnostic approaches even if the traditional tests do the job. Such tests are more rapid and can be used to enable personalized medicine. Our success relies on collaboration and support from clinicians.”
 

Further validation needed

Daniel Kuritzkes, MD, chief of infectious diseases at Brigham and Women’s Hospital and the Harriet Ryan Albee Professor of Medicine at Harvard Medical School, Boston, commented on the study in response to a request from this news organization.

While “it’s always good to have more testing options available,” he said, “we don’t yet have very much information about performance characteristics of the test – that is, its sensitivity and specificity. I’d like to see the performance characteristics of this test compared to PCR tests and to the current rapid antigen tests using a large number of patient samples with currently circulating variants, and tests over time to see how soon tests become positive after symptom onset and for how long they remain positive.”

“Further validation studies and emergency use authorization or approval by regulatory authorities are needed before we will see this test implemented in the field,” Dr. Kuritzkes concluded.

A version of this article first appeared on Medscape.com.

A rapid, saliva-based test for COVID-19 could enable testing, diagnosis, and prescribing to take place in a single office visit by immediately confirming whether a patient has the infection and needs to be treated, researchers say. The test has sparked commercial interest and earned additional funding from the Canadian government.

The test uses a DNA aptamer – a short, synthetic oligonucleotide that binds to a specific molecular target – that shows high affinity for the SARS-CoV-2 spike protein and its variants. The approach “can be rapidly adapted to different threats,” as well, Leyla Soleymani, PhD, an associate professor of engineering physics at McMaster University, Hamilton, Ontario, Canada, told this news organization. Her team invented the approach.
 

Adaptable to other pathogens

Current gold-standard COVID-19 tests are based on reverse transcription-polymerase chain reaction (RT-PCR), which are sensitive but costly, complicated, and require waiting at least a couple of days for results, according to Dr. Soleymani and colleagues. Rapid nucleic acid and antigen tests have only “moderate” sensitivity and specificity, particularly when viral loads are low. None have been shown to work well with saliva samples.

By contrast, the new test “uses a reader and test cartridges, similar to the glucose reader,” said Dr. Soleymani, who is also Canada Research chair in Miniaturized Biomedical Devices. A small sample of saliva is added to a chemical reagent and inserted into the reader, which is attached to a smartphone. Once commercialized, the point-of-care test is expected to be performed quickly in a physician’s office or in a clinic.

“The same reader can be applied to a variety of infectious diseases or infection panels by developing new cartridges,” Dr. Soleymani explained. “Noroviruses and bacteria such as C. difficile are on our list” to examine next.What’s more, she added, “this test is ideally positioned for settings where access to centralized labs is not possible, such as less developed countries.”

The team’s recent studies seem to support the promise. A study published last year in the international edition of Angewandte Chemie documents the development of the test, which at that point could detect wild-type SARS-CoV-2 and its Alpha and Delta variants in unprocessed saliva samples in 10 minutes with 80.5% sensitivity and 100% specificity.

This study was followed in January 2022 by a paper in Chemistry showing that the device also detected Alpha, Gamma, Epsilon, Kappa, and Omicron variants, demonstrating its potential for recognizing rapidly evolving targets such as those found in SARS-CoV-2.

In another demonstration of its versatility, the technology was recently adapted and successfully detected animal viruses from saliva samples.
 

Commercial and government funding

The findings prompted Zentek, an intellectual property development and commercialization company in Guelph, Ont., to license the technology, with plans to invest more than $1 million in the next 5 years to scale up production of the test components and adapt the technology for other forms of infection.

Furthermore, the collaborative efforts required to develop the test and move it forward gained funding from Canada’s Natural Sciences and Engineering Research Council, which is investing nearly $1.5 million in the form of two grants: $1 million to further streamline the technology development in preparation for the next pandemic and $488,440 (including $140,000 from Zentek) to get the current test to market as quickly as possible.

Meanwhile, Dr. Soleymani is urging clinicians “to be open to nontraditional diagnostic approaches even if the traditional tests do the job. Such tests are more rapid and can be used to enable personalized medicine. Our success relies on collaboration and support from clinicians.”
 

Further validation needed

Daniel Kuritzkes, MD, chief of infectious diseases at Brigham and Women’s Hospital and the Harriet Ryan Albee Professor of Medicine at Harvard Medical School, Boston, commented on the study in response to a request from this news organization.

While “it’s always good to have more testing options available,” he said, “we don’t yet have very much information about performance characteristics of the test – that is, its sensitivity and specificity. I’d like to see the performance characteristics of this test compared to PCR tests and to the current rapid antigen tests using a large number of patient samples with currently circulating variants, and tests over time to see how soon tests become positive after symptom onset and for how long they remain positive.”

“Further validation studies and emergency use authorization or approval by regulatory authorities are needed before we will see this test implemented in the field,” Dr. Kuritzkes concluded.

A version of this article first appeared on Medscape.com.

