Clinical Edge Journal Scan

Key clinical point: Dose-escalated chemoradiation (CRT) for locally advanced rectal cancer (LARC) had transient but considerable impact on quality of life (QoL), which was largely resolved from 12 months onwards.

Major finding: Dose-escalated vs standard CRT resulted in larger decline in global health score, role functioning, physical functioning, and social functioning at 6 months and higher fatigue (89% vs. 76%), pain (67% vs 36%), and diarrhea (45% vs 29%) at 3 months after treatment initiation (all P < .05). All symptoms and QoL were similar between the 2 treatment groups from 12 months onwards.

Study details: Findings are from 2 years of follow-up of RECTAL-BOOST trial including 128 patients with LARC treated with either standard CRT (50 Gy in 25 fractions with concurrent capecitabine) or dose-escalated CRT (radiation boost of 15 Gy in 5 fractions without concurrent chemotherapy in the week prior to CRT initiation).

Disclosures: The study was partially supported by Maag Lever Darm Stichting (MLDS), the Netherlands, Grant. HM Verkooijen declared receiving research funding and MPWI personal fees from Elekta AB (Stockholm, Sweden).

Source: Verweij ME et al. Int J Radiat Oncol Biol Phys. 2021 Oct 8. doi: 10.1016/j.ijrobp.2021.09.052.

Key clinical point: Dose-escalated chemoradiation (CRT) for locally advanced rectal cancer (LARC) had transient but considerable impact on quality of life (QoL), which was largely resolved from 12 months onwards.

Major finding: Dose-escalated vs standard CRT resulted in larger decline in global health score, role functioning, physical functioning, and social functioning at 6 months and higher fatigue (89% vs. 76%), pain (67% vs 36%), and diarrhea (45% vs 29%) at 3 months after treatment initiation (all P < .05). All symptoms and QoL were similar between the 2 treatment groups from 12 months onwards.

Study details: Findings are from 2 years of follow-up of RECTAL-BOOST trial including 128 patients with LARC treated with either standard CRT (50 Gy in 25 fractions with concurrent capecitabine) or dose-escalated CRT (radiation boost of 15 Gy in 5 fractions without concurrent chemotherapy in the week prior to CRT initiation).

Disclosures: The study was partially supported by Maag Lever Darm Stichting (MLDS), the Netherlands, Grant. HM Verkooijen declared receiving research funding and MPWI personal fees from Elekta AB (Stockholm, Sweden).

Source: Verweij ME et al. Int J Radiat Oncol Biol Phys. 2021 Oct 8. doi: 10.1016/j.ijrobp.2021.09.052.

Key clinical point: Dose-escalated chemoradiation (CRT) for locally advanced rectal cancer (LARC) had transient but considerable impact on quality of life (QoL), which was largely resolved from 12 months onwards.

Major finding: Dose-escalated vs standard CRT resulted in larger decline in global health score, role functioning, physical functioning, and social functioning at 6 months and higher fatigue (89% vs. 76%), pain (67% vs 36%), and diarrhea (45% vs 29%) at 3 months after treatment initiation (all P < .05). All symptoms and QoL were similar between the 2 treatment groups from 12 months onwards.

Study details: Findings are from 2 years of follow-up of RECTAL-BOOST trial including 128 patients with LARC treated with either standard CRT (50 Gy in 25 fractions with concurrent capecitabine) or dose-escalated CRT (radiation boost of 15 Gy in 5 fractions without concurrent chemotherapy in the week prior to CRT initiation).

Disclosures: The study was partially supported by Maag Lever Darm Stichting (MLDS), the Netherlands, Grant. HM Verkooijen declared receiving research funding and MPWI personal fees from Elekta AB (Stockholm, Sweden).

Source: Verweij ME et al. Int J Radiat Oncol Biol Phys. 2021 Oct 8. doi: 10.1016/j.ijrobp.2021.09.052.

Key clinical point: Fasting blood glucose (FBG) variability was significantly associated with an increased risk of colorectal cancer (CRC) in healthy population without overt diabetes.

Major finding: Overall, CRC incidence during the follow-up period was 116.7 per 100,000 person-years. The highest vs lowest quintile of standard deviation of FBG showed a significantly higher risk of incident CRC (adjusted hazard ratio, 1.19; 95% confidence interval, 1.07-1.32) with each increase in standard deviation quintile being significantly associated with an increased risk of CRC (P for trend = .001).

