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Folic Acid May Be Beneficial in Patients with Recurrent Colorectal Adenoma Who Are Folate Deficient (11/20/2009)
Researchers affiliated with the Health Professional Follow-Up Study and the Nurses’ Health Study have reported that folic acid supplementation in patients with recurrent colorectal adenoma was not protective or harmful in most patients. However, patients who were folate deficient had a significant 39% decrease in adenoma recurrence. The details of this study appeared in an early online publication on October 28, 2009 in the American Journal of Clinical Nutrition.
Early Morning Colonoscopies Detect More Polyps (11/13/2009)
Researchers affiliated with the Veterans Administration of greater Los Angeles have reported that a greater number of polyps was detected among patients seen early in the morning than among patients seen later in the day. The reasons for this are uncertain, but it’s possible that the lower rate of polyp detection later in the day is the result of provider fatigue or less complete bowel preparation. These results were published in November, 2009 issue of Clinical Gastroenterology and Hepatology.
Israeli Jewish Holocaust Survivors May Have Increased Risk of Cancer (11/12/2009)
Researchers from Israel have reported that the incidence of all cancers, and especially breast and colorectal cancers, is higher among Israeli Jews who were potentially exposed to the Holocaust compared with those who were not. The details of this study were published in the November 4, 2009 issue of the Journal of the National Cancer Institute.
Daily Aspirin May Decrease Risk of Colorectal Cancer in Lynch Syndrome (10/7/2009)
Researchers involved in the international multi-institutional study, CAPP2, have reported that the use of daily aspirin may reduce the incidence of colorectal adenomas and cancers in individuals with hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch Syndrome. The details of this study were presented on September 21, 2009 at Europe’s largest cancer congress, ECCO 15-ESMO 34, in Berlin.
Vectibix® plus Chemotherapy Improves Progression-free Survival After Initial Treatment of Metastatic Colorectal Cancer (9/30/2009)
Researchers involved in the international randomized trial, PRIME, have reported that the addition of Vectibix® (panitumumab) to FOLFOX4 chemotherapy improves progression-free survival (PFS) compared with FOLFOX4 alone in patients with previously untreated metastatic colorectal cancer. This benefit was only observed in patients whose tumors did not contain a mutation in the KRAS gene (those with wild type). These results were presented at the Joint ECCO 15 -34th ESMO Multidisciplinary Congress in Berlin, September 20-24, 2009.
Extended Lymphadenectomy May Not Improve Outcomes of Patients with Rectal Cancer (9/29/2009)
Researchers from the UK have reported that extended lymphadenectomy for rectal cancer may not improve outcomes and may increase the risk of urinary and sexual dysfunction. The details of this study appeared in an early online publication in Lancet Oncology on September 20, 2009.
Vectibix® Improves PFS in Second-line Therapy of Colorectal Cancer with FOLFIRI (9/23/2009)
Researchers involved in an international randomized trial have reported that the addition of Vectibix® (panitumumab) to FOLFIRI (5-fluorourcil, Camptosar® [irinotecan], and leucovorin) improves progression-free survival (PFS) in patients with colorectal cancer with wild-type KRAS receiving second-line therapy. The details of this study were presented at the Joint ECCO 15-34th ESMO Congress in Berlin, September 20-24.
Adherence Important for Effectiveness of Diet in Preventing Colorectal Adenoma Recurrences (8/31/2009)
Researchers associated with the U.S. Polyp Prevention Trial have reported that high compliance with a low-fat, high-fiber diet is associated with a reduced risk of adenoma recurrence. The details of this study appeared in the September 1, 2009 issue of the American Journal of Epidemiology.
Addition of Vectibix® to Second-line Chemotherapy Improves Progression-free Survival in Metastatic Colorectal Cancer (8/27/2009)
A press release from Amgen has reported that patients with previously treated metastatic colorectal cancer with KRAS wild-type have delayed cancer progression following treatment with Vectibix® (panitumumab) and chemotherapy.
FDG-PET Scans Reduce Number of Futile Surgeries for Hepatic Colorectal Metastases (8/25/2009)
Researchers from the Netherlands have reported that the use 18F-FDG PET scans reduced the number of futile surgeries for hepatic metastases from 45% to 28%. The details of this study appeared in the July 2009 issue of the Journal of Nuclear Medicine.
Regular Aspirin Use Decreases Mortality After the Diagnosis of Colorectal Cancer (8/14/2009)
Researchers from Harvard Medical School have reported that regular aspirin use after the diagnosis of colorectal cancer decreases the risk or dying of colorectal cancer that expresses COX-2. The details of this study were published in the August 12, 2009 issue of the Journal of the American Medical Association.
Addition of Vectibix® to First-line Chemotherapy Improves Progression-free Survival in Metastatic Colorectal Cancer (8/11/2009)
Among patients with metastatic colorectal cancer, the addition of the targeted therapy Vectibix® (panitumumab) to chemotherapy delayed cancer progression. This benefit was only observed in patients whose tumors did not contain a mutation in the KRAS gene. These results were made available in a press release from Amgen.
False-positive Results Are Common with Cancer Screening (7/21/2009)
Researchers affiliated with the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial have reported that the risk of obtaining a false-positive result from screening for prostate, lung, colorectal, and ovarian cancer is high and becomes cumulatively higher with ongoing screening—after 14 screening tests, the cumulative risk of a false-positive is 60.4% for men and 48.8% for women. The results of this study were published in the May/June 2009 issue of the Annals of Family Medicine.
Meta-analysis Confirms that Diet and Lifestyle Choices Are Key to Preventing Colorectal Cancer (7/10/2009)
Researchers from Australia have reported that exercise, diet, and lifestyle choices are key factors in preventing colon cancer. The details of this study were published in the July 1, 2009 issue of the International Journal of Cancer.
Age and Illness Increase Colonoscopy Risks (6/22/2009)
Researchers from the National Cancer Institute and the University of North Carolina have reported that the risk of complications from colonoscopy is increased in the very elderly and in those with certain chronic health conditions. The results of this study were published in the June 16, 2009 issue of the Annals of Internal Medicine.
Preemptive Skin Treatment Reduces Skin Toxicity Associated with Vectibix® in Patients with Metastatic Colorectal Cancer (6/10/2009)
Researchers affiliated with a U.S. multicenter trial have reported that skin treatment that is initiated prior to the start of treatment with Vectibix® (panitumumab) reduces the incidence and severity of skin toxicity and improves quality of life in patients with metastatic colorectal cancer. The details of this study were presented at the 2009 annual meeting of the American Society of Clinical Oncology in Orlando, Florida, on June 1.
Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer (6/4/2009)
Researchers from the Memorial Sloan-Kettering Cancer Center have reported that patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications. The details of this study were presented at the 2009 Annual Meeting of the American Society of Clinical Oncology in Orlando, Florida, on March 31.
Coffee Does Not Decrease Risk of Colorectal Cancer (5/5/2009)
Researchers from the Harvard School of Public Health have reported that, contrary to the results of several previous studies, coffee consumption does not appear to reduce the risk of colorectal cancer. The details of this study were reported in the April 1, 2009 issue of the International Journal of Cancer.
Neoadjuvant Xeloda®, Eloxatin®, and Radiotherapy Highly Effective for Locally Advanced Rectal Cancer (5/4/2009)
Researchers from Italy have reported that neoadjuvant Xeloda® (capecitabine), Eloxatin® (oxaliplatin), and radiotherapy results in a high rate of complete and near complete responses in patients with Stage II-III rectal cancer. The details of this study appeared in the May 1, 2009 issue of Annals of Oncology.
Erbitux® plus FOLFIRI Reduces Time to Recurrence as First-line Treatment of Metastatic Colorectal Cancer (4/3/2009)
Researchers affiliated the CRYSTAL trial have reported that the addition of Erbitux® (cetuximab) to FOLFIRI chemotherapy reduces the risk of progression in patients with metastatic colorectal cancer. The details of this study were published in the April 2, 2009 issue of the New England Journal of Medicine.
TheraSphere® Shows Promise in Treatment of Liver Metastases (3/19/2009)
Researchers from Northwestern University have reported that radioembolization of colorectal hepatic metastases with TheraSphere® (yttrium-90 microspheres) appears to produce sustained stable disease in some patients. Results of this Phase II trial appeared early online in Cancer on March 6, 2009.
