Tag Archives: colorectal cancer prognosis

Adding Erbitux to First Line Chemotherapy Helps Advanced Colorectal Cancer Patients with Wild Type KRAS

Does adding Erbitux to chemotherapy help people whose colorectal cancer has spread beyond the colon or rectum to distant body sites? The answer is yes, according to a pooled analysis of two large randomized clinical trials comparing chemotherapy alone to chemotherapy plus Erbitux® (cetuximab).  However, benefits depend on whether or not patient tumors have mutations of two genes, KRAS and BRAF. Previous studies have shown that only patients with normal or wild type KRAS get any benefit from EGFR inhibitors Erbitux or Vectibix™ (panitumumab) so a combined analysis of the CRYSTAL and OPUS studies looked only a outcomes in KRAS wild type tumors.  In addition, the research team studied the

Many Doctors Doing Colorectal Cancer Screening Wrong

FOBT screening saves lives, but only when it is done right. Three out of four primary care doctors did a fecal occult blood test once during an office visit, a method that is ineffective in finding cancer or preventing death from colorectal cancer. One out of four used the in-office test exclusively. Less than half of doctors had a system in place to be sure that home tests were completed and returned. 

Diabetics Do Better Right After Colorectal Surgery

In a surprising results, doctors studying surgical complications and hospital deaths after colorectal surgery found that diabetic patients do better than non-diabetics after surgery. There was a 23 percent reduction in deaths after surgery for diabetics and 18 percent fewer complications. Unfortunately, this improvement in outcomes did not extend to the uninsured or to people under 50.

High Levels of Gene MACC1 Predicts Colorectal Cancer Spread

German scientists have identified a gene that has higher levels in colon cancer patients whose tumors are destined to spread. By initiating a signaling pathway in the cancer cell, MACC1 (Metastasis-Associated in Colon Cancer 1) promotes faster cell growth and cancer spread  to distant sites in the body (metastasis) . Their research was published online in Nature Medicine. About a third of patients whose cancer is found in early stages will eventually have it spread to other organs.  Measuring MACC1 may help doctors identify those patients, treat them more aggressively, and follow them  more closely.

Hypertension Clue to Better Outcomes with Avastin

Patients who developed hypertension with Avastin® (bevacizumab) had better response to treatment for colorectal cancer.  More had tumors shrink, and it took significantly longer for their cancer to get worse. In a small Italian study, researchers measured blood pressure in 39 patients receiving Avastin along with irinotecan and 5-FU for the initial treatment of colorectal cancer.  Eight patients (20 percent) experienced grade 2 or 3 hypertension.

Changes in Blood Magnesium Levels Predict Response to Erbitux

Hypomagnesemia, or reduced magnesium levels, is a side effect of Erbitux® (cetuximab) treatment.  Patients with colorectal cancer whose blood magnesium dropped the fastest also had the best response to Erbitux given with Camptosar® (irinotecan) . Italian researchers measured magnesium levels for 68 patients before treatment began and then 6 hours, 1 7, 14, 21, 50, and 92 days later.  After the seventh day, readings decreased consistently. Magnesium levels fell at least 20 percent for 25 patients by the third week.  More of these patients responded to treatment, they lived longer before their cancer got worse and had longer overall survival.

Age and Gender Affect Survival in Metastatic Colorectal Cancer

More News from ASCO 2008 Although men and women with metastatic colon or rectal cancer have similar overall survival after their diagnosis, age has an impact.  Women in premenopausal years, 18 to 44, live longer than younger men.  However, after the age of 75, women have significant worse survival than men. Across all age groups, Hispanics survive the longest, followed by whites, Asians, African Americans, and, finally, Native Americans according to a study from the University of Southern California Norris Comprehensive Cancer Center and reported at ASCO.

Some Stage II Colon and Rectal Cancers can be More Dangerous than Stage III

Advance Abstracts from ASCO 2008 How far a colon or rectal cancer penetrates through the wall of the bowel may be more important in deciding survival risks than current staging that focuses on positive lymph nodes. Five year survival statistics for a large number of rectal and cancer patients verified an earlier study that found some stage III colorectal cancers had better prognosis than stage II cancers that extended through the bowel wall but did not invade nearby lymph nodes. The information has implications for treating colorectal cancer after surgery.

Poorly Controlled Type 2 Diabetes Leads to Worse Outcomes for Colorectal Cancer

Patients who have poorly controlled type-2 diabetes and colorectal cancer have worse outcomes than patients whose diabetes is controlled or patients without diabetes. Poorly controlled type 2 diabetes led to more right-sided tumors, more advanced cancer at diagnosis, diagnosis at a younger age, and poorer five year survival. Researchers at the Dallas Veterans Medical Center reviewed records of patients with colorectal cancer whose also had type 2 diabetes and matched them to a control group of colorectal cancer patients without diabetes.  Poorly controlled type 2 diabetes was defined as a HbA1c level of 7.5 percent or more.