Clinical Edge Journal Scan

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.

Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.

Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.

Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.

Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4

Key clinical point: Patients with KRAS p.G12C-mutant metastatic colorectal cancer (mCRC) show poor treatment outcomes, which are numerically worse than those in patients without this mutation or with KRAS non-p.G12C mutations, thus highlighting the prognostic value of KRAS p.G12C mutations.

Major finding: After the first-line therapy, the KRAS p.G12C, KRAS non-p.G12C, and non-KRAS (RAS/BRAF wild-type) mutation cohorts and the overall mCRC cohort had a median overall survival (95% CI) of 16.1 (13.0-19.0), 18.3 (17.2-19.3), 23.4 (21.9-24.9), and 19.2 (18.5-19.8) months and a median real-world progression-free survival (95% CI) of 7.4 (6.3-9.5), 9.0 (8.2-9.7), 10.6 (9.8-11.6), and 9.2 (8.6-9.7) months, respectively.

Study details: This retrospective real-world study included 6477 adult patients with mCRC and genomic sequencing data, of which 238, 2947, and 2249 had KRAS p.G12C, KRAS non-p.G12C, and non-KRAS mutations, respectively.

Disclosures: The study was funded by Amgen Inc. Some authors reported serving as consultants or advisors for and receiving honoraria or research funds from various sources, including Amgen. The other authors are employees of Amgen.

Source: Fakih M et al. Real-world study of characteristics and treatment outcomes among patients with KRAS p.G12C-mutated or other KRAS mutated metastatic colorectal cancer. Oncologist. 2022 (Apr 26). Doi: 10.1093/oncolo/oyac077

Key clinical point: Patients with KRAS p.G12C-mutant metastatic colorectal cancer (mCRC) show poor treatment outcomes, which are numerically worse than those in patients without this mutation or with KRAS non-p.G12C mutations, thus highlighting the prognostic value of KRAS p.G12C mutations.

Major finding: After the first-line therapy, the KRAS p.G12C, KRAS non-p.G12C, and non-KRAS (RAS/BRAF wild-type) mutation cohorts and the overall mCRC cohort had a median overall survival (95% CI) of 16.1 (13.0-19.0), 18.3 (17.2-19.3), 23.4 (21.9-24.9), and 19.2 (18.5-19.8) months and a median real-world progression-free survival (95% CI) of 7.4 (6.3-9.5), 9.0 (8.2-9.7), 10.6 (9.8-11.6), and 9.2 (8.6-9.7) months, respectively.

Study details: This retrospective real-world study included 6477 adult patients with mCRC and genomic sequencing data, of which 238, 2947, and 2249 had KRAS p.G12C, KRAS non-p.G12C, and non-KRAS mutations, respectively.

Disclosures: The study was funded by Amgen Inc. Some authors reported serving as consultants or advisors for and receiving honoraria or research funds from various sources, including Amgen. The other authors are employees of Amgen.

Source: Fakih M et al. Real-world study of characteristics and treatment outcomes among patients with KRAS p.G12C-mutated or other KRAS mutated metastatic colorectal cancer. Oncologist. 2022 (Apr 26). Doi: 10.1093/oncolo/oyac077

Key clinical point: Patients with KRAS p.G12C-mutant metastatic colorectal cancer (mCRC) show poor treatment outcomes, which are numerically worse than those in patients without this mutation or with KRAS non-p.G12C mutations, thus highlighting the prognostic value of KRAS p.G12C mutations.

Major finding: After the first-line therapy, the KRAS p.G12C, KRAS non-p.G12C, and non-KRAS (RAS/BRAF wild-type) mutation cohorts and the overall mCRC cohort had a median overall survival (95% CI) of 16.1 (13.0-19.0), 18.3 (17.2-19.3), 23.4 (21.9-24.9), and 19.2 (18.5-19.8) months and a median real-world progression-free survival (95% CI) of 7.4 (6.3-9.5), 9.0 (8.2-9.7), 10.6 (9.8-11.6), and 9.2 (8.6-9.7) months, respectively.

Study details: This retrospective real-world study included 6477 adult patients with mCRC and genomic sequencing data, of which 238, 2947, and 2249 had KRAS p.G12C, KRAS non-p.G12C, and non-KRAS mutations, respectively.

Disclosures: The study was funded by Amgen Inc. Some authors reported serving as consultants or advisors for and receiving honoraria or research funds from various sources, including Amgen. The other authors are employees of Amgen.