A rapid, saliva-based test for COVID-19 could enable testing, diagnosis, and prescribing to take place in a single office visit by immediately confirming whether a patient has the infection and needs to be treated, researchers say. The test has sparked commercial interest and earned additional funding from the Canadian government.

The test uses a DNA aptamer – a short, synthetic oligonucleotide that binds to a specific molecular target – that shows high affinity for the SARS-CoV-2 spike protein and its variants. The approach “can be rapidly adapted to different threats,” as well, Leyla Soleymani, PhD, an associate professor of engineering physics at McMaster University, Hamilton, Ontario, Canada, told this news organization. Her team invented the approach.
 

Adaptable to other pathogens

Current gold-standard COVID-19 tests are based on reverse transcription-polymerase chain reaction (RT-PCR), which are sensitive but costly, complicated, and require waiting at least a couple of days for results, according to Dr. Soleymani and colleagues. Rapid nucleic acid and antigen tests have only “moderate” sensitivity and specificity, particularly when viral loads are low. None have been shown to work well with saliva samples.

By contrast, the new test “uses a reader and test cartridges, similar to the glucose reader,” said Dr. Soleymani, who is also Canada Research chair in Miniaturized Biomedical Devices. A small sample of saliva is added to a chemical reagent and inserted into the reader, which is attached to a smartphone. Once commercialized, the point-of-care test is expected to be performed quickly in a physician’s office or in a clinic.

“The same reader can be applied to a variety of infectious diseases or infection panels by developing new cartridges,” Dr. Soleymani explained. “Noroviruses and bacteria such as C. difficile are on our list” to examine next.What’s more, she added, “this test is ideally positioned for settings where access to centralized labs is not possible, such as less developed countries.”

The team’s recent studies seem to support the promise. A study published last year in the international edition of Angewandte Chemie documents the development of the test, which at that point could detect wild-type SARS-CoV-2 and its Alpha and Delta variants in unprocessed saliva samples in 10 minutes with 80.5% sensitivity and 100% specificity.

This study was followed in January 2022 by a paper in Chemistry showing that the device also detected Alpha, Gamma, Epsilon, Kappa, and Omicron variants, demonstrating its potential for recognizing rapidly evolving targets such as those found in SARS-CoV-2.

In another demonstration of its versatility, the technology was recently adapted and successfully detected animal viruses from saliva samples.
 

Commercial and government funding

The findings prompted Zentek, an intellectual property development and commercialization company in Guelph, Ont., to license the technology, with plans to invest more than $1 million in the next 5 years to scale up production of the test components and adapt the technology for other forms of infection.

Furthermore, the collaborative efforts required to develop the test and move it forward gained funding from Canada’s Natural Sciences and Engineering Research Council, which is investing nearly $1.5 million in the form of two grants: $1 million to further streamline the technology development in preparation for the next pandemic and $488,440 (including $140,000 from Zentek) to get the current test to market as quickly as possible.

Meanwhile, Dr. Soleymani is urging clinicians “to be open to nontraditional diagnostic approaches even if the traditional tests do the job. Such tests are more rapid and can be used to enable personalized medicine. Our success relies on collaboration and support from clinicians.”
 

Further validation needed

Daniel Kuritzkes, MD, chief of infectious diseases at Brigham and Women’s Hospital and the Harriet Ryan Albee Professor of Medicine at Harvard Medical School, Boston, commented on the study in response to a request from this news organization.

While “it’s always good to have more testing options available,” he said, “we don’t yet have very much information about performance characteristics of the test – that is, its sensitivity and specificity. I’d like to see the performance characteristics of this test compared to PCR tests and to the current rapid antigen tests using a large number of patient samples with currently circulating variants, and tests over time to see how soon tests become positive after symptom onset and for how long they remain positive.”

“Further validation studies and emergency use authorization or approval by regulatory authorities are needed before we will see this test implemented in the field,” Dr. Kuritzkes concluded.

A version of this article first appeared on Medscape.com.

Key clinical point: Multi-agent adjuvant chemotherapy (MAC) offers a survival benefit over single-agent adjuvant chemotherapy (SAC) in patients with stage III colon cancer (CC) aged 70-75 years, but not for older patients.

Major finding: MAC vs. SAC was associated with a survival benefit in patients aged 70-75 years (hazard ratio [HR] 0.81; P < .001), but not in those aged 76-80 (HR 0.90; P = .051), 81-85 (HR 0.97; P = .637), or 86-90+ (HR 0.95; P = .691) years.

Study details: This retrospective, age group-based study included 20,257 patients aged ≥70 years with stage III CC who received either SAC (n = 7334) or MAC (n = 12,923).

Disclosures: The study was supported by the Winship Research Informatics Shared Resource of Winship Cancer Institute of Emory University and US National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Khalil L et al. Survival outcomes of adjuvant chemotherapy in elderly patients with stage III colon cancer. Oncologist. 2022 (Jun 1). Doi: 10.1093/oncolo/oyac082

Key clinical point: Multi-agent adjuvant chemotherapy (MAC) offers a survival benefit over single-agent adjuvant chemotherapy (SAC) in patients with stage III colon cancer (CC) aged 70-75 years, but not for older patients.