Study details: Findings are from an analysis of 246,241 healthy subjects without overt diabetes who underwent general health screening at least once between 2002 and 2003.

Disclosures: The study was funded by National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflict of interests.

Source: Jun H et al. Gut Liver. 2021 Oct 1. doi: 10.5009/gnl210048.

Key clinical point: Fasting blood glucose (FBG) variability was significantly associated with an increased risk of colorectal cancer (CRC) in healthy population without overt diabetes.

Major finding: Overall, CRC incidence during the follow-up period was 116.7 per 100,000 person-years. The highest vs lowest quintile of standard deviation of FBG showed a significantly higher risk of incident CRC (adjusted hazard ratio, 1.19; 95% confidence interval, 1.07-1.32) with each increase in standard deviation quintile being significantly associated with an increased risk of CRC (P for trend = .001).

Study details: Findings are from an analysis of 246,241 healthy subjects without overt diabetes who underwent general health screening at least once between 2002 and 2003.

Disclosures: The study was funded by National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflict of interests.

Source: Jun H et al. Gut Liver. 2021 Oct 1. doi: 10.5009/gnl210048.

Key clinical point: Fasting blood glucose (FBG) variability was significantly associated with an increased risk of colorectal cancer (CRC) in healthy population without overt diabetes.

Major finding: Overall, CRC incidence during the follow-up period was 116.7 per 100,000 person-years. The highest vs lowest quintile of standard deviation of FBG showed a significantly higher risk of incident CRC (adjusted hazard ratio, 1.19; 95% confidence interval, 1.07-1.32) with each increase in standard deviation quintile being significantly associated with an increased risk of CRC (P for trend = .001).

Study details: Findings are from an analysis of 246,241 healthy subjects without overt diabetes who underwent general health screening at least once between 2002 and 2003.

Disclosures: The study was funded by National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflict of interests.

Source: Jun H et al. Gut Liver. 2021 Oct 1. doi: 10.5009/gnl210048.

Key clinical point: Real-world analysis confirms the safety and efficacy of trifluridine/tipiracil observed in phase 3 studies in metastatic colorectal cancer (mCRC).

Major finding: The median overall survival and progression-free survival was 7.6 (95% confidence interval [CI], 6.5-8.6) months and 3.3 (95% CI, 3.03-3.57) months, respectively. The objective response rate and disease control rate were 2.4% and 24.0%, respectively. The most frequent grade 3 toxicities included neutropenia (37%), fatigue (10%), anemia (9%), and febrile neutropenia (5%). Overall, 27% of patients required dose reduction mainly because of hematological toxicities (60%).

Study details: This was a retrospective analysis of 236 patients with chemotherapy refractive mCRC who received at least 1 dose of trifluridine/tipiracil as third-line treatment.

Disclosures: The study did not declare any source of funding. Some of the authors including the lead author declared receiving research funding, travel and accommodation expenses, honoraria, and/or lecture fees from and/or served in consulting or advisory roles for various sources.

Source: Stavraka C et al. Clin Colorectal Cancer. 2021 Sep 26. doi: 10.1016/j.clcc.2021.09.009.

Key clinical point: Real-world analysis confirms the safety and efficacy of trifluridine/tipiracil observed in phase 3 studies in metastatic colorectal cancer (mCRC).

Major finding: The median overall survival and progression-free survival was 7.6 (95% confidence interval [CI], 6.5-8.6) months and 3.3 (95% CI, 3.03-3.57) months, respectively. The objective response rate and disease control rate were 2.4% and 24.0%, respectively. The most frequent grade 3 toxicities included neutropenia (37%), fatigue (10%), anemia (9%), and febrile neutropenia (5%). Overall, 27% of patients required dose reduction mainly because of hematological toxicities (60%).

Study details: This was a retrospective analysis of 236 patients with chemotherapy refractive mCRC who received at least 1 dose of trifluridine/tipiracil as third-line treatment.

Disclosures: The study did not declare any source of funding. Some of the authors including the lead author declared receiving research funding, travel and accommodation expenses, honoraria, and/or lecture fees from and/or served in consulting or advisory roles for various sources.

Source: Stavraka C et al. Clin Colorectal Cancer. 2021 Sep 26. doi: 10.1016/j.clcc.2021.09.009.

