Intraoperative Chemotherapy with a Novel Regimen Improved the Therapeutic Outcomes of Colorectal Cancer

Colorectal cancer (CRC) is one of the most common and lethal human malignancies worldwide; however, the therapeutic outcomes in the clinic still are unsatisfactory due to the lack of effective and safe therapeutic regimens. Orally administrable and CRC-targetable drug delivery is an attractive approach for CRC therapy as it improves the efficacy by local drug delivery and reduces systemic toxicity. Currently, chemotherapy remains the mainstay modality for CRC therapy; however, most of chemo drugs have low water solubility and are unstable in the gastrointestinal tract (GIT), poor intestinal permeability, and are susceptible to P-glycoprotein (P-gp) efflux, resulting in limited therapeutic outcomes. Orally administrable nanoformulations hold the great potential for improving the bioavailability of poorly permeable and poorly soluble therapeutics, but there are still limitations associated with these regimes. This review focuses on the barriers for oral drug delivery and various oral therapeutic nanoparticles for the management of CRC.

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Safety of intraoperative chemotherapy with 5-FU for colorectal cancer patients receiving curative resection: A randomized, multicenter, prospective, phase III IOCCRC trial (IOCCRC).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15002 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15002-e15002

Author(s):

Rong-xin Zhang ◽

Jun-zhong Lin ◽

Gong Chen ◽

Li-ren LI ◽

Zhen-hai LU ◽

...

Keyword(s):

Colorectal Cancer ◽

Side Effects ◽

Cancer Patients ◽

Surgical Resection ◽

Control Group ◽

Control Groups ◽

Safety And Efficacy ◽

Colorectal Cancer Patients ◽

And Control ◽

Intraoperative Chemotherapy

e15002 Background: The safety and efficacy of intraoperative chemotherapy in colorectal cancer have not yet been extensively investigated. This randomized control trial was designed to compare the safety and efficacy of intraoperative chemotherapy in combination with surgical resection to those of traditional surgical resection alone. Patients and Methods: From January 2011 to January 2016, 696 colorectal cancer patients were enrolled in this study: 341 patients were randomly assigned to the intraoperative plus surgery group to receive intraoperative chemotherapy (portal vein, intraluminal, and intraperitoneal chemotherapy plus surgical resection), whereas 344 patients were randomized to the control group to undergo surgery alone. Eleven patients withdrew consent. Surgical complications and side effects of intraoperative chemotherapy were compared between the two groups. Results: Intraoperative chemotherapy did not increase the rate of surgical complications, and no severe chemotherapy-associated side effects were observed. There were no significant differences in the length of hospital stay (8.31 vs. 7.98 days, P = 0.138), length of surgery (170.4 vs. 167.0 min, P = 0.526), length of antibiotic use (2.28 vs. 2.15 days, P = 0.322), or length of drain usage (6.37 vs. 6.16 days, P = 0.387) between the intraoperative chemotherapy and control groups. Four patients in each of the intraoperative chemotherapy and the control groups experienced anastomotic leakage and underwent a second operation (1.2% vs. 1.2%, P = 0.99). There were no deaths within 90 days after surgery in the chemotherapy group, whereas one patient died in the control group (0% vs. 0.3%, P = 0.99). Intraoperative chemotherapy did not decrease the rate of patients who received postoperative adjuvant chemotherapy between the intraoperative group and control group (29.3% vs. 30.2%, P = 0.795). Conclusions: Intraoperative chemotherapy can be safely performed during colorectal surgery; however, follow-up is necessary for a better assessment of its efficacy. Register Number: NCT01465451. Clinical trial information: NCT01465451.