Major finding: MAC vs. SAC was associated with a survival benefit in patients aged 70-75 years (hazard ratio [HR] 0.81; P < .001), but not in those aged 76-80 (HR 0.90; P = .051), 81-85 (HR 0.97; P = .637), or 86-90+ (HR 0.95; P = .691) years.

Study details: This retrospective, age group-based study included 20,257 patients aged ≥70 years with stage III CC who received either SAC (n = 7334) or MAC (n = 12,923).

Disclosures: The study was supported by the Winship Research Informatics Shared Resource of Winship Cancer Institute of Emory University and US National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Khalil L et al. Survival outcomes of adjuvant chemotherapy in elderly patients with stage III colon cancer. Oncologist. 2022 (Jun 1). Doi: 10.1093/oncolo/oyac082

Key clinical point: Multi-agent adjuvant chemotherapy (MAC) offers a survival benefit over single-agent adjuvant chemotherapy (SAC) in patients with stage III colon cancer (CC) aged 70-75 years, but not for older patients.

Major finding: MAC vs. SAC was associated with a survival benefit in patients aged 70-75 years (hazard ratio [HR] 0.81; P < .001), but not in those aged 76-80 (HR 0.90; P = .051), 81-85 (HR 0.97; P = .637), or 86-90+ (HR 0.95; P = .691) years.

Study details: This retrospective, age group-based study included 20,257 patients aged ≥70 years with stage III CC who received either SAC (n = 7334) or MAC (n = 12,923).

Disclosures: The study was supported by the Winship Research Informatics Shared Resource of Winship Cancer Institute of Emory University and US National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Khalil L et al. Survival outcomes of adjuvant chemotherapy in elderly patients with stage III colon cancer. Oncologist. 2022 (Jun 1). Doi: 10.1093/oncolo/oyac082

Key clinical point: Metabolic syndrome (MetS) and obesity in individuals aged between 20 and 49 years are associated with an increased risk for earlier-onset colorectal cancer (CRC).

Major finding: MetS (adjusted hazard ratio [aHR] 1.20; 95% CI 1.14-1.27) and a higher body mass index (BMI; 25.0-29.9 kg/m²: aHR 1.19; 95% CI 1.12-1.25; ≥30 kg/m²: aHR 1.45; 95% CI 1.31-1.61) and waist circumference (WC; ≥100 cm in men or ≥95 cm in women: aHR 1.53; 95% CI 1.34-1.74) were associated with an increased earlier-onset CRC risk.

Study details: Findings are from a nationwide population-based cohort study that enrolled 5,672,153 individuals aged 20-49 years with health checkup data (i.e., anthropometric measurement, laboratory test, and health behavior data), of which 8320 developed earlier-onset CRC.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Jin EH et al. Association between metabolic syndrome and the risk of colorectal cancer diagnosed before 50 years according to tumor location. Gastroenterology. 2022 (May 26). Doi: 10.1053/j.gastro.2022.05.032

Key clinical point: Metabolic syndrome (MetS) and obesity in individuals aged between 20 and 49 years are associated with an increased risk for earlier-onset colorectal cancer (CRC).

Major finding: MetS (adjusted hazard ratio [aHR] 1.20; 95% CI 1.14-1.27) and a higher body mass index (BMI; 25.0-29.9 kg/m²: aHR 1.19; 95% CI 1.12-1.25; ≥30 kg/m²: aHR 1.45; 95% CI 1.31-1.61) and waist circumference (WC; ≥100 cm in men or ≥95 cm in women: aHR 1.53; 95% CI 1.34-1.74) were associated with an increased earlier-onset CRC risk.

Study details: Findings are from a nationwide population-based cohort study that enrolled 5,672,153 individuals aged 20-49 years with health checkup data (i.e., anthropometric measurement, laboratory test, and health behavior data), of which 8320 developed earlier-onset CRC.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Jin EH et al. Association between metabolic syndrome and the risk of colorectal cancer diagnosed before 50 years according to tumor location. Gastroenterology. 2022 (May 26). Doi: 10.1053/j.gastro.2022.05.032

Key clinical point: Metabolic syndrome (MetS) and obesity in individuals aged between 20 and 49 years are associated with an increased risk for earlier-onset colorectal cancer (CRC).

Major finding: MetS (adjusted hazard ratio [aHR] 1.20; 95% CI 1.14-1.27) and a higher body mass index (BMI; 25.0-29.9 kg/m²: aHR 1.19; 95% CI 1.12-1.25; ≥30 kg/m²: aHR 1.45; 95% CI 1.31-1.61) and waist circumference (WC; ≥100 cm in men or ≥95 cm in women: aHR 1.53; 95% CI 1.34-1.74) were associated with an increased earlier-onset CRC risk.

