Clinical Edge Journal Scan

Key clinical point: Elevated pretreatment plasma levels of programmed death-ligand 1 (PD-L1) predicted poor disease-specific survival (DSS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC).

Major finding: The pretreatment PD-L1 levels were significantly lower in patients with metachronous vs synchronous metastases (P  =  .0412) and in those without vs with signs of disease progression (P  =  .0443), with a significant association observed between elevated PD-L1 levels and shorter DSS (P  =  .0257) and PFS (P  =  .0141).

Study details: Findings are from a retrospective analysis of 37 patients with stage IV mCRC who were included prior to any metastatic setting treatments.

Disclosures: This study was supported by the National Research, Development, and Innovation Office, Hungary. The authors declared no conflicts of interest.

Source: Dank M et al. Does elevated pre-treatment plasma PD-L1 level indicate an increased tumor burden and worse prognosis in metastatic colorectal cancer? J Clin Med. 2022;11(16):4815 (Aug 17). Doi: 10.3390/jcm11164815

Key clinical point: Elevated pretreatment plasma levels of programmed death-ligand 1 (PD-L1) predicted poor disease-specific survival (DSS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC).

Major finding: The pretreatment PD-L1 levels were significantly lower in patients with metachronous vs synchronous metastases (P  =  .0412) and in those without vs with signs of disease progression (P  =  .0443), with a significant association observed between elevated PD-L1 levels and shorter DSS (P  =  .0257) and PFS (P  =  .0141).

Study details: Findings are from a retrospective analysis of 37 patients with stage IV mCRC who were included prior to any metastatic setting treatments.

Disclosures: This study was supported by the National Research, Development, and Innovation Office, Hungary. The authors declared no conflicts of interest.

Source: Dank M et al. Does elevated pre-treatment plasma PD-L1 level indicate an increased tumor burden and worse prognosis in metastatic colorectal cancer? J Clin Med. 2022;11(16):4815 (Aug 17). Doi: 10.3390/jcm11164815

Key clinical point: Elevated pretreatment plasma levels of programmed death-ligand 1 (PD-L1) predicted poor disease-specific survival (DSS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC).

Major finding: The pretreatment PD-L1 levels were significantly lower in patients with metachronous vs synchronous metastases (P  =  .0412) and in those without vs with signs of disease progression (P  =  .0443), with a significant association observed between elevated PD-L1 levels and shorter DSS (P  =  .0257) and PFS (P  =  .0141).

Study details: Findings are from a retrospective analysis of 37 patients with stage IV mCRC who were included prior to any metastatic setting treatments.

Disclosures: This study was supported by the National Research, Development, and Innovation Office, Hungary. The authors declared no conflicts of interest.

Source: Dank M et al. Does elevated pre-treatment plasma PD-L1 level indicate an increased tumor burden and worse prognosis in metastatic colorectal cancer? J Clin Med. 2022;11(16):4815 (Aug 17). Doi: 10.3390/jcm11164815

Key clinical point: The coadministration of histamine H₂ receptor antagonists (H₂RA) is unlikely to affect the efficacy of capecitabine monotherapy and capecitabine and oxaliplatin (CapeOX) regimen in patients with early-stage colorectal cancer (CRC).

Major finding: At 5 years, the relapse-free survival (RFS) in the H₂RA and non-H₂RA groups were 76.7% (95% CI 57.2%-88.1%) and 79.8% (95% CI 76.0%-83.0%), respectively, with RFS not being significantly different between the H₂RA and non-H₂RA groups of patients receiving capecitabine monotherapy or CapeOX (P  =  .772).

Study details: Findings are from a retrospective analysis of 552 patients with stage II-III CRC who received either capecitabine alone or CapeOX as adjuvant therapy. H₂RA were coadministered to 30 patients.

Disclosures: This study was partly supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research and the Policy-based Medical Services Foundation in Japan. R Uozumi and H Kawazoe declared ties with various sources.

Source: Yamazaki T et al. Association between the co-administration of histamine H₂ receptor antagonists and the effectiveness of capecitabine in patients with colorectal cancer: Propensity score analysis. J Cancer. 2022;13(10):3073-3083 (Aug 8). Doi: 10.7150/jca.73385

Key clinical point: The coadministration of histamine H₂ receptor antagonists (H₂RA) is unlikely to affect the efficacy of capecitabine monotherapy and capecitabine and oxaliplatin (CapeOX) regimen in patients with early-stage colorectal cancer (CRC).

