Clinical colorectal cancer最新文献

{"title":"Trends and Disparities in the Receipt of Treatment for Colon Cancer in Older Adults in Alberta, Canada","authors":"Abisola A. Adegbulugbe ,&nbsp;Philip Q. Ding ,&nbsp;Chantelle Carbonell ,&nbsp;Dylan E. O’Sullivan ,&nbsp;Winson Y. Cheung","doi":"10.1016/j.clcc.2025.09.006","DOIUrl":"10.1016/j.clcc.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Adults aged ≥ 70 years represent approximately half of all patients diagnosed with colon cancer, but undertreatment in this population persists. Recent guidelines have aimed to reduce age-related biases in the treatment of colon cancer. We evaluated the age-related disparities in the receipt of curative-intent surgical and medical treatment of colon cancer, and their changes over time.</div></div><div><h3>Methods</h3><div>This was a population-based cohort study of adult patients diagnosed with colon adenocarcinoma between 2010 and 2018 in Alberta, Canada. Surgery receipt was assessed in patients with stage I-III disease, while systemic therapy receipt was assessed in stage III to IV disease. Patients were stratified by age at diagnosis (&lt; 70 and ≥ 70 years). Cox proportional hazard models were used to evaluate interactions between age and treatment status, and their associations with cancer-specific survival (CSS). Time trends associated with treatment receipt were identified with multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the 10,838 patients included, 48% were aged ≥ 70 years. For surgery recipients, 5-year CSS was 0.90 (95% CI, 0.88-0.91) and 0.79 (95% CI, 0.77-0.80) for patients &lt; 70 and patients ≥ 70 years of age respectively. Systemic therapy recipients aged &lt; 70 years had a 5-year CSS of 0.57 (95% CI, 0.55-0.60), while individuals aged ≥ 70 years had a 5-year CSS of 0.51 (95% CI, 0.49-0.55). The association between treatment receipt and CSS was independent of age for both treatment modalities (<em>P</em> = .17). Treatment receipt trends remained consistent between 2010 and 2018.</div></div><div><h3>Conclusion</h3><div>Despite evolving practice guidelines and non-age-dependent survival benefits, disparities persist in the receipt of treatment for older adults with colon adenocarcinoma.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 33-42"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Tumor Sidedness Matter After Curative Surgery in Colorectal Cancer? A Retrospective Cohort Study on Recurrence Patterns and Post Recurrence Survival","authors":"Fernando Mendoza-Moreno ,&nbsp;Manuel Díez-Alonso ,&nbsp;Belén Matías-García ,&nbsp;Enrique Ovejero-Merino ,&nbsp;Héctor Aguado López ,&nbsp;Cristina Vera-Mansilla ,&nbsp;Lucía Diego-García ,&nbsp;Beatriz Castro-Catalán ,&nbsp;Alberto Vilar-Tabanera ,&nbsp;Rubén Jiménez-Martín ,&nbsp;Raúl Díaz-Pedrero ,&nbsp;Miguel A. Ortega ,&nbsp;Melchor Alvarez-Mon ,&nbsp;Alberto Gutiérrez-Calvo","doi":"10.1016/j.clcc.2025.10.006","DOIUrl":"10.1016/j.clcc.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic and predictive relevance of primary tumor sideness in colorectal cancer (CRC) has garnered growing interest. While clinical and molecular differences between right-sided (RS), left-sided (LS) and rectal (RT) tumors are well established in metastatic disease, their impact in non-metastatic, surgically treated patients remains less clear. This study aims to evaluate whether tumor location influences recurrence patterns and post-recurrence survival (PRS) following curative-intent resection for CRC. Patients and Methods We conducted a retrospective cohort study including 1,425 patients with histologically confirmed stage I-III colorectal adenocarcinoma who underwent R0 resection.