Study details: Findings are from a nationwide population-based cohort study that enrolled 5,672,153 individuals aged 20-49 years with health checkup data (i.e., anthropometric measurement, laboratory test, and health behavior data), of which 8320 developed earlier-onset CRC.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Jin EH et al. Association between metabolic syndrome and the risk of colorectal cancer diagnosed before 50 years according to tumor location. Gastroenterology. 2022 (May 26). Doi: 10.1053/j.gastro.2022.05.032

Key clinical point: Individuals with the highest vs. lowest intake of nuts and legumes had a 16% and 10% lower risk for colorectal cancer (CRC), respectively.

Major finding: The pooled relative risk (RR) for CRC among individuals with the highest vs. lowest consumption of nuts and legumes was 0.84 (95% CI 0.71-0.99) and 0.90 (95% CI 0.83-0.98), respectively. A once-daily consumption of 28 g nuts and 100 g legumes was associated with a 33% (RR 0.67; 95% CI 0.45-0.98) and 21% (RR 0.79; 95% CI 0.64-0.97) lower risk for CRC, respectively.

Study details: Findings are from a meta-analysis of 13 and 29 studies that evaluated the association of the consumption of nuts and legumes with CRC risk, respectively.

Disclosures: The study was supported by the National Research Foundation of Korea, Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Jin S,  Je Y. Nuts and legumes consumption and risk of colorectal cancer: A systematic review and meta-analysis. Eur J Epidemiol. 2022 (May 27). Doi: 10.1007/s10654-022-00881-6

Key clinical point: Individuals with the highest vs. lowest intake of nuts and legumes had a 16% and 10% lower risk for colorectal cancer (CRC), respectively.

Major finding: The pooled relative risk (RR) for CRC among individuals with the highest vs. lowest consumption of nuts and legumes was 0.84 (95% CI 0.71-0.99) and 0.90 (95% CI 0.83-0.98), respectively. A once-daily consumption of 28 g nuts and 100 g legumes was associated with a 33% (RR 0.67; 95% CI 0.45-0.98) and 21% (RR 0.79; 95% CI 0.64-0.97) lower risk for CRC, respectively.

Study details: Findings are from a meta-analysis of 13 and 29 studies that evaluated the association of the consumption of nuts and legumes with CRC risk, respectively.

Disclosures: The study was supported by the National Research Foundation of Korea, Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Jin S,  Je Y. Nuts and legumes consumption and risk of colorectal cancer: A systematic review and meta-analysis. Eur J Epidemiol. 2022 (May 27). Doi: 10.1007/s10654-022-00881-6

Key clinical point: Individuals with the highest vs. lowest intake of nuts and legumes had a 16% and 10% lower risk for colorectal cancer (CRC), respectively.

Major finding: The pooled relative risk (RR) for CRC among individuals with the highest vs. lowest consumption of nuts and legumes was 0.84 (95% CI 0.71-0.99) and 0.90 (95% CI 0.83-0.98), respectively. A once-daily consumption of 28 g nuts and 100 g legumes was associated with a 33% (RR 0.67; 95% CI 0.45-0.98) and 21% (RR 0.79; 95% CI 0.64-0.97) lower risk for CRC, respectively.

Study details: Findings are from a meta-analysis of 13 and 29 studies that evaluated the association of the consumption of nuts and legumes with CRC risk, respectively.

Disclosures: The study was supported by the National Research Foundation of Korea, Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Jin S,  Je Y. Nuts and legumes consumption and risk of colorectal cancer: A systematic review and meta-analysis. Eur J Epidemiol. 2022 (May 27). Doi: 10.1007/s10654-022-00881-6

Key clinical point: Compared with hybrid and open resection, simultaneous laparoscopic resection of colorectal cancer (CRC) and liver metastases offers improved postoperative outcomes and equivalent long-term oncological outcomes.

Major finding: The laparoscopic group had a lower wound complication rate than the open group (2.1% vs. 13.2%; P = .028) and a shorter postoperative hospital stay than the hybrid and open groups (8 vs. 11 days; P < .001 for both). The 5-year liver-specific recurrence rates were similar between the laparoscopic and hybrid groups (P = .270) and between the laparoscopic and open groups (P = .391).

Study details: The data come from a retrospective study including 647 patients who underwent simultaneous surgery for primary CRC and synchronous liver metastases and were categorized into the laparoscopic (n = 42) vs. hybrid (n = 81) and laparoscopic (n = 48) vs. open (n = 136) group sets after propensity score matching.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Lim H-K et al. Outcomes of simultaneous laparoscopic, hybrid, and open resection in colorectal cancer with synchronous liver metastases: a propensity score-matched study. Sci Rep. 2022;12:8867 (May 25). Doi: 10.1038/s41598-022-12372-5

Key clinical point: Compared with hybrid and open resection, simultaneous laparoscopic resection of colorectal cancer (CRC) and liver metastases offers improved postoperative outcomes and equivalent long-term oncological outcomes.

Major finding: The laparoscopic group had a lower wound complication rate than the open group (2.1% vs. 13.2%; P = .028) and a shorter postoperative hospital stay than the hybrid and open groups (8 vs. 11 days; P < .001 for both). The 5-year liver-specific recurrence rates were similar between the laparoscopic and hybrid groups (P = .270) and between the laparoscopic and open groups (P = .391).