Major finding: At 5 years, the relapse-free survival (RFS) in the H₂RA and non-H₂RA groups were 76.7% (95% CI 57.2%-88.1%) and 79.8% (95% CI 76.0%-83.0%), respectively, with RFS not being significantly different between the H₂RA and non-H₂RA groups of patients receiving capecitabine monotherapy or CapeOX (P  =  .772).

Study details: Findings are from a retrospective analysis of 552 patients with stage II-III CRC who received either capecitabine alone or CapeOX as adjuvant therapy. H₂RA were coadministered to 30 patients.

Disclosures: This study was partly supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research and the Policy-based Medical Services Foundation in Japan. R Uozumi and H Kawazoe declared ties with various sources.

Source: Yamazaki T et al. Association between the co-administration of histamine H₂ receptor antagonists and the effectiveness of capecitabine in patients with colorectal cancer: Propensity score analysis. J Cancer. 2022;13(10):3073-3083 (Aug 8). Doi: 10.7150/jca.73385

Key clinical point: The coadministration of histamine H₂ receptor antagonists (H₂RA) is unlikely to affect the efficacy of capecitabine monotherapy and capecitabine and oxaliplatin (CapeOX) regimen in patients with early-stage colorectal cancer (CRC).

Major finding: At 5 years, the relapse-free survival (RFS) in the H₂RA and non-H₂RA groups were 76.7% (95% CI 57.2%-88.1%) and 79.8% (95% CI 76.0%-83.0%), respectively, with RFS not being significantly different between the H₂RA and non-H₂RA groups of patients receiving capecitabine monotherapy or CapeOX (P  =  .772).

Study details: Findings are from a retrospective analysis of 552 patients with stage II-III CRC who received either capecitabine alone or CapeOX as adjuvant therapy. H₂RA were coadministered to 30 patients.

Disclosures: This study was partly supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research and the Policy-based Medical Services Foundation in Japan. R Uozumi and H Kawazoe declared ties with various sources.

Source: Yamazaki T et al. Association between the co-administration of histamine H₂ receptor antagonists and the effectiveness of capecitabine in patients with colorectal cancer: Propensity score analysis. J Cancer. 2022;13(10):3073-3083 (Aug 8). Doi: 10.7150/jca.73385

Key clinical point: This real-world study confirms the efficacy and safety of trifluridine/tipiracil plus bevacizumab in patients with refractory metastatic colorectal cancer (mCRC), with a tolerability and safety profile consistent with previous reports.

Major finding: After a median follow-up of 11.6 months, the overall response rate and disease control rate were 3.2% and 51.6%, respectively, with the median progression-free survival and overall survival being 4.3 months (95% CI 3.4-5.1) and 9.3 months (95% CI 6.6-12.1), respectively. Neutropenia (45.7%), asthenia (17.1%), and nausea/vomiting (8.6%) were the most common grade 3-4 adverse events.

Study details: Findings are from a retrospective study including 35 patients with mCRC who were refractory or intolerant to standard therapies and received trifluridine/tipiracil plus bevacizumab.

Disclosures: This study was funded by the Biomedical Research Institute of A Coruña, Spain. The authors declared no competing interests.

Source: Martínez-Lago N et al. Efficacy, safety and prognostic factors in patients with refractory metastatic colorectal cancer treated with trifluridine/tipiracil plus bevacizumab in a real-world setting. Sci Rep. 2022;12(1):14612 (Aug 26). Doi: 10.1038/s41598-022-18871-9

Key clinical point: This real-world study confirms the efficacy and safety of trifluridine/tipiracil plus bevacizumab in patients with refractory metastatic colorectal cancer (mCRC), with a tolerability and safety profile consistent with previous reports.

Major finding: After a median follow-up of 11.6 months, the overall response rate and disease control rate were 3.2% and 51.6%, respectively, with the median progression-free survival and overall survival being 4.3 months (95% CI 3.4-5.1) and 9.3 months (95% CI 6.6-12.1), respectively. Neutropenia (45.7%), asthenia (17.1%), and nausea/vomiting (8.6%) were the most common grade 3-4 adverse events.

Study details: Findings are from a retrospective study including 35 patients with mCRC who were refractory or intolerant to standard therapies and received trifluridine/tipiracil plus bevacizumab.

Disclosures: This study was funded by the Biomedical Research Institute of A Coruña, Spain. The authors declared no competing interests.

Source: Martínez-Lago N et al. Efficacy, safety and prognostic factors in patients with refractory metastatic colorectal cancer treated with trifluridine/tipiracil plus bevacizumab in a real-world setting. Sci Rep. 2022;12(1):14612 (Aug 26). Doi: 10.1038/s41598-022-18871-9

Key clinical point: This real-world study confirms the efficacy and safety of trifluridine/tipiracil plus bevacizumab in patients with refractory metastatic colorectal cancer (mCRC), with a tolerability and safety profile consistent with previous reports.