Meta-analysis Confirms that Aspirin Helps Prevent Colorectal Adenomas (3/17/2009)
An international group of researchers have reported that daily use of aspirin may reduce the risk of colorectal adenomas, especially advanced lesions. The details of this study appeared in the February 2009 issue of the Journal of the National Cancer Institute.
Moderate Alcohol Consumption Increases Risk of Cancer in Women (3/13/2009)
Researchers from the UK have reported that women who regularly consume low to moderate amounts of alcohol have an increased risk of cancers of the upper digestive tract, rectum, liver, and breast when compared with women who do not drink. The results of this study were published in the March 4, 2009 issue of the Journal of the National Cancer Institute.
Neoadjuvant Radiation Therapy Prevents Local Recurrences of Operable Rectal Cancer (3/9/2009)
Researchers affiliated with a multicenter international randomized trial have reported that a short course of preoperative radiotherapy is effective treatment for patients with operable rectal cancer. The details of this randomized trial were published in the March 7, 2009 issue of the Lancet.
Patients with Rectal Cancer Responding to Neoadjuvant Radiation Therapy Have Improved Survival (3/6/2009)
Researchers from Vanderbilt University have reported that patients with rectal cancer who are downstaged by neoadjuvant radiation therapy have improved outcomes compared with non-responders. The details of this study appeared in the February, 2009 issue of the Archives of Surgery.
Mailed Reminders Promote Colorectal Cancer Screening (3/2/2009)
Researchers from Harvard University have reported that mailed reminders improve colorectal cancer screening rates. The details of this study appeared in the February 23, 2009 issue of the Archives of Internal Medicine.
Test May Help Predict Recurrence Risk in Early Colorectal Cancer (2/27/2009)
Researchers from Thomas Jefferson University, McGill University, and the Fox Chase Cancer Center have reported that testing lymph nodes for the presence of a protein known as guanylyl cyclase 2C (GUCY2C) may help predict risk of recurrence among colorectal cancer patients with no apparent lymph node metastases (pN0). These results were published in the February 18, 2009 issue of the Journal of the American Medical Association.
Calcium Rich Diet May Reduce Colorectal Cancer Risk (2/26/2009)
Researchers from the National Cancer Institute have reported that high calcium intake is associated with a “lower risk of total cancer and cancers of the digestive system, especially colorectal cancer.” The details of this study appeared in the February 23, 2009 issue of the Archives of Internal Medicine.
Colorectal Cancer FOBT Screening Reduces Mortality (2/26/2009)
Researchers from Italy have reported that the implementation of colorectal cancer screening by a fecal occult blood test (FOBT) appears to reduce mortality, as evidenced by the disparity between mortality rates among regions that implemented FOBT screening at different times. The results of this study were published in the December 17, 2008 issue of the Journal of the National Cancer Institute.
Aspirin and/or Resistant Starch Have No Effect on Colorectal Cancer Incidence Among People with Lynch Syndrome (2/23/2009)
Researchers involved in an international multi-institutional study have reported that the use of aspirin and/or resistant starch has no effect on the incidence of colon cancer among individuals with Lynch Syndrome. The details of his study were published in the December 11, 2008 issue of the New England Journal of Medicine.
Newer Immunochemical Fecal Occult Blood Tests Confirmed More Reliable Than Older Guaiac Tests for Detection of Colorectal Cancer (2/17/2009)
Researchers from Germany have reported that immunochemical tests for fecal blood are more accurate than the older guaiac test but different immunochemical tests have significant variability in accuracy. The details of this study were reported in the February 3, 2009 issue of the Annals of Internal Medicine.
Addition of Erbitux® to Avastin®-based Chemotherapy Harmful to Patients with Metastatic Colorectal Cancer (2/12/2009)
Researchers from the Netherlands have reported that the addition of Erbitux® (cetuximab) to the established regimen of Avastin® (bevacizumab), Xeloda® (capecitabine), and Eloxatin® (oxaliplatin) reduces progression-free survival and quality of life in patients with metastatic colorectal cancer. The details of this study appeared in the February 5, 2009 issue of the New England Journal of Medicine.
Postmenopausal Hormones Reduce the Risk of Colorectal Cancer (2/4/2009)
Researchers from the University of Minnesota have reported that the use of postmenopausal hormones reduces the risk of colorectal cancer for women. The details of this study appeared in the January 1, 2009 issue of Cancer Epidemiology, Biomarkers, & Prevention.
Avastin® plus Fluorouracil-based Chemotherapy Effective in Elderly with Metastatic Colorectal Cancer (1/27/2009)
Researchers from Duke University have reported that patients 65 years of age or older benefit as much from Avastin® (bevacizumab) and fluorouracil-based chemotherapy as younger patients with metastatic colorectal cancer. The details of this analysis appeared in the January 10, 2008 issue of the Journal of Clinical Oncology.
The Evolving Role of EGFR Inhibitors in Colorectal Cancer—A Report from ASCO 2008 (1/23/2009)
Results from the 2008 annual meeting of the American Society of Clinical Oncology (ASCO), held May 30–June 2 in Chicago, Illinois, revealed significant steps towards the improvement of outcomes for patients with varying types of cancers. As seen during the past few years, attention has turned towards individualizing patient care through targeted therapies, optimizing patient selection for specific therapies, as well as a focus on quality of life and survivorship issues.
Avastin® Increases Risk of Venous Thromboembolism (11/20/2008)
Researchers from Stony Brook University have reported that the use of Avastin® (bevacizumab) increases the risk of thromboembolism. The details of this review were published in the November 19, 2008 issue of the Journal of the American Medical Association.
Vitamin D Prevents Colorectal Adenomas (11/10/2008)
Researchers from several U.S. medical institutions have reported that higher circulating 25-hydroxyvitamin D serum levels and high vitamin D intake are associated with a decreased incidence of colorectal adenomas and recurrent adenomas. The details of this meta-analysis were published in the November 1, 2008 issue of Cancer Epidemiology Biomarkers and Prevention.
Vitamin Supplementation Has No Effect on Cancer Risk in Women (11/6/2008)
Researchers affiliated with the Women’s Antioxidant and Folic Acid Cardiovascular Study reported that supplementation with folic acid, vitamin B6, and B12 has no impact on the incidence of cancer. The details of this study appeared in the November 5, 2008 issue of the Journal of the American Medical Association.
Primary Physicians are not Recommending Cancer Screening of Medicaid Recipients (10/28/2008)
Researchers from the University of North Carolina have reported that primary care physicians were not recommending cancer screening for colorectal, breast and cervical cancer for half of the eligible patients. The details of this study appeared in the October 13, 2008 issue of the Archives of Internal Medicine.
Patients with Metastatic Colorectal Cancers with KRAS Mutations do not Benefit from Erbitux® (10/24/2008)
Researchers involved with a randomized study of Erbitux (cetuximab) versus best supportive care have reported that patients with locally advanced or metastatic colorectal tumors that have a mutated KRAS do not benefit from single-agent Erbitux. The details of this study were reported in the October 23, 2008 issue of the New England Journal of Medicine.
United States Preventive Task Force Provides Recommendations for Colorectal Cancer Screening (10/14/2008)
The United States Preventive Services Task Force (USPSTF) has recently issued recommendations for the screening of colorectal cancer. These recommendations were published October 7, 2008 in an early online publication in the Archives of Internal Medicine.
Risk of Colon Cancer Associated with Genetic Variants (10/9/2008)
Researchers from several medical centers have reported that genetic changes in the surrounding region of the ADIPQ gene are associated with a decrease in the risk of developing colorectal cancer. Results such as these may aid in the understanding of genetic risk of various cancers, ultimately changing the way in which cancer is managed. These results were recently published in the October 1, 2008 issue of the Journal of the American Medical Association.
African Americans Have More Colon Polyps on Screening Colonoscopy than Whites (9/25/2008)
Researchers from Oregon Health and Science University have reported that African-American men and women have a higher risk of larger polyps than White persons. The details of this study appeared in the September 24, 2008 issue of the Journal of the American Medical Association.