</div></div><div><h3>Results</h3><div>Tumor recurrence was observed in 22.4% of patients. However, recurrence site differed significantly by tumor location: RS tumors were more likely to develop peritoneal metastases (9.5% vs. 6.6% LS and 5.3% RT; p=0.044), whereas RT tumors had a higher incidence of pulmonary metastases (12.4% vs. 6.3% RS and 7.4% LS; p=0.004). PRS differed markedly: 36-month PRS was 21% for RS, 41% for LS, and 32% for RT (p=0.005). Multivariate analysis confirmed primary tumor location as an independent prognostic factor for PRS. RS tumors conferred a significantly higher risk of death post-recurrence compared to LS and RT tumors. Although tumor sidedness does not appear to influence overall recurrence rates after curative resection, it is associated with distinct metastatic patterns and significantly worse post-recurrence outcomes.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need to incorporate tumor location into prognostic stratification and post-surgical surveillance strategies in CRC. Personalized follow-up protocols, based on tumor biology and recurrence risk, may improve long-term outcomes.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 87-96"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrogen Receptor May Play Important Role in Gender Differences of Early-Onset Colorectal Cancer","authors":"Qian-Nan Wang,&nbsp;Xiao Zhang,&nbsp;Lan-Lan Feng,&nbsp;Na Ning,&nbsp;Fu-Qin Zhang,&nbsp;Jia-Min Liang,&nbsp;Wei Zhang,&nbsp;Li Gong","doi":"10.1016/j.clcc.2025.10.008","DOIUrl":"10.1016/j.clcc.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of early-onset colorectal cancer (EOCRC) is increasing year by year. However, it is still unclear and controversial whether there is a significant gender difference. Our aims to investigate the clinicopathological characteristics of EOCRC, especially gender differences, and their correlation with the expression of estrogen receptor (ER), so as to provide a scientific basis for optimizing the early screening and treatment strategy of EOCRC.</div></div><div><h3>Methods</h3><div>All surgical specimens of CRC were collected from January 2015 to July 2024. Then, the clinicopathological characteristics were analyzed between EOCRC and late-onset CRC (LOCRC). Simultaneously, the expression of ER was investigated in EOCRC by RT-PCR and immunohistochemical staining.</div></div><div><h3>Results</h3><div>A total of 3041 CRC cases were analyzed in this study, which included 485 EOCRC and 2556 LOCRC cases. Specifically, EOCRC had significant differences in gender (<em>P</em> = .0356), deficient mismatch repair (dMMR) status (<em>P</em> = .0029), and lymph node metastases (<em>P</em> = .0425) compared with LOCRC. Simultaneously, in EOCRC, males were more susceptible to colon cancer (<em>P</em> = .0009) and dMMR status (<em>P</em> = .0365) compared with females. Moreover, the variation of dMMR status was related to the absence of genetic history of disease (<em>P</em> = .0034). Totally, the expression of ER mRNA was higher in female CRC than that in male one (<em>P</em> = .0009), which was also in EOCRC (<em>P</em> = .0092). In addition, its expression was higher in LOCRC (<em>P</em> = .0056) and female LOCRC with dMMR (dLOF) (<em>P</em> = .0341) than that in EOCRC and female EOCRC with dMMR (dEOF). Further analysis showed that the expression of ER mRNA was significantly higher in male LOCRC (LOM) (<em>P</em> = .0305), LOCRC with dMMR (dLO) (<em>P</em> = .0030), male LOCRC with dMMR (dLOM) (<em>P</em> = .0275), and sporadic LOM (dLOM-s) (<em>P</em> = .0274) than that in their corresponding male EOCRC (EOM), EOCRC with dMMR (dEO), male EOCRC with dMMR (dEOM), and sporadic dEOM (dEOM-s) in turn, but there was no significant difference in proficient MMR (pMMR) (<em>P</em> = .6046).</div></div><div><h3>Conclusions</h3><div>There were significant differences in the clinicopathological features and sex hormone expression in EOCRC with different genders, suggesting that gender may be an independent factor in clinical classification of EOCRC.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 107-114.e3"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Deep Learning-Aided Detection of Microsatellite Instability in Colorectal Cancer: A Systematic Review and Meta-Analysis","authors":"Zihong Wang,&nbsp;Feiba Chang,&nbsp;Hongbo Wu,&nbsp;Xianju Yuan,&nbsp;Yong Chen,&nbsp;Jinchuan Han","doi":"10.1016/j.clcc.2025.09.004","DOIUrl":"10.1016/j.clcc.2025.