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Clinical yield of screening colonoscopies in Jamaica

Tropical Doctor ◽

10.1177/00494755211039591 ◽

2021 ◽

pp. 004947552110395

Author(s):

Shamir O Cawich ◽

Avidesh H Mahabir ◽

Milton Arthurs

Keyword(s):

Colorectal Cancer ◽

Screening Programme ◽

Colorectal Polyps ◽

Screening Colonoscopy ◽

Opportunistic Screening ◽

Precursor Lesions ◽

Invasive Adenocarcinoma ◽

Policy Makers ◽

Therapeutic Outcomes ◽

Cancer Screening Programme

There is still no organised national screening programme for colorectal cancer in Jamaica. We sought to evaluate the detection of colorectal cancer precursor lesions in patients who underwent opportunistic screening over three years. Patients with colorectal polyps were selected for further study. In 431 procedures, there were 84 (19.5%) patients with colorectal polyps identified at screening colonoscopy, which gave a 19.5% sensitivity to identify patients with polyps at risk of developing colorectal cancer, 9.5% being <50 years of age. At the time of examination, 16.7% had already developed invasive adenocarcinoma. We conclude that it is time for policy makers to develop a national colorectal cancer screening programme to diagnose patients early and improve their therapeutic outcomes.

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EP1.15-13 Prognosis of Colorectal Cancer Cases That Underwent Lung and Liver Metastasectomy and Therapeutic Outcomes of Brain Metastasis

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.2348 ◽

2019 ◽

Vol 14 (10) ◽

pp. S1057

Author(s):

T. Fujita ◽

M. Kataoka ◽

K. Suemori ◽

D. Okutani ◽

K. Watanabe ◽

...

Keyword(s):

Colorectal Cancer ◽

Brain Metastasis ◽

Therapeutic Outcomes

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Faculty Opinions recommendation of Predictive impact of genetic polymorphisms in DNA repair genes on susceptibility and therapeutic outcomes to colorectal cancer patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729338367.793537091 ◽

2017 ◽

Author(s):

Vilhelm Bohr

Keyword(s):

Colorectal Cancer ◽

Dna Repair ◽

Cancer Patients ◽

Genetic Polymorphisms ◽

Dna Repair Genes ◽

Therapeutic Outcomes ◽

Colorectal Cancer Patients ◽

Repair Genes

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Albuca Bracteate Polysaccharides Synergistically Enhance the Anti-Tumor Efficacy of 5-Fluorouracil Against Colorectal Cancer by Modulating β-Catenin Signaling and Intestinal Flora

Frontiers in Pharmacology ◽

10.3389/fphar.2021.736627 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xinyu Yuan ◽

Jiao Xue ◽

Yingxia Tan ◽

Qingguo Yang ◽

Ziyan Qin ◽

...

Keyword(s):

Colorectal Cancer ◽

Intestinal Microbiota ◽

Intestinal Flora ◽

Migratory Activity ◽

Synergistic Interactions ◽

Therapeutic Outcomes ◽

Anti Oxidant ◽

Intestinal Mucositis

The first-line treatment for colorectal cancer (CRC) is 5-fluorouracil (5-FU). However, the efficacy of this treatment is sometimes limited owing to chemoresistance as well as treatment-associated intestinal mucositis and other adverse events. Growing evidence suggests that certain phytochemicals have therapeutic and cancer-preventing properties. Further, the synergistic interactions between many such plant-derived products and chemotherapeutic drugs have been linked to improved therapeutic efficacy. Polysaccharides extracted from Albuca bracteata (Thunb.) J.C.Manning and Goldblatt (ABP) have been reported to exhibit anti-oxidant, anti-inflammatory, and anti-tumor properties. In this study, murine CRC cells (CT26) and a murine model of CRC were used to examine the anti-tumor properties of ABP and explore the mechanism underlying the synergistic interactions between ABP and 5-FU. Our results revealed that ABP could inhibit tumor cell proliferation, invasion, and migratory activity in vitro and inhibited tumor progression in vivo by suppressing β-catenin signaling. Additionally, treatment with a combination of ABP and 5-FU resulted in better outcomes than treatment with either agent alone. Moreover, this combination therapy resulted in the specific enrichment of Ruminococcus, Anaerostipes, and Oscillospira in the intestinal microbiota and increased fecal short-chain fatty acid (SCFA) levels (acetic acid, propionic acid, and butyric acid). The improvement in the intestinal microbiota and the increase in beneficial SCFAs contributed to enhanced therapeutic outcomes and reduced the adverse effects of 5-FU. Together, these data suggest that ABP exhibits anti-neoplastic activity and can effectively enhance the efficacy of 5-FU in CRC treatment. Therefore, further research on the application of ABP in the development of novel anti-tumor drugs and adjuvant compounds is warranted and could improve the outcomes of CRC patients.

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