Trends in Colorectal Cancer Surveillance: Current Strategies and Future Innovations-
AbstractPurpose of ReviewThis review article strives to reflect on the historic surveillance debate in colorectal cancer, outline current strategies, and guidelines, and discuss new techniques being explored in surveilling colorectal adenocarcinoma.Recent FindingsWithin the past decade, major governing bodies have proposed surveillance guidelines with the goal of earlier identification of cancer recurrence, thereby possibly reducing the morbidity and mortality of necessary interventions. With the innovation of tissue-specific tumor markers and fluorescence endoscopy, the approach to surveillance may be changing. The use of...
Source: Current Colorectal Cancer Reports - April 25, 2019 Category: Cancer & Oncology Source Type: research

Current Trends in Colorectal Cancer Screening
AbstractPurpose of ReviewThe following review is to assess the current methods, both non-invasive and invasive, in colorectal cancer screening and discuss novel screening techniques.Recent FindingsColorectal cancer continues to affect millions of people across the world. Through increased and widespread adoption of various screening methods, the rates of colon cancer-related deaths are decreasing. However, this decline has not been observed worldwide, possibly due to the lack of widespread screening adoption. Although there are many methods for screening colorectal cancer, colonoscopy remains the gold standard, due to high...
Source: Current Colorectal Cancer Reports - April 10, 2019 Category: Cancer & Oncology Source Type: research

Targeted Therapy in Metastatic Colorectal Cancer: Current Standards and Novel Agents in Review
AbstractPurpose of ReviewTreatment options for patients with metastatic colorectal cancer continue to advance as the therapeutic implications of the molecular subtypes of this disease are becoming better understood. DNA sequencing and mismatch repair assessment are now standard of care analyses for patients with metastatic colorectal cancer This review describes important aspects of the biology of the clinically relevant molecular subtypes of colorectal cancer based on the current standard of care testing. In addition, the clinical treatment strategies available now and potentially in the future for these colorectal cancer...
Source: Current Colorectal Cancer Reports - March 19, 2019 Category: Cancer & Oncology Source Type: research

The Duplex Interaction of Microbiome with Chemoradiation and Immunotherapy: Potential Implications for Colorectal Cancer
AbstractPurpose of reviewGut microbiota has the ability to modify the metabolism of wide array of therapeutic drugs. Current treatment modalities used in colorectal cancer have a narrow therapeutic index with a side effects profile that decreases tolerance to these treatments and adversely affects treatment outcome. Harnessing the gut microbiota ability to modify oncotherapeutic drugs metabolism and hence efficacy, could be potentially used to improve treatment outcomes in colorectal cancer patients. This review will shed lights on important findings from recent microbiome interaction studies which would hopefully serve as...
Source: Current Colorectal Cancer Reports - March 11, 2019 Category: Cancer & Oncology Source Type: research

Current Trends in the Management of Low Rectal Tumors: Transanal Total Mesorectal Excision
AbstractPurpose of ReviewThe access of the low rectum is a surgical challenge and, in case of cancer, the outcome of the patient depends on the quality of the surgery. The transanal total mesorectal excision (taTME) is a surgical technique with a combined abdominal and perineal approach. We review the literature for technical aspect of taTME as well as comparisons with other techniques.Recent FindingsComparison with laparoscopic total mesorectal excision and taTME was summarized in a meta-analysis which showed better oncological results with lower circumferential margin involvement and better completeness of the mesorectum...
Source: Current Colorectal Cancer Reports - March 7, 2019 Category: Cancer & Oncology Source Type: research

Systemic Therapy in BRAF V600E-Mutant Metastatic Colorectal Cancer: Recent Advances and Future Strategies
AbstractPurpose of ReviewThis review seeks to detail the clinical and pathologic features specific toBRAFV600E colorectal cancer. Application of novel preclinical findings translated into the clinic for the development of new therapeutic options for patients withBRAFV600E metastatic colorectal cancer will be detailed.Recent FindingsWhile BRAF inhibitors as monotherapy do not have the same clinical activity for colorectal cancer relative to other solid tumors harboring an oncogenicBRAFV600E mutation, combination approaches targeting BRAF + MEK + EGFR hold promise for patients withBRAFV600E colorectal cancer.SummarySimultane...
Source: Current Colorectal Cancer Reports - March 5, 2019 Category: Cancer & Oncology Source Type: research

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS) for Colorectal Cancer: Potential for Individualized Care, Review of Current Treatment Trends, Recent Advancements, and a Look into the Future
AbstractPurpose of ReviewPeritoneal metastases (PM) secondary to colorectal cancer is associated with a poor prognosis. However, cytoreductive surgery with hyperthermia intraperitoneal chemotherapy (CRS/HIPEC) has risen to a more accepted roll in the treatment of peritoneal metastatic disease for various cancers; colorectal cancer is no exception. This review aims to discuss the recent updates and findings for treatment of peritoneal disease secondary to colorectal cancer, especially with respect to individualized patient factors that affect outcomes.Recent FindingsThere are many new studies showing the validity of cytored...
Source: Current Colorectal Cancer Reports - February 21, 2019 Category: Cancer & Oncology Source Type: research

