Adjuvant Chemotherapy for Colorectal Cancer: State of the Art and Future Perspectives

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: closed (1 May 2022) | Viewed by 3238

Special Issue Editors


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Guest Editor
1. Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
2. Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
Interests: liquid biopsy; colorectal cancer; CDX2 marker; translational research

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Co-Guest Editor
Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
Interests: liquid biopsy; colorectal cancer; CDX2 marker; lung cancer; translational research

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Co-Guest Editor
INCLIVA Biomedical Research Institute, Department of Medical Oncology, University of Valencia, Valencia, Spain
Interests: liquid biopsy; colorectal cancer; CDX2 marker; lung cancer; translational research

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is a major health issue worldwide. A considerable challenge is the identification of patients at high risk of recurrence after curative intent surgery. Currently, staging is based upon the pathological analysis of the resected specimen, and it is the gold standard for determining prognosis and for adjuvant chemotherapy (ACT) decision making. However, despite an optimal initial treatment, up to 40% of patients will relapse. The identification of new predictive and prognostic markers could help to identify patients at high risk of relapse and establish innovative therapeutic options to optimize adjuvant treatment. Plasma circulating tumor DNA is a potential new biomarker detecting minimal residual disease (MRD) and accurately monitoring patients’ response to ACT. Additionally, the characterization of circulating tumor cells may determine whether any novel approach to MRD can lead to the selection of personalized treatments that improve response over current standard therapies. On the other hand, the value of CDX2 expression, deep-learning radiomics-based prediction of distant metastasis, and generation of organoids as a preclinical model may help to better select patients to ACT and develop new strategies guiding CRC patient treatment.

Dr. Noelia Tarazona
Dr. Francisco Gimeno-Valiente
Dr. Elena Duréndez Sáez
Guest Editors

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Keywords

  • localized colon cancer
  • pathological staging
  • adjuvant chemotherapy
  • circulating tumor DNA
  • CDX2 expression
  • clinical trials

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Published Papers (1 paper)

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Research

20 pages, 394 KiB  
Article
Current Perspectives on the Importance of Pathological Features in Prognostication and Guidance of Adjuvant Chemotherapy in Colon Cancer
by Kabytto Chen, Henry Wang, Geoffrey Collins, Emma Hollands, Irene Yuen Jing Law and James Wei Tatt Toh
Curr. Oncol. 2022, 29(3), 1370-1389; https://doi.org/10.3390/curroncol29030116 - 23 Feb 2022
Cited by 3 | Viewed by 2696
Abstract
There is not a clear consensus on which pathological features and biomarkers are important in guiding prognosis and adjuvant therapy in colon cancer. The Pathology in Colon Cancer, Prognosis and Uptake of Adjuvant Therapy (PiCC UP) Australia and New Zealand questionnaire was distributed [...] Read more.
There is not a clear consensus on which pathological features and biomarkers are important in guiding prognosis and adjuvant therapy in colon cancer. The Pathology in Colon Cancer, Prognosis and Uptake of Adjuvant Therapy (PiCC UP) Australia and New Zealand questionnaire was distributed to colorectal surgeons, medical oncologists and pathologists after institutional board approval. The aim of this study was to understand current specialist attitudes towards pathological features in the prognostication of colon cancer and adjuvant therapy in stage II disease. A 5-scale Likert score was used to assess attitudes towards 23 pathological features for prognosis and 18 features for adjuvant therapy. Data were analysed using a rating scale and graded response model in item response theory (IRT) on STATA (Stata MP, version 15; StataCorp LP). One hundred and sixty-four specialists (45 oncologists, 86 surgeons and 33 pathologists) participated. Based on IRT modelling, the most important pathological features for prognosis in colon cancer were distant metastases, lymph node metastases and liver metastases. Other features seen as important were tumour rupture, involved margin, radial margin, CRM, lymphovascular invasion and grade of differentiation. Size of tumour, location, lymph node ratio and EGFR status were considered less important. The most important features in decision making for adjuvant therapy in stage II colon cancer were tumour rupture, lymphovascular invasion and microsatellite instability. BRAF status, size of tumour, location, tumour budding and tumour infiltrating lymphocytes were factored as lesser importance. Biomarkers such as CDX2, EGFR, KRAS and BRAF status present areas for further research to improve precision oncology. This study provides the most current status on the importance of pathological features in prognostication and recommendations for adjuvant therapy in Australia and New Zealand. Results of this nationwide study may be useful to help in guiding prognosis and adjuvant treatment in colon cancer. Full article
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