Clinical Edge Journal Scan

Key clinical point: Female sex was the only independent risk factor for early and any time toxicity to regorafenib treatment for metastatic colorectal cancer (mCRC), with females being 2- to 3-fold more likely than men to suffer from moderate-to-severe treatment-related adverse events (TRAEs).

Major finding: Females vs males had more frequent grade 2 or more TRAEs during the first cycle of treatment (84% vs 60%; P = .002) and grade 3 or more TRAEs throughout the treatment (71% vs 53%; P = .035), with sex being the only independent predictive factor for early grade 2 or more (odds ratio [OR], 3.4; P = .02) and late grade 3 or more (OR, 2.1; P = .045) TRAEs.

Study details: Findings are from the safety analysis of RegARd-C, a phase 2 clinical trial including 136 patients who received regorafenib treatment for mCRC.

Disclosures: This work was supported by ESMO. The clinical part of the RegARd-C trial was supported by Bayer Pharmaceuticals. A Deleporte, A Hendlisz, and F Sclafani reported receiving travel grants, consultancy, advisory board, and/or research grants from various sources including Bayer.

Source: Vandeputte C et al. Clin Colorectal Cancer. 2021 Jul 24. doi: 10.1016/j.clcc.2021.07.006.

Key clinical point: Female sex was the only independent risk factor for early and any time toxicity to regorafenib treatment for metastatic colorectal cancer (mCRC), with females being 2- to 3-fold more likely than men to suffer from moderate-to-severe treatment-related adverse events (TRAEs).

Major finding: Females vs males had more frequent grade 2 or more TRAEs during the first cycle of treatment (84% vs 60%; P = .002) and grade 3 or more TRAEs throughout the treatment (71% vs 53%; P = .035), with sex being the only independent predictive factor for early grade 2 or more (odds ratio [OR], 3.4; P = .02) and late grade 3 or more (OR, 2.1; P = .045) TRAEs.

Study details: Findings are from the safety analysis of RegARd-C, a phase 2 clinical trial including 136 patients who received regorafenib treatment for mCRC.

Disclosures: This work was supported by ESMO. The clinical part of the RegARd-C trial was supported by Bayer Pharmaceuticals. A Deleporte, A Hendlisz, and F Sclafani reported receiving travel grants, consultancy, advisory board, and/or research grants from various sources including Bayer.

Source: Vandeputte C et al. Clin Colorectal Cancer. 2021 Jul 24. doi: 10.1016/j.clcc.2021.07.006.

Key clinical point: Female sex was the only independent risk factor for early and any time toxicity to regorafenib treatment for metastatic colorectal cancer (mCRC), with females being 2- to 3-fold more likely than men to suffer from moderate-to-severe treatment-related adverse events (TRAEs).

Major finding: Females vs males had more frequent grade 2 or more TRAEs during the first cycle of treatment (84% vs 60%; P = .002) and grade 3 or more TRAEs throughout the treatment (71% vs 53%; P = .035), with sex being the only independent predictive factor for early grade 2 or more (odds ratio [OR], 3.4; P = .02) and late grade 3 or more (OR, 2.1; P = .045) TRAEs.

Study details: Findings are from the safety analysis of RegARd-C, a phase 2 clinical trial including 136 patients who received regorafenib treatment for mCRC.

Disclosures: This work was supported by ESMO. The clinical part of the RegARd-C trial was supported by Bayer Pharmaceuticals. A Deleporte, A Hendlisz, and F Sclafani reported receiving travel grants, consultancy, advisory board, and/or research grants from various sources including Bayer.

Source: Vandeputte C et al. Clin Colorectal Cancer. 2021 Jul 24. doi: 10.1016/j.clcc.2021.07.006.

Key clinical point: Among patients with stenotic left‐sided colorectal cancer (CRC) who underwent incomplete colonoscopy, absence of negative preoperative 18‐fluoro‐2‐deoxy‐glucose (FDG)‐avid lesions in the proximal colon other than the target CRC ensures the absence of additional lesions warranting changes in surgical plan.

Major finding: The cumulative detection rate of advanced adenoma was significantly higher in the incomplete vs complete colonoscopy group at 1 year (6.3% vs 0.7%) and 5 years (12.5% vs 9.9%; P = .012). However, the cumulative rate of detection of adenocarcinoma at 1 and 5 years (P = .15) and 5-year cumulative rate of additional surgery (P = .85) were not different between the groups.

Study details: Findings are from an analysis of 754 patients with left‐sided CRC without synchronous FDG‐avid lesions on preoperative 18‐FDG positron emission tomography/computed tomography. Patients were categorized into those who underwent complete (n=616) and incomplete (n=138) preoperative colonoscopy.