Source: Fakih M et al. Real-world study of characteristics and treatment outcomes among patients with KRAS p.G12C-mutated or other KRAS mutated metastatic colorectal cancer. Oncologist. 2022 (Apr 26). Doi: 10.1093/oncolo/oyac077

Key clinical point: Colorectal cancer (CRC) screening before 50 years of age was associated with a reduced risk for CRC among US women, including CRC diagnosis before 55 years of age.

Major finding: Compared with no endoscopy, initiating endoscopy at the age of <45 (adjusted hazard ratio [aHR] 0.37; 95% CI 0.26-0.53), 45-49 (aHR 0.43; 95% CI 0.29-0.62), 50-54 (aHR 0.47; 95% CI 0.35-0.62), and ≥55 (aHR 0.46; 95% CI 0.30-0.69) years was associated with a significantly lower CRC risk, with initiating endoscopy before 50 years of age being associated with a decreased risk for CRC diagnosis before 55 years of age (<45 years: aHR 0.45, 95% CI 0.29-0.70; 45-49 years: aHR 0.43, 95% CI, 0.24-0.76).

Study details: This prospective cohort study enrolled 111,801 female health professionals aged 26-46 years with no history of cancer from the Nurses’ Health Study II.

Disclosures: The study was supported by the US National Institutes of Health (NIH). Some authors reported serving as consultants for or receiving research grants or personal fees from various organizations, including NIH.

Source: Ma W et al. Age at initiation of lower gastrointestinal endoscopy and colorectal cancer risk among US women. JAMA Oncol. 2022 (May 5). Doi: 10.1001/jamaoncol.2022.0883

Key clinical point: Colorectal cancer (CRC) screening before 50 years of age was associated with a reduced risk for CRC among US women, including CRC diagnosis before 55 years of age.

Major finding: Compared with no endoscopy, initiating endoscopy at the age of <45 (adjusted hazard ratio [aHR] 0.37; 95% CI 0.26-0.53), 45-49 (aHR 0.43; 95% CI 0.29-0.62), 50-54 (aHR 0.47; 95% CI 0.35-0.62), and ≥55 (aHR 0.46; 95% CI 0.30-0.69) years was associated with a significantly lower CRC risk, with initiating endoscopy before 50 years of age being associated with a decreased risk for CRC diagnosis before 55 years of age (<45 years: aHR 0.45, 95% CI 0.29-0.70; 45-49 years: aHR 0.43, 95% CI, 0.24-0.76).

Study details: This prospective cohort study enrolled 111,801 female health professionals aged 26-46 years with no history of cancer from the Nurses’ Health Study II.

Disclosures: The study was supported by the US National Institutes of Health (NIH). Some authors reported serving as consultants for or receiving research grants or personal fees from various organizations, including NIH.

Source: Ma W et al. Age at initiation of lower gastrointestinal endoscopy and colorectal cancer risk among US women. JAMA Oncol. 2022 (May 5). Doi: 10.1001/jamaoncol.2022.0883

Key clinical point: Colorectal cancer (CRC) screening before 50 years of age was associated with a reduced risk for CRC among US women, including CRC diagnosis before 55 years of age.

Major finding: Compared with no endoscopy, initiating endoscopy at the age of <45 (adjusted hazard ratio [aHR] 0.37; 95% CI 0.26-0.53), 45-49 (aHR 0.43; 95% CI 0.29-0.62), 50-54 (aHR 0.47; 95% CI 0.35-0.62), and ≥55 (aHR 0.46; 95% CI 0.30-0.69) years was associated with a significantly lower CRC risk, with initiating endoscopy before 50 years of age being associated with a decreased risk for CRC diagnosis before 55 years of age (<45 years: aHR 0.45, 95% CI 0.29-0.70; 45-49 years: aHR 0.43, 95% CI, 0.24-0.76).

Study details: This prospective cohort study enrolled 111,801 female health professionals aged 26-46 years with no history of cancer from the Nurses’ Health Study II.

Disclosures: The study was supported by the US National Institutes of Health (NIH). Some authors reported serving as consultants for or receiving research grants or personal fees from various organizations, including NIH.

Source: Ma W et al. Age at initiation of lower gastrointestinal endoscopy and colorectal cancer risk among US women. JAMA Oncol. 2022 (May 5). Doi: 10.1001/jamaoncol.2022.0883

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: The proximal serrated polyp (PSP) detection rate (DR) of an endoscopist is inversely associated with the incidence of interval post-colonoscopy colorectal cancer (CRC) and should be universally adopted as a separate quality indicator alongside adenoma DR (ADR) to accelerate CRC prevention.

Major finding: With each percentage point increase in PSP DR, the adjusted interval post-colonoscopy CRC rate reduced by 7% (adjusted hazard ratio 0.93; P < .0001).

