Review
Oncology
Zhen Yu, Yuying Hao, Yuhua Huang, Ling Ling, Xigang Hu, Simiao Qiao
Summary: Radiotherapy and chemotherapy are effective treatments for locally advanced rectal cancer. New neoadjuvant treatment options need to be explored for better outcomes. Targeted drugs and immunologic agents have shown efficacy in advanced rectal cancer but have not been commonly used in neoadjuvant therapy for LARC patients.
FRONTIERS IN ONCOLOGY
(2023)
Review
Oncology
Xiaoyu Hu, Zhuang Xue, Kewen He, Yaru Tian, Yu Chen, Mengyu Zhao, Jinming Yu, Jinbo Yue
Summary: Locally advanced rectal cancer (LARC) is a highly heterogeneous tumor group, and the risk of recurrence can be classified by MRI as low to very high according to ESMO guidelines. In the era of precision medicine, treatment decisions should be based on risk stratification. Not all LARC cases are appropriate for the traditional neoadjuvant sandwich strategy. Treatment modalities for LARC have evolved dramatically in recent years, with multiple clinical trials focused on optimizing strategies to improve outcomes for patients.
Article
Oncology
Anthony B. Mariathasan, Kjetil Boye, Svein Dueland, Kjersti Flatmark, Stein G. Larsen
Summary: This study aimed to describe the frequency, pattern, and outcome of metastatic disease in locally advanced rectal cancer (LARC) patients after curative resection. Liver and lungs were the most common sites of metastasis, with factors such as involved resection margins, tumor stage, and response to chemoradiotherapy affecting metastasis development and overall survival. Selective metastasectomy was associated with better long-term outcomes in LARC patients with liver and lung metastases.
Article
Oncology
Darlene Rodrigues, Joana Simoes, Laetitia Teixeira, Fatima Aires, Catarina Fernandes, Carmen Rey, Cristina Sarmento, Margarida Marques
Summary: The study revealed a high prevalence of anemia among elderly rectal cancer patients, with baseline anemia associated with shorter LARC-free interval and significantly higher risks of mortality. Patients over 75 years old had a negative impact on overall survival and LARC-specific survival. No significant impact was found for age-adjusted Charlson comorbidity index on survival outcomes.
SUPPORTIVE CARE IN CANCER
(2021)
Article
Oncology
Francesca De Felice, Vincenzo Tombolini, Enrico Cortesi
Summary: Locally advanced rectal cancer requires a multidisciplinary management involving neoadjuvant radiotherapy, conservative surgery, and chemotherapy. Recent studies have examined the potential benefits of altering the sequencing or intensity of the standard trimodal therapy components, with a focus on the clinical significance of total neoadjuvant treatment. More long-term results and prospective studies are needed to accurately determine the clinical benefits and establish the role of total neoadjuvant therapy in locally advanced rectal cancer.
TRANSLATIONAL ONCOLOGY
(2021)
Article
Oncology
Chie Takasu, Masaaki Nishi, Kozo Yoshikawa, Takuya Tokunaga, Toshihiro Nakao, Hideya Kashihara, Yuma Wada, Toshiaki Yoshimoto, Shohei Okikawa, Shoko Yamashita, Mitsuo Shimada
Summary: This study investigated the prognostic significance of IDO expression in patients with LARC who received preoperative CRT and found that IDO expression was significantly associated with worse overall survival. IDO expression may be a useful marker for specifying individual treatment strategies in LARC.
Article
Oncology
Cihan Gani, Ulf Lamprecht, Alexander Ziegler, Matthias Moll, Johanna Gellermann, Vanessa Heinrich, Svetlana Wenz, Falko Fend, Alfred Koenigsrainer, Michael Bitzer, Daniel Zips
Summary: The study investigated the impact of deep regional hyperthermia on oncological outcomes in rectal cancer patients receiving preoperative radiochemotherapy, finding that deep hyperthermia was feasible and had promising long-term effects on survival and quality of life.