Disclosures: This study was funded by the Korea Institute of Radiological and Medical Sciences, funded by the Ministry of Science and ICT, Republic of Korea. The authors declare no competing interests.

Source: Lee JI et al. Sci Rep. 2021 Jul 19. doi: 10.1038/s41598-021-94030-w.

Key clinical point: Among patients with stenotic left‐sided colorectal cancer (CRC) who underwent incomplete colonoscopy, absence of negative preoperative 18‐fluoro‐2‐deoxy‐glucose (FDG)‐avid lesions in the proximal colon other than the target CRC ensures the absence of additional lesions warranting changes in surgical plan.

Major finding: The cumulative detection rate of advanced adenoma was significantly higher in the incomplete vs complete colonoscopy group at 1 year (6.3% vs 0.7%) and 5 years (12.5% vs 9.9%; P = .012). However, the cumulative rate of detection of adenocarcinoma at 1 and 5 years (P = .15) and 5-year cumulative rate of additional surgery (P = .85) were not different between the groups.

Study details: Findings are from an analysis of 754 patients with left‐sided CRC without synchronous FDG‐avid lesions on preoperative 18‐FDG positron emission tomography/computed tomography. Patients were categorized into those who underwent complete (n=616) and incomplete (n=138) preoperative colonoscopy.

Disclosures: This study was funded by the Korea Institute of Radiological and Medical Sciences, funded by the Ministry of Science and ICT, Republic of Korea. The authors declare no competing interests.

Source: Lee JI et al. Sci Rep. 2021 Jul 19. doi: 10.1038/s41598-021-94030-w.

Key clinical point: Among patients with stenotic left‐sided colorectal cancer (CRC) who underwent incomplete colonoscopy, absence of negative preoperative 18‐fluoro‐2‐deoxy‐glucose (FDG)‐avid lesions in the proximal colon other than the target CRC ensures the absence of additional lesions warranting changes in surgical plan.

Major finding: The cumulative detection rate of advanced adenoma was significantly higher in the incomplete vs complete colonoscopy group at 1 year (6.3% vs 0.7%) and 5 years (12.5% vs 9.9%; P = .012). However, the cumulative rate of detection of adenocarcinoma at 1 and 5 years (P = .15) and 5-year cumulative rate of additional surgery (P = .85) were not different between the groups.

Study details: Findings are from an analysis of 754 patients with left‐sided CRC without synchronous FDG‐avid lesions on preoperative 18‐FDG positron emission tomography/computed tomography. Patients were categorized into those who underwent complete (n=616) and incomplete (n=138) preoperative colonoscopy.

Disclosures: This study was funded by the Korea Institute of Radiological and Medical Sciences, funded by the Ministry of Science and ICT, Republic of Korea. The authors declare no competing interests.

Source: Lee JI et al. Sci Rep. 2021 Jul 19. doi: 10.1038/s41598-021-94030-w.

Key clinical point: Combination of bevacizumab with S-1 and irinotecan vs 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6)/capecitabine and oxaliplatin (CapeOX) as the first-line treatment for metastatic colorectal cancer (mCRC) showed comparable overall survival and noninferior progression-free survival (PFS).

Major finding: During a median follow-up of 48.7 months, median survival and PFS in patients assigned to bevacizumab+mFOLFOX6/CapeOX vs bevacizumab+S-1/irinotecan were 32.6 months vs 34.3 months (hazard ratio [HR], 0.89; P = .293) and 10.8 months vs 14.0 months (HR, 0.86; P less than .0001 for noninferiority), respectively. Safety results were as reported previously.

Study details: Findings are from phase 3 TRICOLORE trial including 487 patients with previously untreated mCRC who were randomly assigned to receive bevacizumab+mFOLFOX6/CapeOX or bevacizumab+S-1 and irinotecan.

Disclosures: This study was funded by Tokyo Cooperative Oncology Group with funding from Taiho Pharmaceutical Co. Ltd., Japan. Some of the authors including the lead author declared receiving honoraria, research funding, and/or consulting fees from various sources.

Source: Denda T et al. Eur J Cancer. 2021 Jul 22. doi: 10.1016/j.ejca.2021.06.013.

Key clinical point: Combination of bevacizumab with S-1 and irinotecan vs 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6)/capecitabine and oxaliplatin (CapeOX) as the first-line treatment for metastatic colorectal cancer (mCRC) showed comparable overall survival and noninferior progression-free survival (PFS).

Major finding: During a median follow-up of 48.7 months, median survival and PFS in patients assigned to bevacizumab+mFOLFOX6/CapeOX vs bevacizumab+S-1/irinotecan were 32.6 months vs 34.3 months (hazard ratio [HR], 0.89; P = .293) and 10.8 months vs 14.0 months (HR, 0.86; P less than .0001 for noninferiority), respectively. Safety results were as reported previously.