Study details: The data come from a retrospective study including 647 patients who underwent simultaneous surgery for primary CRC and synchronous liver metastases and were categorized into the laparoscopic (n = 42) vs. hybrid (n = 81) and laparoscopic (n = 48) vs. open (n = 136) group sets after propensity score matching.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Lim H-K et al. Outcomes of simultaneous laparoscopic, hybrid, and open resection in colorectal cancer with synchronous liver metastases: a propensity score-matched study. Sci Rep. 2022;12:8867 (May 25). Doi: 10.1038/s41598-022-12372-5

Key clinical point: Compared with hybrid and open resection, simultaneous laparoscopic resection of colorectal cancer (CRC) and liver metastases offers improved postoperative outcomes and equivalent long-term oncological outcomes.

Major finding: The laparoscopic group had a lower wound complication rate than the open group (2.1% vs. 13.2%; P = .028) and a shorter postoperative hospital stay than the hybrid and open groups (8 vs. 11 days; P < .001 for both). The 5-year liver-specific recurrence rates were similar between the laparoscopic and hybrid groups (P = .270) and between the laparoscopic and open groups (P = .391).

Study details: The data come from a retrospective study including 647 patients who underwent simultaneous surgery for primary CRC and synchronous liver metastases and were categorized into the laparoscopic (n = 42) vs. hybrid (n = 81) and laparoscopic (n = 48) vs. open (n = 136) group sets after propensity score matching.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Lim H-K et al. Outcomes of simultaneous laparoscopic, hybrid, and open resection in colorectal cancer with synchronous liver metastases: a propensity score-matched study. Sci Rep. 2022;12:8867 (May 25). Doi: 10.1038/s41598-022-12372-5

Key clinical point: Compared with regorafenib, raltitrexed plus S-1 (RS) prolonged overall survival without causing unmanageable adverse effects in patients with metastatic colorectal cancer (mCRC) who did not respond to previous standard treatments.

Major finding: Patients receiving RS vs. regorafenib had a significantly longer overall survival (13.3 vs. 10.0 months; P = .02). Adverse events were well tolerated in both the groups.

Study details: The findings are from a real-world, retrospective cohort study including 187 adult patients with mCRC who received RS or regorafenib after the failure of ≥2 standard treatments and were propensity score-matched to form 78 pairs.

Disclosures: This study was sponsored by the Sichuan Science and Technology Department Key Research and Development Project, among others. The authors declared no conflicts of interest.

Source: Zhou Y-W et al. Efficacy and safety of raltitrexed plus S-1 versus regorafenib in patients with refractory metastatic colorectal cancer: A real-world propensity score matching study. Therap Adv Gastroenterol. 2022 (May 18). Doi: 10.1177/17562848221098246

Key clinical point: Compared with regorafenib, raltitrexed plus S-1 (RS) prolonged overall survival without causing unmanageable adverse effects in patients with metastatic colorectal cancer (mCRC) who did not respond to previous standard treatments.

Major finding: Patients receiving RS vs. regorafenib had a significantly longer overall survival (13.3 vs. 10.0 months; P = .02). Adverse events were well tolerated in both the groups.

Study details: The findings are from a real-world, retrospective cohort study including 187 adult patients with mCRC who received RS or regorafenib after the failure of ≥2 standard treatments and were propensity score-matched to form 78 pairs.

Disclosures: This study was sponsored by the Sichuan Science and Technology Department Key Research and Development Project, among others. The authors declared no conflicts of interest.

Source: Zhou Y-W et al. Efficacy and safety of raltitrexed plus S-1 versus regorafenib in patients with refractory metastatic colorectal cancer: A real-world propensity score matching study. Therap Adv Gastroenterol. 2022 (May 18). Doi: 10.1177/17562848221098246

Key clinical point: Compared with regorafenib, raltitrexed plus S-1 (RS) prolonged overall survival without causing unmanageable adverse effects in patients with metastatic colorectal cancer (mCRC) who did not respond to previous standard treatments.

Major finding: Patients receiving RS vs. regorafenib had a significantly longer overall survival (13.3 vs. 10.0 months; P = .02). Adverse events were well tolerated in both the groups.

Study details: The findings are from a real-world, retrospective cohort study including 187 adult patients with mCRC who received RS or regorafenib after the failure of ≥2 standard treatments and were propensity score-matched to form 78 pairs.

Disclosures: This study was sponsored by the Sichuan Science and Technology Department Key Research and Development Project, among others. The authors declared no conflicts of interest.

Source: Zhou Y-W et al. Efficacy and safety of raltitrexed plus S-1 versus regorafenib in patients with refractory metastatic colorectal cancer: A real-world propensity score matching study. Therap Adv Gastroenterol. 2022 (May 18). Doi: 10.1177/17562848221098246

Key clinical point: Heavy alcohol use strongly contributes to increased early-onset colorectal cancer (EOCRC) risk irrespective of polygenic risk score (PRS) levels. Abstinence from heavy drinking may reduce EOCRC risk to a degree equivalent to having a much lower genetic risk.

