Use of Yttrium-90 Radioembolization for Management of Colorectal Liver Metastases
AbstractApproximately 20 % of patients diagnosed with colorectal cancer present with metastatic disease at the time of diagnosis, predominantly to the liver. Surgical resection is the only real chance at a cure for a majority of these patients. A subset of patients present with unresectable disease with systemic and local therapy as the only available options. The advent of irinotecan- and oxaliplatin-based systemic therapy has increased median survival from about 5 months to greater than 20 months in metastatic disease. Addition of local therapy has the potential to further improve outcomes. With many avenues of regio...
Source: Current Colorectal Cancer Reports - August 19, 2016 Category: Cancer & Oncology Source Type: research
Colorectal Cancer Screening: a North American Point of View
AbstractWorldwide, colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and second in females, with an estimated 1.4 million cases and 693,900 deaths in 2012. The current screening modalities utilized in the USA are examined in this review, along with current colonoscopy quality indicators. The contribution of CRC screening to the rising cost of health care in the USA has warranted recent public interest and has overall been demonstrated to be cost-effective. In addition, numerous barriers to screening are analyzed along with models for risk stratifying CRC risk at both an individual and population ...
Source: Current Colorectal Cancer Reports - August 16, 2016 Category: Cancer & Oncology Source Type: research
Organoids as a Model for Colorectal Cancer
AbstractModelling human diseases in in vitro systems is undisputedly an invaluable research tool, yet there are many limitations. Some of those limitations have been overcome through the introduction of organoid culture systems, which have revolutionised colorectal cancer research and enabled an array of new experimental techniques. This 3D system models the physiology, shape, dynamics and cell make-up of the intestinal epithelium producing a relevant and highly adaptable model system. The increased functional relevance of this model compared to the use of 2D cancer cell lines makes it an invaluable tool for both basic and...
Source: Current Colorectal Cancer Reports - August 5, 2016 Category: Cancer & Oncology Source Type: research
Adjuvant Chemotherapy for Rectal Cancer After Neoadjuvant Treatment: FOLFOX, 5-FU, or Observation
AbstractA multimodality approach incorporating concurrent chemotherapy with radiotherapy prior to surgery has become the standardized approach in the management of localized rectal cancer. However, it is unknown whether any further therapy after surgery may be beneficial in improving patient outcomes. Previous completed randomized clinical trials have not added any clarity in this regard, whether adjuvant chemotherapy or intensified chemotherapy regimens improve patient outcomes in those who have previously received neoadjuvant therapy. Despite the lack of evidence, based off the survival data in stage III colon cancer, ad...
Source: Current Colorectal Cancer Reports - August 3, 2016 Category: Cancer & Oncology Source Type: research
Advancements in Modeling Colorectal Cancer in Rodents
AbstractColorectal cancer (CRC) has become a large burden on the health care system with 700,000 people dying from this disease annually in the world. Rodent cancer models, especially the mouse models, play critical roles in the understanding of CRC etiology and the development of CRC therapies. This review is focused on reporting the significant progress that has been made in CRC studies using transplant models and forward genetics mouse models. Rat CRC models are also described as they were usually skipped in other related reviews. We also try to discuss what needs to be improved in rodent model studies to better serve a...
Source: Current Colorectal Cancer Reports - August 3, 2016 Category: Cancer & Oncology Source Type: research
Ramucirumab: a Novel Anti-Angiogenic Agent in the Treatment of Metastatic Colorectal Cancer
AbstractAngiogenesis is a multistep process that plays a key role in cancer growth and metastases. It is mediated through multiple vascular endothelial growth factor receptors (VEGFRs) and their ligands. The expression of VEGFR-2 is upregulated in tumor endothelial cells, and it is considered to be the primary receptor driving malignant angiogenesis. Ramucirumab (IMC-1121B, LY3009806) is a fully human monoclonal antibody that directly binds to VEGFR-2 with high affinity and specificity. It is also the most recent addition to our armamentarium of anti-angiogenic drugs approved for the treatment of metastatic colorectal canc...
Source: Current Colorectal Cancer Reports - August 1, 2016 Category: Cancer & Oncology Source Type: research
Findings from the Adjuvant Colon Cancer End Points (ACCENT) Collaborative Group: the Power of Pooled Individual Patient Data from Multiple Clinical Trials
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > Randomized clinical trials (RCTs) are relied upon for determining the standard of care and changes to the standard of care in oncology. Through data sharing, the pooled individual patient data (IPD) from these trials can provide high-quality sources and enriched power for analyses beyond the original goals of each trial. To address important scientific questions in early-stage colon cancer, the Adjuvant Colon Cancer End Points (ACCENT) Collaborative Group has continuously integrated IPD from large adjuvant colon cancer RCTs conducted worldwide. Thr...
Source: Current Colorectal Cancer Reports - July 29, 2016 Category: Cancer & Oncology Source Type: research
Treatment of High Rectal Cancers: Do We Need Radiation?