Study details: Findings are from phase 3 TRICOLORE trial including 487 patients with previously untreated mCRC who were randomly assigned to receive bevacizumab+mFOLFOX6/CapeOX or bevacizumab+S-1 and irinotecan.

Disclosures: This study was funded by Tokyo Cooperative Oncology Group with funding from Taiho Pharmaceutical Co. Ltd., Japan. Some of the authors including the lead author declared receiving honoraria, research funding, and/or consulting fees from various sources.

Source: Denda T et al. Eur J Cancer. 2021 Jul 22. doi: 10.1016/j.ejca.2021.06.013.

Key clinical point: Combination of bevacizumab with S-1 and irinotecan vs 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6)/capecitabine and oxaliplatin (CapeOX) as the first-line treatment for metastatic colorectal cancer (mCRC) showed comparable overall survival and noninferior progression-free survival (PFS).

Major finding: During a median follow-up of 48.7 months, median survival and PFS in patients assigned to bevacizumab+mFOLFOX6/CapeOX vs bevacizumab+S-1/irinotecan were 32.6 months vs 34.3 months (hazard ratio [HR], 0.89; P = .293) and 10.8 months vs 14.0 months (HR, 0.86; P less than .0001 for noninferiority), respectively. Safety results were as reported previously.

Study details: Findings are from phase 3 TRICOLORE trial including 487 patients with previously untreated mCRC who were randomly assigned to receive bevacizumab+mFOLFOX6/CapeOX or bevacizumab+S-1 and irinotecan.

Disclosures: This study was funded by Tokyo Cooperative Oncology Group with funding from Taiho Pharmaceutical Co. Ltd., Japan. Some of the authors including the lead author declared receiving honoraria, research funding, and/or consulting fees from various sources.

Source: Denda T et al. Eur J Cancer. 2021 Jul 22. doi: 10.1016/j.ejca.2021.06.013.

Key clinical point: Sequential vs concurrent administration of bevacizumab and chemotherapy failed to improve objective response rate (ORR) in patients with metastatic colorectal cancer (mCRC), but was associated with survival advantage and fewer adverse effects.

Major finding: ORR (odds ratio, 0.96; P = .89) was not significantly different among patients who received bevacizumab and chemotherapy concurrently or sequentially. However, sequential administration was associated with survival benefit (adjusted hazard ratio, 0.73; P = .04), significantly reduced rates of severe diarrhea (5.3% vs 16.5%; P = .006), and improved physical functioning at cycle 12 (P = .02).

Study details: Findings are from OBELICS, a phase 3 trial including 230 patients with unresectable, previously untreated, or single line-treated mCRC who were randomly assigned to receive 12 biweekly cycles of standard oxaliplatin-based regimens and bevacizumab administered either concurrently with chemotherapy or sequentially (4 days before chemotherapy).

Disclosures: The trial was supported by the Italian Ministry of Health. Some of the authors reported receiving personal fees, research grants, consulting or advisory fees, and/or nonfinancial support from various sources.

Source: Avallone A et al. JAMA Netw Open. 2021 Jul 26. doi: 10.1001/jamanetworkopen.2021.18475.

Key clinical point: Sequential vs concurrent administration of bevacizumab and chemotherapy failed to improve objective response rate (ORR) in patients with metastatic colorectal cancer (mCRC), but was associated with survival advantage and fewer adverse effects.

Major finding: ORR (odds ratio, 0.96; P = .89) was not significantly different among patients who received bevacizumab and chemotherapy concurrently or sequentially. However, sequential administration was associated with survival benefit (adjusted hazard ratio, 0.73; P = .04), significantly reduced rates of severe diarrhea (5.3% vs 16.5%; P = .006), and improved physical functioning at cycle 12 (P = .02).

Study details: Findings are from OBELICS, a phase 3 trial including 230 patients with unresectable, previously untreated, or single line-treated mCRC who were randomly assigned to receive 12 biweekly cycles of standard oxaliplatin-based regimens and bevacizumab administered either concurrently with chemotherapy or sequentially (4 days before chemotherapy).

Disclosures: The trial was supported by the Italian Ministry of Health. Some of the authors reported receiving personal fees, research grants, consulting or advisory fees, and/or nonfinancial support from various sources.

Source: Avallone A et al. JAMA Netw Open. 2021 Jul 26. doi: 10.1001/jamanetworkopen.2021.18475.

Key clinical point: Sequential vs concurrent administration of bevacizumab and chemotherapy failed to improve objective response rate (ORR) in patients with metastatic colorectal cancer (mCRC), but was associated with survival advantage and fewer adverse effects.