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>We synthesized the evidence on the accuracy of Deep learning in detecting colorectal cancer microsatellite instability to contribute to the development and updating of intelligent detection tools.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, Embase, and Cochrane Library from their inception until December 1, 2024. The included studies were assessed for the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2. Only the diagnostic fourfold tables in the validation set underwent meta-analyses.</div></div><div><h3>Results</h3><div>Thirty original studies were finally included. The pooled specificity, sensitivity and area under the summary receiver operating characteristic curve of pathology slice-based deep learning were 0.86 (95% CI, 0.80-0.90), 0.90 (95% CI, 0.85-0.93) and 0.94 (95% CI 0.30-1.00), respectively. For the external validation of pathology slice-based deep learning, the pooled specificity, sensitivity and summary receiver operating characteristic curve were 0.84 (95% CI, 0.76-0.89), 0.88 (95% CI, 0.83-0.92) and 0.93 (95% CI, 1.00-0.00), respectively. The number of included studies on MRI-, colonoscopy-, and Raman spectrum-based deep learning was extremely small.</div></div><div><h3>Conclusions</h3><div>Pathology slice-based deep learning is accurate for colorectal cancer microsatellite detection and has potential for future software development, but imaging image-based deep learning needs more validation.</div></div><div><h3>Trial Registration</h3><div>This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). The protocol was prospectively registered with PROSPERO (CRD42025629990).</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 1-20"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Regression of Colon Adenocarcinoma: A Case for Reconsideration","authors":"S. Sharareh Dehghani ,&nbsp;Arunima Kaul ,&nbsp;Hilary Hertan ,&nbsp;Bahar Laderian ,&nbsp;Christopher Andreade","doi":"10.1016/j.clcc.2025.11.003","DOIUrl":"10.1016/j.clcc.2025.11.003","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>What is already known about this subject?</div><div>Spontaneous regression (SR) of solid tumors is a rare but documented phenomenon, particularly in cancers with high immunogenicity such as mismatch repair-deficient (dMMR) colorectal cancer. However, the underlying mechanisms and long-term outcomes remain poorly understood</div></span></li><li><span>•</span><span><div>What does this study add?</div><div>This case report describes a rare instance of SR in a descending colon adenocarcinoma with dMMR (loss of MLH1/PMS2), followed by documented tumor recurrence nearly 3 years later. It underscores a potential link between infection-induced immune activation and tumor regression, while also highlighting the importance of histological confirmation and long-term surveillance.</div></span></li><li><span>•</span><span><div>How might this change clinical practice?</div><div>Clinicians should be aware that spontaneous regression can occur in dMMR colorectal cancers, especially in the setting of infection or immune stimulation. However, such regression does not imply durable remission. These patients warrant close, long-term follow-up with repeat colonoscopy and imaging to detect possible recurrence.</div></span></li></ul></div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 168-171"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Cancer Treatment on Inflammation in Colorectal Cancer Patients: A Longitudinal Study","authors":"Anouk E.C. Bruijnzeels ,&nbsp;Floortje Mols ,&nbsp;Katrijn Van Deun ,&nbsp;Dounya Schoormans","doi":"10.1016/j.clcc.2025.12.001","DOIUrl":"10.1016/j.clcc.