Major finding: After a median follow-up of 11.6 months, the overall response rate and disease control rate were 3.2% and 51.6%, respectively, with the median progression-free survival and overall survival being 4.3 months (95% CI 3.4-5.1) and 9.3 months (95% CI 6.6-12.1), respectively. Neutropenia (45.7%), asthenia (17.1%), and nausea/vomiting (8.6%) were the most common grade 3-4 adverse events.

Study details: Findings are from a retrospective study including 35 patients with mCRC who were refractory or intolerant to standard therapies and received trifluridine/tipiracil plus bevacizumab.

Disclosures: This study was funded by the Biomedical Research Institute of A Coruña, Spain. The authors declared no competing interests.

Source: Martínez-Lago N et al. Efficacy, safety and prognostic factors in patients with refractory metastatic colorectal cancer treated with trifluridine/tipiracil plus bevacizumab in a real-world setting. Sci Rep. 2022;12(1):14612 (Aug 26). Doi: 10.1038/s41598-022-18871-9

Key clinical point: The response to standard treatments is disappointing in patients with KRASG12C-mutant metastatic colorectal cancer (mCRC), highlighting an urgent need for target therapies with selective KRASG12C inhibitors.

Major finding: The overall response rate was 38.7%, and the median progression-free survival and overall survival were 9 months (95% CI 7.5-10.5) and 21 months (95% CI 17.4-24.6), respectively. Only 62% and 36% of the patients who progressed received a second- and third-line treatment, respectively, with limited clinical benefits.

Study details: Findings are from a retrospective analysis of 111 patients with unresectable mCRC harboring KRASG12C mutation who received first-line doublet or triplet chemotherapy.

Disclosures: The study did not declare any source of funding. Some authors declared serving as consultants, advisors, or speakers for or receiving personal fees, travel and accommodation expenses, or research grants from various sources.

Source: Ciardiello D et al. Clinical efficacy of sequential treatments in KRASG12C-mutant metastatic colorectal cancer: Findings from a real-life multicenter Italian study (CRC-KR GOIM). ESMO Open. 2022;7(5):100567 (Aug 19). Doi: 10.1016/j.esmoop.2022.100567

Key clinical point: The response to standard treatments is disappointing in patients with KRASG12C-mutant metastatic colorectal cancer (mCRC), highlighting an urgent need for target therapies with selective KRASG12C inhibitors.

Major finding: The overall response rate was 38.7%, and the median progression-free survival and overall survival were 9 months (95% CI 7.5-10.5) and 21 months (95% CI 17.4-24.6), respectively. Only 62% and 36% of the patients who progressed received a second- and third-line treatment, respectively, with limited clinical benefits.

Study details: Findings are from a retrospective analysis of 111 patients with unresectable mCRC harboring KRASG12C mutation who received first-line doublet or triplet chemotherapy.

Disclosures: The study did not declare any source of funding. Some authors declared serving as consultants, advisors, or speakers for or receiving personal fees, travel and accommodation expenses, or research grants from various sources.

Source: Ciardiello D et al. Clinical efficacy of sequential treatments in KRASG12C-mutant metastatic colorectal cancer: Findings from a real-life multicenter Italian study (CRC-KR GOIM). ESMO Open. 2022;7(5):100567 (Aug 19). Doi: 10.1016/j.esmoop.2022.100567

Key clinical point: The response to standard treatments is disappointing in patients with KRASG12C-mutant metastatic colorectal cancer (mCRC), highlighting an urgent need for target therapies with selective KRASG12C inhibitors.

Major finding: The overall response rate was 38.7%, and the median progression-free survival and overall survival were 9 months (95% CI 7.5-10.5) and 21 months (95% CI 17.4-24.6), respectively. Only 62% and 36% of the patients who progressed received a second- and third-line treatment, respectively, with limited clinical benefits.

Study details: Findings are from a retrospective analysis of 111 patients with unresectable mCRC harboring KRASG12C mutation who received first-line doublet or triplet chemotherapy.

Disclosures: The study did not declare any source of funding. Some authors declared serving as consultants, advisors, or speakers for or receiving personal fees, travel and accommodation expenses, or research grants from various sources.

