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Immunotherapy has no involvement in microsatellite stable mCRC, a "cold" tumor that is used-of-care for metastatic colorectal cancer, although chemotherapy is common-of-care for metastatic colorectal cancer. PolyPEPI1018 was tested in MSS mCRC patients as well as first-line maintenance therapy. Following first-line induction with chemotherapy and a biologic, 11 patients with MSS mCRC were treated with PolyPEPI1018 and Montanide ISA51VG adjuvant subcutaneously, as well as fluoropyrimidine/biologic. In Part A of the study, five patients received a single dose of PolyPEPI1018 every 12 weeks, and in Part B six patients, up to three doses of PolyPEPI1018 every 12 weeks. 80% of patients had CD8+ T-cell responses against greater than or equal to 3 TAAs. The host HLA genotype predicted multi-antigen-specific T-cell responses indicative of clinical outcome, according to the host's HLA genotype. PolyPEPI1018 was added to maintenance chemotherapy for patients with unresectable, MSS mCRC, and was safe and associated with specific immune responses and antitumor activity, requiring further confirmation in a randomized, controlled environment.
Source link: https://europepmc.org/article/MED/35472243
Using a de-identified database, we can better explain KRAS p. G12C disease, diagnosis patterns, overall survival, and real-world progression-free survival in patients with metastatic colorectal cancer, KRAS p. G12C mutations, and other KRAS mutations. KRAS G12C mutations in 6477 patients with mCRC were reported in 238, and 2947 had KRAS non-G12C mutations. In the KRAS G12C versus KRAS non-G12C cohorts, treatment patterns were generally similar across lines of therapy. The first LOT was 16. 1 months for the KRAS non-G12C cohort, and 19. 2 months for the mCRC overall cohort; median rwPFS was 7. 4, 9. 0, and 9. 2 months, respectively, according to Median OS; the first LOT was 16. 1 months for the KRAS G12C cohort and 19. 3 months for the mCRC overall cohort. Patients with KRAS p. G12C-mutant mCRC have poor treatment outcomes, and their results appear numerically worse than those without this mutation, indicating potentially harmful medical implications for KRAS p. G12C mutations and unmet medical need in this population.
Source link: https://europepmc.org/article/MED/35472176
Colorectal cancer accounts for just 10% of all cancers and is the second most common cause of cancer deaths. About 20% of patients are in need of a temporary medicalization. In addition, up to 50% of patients with localized disease suffer metastases. In the emergence of precision medicine, this report summarizes the advancements in the clinical management of patients with mCRC in this period. The next steps in the clinical management of mCRC will include comprehensive knowledge of tumor gene expression profiling, tumor and microenvironment gene and protein expression profiling, as well as the application of the latest innovations in precision medicine-based continuum of care for each patient. This approach may result in the identification of individual prognostic and predictive parameters, which may help the clinician in choosing the most appropriate therapeutic regimen for each patient with mCRC throughout the entire disease course.
Source link: https://europepmc.org/article/MED/35472088
Objectives Many clinical trials for older patients with metastatic colorectal cancer have been conducted, and fluoropyrimidine and bevacizumab are common treatments. In older metastatic colorectal cancer patients, the connection between age and the efficacy and safety of this therapy is uncertain. Methods Individual results from two phase II studies on older, non-frail patients with metastatic colorectal cancer treated with uracil-tegafur/leucovorin or S-1 combined with bevacizumab were gathered, including bevacizumab. The result We recruited 102 patients with a median age of 80 years old, with a median age of 80 years. Grade 2 exhaustion was the most common cause of treatment failures. Age was little linked to non-hematologic adverse events, including exhaustion and nausea, but not with hematologic or bevacizumab-related adverse events. Conclusions: Fluoropyrimidine plus bevacizumab was age-independence in patients with metastatic colorectal cancer aged 75 years, and caution should be paid to non-hematologic adverse events as the age rises.
Source link: https://europepmc.org/article/MED/35470391
Objectie: Effective first-line therapy is a key determinant of long-term treatment outcomes in patients with metastatic colorectal cancer. We monitored changes in renal function in 1 year among patients with mCRC who received first-line chemotherapy. Methods We retrospectively reviewed patients with mCRC who were treated with a standard triplet regimen in the first-line setting at Korea University Anam Hospital from 2015 to 2020. Among 472 patients with mCRC, the median eGFR at baseline was 90. 9 mL/min/1. 73 m 2; it was significantly lower at 12 months after chemotherapy started. Patients treated with FOLFIRI + Bevacizumab had an eGFR of 74. 9 mL/min/1. 73 m 2 in particular. Patients receiving FOLFOX/cetuximab were the least frequent in patients receiving FOLFIRI + bevacizumab, while those receiving FOLFIRI + bevacizumab were 9. 1%, with the lowest incidence in patients receiving FOLFOX/cetuximab being the lowest among patients receiving FOLFOX/cetuximab and the highest in those receiving FOLFIRI + bevacizumab.