Key clinical point: Real-world analysis confirms the safety and efficacy of trifluridine/tipiracil observed in phase 3 studies in metastatic colorectal cancer (mCRC).

Major finding: The median overall survival and progression-free survival was 7.6 (95% confidence interval [CI], 6.5-8.6) months and 3.3 (95% CI, 3.03-3.57) months, respectively. The objective response rate and disease control rate were 2.4% and 24.0%, respectively. The most frequent grade 3 toxicities included neutropenia (37%), fatigue (10%), anemia (9%), and febrile neutropenia (5%). Overall, 27% of patients required dose reduction mainly because of hematological toxicities (60%).

Study details: This was a retrospective analysis of 236 patients with chemotherapy refractive mCRC who received at least 1 dose of trifluridine/tipiracil as third-line treatment.

Disclosures: The study did not declare any source of funding. Some of the authors including the lead author declared receiving research funding, travel and accommodation expenses, honoraria, and/or lecture fees from and/or served in consulting or advisory roles for various sources.

Source: Stavraka C et al. Clin Colorectal Cancer. 2021 Sep 26. doi: 10.1016/j.clcc.2021.09.009.

Key clinical point: Adavosertib vs active monitoring (AM) following induction chemotherapy showed a significant progression-free survival (PFS) advantage along with a favorable safety profile in patients with RAS/TP53-mutant metastatic colorectal cancer (mCRC).

Major finding: Adavosertib showed significant PFS advantage over AM (3.61 months vs 1.87 months; adjusted hazard ratio, 0.35; P = .0022). The frequency of diarrhea (61% vs 28%), fatigue (75% vs 56%), nausea (68% vs 32%), and vomiting (41% vs 4%) were higher in adavosertib than AM arms, with majority being low grade.

Study details: Findings are from FOCUS4-C, a phase 2 trial including patients with RAS/TP53-mutant mCRC who had stable disease or response at the end of 16-week induction chemotherapy and were further randomly assigned to AM (n=25) or adavosertib (n=44).

Disclosures: FOCUS4-C was cofunded by the MRC/NIHR Efficacy and Mechanism Evaluation program and CRUK. AstraZeneca provided drug supply and distribution of adavosertib and an educational grant. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including AstraZeneca.

Source: Seligmann JF et al. J Clin Oncol. 2021 Sep 18. doi: 10.1200/JCO.21. 01435.

Key clinical point: Adavosertib vs active monitoring (AM) following induction chemotherapy showed a significant progression-free survival (PFS) advantage along with a favorable safety profile in patients with RAS/TP53-mutant metastatic colorectal cancer (mCRC).

Major finding: Adavosertib showed significant PFS advantage over AM (3.61 months vs 1.87 months; adjusted hazard ratio, 0.35; P = .0022). The frequency of diarrhea (61% vs 28%), fatigue (75% vs 56%), nausea (68% vs 32%), and vomiting (41% vs 4%) were higher in adavosertib than AM arms, with majority being low grade.

Study details: Findings are from FOCUS4-C, a phase 2 trial including patients with RAS/TP53-mutant mCRC who had stable disease or response at the end of 16-week induction chemotherapy and were further randomly assigned to AM (n=25) or adavosertib (n=44).

Disclosures: FOCUS4-C was cofunded by the MRC/NIHR Efficacy and Mechanism Evaluation program and CRUK. AstraZeneca provided drug supply and distribution of adavosertib and an educational grant. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including AstraZeneca.

Source: Seligmann JF et al. J Clin Oncol. 2021 Sep 18. doi: 10.1200/JCO.21. 01435.

Key clinical point: Adavosertib vs active monitoring (AM) following induction chemotherapy showed a significant progression-free survival (PFS) advantage along with a favorable safety profile in patients with RAS/TP53-mutant metastatic colorectal cancer (mCRC).

Major finding: Adavosertib showed significant PFS advantage over AM (3.61 months vs 1.87 months; adjusted hazard ratio, 0.35; P = .0022). The frequency of diarrhea (61% vs 28%), fatigue (75% vs 56%), nausea (68% vs 32%), and vomiting (41% vs 4%) were higher in adavosertib than AM arms, with majority being low grade.

Study details: Findings are from FOCUS4-C, a phase 2 trial including patients with RAS/TP53-mutant mCRC who had stable disease or response at the end of 16-week induction chemotherapy and were further randomly assigned to AM (n=25) or adavosertib (n=44).