Source: Ciardiello D et al. Clinical efficacy of sequential treatments in KRASG12C-mutant metastatic colorectal cancer: Findings from a real-life multicenter Italian study (CRC-KR GOIM). ESMO Open. 2022;7(5):100567 (Aug 19). Doi: 10.1016/j.esmoop.2022.100567

Key clinical point: A significant association was observed between high intake of red and processed meat and the presence of advanced colorectal lesions at colonoscopy in fecal occult blood test (FIT)-positive participants.

Major finding: Each 100 g/day increase in the intake of red and processed meat increased the risk for advanced colorectal lesion by 32% (odds ratio [OR] 1.32; 95% CI 1.09-1.60). The risk was prominent among patients with high vs low (≥100 vs <50 g/day) absolute intake of processed meat (OR 1.19; 95% CI 1.09-1.31).

Study details: This study evaluated associations between red and processed meat intake and screen-detected colorectal lesions in 1162 FIT-positive participants from the Norwegian CRCbiome study.

Disclosures: This study was supported by the Norwegian Cancer Society, the Research Council of Norway, and the South Eastern Norway Regional Health Authority. No competing interests were declared.

Source: Kværner AS et al. Associations of red and processed meat intake with screen-detected colorectal lesions. Br J Nutr. 2022 (Sep 7). Doi: 10.1017/S0007114522002860

Key clinical point: A significant association was observed between high intake of red and processed meat and the presence of advanced colorectal lesions at colonoscopy in fecal occult blood test (FIT)-positive participants.

Major finding: Each 100 g/day increase in the intake of red and processed meat increased the risk for advanced colorectal lesion by 32% (odds ratio [OR] 1.32; 95% CI 1.09-1.60). The risk was prominent among patients with high vs low (≥100 vs <50 g/day) absolute intake of processed meat (OR 1.19; 95% CI 1.09-1.31).

Study details: This study evaluated associations between red and processed meat intake and screen-detected colorectal lesions in 1162 FIT-positive participants from the Norwegian CRCbiome study.

Disclosures: This study was supported by the Norwegian Cancer Society, the Research Council of Norway, and the South Eastern Norway Regional Health Authority. No competing interests were declared.

Source: Kværner AS et al. Associations of red and processed meat intake with screen-detected colorectal lesions. Br J Nutr. 2022 (Sep 7). Doi: 10.1017/S0007114522002860

Key clinical point: A significant association was observed between high intake of red and processed meat and the presence of advanced colorectal lesions at colonoscopy in fecal occult blood test (FIT)-positive participants.

Major finding: Each 100 g/day increase in the intake of red and processed meat increased the risk for advanced colorectal lesion by 32% (odds ratio [OR] 1.32; 95% CI 1.09-1.60). The risk was prominent among patients with high vs low (≥100 vs <50 g/day) absolute intake of processed meat (OR 1.19; 95% CI 1.09-1.31).

Study details: This study evaluated associations between red and processed meat intake and screen-detected colorectal lesions in 1162 FIT-positive participants from the Norwegian CRCbiome study.

Disclosures: This study was supported by the Norwegian Cancer Society, the Research Council of Norway, and the South Eastern Norway Regional Health Authority. No competing interests were declared.

Source: Kværner AS et al. Associations of red and processed meat intake with screen-detected colorectal lesions. Br J Nutr. 2022 (Sep 7). Doi: 10.1017/S0007114522002860

Key clinical point: Fecal immunochemical testing (FIT) at a threshold of ≥10 μg of hemoglobin per gram of feces safely triaged primary care patients with low-risk symptoms, with negative results effectively ruling out colorectal cancer (CRC).

Major finding: The sensitivity, specificity, positive predictive value, and negative predictive value of FIT for CRC detection at a fecal hemoglobin cutoff of ≥10 μg/g were 91.1% (95% CI 77.9%-97.1%), 80.7% (95% CI 79.3%-82.0%), 5.8% (95% CI 4.2%-7.8%), and 99.9% (95% CI 99.60%-99.95%), respectively, and the area under the receiver operating characteristic curve was 0.93 (95% CI 0.91-0.96).

Study details: This study included 3506 low-risk symptomatic adult patients managed in primary care who were referred for FIT.

Disclosures: This study was supported by the South Yorkshire, Bassetlaw & North Derbyshire Cancer Alliance, UK. The authors declared no conflicts of interest.

Source: Ball AJ et al. Fecal immunochemical testing in patients with low-risk symptoms of colorectal cancer: A diagnostic accuracy study. J Natl Compr Canc Netw. 2022;20(9):989-996.e1 (Sep). Doi: 10.6004/jnccn.2022.7037

Key clinical point: Fecal immunochemical testing (FIT) at a threshold of ≥10 μg of hemoglobin per gram of feces safely triaged primary care patients with low-risk symptoms, with negative results effectively ruling out colorectal cancer (CRC).

