TRAITEMENT DU CANCER COLORECTAL ET MISES À JOUR SUR LA RECHERCHE CLINIQUE
Month Ending January 19th, 2023
The following colorectal cancer treatment and research updates extend from November 17,, 2022, to January 19,, 2023, inclusive and are intended for informational purposes only.
Ce contenu n'est pas destiné à se substituer à un avis médical professionnel. Consultez toujours votre médecin traitant ou les conseils d'un professionnel de la santé qualifié pour toute question concernant votre santé ou un problème médical. Ne négligez jamais l'avis d'un professionnel de la santé et ne tardez jamais à le solliciter en raison d'un élément que vous avez lu sur ce site web.
CONTENU
1. Essai clinique LEAP de phase II pour le traitement du CCRm
2. TRK Fusion Cancer and How to Test for It
3. A Phase II, Open-Label, Multicentre, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population
4. Phase III Study at the Odette Cancer Centre Comparing Arfolitixorin vs. Leucovorin: Both in Combination with 5FU, Oxaliplatin, and Bevacizumab in Patients with Advanced CRC
5. In Vivo Lung Perfusion (IVLP) for CRC Metastatic to Lung
6. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Hospital
7. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases
8. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer
9. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age
10. Stool Tests like Cologuard are Gaining Popularity Over Colonoscopy
11. Researchers Assess Reasons for Non-Follow-up After a Positive CRC Test
12. Guardant DNA Blood Test Finds 83% of CRCs in Trial
13. LifeLabs Forms New Collaboration with Natera to Offer Molecular Residual Disease (MRD) Testing for Cancer in Canada
14. Young Adult CRC Clinic Available at Sunnybrook Hospital
15. CCRAN’s Partnership with “Count Me In”
16. Patients and Caregivers Needed to Help Shape Early Research for a CRC Therapy
17. Announcing CCRAN’s Upcoming Four New Colorectal Cancer Information/Support Groups
18. CAR T-cell Therapy in CRC
19. Study Finds Positive Psychology Can Help Mediate Some Symptoms of CRC
20. Comprehensive Analysis of the Differences Between Left- and Right-Ride CRC and Respective Prognostic Prediction
21. Cancer PEP – Patient Empowerment Program is Now Open
22. News From AYA Can
23. EXercise for Cancer to Enhance Living Well (EXCEL) Study
24. Dietary Change Could be a Key to Enhancing Colon Cancer Treatment
25. New Evidence Links Healthy Plant-Based Diets with Lower CRC Risk
26. Ultraprocessed Foods Linked to Greater Risk for Colon Cancer, Heart Disease and Death
27. Regular Exercise Improves Outcomes in Patients with CRC
28. Frequently Asked Questions for COVID-19
MÉDICAMENTS / THÉRAPIES SYSTÉMIQUES
1. Phase II LEAP Clinical Trial For mCRC (Dec.10/22)
Le but de cette étude est de déterminer la sécurité et l'efficacité de la thérapie combinée avec le pembrolizumab (MK-3475) et Levantine la levantine (E7080/MK-7902) chez les patients atteints de cancer du sein triple négatif (TNBC), de cancer des ovaires, de cancer gastrique, cancer colorectal (CCR), glioblastoma (GBM), or biliary tract cancers (BTC). Participants will be enrolled in initial tumor-specific cohorts, which will be expanded if adequate efficacy is determined. The trial is available at the Odette Cancer Centre and at the Princess Margaret Cancer Centre in Toronto as well as the following Centres throughout Canada: Abbotsford, BC; Winnipeg, MB; CHU de Quebec. For information, visit the link below.
2. TRK Fusion Cancer and How to Test for It (Dec.13/22)
https://www.bayer.ca/en/media/news/?dt=TmpBPQ==&st=1
3. A Phase II, Open-label, Multicenter, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population (Dec.13/22)
L'objectif de cette étude est d'examiner l'efficacité du vaccin DPX-Survivac en combinaison avec les médicaments cyclophosphamide et l'immunothérapie Pembrolizumab in patients with solid cancers who are identified to be MSI-High. All patients will receive combination therapy of DPX-Survivac, cyclophosphamide, and pembrolizumab. Patients participating will know which treatment they are receiving. The trial is currently hosted at the Odette Cancer Centre, and a new site is opening at Mt. Sinai Hospital.