Major finding: ORR (odds ratio, 0.96; P = .89) was not significantly different among patients who received bevacizumab and chemotherapy concurrently or sequentially. However, sequential administration was associated with survival benefit (adjusted hazard ratio, 0.73; P = .04), significantly reduced rates of severe diarrhea (5.3% vs 16.5%; P = .006), and improved physical functioning at cycle 12 (P = .02).

Study details: Findings are from OBELICS, a phase 3 trial including 230 patients with unresectable, previously untreated, or single line-treated mCRC who were randomly assigned to receive 12 biweekly cycles of standard oxaliplatin-based regimens and bevacizumab administered either concurrently with chemotherapy or sequentially (4 days before chemotherapy).

Disclosures: The trial was supported by the Italian Ministry of Health. Some of the authors reported receiving personal fees, research grants, consulting or advisory fees, and/or nonfinancial support from various sources.

Source: Avallone A et al. JAMA Netw Open. 2021 Jul 26. doi: 10.1001/jamanetworkopen.2021.18475.

Key clinical point: High mesothelin (MSLN) expression in stage IV colorectal cancer (CRC) was associated with chemoresistant properties and poor prognoses.

Major finding: Patients with high vs low MSLN expression had a low objective response rate (22.0% vs 45.5%; P = .0050), disease control rate (65.9% vs 85.9%; P = .0019), and higher rates of progressive disease (31.0% vs 13.5%; P = .028). The rates of 12-month progression-free survival and 3-year overall survival in high vs low MSNL expression group were 20.0% vs 44.1% (P = .0120) and 23.5% vs 41.5% (P = .0120), respectively.

Study details: Findings are from a retrospective analysis of 254 patients with stage IV CRC who received systemic chemotherapy following primary tumor resection between 2000 and 2019.

Disclosures: The study received no financial or material support. The authors declared no conflict of interests related to this article.

Source: Nagata K et al. Ann Surg Oncol. 2021 Jul 27. doi: 10.1245/s10434-021-10507-y.

Key clinical point: High mesothelin (MSLN) expression in stage IV colorectal cancer (CRC) was associated with chemoresistant properties and poor prognoses.

Major finding: Patients with high vs low MSLN expression had a low objective response rate (22.0% vs 45.5%; P = .0050), disease control rate (65.9% vs 85.9%; P = .0019), and higher rates of progressive disease (31.0% vs 13.5%; P = .028). The rates of 12-month progression-free survival and 3-year overall survival in high vs low MSNL expression group were 20.0% vs 44.1% (P = .0120) and 23.5% vs 41.5% (P = .0120), respectively.

Study details: Findings are from a retrospective analysis of 254 patients with stage IV CRC who received systemic chemotherapy following primary tumor resection between 2000 and 2019.

Disclosures: The study received no financial or material support. The authors declared no conflict of interests related to this article.

Source: Nagata K et al. Ann Surg Oncol. 2021 Jul 27. doi: 10.1245/s10434-021-10507-y.

Key clinical point: High mesothelin (MSLN) expression in stage IV colorectal cancer (CRC) was associated with chemoresistant properties and poor prognoses.

Major finding: Patients with high vs low MSLN expression had a low objective response rate (22.0% vs 45.5%; P = .0050), disease control rate (65.9% vs 85.9%; P = .0019), and higher rates of progressive disease (31.0% vs 13.5%; P = .028). The rates of 12-month progression-free survival and 3-year overall survival in high vs low MSNL expression group were 20.0% vs 44.1% (P = .0120) and 23.5% vs 41.5% (P = .0120), respectively.

Study details: Findings are from a retrospective analysis of 254 patients with stage IV CRC who received systemic chemotherapy following primary tumor resection between 2000 and 2019.

Disclosures: The study received no financial or material support. The authors declared no conflict of interests related to this article.

Source: Nagata K et al. Ann Surg Oncol. 2021 Jul 27. doi: 10.1245/s10434-021-10507-y.

Key clinical point: Under real-life settings, aflibercept-FOLFIRI appeared to be a feasible second-line treatment for metastatic colorectal cancer (mCRC) with progression-free survival (PFS) of more than 12 months in the first-line therapy being the only predictive marker for better survival.

Major finding: Overall, the median overall survival and PFS was 13 (95% confidence interval [CI], 10-18) months and 6 (95% CI, 5-7) months, respectively. The overall response rate and disease control rate were 12.3% and 49.1%, respectively. The PFS of more than 12 months in the first-line chemotherapy was associated with better survival (hazard ratio, 0.32; P = .01). Most nonhematological malignancies were grade 1 or 2, whereas hypertension (18.4%) and venous thromboembolism (16.3%) were the most commonly reported grade 3-4 adverse events.

Study details: Findings are from a retrospective analysis of 49 patients with mCRC who progressed after first-line oxaliplatin-based chemotherapy and received second-line treatment with aflibercept in combination with FOLFIRI.