Major finding: The sensitivity, specificity, positive predictive value, and negative predictive value of FIT for CRC detection at a fecal hemoglobin cutoff of ≥10 μg/g were 91.1% (95% CI 77.9%-97.1%), 80.7% (95% CI 79.3%-82.0%), 5.8% (95% CI 4.2%-7.8%), and 99.9% (95% CI 99.60%-99.95%), respectively, and the area under the receiver operating characteristic curve was 0.93 (95% CI 0.91-0.96).

Study details: This study included 3506 low-risk symptomatic adult patients managed in primary care who were referred for FIT.

Disclosures: This study was supported by the South Yorkshire, Bassetlaw & North Derbyshire Cancer Alliance, UK. The authors declared no conflicts of interest.

Source: Ball AJ et al. Fecal immunochemical testing in patients with low-risk symptoms of colorectal cancer: A diagnostic accuracy study. J Natl Compr Canc Netw. 2022;20(9):989-996.e1 (Sep). Doi: 10.6004/jnccn.2022.7037

Key clinical point: Fecal immunochemical testing (FIT) at a threshold of ≥10 μg of hemoglobin per gram of feces safely triaged primary care patients with low-risk symptoms, with negative results effectively ruling out colorectal cancer (CRC).

Major finding: The sensitivity, specificity, positive predictive value, and negative predictive value of FIT for CRC detection at a fecal hemoglobin cutoff of ≥10 μg/g were 91.1% (95% CI 77.9%-97.1%), 80.7% (95% CI 79.3%-82.0%), 5.8% (95% CI 4.2%-7.8%), and 99.9% (95% CI 99.60%-99.95%), respectively, and the area under the receiver operating characteristic curve was 0.93 (95% CI 0.91-0.96).

Study details: This study included 3506 low-risk symptomatic adult patients managed in primary care who were referred for FIT.

Disclosures: This study was supported by the South Yorkshire, Bassetlaw & North Derbyshire Cancer Alliance, UK. The authors declared no conflicts of interest.

Source: Ball AJ et al. Fecal immunochemical testing in patients with low-risk symptoms of colorectal cancer: A diagnostic accuracy study. J Natl Compr Canc Netw. 2022;20(9):989-996.e1 (Sep). Doi: 10.6004/jnccn.2022.7037

Key clinical point: Acquired genomic alterations (Acq-Gas) associated with epidermal growth factor receptor (EGFR)-resistance in later lines were rare with first-line anti-EGFR-antibody combined with highly active chemotherapy and comparable with non-anti-EGFR regimen.

Major finding: On progression, ≥1 Acq-GA of interest developed in 6.6% of patients on anti-EGFR-chemotherapy compared with 10.1% of patients on anti-vascular endothelial growth factor (VEGF)-chemotherapy (odds ratio [OR] 0.62; 95% CI 0.20-2.11) and 62.0% of patients on anti-EGFR-antibody therapy in later lines (OR 0.09; 95% CI 0.03-0.23).

Study details: This was a post hoc analysis of the CALGB/SWOG-80405 trial including patients with mCRC who progressed on first-line cetuximab (anti-EGFR)-chemotherapy or bevacizumab (anti-VEGF)-chemotherapy and had pretreatment and post-progression plasma samples available for circulating tumor DNA testing.

Disclosures: This study was supported by the National Cancer Institute of the US National Institutes of Health. Some authors declared receiving honoraria or research funding from, having consulting or advisory roles or stock or other ownership interests in, or serving on speakers’ bureau for various sources.

Source: Raghav K et al. Acquired genomic alterations on first-line chemotherapy with cetuximab in advanced colorectal cancer: Circulating tumor DNA analysis of the CALGB/SWOG-80405 trial (Alliance). J Clin Oncol. 2022 (Sep 6). Doi: 10.1200/JCO.22.00365

Key clinical point: Acquired genomic alterations (Acq-Gas) associated with epidermal growth factor receptor (EGFR)-resistance in later lines were rare with first-line anti-EGFR-antibody combined with highly active chemotherapy and comparable with non-anti-EGFR regimen.

Major finding: On progression, ≥1 Acq-GA of interest developed in 6.6% of patients on anti-EGFR-chemotherapy compared with 10.1% of patients on anti-vascular endothelial growth factor (VEGF)-chemotherapy (odds ratio [OR] 0.62; 95% CI 0.20-2.11) and 62.0% of patients on anti-EGFR-antibody therapy in later lines (OR 0.09; 95% CI 0.03-0.23).