4. Phase III Study at the centre de cancérologie Odette Comparing Arfolitixorin vs. Leucovorin in Combination with 5FU, Oxaliplatin and Bevacizumab in Patients with Advanced CRC (Dec.12/22)
The purpose of this study is to look at the effectiveness of the drug Arfolitixorin in combination with 5-fluorouracil (5FU), oxaliplatin, and bevacizumab in patients with colorectal cancer (CRC). Patients with advanced/metastatic CRC who meet certain criteria may be able to participate. There will be two groups of patients participating in this study;
- un groupe recevra de L'arfolitixorine en combinaison avec du 5FU), de l'oxaliplatine et du bevacizumab,
- tandis que l'autre groupe recevra le médicament Leucovorin en combinaison avec le 5FU, l'oxaliplatine et le bevacizumab (norme de soins).
Le médecin et le personnel de l'étude ne sauront pas dans quel groupe se trouve un patient. Les patients seront répartis au hasard pour recevoir l'un ou l'autre traitement.
A propos d'Arfolitixorine:
L'arfolitixorine is Isofol’s proprietary drug candidate being developed to increase the efficacy of standard of care chemotherapy for advanced CRC. The drug candidate is currently being studied in a global Phase 3 clinical trial. As the key active metabolite of the widely used folate-based drugs, arfolitixorin can potentially benefit all patients with advanced CRC, as it does not require complicated metabolic activation to become effective.
Traiter les patients atteints de cancer avec de l'arfolitixorine - Les objectifs :
- When treating CRC, for example, arfolitixorin is administered in combination with 5-FU to increase cell mortality in circulating cancer cells and in cancerous tumours.
- Arfolitixorin is administered in conjunction with rescue therapy after high-dose treatment with the cytotoxic agent, methotrexate, in order to suppress the cytotoxic effect in surrounding healthy tissue. The treatment is used for certain types of cancer, such as osteosarcoma, a type of bone cancer. This involves administering arfolitixorin separately, 24 hours after the chemotherapy.
https://sunnybrook.ca/trials/item/?i=293&page=49335 et https://clinicaltrials.gov/ct2/show/NCT03750786
https://isofolmedical.com/arfolitixorin/
LES THÉRAPIES CHIRURGICALES
5. In Vivo Lung Perfusion (IVLP) for CRC Metastatic to Lung (Jan.19/23)
A new study is investigating a technique called In Vivo Lung Perfusion (IVLP) for delivering chemotherapy directly into the lungs at the time of surgery. Delivering chemotherapy directly to the lungs could potentially kill any microscopic cancer cells that are present in the lungs at the time of surgery, while sparing other major organs in the body from the side effects of chemotherapy.
At the University Health Network, this IVLP technique has been used recently in a Phase I study in patients with sarcoma, and they are now expanding on that experience to include patients with colorectal metastases. The purpose of this study is to test the safety of the IVLP technique and find the dose that seems right in humans. Participants are given oxaliplatin into one lung via IVLP and are watched very closely to see what side effects they have and to make sure the side effects are not severe. If the side effects are not severe, then more participants are asked to join the study and are given a higher dose of oxaliplatin. Participants joining the study later on will get higher doses of oxaliplatin than participants who join earlier. This will continue until a dose is found that causes severe but temporary side effects. The other lung will not be infused with anything, so that researchers can limit unforeseen toxicity to a single lung and see if one lung does better than the other.
The estimated enrolment is 10 participants, each with a diagnosis of colorectal carcinoma. The primary outcome is safety as measured by acute lung injury findings and the estimated primary completion date is January 1, 2027.