Disclosures: FOCUS4-C was cofunded by the MRC/NIHR Efficacy and Mechanism Evaluation program and CRUK. AstraZeneca provided drug supply and distribution of adavosertib and an educational grant. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including AstraZeneca.

Source: Seligmann JF et al. J Clin Oncol. 2021 Sep 18. doi: 10.1200/JCO.21. 01435.

Key clinical point: Meta-analysis confirms the detrimental effect of KRAS and BRAF mutations on disease-free survival (DFS) and overall survival (OS) in patients with stage II/III colon cancer, with the effect being enhanced by adjustment for microsatellite instability (MSI).

Major finding: KRAS mutations significantly deteriorated both DFS (pooled hazard ratio [pHR], 1.36; P less than .001) and OS (pHR, 1.27; P = .03), whereas BRAF mutations significantly deteriorated only OS (pHR, 1.49; P < .001), but not DFS. Adjustment for MSI enhanced the effect of KRAS (pHR_DFS, 1.43; P = .001; pHR_OS, 1.33; P = .03) and BRAF (pHR_DFS, 1.59; P = .001; pHR_OS, 1.67; P less than .001) mutations.

Study details: This was a meta-analysis of 9 phase 3 adjuvant trials including 10,893 patients with stage II/III colon cancer.

Disclosures: No specific funding was declared. Some of the authors including the lead author declared receiving research funding and personal fees from and/or consulting or advisory role for various sources.

Source: Formica V et al. J Natl Cancer Inst. 2021 Sep 20. doi: 10.1093/jnci/djab190.

Key clinical point: Meta-analysis confirms the detrimental effect of KRAS and BRAF mutations on disease-free survival (DFS) and overall survival (OS) in patients with stage II/III colon cancer, with the effect being enhanced by adjustment for microsatellite instability (MSI).

Major finding: KRAS mutations significantly deteriorated both DFS (pooled hazard ratio [pHR], 1.36; P less than .001) and OS (pHR, 1.27; P = .03), whereas BRAF mutations significantly deteriorated only OS (pHR, 1.49; P < .001), but not DFS. Adjustment for MSI enhanced the effect of KRAS (pHR_DFS, 1.43; P = .001; pHR_OS, 1.33; P = .03) and BRAF (pHR_DFS, 1.59; P = .001; pHR_OS, 1.67; P less than .001) mutations.

Study details: This was a meta-analysis of 9 phase 3 adjuvant trials including 10,893 patients with stage II/III colon cancer.

Disclosures: No specific funding was declared. Some of the authors including the lead author declared receiving research funding and personal fees from and/or consulting or advisory role for various sources.

Source: Formica V et al. J Natl Cancer Inst. 2021 Sep 20. doi: 10.1093/jnci/djab190.

Key clinical point: Meta-analysis confirms the detrimental effect of KRAS and BRAF mutations on disease-free survival (DFS) and overall survival (OS) in patients with stage II/III colon cancer, with the effect being enhanced by adjustment for microsatellite instability (MSI).

Major finding: KRAS mutations significantly deteriorated both DFS (pooled hazard ratio [pHR], 1.36; P less than .001) and OS (pHR, 1.27; P = .03), whereas BRAF mutations significantly deteriorated only OS (pHR, 1.49; P < .001), but not DFS. Adjustment for MSI enhanced the effect of KRAS (pHR_DFS, 1.43; P = .001; pHR_OS, 1.33; P = .03) and BRAF (pHR_DFS, 1.59; P = .001; pHR_OS, 1.67; P less than .001) mutations.

Study details: This was a meta-analysis of 9 phase 3 adjuvant trials including 10,893 patients with stage II/III colon cancer.

Disclosures: No specific funding was declared. Some of the authors including the lead author declared receiving research funding and personal fees from and/or consulting or advisory role for various sources.

Source: Formica V et al. J Natl Cancer Inst. 2021 Sep 20. doi: 10.1093/jnci/djab190.

Key clinical point: Addition of panitumumab (Pmab) to fluorouracil/folinic acid (FU/FA) maintenance therapy significantly prolonged progression-free survival (PFS) compared with FU/FA alone in patients with RAS wild-type metastatic colorectal cancer (mCRC).