Study details: This was a post hoc analysis of the CALGB/SWOG-80405 trial including patients with mCRC who progressed on first-line cetuximab (anti-EGFR)-chemotherapy or bevacizumab (anti-VEGF)-chemotherapy and had pretreatment and post-progression plasma samples available for circulating tumor DNA testing.

Disclosures: This study was supported by the National Cancer Institute of the US National Institutes of Health. Some authors declared receiving honoraria or research funding from, having consulting or advisory roles or stock or other ownership interests in, or serving on speakers’ bureau for various sources.

Source: Raghav K et al. Acquired genomic alterations on first-line chemotherapy with cetuximab in advanced colorectal cancer: Circulating tumor DNA analysis of the CALGB/SWOG-80405 trial (Alliance). J Clin Oncol. 2022 (Sep 6). Doi: 10.1200/JCO.22.00365

Key clinical point: Acquired genomic alterations (Acq-Gas) associated with epidermal growth factor receptor (EGFR)-resistance in later lines were rare with first-line anti-EGFR-antibody combined with highly active chemotherapy and comparable with non-anti-EGFR regimen.

Major finding: On progression, ≥1 Acq-GA of interest developed in 6.6% of patients on anti-EGFR-chemotherapy compared with 10.1% of patients on anti-vascular endothelial growth factor (VEGF)-chemotherapy (odds ratio [OR] 0.62; 95% CI 0.20-2.11) and 62.0% of patients on anti-EGFR-antibody therapy in later lines (OR 0.09; 95% CI 0.03-0.23).

Study details: This was a post hoc analysis of the CALGB/SWOG-80405 trial including patients with mCRC who progressed on first-line cetuximab (anti-EGFR)-chemotherapy or bevacizumab (anti-VEGF)-chemotherapy and had pretreatment and post-progression plasma samples available for circulating tumor DNA testing.

Disclosures: This study was supported by the National Cancer Institute of the US National Institutes of Health. Some authors declared receiving honoraria or research funding from, having consulting or advisory roles or stock or other ownership interests in, or serving on speakers’ bureau for various sources.

Source: Raghav K et al. Acquired genomic alterations on first-line chemotherapy with cetuximab in advanced colorectal cancer: Circulating tumor DNA analysis of the CALGB/SWOG-80405 trial (Alliance). J Clin Oncol. 2022 (Sep 6). Doi: 10.1200/JCO.22.00365

Key clinical point: Fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus anti-vascular endothelial growth factor (VEGF) therapy (triplet group) showed no survival benefits over fluoropyrimidine and oxaliplatin/irinotecan plus anti-VEGF therapy (doublet group) in a real-world cohort of patients with previously untreated BRAFV^600E-mutant metastatic colorectal cancer (mCRC).

Major finding: Progression-free survival (hazard ratio [HR] 0.82; P  =  .22) and overall survival (HR 0.88; P  =  .48) were not significantly different between the triplet and doublet chemotherapy groups. Grade 3 or 4 adverse events were more frequent in the triplet vs doublet group (65% vs 47%).

Study details: Findings are from WJOG13219G, a retrospective study, including patients with BRAFV^600E-mutant mCRC who received first-line triplet (n = 79) or doublet (n = 91) chemotherapy.

Disclosures: This study did not receive any funding. Some authors declared receiving honoraria, research funding, or consulting fees from various sources.

Source: Shimozaki K et al. WJOG13219G: The efficacy and safety of FOLFOXIRI or doublet plus anti-VEGF therapy in previously untreated BRAFV^600E mutant metastatic colorectal cancer: A multi-institutional registry-based study (BRACELET study). Clin Colorectal Cancer. 2022 (Aug 11). Doi: 10.1016/j.clcc.2022.08.002

Key clinical point: Fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus anti-vascular endothelial growth factor (VEGF) therapy (triplet group) showed no survival benefits over fluoropyrimidine and oxaliplatin/irinotecan plus anti-VEGF therapy (doublet group) in a real-world cohort of patients with previously untreated BRAFV^600E-mutant metastatic colorectal cancer (mCRC).

Major finding: Progression-free survival (hazard ratio [HR] 0.82; P  =  .22) and overall survival (HR 0.88; P  =  .48) were not significantly different between the triplet and doublet chemotherapy groups. Grade 3 or 4 adverse events were more frequent in the triplet vs doublet group (65% vs 47%).

Study details: Findings are from WJOG13219G, a retrospective study, including patients with BRAFV^600E-mutant mCRC who received first-line triplet (n = 79) or doublet (n = 91) chemotherapy.

Disclosures: This study did not receive any funding. Some authors declared receiving honoraria, research funding, or consulting fees from various sources.