Study Confirms Utility of CT Colonography Screening (9/19/2008)
Researchers involved in a U.S. multicenter trial comparing CT colonoscopy with optical colonoscopy have concluded that CT colonography is accurate enough to be used as a routine screening technique in persons at average risk of developing colon cancer. The details of this study appeared in the September 18, 2008 issue of the New England Journal of Medicine.
Incidence of Advanced Adenomas Low with a Rescreening Interval of Five Years (9/18/2008)
Researchers affiliated with the Lilly Colorectal Cancer Prevention Program have reported that the risk of colorectal cancer five years after a screening colonoscopy is very low. The details of this study appeared in the September 18, 2008 issue of the New England Journal of Medicine.
Early Skin Treatment Reduces Skin Reactions in Colorectal Cancer Patients Treated with Vectibix® (8/25/2008)
Among patients with colorectal cancer, skin treatment beginning on the day prior to therapy with Vectibix® (panitumumab) significantly reduces skin side effects associated with Vectibix compared with skin treatment after side effects occur. These results were presented at the 10th World Congress on Gastrointestinal Cancer held in Spain in June 2008.
More Fruits and Veggies, Less Meat Reduces Colorectal Cancer (8/14/2008)
Researchers affiliated with the NIH-AARP Diet and Health Study have reported that individuals who consume a diet that is rich in vegetables, fruits, whole grains, and healthy oils, contains sufficient dietary calcium and vitamin D, and is low in solid fats, added sugar, and red meats have a significantly reduced risk of developing colorectal cancer. These results were recently published in the July 1, 2008 issue of the American Journal of Epidemiology.
Adjuvant Chemotherapy Does Not Adversely Affect Quality of Life of Elderly Patients with Colorectal Cancer (8/11/2008)
Researchers from France have reported that patients 75 years of age or older with Stage III colon or rectal cancer receiving adjuvant chemotherapy or radiotherapy did not have negative effects on quality-of-life parameters compared with patients not receiving adjuvant therapy. The details of this study appeared in the August 15, 2008 issue of Cancer.
Management of Colonoscopic Perforations Described (8/7/2008)
Researchers from the Mayo Clinic have reported that “Colonoscopic perforation occurs in fewer than 1 in 1000 patients and is associated with significant morbidity and mortality.” The details of this retrospective review were published in the July 2008 issue of the Archives of Surgery.
Low Socioeconomic Status Increases Cancer Mortality (7/24/2008)
Researchers affiliated with the Findings from the National Program Registries Patterns of Care Study have reported that low socioeconomic status is associated with a high mortality due to later diagnoses and less aggressive treatments for cancer. The details of this study were reported in the August 1, 2008 issue of Cancer.
Radiofrequency Ablation Effective for Lung Tumors (7/22/2008)
Researchers involved in a multicenter international trial have reported that the use of radiofrequency ablation for the treatment of lung cancer or pulmonary metastases provides an effective and safe therapeutic option for selected patients. These results were recently published in the July 7, 2008 issue of Lancet Oncology.
Higher Vitamin D Levels Result in Better Survival Among Colorectal Cancer Patients (7/17/2008)
Researchers from the Dana Farber Cancer Center have reported that patients with colorectal cancer who have higher levels of vitamin D in their blood prior to diagnosis have an improved survival compared with those with lower levels. These results were published in the June 20, 2008 issue of the Journal of Clinical Oncology.
Erbitux®/Avastin® Combo Not Effective in Colorectal Cancer (7/7/2008)
Researchers affiliated with the CAIRO2 trial reported that the addition of Erbitux® (cetuximab) to Avastin® (bevacizumab), Eloxatin® (oxaliplatin), and Xeloda® (capecitabine) did not provide a clinical benefit and actually reduced progression-free survival in metastatic colorectal cancer. These findings are consistent with results from other trials indicating that the combination of agents targeting the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor receptor (VEGF) pathways does not provide clinical benefit. These results were recently presented as a late-breaking abstract at the 2008 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Illinois.
Patients with KRAS Mutation Do Not Benefit from EGFR Inhibitors (6/20/2008)
Several presentations at the 2008 annual meeting of the American Society of Clinical Oncology (ASCO) reported confirmatory data that treatment with epidermal growth factor receptor (EGFR) inhibitors such as Erbitux® (cetuximab) and Vectibix® (panitumumab) is only effective among patients with the normal KRAS gene, while those with a mutated KRAS gene demonstrate virtually no response to these agents. In essence, global consent was achieved at this year’s ASCO that all patients eligible for EGFR-targeted therapies should first undergo KRAS testing prior to initiation of therapy.
Non-invasive Test Effective for Colorectal Cancer Screening (6/9/2008)
A new, non-invasive colorectal cancer screening test from Exact Sciences is now available and supported by the American Cancer Society and other major medical groups. Study results showing the test’s efficacy have been reported in the April 2008 supplement of Gastroenterology.
Physicians with More Training Perform More-effective Colonoscopies (5/8/2008)
Researchers from Korea have reported that a physician must perform at least 150 colonoscopies to be considered competent at the procedure. Details of the study were recently published in the April 2008 issue of Gastrointestinal Endoscopy.
Pre-existing Antibodies Explain Severe Hypersensitivity Reactions to Erbitux® (5/6/2008)
Researchers from Vanderbilt University have reported that hypersensitivity reactions to Erbitux® (cetuximab) are related to the presence of IgE antibodies present before therapy. The details of this study appeared in the March 13, 2008 issue of the New England Journal of Medicine.
Celebrex® Reduces Colon Adenomas (4/25/2008)
Researchers affiliated with the APC trial (Adenoma Prevention Celebrex) have reported that Celebrex® (celecoxib) reduces the rate of colon adenomas at five years and appears safe, even among patients with cardiovascular disease. These results were recently presented as a late-breaking abstract at the 2008 annual meeting of the American Association for Cancer Research, April 12-16, in San Diego.
Drug Combination Decreases Recurrence Rate of Colon Polyps (4/22/2008)
Researchers from the University of California Irvine have reported that the combination of the difluoromethylornithine (DFMO) and sulindac reduces the rate of colon adenomas by up to 95% among patients who have had prior colon polyps. These results were presented as a late-breaking abstract at the 2008 annual meeting of the American Association for Cancer Research held in San Diego, April 12-16, 2008.
Neoadjuvant Avastin®, Xeloda®, and Eloxatin® Safe in Patients with Colorectal Hepatic Metastases (4/21/2008)
Researchers from Austria have reported that a neoadjuvant regimen of Avastin® (bevacizumab), Xeloda® (capecitabine), and Eloxatin® (oxaliplatin) is well tolerated and effective in patients with colorectal metastases to the liver. The details of this study appeared in the April 10, 2008 issue of the Journal of Clinical Oncology.
CT Colonography Screening Deemed Cost Effective (4/21/2008)
Researchers from the United States and Italy have reported that the ability of computerized tomographic colonography (CTC) to detect abdominal aortic aneurisms and extracolonic cancers in addition to premalignant and malignant colonic neoplasms makes this technique cost effective as compared with colonoscopy or colonoscopy plus ultrasonography. The details of this study appeared in the April 14, 2008 issue of the Archives of Internal Medicine.
EGFR FISH Assay May Identify Patients with Refractory Colorectal Cancer Who Benefit from Erbitux® (4/16/2008)
Researchers from Italy have reported that patients with refractory colorectal cancer who have high EGFR (epidermal growth factor receptor) gene copies by FISH (fluorescence in situ hybridization) are more likely to respond to treatment with Erbitux® (cetuximab). Details of the study were published in the April 2008 issue of the Annals of Oncology.
Erbitux® and Camptosar® Improves Outcomes of Metastatic Colorectal Cancer Patients (4/15/2008)
Researchers affiliated with an international randomized study (EPIC) have reported that the addition of Erbitux® (cetuximab) to Camptosar® (irinotecan) was more effective than Camptosar alone in patients with epidermal growth factor receptor (EGFR)-positive metastatic colorectal cancer who had failed fluoropyrimidine and Eloxatin® (oxaliplatin) therapy. The details of this study appeared in an early online publication on April 7, 2008 in the Journal of Clinical Oncology.