Major finding: The trial achieved its primary endpoint with a significant improvement in PFS with the addition of Pmab to FU/FA vs. only FU/FA maintenance therapy (8.8 months vs. 5.7 months; hazard ratio [HR], 0.72; P = .014). The most frequent grade 3 or more adverse event during maintenance in the Pmab arm was acneiform rash (7.2%).

Study details: PANAMA, a phase 2 trial included 377 patients with RAS wild-type mCRC who received induction therapy with 6 cycles of FOLFOX+Pmab. Patients with stable disease, partial or complete remission after induction, were randomly assigned to FU/FA+Pmab (n=125) or only FU/FA (n=123) maintenance therapy.

Disclosures: This trial was funded by AIO Studien gGmbH, Berlin, Germany, and Amgen. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including Amgen.

Source: Modest DP et al. J Clin Oncol. 2021 Sep 17. doi: 10.1200/JCO.21.01332.

Key clinical point: Addition of panitumumab (Pmab) to fluorouracil/folinic acid (FU/FA) maintenance therapy significantly prolonged progression-free survival (PFS) compared with FU/FA alone in patients with RAS wild-type metastatic colorectal cancer (mCRC).

Major finding: The trial achieved its primary endpoint with a significant improvement in PFS with the addition of Pmab to FU/FA vs. only FU/FA maintenance therapy (8.8 months vs. 5.7 months; hazard ratio [HR], 0.72; P = .014). The most frequent grade 3 or more adverse event during maintenance in the Pmab arm was acneiform rash (7.2%).

Study details: PANAMA, a phase 2 trial included 377 patients with RAS wild-type mCRC who received induction therapy with 6 cycles of FOLFOX+Pmab. Patients with stable disease, partial or complete remission after induction, were randomly assigned to FU/FA+Pmab (n=125) or only FU/FA (n=123) maintenance therapy.

Disclosures: This trial was funded by AIO Studien gGmbH, Berlin, Germany, and Amgen. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including Amgen.

Source: Modest DP et al. J Clin Oncol. 2021 Sep 17. doi: 10.1200/JCO.21.01332.

Key clinical point: Addition of panitumumab (Pmab) to fluorouracil/folinic acid (FU/FA) maintenance therapy significantly prolonged progression-free survival (PFS) compared with FU/FA alone in patients with RAS wild-type metastatic colorectal cancer (mCRC).

Major finding: The trial achieved its primary endpoint with a significant improvement in PFS with the addition of Pmab to FU/FA vs. only FU/FA maintenance therapy (8.8 months vs. 5.7 months; hazard ratio [HR], 0.72; P = .014). The most frequent grade 3 or more adverse event during maintenance in the Pmab arm was acneiform rash (7.2%).

Study details: PANAMA, a phase 2 trial included 377 patients with RAS wild-type mCRC who received induction therapy with 6 cycles of FOLFOX+Pmab. Patients with stable disease, partial or complete remission after induction, were randomly assigned to FU/FA+Pmab (n=125) or only FU/FA (n=123) maintenance therapy.

Disclosures: This trial was funded by AIO Studien gGmbH, Berlin, Germany, and Amgen. The authors declared receiving honoraria, research funding, travel and accommodation expenses, and/or consulting/advisory roles from various sources including Amgen.

Source: Modest DP et al. J Clin Oncol. 2021 Sep 17. doi: 10.1200/JCO.21.01332.

Key clinical point: Survival was not significantly different in patients with metastatic colorectal cancer (mCRC) younger than 50 years vs. those aged 50 years or older.

Major finding: The median overall survival (adjusted hazard ratio [aHR], 0.98; P = .78) and progression-free survival (aHR, 1.02; P = .67) were not significantly different in younger- vs. older-onset patients with mCRC.

Study details: This study included 2,326 patients with mCRC from CALGB/SWOG 80405 phase 3 trial, of which 514 patients younger than 50 years at study entry were included in the younger CRC cohort.

Disclosures: The study was funded by the National Cancer Institute of the National Institutes of Health and in part by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some of the authors reported receiving research funding/honoraria from and/or consulting/advising for various sources.

Source: Lipsyc-Sharf M et al. J Natl Cancer Inst. 2021 Oct 12. doi: 10.1093/jnci/djab200.

Key clinical point: Survival was not significantly different in patients with metastatic colorectal cancer (mCRC) younger than 50 years vs. those aged 50 years or older.

