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Latest & greatest articles for colorectal cancer
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initially unresectable and previously untreated RAS and BRAF wild-type metastatic colorectalcancer patients are randomised to receive a standard treatment with mFOLFOX6 plus panitumumab or an experimental regimen with modified FOLFOXIRI (irinotecan 150 mg/m2, oxaliplatin 85 mg/m2, L-leucovorin 200 mg/m2, 5-fluoruracil 2400 mg/m2 48-hour continuous infusion) plus panitumumab up to 12 cycles, followed by panitumumab plus 5-fluorouracil and L-leucovorin until disease progression. The primary endpoint (...) TRIPLETE: a randomised phase III study of modified FOLFOXIRI plus panitumumab versus mFOLFOX6 plus panitumumab as initial therapy for patients with unresectable RAS and BRAF wild-type metastatic colorectalcancer FOLFOXIRI plus bevacizumab is considered a standard option in the upfront treatment of clinically selected patients with metastatic colorectalcancer irrespective of RAS and BRAF molecular status. The randomised MACBETH and VOLFI studies showed that a modified FOLFOXIRI regimen
Bowel Obstruction and Ventral Hernia After Laparoscopic Versus Open Surgery for Rectal Cancer in A Randomized Trial (COLOR II) The aim of this study was to evaluate the risk of bowel obstruction, incisional, and parastomal hernia following laparoscopic versus open surgery for rectal cancer.Laparoscopic surgery for rectal cancer has been adopted worldwide, after trials reported similar oncological outcomes compared with open surgery. Little is known about long-term morbidity, including bowel (...) in risk of bowel obstruction, incisional, or parastomal hernia following laparoscopic or open surgery for rectal cancer.Based on long-term morbidity outcomes, laparoscopic surgery for rectal cancer could be considered a routine technique as there are no differences with open surgery.
FOLFOX or CAPOX in Stage II to III ColonCancer: Efficacy Results of the Italian Three or Six Colon Adjuvant Trial Purpose Given the cumulative neurotoxicity associated with oxaliplatin, a shorter duration of adjuvant therapy, if equally efficacious, would be advantageous for patients and health-care systems. Methods The Three or Six Colon Adjuvant trial is an open-label, phase III, multicenter, noninferiority trial randomizing patients with high-risk stage II or stage III coloncancer (...) . Conclusion The Three or Six Colon Adjuvant trial failed to formally show noninferiority of 3 versus 6 months of treatment to the predefined margin of 20% relative increase. The results depended on the adjuvant regimen and risk. For CAPOX, 3 months were as good as 6 months; for FOLFOX, 6 months added extra benefit. Counter-intuitively, the low-risk patients benefitted more than the high-risk population from the 6-month duration. The choice of regimen and duration should depend on patient characteristics
Three Versus 6 Months of Oxaliplatin-Based Adjuvant Chemotherapy for Patients With Stage III ColonCancer: Disease-Free Survival Results From a Randomized, Open-Label, International Duration Evaluation of Adjuvant (IDEA) France, Phase III Trial Purpose Reduction of adjuvant treatment duration may decrease toxicities without loss of efficacy in stage III coloncancer. This could offer clear advantages to patients and health care providers. Methods In International Duration Evaluation of Adjuvant (...) Chemotherapy (IDEA) France, as part of the IDEA international collaboration, patient with coloncancer patients were randomly assigned to 3 and 6 months of modified FOLFOX6 (mFOLFOX6: infusional fluorouracil, leucovorin, and oxaliplatin) or capecitabine plus oxaliplatin (CAPOX) by physician choice. The primary end point was disease-free survival (DFS), and analyses were descriptive. Results A total of 2,010 eligible patients received either 3 or 6 months of chemotherapy (modified intention-to-treat