Source link: https://europepmc.org/article/PPR/PPR485657
Purpose We aimed to compare the diagnostic reliability of perioperative cfDNA to a CEA for determining colon cancer recurrence. Patients undergoing elective resection for colon cancer with curative intent were chosen for inclusion. Both CEA and EG levels were measured in the same patients up to 2 years post-operatively. Results Longitudinal data on twenty-two patients was analysed for a median of 29 months, after which three patients experienced recurrence. This translated into a sensitivity of 91 percent for cfDNA and 77. 5% sensitivity in the immediate postoperative period, as well as an 88. 9% specificity and 76. 5% sensitivity for CEA over the first two years post-operatively. Conclusions are drawn in this pilot study, which follows curative resection of colon cancer in perioperative cfDNA, identify those at risk of recurrent disease before recurrence arises, which is at least six months earlier than CEA trends that are only observed when recurrence is established.
Source link: https://europepmc.org/article/MED/35441872
Introduction In patients with unresectable metastatic colorectal cancer that is ineligible for intensive chemotherapy, therapeutic options are limited. In the TASCO1 trial, the use of trifluridine/tipiracil plus bevacizumab was evaluated; here, we present the final overall survival results. Methods TASCO1 was an open-label, non-comparative phase II trial. C-B and 17. 7 months with C-B at 1 September 1, 2020, median OS was 22. 3 months with TT-B and 17. 7 months with C-B. Conclusions TT-B is a promising therapeutic regimen in mCRC patients who are ineligible for intensive chemotherapy.
Source link: https://europepmc.org/article/MED/35440667
Objectives We are reviewing the latest findings on circulating tumour DNA and its clinical relevance in predicting outcomes in patients with metastatic colorectal cancer patients. We included reviews of patients with mCRC who are unaware of the predictive or prognostic value of ctDNA. Base ctDNA and early changes in ctDNA levels during treatment were both related to survival, according to a study conducted by separate random-effects meta-analyses to see if survival was related to baseline ctDNA and early changes in ctDNA values during treatment. Short PFS and OS were associated with a modest or no early decrease in ctDNA levels during therapy. Prognostic biomarker in mCRC, plasma ctDNA is a good prognostic biomarker.
Source link: https://europepmc.org/article/MED/35440666
Background Encorafenib plus cetuximab is safe in anti-EGFR-nave patients with BRAF V600E mutationated metastatic colorectal cancer, which is BRAF-based. No studies are available regarding the safety of BRAF inhibitors related to anti-EGFRs in patients recently treated with an anti-EGFR agent. Methods We retrospectively collected a series of patients with BRAFm mCRC treated with B + E after previous anti-EGFR therapy in 14 centers. 4/10/11 patients were treated with 1/2/> 2 recent treatment lines before starting B + E therapy. One patient received recent panitumumab, 14 cetuximab, 1 both. Anti-BRAF was encorafenib for 21 patients, dabrafenib for 4 patients, with cetuximab for 24 patients and panitumumab for one patient. DCR among patients with prior primary resistance to anti-EGFR was 100 percent. Conclusions These findings, though limited retrospective series of patients, reveal the effectiveness of the combination of anti-BRAF and anti-EGFR in BRAFm mCRC patients previously treated with an anti-EGFR.
Source link: https://europepmc.org/article/MED/35436675
The present research investigated 35 patients with mCRC and sought to elucidate the benefits of prophylactic pegfilgrastim for the treatment of severe neutropenia. Patients received TAS-102 orally twice daily on days 1-5 and 8-12 of each 28-day medical cycle, as well as intravenous bevacizumab on days 1 and 15. Among these eight patients, 6 and 3 developed neutropenia before being offered pegfilgrastim or following the discontinuation of pegfilgrastim therapy, respectively. In addition, one patient among these 8 patients died of grade 3 neutropenia immediately prior to being treated with pegfilgrastim and subsequent discontinuation of pegfilgrastim. After pegfilgrastim administration, none of the patients developed severe neutropenia during chemotherapy, thus avoiding dose delays and dose reduction of TAS-102. In conclusion, prophylactic pegfilgrastim may have been able to support the treatment of acute neutropenia in patients with mCRC treated with TAS-102 plus bevacizumab.
Source link: https://europepmc.org/article/MED/35463210
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