Disclosures: The study received no external funding. The authors declared no conflict of interests.

Source: Lavacchi D et al. Cancers (Basel). 2021 Jul 31. doi: 10.3390/cancers13153863.

Key clinical point: Under real-life settings, aflibercept-FOLFIRI appeared to be a feasible second-line treatment for metastatic colorectal cancer (mCRC) with progression-free survival (PFS) of more than 12 months in the first-line therapy being the only predictive marker for better survival.

Major finding: Overall, the median overall survival and PFS was 13 (95% confidence interval [CI], 10-18) months and 6 (95% CI, 5-7) months, respectively. The overall response rate and disease control rate were 12.3% and 49.1%, respectively. The PFS of more than 12 months in the first-line chemotherapy was associated with better survival (hazard ratio, 0.32; P = .01). Most nonhematological malignancies were grade 1 or 2, whereas hypertension (18.4%) and venous thromboembolism (16.3%) were the most commonly reported grade 3-4 adverse events.

Study details: Findings are from a retrospective analysis of 49 patients with mCRC who progressed after first-line oxaliplatin-based chemotherapy and received second-line treatment with aflibercept in combination with FOLFIRI.

Disclosures: The study received no external funding. The authors declared no conflict of interests.

Source: Lavacchi D et al. Cancers (Basel). 2021 Jul 31. doi: 10.3390/cancers13153863.

Key clinical point: Under real-life settings, aflibercept-FOLFIRI appeared to be a feasible second-line treatment for metastatic colorectal cancer (mCRC) with progression-free survival (PFS) of more than 12 months in the first-line therapy being the only predictive marker for better survival.

Major finding: Overall, the median overall survival and PFS was 13 (95% confidence interval [CI], 10-18) months and 6 (95% CI, 5-7) months, respectively. The overall response rate and disease control rate were 12.3% and 49.1%, respectively. The PFS of more than 12 months in the first-line chemotherapy was associated with better survival (hazard ratio, 0.32; P = .01). Most nonhematological malignancies were grade 1 or 2, whereas hypertension (18.4%) and venous thromboembolism (16.3%) were the most commonly reported grade 3-4 adverse events.

Study details: Findings are from a retrospective analysis of 49 patients with mCRC who progressed after first-line oxaliplatin-based chemotherapy and received second-line treatment with aflibercept in combination with FOLFIRI.

Disclosures: The study received no external funding. The authors declared no conflict of interests.

Source: Lavacchi D et al. Cancers (Basel). 2021 Jul 31. doi: 10.3390/cancers13153863.

Key clinical point: Tumor deposits (TDs) are associated with a worse prognosis, thereby indicating that the addition of number of TDs to lymph node metastases count could improve prognostication accuracy in stage III colon cancer.

Major finding: The presence of TD was associated with poorer disease-free survival (DFS; hazard ratio [HR], 1.63; P < .0001) and overall survival (OS; HR, 1.59; P = .0004). Combining TD and number of lymph node metastases restaged 7.1% of pN1 patients as pN2 who had worse rates of 3-year DFS (80.5% vs 65.4%; P = .0003) and 5-year OS (87.9% vs 69.1%; P = .0001) vs those who remained classified as pN1.

Study details: Findings are from a post hoc analysis of CALGB/SWOG 80702 phase 3 trial involving 2,028 patients with stage III colon cancers. Overall, 74% of patients had TD-positive tumors.

Disclosures: This work was supported by the National Cancer Institute of the National Institutes of Health and in part by funds from Pfizer. R Cohen declared receiving honoraria and research grants from various sources.

Source: Cohen R et al. Ann Oncol. 2021 Jul 19. doi: 10.1016/j.annonc.2021.07.009.

Key clinical point: Tumor deposits (TDs) are associated with a worse prognosis, thereby indicating that the addition of number of TDs to lymph node metastases count could improve prognostication accuracy in stage III colon cancer.

Major finding: The presence of TD was associated with poorer disease-free survival (DFS; hazard ratio [HR], 1.63; P < .0001) and overall survival (OS; HR, 1.59; P = .0004). Combining TD and number of lymph node metastases restaged 7.1% of pN1 patients as pN2 who had worse rates of 3-year DFS (80.5% vs 65.4%; P = .0003) and 5-year OS (87.9% vs 69.1%; P = .0001) vs those who remained classified as pN1.

Study details: Findings are from a post hoc analysis of CALGB/SWOG 80702 phase 3 trial involving 2,028 patients with stage III colon cancers. Overall, 74% of patients had TD-positive tumors.

Disclosures: This work was supported by the National Cancer Institute of the National Institutes of Health and in part by funds from Pfizer. R Cohen declared receiving honoraria and research grants from various sources.