Statement R. Goodwin, C. Agbassi, E. Kennedy, J. Biagi, R. Wong, S. Welch, S. Berry, and the GastrointestinalDisease Site Group Report Date: July 3, 2018 This document describes the CCO- GastrointestinalCancerDisease Site Group endorsement of The predictive effect of primary tumour location in the treatment of metastatic colorectalcancer: a Canadian consensus statement published in 2017 by Abrahao et al. The original publication is available at Current Oncology Vol 24, No 6 (2017) For information (...) , Agbassi C, Kennedy E, Biagi J, Wong R, Welch S, Berry S, and the GastrointestinalDisease Site Group. The Role of Primary Tumour Location in the selection of Biologics for the Treatment of Unresectable Metastatic ColorectalCancer: An Endorsement of a Canadian Consensus Statement. Toronto (ON): Cancer Care Ontario; 2018 May. Program in Evidence-based Care Guideline No.: 2-31. Copyright This report is copyrighted by Cancer Care Ontario; the report and the illustrations herein may not be reproduced
Effect of Fruquintinib vs Placebo on Overall Survival in Patients With Previously Treated Metastatic ColorectalCancer: The FRESCO Randomized Clinical Trial. Patients with metastatic colorectalcancer (CRC) have limited effective and tolerable treatment options.To evaluate the efficacy and safety of oral fruquintinib, a vascular endothelial growth factor receptor (VEGFR) inhibitor, as third-line or later therapy in patients with metastatic CRC.FRESCO (Fruquintinib Efficacy and Safety in 3+ Line (...) ColorectalCancer Patients) was a randomized, double-blind, placebo-controlled, multicenter (28 hospitals in China), phase 3 clinical trial. From December 2014 to May 2016, screening took place among 519 patients aged 18 to 75 years who had metastatic CRC that progressed after at least 2 lines of chemotherapy but had not received VEGFR inhibitor therapy; 416 met the eligibility criteria and were stratified by prior anti-VEGF therapy and K-ras status. The final date of follow-up was January 17, 2017
Shortening adjuvant chemotherapy in stage III coloncancer: are we ready for a change? 29942667 2019 01 30 2059-7029 3 4 2018 ESMO open ESMO Open Shortening adjuvant chemotherapy in stage III coloncancer: are we ready for a change? e000392 10.1136/esmoopen-2018-000392 Roda Desamparados D CIBERONC, Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain. Ciardiello Fortunato F Oncologia Medica, Dipartimento di Internistica Clinica e (...) Sperimentale 'F. Magrassi', Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy. Cervantes Andrés A CIBERONC, Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain. eng Editorial 2018 06 20 England ESMO Open 101690685 2059-7029 coloncancer Competing interests: None declared. 2018 04 30 2018 05 01 2018 6 27 6 0 2018 6 27 6 0 2018 6 27 6 1 epublish 29942667 10.1136/esmoopen-2018-000392 esmoopen-2018-000392 PMC6012558 Ann Oncol. 2017
Role of chemotherapy in resectable liver metastases from colorectalcancer: food for thought from pooled evidence 29942665 2019 01 30 2059-7029 3 4 2018 ESMO open ESMO Open Role of chemotherapy in resectable liver metastases from colorectalcancer: food for thought from pooled evidence. e000367 10.1136/esmoopen-2018-000367 Mauri Davide D Department of Medical Oncology, University Medical School of Ioannina, Ioannina, Greece. Filis Panagiotis P Department of Medical Oncology, University Medical (...) 2018 05 01 2018 6 27 6 0 2018 6 27 6 0 2018 6 27 6 1 epublish 29942665 10.1136/esmoopen-2018-000367 esmoopen-2018-000367 PMC6012563 Lancet Oncol. 2013 Nov;14(12):1208-15 24120480 J Clin Oncol. 2007 Oct 10;25(29):4575-80 17925551 Neoplasia. 2017 Feb;19(2):93-99 28088688 J Clin Oncol. 2006 Nov 1;24(31):4976-82 17075115 Surg Clin North Am. 2002 Oct;82(5):1075-90, x-xi 12507210 BMC Cancer. 2015 Mar 26;15:180 25884448 Lancet Oncol. 2014 May;15(6):601-11 24717919
Phase Ib/II trial evaluating the safety, tolerability and immunological activity of durvalumab (MEDI4736) (anti-PD-L1) plus tremelimumab (anti-CTLA-4) combined with FOLFOX in patients with metastatic colorectalcancer 5-Fluorouracil plus irinotecan or oxaliplatin alone or in association with target therapy are standard first-line therapy for metastatic colorectalcancer (mCRC). Checkpoint inhibitors targeting PD-1/PD-L1 demonstrated efficacy on mCRC with microsatellite instability but remain (...) ineffective alone in microsatellite stable tumour. 5-Fluorouracil and oxaliplatin were known to present immunogenic properties. Durvalumab (D) is a human monoclonal antibody (mAb) that inhibits binding of programmed cell death ligand 1 (PD-L1) to its receptor. Tremelimumab (T) is a mAb directed against the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). This study is designed to evaluate whether the addition of PD-L1 and CTLA-4 inhibition to oxaliplatin, fluorouracil and leucovorin (FOLFOX