U.S. Capacity Deemed Adequate for Large Scale CT Colonography Screening (4/9/2008)
Researchers from the University of Wisconsin have reported that, at 64, there is an adequate number of slice multi-detector computed tomography (MDCT) systems in the Unites States for mass screening by CT colonography (CTC). The details of this study were published in the April 2008 issue of the American Journal of Roentgenology.
Studies Confirm Effectiveness of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer (4/8/2008)
Two recent studies in the British journal of Cancer have reported improved outcomes of patients with advanced rectal cancer treated with neoadjuvant chemoradiotherapy.
Perioperative Chemotherapy Improves Outcome of Metastases to the Liver (3/25/2008)
Researchers involved in an international multicenter randomized trial have reported that perioperative chemotherapy improves outcomes of patients with colorectal cancer metastases to the liver. The details of this study appeared in the March 22, 2008 issue of The Lancet.
NonPolypoid Colorectal Neoplasms Common and More Malignant than Polypoid Lesions (3/12/2008)
Researchers from the Veteran’s Affairs Palo Alto Health Care System have reported that nonpolypoid colorectal neoplasms are more common than polypoid neoplasms and are almost 10 times more likely to be malignant. The details of this study appeared in the March 5, 2008 issue of the Journal of the American Medical Association.
Elderly with Stage II-III Rectal Cancer May Benefit from Adjuvant Chemoradiotherapy (2/22/2008)
Researchers from several U.S. medical institutions have reported that elderly patients with Stage II–III rectal cancer who complete both adjuvant radiation therapy and adjuvant chemotherapy have a lower rate of disease recurrence than patients not receiving such therapy or not receiving full courses. These results were published in the January 15, 2008, issue of Cancer.
Smoking Increases Risk of Rectal Cancer (12/3/2007)
Researchers involved in the Women’s Health Initiative (WHI) have reported that smoking increases the risk of developing rectal cancer. The details of this study appeared in the November 20, 2007 issue of the Journal of the National Cancer Institute.
Erbitux® Alone Improves Outcomes in Refractory Colorectal Cancer (11/26/2007)
Researchers from Canada, Australia, New Zealand, and Singapore have reported that Erbitux (cetuximab) alone improves overall survival and progression-free survival in patients with relapsed and refractory advanced colorectal cancer. The details of this study were published in the November 15, 2007 issue of the New England Journal of Medicine.
Radiofrequency Ablation Effective in Small Renal Cell Carcinomas (8/9/2007)
Researchers from Wake Forest University have reported that radiofrequency ablation is an effective treatment option for small renal cell carcinomas (RCC). The details of this study were published in the August, 2007 issue of the Journal of Roentgenology.
FDA Approves Torisel™ for Treatment of Advanced Renal Cell Carcinoma (6/6/2007)
On March 30, 2007 the US Food and Drug Administration (FDA) approved Torisel (temsirolimus) for the treatment of advanced renal cell carcinoma (RCA).
Cetuximab (Erbitux®) Combinations Evaluated in Rectal and Esophageal Cancer (1/2/2007)
Two recent studies presented at the 2006 meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) suggest that cetuximab can be added safely to combination chemotherapy regimens for rectal and esophageal cancer.
Anemia Influences Outcome of Neoadjuvant Therapy for Rectal Cancer (11/2/2006)
Researchers from Italy have reported that anemia was the only predictor of disease-free survival among 317 patients treated with colorectal cancer treated with neoadjuvant radiotherapy, or chemoradiotherapy.
MRI Predicts Curative Resection of Rectal Cancer (10/20/2006)
Physicians from 20 colorectal clinics in four European countries affiliated with the MERCURY study group have reported that high resolution magnetic resonance imaging (MRI) accurately predicts rectal cancers that can be completely or incompletely resected.
Adjuvant and/or Neoadjuvant Chemotherapy Decreases Local Recurrences but Does Not Improve Survival in Operable Rectal Cancer (9/27/2006)
Researchers affiliated with the EORTC Radiotherapy Group Trial 22921 have reported that the addition of neoadjuvant or adjuvant chemotherapy to neoadjuvant radiotherapy improves local control of operable rectal cancer but does not improve survival.
European Study Suggests Xeloda® is Cost Effective Compared to 5-FU-LV for Colon Cancer (5/2/2006)
Researchers from the UK have determined that Xeloda (capecitabine) is more economical to administer that 5-fluorouracil/leucovorin (5-FU/LV) for the treatment of metastatic colorectal cancer. The details of this analysis appeared in the April 24, 2005 issue of the British Journal of Cancer.
Xeloda®, Eloxatin® and Tarceva® Effective for Previously Treated Metastatic Colorectal Cancer (4/28/2006)
Researchers from the Dana Farber Cancer Center have reported that the combination of oral Xeloda (capecitabine), intravenous Eloxatin (oxaliplatin) and oral Tarceva (erlotinib) is an effective palliative regimen for patients with previously treated metastatic colorectal cancer. The details of this phase II study appeared in the April 20, 2006 issue of the Journal of Clinical Oncology.
Chemoradiotherapy Improves Local Control of T3-4 Rectal Cancer (11/1/2005)
A multicenter French trial has determined that neoadjuvant chemoradiotherapy is more effective than neoadjuvant radiotherapy alone for treating T3-4 rectal cancer.
Statins May Improve Response Rate to Neo-Adjuvant Chemoradiation for Rectal Cancer (7/28/2005)
Researchers from Memorial Sloan-Kettering Cancer Center have reported that patients receiving statins during neo-adjuvant chemoradiation therapy had a higher complete pathological response than patients not taking statins.
Laparoscopic Surgery for Colorectal Cancer Evaluated (5/20/2005)
Researchers from the UK have concluded that laparoscopic-assisted surgery for colon cancer is as effective as open surgery in the short term. However, they suggest that routine use in rectal cancer is not justifiable.
African-Americans Encouraged to Begin Colorectal Cancer Screening at Age 45 (4/5/2005)
The American College of Gastroenterology has recently recommended that African-Americans initiate colorectal cancer screening at the age of 45 years instead of age 50 years, which is the recommendation for Caucasian and Asian populations. The details of this report and an extensive bibliography on this subject were published in the March 2005 issue of the American Journal of Gastroenterology.
Local Control of Rectal Cancer Better with Pre than with Post-Operative Chemoradiotherapy (10/27/2004)
Researchers affiliated with the German Rectal Cancer Study Group have reported that preoperative chemoradiotherapy was associated with improved local control and reduced toxicity when compared with postoperative chemoradiotherapy in patients with locally advanced rectal cancer, but did not appear to improve overall survival. The details of this report appeared in the October 21, 2004 issue of the New England Journal of Medicine. Preliminary results of this study were presented at the 45th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in October of 2003.
Bevacizumab (Avastin™) plus Chemotherapy Improves Survival of Patients with Metastatic Colorectal Cancer (6/7/2004)
A multicenter randomized trial has shown that the addition of Avastin™ to irinotecan, 5-FU and leucovorin improves outcomes of newly diagnosed patients with metastatic colorectal cancer. The details of this report appeared in the June 3, 2004 issue of the New England Journal of Medicine.
Promising Results Combining Alimta® with Other Agents in Advanced Colorectal Cancer (11/20/2003)
Based on the single agent activity of Alimta®, Eloxatin®, and Camptosar® in the treatment of locally advanced or metastatic colorectal cancer (CRC), investigators are now evaluating combinations of these drugs. According to a presentation at the Chemotherapy Foundation Symposium XXI, one study combining Alimta® and Eloxatin® has already suggested efficacy as first-line treatment and further studies are ongoing.
Aspirin Suppresses Earliest Pre-malignant Lesions in the Colon (11/13/2003)
Researchers from Israel have reported that aspirin use is associated with a reduction in the density of aberrant crypt foci (ACF) of the colon. These observations may explain why aspirin use is associated with a lower incidence of colon cancer. The results of this study appeared in the November 2003 issue of Gut.
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Neoadjuvant Therapy Gives Better Surgical Results than Adjuvant Therapy for Advanced Rectal Cancer (10/29/2003)
Researchers affiliated with the German Rectal Study Group have reported that neoadjuvant therapy results in decreased local relapses and better sphincter preservation than adjuvant therapy for advanced rectal cancer. This was accomplished with less toxicity than that associated with adjuvant combined therapy. However, there was no improvement in distant failure or overall survival. The results of this randomized trial were presented on October 20 at the 45th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).