Major finding: The median overall survival (adjusted hazard ratio [aHR], 0.98; P = .78) and progression-free survival (aHR, 1.02; P = .67) were not significantly different in younger- vs. older-onset patients with mCRC.

Study details: This study included 2,326 patients with mCRC from CALGB/SWOG 80405 phase 3 trial, of which 514 patients younger than 50 years at study entry were included in the younger CRC cohort.

Disclosures: The study was funded by the National Cancer Institute of the National Institutes of Health and in part by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some of the authors reported receiving research funding/honoraria from and/or consulting/advising for various sources.

Source: Lipsyc-Sharf M et al. J Natl Cancer Inst. 2021 Oct 12. doi: 10.1093/jnci/djab200.

Key clinical point: Survival was not significantly different in patients with metastatic colorectal cancer (mCRC) younger than 50 years vs. those aged 50 years or older.

Major finding: The median overall survival (adjusted hazard ratio [aHR], 0.98; P = .78) and progression-free survival (aHR, 1.02; P = .67) were not significantly different in younger- vs. older-onset patients with mCRC.

Study details: This study included 2,326 patients with mCRC from CALGB/SWOG 80405 phase 3 trial, of which 514 patients younger than 50 years at study entry were included in the younger CRC cohort.

Disclosures: The study was funded by the National Cancer Institute of the National Institutes of Health and in part by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some of the authors reported receiving research funding/honoraria from and/or consulting/advising for various sources.

Source: Lipsyc-Sharf M et al. J Natl Cancer Inst. 2021 Oct 12. doi: 10.1093/jnci/djab200.

Key clinical point: Delaying surgery after completing neoadjuvant chemoradiotherapy (CRT) could be a risk factor for worse outcomes in patients with locally advanced rectal cancer with poor or no pathological response to preoperative CRT.

Major finding: A longer vs. shorter waiting period between surgery and end of CRT was associated with worse overall survival (5 years: 67.6% vs 80.3%; 10 years: 40.1% vs 57.8%; P < .001) and disease-free survival (5 years: 59.6% vs 72.0%; 10 years: 36.2% vs 53.9%; P < .001).

Study details: Findings are from a retrospective analysis of 1,064 patients who underwent CRT and surgery for locally advanced rectal cancer and showed partial or no pathological response to neoadjuvant CRT. Wait time between CRT completion and colorectal surgery categorized patients into shorter (8 weeks or less; n=579) or longer (greater than 8 weeks; n=485) interval groups.

Disclosures: The study did not declare any source of funding. No conflict of interests was reported.

Source: Deidda S et al. JAMA Surg. 2021 Sep 29. doi: 10.1001/jamasurg.2021.4566.

Key clinical point: Delaying surgery after completing neoadjuvant chemoradiotherapy (CRT) could be a risk factor for worse outcomes in patients with locally advanced rectal cancer with poor or no pathological response to preoperative CRT.

Major finding: A longer vs. shorter waiting period between surgery and end of CRT was associated with worse overall survival (5 years: 67.6% vs 80.3%; 10 years: 40.1% vs 57.8%; P < .001) and disease-free survival (5 years: 59.6% vs 72.0%; 10 years: 36.2% vs 53.9%; P < .001).

Study details: Findings are from a retrospective analysis of 1,064 patients who underwent CRT and surgery for locally advanced rectal cancer and showed partial or no pathological response to neoadjuvant CRT. Wait time between CRT completion and colorectal surgery categorized patients into shorter (8 weeks or less; n=579) or longer (greater than 8 weeks; n=485) interval groups.

Disclosures: The study did not declare any source of funding. No conflict of interests was reported.

Source: Deidda S et al. JAMA Surg. 2021 Sep 29. doi: 10.1001/jamasurg.2021.4566.

Key clinical point: Delaying surgery after completing neoadjuvant chemoradiotherapy (CRT) could be a risk factor for worse outcomes in patients with locally advanced rectal cancer with poor or no pathological response to preoperative CRT.

Major finding: A longer vs. shorter waiting period between surgery and end of CRT was associated with worse overall survival (5 years: 67.6% vs 80.3%; 10 years: 40.1% vs 57.8%; P < .001) and disease-free survival (5 years: 59.6% vs 72.0%; 10 years: 36.2% vs 53.9%; P < .001).