Source: Shimozaki K et al. WJOG13219G: The efficacy and safety of FOLFOXIRI or doublet plus anti-VEGF therapy in previously untreated BRAFV^600E mutant metastatic colorectal cancer: A multi-institutional registry-based study (BRACELET study). Clin Colorectal Cancer. 2022 (Aug 11). Doi: 10.1016/j.clcc.2022.08.002

Key clinical point: Fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus anti-vascular endothelial growth factor (VEGF) therapy (triplet group) showed no survival benefits over fluoropyrimidine and oxaliplatin/irinotecan plus anti-VEGF therapy (doublet group) in a real-world cohort of patients with previously untreated BRAFV^600E-mutant metastatic colorectal cancer (mCRC).

Major finding: Progression-free survival (hazard ratio [HR] 0.82; P  =  .22) and overall survival (HR 0.88; P  =  .48) were not significantly different between the triplet and doublet chemotherapy groups. Grade 3 or 4 adverse events were more frequent in the triplet vs doublet group (65% vs 47%).

Study details: Findings are from WJOG13219G, a retrospective study, including patients with BRAFV^600E-mutant mCRC who received first-line triplet (n = 79) or doublet (n = 91) chemotherapy.

Disclosures: This study did not receive any funding. Some authors declared receiving honoraria, research funding, or consulting fees from various sources.

Source: Shimozaki K et al. WJOG13219G: The efficacy and safety of FOLFOXIRI or doublet plus anti-VEGF therapy in previously untreated BRAFV^600E mutant metastatic colorectal cancer: A multi-institutional registry-based study (BRACELET study). Clin Colorectal Cancer. 2022 (Aug 11). Doi: 10.1016/j.clcc.2022.08.002

Key clinical point: Between 2006 and 2016, the treatment pattern for stage II/III rectal cancer in the US showed a shift from postoperative chemotherapy/radiation therapy (C/RT) to preoperative C/RT, along with improvements in overall survival.

Major finding: Fewer patients received postoperative C/RT+multiagent chemotherapy (MA) in 2016 vs 2006 (8% vs 28%; P < .001), whereas more patients received preoperative C/RT+MA (45% vs 24%; P < .001), with diagnosis in 2015 vs 2006 being associated with improved survival within 36 months after diagnosis (adjusted hazard ratio for mortality 0.77; 95% CI 0.67-0.87).

Study details: Findings are from a retrospective cohort analysis of records of 32,467 patients with stage II/III rectal cancer treated with trimodality therapy.

Disclosures: Dr. Lin and Dr. Simianu declared receiving personal fees or grants from or serving as consultants or expert reviewers for various sources.

Source: Kennecke HF et al. Patterns of practice and improvements in survival among patients with stage 2/3 rectal cancer treated with trimodality therapy. JAMA Oncol. 2022 (Aug 18). Doi: 10.1001/jamaoncol.2022.2831

Key clinical point: Between 2006 and 2016, the treatment pattern for stage II/III rectal cancer in the US showed a shift from postoperative chemotherapy/radiation therapy (C/RT) to preoperative C/RT, along with improvements in overall survival.

Major finding: Fewer patients received postoperative C/RT+multiagent chemotherapy (MA) in 2016 vs 2006 (8% vs 28%; P < .001), whereas more patients received preoperative C/RT+MA (45% vs 24%; P < .001), with diagnosis in 2015 vs 2006 being associated with improved survival within 36 months after diagnosis (adjusted hazard ratio for mortality 0.77; 95% CI 0.67-0.87).

Study details: Findings are from a retrospective cohort analysis of records of 32,467 patients with stage II/III rectal cancer treated with trimodality therapy.

Disclosures: Dr. Lin and Dr. Simianu declared receiving personal fees or grants from or serving as consultants or expert reviewers for various sources.

Source: Kennecke HF et al. Patterns of practice and improvements in survival among patients with stage 2/3 rectal cancer treated with trimodality therapy. JAMA Oncol. 2022 (Aug 18). Doi: 10.1001/jamaoncol.2022.2831

Key clinical point: Between 2006 and 2016, the treatment pattern for stage II/III rectal cancer in the US showed a shift from postoperative chemotherapy/radiation therapy (C/RT) to preoperative C/RT, along with improvements in overall survival.

Major finding: Fewer patients received postoperative C/RT+multiagent chemotherapy (MA) in 2016 vs 2006 (8% vs 28%; P < .001), whereas more patients received preoperative C/RT+MA (45% vs 24%; P < .001), with diagnosis in 2015 vs 2006 being associated with improved survival within 36 months after diagnosis (adjusted hazard ratio for mortality 0.77; 95% CI 0.67-0.87).