RADIOTHERAPY AND ONCOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Valentina Dapra, Marco Airoldi, Michela Bartolini, Roberta Fazio, Giuseppe Mondello, Maria Chiara Tronconi, Maria Giuseppina Prete, Giuseppe D'Agostino, Caterina Foppa, Antonino Spinelli, Alberto Puccini, Armando Santoro
Summary: Recently, there has been a significant shift in the therapeutic landscape of locally advanced rectal cancer (LARC) with the increasing adoption of total neoadjuvant treatment (TNT). This comprehensive approach involves administering chemotherapy and radiation therapy prior to surgery, followed by optional adjuvant chemotherapy. To provide the optimal tailored treatment regimen for patients, collaboration among healthcare professionals from various specialties is crucial. This review aims to provide insights into the current state of TNT for LARC and emerging strategies for future research and clinical practice, such as circulating tumor DNA, immunotherapy in mismatch repair-deficient tumors, and nonoperative management.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Medicine, General & Internal
Alfonso Martin-Carnicero, Enrique Ramalle-Gomara, Susana Rubio-Mediavilla, Martina Alonso-Lago, Miriam Zorrilla-Larraga, Isabel Manrique-Abos, Maria E. de las Heras-Duena, Ignacio M. Larrayoz, Alfredo Martinez
Summary: This retrospective study focuses on the clinical, analytical, and pathological parameters of locally advanced rectal cancer patients who received neoadjuvant chemoradiotherapy (CRT) and surgery. The study found that lower hemoglobin levels, lower lymphocyte/monocyte ratio, and higher platelet/lymphocyte ratio were associated with relapse. Additionally, the number of positive nodes after surgery and KRAS mutations were linked to worse prognosis.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Oncology
Haoyan Wu, Chuanwen Fan, Chao Fang, Libin Huang, Yuan Li, Zongguang Zhou
Summary: The addition of consolidation chemotherapy to preoperative short-course radiotherapy can enhance pathologic response in locally advanced rectal cancer, without increasing toxicity. Short-course radiotherapy followed by consolidation chemotherapy is recommended as a neoadjuvant treatment option for locally advanced rectal cancer.
RADIATION ONCOLOGY
(2022)
Article
Oncology
Yohan Lee, Sunghyun Kim, Hyejung Cha, Jae Hun Han, Hyun Joon Choi, Eun Go, Sei Hwan You
Summary: This study demonstrates the feasibility and potential therapeutic effects of using 13.56 MHz modulated electro-hyperthermia (mEHT) boost in neoadjuvant treatment for rectal cancer. It also suggests that mEHT could be a useful tool in combination treatment with radiotherapy due to its low thermotoxicity and improved treatment compliance.
Article
Oncology
Myroslav Lutsyk, Tarek Taha, Salem Billan
Summary: The aim of this study is to identify factors that may predict the response of locally advanced rectal cancer tumors to neoadjuvant chemoradiotherapy. The study found that an absolute decrease in the level of circulating lymphocytes is associated with poorer tumor response to treatment, and may serve as a predictive biomarker for treatment resistance.
FRONTIERS IN ONCOLOGY
(2023)
Review
Oncology
I Drami, A. C. Lord, P. Sarmah, R. P. Baker, I. R. Daniels, K. Boyle, B. Griffiths, H. M. Mohan, J. T. Jenkins
Summary: The pre-operative phase is crucial for planning pelvic exenteration or extended resections in patients with locally advanced rectal cancer. It involves multidisciplinary review, anaesthetic assessment, shared decision making, prehabilitation, and technical surgical planning. Optimizing patient outcomes requires achieving negative resection margins and ensuring patients are fit for extended surgery. Advanced communication and preoperative preparation are important, as well as physiotherapy, psychological support, and nutritional input. Image-based technical planning helps identify risk points and ensure the correct surgical strategy.