Study details: Findings are from a retrospective analysis of 1,064 patients who underwent CRT and surgery for locally advanced rectal cancer and showed partial or no pathological response to neoadjuvant CRT. Wait time between CRT completion and colorectal surgery categorized patients into shorter (8 weeks or less; n=579) or longer (greater than 8 weeks; n=485) interval groups.

Disclosures: The study did not declare any source of funding. No conflict of interests was reported.

Source: Deidda S et al. JAMA Surg. 2021 Sep 29. doi: 10.1001/jamasurg.2021.4566.

Key clinical point: Primary tumor resection (PTR) of asymptomatic tumor followed by systemic therapy is associated with a significantly higher 60-day mortality than systemic therapy alone in patients with nonresectable metastatic colorectal cancer (mCRC).

Major finding: Deaths within 60 days of randomization were significantly higher in the PTR vs systemic therapy alone (11% vs 3%; P = .03) arm with elevated levels of lactate dehydrogenase (P = .046), neutrophils (P = .04), aspartate aminotransferase (P < .001), and alanine aminotransferase (P = .002) being associated with higher 60-day mortality in the PTR arm.

Study details: CAIRO4 is a randomized phase 3 trial including 198 patients with nonresectable mCRC and asymptomatic primary tumor randomly assigned to systemic therapy alone or PTR followed by systemic therapy with palliative intent.

Disclosures: The study was funded by Dutch Cancer Society and Hoffmann-La Roche. Dr. DEW van der Kruijssen, Dr. GR Vink, Dr. JHW de Wilt, and Dr. M Koopman reported receiving grants and/or nonfinancial support from various sources including Hoffmann-La Roche Ltd.

Source: van der Kruijssen DEW et al. JAMA Surg. 2021 Oct 6. doi: 10.1001/jamasurg.2021.4992.

Key clinical point: Primary tumor resection (PTR) of asymptomatic tumor followed by systemic therapy is associated with a significantly higher 60-day mortality than systemic therapy alone in patients with nonresectable metastatic colorectal cancer (mCRC).

Major finding: Deaths within 60 days of randomization were significantly higher in the PTR vs systemic therapy alone (11% vs 3%; P = .03) arm with elevated levels of lactate dehydrogenase (P = .046), neutrophils (P = .04), aspartate aminotransferase (P < .001), and alanine aminotransferase (P = .002) being associated with higher 60-day mortality in the PTR arm.

Study details: CAIRO4 is a randomized phase 3 trial including 198 patients with nonresectable mCRC and asymptomatic primary tumor randomly assigned to systemic therapy alone or PTR followed by systemic therapy with palliative intent.

Disclosures: The study was funded by Dutch Cancer Society and Hoffmann-La Roche. Dr. DEW van der Kruijssen, Dr. GR Vink, Dr. JHW de Wilt, and Dr. M Koopman reported receiving grants and/or nonfinancial support from various sources including Hoffmann-La Roche Ltd.

Source: van der Kruijssen DEW et al. JAMA Surg. 2021 Oct 6. doi: 10.1001/jamasurg.2021.4992.

Key clinical point: Primary tumor resection (PTR) of asymptomatic tumor followed by systemic therapy is associated with a significantly higher 60-day mortality than systemic therapy alone in patients with nonresectable metastatic colorectal cancer (mCRC).

Major finding: Deaths within 60 days of randomization were significantly higher in the PTR vs systemic therapy alone (11% vs 3%; P = .03) arm with elevated levels of lactate dehydrogenase (P = .046), neutrophils (P = .04), aspartate aminotransferase (P < .001), and alanine aminotransferase (P = .002) being associated with higher 60-day mortality in the PTR arm.

Study details: CAIRO4 is a randomized phase 3 trial including 198 patients with nonresectable mCRC and asymptomatic primary tumor randomly assigned to systemic therapy alone or PTR followed by systemic therapy with palliative intent.

Disclosures: The study was funded by Dutch Cancer Society and Hoffmann-La Roche. Dr. DEW van der Kruijssen, Dr. GR Vink, Dr. JHW de Wilt, and Dr. M Koopman reported receiving grants and/or nonfinancial support from various sources including Hoffmann-La Roche Ltd.

Source: van der Kruijssen DEW et al. JAMA Surg. 2021 Oct 6. doi: 10.1001/jamasurg.2021.4992.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.