Avastin™ Plus Gemzar®: An Active Regimen for Pancreatic Cancer (6/23/2003)
At the 2003 meeting of the American Society of Clinical Oncology, researchers from the University of Chicago presented the results of a phase II study of bevacizumab (Avastin ") and
Gemzar® for the treatment of pancreatic cancer. The observed a one year survival of 54% which was considered “encouraging”.
Night-Shift Workers at Higher Risk for Colorectal Cancer (6/17/2003)
In the June 4 2003 issue of the
Journal of the National Cancer Institute, researchers affiliated with the Nurses’ Health Study have reported a possible 35% increase in the incidence of colorectal cancer in long-term night shift workers.
Cetuximab (Erbitux®) And Camptosar® More Effective Than Cetuximab Alone For Colorectal Cancer (6/10/2003)
In an oral session of the 39th annual meeting of the American Society of Clinical Oncology in June of 2003, researchers from Europe reported that the combination of Erbitux® plus Camptosar® more than doubled the response rate in Camptosar® refractory epithelial growth factor receptor (EGFR)-positive colorectal cancer patients. compared to Erbutux® alone. Erbitux® is a monoclonal antibody that binds to the extracellular domain of EGFR, competitively inhibiting the binding of extracellular ligand. When Erbitux™ is bound, it appears to stimulate internalization of EGFR.
Antiangiogenic Drug, Bevacizumab (Avastin"), Improves Response of Colorectal Cancer to Combination Chemotherapy (6/10/2003)
At the 2003 meeting of the American Society of Clinical Oncology, Dr. Herbert Hurwitz from Duke University Medical Center presented the results of a randomized multi-center trial demonstrating the effectiveness of Avastin™ plus combination chemotherapy for the treatment of metastatic colorectal cancer. This paper was presented as a late breaking oral presentation and the abstract has not yet been published. The summary of this study was published in the ASCO Daily News for June 2, 2003.
Beta Carotene Increases Colorectal Adenoma Incidence in Smokers and Drinkers but is Preventative in Abstainers (5/21/2003)
Researchers from Dartmouth, USC, University of Minnesota, and the Cleveland Clinic reported in the May 21, 2003 issue of the
Journal of the National Cancer Institute that supplementation with beta carotene increased the incidence of colorectal adenomas in smokers and drinkers but decreased incidence in abstainers.
Beta Carotene Increases Colorectal Adenoma Incidence in Smokers and Drinkers but is Preventative in Abstainers (5/21/2003)
Researchers from Dartmouth, USC, University of Minnesota, and the Cleveland Clinic reported in the May 21, 2003 issue of the
Journal of the National Cancer Institute that supplementation with beta carotene increased the incidence of colorectal adenomas in smokers and drinkers but decreased incidence in abstainers.
Rectal Cancer Outcomes Improve when Institutions Treat More Patients (5/21/2003)
Researchers reported an inverse relationship between the number of patients treated for rectal cancer and outcome as measured by permanent colostomies, 30 day survival, and 2 year survival. These results are based on analysis of data from California hospitals and were published in the May 21, 2003 issue of the
Journal of the National Cancer Institute. (1)
Keratinocyte Growth Factor May Decrease Chemotherapy Induced Mucositis (4/17/2003)
Keratinocyte growth factor (KGF) is a normal cytokine which is present in many tissues and is produced in response to tissue injury. KGF stimulates growth of epithelial cells in tissues which have receptors for this cytokine. It is generally thought that KGF is an important component of the body’s repair mechanism. Keratinocyte growth factor has been synthesized and has undergone clinical testing in animals and normal human volunteers.
Screening Sigmoidoscopy Can Reduce Risk of Distal Colo-Rectal Cancer by 76% (4/16/2003)
Researchers from the Fred Hutchinson Cancer Research Center, Seattle, WA. Have determined that screening sigmoidoscopy can reduce the incidence of colorectal cancer by approximately 76%. They reported their results in the April 16 2003 issue of the
Journal of the National Cancer Institute.
Acceptability of Genetic Testing for Hereditary Nonpolyposis Colorectal Cancer (4/15/2003)
Mutations of specific genes increase the risk of cancer. However, the body has a built in repair mechanism to correct most mutations before cancer develops. The body’s DNA mismatch repair system recognizes one type of mutation and corrects it by substituting the right chemical structures in the gene. However, there can be mutations of the genes of the repair system.
Neoadjuvant Chemotherapy and Radiation Therapy Effective for Localized Rectal Cancer (4/14/2003)
English researchers reported In the April 7, 2003 issue of the
British Journal of Cancer that the use of neoadjuvant chemotherapy is a promising approach for the treatment of locally advanced rectal cancer.
Single Agent Gemzar® or Navelbine® Equally Effective and Less Toxic Than Combination for Treatment of Elderly with NSCLC (3/19/2003)
Until recently, many elderly patients with metastatic non-small cell lung cancer (NSCL) were treated only with supportive care. It is estimated that only 20% of elderly patients with advanced lung cancer ever receive chemotherapy. Previous studies, however, have suggested that palliative chemotherapy in this group of patients increased the average survival by approximately one month and the one year survival by 9%. These results are comparable with those achieved in younger patients with this disease treated with chemotherapy. As a generality, combination chemotherapy offers better palliation for patients with locally advanced or metastatic NSCLC than do single agents. However, the situation is less clear for patients older than age 70 years because of existing co-morbidities. In the March 2003 issue of the
Journal of the National Cancer Institute, Italian researchers reported the results of a randomized trial which suggests that single agent chemotherapy is as effective as combination chemotherapy for elderly patients with NSCLC.
Randomized Trials Confirm Benefit of Aspirin in Preventing Colorectal Adenomas (3/13/2003)
There have been several retrospective comparative studies suggesting that aspirin may lower the risk of colorectal cancer by decreasing the formation of precursor adenomas. These studies were based on information provided by individuals concerning aspirin intake and these data were correlated with the incidence of colorectal cancer. In addition to these, epidemiology studies in animals have also suggested that aspirin has a chemopreventive effect in preventing adenomas. In the March 6, 2003 issue of the
New England Journal of Medicine, the results of two randomized trials were presented which documented the effects of aspirin in preventing colorectal adenomas.
Relative Risks of Colonoscopy and Sigmoidoscopy Defined (2/13/2003)
It is currently recommended that all persons over the age of 50 years who are at average risk for colon cancer have screening for colon cancer with biannual testing for fecal occult blood and a sigmoidoscopy every 5 years. However, sigmoidoscopy can only detect polyps and cancers in the lower 40% of the bowel while colonoscopy visualizes the entire colon. There has been reluctance to advise the use of colonoscopy as a routine screening procedure due to the increased risks involved in this procedure. Colonoscopy is performed in the operating room under heavy sedation or anesthesia and has more complications, especially perforation which can lead to death, than sigmoidoscopy. Although the risk of perforation from colonoscopy in the hands of a skilled physician is considered small, it is admitted by most reviewers who have evaluated this issue that there are not enough skilled physicians in the U.S. to make colonoscopy a practical screening procedure for everyone. Thus, physicians and patients need to make choices about screening procedures.
Randomized Trial Does Not Show Benefit For Intra-Arterial Chemotherapy For Colorectal Cancer Metastatic to Liver (2/3/2003)
The liver is the most frequent site of metastasis for patients with colorectal cancer and is the second most frequent cause of cancer death in this patient population. There have been a variety of treatments used for the majority of patients with colorectal cancer metastatic to the liver who are inoperable, including: intravenous chemotherapy, intra-arterial chemotherapy, interferon-alfa, conformal radiation therapy, radioactive lipitiol, liver transplantation, embolization, chemoembolization, cryotherapy, radiation-delivering microspheres and radiofrequency ablation. The most commonly used methods are intravenous chemotherapy with 5-FU and folinic acid or the same drugs administered intra-arterially. There are theoretical reasons to suggest that direct intra-arterial chemotherapy should be more effective and less toxic than intravenous administration. However, intra-arterial infusions require placement of a catheter into the hepatic artery and maintenance of this catheter for the duration of treatment.