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) treatment commonly involves surgery combined with chemotherapy (CT) and/or radiotherapy (RT), which can trigger acute and chronic immune alterations. Understanding treatment-related inflammation is critical, as persistent immune dysregulation may influence therapeutic response, toxicity, and long-term outcomes. This study investigates longitudinal changes in inflammatory markers among CRC patients from pre-treatment to 2 years post-diagnosis and compares them to a matched cancer-free control group to isolate treatment-related effects.</div></div><div><h3>Materials and Methods</h3><div>Data were drawn from the PROCORE study (<em>n</em> = 411), and a sex- and age-matched normative sample (<em>n</em> = 204). Inflammatory markers (IL-1α, IL-1β, IL-6, IL-8, IL-10, IL-17A, IL-22, CRP, IFN-γ, sTNFRI, sTNFRII) were measured at diagnosis (pre-treatment), and 12- and 24-month follow-ups. Linear mixed models assessed longitudinal biomarker trajectories across treatment groups (CT, RT, both, neither), controlling for demographic and clinical covariates. Group differences in inflammatory markers were compared to normative reference values.</div></div><div><h3>Results</h3><div>Across timepoints, CRC patients exhibited persistently altered biomarker levels compared with controls (higher IFN-γ, IL-1β, IL-10; lower IL-6, IL-8, sTNFRI), partly independent of treatment modality. Significant time x treatment interactions were visible for IL-6, IL-8, IL-17A, IL-22, sTNFRI and sTNFRII, with most post-hoc differences between RT only and CT only groups.</div></div><div><h3>Conclusion</h3><div>Chronic immune alterations in CRC patients appear only partly attributable to treatment type, suggesting broader cancer-related immune dysregulation. These findings highlight the importance of incorporating immune monitoring into clinical care and raise the potential for therapeutic strategies targeting inflammation to mitigate late effects.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 135-151.e4"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Oncological Outcomes of Transanal Total Mesorectal Excision in Rectal Cancer: A Retrospective Study from a High-Volume Italian Center","authors":"Roberto Persiani,&nbsp;Flavio Tirelli,&nbsp;Laura Lorenzon,&nbsp;Ilaria Neri,&nbsp;Annamaria Agnes,&nbsp;Massimo Pascariello,&nbsp;Gloria Santoro,&nbsp;Alberto Biondi","doi":"10.1016/j.clcc.2025.10.003","DOIUrl":"10.1016/j.clcc.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Despite the documented technical advantages in terms of pelvis dissection and increased rate of sphincter-preserving procedures, the long-term oncological outcomes after transanal total mesorectal excision (TaTME) are still a matter of debate. This study aimed to report mid- and long-term survival outcomes of patients with rectal cancer treated with TaTME.</div></div><div><h3>Methods</h3><div>Patients with non-metastatic mid to low rectal adenocarcinoma who underwent double-team trans-anal/laparoscopic trans-abdominal total mesorectal excision between 2015 and 2020 were selected and reviewed. Three and 5-year overall survival (OS), 3 and 5-year disease-free survival (DFS), 3 and 5-year disease-specific survival (DSS), and 3 and 5-year local recurrence (LR) rate. Univariable and multivariable analyses were performed to correlate clinical and pathological variables with the outcomes of interest.</div></div><div><h3>Results</h3><div>Of 146 patients treated with TaTME during the study period, 114 non-metastatic patients were analyzed (M/F 1.7; mean age: 69.1 years). The mean follow-up time was 58.6 months. Sixty four percentage received neoadjuvant treatment before TaTME. Pathologic stages were documented as being stage 0-I in 62 (54.4%) and stage II-III in the remaining 52 patients (45.6%); 5 patients had a positive circumferential margin (4.4%), and overall, one-third of the cohort received adjuvant therapy. 3-year survival outcomes were: OS 89.4%, DFS 95.5%, DSS 85.5%, and LR 3.5%.</div><div>The multivariable analysis of the 3-year outcomes showed a significant association between OS and age at the time of surgery and between DFS and pathological stages. A 5-year survival analysis was conducted on 68 patients. 