In Vivo Lung Perfusion Model
https://clinicaltrials.gov/ct2/show/NCT05611034?term=ivlp&draw=2&rank=1
Source de l'image : https://pie.med.utoronto.ca/TVASurg/project/in-vivo-lung-perfusion/
6. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Odette Cancer Centre (Dec.1/22)
Le programme PPAH est une première au Canada pour les personnes dont le cancer du côlon ou du rectum (cancer colorectal) s'est propagé au foie et ne peut être retiré par une intervention chirurgicale. Le programme implique une approche coordonnée et multidisciplinaire des soins, avec une étroite collaboration entre l'oncologie chirurgicale, l'oncologie médicale (chimiothérapie), la radiologie interventionnelle, la médecine nucléaire et les soins infirmiers en oncologie. La pompe à perfusion de l'artère hépatique (PPAH) est un petit dispositif en forme de disque qui est chirurgicalement implanté juste sous la peau du patient et est relié par un cathéter à l'artère hépatique (principale) du foie. Environ 95 % de la chimiothérapie administrée par cette pompe reste dans le foie, épargnant ainsi le reste du corps des effets secondaires. Les patients reçoivent une chimiothérapie dirigée par PPAH en plus de la chimiothérapie intraveineuse (IV) régulière (chimiothérapie systémique), afin de réduire le nombre et la taille des tumeurs. Drs. Paul Karanicolas and Michael Raphael are the program leads and happy to see patients who may be eligible for the therapy.
Maintenant au centre de cancérologie Odette, le PPAH est utilisé chez les patients atteints d'un cancer colorectal qui s'est propagé au foie et qui ne peut être enlevé chirurgicalement et ne s'est pas propagé à d'autres parties du corps. Les patients qui ont peu (1-5) et de très petites tumeurs dans les poumons peuvent être pris en considération si la maladie pulmonaire est jugée traitable avant le PPAH. Si vous pensez pouvoir bénéficier de cette thérapie et/ou si vous souhaitez en savoir plus sur l'essai clinique, votre oncologue médical ou votre chirurgien peut vous adresser par télécopie au 416-480-6179. Pour plus d'informations sur l'essai clinique PPAH, veuillez cliquer sur le lien fourni ci-dessous
http://sunnybrook.ca/content/?page=colorectal-colon-bowel-haip-chemotherapy
7. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases (Dec.2/22)
Environ la moitié des patients atteints de cancer colorectal (CCR) développent des métastases, généralement au niveau du foie et des poumons. L'ablation chirurgicale des métastases hépatiques (MH) est la seule option de traitement, bien que seulement 20 à 40 % des patients soient candidats à un traitement chirurgical. La thérapie chirurgicale apporte un avantage significatif en termes de survie, avec une survie à 5 ans après résection du foie de 40 à 50 % pour les MH, contre 10 à 20 % pour la chimiothérapie seule. La transplantation du foie (TF) permettrait d'éliminer toute maladie évidente dans les cas où les métastases colorectales sont isolées au foie mais considérées comme non résécables.
Source de l'image : https://www.slideshare.net/AhmedAdel65/preoperative
While CRC LM is considered a contraindication for LT at most cancer centers, a single center in Oslo, Norway demonstrated a 5-year survival of 56%. A clinical trial sponsored by the University Health Network in Toronto will offer live donor liver transplantation (LDLT) to select patients with unresectable metastases limited to the liver and are non-progressing on standard chemotherapy. Patients will be screened for liver transplant suitability and must also have a healthy living donor come forward for evaluation. Patients who undergo LDLT will be followed for survival, disease-free survival, and quality of life for 5 years and compared to a control group who discontinue the study before transplantation due to reasons other than cancer progression.