Major finding: High (≥25 g/day) vs. low (0.1 to <25 g/day) lifetime average alcohol consumption was strongly associated with increased EOCRC risk (odds ratio 1.8; 95% CI 1.2-2.8). The effect of high lifetime alcohol consumption on EOCRC was equivalent to that of having 47 percentiles higher PRS (genetic risk equivalent 47; 95% CI 12-82).

Study details: This retrospective study included 5104 patients with colorectal cancer and 4131 non-colorectal cancer controls from the large, population-based German DACHS study.

Disclosures: The DACHS study was supported by the German Research Council and German Federal Ministry of Education and Research. The authors declared no conflicts of interest.

Source: Chen X et al. Alcohol consumption, polygenic risk score, and early- and late-onset colorectal cancer risk. EClinicalMedicine. 2022;49:101460 (May 20). Doi: 10.1016/j.eclinm.2022.101460

Key clinical point: Heavy alcohol use strongly contributes to increased early-onset colorectal cancer (EOCRC) risk irrespective of polygenic risk score (PRS) levels. Abstinence from heavy drinking may reduce EOCRC risk to a degree equivalent to having a much lower genetic risk.

Major finding: High (≥25 g/day) vs. low (0.1 to <25 g/day) lifetime average alcohol consumption was strongly associated with increased EOCRC risk (odds ratio 1.8; 95% CI 1.2-2.8). The effect of high lifetime alcohol consumption on EOCRC was equivalent to that of having 47 percentiles higher PRS (genetic risk equivalent 47; 95% CI 12-82).

Study details: This retrospective study included 5104 patients with colorectal cancer and 4131 non-colorectal cancer controls from the large, population-based German DACHS study.

Disclosures: The DACHS study was supported by the German Research Council and German Federal Ministry of Education and Research. The authors declared no conflicts of interest.

Source: Chen X et al. Alcohol consumption, polygenic risk score, and early- and late-onset colorectal cancer risk. EClinicalMedicine. 2022;49:101460 (May 20). Doi: 10.1016/j.eclinm.2022.101460

Key clinical point: Heavy alcohol use strongly contributes to increased early-onset colorectal cancer (EOCRC) risk irrespective of polygenic risk score (PRS) levels. Abstinence from heavy drinking may reduce EOCRC risk to a degree equivalent to having a much lower genetic risk.

Major finding: High (≥25 g/day) vs. low (0.1 to <25 g/day) lifetime average alcohol consumption was strongly associated with increased EOCRC risk (odds ratio 1.8; 95% CI 1.2-2.8). The effect of high lifetime alcohol consumption on EOCRC was equivalent to that of having 47 percentiles higher PRS (genetic risk equivalent 47; 95% CI 12-82).

Study details: This retrospective study included 5104 patients with colorectal cancer and 4131 non-colorectal cancer controls from the large, population-based German DACHS study.

Disclosures: The DACHS study was supported by the German Research Council and German Federal Ministry of Education and Research. The authors declared no conflicts of interest.

Source: Chen X et al. Alcohol consumption, polygenic risk score, and early- and late-onset colorectal cancer risk. EClinicalMedicine. 2022;49:101460 (May 20). Doi: 10.1016/j.eclinm.2022.101460

Key clinical point: The association between metachronous colorectal cancer (CRC) diagnosis and biopsy of nontumor sites after biopsy of an initial CRC in the same colonoscopy is not significant.

Major finding: Nontumor site biopsy after initial CRC biopsy was not significantly associated with the risk for metachronous CRC in the colonic segment of the additional biopsy site (adjusted odds ratio 2.29; 95% CI 0.77-6.81).

Study details: This retrospective case-control study included 45 adult patients, diagnosed with CRC by colonoscopy with biopsy who underwent complete curative resection and were re-diagnosed with CRC within 6 months to 4 years of the initial diagnosis, and 212 matched control individuals.

Disclosures: The study was supported by the Population-based Research to Optimize the Screening Process Consortium, US National Cancer Institute. The authors declared no conflicts of interest.

Source: Lam AY et al. Biopsy of non-tumor sites after biopsy of a colorectal cancer is not associated with metachronous cancers: a case-control study. Clin Gastroenterol Hepatol. 2022 (May 26). Doi: 10.1016/j.cgh.2022.05.006

Key clinical point: The association between metachronous colorectal cancer (CRC) diagnosis and biopsy of nontumor sites after biopsy of an initial CRC in the same colonoscopy is not significant.

Major finding: Nontumor site biopsy after initial CRC biopsy was not significantly associated with the risk for metachronous CRC in the colonic segment of the additional biopsy site (adjusted odds ratio 2.29; 95% CI 0.77-6.81).