Source: Cohen R et al. Ann Oncol. 2021 Jul 19. doi: 10.1016/j.annonc.2021.07.009.

Key clinical point: Tumor deposits (TDs) are associated with a worse prognosis, thereby indicating that the addition of number of TDs to lymph node metastases count could improve prognostication accuracy in stage III colon cancer.

Major finding: The presence of TD was associated with poorer disease-free survival (DFS; hazard ratio [HR], 1.63; P < .0001) and overall survival (OS; HR, 1.59; P = .0004). Combining TD and number of lymph node metastases restaged 7.1% of pN1 patients as pN2 who had worse rates of 3-year DFS (80.5% vs 65.4%; P = .0003) and 5-year OS (87.9% vs 69.1%; P = .0001) vs those who remained classified as pN1.

Study details: Findings are from a post hoc analysis of CALGB/SWOG 80702 phase 3 trial involving 2,028 patients with stage III colon cancers. Overall, 74% of patients had TD-positive tumors.

Disclosures: This work was supported by the National Cancer Institute of the National Institutes of Health and in part by funds from Pfizer. R Cohen declared receiving honoraria and research grants from various sources.

Source: Cohen R et al. Ann Oncol. 2021 Jul 19. doi: 10.1016/j.annonc.2021.07.009.

Key clinical point: Patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC) with liver metastasis showed resistance to programmed cell death receptor 1/programmed death ligand 1 (PD-1/PD-L1) inhibition, whereas those without liver involvement may derive clinical benefit.

Major finding: Patients without vs with liver metastases had a significantly superior objective response rate (19.5% vs 0.0%; P less than .001) and median progression-free survival (PFS; 4.0 months vs 1.5 months; P less than .001). Liver metastasis at the time of initiation of PD-1/PD-L1 therapy was the most significant factor associated with worse PFS (hazard ratio, 7.00; P < .001).

Study details: Findings are from a retrospective cohort study of 95 patients with MSS mCRC who received PD-1/PD-L1–targeting therapy after progression with prior standard chemotherapy.

Disclosures: No source of funding was declared. Dr. Fakih reported receiving honoraria and research funding and serving as an advisor and on the speakers’ bureau for various sources. No other disclosures were reported.

Source: Wang C et al. JAMA Netw Open. 2021 Aug 9. doi: 10.1001/jamanetworkopen.2021.18416.

Key clinical point: Patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC) with liver metastasis showed resistance to programmed cell death receptor 1/programmed death ligand 1 (PD-1/PD-L1) inhibition, whereas those without liver involvement may derive clinical benefit.

Major finding: Patients without vs with liver metastases had a significantly superior objective response rate (19.5% vs 0.0%; P less than .001) and median progression-free survival (PFS; 4.0 months vs 1.5 months; P less than .001). Liver metastasis at the time of initiation of PD-1/PD-L1 therapy was the most significant factor associated with worse PFS (hazard ratio, 7.00; P < .001).

Study details: Findings are from a retrospective cohort study of 95 patients with MSS mCRC who received PD-1/PD-L1–targeting therapy after progression with prior standard chemotherapy.

Disclosures: No source of funding was declared. Dr. Fakih reported receiving honoraria and research funding and serving as an advisor and on the speakers’ bureau for various sources. No other disclosures were reported.

Source: Wang C et al. JAMA Netw Open. 2021 Aug 9. doi: 10.1001/jamanetworkopen.2021.18416.

Key clinical point: Patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC) with liver metastasis showed resistance to programmed cell death receptor 1/programmed death ligand 1 (PD-1/PD-L1) inhibition, whereas those without liver involvement may derive clinical benefit.

Major finding: Patients without vs with liver metastases had a significantly superior objective response rate (19.5% vs 0.0%; P less than .001) and median progression-free survival (PFS; 4.0 months vs 1.5 months; P less than .001). Liver metastasis at the time of initiation of PD-1/PD-L1 therapy was the most significant factor associated with worse PFS (hazard ratio, 7.00; P < .001).

Study details: Findings are from a retrospective cohort study of 95 patients with MSS mCRC who received PD-1/PD-L1–targeting therapy after progression with prior standard chemotherapy.

Disclosures: No source of funding was declared. Dr. Fakih reported receiving honoraria and research funding and serving as an advisor and on the speakers’ bureau for various sources. No other disclosures were reported.

Source: Wang C et al. JAMA Netw Open. 2021 Aug 9. doi: 10.1001/jamanetworkopen.2021.18416.

Key clinical point: Computer-aided detection (CADe) has higher rates of colorectal neoplasia detection than other advanced endoscopic techniques like chromoendoscopy or mucosal visualization tools.