5-year survivals were OS 75.0%, DFS 91.0%, and DSS 82.0%. Multivariate analysis showed that elderly age had a negative impact on 5-year OS.</div></div><div><h3>Conclusions</h3><div>When performed by experienced surgeons in a high-volume center, TaTME is a mini-invasive procedure with good mid/long-term oncological outcomes.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 68-76"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ideal Cardiovascular Health in Colorectal Cancer Patients at Diagnosis","authors":"María Romero-Elías ,&nbsp;Alejandro Álvarez-Bustos ,&nbsp;Lourdes Gutierrez ,&nbsp;Antonio Sánchez Ruiz ,&nbsp;Marta Méndez-Otero ,&nbsp;Carmen Fiuza-Luces ,&nbsp;Ana Ruiz-Casado","doi":"10.1016/j.clcc.2025.10.001","DOIUrl":"10.1016/j.clcc.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular disease (CVD) and cancer are the leading causes of chronic illness and mortality in Western societies. Colorectal cancer (CRC) is the third most prevalent cancer and shares some risk factors with CVD, which is the major cause of mortality in CRC survivors. The American Heart Association recommends Life's Simple 7 to define and measure ideal cardiovascular health (iCVH). This study aimed to detail the iCVH in CRC patients at diagnosis.</div></div><div><h3>Methods</h3><div>A cross-sectional study of a cohort of Spanish patients with CRC describes health and behavioral factors at diagnosis. Physical activity was monitored using accelerometers; Diet was assessed through adherence to Mediterranean diet, and anthropometry was assessed by the body mass index (BMI). Hypertension, diabetes, hypercholesterolemia, and smoking were collected from clinical records.</div></div><div><h3>Results</h3><div>Two hundred thirty-eight CRC patients participated (66.4% male, 64.7 years mean age), 153 (64.3%) had localized disease, and 85 (35.7%) had metastatic disease. 10% had a history of CVD. 10 patients (4.3%) met 7 components of iCVH. Non-smoking (89.5%) was the most prevalent healthy behaviour, whereas BMI &lt; 25 was the least (39.1%). Hypertension (62%) was the most common risk factor.</div></div><div><h3>Conclusions</h3><div>There is still some room for decreasing the habit of smoking. Initiatives for keeping a healthy diet and body composition are needed during and after the treatment.</div></div><div><h3>Implications for Practice</h3><div>Assessing iCVH at diagnosis, which is considered a teachable moment, would raise awareness among health practitioners and patients about the importance of cardiovascular health along CRC trajectory and about behaviours that can be improved and impact on both cardiovascular and cancer outcomes.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 43-50"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Blood-Based Biomarker Candidates in Screening for Colorectal Cancer","authors":"Mathias M. Petersen ,&nbsp;Jakob Kleif ,&nbsp;Jason Liggett ,&nbsp;Morten Rasmussen ,&nbsp;Lars N. Jørgensen ,&nbsp;Jakob B. Seidelin ,&nbsp;Claudia Jaensch ,&nbsp;Jesper Vilandt ,&nbsp;Kåre A. Gotschalck ,&nbsp;Peter Bondeven ,&nbsp;Uffe Schou Løve ,&nbsp;Berit Andersen ,&nbsp;Ib J. Christensen ,&nbsp;Herbert A. Fritsche ,&nbsp;Eric Mayer ,&nbsp;Christina Therkildsen","doi":"10.1016/j.clcc.2025.10.007","DOIUrl":"10.1016/j.clcc.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Blood-based biomarkers could be an alternative method to increase compliance in population-based screening programs for early detection of colorectal cancer (CRC). We aimed to identify blood-based biomarkers that can identify patients with early-stage asymptomatic CRC for use in national screening programs.</div></div><div><h3>Materials and Methods</h3><div>In a nested cohort of 1982 participants with a positive fecal immunochemical test (FIT, with &gt; 100 ng Hemoglobin/mL) from the Danish CRC screening program, serum levels of 18 blood-based biomarkers (including GDF-15, hepsin, IL-8, keratin 1/10, L1CAM, MIA, MCP-1, NSE, OPG, AFP, CD44, CATD, TWEAK, YKL-40, CEA, midkine, osteonectin and ferritin) were measured. Biomarkers associated to CRC after adjusting for various possible confounders were combined with age and sex in a predictive multivariable model for CRC.