Article
Medicine, General & Internal
Andrea Cercek, Melissa Lumish, Jenna Sinopoli, Jill Weiss, Jinru Shia, Michelle Lamendola-Essel, Imane H. El Dika, Neil Segal, Marina Shcherba, Ryan Sugarman, Zsofia Stadler, Rona Yaeger, J. Joshua Smith, Benoit Rousseau, Guillem Argiles, Miteshkumar Patel, Avni Desai, Leonard B. Saltz, Maria Widmar, Krishna Iyer, Janie Zhang, Nicole Gianino, Christopher Crane, Paul B. Romesser, Emmanouil P. Pappou, Philip Paty, Julio Garcia-Aguilar, Mithat Gonen, Marc Gollub, Martin R. Weiser, Kurt A. Schalper, Luis A. Diaz
Summary: This study found that mismatch repair-deficient, locally advanced rectal cancer is highly sensitive to PD-1 blockade. Additionally, no adverse events of grade 3 or higher have been reported, and no cases of progression or recurrence have been observed. Longer follow-up is needed to assess the duration of response.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Oncology
Daniela Rega, Vincenza Granata, Antonella Petrillo, Ugo Pace, Cinzia Sassaroli, Massimiliano Di Marzo, Carmela Cervone, Roberta Fusco, Valeria D'Alessio, Guglielmo Nasti, Carmela Romano, Antonio Avallone, Biagio Pecori, Gerardo Botti, Fabiana Tatangelo, Piera Maiolino, Paolo Delrio
Summary: This Phase II randomized controlled trial investigates whether using Electrochemotherapy (ECT) before surgery in patients with major clinical response after neoadjuvant therapy allows for a more conservative surgical approach in Locally Advanced Rectal Cancer (LARC). The study aims to evaluate the increase of complete response rate after neoadjuvant treatment and spare organ function due to TME, by assessing treatment response using histopathological tumor regression grade on tissue specimens.
Article
Oncology
Ethan Basch, Allison M. Deal, Mark G. Kris, Howard I. Scher, Clifford A. Hudis, Paul Sabbatini, Lauren Rogak, Antonia V. Bennett, Amylou C. Dueck, Thomas M. Atkinson, Joanne F. Chou, Dorothy Dulko, Laura Sit, Allison Barz, Paul Novotny, Michael Fruscione, Jeff A. Sloan, Deborah Schrag
JOURNAL OF CLINICAL ONCOLOGY
(2016)
Article
Oncology
Martin R. Weiser, Mithat Goenen, Joanne F. Chou, Michael W. Kattan, Deborah Schrag
JOURNAL OF CLINICAL ONCOLOGY
(2011)
Article
Oncology
Deborah Schrag, Martin R. Weiser, Karyn A. Goodman, Mithat Gonen, Ellen Hollywood, Andrea Cercek, Diane L. Reidy-Lagunes, Marc J. Gollub, Jinru Shia, Jose G. Guillem, Larissa K. F. Temple, Philip B. Paty, Leonard B. Saltz
JOURNAL OF CLINICAL ONCOLOGY
(2014)
Article
Oncology
Kenneth L. Kehl, Michael J. Hassett, Deborah Schrag
Editorial Material
Oncology
Christopher R. Manz, Deborah Schrag
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2021)
Article
Oncology
Marla Lipsyc-Sharf, Fang-Shu Ou, Matthew B. Yurgelun, Douglas A. Rubinson, Deborah Schrag, Shaker R. Dakhil, Philip J. Stella, Douglas J. Weckstein, Donald B. Wender, Meredith Faggen, Tyler J. Zemla, Erica N. Heying, Samantha R. Schuetz, Stephanie Noble, Jeffrey A. Meyerhardt, Tanios Bekaii-Saab, Charles S. Fuchs, Kimmie Ng
Summary: The study investigated the efficacy of combining bevacizumab with irinotecan and cetuximab in patients with irinotecan-refractory metastatic colorectal cancer. Although there was no significant difference in progression-free survival between the two treatment groups, there was a statistically significant improvement in overall survival favoring the group that received bevacizumab in addition to irinotecan and cetuximab. Further investigation on this combination therapy is warranted.