Major finding: The magnitude of increase in adenoma detection rate was higher with CADe vs chromoendoscopy (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.14-1.85) or with increased mucosal visualization systems (OR, 1.54; 95% CI, 1.22-1.94). Compared with high-definition white-light endoscopy, only CADe showed a significant increase in the detection of large adenomas (OR, 1.69; 95% CI, 1.10-2.60).

Study details: Findings are from a systematic review and meta-analysis of 50 randomized control trials including 34,445 participants who underwent colonoscopy.

Disclosures: There was no source of funding for this study. Some of the authors declared receiving consulting fees from Olympus, Medtronic, Fuji, Boston, Aries Pharmaceutical, Braintree Laboratories, Norgine, Endokey, and GI Supply.

Source: Spadaccini M et al. Lancet Gastroenterol Hepatol. 2021 Aug 4. doi: 10.1016/S2468-1253(21)00215-6.  

Key clinical point: Computer-aided detection (CADe) has higher rates of colorectal neoplasia detection than other advanced endoscopic techniques like chromoendoscopy or mucosal visualization tools.

Major finding: The magnitude of increase in adenoma detection rate was higher with CADe vs chromoendoscopy (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.14-1.85) or with increased mucosal visualization systems (OR, 1.54; 95% CI, 1.22-1.94). Compared with high-definition white-light endoscopy, only CADe showed a significant increase in the detection of large adenomas (OR, 1.69; 95% CI, 1.10-2.60).

Study details: Findings are from a systematic review and meta-analysis of 50 randomized control trials including 34,445 participants who underwent colonoscopy.

Disclosures: There was no source of funding for this study. Some of the authors declared receiving consulting fees from Olympus, Medtronic, Fuji, Boston, Aries Pharmaceutical, Braintree Laboratories, Norgine, Endokey, and GI Supply.

Source: Spadaccini M et al. Lancet Gastroenterol Hepatol. 2021 Aug 4. doi: 10.1016/S2468-1253(21)00215-6.  

Key clinical point: Computer-aided detection (CADe) has higher rates of colorectal neoplasia detection than other advanced endoscopic techniques like chromoendoscopy or mucosal visualization tools.

Major finding: The magnitude of increase in adenoma detection rate was higher with CADe vs chromoendoscopy (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.14-1.85) or with increased mucosal visualization systems (OR, 1.54; 95% CI, 1.22-1.94). Compared with high-definition white-light endoscopy, only CADe showed a significant increase in the detection of large adenomas (OR, 1.69; 95% CI, 1.10-2.60).

Study details: Findings are from a systematic review and meta-analysis of 50 randomized control trials including 34,445 participants who underwent colonoscopy.

Disclosures: There was no source of funding for this study. Some of the authors declared receiving consulting fees from Olympus, Medtronic, Fuji, Boston, Aries Pharmaceutical, Braintree Laboratories, Norgine, Endokey, and GI Supply.

Source: Spadaccini M et al. Lancet Gastroenterol Hepatol. 2021 Aug 4. doi: 10.1016/S2468-1253(21)00215-6.  

Atopic dermatitis (AD) is a complex disease with varying degrees of itch, pain, eczematous skin lesions and quality of life impact. Research over the past decade uncovered myriad associations of AD with comorbid health disorders. There are well-established associations of AD with atopic comorbidities in children and adults, including asthma, hay fever, food allergies and less commonly eosinophilic esophagitis. AD is also associated with higher rates of mental health disorders, including depression, anxiety and attention deficit (hyperactivity) disorder.

AD patients also have multiple risk factors for hypertension, including chronic sleep deprivation and limitations on physical activity from itch. Yousaf et al conducted a systematic literature review and meta-analysis of 19 studies and found significantly increased likelihood of hypertension in patients with AD compared to healthy controls, particularly moderate-to-severe AD. Though, the odds of hypertension were lower in patients with AD compared to psoriasis.

Sleep disturbances (SD) are also common in AD patients. Manjunath et al conducted a cross-sectional, dermatology practice-based study to examine clinical differences in geriatric vs younger adult AD patients. Geriatric age was not associated with any significant differences of AD severity. However, geriatric AD patients had significantly more nights of SD, particularly trouble staying asleep, and increased fatigue than younger adults. In general, having good sleep hygiene and getting adequate sleep are important for overall health and longevity. SD therefore warrant particular attention in clinical management of AD as they are often modifiable with improved AD control.

Likewise, the myriad comorbidities associated with AD may lead to poorer health outcomes, such as hospitalization. Edigin et al conducted a longitudinal study of 23,410 adults hospitalized in the United States with AD. Hospitalizations rates increased between 1998 and 2018 owing to comorbid health disorders, but not AD itself.