</div></div><div><h3>Results</h3><div>Complete biomarker and clinical data were collected from 1959 subjects, including 237 (12.1%) with CRC and 623 (31.8%) with advanced adenomas. IL-8 was unaffected by confounders, increased across the adenoma-carcinoma progression, and associated to CRC (OR: 1.83, 95% CI, 1.59-2.11, <em>P</em> &lt; .01) even when restricting analyses to early-stage CRC (OR: 1.41, 95% CI, 1.15-1.73, <em>P</em> &lt; .01). Combining IL-8, OPG, CEA, ferritin, and age resulted in an AUC of 0.717 (0.682-0.751) for discriminating subjects with and without CRC.</div></div><div><h3>Conclusion</h3><div>Application of blood-based biomarker panels consisting of colorectal neoplasia-associated proteins seem to be potential predictors for early detection of CRC. Especially IL-8 could have a significant impact on future screening models, though further testing in true screening cohorts is needed.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 97-106.e4"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall Survival for Bevacizumab Therapy in Metastatic Colorectal Cancer: An Updated Analysis of the TRAVASTIN Study","authors":"Rosie Maye Solomon ,&nbsp;Robert D. Morgan ,&nbsp;Laura Horsley ,&nbsp;Kalena Marti-Marti ,&nbsp;Danielle Shaw ,&nbsp;Andrew R. Clamp ,&nbsp;Mark P. Saunders ,&nbsp;Saifee Mullamitha ,&nbsp;Jurjees Hasan ,&nbsp;Prakash Manoharan ,&nbsp;James P.B. O’Connor ,&nbsp;Caroline Dive ,&nbsp;Michael Braun ,&nbsp;Cong Zhou ,&nbsp;Gordon C. Jayson","doi":"10.1016/j.clcc.2025.11.001","DOIUrl":"10.1016/j.clcc.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>The TRAVASTIN study dentified plasma Tie2 as the first vascular response biomarker for bevacizumab in metastatic colorectal cancer. Tie2-defined vascular responders had significantly longer progression-free survival (PFS) compared to nonresponders. Here, we report overall survival (OS) in TRAVASTIN after 7.7 years of follow-up, explore efficacy of bevacizumab use and reuse, and assess plasma Tie2 performance as a response biomarker.</div></div><div><h3>Methods</h3><div>This single-center, prospective study recruited 70 patients with newly diagnosed, large volume, metastatic colorectal cancer. Patients received first-line oxaliplatin-fluoropyrimidine chemotherapy plus bevacizumab. After disease progression, 22 patients were randomized to receive second-line fluorouracil-irinotecan chemotherapy with or without bevacizumab. A vascular response was defined as a 5% or more reduction in plasma Tie2 within 9 weeks of starting treatment. Survival outcomes were estimated using Kaplan–Meier statistics and analyzed using Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>The updated median PFS and OS were 9.7 months (95% confidence interval [CI] 8.7-11.6) and 19.2 months (95% CI, 16.7-22.0), respectively. Multivariable analysis of key prognostic variables showed Tie2-defined vascular response associated with a significantly improved PFS (hazard ratio [HR] 0.49, 95% CI, 0.29-0.85, <em>P</em> = .011) and moderately improved OS (HR 0.71, 95% CI, 0.42-1.2, <em>P</em> = .195). Patients with a Tie2-defined vascular response to first-line bevacizumab therapy had a 3.7-month longer median OS with bevacizumab reuse than chemotherapy alone (10.5 months vs. 6.8 months, respectively), although this was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Plasma Tie2 is a response biomarker for PFS benefit with first-line bevacizumab in metastatic colorectal cancer, although OS benefit was not significant in TRAVASTIN. Our study highlights the promising use of Tie2 to guide bevacizumab treatment, including retreatment, in colorectal cancer.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 1","pages":"Pages 115-124"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}