Study details: This was a population-based study including patients aged 55-76 years with a positive fecal immunochemical test who underwent a colonoscopy; the data of 277,555 colonoscopies were included in the PSP DR calculations.

Disclosures: The study did not receive any funding. A few authors declared serving as speakers or advisory board members or receiving consulting fees or research grants from various sources.

Source: van Toledo DEFWM et al. Serrated polyp detection and risk of interval post-colonoscopy colorectal cancer: a population-based study. Lancet Gastroenterol Hepatol. 2022 (May 9). Doi: 10.1016/S2468-1253(22)00090-5

Key clinical point: Patients with synchronous (s) vs metachronous (m) onset of colorectal peritoneal metastasis (PM) had poor overall survival (OS) after cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC); however, s-PM was not an independent predictor of OS.

Major finding: Patients with s-PM vs m-PM had a significantly shorter median OS (28 vs 33 months; P = .045). However, rather than the onset of PM (P = .193), factors such as poor differentiation of the primary tumor (adjusted hazard ratio [aHR] 1.95; P = .001), N stage (aHR 1.76; P = .020), and peritoneal cancer index (aHR 1.07; P < .001) independently predicted OS.

Study details: Findings are from a retrospective study including 390 patients who underwent complete CRS-HIPEC for colorectal s-PM (diagnosed during presentation/staging/primary surgery; n = 179) or m-PM (diagnosed during follow-up; n = 211).

Disclosures: No source of funding was reported. the authors declared no conflicts of interest.

source: dietz mv et al. survival outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with synchronous versus metachronous onset of peritoneal metastases of colorectal carcinoma. Ann Surg Oncol. 2022 (May 5). Doi: 10.1245/s10434-022-11805-9

Key clinical point: Patients with synchronous (s) vs metachronous (m) onset of colorectal peritoneal metastasis (PM) had poor overall survival (OS) after cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC); however, s-PM was not an independent predictor of OS.

Major finding: Patients with s-PM vs m-PM had a significantly shorter median OS (28 vs 33 months; P = .045). However, rather than the onset of PM (P = .193), factors such as poor differentiation of the primary tumor (adjusted hazard ratio [aHR] 1.95; P = .001), N stage (aHR 1.76; P = .020), and peritoneal cancer index (aHR 1.07; P < .001) independently predicted OS.

Study details: Findings are from a retrospective study including 390 patients who underwent complete CRS-HIPEC for colorectal s-PM (diagnosed during presentation/staging/primary surgery; n = 179) or m-PM (diagnosed during follow-up; n = 211).

Disclosures: No source of funding was reported. the authors declared no conflicts of interest.

source: dietz mv et al. survival outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with synchronous versus metachronous onset of peritoneal metastases of colorectal carcinoma. Ann Surg Oncol. 2022 (May 5). Doi: 10.1245/s10434-022-11805-9

Key clinical point: Patients with synchronous (s) vs metachronous (m) onset of colorectal peritoneal metastasis (PM) had poor overall survival (OS) after cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC); however, s-PM was not an independent predictor of OS.

Major finding: Patients with s-PM vs m-PM had a significantly shorter median OS (28 vs 33 months; P = .045). However, rather than the onset of PM (P = .193), factors such as poor differentiation of the primary tumor (adjusted hazard ratio [aHR] 1.95; P = .001), N stage (aHR 1.76; P = .020), and peritoneal cancer index (aHR 1.07; P < .001) independently predicted OS.

Study details: Findings are from a retrospective study including 390 patients who underwent complete CRS-HIPEC for colorectal s-PM (diagnosed during presentation/staging/primary surgery; n = 179) or m-PM (diagnosed during follow-up; n = 211).

Disclosures: No source of funding was reported. the authors declared no conflicts of interest.

source: dietz mv et al. survival outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with synchronous versus metachronous onset of peritoneal metastases of colorectal carcinoma. Ann Surg Oncol. 2022 (May 5). Doi: 10.1245/s10434-022-11805-9

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Coadministration of proton pump inhibitors (PPI) may decrease the effectiveness of capecitabine monotherapy and worsen survival outcomes in patients with stage II-III colorectal cancer (CRC); however, this negative impact may be counteracted with capecitabine plus oxaliplatin (CapeOX).

Major finding: The concomitant use vs nonuse of PPI with capecitabine monotherapy led to shorter relapse-free survival (RFS; adjusted hazard ratio [aHR] 2.48; P = .013) and overall survival (OS; aHR 2.58; P = .052). However, use vs nonuse of PPI with CapeOX had no significant effect on RFS (aHR 0.82; P = .658) or OS (aHR 0.73; P = .621).

