Clinical colorectal cancer
-
Clin Colorectal Cancer · Jun 2015
Randomized Controlled Trial Multicenter StudyBowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial.
We investigated very long-term bowel function after total mesorectal excision (TME) with or without preoperative short-course radiotherapy (PRT) for rectal cancer, the risk factors for bowel dysfunction, and the association of bowel dysfunction with health-related quality of life (HRQL). ⋯ A considerable proportion of nonstoma patients endured major LARS years after TME. PRT and age ≤ 75 years at follow-up pose further risks of major LARS in addition to surgery. Major LARS is associated with reduced HRQL.
-
Clin Colorectal Cancer · Jun 2015
Meta AnalysisRole of first-line anti-epidermal growth factor receptor therapy compared with anti-vascular endothelial growth factor therapy in advanced colorectal cancer: a meta-analysis of randomized clinical trials.
Monoclonal antibodies targeting epidermal growth factor receptor (EGFR) or vascular endothelial growth factor (VEGF) have demonstrated efficacy in combination with chemotherapy in the first-line therapy of advanced colorectal cancer (CRC). Data from randomized studies comparing these monoclonal antibodies as initial therapy is conflicting, and their comparative efficacy remains unclear. We aimed to evaluate the impact of these targeted therapies on patient outcomes by combining the data from randomized clinical trials. ⋯ The results of our research show superior ORR and OS with first-line anti-EGFR therapy compared with anti-VEGF therapy in both KRAS-WT and all RAS-WT patients with advanced CRC. These results suggest that anti-EGFR monoclonal antibodies may be a real alternative to anti-VEGF therapy as initial treatment of advanced CRC.
-
Clin Colorectal Cancer · Sep 2014
ReviewSequencing of antiangiogenic agents in the treatment of metastatic colorectal cancer.
Significant advances have been made with respect to our understanding of the critical role of agents targeting angiogenic pathways in the treatment of metastatic colorectal cancer (mCRC). The approval of 3 agents that target angiogenic signaling, bevacizumab, ziv-aflibercept, and regorafenib, provides strong evidence that angiogenesis is an important process in mCRC. The addition of bevacizumab to combination chemotherapy in the first- and second-line treatment of mCRC has resulted in meaningful improvement in overall and progression-free survival. ⋯ Each of these agents has been integrated into an evidence-based-albeit, still evolving-treatment continuum for initial treatment, treatment after first progression, and treatment after second progression. However, the most effective strategy for the use of these agents, and others in development remains unclear. This review provides an overview of the current clinical evidence for the use of antiangiogenic agents targeting in the treatment of mCRC.
-
Clin Colorectal Cancer · Sep 2014
Randomized Controlled Trial Comparative StudyRandomized phase II open-label study of mFOLFOX6 in combination with linifanib or bevacizumab for metastatic colorectal cancer.
Although CRC is the third most commonly diagnosed cancer in the United States, second-line CRC treatment is limited. In this trial we examined the efficacy and safety of linifanib, an oral, potent, selective tyrosine kinase inhibitor of vascular endothelial growth factor and platelet-derived growth factor receptor families, with mFOLFOX6, compared with bevacizumab and mFOLFOX6, in previously treated metastatic CRC. ⋯ Combining linifanib with mFOLFOX6 as a second-line treatment for metastatic CRC did not improve PFS, radiographic findings, or duration of response versus bevacizumab and mFOLFOX6.
-
Clin Colorectal Cancer · Sep 2014
Adjuvant treatment for locally advanced rectal cancer patients after preoperative chemoradiotherapy: when, and for whom?
The standard treatment for patients with locally advanced rectal cancer (clinical tumor, node, metastases [TNM] stage II or III) is radiotherapy before surgery (with or without concomitant fluoropyrimidine-based chemotherapy) followed by surgery. The role of adjuvant chemotherapy in this setting of patients is controversial in terms of the overall benefit on survival, the subgroup of patients who might not need it, and the best regimen (combination regimens vs. fluoropyrimidine alone). ⋯ ypN+ patients are candidate for intensified adjuvant chemotherapy.