Insurance not a Factor in Low Rate of Screening for Colorectal Cancer (1/9/2003)
Colorectal cancer is the second leading cause of death in the United States. Screening is thought to be very important for the prevention and early treatment of colorectal cancer in average risk individuals. It is currently recommended that all patients over the age of 50 be screened regularly for colorectal cancer. Additionally, people with a personal or family history of adenomatous polyps or colorectal cancer may begin screening much earlier.
Radiofrequency Ablation Superior to Cryosurgery for Treatment of Inoperable Primary or Secondary Liver Cancer (1/9/2003)
Currently, the only curative treatment option for primary or secondary liver cancer is surgical resection. However, only a small percentage of patients are eligible for surgery because the majority of patients have cancer that has replaced too much of the liver or spread outside the liver to other parts of the body. There are several non-surgical options for palliative treatment of inoperable primary or secondary liver cancer including percutaneous cryosurgery and percutaneous radiofrequency ablation. Cryosurgery utilizes extremely low temperatures to destroy cancers while radiofrequency ablation entails the use of an electric current that is passed into the area of cancer. Both techniques use ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) to place a needle probe into the cancer. Although both cryosurgery and radiofrequency ablation have been shown to be effective treatments for inoperable primary or secondary liver cancer, there have been no direct comparisons of these techniques. In the December 2002 issue of
Archives of Surgery, French researchers have compared the two techniques and concluded that percutaneous radiofrequency ablation produces more long lasting remissions than percutaneous cryosurgery.
Bevacizumab (Avastin"), a Monoclonal Antibody Against Vascular Endothelial Growth Factor (VEGF), Active in Colon Cancer (1/6/2003)
There is compelling evidence that angiogenesis plays a major role in the growth and spread of many cancers. Vascular endothelial growth factor (VEGF) is a factor that regulates normal and pathologic angiogenesis and has been implicated in the growth or several types of cancer including colon cancer. These observations have led to the development of antibodies that inhibit VEGF. There is evidence from animal models that anti-VEGF antibodies and chemotherapy are more effective than either modality alone. Avastin" is a recombinant humanized monoclonal antibody to VEGF which is currently being tested in number of clinical trials.
Yttrium 90 Labeled Microspheres Enhance Palliation of Liver Metastasis (11/27/2002)
Patients with large bowel cancer frequently have metastasis to the liver. Whenever possible, such lesions are removed surgically. However, the majority of patients with bowel cancer metastatic to the liver have inoperable lesions. Treatment of patients with bowel cancer metastatic to the liver includes systemic chemotherapy, hepatic artery chemotherapy and embolization. More recently, microspheres containing radioactive yttrium 90 (SIR-Spheres®) have been evaluated, usually in combination with hepatic artery infusion. These microspheres produce high levels of local radiation in the area of injection. Recently, researchers from Australia compared the efficacy of hepatic artery chemotherapy with hepatic artery chemotherapy plus the infusion of SIR-Spheres®. They reported their findings in the December 2002 issue of the
Annals of Oncology.
Further Evidence That a High Dietary Fiber Diet Does Not Prevent Recurrence of Colon Polyps (11/7/2002)
In non-randomized trials, it has been suggested that diets high in bran fiber and low in fats prevent the development of colon cancer by preventing the development of adenomatous polyps. Similar findings have been made in regard to diets high in fiber from fruits and vegetables. In 2000, the Phoenix Colon Cancer Prevention Network published results of a randomized trial casting doubt on these observations.
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In this study, published in The New England Journal of Medicine, the researchers randomly allocated 1,429 men and women, ages 40 to 80 years, who had previously had one or more colorectal adenomatous polyps to receive a high-fiber wheat bran dietary supplement or a low-fiber wheat bran dietary supplement. The results demonstrated that approximately 50% of persons from both groups developed additional polyps. It was concluded that a dietary supplement of wheat bran did not reduce the risk for developing pre-cancerous adenomatous polyps of the colon and rectum.
U.S. Preventive Services Task Force Issues Recommendations for Hormone Replacement Therapy (10/23/2002)
On October 15, the U.S. Preventive Services Task Force (USPSTF) issued guidelines for hormone replacement therapy. This document was prepared after the recent publications which cast doubt on the benefits of women taking hormonal therapy after menopause. These recommendations can be reviewed in total at http://www.preventiveservices.ahrq.gov and http://www.guideline.gov. This is the first update since 1996.
Motexafin Gadolinium (Xcytrin®) Improves Results of Whole Brain Radiation Therapy in Patients with Cancer Metastatic to Brain (10/14/2002)
Cancers often consist of areas of low oxygen concentration which complicates treatment. Hypoxic cells are more resistant to the effects of radiation than well-oxygenated tissues and there have been many candidate drugs for increasing oxygenation of cancers (radiosensitizers), none of which have been very successful. Xcytrin® (motexafin gadolinium) is a new type of radiation sensitizer that sensitizes both oxygenated and hypoxic cells to the effects of radiation. Xcytrin® also localizes selectively in tumors and this can be detected by magnetic resonance imaging (MRI). Laboratory and preclinical studies suggested that Xcytrin® could potentiate the effects of radiation for the treatment of cancers. In 1999, researchers at the University of Pennsylvania determined the optimal dose of Xcytrin® that could be given to patients with a variety of cancers receiving radiation therapy in a phase I trial.
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Temodol® Improves the Response Rate to Radiation Therapy for Cancer Metastatic to Brain (10/11/2002)
Temozolomide (Temodol®) is an analog of the alkylating agent procarbazine which has been approved by the U.S. Food and Drug Administration for the treatment of recurrent brain tumors. Current research with this drug primarily involves treatment of newly diagnosed brain tumors. However, researchers in Greece have evaluated the effectiveness of Temodol® for the treatment of cancer metastatic to brain. At the 2002 meeting of the American Society for Therapeutic Radiology and Oncology, the researchers reported that the addition of Temodol® to whole-brain radiation therapy resulted in significantly higher response rates of brain metastases compared to whole brain radiation alone.
National Colorectal Cancer Roundtable Publishes Strategy For Prevention of Colorectal Cancer (10/9/2002)
The National Colorectal Cancer Roundtable (NCCRT) was founded in 1997 by the American Cancer Society and the Centers for Disease Control and Prevention. The goal of this organization is to promote methods of preventing colorectal cancer. In the October 2002 issue of
Cancer, these researchers presented a summary of the failure of the U.S. population to take advantage of screening methods of detecting early pre-cancerous lesions of the bowel. They point out that screening methods could reduce the 56,600 deaths per year from colorectal cancer by 50%. They estimate that the life-time risk of the population for developing colorectal cancer is 6%.
Stereotactic Radiosurgery Following Whole Brain Radiation Therapy Improves Palliation of Patients with Cancer Metastatic to Brain (10/8/2002)
Whole brain radiation therapy (WBRT) is the most frequent palliative modality for patients with cancer metastatic to the brain. Stereotactic radiosurgery (SRS), also called gamma knife therapy or 3-dimensional radiation therapy, can deliver precise doses of radiation to tumor sites while sparing normal tissue. Stereotactic techniques are used to treat a variety of cancers and are widely accepted as superior to non-precise radiation techniques. Since 1996, researchers from 34 medical institutions affiliated with the Radiation Therapy Oncology Group have been carrying out a study to document the benefits of SRS in individuals with cancers that are metastatic to the brain. They have concluded from this study that SRS adds significantly to the palliation achieved with WBRT alone. They reported these results at a plenary session of the annual meeting of the
American Society of Therapeutic Radiology and Oncology in October of 2002.
Intraspinal Implantable Drug System Effective in Controlling Pain Due to Metastatic Cancer (10/1/2002)
The management of pain is an important component for the treatment of most patients with metastatic cancer. It is estimated that 5-15% of patients with metastatic cancer have pain that is refractory to oral and i.v. narcotics. Intraspinal implantable drug delivery systems (IDDSs) deliver small doses of morphine directly to the spinal fluid, theoretically requiring smaller doses of narcotics. Although this system is known to be effective, there have been no randomized controlled trials. Researchers in the U.S. and Europe affiliated with the Implantable Drug Delivery Systems Study Group have determined that IDDSs are better than conventional pain management techniques. They reported these results in the October 2002 issue of the
Journal of Clinical Oncology.
