Translational Considerations on the Outlook of Immunotherapy for Colorectal Cancer
Abstract
Immunotherapy is an emerging strategy for many types of cancers and is already a standard treatment for malignant melanoma. Several aspects of colorectal cancer would appear to make it a good target for immunotherapy. Colorectal cancer is associated with a high mutation burden that may generate tumor-specific neo-epitopes that could elicit adaptive immune responses. Tumors with infiltrating immune cells appear to have better clinical outcome and response to chemotherapy. Patients with impaired DNA repair mechanisms have circulating antibodies and T cells that recognize resulting frameshift peptid...
Source: Current Colorectal Cancer Reports - February 10, 2015 Category: Cancer & Oncology Source Type: research
Hepatic Resection for Extrahepatic Metastatic Disease: When Is It Reasonable?
Abstract
The presence of limited and resectable extrahepatic metastases (EHM) in addition to colorectal liver metastases (LM) is no longer a contraindication to surgery. Long-term survival (between 25 and 30 % at 5 years) is possible for highly selected patients. The site of occurrence is a key prognostic factor. Results are best for lung EHM and limited peritoneal metastases (PM), lower when EHM invade the proximal hepatic lymph nodes, and worse for other EHM. Treatment decision making is difficult when faced with an infinite number of possible combinations between the different sites of metastases, th...
Source: Current Colorectal Cancer Reports - February 10, 2015 Category: Cancer & Oncology Source Type: research
What Are the Best Questionnaires To Capture Anorectal Function After Surgery in Rectal Cancer?
This article reviews various questionnaires for capturing anorectal function after surgery in rectal cancer, discussing their attributes and suitability for different evaluation contexts. (Source: Current Colorectal Cancer Reports)
Source: Current Colorectal Cancer Reports - February 1, 2015 Category: Cancer & Oncology Source Type: research
Prediction of Colorectal Cancer or Colonic Neoplasia Risk: From Symptoms to Scores
Abstract
A large part of colorectal cancer (CRC) could be prevented if our current knowledge of risk factors was used to identify high-risk patients and to provide them efficient and adapted screening. Algorithms allowing the estimation of the individual risk of currently having or developing a CRC has been developed. Though these scores have a real potential in triage ability, their clinical impact as triage tools or to design tailored preventive action remains poor. (Source: Current Colorectal Cancer Reports)
Source: Current Colorectal Cancer Reports - January 17, 2015 Category: Cancer & Oncology Source Type: research
Colonoscopy for Colorectal Cancer Screening: Current Challenges and Future Directions
Abstract
It is estimated that over 50,000 people will die from colorectal cancer (CRC) in 2014, making CRC the third leading cause of cancer death in the USA. During the last decade, we gained a better understanding of CRC pathophysiology and improved techniques for CRC prevention. Colonoscopy, as a cancer prevention measure, is essential in this task. Our article will review several aspects of colonoscopy and its use in CRC prevention. In addition, we will cover non-technical aspect such as quality measures, improving colonoscopy uptake, new bowel preparation formulations, sedation, and quality metrics. ...
Source: Current Colorectal Cancer Reports - December 11, 2014 Category: Cancer & Oncology Source Type: research
Identifying Appropriate Colorectal Cancer-Associated Antigens for the Clinical Trials
Abstract
Clinical trials using immunotherapy as a targeted approach to the treatment of metastatic colorectal cancer (CRC) have limited clinical efficacy. Lack of proper identification of colorectal cancer-associated antigens and complexity of immunological functions could have hampered the proper therapeutic development. The review focuses on the tumor-associated antigens (TAA) that have been tested in clinical trial setting for treatment of advanced CRC. Since many of the tumor-associated antigens including carcinoembryonic antigen (CEA), beta human chorionic gonadotrophin (β-hCG), MUC1, guanylyl cycla...
Source: Current Colorectal Cancer Reports - December 11, 2014 Category: Cancer & Oncology Source Type: research
MUTYH Status and Colorectal Cancer Risk: Implication for Surveillance
Abstract
MUTYH polyposis (MAP) is responsible for approximately 10 and 30 % of classical and attenuated forms of adenomatous colorectal polyposes, respectively. The underlying molecular mechanism is a biallelic germline mutation of the MUTYH gene responsible for the failure of the base excision repair (BER) DNA repair system with subsequent accumulation of somatic transversion mutations. The cumulative risk of colorectal cancer is very high in the absence of adequate care. Lifelong close colonoscopic surveillance with polypectomies is recommended. Surgery (total rather than partial c...
Source: Current Colorectal Cancer Reports - December 11, 2014 Category: Cancer & Oncology Source Type: research
Are NSAIDs Coming Back to Colorectal Cancer Therapy or Not?