Study details: Findings are from a retrospective cohort analysis of records of 32,467 patients with stage II/III rectal cancer treated with trimodality therapy.

Disclosures: Dr. Lin and Dr. Simianu declared receiving personal fees or grants from or serving as consultants or expert reviewers for various sources.

Source: Kennecke HF et al. Patterns of practice and improvements in survival among patients with stage 2/3 rectal cancer treated with trimodality therapy. JAMA Oncol. 2022 (Aug 18). Doi: 10.1001/jamaoncol.2022.2831

Key clinical point: Three months of induction therapy with modified folinic acid-fluorouracil-oxaliplatin 6 (mFOLFOX6)/capecitabine-oxaliplatin (CAPOX) downstaged early-stage I/IIA rectal cancer in the majority of selected patients, allowing a well-tolerated organ-preserving surgery.

Major finding: Induction therapy with mFOLFOX6/CAPOX followed by transanal excision surgery (TES) downstaged tumors to ypT0/T1 cN0 in 57% of patients, with 79% (90% CI 69%-88%) of overall patients achieving organ preservation with no unexpected toxicities.

Study details: Findings are from the phase 2 NEO trial including 58 patients with clinical T1-T3abN0 low- or mid-rectal adenocarcinoma with no unfavorable histologic characteristics who were treated with 3 months of chemotherapy (mFOLFOX6/CAPOX), of which 56 proceeded to TES.

Disclosures: This study was supported by the Canadian Cancer Society. Some authors declared receiving honoraria or research funding from or serving as consultants or advisors or on speakers’ bureau for various sources.

Source: Kennecke HF et al. Neoadjuvant chemotherapy, excision, and observation for early rectal cancer: The phase II NEO trial (CCTG CO.28) primary end point results. J Clin Oncol. 2022 (Aug 18). Doi: 10.1200/JCO.22.00184

Key clinical point: Three months of induction therapy with modified folinic acid-fluorouracil-oxaliplatin 6 (mFOLFOX6)/capecitabine-oxaliplatin (CAPOX) downstaged early-stage I/IIA rectal cancer in the majority of selected patients, allowing a well-tolerated organ-preserving surgery.

Major finding: Induction therapy with mFOLFOX6/CAPOX followed by transanal excision surgery (TES) downstaged tumors to ypT0/T1 cN0 in 57% of patients, with 79% (90% CI 69%-88%) of overall patients achieving organ preservation with no unexpected toxicities.

Study details: Findings are from the phase 2 NEO trial including 58 patients with clinical T1-T3abN0 low- or mid-rectal adenocarcinoma with no unfavorable histologic characteristics who were treated with 3 months of chemotherapy (mFOLFOX6/CAPOX), of which 56 proceeded to TES.

Disclosures: This study was supported by the Canadian Cancer Society. Some authors declared receiving honoraria or research funding from or serving as consultants or advisors or on speakers’ bureau for various sources.

Source: Kennecke HF et al. Neoadjuvant chemotherapy, excision, and observation for early rectal cancer: The phase II NEO trial (CCTG CO.28) primary end point results. J Clin Oncol. 2022 (Aug 18). Doi: 10.1200/JCO.22.00184

Key clinical point: Three months of induction therapy with modified folinic acid-fluorouracil-oxaliplatin 6 (mFOLFOX6)/capecitabine-oxaliplatin (CAPOX) downstaged early-stage I/IIA rectal cancer in the majority of selected patients, allowing a well-tolerated organ-preserving surgery.

Major finding: Induction therapy with mFOLFOX6/CAPOX followed by transanal excision surgery (TES) downstaged tumors to ypT0/T1 cN0 in 57% of patients, with 79% (90% CI 69%-88%) of overall patients achieving organ preservation with no unexpected toxicities.

Study details: Findings are from the phase 2 NEO trial including 58 patients with clinical T1-T3abN0 low- or mid-rectal adenocarcinoma with no unfavorable histologic characteristics who were treated with 3 months of chemotherapy (mFOLFOX6/CAPOX), of which 56 proceeded to TES.

Disclosures: This study was supported by the Canadian Cancer Society. Some authors declared receiving honoraria or research funding from or serving as consultants or advisors or on speakers’ bureau for various sources.

Source: Kennecke HF et al. Neoadjuvant chemotherapy, excision, and observation for early rectal cancer: The phase II NEO trial (CCTG CO.28) primary end point results. J Clin Oncol. 2022 (Aug 18). Doi: 10.1200/JCO.22.00184