Further Evidence that Adjuvant Therapy is Effective in Elderly Stage III Colon Cancer Patients (10/1/2002)
Randomized trials have clearly demonstrated that adjuvant chemotherapy improves survival in patients with stage III colon cancer by approximately 30%. However, few elderly patients are entered on these randomized trials and it has not been certain that such patients benefit from adjuvant therapy. This issue is of particular interest since the incidence of colon cancer is 11 times higher in patients over 65, compared to those who are younger. In a review of 7 separate clinical trials that were conducted to evaluate adjuvant chemotherapy in patients with stage II or III colon cancer, there were no differences in survival rates between older and younger patients
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. A second single institution study concluded that age was not a predictor of relapse or overall survival in patients receiving adjuvant chemotherapy for stage II-III colon cancer
2
. Researchers from the University of Pennsylvania and the Pritzker School of Medicine have used information from the Surveillance, Epidemiology, and End-Results (SEER)-Medicare data to evaluate the effects of adjuvant therapy for stage III colon cancer in elderly patients
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. The results of this analysis were published in the October 2002 issue of the
Journal of Clinical Oncology.
Intensive Eloxatin™, Camptosar®, 5 FU and Leucovorin Regimen Promising for Metastatic Colon Cancer (9/30/2002)
For the past two decades, the standard palliative treatment for patients with metastatic colon cancer has been 5 FU and leucovorin. Over the past several years, Camptosar® has been evaluated and found to be equivalent or better than 5-FU/leucovorin. More recently, Eloxatin" has also emerged as a very active agent for the treatment of colon cancer. The exact sequence of administration of these active drugs for the treatment of patients with colon cancer is unknown. One approach is to administer all active drugs up front in order to obtain the maximum initial response. In some situations, a maximum initial response to chemotherapy could allow some inoperable patients to become operable. Researchers in Italy have evaluated a regimen of intensive treatment with the combination of Eloxatin", Camptosar®, 5 FU and leucovorin. They reported their results in the October 2002 issue of the
Journal of Clinical Oncology.
Dutch Prospective Study Confirms Increased Risk of Colorectal Cancer with Low Dietary Folate Intake (9/24/2002)
An adequate intake of folic acid is achieved by eating fresh fruits and vegetables. In previous retrospective studies, researchers have documented an approximate 35% increase in the risk of colorectal cancer in persons who consume the lowest amount of folic acid, compared to persons who consume the highest amount of folic acid. These observations have led to three large ongoing clinical trials evaluating chemoprevention of colorectal cancer with folic acid supplements. In the September 2002 issue of Cancer, Dutch researchers report the first prospective study of dietary folic acid intake on the incidence of colon and rectal cancer. This study started in 1986 and has a 7.3 year follow-up. Since 1986, the researchers have followed 120,852 men and women aged 55-69 years. There were 760 colon cancers and 411 rectal cancers during the follow-up period. For men and women, the risk of colon cancer was reduced by 27% in persons with the highest folic acid intake, compared to the lowest intake. For rectal cancer there were no differences in women, but men with high folic acid intake had a 34% reduction of cancer rates. The researchers found no differences in outcomes when they analyzed for the form of folic acid (i.e. whether it was in the form of polyglutamates or monoglutamates). They also found suggestive evidence that men who consume higher amounts of alcohol combined with inadequate intakes of folate and methionine are at a higher risk of developing rectal carcinoma.
Obesity is a Risk Factor for Colorectal Cancer in Premenopausal but not Postmenopausal women (9/19/2002)
Obesity in men has been associated with an increased incidence of colorectal cancer. However, studies in women have failed to show this association. Researchers from the Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine believe that the failure to show an association between obesity and colorectal cancer in women is because age has not been taken into consideration. In the August 2002 issue of the journal
Gut, researchers report that premenopausal obese women have a two-fold increase in the incidence of colorectal cancer.
Swiss Study Confirms Ability of Virtual Colonoscopy to Detect Lesions 10 mm or Greater in Size (9/5/2002)
Virtual colonoscopy, also called colonography, is a technique that uses rapid computerized tomography (CT) scanning with conventional or electron beam (EB) machines combined with sophisticated computer programs. Patients undergoing virtual colonoscopy have the same extensive bowel purging as those undergoing actual colonoscopy and have the same insufflation of air to outline the bowel. The important part of this approach is the computer programs that can produce images of the colon that mimic an actual colonoscopy. Virtual colonoscopy has been evaluated more and more over the past several years in order to determine how virtual colonoscopy compares to actual colonoscopy. This is important since actual colonoscopy is the best way to detect and monitor pre-malignant polyps, but is limited by the need for heavy sedation or anesthesia and a small but definite risk of perforation of the bowel. In addition, there are not enough skilled physicians to perform colonoscopy on all individuals who should have it done for screening for colon cancer. A previous study from the U.S. clearly demonstrated that almost all lesions in the colon that were 10 mm or greater could be detected by virtual colonoscopy, but not smaller lesions.
St. John's Wort (SJW) Interferes With the Metabolism of Irinotecan (8/23/2002)
One of the major concerns about the use of alternative or complimentary medicines is the interactions with conventional treatments for cancer. Patients and physicians have to be cognizant of the interactions of alternative or complementary therapies with chemotherapeutic agents used to treat cancer. St. John's Wort (SJW) is an herbal medicine used to treat depression. Unfortunately, SJW has an effect on the cytochrome P450 enzyme system and drug-transporting proteins. St. John’s Wort induces the expression of the cytochrome P450 CYP3A4 isoform in intestinal and hepatic cells and induces the expression of MDR1 P-glycoprotein in intestinal cells. Irinotecan is eliminated via CYP3A4- and P-glycoprotein-mediated routes. Thus, SJW could interfere with the action of irinotecan in patients with colon cancer. Researchers in Holland determined the effects of SJW on the metabolism of irinotecan in 5 patients and reported their results in the August 20, 2002 issue of the
Journal of the National Cancer Institute. They concluded that patients with colon cancer receiving irinotecan should not receive SJW.
Preoperative Radiation Therapy May Improve Survival of Some Patients with T3 Rectal Cancers Compared to Surgery Alone (8/22/2002)
Patients with T3 rectal cancer have cancer that invades through the muscularis propria into the subserosa or into nonperitonealized pericolic or perirectal tissues. Patients with T3 rectal cancers can have or not have lymph node spread. This type of cancer is treated with a total mesorectal excision (TME) or TME preceded or followed by radiation therapy. Several non-randomized studies and a large meta-analysis have suggested that pre or post-operative radiation may decrease the local recurrence rate for patients with operable stage I-III rectal cancer. Some of these studies, however, have noted increased morbidity and mortality in patients receiving radiation therapy. However, there have been no randomized controlled trials of radiation versus no radiation therapy for such patients. In the August issue of the
Annals of Surgery, researchers from the Cleveland Clinic Foundation present data that suggests that patients with T3 rectal cancers benefit from preoperative radiation therapy.
Eloxatin® (Oxaliplatin) Approved for Colorectal Cancer in the United States (8/15/2002)
The Food and Drug Administration approved Eloxatin® (oxaliplatin) for the treatment of colorectal cancer. The standard chemotherapy combination for metastatic colorectal cancer is 5-FU/LV plus Camptosar® (irinotecan). Eloxatin® is approved for use in combination with 5-fluorouracil (5-FU)/leucovorin (LV) for advanced colorectal cancer that has progressed or recurred following therapy with Camptosar®/5-FU/LV.
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Virtual Colonoscopy Detects Larger Neoplasms of Colon (8/6/2002)
Virtual colonoscopy is a technique that uses rapid computerized tomography (CT) scanning with conventional or electron beam (EB) machines combined with sophisticated computer programs. Patients undergoing virtual colonoscopy have the same extensive bowel purging as those undergoing actual colonoscopy and have the same insufflation of air to outline the bowel. The important part of this approach is the computer programs that can produce images of the colon that mimic an actual colonoscopy. Virtual colonoscopy has been evaluated more and more over the past several years in order to determine how virtual colonoscopy compares to actual colonoscopy. This is important since actual colonoscopy is the best way to detect and monitor pre-malignant polyps, but is limited by the need for heavy sedation or anesthesia and a small but definite risk of perforation of the bowel. In addition, there are not enough skilled physicians to perform colonoscopy on all individuals who should have it done for screening for colon cancer.