https://clinicaltrials.gov/ct2/show/NCT02864485
LES RADIOTHÉRAPIES/RADIOLOGIE INTERVENTIONNELLE
9. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer (Dec.9/22)
Magnetic resonance-guided focused ultrasound (MRg-FU) is a less invasive; outpatient modality being investigated for the thermal treatment of cancer. In MRg-FU, a specially designed transducer is used to focus a beam of low-intensity ultrasound energy into a small volume at a specific target site in the body. MR is used to identify and delineate the tumour, focus the ultrasound beam on the target, and provide a real-time thermal mapping to ensure accurate heating of the designated target with minimal effect to the adjacent healthy tissue. The focused ultrasound beam produces therapeutic hyperthermia (40-42°C) in the target field, causing protein denaturation and cell damage. Currently, there is no prospective clinical data reported on the use of MRg-FU in the setting of recurrent rectal cancer. Recurrent rectal cancer is a vexing clinical problem. Current retreatment protocols have limited efficacy. The addition of hyperthermia to radiation and chemotherapy may enhance the therapeutic response. With recent advances in technology, the investigators hypothesize that MRg-FU is technically feasible and can be safely used in combination with concurrent reirradiation and chemotherapy for the treatment of recurrent rectal cancer without increased side-effects. The study is being offered at the Odette Cancer Centre. Here is the link to the study protocol:
DÉPISTAGE
9. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age (Dec.10/22)
With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), the objective of this population-based longitudinal study was to evaluate the incidence of yCRC in one-year age increments, particularly focusing on the screening age of 50 years. The study was conducted using linked administrative health databases in British Columbia, Canada including a provincial cancer registry, inpatient/outpatient visits, and vital statistics from January 1, 1986 to December 31, 2016. Researchers calculated the incidence rates per 100,000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis. 3,614 individuals were identified with yCRC (49.9% women). The incidence of CRC steadily rose from 20 to 60 years, with a marked increase from 49 to 50 years. Furthermore, there was a trend of increased incidence of yCRC among women. Analyses stratified by age yielded APCi’s of 2.49% and 0.12% for women aged 30-39 years and 40-49 years, respectively and 2.97% and 1.86% for men. These findings indicate a steady increase over one-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.
10. Stool Tests like Cologuard are Gaining Popularity Over Colonoscopy (Nov.29/22)
Over time, stool tests – including fecal immunochemical tests, or FIT, and the heavily advertised Cologuard – can be just as effective at saving lives, and they avoid some of the down sides of colonoscopies, experts say. They can be done at home, mailed into a lab and don’t require any special preparation. The main issue with stool tests is they have to be done more often: FIT annually, and Cologuard every three years. In contrast, routine colonoscopies should be done once a decade. The colonoscopy has long been considered the gold standard. However, it is important to note that no test is objectively better than the others. The best colorectal cancer (CRC) screening test is the one you actually choose to take.
Source de l'image : https://www.mykawartha.com/community-story/9500717-new-at-home-colon-cancer-screening-test-is-more-accurate-says-lakeridge-health-doctor/
11. Researchers Assess Reasons for Non-Follow-up After a Positive CRC Test (Nov.29/22)
While screening by Fecal Immunochemical Test (FIT) can detect colorectal cancers (CRCs) early, successful treatment depends on the patient undergoing follow-up colonoscopy after an unfavourable test result. A paper published by Dutch researchers examined the reasons why some people do not follow up after a positive at-home test.
Reasons for lack of follow-up include concerns about having a colonoscopy, lack of opportunity to discuss next steps with a medical provider, assumptions and perceptions about their personal risk, a belief that the test result is not indicative of cancer, and questioned effectiveness of polyp removal, as well as poor overall health behaviours. The strongest positive association with follow-up was the patient’s belief that their family physician would support colonoscopy, as well as fear of cancer. Such a pattern has global implications for all people at risk of the cancer as it is best treated early. Researchers suggest that personalized screening counselling may help, as well as the involvement of family practitioners.
12. Guardant DNA Blood Test Finds 83% of CRCs in Trial (Dec.15/22)
Guardant Health Inc announced a pivotal trial of its DNA blood test showed it detected 83% of colorectal cancers (CRCs) and 13% of advanced adenomas, a cancer precursor, but the results fell short of a rival stool-based test, sending the company’s shares sharply lower. The results “were much lower versus [researcher] expectations,” and the findings “are likely to disappoint investor expectations”. Cologuard, a stool-based DNA test, identifies 92% of CRCs and 42% of pre-cancerous polyps, according to data from Exact Sciences, which markets the test. This is showing for the first time that a blood test can really detect CRC with high sensitivity. Guardant expects to finish submitting its data to the U.S. Food and Drug Administration (FDA) early next year, and hopes to get FDA approval in the very early part of 2024.