Study details: This retrospective case-control study included 45 adult patients, diagnosed with CRC by colonoscopy with biopsy who underwent complete curative resection and were re-diagnosed with CRC within 6 months to 4 years of the initial diagnosis, and 212 matched control individuals.

Disclosures: The study was supported by the Population-based Research to Optimize the Screening Process Consortium, US National Cancer Institute. The authors declared no conflicts of interest.

Source: Lam AY et al. Biopsy of non-tumor sites after biopsy of a colorectal cancer is not associated with metachronous cancers: a case-control study. Clin Gastroenterol Hepatol. 2022 (May 26). Doi: 10.1016/j.cgh.2022.05.006

Key clinical point: The association between metachronous colorectal cancer (CRC) diagnosis and biopsy of nontumor sites after biopsy of an initial CRC in the same colonoscopy is not significant.

Major finding: Nontumor site biopsy after initial CRC biopsy was not significantly associated with the risk for metachronous CRC in the colonic segment of the additional biopsy site (adjusted odds ratio 2.29; 95% CI 0.77-6.81).

Study details: This retrospective case-control study included 45 adult patients, diagnosed with CRC by colonoscopy with biopsy who underwent complete curative resection and were re-diagnosed with CRC within 6 months to 4 years of the initial diagnosis, and 212 matched control individuals.

Disclosures: The study was supported by the Population-based Research to Optimize the Screening Process Consortium, US National Cancer Institute. The authors declared no conflicts of interest.

Source: Lam AY et al. Biopsy of non-tumor sites after biopsy of a colorectal cancer is not associated with metachronous cancers: a case-control study. Clin Gastroenterol Hepatol. 2022 (May 26). Doi: 10.1016/j.cgh.2022.05.006

Key clinical point: Patients with metastatic colorectal cancer (mCRC) show a clear-cut attrition across subsequent lines of therapy, with most patients with RAS/BRAF wild-type mCRC opting for anti-epidermal growth factor receptor (EGFR)-containing regimens as the treatment of choice after the second progressive disease (PD).

Major finding: The number of patients receiving subsequent systemic treatment decreased with each progressive line of therapy (53%, 27%, and 11% of patients received treatment after the second, third, and fourth PD, respectively). After the second PD, anti-EGFR-containing regimens were preferred by most (67%) patients with RAS/BRAF wild-type mCRC.

Study details: This pooled analysis study included 1187 patients with mCRC from two phase 3 trials, TRIBE and TRIBE2, who received fluorouracil, irinotecan, and oxaliplatin (FOLFOXIRI) + bevacizumab or doublets (fluorouracil + oxaliplatin [FOLFOX] or fluorouracil + irinotecan [FOLFIRI]) + bevacizumab as the first-line therapy.

Disclosures: The study was supported by the GONO and ARCO Foundations. Some authors declared serving as consultants, advisors, or speakers for or receiving honoraria or research funding from various organizations.

Source: Rossini D et al. Treatments after second progression in metastatic colorectal cancer: A pooled analysis of the TRIBE and TRIBE2 studies. Eur J Cancer. 2022;170:64-72 (May 17). Doi: 10.1016/j.ejca.2022.04.019

Key clinical point: Patients with metastatic colorectal cancer (mCRC) show a clear-cut attrition across subsequent lines of therapy, with most patients with RAS/BRAF wild-type mCRC opting for anti-epidermal growth factor receptor (EGFR)-containing regimens as the treatment of choice after the second progressive disease (PD).

Major finding: The number of patients receiving subsequent systemic treatment decreased with each progressive line of therapy (53%, 27%, and 11% of patients received treatment after the second, third, and fourth PD, respectively). After the second PD, anti-EGFR-containing regimens were preferred by most (67%) patients with RAS/BRAF wild-type mCRC.

Study details: This pooled analysis study included 1187 patients with mCRC from two phase 3 trials, TRIBE and TRIBE2, who received fluorouracil, irinotecan, and oxaliplatin (FOLFOXIRI) + bevacizumab or doublets (fluorouracil + oxaliplatin [FOLFOX] or fluorouracil + irinotecan [FOLFIRI]) + bevacizumab as the first-line therapy.

Disclosures: The study was supported by the GONO and ARCO Foundations. Some authors declared serving as consultants, advisors, or speakers for or receiving honoraria or research funding from various organizations.

Source: Rossini D et al. Treatments after second progression in metastatic colorectal cancer: A pooled analysis of the TRIBE and TRIBE2 studies. Eur J Cancer. 2022;170:64-72 (May 17). Doi: 10.1016/j.ejca.2022.04.019

Key clinical point: Patients with metastatic colorectal cancer (mCRC) show a clear-cut attrition across subsequent lines of therapy, with most patients with RAS/BRAF wild-type mCRC opting for anti-epidermal growth factor receptor (EGFR)-containing regimens as the treatment of choice after the second progressive disease (PD).

Major finding: The number of patients receiving subsequent systemic treatment decreased with each progressive line of therapy (53%, 27%, and 11% of patients received treatment after the second, third, and fourth PD, respectively). After the second PD, anti-EGFR-containing regimens were preferred by most (67%) patients with RAS/BRAF wild-type mCRC.