Lack of Benefit and Potential Harm Halts Clinical Trial of Hormone Replacement for Post-Menopausal Women (7/10/2002)
Hormone replacement with estrogen plus progestin is often used to treat menopausal symptoms and to prevent osteoporosis and subsequent bone fractures. There has also been conflicting evidence that hormone replacement prevents heart disease. The association of hormone replacement with breast and uterine cancer has been well known, but usually these cancers present in early stages and do not affect survival. Estrogen and progestin are usually given together for women who have an intact uterus in order to prevent uterine cancer. Women who have had a hysterectomy usually are given estrogen alone. Researchers affiliated with the Women's Health Initiative have now reported that hormone replacement is not associated with prevention of heart disease, although overall survival was not affected one way or the other. Their results were published in the July 17 issue of the
Journal of the American Medical Association.
Raltitrexed and Oxaliplatin (TOMOX) is an Effective and Easy to Administer Regimen for Patients with Colorectal Cancer (6/19/2002)
Standard palliative treatment regimens for patients with advanced and metastatic colorectal cancer usually include 5-fluorouracil and leucovorin. However, new drug combinations continue to be evaluated. Italian researchers from 13 cancer centers recently reported the results of treating newly diagnosed patients with metastatic colorectal cancer with the combination of raltitrexed and oxaliplatin (TOMOX).
A Regimen of Camptosar®, Oxaliplatin, 5-Fluorouracil (5-FU) and Leucovorin is Highly Active for the Treatment of Metastatic Colorectal Cancer (6/6/2002)
Treatment of patients with metastatic colorectal cancer remains palliative, stimulating the development of new treatment regimens. Bolus and continuous infusion of 5-FU with leucovorin until recently was the most active regimen. Two new chemotherapy agents that have demonstrated anti-cancer effects for colorectal cancer are Camptosar® and oxaliplatin. Camptosar® has recently been approved by the Food and Drug Administration for treatment of colorectal cancer and the combination consisting of Camptosar®/5-FU/LV is now considered the standard initial chemotherapy treatment for patients with advanced colorectal cancer. Oxaliplatin is approved for the treatment of colorectal cancer in Europe and Asia and is currently in the last phases of clinical trials in the United States.
Virtual Colonoscopy Can be Used for Follow-up of Patients who have had Surgery or Radiation Therapy (5/15/2002)
Conventional colonoscopy sometimes fails to visualize the entire colon in patients who have a history of surgery and/or radiation therapy to the abdomen and/or pelvis. In addition, colonoscopy is not without risk and is an unpleasant experience for patients. Virtual colonoscopy, using similar methods to cleanse the bowel, is being explored as an alternative to colonoscopy. In this procedure, sophisticated computer programs simulate an actual colonoscopy.
Capecitabine and Oxaliplatin is an Active Drug Combination for Treatment of Advanced Colorectal Cancer (4/24/2002)
The results of a Swiss study evaluating the combination of capecitabine and oxaliplatin for treatment of advanced colorectal cancer were recently published in the
Journal of Clinical Oncology.
Early Radiotherapy with Concurrent Chemotherapy after Resection of Stage II and III Rectal Cancer is Superior to Late Radiotherapy with Chemotherapy (4/24/2002)
According to results recently published in the
Journal of Clinical Oncology, Korean researchers evaluated different sequences of adjuvant chemotherapy and radiation therapy in patients with surgically resected stage II and III rectal cancer and they determined that early treatment was better than delayed treatment.
Advanced Age is not a Contraindication to Adjuvant Chemotherapy for High-Risk, Resected Colon Cancer (4/22/2002)
Researchers in Pennsylvania have concluded that advanced age is not a barrier to receiving adjuvant chemotherapy for high risk cancer of the colon. Adjuvant chemotherapy is the standard of care for patients with stage III cancer of the colon. However, it is unclear whether or not toxicities outweigh benefits in elderly patients. Thus, elderly patients with resected stage III colon cancer often do not receive adjuvant chemotherapy.
Gene Therapy with ONYX-015 Shows Responses in Patients with Colon Cancer Metastatic to the Liver (4/19/2002)
ONYX-015 is a tumor-selective, modified adenovirus that has been genetically engineered to replicate in and kill cancer cells that have abnormal p53 pathway while sparing normal cells that have functioning p53 protein. P53, a protein that protects the cell from developing into a tumor cell, is the most commonly altered gene in human cancer.
Mortality from Major Cancer Surgery and Morbidity From Prostate Surgery Lower in High Volume Hospitals Than in Low Volume Hospitals (4/16/2002)
There were two reports in the April 11 issue of the
New England Journal of Medicine which strongly support the concept that patients facing major cancer surgery should select a high volume hospital near where they live.
Study Documents Effectiveness of Single Sigmoidoscopy at Age 60 in Detecting Cancer of the Colon (4/16/2002)
English investigators have reported in the April 13 issue of the
Lancet that flexible sigmoidoscopy screening regimen is acceptable, feasible, and safe. They found a high prevalence of cancer with a referral rate for colonoscopy of 5%.
St John’s Wort Interferes with Action of Camptosar® in Patients with Colorectal cancer (4/12/2002)
Camptosar® (CPT-11) is an important drug for the treatment of advanced colorectal cancer. Its metabolism is extremely complex, with the involvement of several enzymes and drug-transporting proteins. Cytochrome P450 isozyme 3A4 (CYP3A4) mediated oxidation of CPT-11 is the principal elimination route of CPT-11 and leads to the formation of a series of inactive compounds, including APC.
Follow Up After Curative Resection for Colorectal Cancer Improves Survival (4/9/2002)
Researchers in England have reported in the April issue of the
British Medical Journal that intensive follow-up after curative surgery for colorectal cancer improves survival. They reviewed evidence from clinical trials of follow up of patients after curative resection for colorectal cancer. They performed this study because of an apparent lack of direct evidence that intensive follow up after initial curative treatment for colorectal cancer leads to increased survival.
Four Weeks of Anticoagulation Better Than One Week Following Cancer Surgery (4/5/2002)
Researchers from Sweden, Italy, England and Israel have reported in the March 28 issue of the
New England Journal of Medicine that prolonged anticoagulation versus one week of anticoagulation is better for patients undergoing abdominal cancer surgery.
Plasma Free Metanephrines Best Test for Excluding or Confirming Pheochromocytoma (4/3/2002)
A multicenter international study has determined that plasma free metanephrines provide the best test for excluding or confirming the diagnosis of pheochromocytoma. The data establishing this was published in the March 20 issue of the
Journal of the American Medical Association.
Women Experience Greater Toxicity With 5-FU-Based Chemotherapy for Colorectal Cancer (3/21/2002)
Researchers from the US and Canada have evaluated the toxicities in men and women associated with fluorouracil (5-FU)–based chemotherapy given on 5 consecutive days at doses of 370 to 450 mg/m2. They analyzed data from 1,093 women and 1,355 men treated with 5-FU. They found an increased incidence of stomatitis, leukopenia, alopecia and diarrhea but not of nausea, and vomiting in women. Half of the women experienced severe toxicity compared to only a third of the men (P < .0001). The differences were consistent across treatment cycles. Response rates and survival distributions were the same for both sexes. These researchers concluded that women experience toxicity more frequently and with more severity than men following 5-FU–based chemotherapy in a 5-day bolus schedule. They also suggest “these data raise the question of whether the recommended initial dose of 5-FU–based chemotherapy for women shouldbe lower than that for men”.
New DNA Fecal Test Can Detect Colorectal Cancer (2/22/2002)
Several strategies for the early detection of colorectal cancers have been devised. Colonoscopy, sigmoidoscopy and barium enemas are highly specific and sensitive tests for cancer but they are invasive and limited by the availability of experts in the procedures and patient compliance. Virtual colonoscopy is an emerging approach to early diagnosis but is relatively untested. Evidence from some studies have shown that testing for occult blood in the stool may reduce incidence, morbidity and mortality from colorectal cancer. However, one limitation of testing for occult blood in the stool is that this test is not very specific.
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