Gastrointestinal Cancer

Advanced colorectal cancer patients with BRAF mutations have markedly worse prognosis than non-mutant patients, according to a large analysis. Post-progression survival in particular is worse among BRAF-mutant patients.

Patients with metastatic colorectal cancer who engaged in more hours of physical activity at the time of their diagnosis had improvements in both progression-free and overall survival compared with patients who had less physical activity.

Using a watch-and-wait strategy among a group of highly selected patients with rectal cancer who have undergone neoadjuvant chemoradiation did not appear to compromise outcomes.

Using PET scans during induction chemotherapy for esophageal cancer, researchers were able to assess patient response to treatment and adjust their therapy, leading to an improved rate of pathologic complete response prior to surgery.

Adding cetuximab to chemoradiation yielded better locoregional failure rates than historical data in a small trial of patients with squamous cell carcinoma of the anal canal, but the treatment resulted in substantial toxicity.

The regular use of aspirin reduced the risk for pancreatic cancer by almost 50%, according to the results of a Chinese study.

Non-aspirin NSAIDs are more effective than other options for colorectal chemoprevention in individuals with previous colorectal neoplasia, according to a new meta-analysis. Low-dose aspirin, however, is a safer option, and offers the best risk-benefit profile.

More than 15% of patients with early-onset colorectal cancer may harbor mutations to cancer susceptibility genes, suggesting a need for genetic counseling and a multigene panel.

The occurrence of colon cancer on the right vs left side of the colon is a prognostic factor for all stages of the disease.

Patients with peritoneal metastatic colorectal cancer had significantly shorter overall survival compared with patients with other isolated sites of metastases.

The expansion of healthcare in Massachusetts in 2006 was associated with increased rates of resection for patients with colorectal cancer.

Colonoscopy screening is modestly effective for preventing colorectal cancer in patients aged 70 to 74, but the benefits may begin to diminish after that.

A set of genes that are more likely to be mutated in African-Americans vs Caucasians with colorectal cancer appears to increase the risk of metastases and relapse in mutant versions.

In this interview we discuss the GeneFx Colon test (or the ColDx assay), which can helpful identify patients with low- or high-risk stage II colon cancer.

A gene expression microarray-based assay was able to successfully identify patients with stage II colon cancer who are at high risk for recurrence.

A study found that fusobacteria, commonly found in the mouth, can enrich colorectal cancer cells, in a process mediated by the Fap2 protein.

These guidelines review the use of radiation, chemotherapy, and surgery in borderline and unresectable pancreas cancer. Radiation technique, dose, and targets were evaluated, as was the recommended chemotherapy, administered either alone or concurrently with radiation. This report will aid clinicians in determining guidelines for the optimal treatment of borderline and unresectable pancreatic cancer.

Here we review the evidence supporting current approaches to resectable gastric cancer, including discussion of the optimal extent of surgery and lymphadenectomy, adjuvant chemotherapy, postoperative chemotherapy with chemoradiation, and perioperative chemotherapy.

Current methods of treatment still have a small impact on the survival of patients with localized disease. Improved understanding of the underlying mutations seen in gastric cancer might suggest alternative treatments and ways to better select patients.

Combination treatment with the MEK inhibitor cobimetinib and the anti–PD-L1 drug atezolizumab was active in patients with microsatellite-stable metastatic colorectal cancer.

Lymph node status after undergoing neoadjuvant chemotherapy and resection of esophagogastric cancer was the only independent predictor of survival.

A retrospective analysis of a phase III clinical trial found that the physical location of the primary tumor predicts survival in patients with metastatic colorectal cancer.

The USPSTF has issued an updated guideline with recommendations regarding screening for colorectal cancer. A systematic review found that screening can be of “substantial net benefit.”

Here we discuss the evolution of standard therapy for rectal cancer patients and the use of preoperative CRT for the treatment of locally advanced disease. Treatment schemes that have attempted to broaden the horizons of standard therapy include the use of induction chemotherapy and “watch-and-wait” approaches.

By adjusting the sequencing of currently available treatments, improved compliance with therapy is ensured, and novel scientific and clinically relevant hypotheses can be further explored.

The ESPAC-4 trial found that adding capecitabine to gemcitabine in patients with resected pancreatic cancer resulted in an improved estimated 5-year survival rate.

In this interview we discuss the CheckMate 142 trial, which looked at nivolumab and ipilimumab for the treatment of metastatic colorectal cancer.

A novel first-in-class antibody can significantly extend median survival when added to standard chemotherapy for patients with advanced gastric cancer.

Matching targeted therapies to genetic abnormalities harbored by tumor types for which those therapies are not approved by the FDA might expand treatment options for some patients with advanced cancers.

Use of hypofractionated chemoradiation prior to pancreatoduodenectomy resulted in similar resection rates and outcomes vs standard fractionation.