Abstract
Despite adjuvant chemotherapy, between 20 and 50 % of patients with stage II/III colorectal cancer (CRC) will suffer recurrence, usually as incurable metastatic disease. Attempts to improve the efficacy of adjuvant regimens with addition of biologics have failed, and there is therefore a pressing need for novel therapeutic approaches. Inflammatory mediators, including the cyclooxygenase (COX) enzyme family, are commonly upregulated in CRC and known to promote tumour growth in preclinical models. COX inhibition by aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) may exert an ant...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
How Can Next-Generation Sequencing (Genomics) Help Us in Treating Colorectal Cancer?
Abstract
Next-generation sequencing methods have exponentially increased the amount of genomic information available to scientists and clinicians. This review will explain the evolution of tumor gene sequencing and identify its potential to accelerate therapeutic progress by using colorectal cancer to illustrate the benefits of this type of analysis. A milestone in sequencing occurred when The Cancer Genome Atlas investigators characterized the genomes of 276 colorectal cancer samples, with the resulting information expected to provide future clinical applications and help to guide the treatment of colo...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
Mechanisms by Which Pleiotropic Amphiphilic n −3 PUFA Reduce Colon Cancer Risk
Abstract
Colorectal cancer is one of the major causes of cancer-related mortality in both men and women worldwide. Genetic susceptibility and diet are primary determinants of cancer risk and tumor behavior. Experimental, epidemiological, and clinical data substantiate the beneficial role of n−3 polyunsaturated fatty acids (PUFA) in preventing chronic inflammation and colon cancer. From a mechanistic perspective, n−3 PUFA are pleiotropic and multifaceted with respect to their molecular mechanisms of action. For example, this class of dietary lipid uniquely alters membrane structure/cytoskeletal funct...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
Can Circulating MicroRNAs Become the Test of Choice for Colorectal Cancer?
Abstract
MicroRNAs (miRNAs) are small noncoding RNA strings of 19–25 nucleotides, encoded by eukaryotic genomic DNA, which function in the posttranscriptional regulation of target gene expression via base pairing with complementary sequences in messenger RNAs (mRNAs), to induce mRNA degradation and translational inhibition. Aberrant miRNA modifications occur at a very early stage in colorectal cancer (CRC) development and are widely described as essential players in its progression. As circulating cell-free miRNAs have become identified, the potential of cell-free miRNAs in the blood or other body flu...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
Anti-EGFR Resistance in Colorectal Cancer: Current Knowledge and Future Perspectives
Abstract
Anti-EGFR therapy in metastatic colorectal cancer (mCRC) has improved survival outcome. However, many patients do not respond to this therapy and almost all patients develop resistance after a few months of treatment. Since 2008, the therapy has been restricted to patients without mutations in KRAS, an important target in the EGFR pathway, as these patients do not benefit from anti-EGFR therapy. Recently, this has been changed to an all-RAS wild-type strategy. Despite these restrictions, still 40 to 60 % of mCRC patients are resistant. New biomarkers need to be identified in order to improve p...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
The Role of Predictive Molecular Biomarkers for the Treatment of Metastatic Colorectal Cancer
Abstract
Colorectal cancer (CRC) is a major public health problem in the USA and globally. Over the past 20 years, significant advances have been made in the treatment of patients with metastatic colorectal cancer (mCRC). Recent efforts have focused on developing molecular biomarkers to further define the subset of patients with mCRC who would derive a substantial benefit from anti-epidermal growth factor receptor (EGFR) therapy. Activating mutations in KRAS and NRAS are a predictive marker for resistance to anti-EGFR therapy in mCRC. BRAF
V600E and PIK3CA mutations have been repo...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
Dendritic Cell Cancer Vaccines for Treatment of Colon Cancer
Abstract
Despite advances in treatment modalities, colorectal cancer (CRC) still accounts for about half a million deaths yearly worldwide. The majority of metastatic CRC are unresectable, and of those who undergo resection, few are cured. Advances in chemotherapy and targeted therapy have improved survival, but options remain limited, making the case for incorporating novel modalities in CRC treatment paradigm. Our improved understanding of the tumor immune microenvironment had led to the development of novel immunotherapeutic agents that have been tested in clinical trials such as cancer vaccines. Can...
Source: Current Colorectal Cancer Reports - November 12, 2014 Category: Cancer & Oncology Source Type: research
Targeting Cancer Stem Cells by Phytochemicals: a Multimodal Approach to Colorectal Cancer
Abstract
Cancer stem cells (CSCs) exist within a tumor as a rare subpopulation, with the capacity of self-renewal and the ability to differentiate into heterogeneous population of cancer cells. CSCs are increasingly being implicated in tumor recurrence thereby further augmenting the menace of the malignant disease. Characterization of CSCs has unearthed their pivotal role in all the hallmarks of cancer including tumorigenesis, angiogenesis, metastasis and drug resistance, thereby designating cancer as a “stem cell disease.” Here, we discuss the limitations of current therapeutic strategies that spare ...
Source: Current Colorectal Cancer Reports - October 3, 2014 Category: Cancer & Oncology Source Type: research