Validation of the Survival Benefits of Metformin in Middle Eastern Patients With Type II Diabetes Mellitus and ColorectalCancer Purpose Epidemiologic data from several populations suggest that metformin may decrease cancer risk and mortality in patients with colorectalcancer (CRC) and type II diabetes mellitus (DM). Although type II DM and CRC are major health problems in the Middle East, no investigations have been performed to test the effect metformin has on the outcome of patients (...) with type II DM and CRC who are also treated with metformin. Materials and Methods We retrospectively reviewed the medical records of 1,902 patients diagnosed with CRC at King Hussein Cancer Center between January 2004 and December 2012, and identified 349 patients (18%) with type II DM; we censored the data of 28 patients because their antidiabetic medications were unknown. We then categorized these 321 patients into two groups: 192 patients treated with metformin (group A) and 129 patients treated
Clonal evolution of colorectalcancer in a patient with serially resected metastases and liquid biopsies: a case report and discussion of the literature Metastatic colorectalcancer represents a striking example of clonal heterogeneity and tumour evolution, which generates acquired resistance to therapy. Once hard to perform, the study of clonal heterogeneity is now significantly aided by the use of liquid biopsies.We herein report a case of a patient with colorectalcancer and serial (...) development of multiple metastases which were all resected and genotyped. A rare point mutation was identified in the primary tumour (but not in any of the organ metastatic sites), as well as in the first and the last out of three consecutive liquid biopsies. The review of the literature offered some insight in the evolution of the patient's tumour and general directions on how to interpret liquid biopsy results.This patient case emphasises the need for large prospective studies designed to bridge liquid
Assessing Clinical Outcomes in ColorectalCancer with Assays for Invasive Circulating Tumor Cells Colorectalcarcinoma (CRC) is the second leading cause of cancer-related mortality. The goals of this study are to evaluate the association between levels of invasive circulating tumor cells (iCTCs) with CRC outcomes and to explore the molecular characteristics of iCTCs. Peripheral blood from 93 patients with Stage I⁻IV CRC was obtained and assessed for the detection and characterization of iCTCs (...) using a functional collagen-based adhesion matrix (CAM) invasion assay. Patients were followed and assessed for overall survival. Tumor cells isolated by CAM were characterized using cell culture and microarray analyses. Of 93 patients, 88 (95%) had detectable iCTCs, ranging over 0⁻470 iCTCs/mL. Patients with Stage I⁻IV disease exhibited median counts of 0.0 iCTCs/mL (n = 6), 13.0 iCTCs/mL (n = 12), 41.0 iCTCs/mL (n = 12), and 133.0 iCTCs/mL (n = 58), respectively (p < 0.001). Kaplan⁻Meier curve
A data-driven, knowledge-based approach to biomarker discovery: application to circulating microRNA markers of colorectalcancer prognosis Recent advances in high-throughput technologies have provided an unprecedented opportunity to identify molecular markers of disease processes. This plethora of complex-omics data has simultaneously complicated the problem of extracting meaningful molecular signatures and opened up new opportunities for more sophisticated integrative and holistic approaches (...) comprising 11 circulating microRNAs. The identified signature predicts the patients' survival outcome and targets pathways underlying colorectalcancer progression. The altered expression of the identified microRNAs was confirmed in an independent public data set of plasma samples of patients in early stage vs advanced colorectalcancer. Furthermore, the generality of the proposed method was demonstrated across three publicly available miRNA data sets associated with biomarker studies in other diseases.
Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second-line therapy for metastatic colorectalcancer (AXEPT): a multicentre, open-label, randomised, non- Studies of a modified XELIRI (mXELIRI; capecitabine plus irinotecan) regimen suggest promising efficacy and tolerability profiles in the first-line and second-line settings. Therefore, we aimed to compare the efficacy and safety of the mXELIRI (...) regimen with that of standard FOLFIRI (leucovorin, fluorouracil, and irinotecan), with or without bevacizumab in both regimens, as a second-line therapy for metastatic colorectal cancer.We did a multicentre, open-label, randomised, non-inferiority, phase 3 trial. We enrolled patients from 98 hospitals in Japan, China, and South Korea who were aged 20 years or older with histologically confirmed and unresectable colorectaladenocarcinoma, and who had withdrawn from first-line chemotherapy
done at 244 centres. Patients aged 18 years or older with high-risk stage II and stage III colorectalcancer underwent central randomisation with minimisation for centre, choice of regimen, sex, disease site, N stage, T stage, and the starting dose of capecitabine. Patients were assigned (1:1) to receive 3 months or 6 months of adjuvant oxaliplatin-containing chemotherapy. The chemotherapy regimens could consist of CAPOX (capecitabine and oxaliplatin) or FOLFOX (bolus and infused fluorouracil (...) 3 versus 6 months of adjuvant oxaliplatin-fluoropyrimidine combination therapy for colorectalcancer (SCOT): an international, randomised, phase 3, non-inferiority trial 6 months of oxaliplatin-containing chemotherapy is usually given as adjuvant treatment for stage 3 colorectalcancer. We investigated whether 3 months of oxaliplatin-containing chemotherapy would be non-inferior to the usual 6 months of treatment.The SCOT study was an international, randomised, phase 3, non-inferiority trial
and abdomen and serum carcinoembryonic antigen at 6, 12, 18, 24, and 36 months after surgery (high-frequency group; n = 1253 patients) or at 12 and 36 months after surgery (low-frequency group; n = 1256 patients).The primary outcomes were 5-year overall mortality and colorectalcancer-specific mortality rates. The secondary outcome was the colorectalcancer-specific recurrence rate. Both intention-to-treat and per-protocol analyses were performed.Among 2555 patients who were randomized, 2509 were included (...) Effect of More vs Less Frequent Follow-up Testing on Overall and ColorectalCancer-Specific Mortality in Patients With Stage II or III ColorectalCancer: The COLOFOL Randomized Clinical Trial. Intensive follow-up of patients after curative surgery for colorectalcancer is common in clinical practice, but evidence of a survival benefit is limited.To examine overall mortality, colorectalcancer-specific mortality, and colorectalcancer-specific recurrence rates among patients with stage II or III
Association Between Intensity of Posttreatment Surveillance Testing and Detection of Recurrence in Patients With ColorectalCancer. Surveillance testing is performed after primary treatment for colorectalcancer (CRC), but it is unclear if the intensity of testing decreases time to detection of recurrence or affects patient survival.To determine if intensity of posttreatment surveillance is associated with time to detection of CRC recurrence, rate of recurrence, resection for recurrence (...) , or overall survival.A retrospective cohort study of patient data abstracted from the medical record as part of a Commission on Cancer Special Study merged with records from the National Cancer Database. A random sample of patients (n=8529) diagnosed with stage I, II, or III CRC treated at a Commission on Cancer-accredited facilities (2006-2007) with follow-up through December 31, 2014.Intensity of imaging and carcinoembryonic antigen (CEA) surveillance testing derived empirically at the facility level