Deciphering the Colorectal Cancer Gut Microbiota: Association vs. Causality
AbstractPurpose of ReviewStudies have identified differences between the gut microbiota of colorectal cancer (CRC) patients versus healthy individuals. In this review, we assess the scientific literature to determine if gut microbes should be considered causal, co-varying, or a necessary but not sufficient agent in CRC development.Recent FindingsOral bacteria may influence CRC susceptibility. Colonic biofilms in both sporadic and hereditary CRC suggest these bacteria are present in early neoplasia. Pathogenic drivers and opportunistic passenger bacteria may underlie direct effect of the gut microbiota on carcinogenesis.Sum...
Source: Current Colorectal Cancer Reports - February 20, 2019 Category: Cancer & Oncology Source Type: research

Current Surgical Strategies in the Management of Rectal Cancer
AbstractPurpose of ReviewThe surgical approach to rectal cancer has become significantly more complex with the introduction of neoadjuvant therapies and organ preservation strategies. Optimal radiological imaging in association with relevant clinical findings provides critical information for final surgical management decision. The present review focuses on the surgical alternatives available in different clinical scenarios for the management of rectal cancer.Recent FindingsMost of evidence for surgical management of rectal cancer is provided by non-randomized studies. However, a few randomized clinical trials have attempt...
Source: Current Colorectal Cancer Reports - February 13, 2019 Category: Cancer & Oncology Source Type: research

Techniques for Colorectal Anastomotic Construction Following Proctectomy and Variables Influencing Anastomotic Leak
AbstractPurpose of ReviewExamine the various technical considerations for pelvic colorectal reconstruction with respective functional and anastomotic healing outcomes. Additionally, several adjuncts to reduce anastomotic complications are individually explored to understand their relative impact on anastomotic healing.Recent FindingsThe benefit of a colorectal reservoir reconstruction instead of a straight anastomosis, in respect to leak and functional outcomes, is marginal, if any. Recent randomized evidence has shown no difference in morbidity, mortality, survival, leakage, or functional outcomes. Unfortunately, anastomo...
Source: Current Colorectal Cancer Reports - February 7, 2019 Category: Cancer & Oncology Source Type: research

A Surgeon ’s Guide to Treating Older Patients With Colorectal Cancer
AbstractPurpose of ReviewReview strategies to improve outcomes of colorectal cancer treatment in older patients.Recent FindingsOlder colorectal patients face many barriers to recovery during their initial inpatient stay following surgery and after leaving the hospital. In addition to the risk of inpatient morbidity and mortality, older patients are more likely to require post-acute care services to face nutritional deficits and to experience complications of chemoradiation.SummaryIn order to improve outcomes for older patients with colorectal cancer, it is important for surgeons to recognize their unique needs and to devel...
Source: Current Colorectal Cancer Reports - February 7, 2019 Category: Cancer & Oncology Source Type: research

Current Status of Maintenance Systemic Therapies in Metastatic Colorectal Cancer: 2018 Update
This article is an update of the 2017 review by Quidde et al. and evaluates the most recent data on maintenance strategies in MCRC.Recent FindingsInduction followed by maintenance and if feasible re-induction treatment does not seem to be inferior to continuous full-dose treatment for patients with MCRC responding to first-line combination regimen but without options for secondary resection or local ablation. Active maintenance seems to be superior to complete stop after at least 3  months of induction treatment in terms of progression-free survival and may add some benefit in terms of OS. The addition of PD-L1 inhibition...
Source: Current Colorectal Cancer Reports - January 24, 2019 Category: Cancer & Oncology Source Type: research

What Is the Future of Circulating Tumor Cells in Colorectal Cancer?
AbstractPurpose of ReviewTo introduce recent progress on circulating tumor cell (CTC) research in colorectal cancer (CRC) and to highlight clinical application of CTCs from detection to assessment of treatment response.Recent FindingsCTC biological characteristics in CRC play an important role in the detection of CTCs. The in vitro culture of CTCs from CRC patients (cell lines and organoids) can potentially facilitate rapid drug testing and treatment prediction. CTC detection should be standardized with improved detection rate in CRC; further, clinical investigation is still needed to clarify its potential as a tool for ea...
Source: Current Colorectal Cancer Reports - November 26, 2018 Category: Cancer & Oncology Source Type: research

Colorectal Cancer and Metabolism
AbstractPurpose of ReviewMetabolic reprogramming is essential for the rapid proliferation of cancer cells and is thus recognized as a hallmark of cancer. In this review, we will discuss the etiologies and effects of metabolic reprogramming in colorectal cancer.Recent FindingsChanges in cellular metabolism may precede the acquisition of driver mutations ultimately leading to colonocyte transformation. Oncogenic mutations and loss of tumor suppressor genes further reprogram CRC cells to upregulate glycolysis, glutaminolysis, one-carbon metabolism, and fatty acid synthesis. These metabolic changes are not uniform throughout t...
Source: Current Colorectal Cancer Reports - November 16, 2018 Category: Cancer & Oncology Source Type: research

Novel Targets in Advanced Colorectal Cancer
AbstractPurpose of ReviewAlthough current guidelines suggest only testing for RAS and BRAF mutations as well as MMR deficiency in metastatic colon cancer, there are many other promising therapeutic targets that are being studied. We aim to review the recent literature and evidence behind some of these novel targets.Recent FindingsMany of these targets such as NTRK, ROS, ALK, and HER2 are being studied in current clinical trials and hold great potential in changing the treatment landscape for metastatic colorectal cancer.SummaryCurrent molecular testing algorithms may need to be expanded to allow better target discovery and...
Source: Current Colorectal Cancer Reports - November 6, 2018 Category: Cancer & Oncology Source Type: research