Study details: This pooled analysis study included 1187 patients with mCRC from two phase 3 trials, TRIBE and TRIBE2, who received fluorouracil, irinotecan, and oxaliplatin (FOLFOXIRI) + bevacizumab or doublets (fluorouracil + oxaliplatin [FOLFOX] or fluorouracil + irinotecan [FOLFIRI]) + bevacizumab as the first-line therapy.

Disclosures: The study was supported by the GONO and ARCO Foundations. Some authors declared serving as consultants, advisors, or speakers for or receiving honoraria or research funding from various organizations.

Source: Rossini D et al. Treatments after second progression in metastatic colorectal cancer: A pooled analysis of the TRIBE and TRIBE2 studies. Eur J Cancer. 2022;170:64-72 (May 17). Doi: 10.1016/j.ejca.2022.04.019

Key clinical point: The addition of atezolizumab to the first-line FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) + bevacizumab improved progression-free survival (PFS) in patients with previously untreated metastatic colorectal cancer (mCRC) without compromising safety.

Major finding: At a median follow-up of 19.9 months, patients receiving FOLFOXIRI + bevacizumab and atezolizumab vs. FOLFOXIRI + bevacizumab had a significantly longer median PFS (13.1 vs. 11.5 months; adjusted hazard ratio 0.70; P = .018), with serious adverse events being reported in 27% vs. 26% of patients, respectively.

Study details: The data come from a phase 2 study, AtezoTRIBE, that included 218 adult patients with previously untreated mCRC who were randomly assigned to receive FOLFOXIRI + bevacizumab (n = 73) or FOLFOXIRI + bevacizumab and atezolizumab (n = 145).

Disclosures: The study was sponsored by the GONO and ARCO Foundations, F Hoffmann-La Roche, and Roche. Some authors declared serving as consultants/advisors for or receiving honoraria or speaker/consulting fees from various sources, including Roche.

Source: Antoniotti C et al. Upfront FOLFOXIRI plus bevacizumab with or without atezolizumab in the treatment of patients with metastatic colorectal cancer (AtezoTRIBE): A multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Oncol. 2022 (May 27). Doi: 10.1016/S1470-2045(22)00274-1

Key clinical point: The addition of atezolizumab to the first-line FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) + bevacizumab improved progression-free survival (PFS) in patients with previously untreated metastatic colorectal cancer (mCRC) without compromising safety.

Major finding: At a median follow-up of 19.9 months, patients receiving FOLFOXIRI + bevacizumab and atezolizumab vs. FOLFOXIRI + bevacizumab had a significantly longer median PFS (13.1 vs. 11.5 months; adjusted hazard ratio 0.70; P = .018), with serious adverse events being reported in 27% vs. 26% of patients, respectively.

Study details: The data come from a phase 2 study, AtezoTRIBE, that included 218 adult patients with previously untreated mCRC who were randomly assigned to receive FOLFOXIRI + bevacizumab (n = 73) or FOLFOXIRI + bevacizumab and atezolizumab (n = 145).

Disclosures: The study was sponsored by the GONO and ARCO Foundations, F Hoffmann-La Roche, and Roche. Some authors declared serving as consultants/advisors for or receiving honoraria or speaker/consulting fees from various sources, including Roche.

Source: Antoniotti C et al. Upfront FOLFOXIRI plus bevacizumab with or without atezolizumab in the treatment of patients with metastatic colorectal cancer (AtezoTRIBE): A multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Oncol. 2022 (May 27). Doi: 10.1016/S1470-2045(22)00274-1

Key clinical point: The addition of atezolizumab to the first-line FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) + bevacizumab improved progression-free survival (PFS) in patients with previously untreated metastatic colorectal cancer (mCRC) without compromising safety.

Major finding: At a median follow-up of 19.9 months, patients receiving FOLFOXIRI + bevacizumab and atezolizumab vs. FOLFOXIRI + bevacizumab had a significantly longer median PFS (13.1 vs. 11.5 months; adjusted hazard ratio 0.70; P = .018), with serious adverse events being reported in 27% vs. 26% of patients, respectively.

Study details: The data come from a phase 2 study, AtezoTRIBE, that included 218 adult patients with previously untreated mCRC who were randomly assigned to receive FOLFOXIRI + bevacizumab (n = 73) or FOLFOXIRI + bevacizumab and atezolizumab (n = 145).

Disclosures: The study was sponsored by the GONO and ARCO Foundations, F Hoffmann-La Roche, and Roche. Some authors declared serving as consultants/advisors for or receiving honoraria or speaker/consulting fees from various sources, including Roche.

Source: Antoniotti C et al. Upfront FOLFOXIRI plus bevacizumab with or without atezolizumab in the treatment of patients with metastatic colorectal cancer (AtezoTRIBE): A multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Oncol. 2022 (May 27). Doi: 10.1016/S1470-2045(22)00274-1