medwireNews: Here is a roundup of recent colorectal cancer (CRC) research, ranging from diagnosis to treatment and prevention.
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Among asymptomatic individuals with an above-average familial or personal CRC risk, the fecal immunochemical test (FIT) has a high diagnostic accuracy for CRC, with a sensitivity of 93% and a specificity of 91%. But the accuracy for detecting advanced neoplasia is only “moderate,” with corresponding values of 48% and 93%, say Anastasia Katsoula, from the Aristotle University of Thessaloniki in Greece, and co-workers.
Their results are based on a systematic review and meta-analysis of 12 studies that compared the diagnostic performance of FIT with colonoscopy or follow-up. The quality of the evidence was low or very low, however, the team notes in JAMA Internal Medicine, limiting “the trustworthiness of our findings.”
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Lead investigator Alan Venook (University of California, San Francisco, USA) and team found comparable overall survival (OS), progression-free survival, and response rates among patients with untreated locally advanced or metastatic CRC wild-type for KRAS regardless of whether they received cetuximab or bevacizumab alongside combination chemotherapy with mFOLFOX6 or FOLFIRI.
Writing in an editorial accompanying the research in JAMA, Christopher Lieu and Wells Messersmith (both from the University of Colorado, Denver, USA) say: “The initial overall survival results are indeed clinically important, although additional analyses such as the effect of right vs left primary tumor location, consensus molecular subtypes, and other factors will likely influence the treatment management for this patient population.”
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An analysis of 2419 patients with incident invasive CRC, reported by Polly Newcomb (Fred Hutchinson Cancer Research Center, Seattle, Washington, USA) and colleagues in the Journal of Clinical Oncology, supports the use of “[a]spirin for secondary prevention of CRC, particularly in subgroups such as those with KRAS wild-type tumors.”
OS was significantly longer for individuals who did versus did not report postdiagnosis nonsteroidal anti-inflammatory drug use, but only if they harbored KRAS wild-type, but not mutant, tumors, with respective hazard ratios of 0.64 and 1.20.
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