Study details: This was a retrospective study including 606 patients aged ≥20 years with stage II-III CRC, of which 54 patients received PPI with ≥1 dose of capecitabine monotherapy (n = 29) or CapeOX (n = 25).

Disclosures: The study was supported by the Keio Gijuku Fukuzawa Memorial Fund for the Advancement of Education and Research in Japan. R Uozumi declared receiving personal fees from a few sources. The other authors declared no conflicts of interest.

Source: Kitazume Y et al. Proton pump inhibitors affect capecitabine efficacy in patients with stage II–III colorectal cancer: A multicenter retrospective study. Sci Rep. 2022;12:6561 (Apr 21). Doi: 10.1038/s41598-022-10008-2

Key clinical point: Trifluridine/tipiracil plus bevacizumab (TT-B) appears to be a promising first-line therapeutic regimen for patients with unresectable metastatic colorectal cancer (mCRC) who are ineligible for intensive chemotherapy.

Major finding: The median overall survival (OS) with TT-B (22.3 months) vs capecitabine plus bevacizumab (C-B; 17.7 months) was longer by 4.6 months (adjusted hazard ratio 0.78; 95% CI 0.55-1.10). No new safety signals were observed.

Study details: The data are the final OS results of the phase 2 TASCO1 study that included 153 adult patients with unresectable mCRC who were randomly assigned to receive first-line TT-B (n = 77) or C-B (n = 76), with cycles repeated every 4 or 3 weeks, respectively.

Disclosures: The study was sponsored by Servier and Taiho. Some authors declared serving as advisory board members or meeting chairs of, or receiving research grants and travel and accommodation expenses from various organizations, including Servier and Taiho. The other authors are employees of Servier.

Source: Van Cutsem E et al. First-line trifluridine/tipiracil + bevacizumab in patients with unresectable metastatic colorectal cancer: Final survival analysis in the TASCO1 study. Br J Cancer. 2022;126:1548-1554 (Apr 19). Doi: 10.1038/s41416-022-01737-2

Key clinical point: Trifluridine/tipiracil plus bevacizumab (TT-B) appears to be a promising first-line therapeutic regimen for patients with unresectable metastatic colorectal cancer (mCRC) who are ineligible for intensive chemotherapy.

Major finding: The median overall survival (OS) with TT-B (22.3 months) vs capecitabine plus bevacizumab (C-B; 17.7 months) was longer by 4.6 months (adjusted hazard ratio 0.78; 95% CI 0.55-1.10). No new safety signals were observed.

Study details: The data are the final OS results of the phase 2 TASCO1 study that included 153 adult patients with unresectable mCRC who were randomly assigned to receive first-line TT-B (n = 77) or C-B (n = 76), with cycles repeated every 4 or 3 weeks, respectively.

Disclosures: The study was sponsored by Servier and Taiho. Some authors declared serving as advisory board members or meeting chairs of, or receiving research grants and travel and accommodation expenses from various organizations, including Servier and Taiho. The other authors are employees of Servier.

Source: Van Cutsem E et al. First-line trifluridine/tipiracil + bevacizumab in patients with unresectable metastatic colorectal cancer: Final survival analysis in the TASCO1 study. Br J Cancer. 2022;126:1548-1554 (Apr 19). Doi: 10.1038/s41416-022-01737-2

Key clinical point: Trifluridine/tipiracil plus bevacizumab (TT-B) appears to be a promising first-line therapeutic regimen for patients with unresectable metastatic colorectal cancer (mCRC) who are ineligible for intensive chemotherapy.

Major finding: The median overall survival (OS) with TT-B (22.3 months) vs capecitabine plus bevacizumab (C-B; 17.7 months) was longer by 4.6 months (adjusted hazard ratio 0.78; 95% CI 0.55-1.10). No new safety signals were observed.

Study details: The data are the final OS results of the phase 2 TASCO1 study that included 153 adult patients with unresectable mCRC who were randomly assigned to receive first-line TT-B (n = 77) or C-B (n = 76), with cycles repeated every 4 or 3 weeks, respectively.

Disclosures: The study was sponsored by Servier and Taiho. Some authors declared serving as advisory board members or meeting chairs of, or receiving research grants and travel and accommodation expenses from various organizations, including Servier and Taiho. The other authors are employees of Servier.

Source: Van Cutsem E et al. First-line trifluridine/tipiracil + bevacizumab in patients with unresectable metastatic colorectal cancer: Final survival analysis in the TASCO1 study. Br J Cancer. 2022;126:1548-1554 (Apr 19). Doi: 10.1038/s41416-022-01737-2