8-1-08 – CRC Screening Rates Remain Low in Europe, Australia and the US
A recently released report summarized on this website showed low CRC screening rates among Asians. Now 2 more reports have been published showing similarly low screening in Europe, Australia and the United States.
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7-18-08 – Asians Are Less Likely To Undergo CRC Screening
A paper in the June 23, 2008 issue of Archives of Internal Medicine reports that Asians are less likely than non-Hispanic whites and other racial or ethnic minorities to undergo CRC screening. Dr Anthony F. Jerant and colleagues analyzed screening behavior data using linked data from 22,973 respondents to the 2001-2005 Medical Expenditure Panel Survey and the 2000-2004 National Health Interview Survey for respondents = age 50 from four major US racial/ethnic categories (non-Hispanic white, black, Hispanic, Asian). In general, they found:
Women were less likely to be screened than men
Minority populations have lower screening rates compares with whites
Traditional barriers (socioeconomic factors, language barriers) don’t explain the disparity among Asians
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7-11-08 – Oxaliplatin Gives a Small 5-year Survival Advantage
Findings from the large, randomized National Surgical Adjuvant Breast and Bowel Project (NSABP) C-07 trial were reported at the Annual Meeting of the American Society of Clinical Oncology (ASCO) in June. Norman Wolmark, M.D. and colleagues presented information suggesting that oxaliplatin should be part of a standard chemotherapy regimen for stage II or III colon cancer. Adding oxaliplatin may provide a small five-year survival advantage, according to C-07 researchers.
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6-26-08 – Predictive Biomarkers in The Treatment of mCRC
Individualizing treatment approaches for various cancers is gaining interest. Clinicians can use biomarkers to help determine appropriate treatment. These biomarkers can correlate with patient outcomes (survival or progression) and are thought of as either prognostic or predictive.1 Although prognostic biomarkers are important, they do not predict whether the patient outcome will be improved by therapy with specific agents, limiting their effect on choices of therapy. If biomarkers could determine whether the outcome of a particular patient will be improved by treatment, unnecessary toxicity and costs associated with specific therapies could be avoided.
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6-10-08 – Fluoropyrimidine Tolerability Differences Among Regions
Haller and colleagues recently published results of a retrospective analysis of three randomized single-agent fluoropyrimidine clinical trials to explore the hypothesis that there are regional tolerability differences. This was prompted by the controversy surrounding tolerability of labeled-
doses of capecitabine in Europe and the concerns that labeled dosing in the United States (US) is too high. Additionally, there were observations that patients receiving adjuvant bolus flurouracil have shown regional tolerability differences.
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5-29-08 – Use of a COX-2 Inhibitor in Prevention of Polyps
Dr Nadir Arber of Tel Aviv University reported 5-year data from the Prevention of Colorectal Sporadic Adenomatous Polyps (PreSAP) trial on May 21, 2008 at Digestive Disease Week in San Diego CA. Patients at high risk for adenomas who took celecoxib (Celebrex), a COX-2 inhibitor, daily for 3 years had a 25% lower risk of new colorectal polyps and significantly fewer advanced ones 2 years after cessation of treatment. The cumulative rate of adenoma detection at year five (3 years on drug or placebo and 2 years off) was 51.4% vs 57.5% in the placebo group (RR 0.75, 95% CI 0.65 to 0.86, P<0.0001) and the advanced adenoma detection rate was 10% vs 13.8% (RR 0.64, 95% CI 0.457 to 0.887, P = 0.0072).
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5-23-08 – New Multi-Organization CRC Screening Guidelines Published
In the May/June 2008 issue of CA: A Cancer Journal for Clinicians (American Cancer Society), Levin and colleagues published screening and surveillance guidelines for the early detection of colorectal cancer (CRC) and adenomatous polyps. The authors represent the American Cancer Society Colorectal Cancer Advisory Group, the US Multi-Society Task Force and the American College of Radiology Colon Cancer Committee. This article updates each organization's guidelines according to current evidence. Screening tests are grouped into those that primarily detect cancer early and those that can detect cancer early and also can detect adenomatous polyps, thus providing a greater potential for prevention through polypectomy.
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5-16-08 – No Benefit with Use of Cisplatin in Treatment for Anal Cancer
A paper published by Ajani and colleagues in the April 23, 2008 issue of the Journal of the American Medical Association (JAMA) reports results of the US Gastrointestinal Intergroup trial RTOG 98-11. This multicenter, phase 3, randomized controlled trial compared the standard treatment of 5-FU, mitomycin and radiation vs treatment with 5-FU, cisplatin and radiation for anal cancer. Researchers found that the addition of cisplatin to 5-FU and radiation may not improve outcomes for patients with anal cancer.
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5-14-08 – Colorectal Cancer in the Elderly
Colorectal cancer (CRC), a commonly occurring cancer and leading cause of death for both sexes, frequently occurs in patients of older age. The median age at diagnosis is 70 with many patients older than 70 when initially diagnosed with colon cancer1 The overall survival (OS) for patients with metastatic CRC (mCRC) has been significantly prolonged, with many patients surviving over 24 months with this disease.
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5-6-08 – Celecoxib for CRC Chemoprevention May Not be Safe for Everyone
Monica Bertagnolli MD, principal investigator of the Adenoma Prevention with Celecoxib (APC) study, an international randomized, placebo-controlled trial, reported on 5-year efficacy and safety results at the American Association of Cancer Research (AACR) annual meeting in San Diego, CA. Results indicate that CRC chemoprevention with the COX-2 inhibitor celecoxib is effective and can be safe for patients without any underlying cardiovascular risk factors. Celecoxib at low doses protects against high-risk lesions that can lead to colon cancer; however, it does not appear to be safe for patients with cardiovascular risk factors.
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4-25-08 – Bevacizumab, Capecitabine, and Oxaliplatin: Neoadjuvant Therapy for Potentially Curable Metastatic Colorectal Cancer (mCRC)
Metastasis to the liver is quite common in patients with colorectal cancer, with 25% of the patients presenting with liver disease at diagnosis, and an additional 25% to 45% developing liver metastases if the disease recurs. Although these patients have a poor prognosis, there have been advances in treatment for this population. Selected patients can derive benefit from receiving neoadjuvant chemotherapy and subsequent surgical resection of their disease.
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