Article
Oncology
David J. Papke Papke Jr, Neal I. Lindeman, Deborah Schrag, J. Bryan Lorgulescu
Summary: Utilization of MMR/MSI testing has increased for advanced colorectal cancer patients, but there is still room for improvement. Testing rates lagged for older patients, those from the poorest households, and those managed at community cancer programs.
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
(2022)
Article
Oncology
Jessica R. Schumacher, Heather B. Neuman, Menggang Yu, David J. Vanness, Yajuan Si, Elizabeth S. Burnside, Kathryn J. Ruddy, Ann H. Partridge, Deborah Schrag, Stephen B. Edge, Ying Zhang, Elizabeth A. Jacobs, Jeffrey Havlena, Amanda B. Francescatti, David P. Winchester, Daniel P. McKellar, Patricia A. Spears, Benjamin D. Kozower, George J. Chang, Caprice C. Greenberg
Summary: This study evaluated the association between different methods of detecting distant recurrence in breast cancer patients and survival rates, finding that asymptomatic imaging detection was associated with better outcomes for patients with estrogen receptor and progesterone receptor negative, HER2 negative or HER2 positive cancers. However, no association was observed in patients with estrogen receptor or progesterone receptor positive, HER2 negative cancers.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2022)
Article
Oncology
Kenneth L. Kehl, Hajime Uno, Alexander Gusev, Stefan Groha, Samantha Brown, Jessica A. Lavery, Deborah Schrag, Katherine S. Panageas
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
(2023)
Article
Oncology
Joan M. Griffin, Barbara L. Kroner, Sandra L. Wong, Liliana Preiss, Ashley Wilder Smith, Andrea L. Cheville, Sandra A. Mitchell, Nicola Lancki, Michael J. Hassett, Deborah Schrag, Raymond U. Osarogiagbon, Jennifer L. Ridgeway, David Cella, Roxanne E. Jensen, Ann Marie Flores, Jessica D. Austin, Betina Yanez
Summary: This study examined portal access and persistence of portal use and associations with patient and structural factors before the implementation of interventions. The results showed that male sex, membership in a racial and ethnic minority group, rural dwelling, not working, and limited broadband access were associated with lower odds of portal access. Younger age and more clinical encounters were associated with higher odds of portal access. Multiple modalities for portal access, being middle-aged, and having more clinical encounters were associated with persistent portal use. Patient and structural factors affect portal access and use and may exacerbate disparities in cancer symptom surveillance and management.
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
(2023)
Meeting Abstract
Gastroenterology & Hepatology
D. Schrag, Q. Shi, M. R. Weiser
DISEASES OF THE COLON & RECTUM
(2023)
Article
Health Care Sciences & Services
Nadine J. McCleary, Ellana K. Haakenstad, Jessica L. F. Cleveland, Michael Manni, Michael J. Hassett, Deb Schrag
Summary: This article describes the development process of the electronic New Patient Intake Questionnaire at the Dana-Farber Cancer Institute, involving various stakeholders and multiple updates in response to feedback. The implementation of the electronic questionnaire improved accessibility and provided more data for patients and clinicians, potentially benefiting cancer care outcomes.
Article
Oncology
Ya-Chen Tina Shih, Ying Xu, Hui Zhao, Deborah Schrag, James Yao
Summary: The study estimated the financial burden of discarded weight-based intravenous antineoplastic drugs on private insurers and patients, finding that private payers spent $5090 per patient and patients' mean out-of-pocket expense on discarded drugs was $63. Approximately 39.7% of patients had high-deductible plans, with those in high-deductible plans having significantly higher out-of-pocket expenses for discarded drugs compared to those without.
JNCI CANCER SPECTRUM
(2021)
Meeting Abstract
Oncology
Ethan M. Basch, Maria Catherine Pietanza, Mark G. Kris, Mary Shaw, Camelia S. Sima, Lauren J. Rogak, Deborah Schrag
JOURNAL OF CLINICAL ONCOLOGY
(2013)