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > Before total mesorectal excision (TME) and radiation therapy/chemoradiation therapy (RT/CRT) were widely adopted in the treatment of rectal cancer, surgery alone was the standard. Therapies have since evolved to neoadjuvant RT or CRT followed by TME as the established paradigm for locally advanced disease. More recently, issues of toxicity and systemic metastasis have risen to the forefront, prompting the exploration of individualized strategies in an attempt to maximize potential cure and local control yet minimize late toxicities. In this article...
Source: Current Colorectal Cancer Reports - July 29, 2016 Category: Cancer & Oncology Source Type: research
Is There a Best Radiosensitizing Agent in the Treatment of Locally Advanced Rectal Cancer?
Abstract
Over the past several decades, the management of localized rectal cancer has evolved from surgery alone as the definitive treatment to incorporating both radiation and chemotherapy to improve rates of local control and disease-free survival. Several chemoradiation regimens have been tested with different mechanisms of action, efficacy, and toxicity. There is little debate that concurrent radiation and a fluoropyrimidine (5-fluorouracil (5-FU) or capecitabine) is the current standard of care prior to total mesorectal excision (TME). Attempts to add additional chemotherapy, such as oxaliplatin or i...
Source: Current Colorectal Cancer Reports - June 14, 2016 Category: Cancer & Oncology Source Type: research
Use of Bevacizumab in the Management of Potentially Resectable Colorectal Liver Metastases: Safety, Pathologic Assessment and Benefit
Abstract
Liver metastases are a frequent and commonly lethal complication of colorectal cancer. Surgical resection of limited liver disease offers currently the best chance of long-term survival, but surgery is not feasible for a rather significant proportion of patients with hepatic metastases. Despite the overall improvement in the medical management of patients with metastatic colorectal cancer, whose median survival has been substantially prolonged with the availability of novel drugs, long-term outcomes remain rather poor if a combined onco-surgical strategy cannot be implemented. Nonetheless, newer ...
Source: Current Colorectal Cancer Reports - June 3, 2016 Category: Cancer & Oncology Source Type: research
Surgical Management of the Colorectal Cancer Patient with Simultaneous Liver and Lung Metastases
The objective of this review is not only to review long-term outcomes after resection of simultaneous colorectal liver and lung metastases but also apply recent data regarding the (1) evolution of indeterminate pulmonary nodules discovered during staging evaluation of colorectal liver metastases, (2) impact of genetic mutations in colorectal cancer on disease outcomes, and (3) influence of lung metastases on overall survival outcomes to the management of patients with simultaneous colorectal liver and lung metastases. (Source: Current Colorectal Cancer Reports)
Source: Current Colorectal Cancer Reports - May 27, 2016 Category: Cancer & Oncology Source Type: research
Managing the Primary Tumor with Unresectable Synchronous Colorectal Metastases
Abstract
Colorectal cancer is the third most commonly diagnosed cancer in men and the second most common in women. Approximately 20 % of patients with colorectal cancer are found to have metastatic disease (stage IV) at the time of diagnosis. A multidisciplinary approach provides the best chance for a potentially curative option in selected patients with metastases, but in most patients, the metastases are unresectable. The treatment strategy for this entity is not fully established, especially regarding whether and when the primary tumor should be resected. In this manuscript, we review current evidence...
Source: Current Colorectal Cancer Reports - May 15, 2016 Category: Cancer & Oncology Source Type: research
The Economics of Personalized Therapy in Metastatic Colorectal Cancer
Abstract
Though the prognosis for patients with advanced colorectal cancer has improved significantly over the past two decades due to the development of new chemotherapeutics and biologic agents, this progress has come at an increased cost to patients and to the healthcare system. The cost of cancer care in the USA is rising at an alarming rate and far in excess of spending in other developed countries. The identification of predictive biomarkers that can help clinicians target existing and future therapies to patients who are most likely to benefit (and away from patients who would not benefit) has the ...
Source: Current Colorectal Cancer Reports - May 13, 2016 Category: Cancer & Oncology Source Type: research
Imaging Advances in Colorectal Cancer
Abstract
The optimal management of rectal cancer is achieved through a shared multidisciplinary decision making process with accurate staging by imaging being critical for treatment planning. Good quality, high-resolution MRI has become the imaging gold standard as it allows consistent staging and stratification of patients into distinct prognostic groups according to MR-findings. Imaging features other than T and N have been proven to influence patient outcomes, and increasingly these features are taken into consideration when determining treatment options: distance of tumour to the potential circumferen...
Source: Current Colorectal Cancer Reports - April 26, 2016 Category: Cancer & Oncology Source Type: research
Surgical Margin in Hepatic Resections for Colorectal Metastasis: Should We Care?
Abstract
Many studies seek to define the appropriate margin width necessary to confer the best survival advantage following hepatic resection for colorectal metastatic disease. The ability to achieve at least a 1-cm tumor-free margin has historically represented one of the strongest prognostic factors determining overall outcomes and has been a necessary condition for resectability. With the advent of modern chemotherapy, the importance of surgical margin width is increasingly questioned and our understanding of its impact is evolving concomitantly to the improvement and the widespread use of more effecti...
Source: Current Colorectal Cancer Reports - April 18, 2016 Category: Cancer & Oncology Source Type: research