Together, these results highlight the importance of holistic management of AD patients, including atopic and non-atopic comorbidities. However, many questions remain about how and when to best screen for various comorbidities. Generally, more severe AD is one of the strongest predictors of atopic and mental health comorbidities, as well as sleep disturbances and hypertension as shown in the abovementioned studies. Additionally, geriatric AD patients warrant closer monitoring of SD. Of course, screening patients for these comorbidities can take up precious time in a busy clinical practice. Though, it is a worthwhile investment of time and will improve patients’ health outcomes and the quality of care you provide for patients.

Atopic dermatitis (AD) is a complex disease with varying degrees of itch, pain, eczematous skin lesions and quality of life impact. Research over the past decade uncovered myriad associations of AD with comorbid health disorders. There are well-established associations of AD with atopic comorbidities in children and adults, including asthma, hay fever, food allergies and less commonly eosinophilic esophagitis. AD is also associated with higher rates of mental health disorders, including depression, anxiety and attention deficit (hyperactivity) disorder.

AD patients also have multiple risk factors for hypertension, including chronic sleep deprivation and limitations on physical activity from itch. Yousaf et al conducted a systematic literature review and meta-analysis of 19 studies and found significantly increased likelihood of hypertension in patients with AD compared to healthy controls, particularly moderate-to-severe AD. Though, the odds of hypertension were lower in patients with AD compared to psoriasis.

Sleep disturbances (SD) are also common in AD patients. Manjunath et al conducted a cross-sectional, dermatology practice-based study to examine clinical differences in geriatric vs younger adult AD patients. Geriatric age was not associated with any significant differences of AD severity. However, geriatric AD patients had significantly more nights of SD, particularly trouble staying asleep, and increased fatigue than younger adults. In general, having good sleep hygiene and getting adequate sleep are important for overall health and longevity. SD therefore warrant particular attention in clinical management of AD as they are often modifiable with improved AD control.

Likewise, the myriad comorbidities associated with AD may lead to poorer health outcomes, such as hospitalization. Edigin et al conducted a longitudinal study of 23,410 adults hospitalized in the United States with AD. Hospitalizations rates increased between 1998 and 2018 owing to comorbid health disorders, but not AD itself.

Together, these results highlight the importance of holistic management of AD patients, including atopic and non-atopic comorbidities. However, many questions remain about how and when to best screen for various comorbidities. Generally, more severe AD is one of the strongest predictors of atopic and mental health comorbidities, as well as sleep disturbances and hypertension as shown in the abovementioned studies. Additionally, geriatric AD patients warrant closer monitoring of SD. Of course, screening patients for these comorbidities can take up precious time in a busy clinical practice. Though, it is a worthwhile investment of time and will improve patients’ health outcomes and the quality of care you provide for patients.

Atopic dermatitis (AD) is a complex disease with varying degrees of itch, pain, eczematous skin lesions and quality of life impact. Research over the past decade uncovered myriad associations of AD with comorbid health disorders. There are well-established associations of AD with atopic comorbidities in children and adults, including asthma, hay fever, food allergies and less commonly eosinophilic esophagitis. AD is also associated with higher rates of mental health disorders, including depression, anxiety and attention deficit (hyperactivity) disorder.

AD patients also have multiple risk factors for hypertension, including chronic sleep deprivation and limitations on physical activity from itch. Yousaf et al conducted a systematic literature review and meta-analysis of 19 studies and found significantly increased likelihood of hypertension in patients with AD compared to healthy controls, particularly moderate-to-severe AD. Though, the odds of hypertension were lower in patients with AD compared to psoriasis.

Sleep disturbances (SD) are also common in AD patients. Manjunath et al conducted a cross-sectional, dermatology practice-based study to examine clinical differences in geriatric vs younger adult AD patients. Geriatric age was not associated with any significant differences of AD severity. However, geriatric AD patients had significantly more nights of SD, particularly trouble staying asleep, and increased fatigue than younger adults. In general, having good sleep hygiene and getting adequate sleep are important for overall health and longevity. SD therefore warrant particular attention in clinical management of AD as they are often modifiable with improved AD control.

Likewise, the myriad comorbidities associated with AD may lead to poorer health outcomes, such as hospitalization. Edigin et al conducted a longitudinal study of 23,410 adults hospitalized in the United States with AD. Hospitalizations rates increased between 1998 and 2018 owing to comorbid health disorders, but not AD itself.

Together, these results highlight the importance of holistic management of AD patients, including atopic and non-atopic comorbidities. However, many questions remain about how and when to best screen for various comorbidities. Generally, more severe AD is one of the strongest predictors of atopic and mental health comorbidities, as well as sleep disturbances and hypertension as shown in the abovementioned studies. Additionally, geriatric AD patients warrant closer monitoring of SD. Of course, screening patients for these comorbidities can take up precious time in a busy clinical practice. Though, it is a worthwhile investment of time and will improve patients’ health outcomes and the quality of care you provide for patients.