Source de l'image : https://www.fiercebiotech.com/medtech/guardant-s-liquid-biopsy-detects-96-early-stage-colorectal-cancer-cases-a-single-blood-draw
13. LifeLabs Forms New Collaboration with Natera to Offer Molecular Residual Disease (MRD) Testing for Cancer in Canada (Dec.15/22)
LifeLabs announced its new collaboration with Natera, Inc., a global leader in cell-free DNA testing, to offer personalized testing for cancer in Canada through Natera’s Signatera Residual Disease Test. Signatera is a highly sensitive, personalized molecular residual disease assay (MRD) test developed by Natera for treatment monitoring and molecular residual disease (MRD) assessment in patients previously diagnosed with cancer. The test uses circulating tumor DNA (ctDNA) and is personalized for each patient to help assess recurrence risk and help identify relapse up to two years earlier than current standard of care tools.
Signatera testing involves two phases with pre-supplied collection kits. The first phase is an initial test that analyzes both a tumour tissue and blood sample, and the second phase involves subsequent blood tests on an as-needed basis. It is a safe, non-invasive way to monitor ctDNA levels to help physicians understand treatment efficacy and detect relapse without the inconvenience of repeated tissue biopsies and/or imaging.
Assessment of response to treatment is essential for evaluating treatment choices. Clinical trials of Signatera show that the test provides precise and informative measurement of residual disease for patients who are being treated for solid tumours. Personalized, highly sensitive assays that are based upon blood samples like Signatera help patients and clinicians manage treatment options while avoiding repeated invasive tissue biopsies.
AUTRE
14. Young Adult CRC Clinic Available at Sunnybrook (Dec.5/22)
A recent study led by the University of Toronto doctors has observed a rise in colorectal cancer (CRC) rates in patients under the age of 50. The study mirrors findings from the U.S., Australia and Europe. The growing CRC rates in young people come after decades of declining rates in people over 50, which have occurred most likely due to increased use of CRC screening (through population-based screening programs) which can identify and remove precancerous polyps. Patients diagnosed under the age of 50 have a unique set of needs, challenges and worries. They are unlike those diagnosed over the age of 50. Le Dr Shady Ashamalla (oncologue chirurgien spécialisé dans le cancer colorectal) et son équipe du Centre des sciences de la santé Sunnybrook comprennent les besoins de cette population de patients.
Le Dr Ashamalla fait partie d'une équipe multidisciplinaire d'experts de La Clinique Du Cancer Colorectal Des Jeunes Adultes who will work with young CRC patients, regardless of disease stage, to create an individualized treatment plan to support each patient through their cancer journey. Their needs and concerns will be addressed as they relate to:
- Préoccupations et questions relatives à la fécondité
- Les jeunes enfants à la maison
- Questions relatives aux données et à l'intimité
- Les défis au travail
- Inquiétudes concernant le cancer héréditaire
- Relations avec la famille et les amis
- Stress psychologique dû à l'un ou à l'ensemble des éléments ci-dessus
L'équipe d'experts est composée de :
- Oncologues (médicaux, chirurgicaux, radiologiques)
- Travailleurs sociaux
- Psychologues
- Généticiens
- Infirmière navigatrice
Si un patient souhaite être orienté vers Sunnybrook, il peut demander à son médecin traitant ou à son spécialiste de l'orienter vers Sunnybrook via le formulaire d'orientation électronique, accessible via le lien figurant ci-dessous. Une fois l'orientation reçue La Clinique Du Cancer Colorectal Des Jeunes Adultes sera informée si le patient a moins de 50 ans. Un rendez-vous sera alors fixé, au cours duquel le patient rencontrera différents membres de l'équipe afin de répondre à leurs préoccupations spécifiques.
http://sunnybrook.ca/content/?page=young-adult-colorectal-cancer-clinic
15. CCRAN’s Partnership with “Count Me In” (Dec.1/22)
CCRAN is proud to partner with Count Me In, a nonprofit research initiative, on The Colorectal Cancer Project. This new project is open to anyone in the United States or Canada who has ever been diagnosed with colorectal cancer (CRC). Patients can find out more and join at JoinCountMeIn.org/Colorectal.
Through the project, patients are asked to complete surveys to share information about their experience with CRC, to share biological sample(s), and to allow for the research team to request copies of their medical records. The project team then de-identifies and shares data from these with the entire research community. 10
Every patient’s story holds a piece of the puzzle that can help us better understand CRC. By discovering more about what drives cancer and sharing this data, CCRAN and the Colorectal Cancer Project believe insights can be gained to develop more effective therapies. One of the aims of the project is to reach populations that have been understudied, including individuals who are diagnosed with CRC at a young age, individuals from marginalized communities who have historically been excluded from research, and patients with metastatic CRC. Together, we can accelerate our understanding of CRC. To learn more or sign up to participate, visit JoinCountMeIn.org/Colorectal.
“Count Me In”, a nonprofit cancer research initiative, is inviting all patients across the United States and Canada who have ever been diagnosed with colorectal cancer (CRC) to participate in research and help drive new discoveries related to this disease. The Colorectal Cancer Project will enable patients to easily share their samples, health information and personal lived experiences directly with researchers in order to accelerate the pace of research.
Patients who have been diagnosed with CRC at any point in their lives can join the project by visiting JoinCountMeIn.org/colorectal. From there, patients will be invited to share information about their experience through surveys and to provide access to medical records as well as saliva samples and optional blood, stool, and/or stored tissue samples for study and analysis. Researchers from the Broad Institute of MIT and Harvard and Dana-Farber Cancer Institute use this information to generate databases of clinical, genomic, molecular, and patient-reported data that is then de-identified and shared with researchers everywhere. To date, more than 9,000 patients with different cancers have joined Count Me In and shared their data. “We still do not know why there is an alarming rise in CRC in young adults”, said Andrea Cercek, MD Co-Director, Center for Young Onset Colorectal and Gastrointestinal Cancers Memorial Sloan Kettering Cancer Center and co-scientific leader of the Colorectal Cancer Project. “What we do know is that this is a global phenomenon that affects otherwise healthy individuals with no known risk factors. The Colorectal Cancer Project will provide researchers important information that will lead to a better understanding of this disease.”
Over 250 patients have joined the Colorectal Cancer Project since the launch in fall 2021. Every patient that joins the Colorectal Cancer Project enables us to learn more about colorectal cancer. Pts diagnosed at any age, whether newly diagnosed or years from their diagnosis, can enroll. If you have ever been diagnosed with colorectal cancer, you can visit JoinCountMeIn.org/Colorectal to enroll and have a direct impact on research and future treatment strategies.
16. Patients and Caregivers Needed to Help Shape Early Research for a CRC Therapy (Dec.10/22)
17. Announcing CCRAN’s Upcoming Four New Colorectal Cancer Information/Support Groups! (Dec.2/22)
The Colorectal Cancer Resource & Action Network (CCRAN) is pleased to share that it will be launching four colorectal cancer information/support groups to help address the unmet needs of our colorectal cancer patients and caregivers across Canada, stratified according to:
- > 50 years of age, advanced stage disease, facilitated by Filomena Servidio, 1-3 p.m. every 3Tiers Sunday of the month
- > 50 years of age, earlier stage disease, facilitated by Frank Pitman and Cassandra Macaulay, TBD
- < 50 years of age, advanced stage disease, facilitated by Hayley Painter R.N. & Sandra Elhilali, 7-9 p.m., every 3Tiers Sunday of the month
- < 50 years of age, earlier stage disease, facilitated by Dr. Petra Wildgoose, 2-3 p.m., 3very 3Tiers Sunday of the month
Please stay tuned as we share the details of the launch dates and information for the new support groups.
For more information, please contact the head of CCRAN’s National Patient Programs, Cassandra Macaulay at Cassandra.m@ccran.org , for she would be delighted to assisted with any inquiries.
18. CAR T-cell Therapy in CRC (Nov.21/22)
In a recent study published in Frontiers in Immunology, researchers assessed the efficacy of chimeric antigen receptor (CAR) T-cells in the immunotherapy of colorectal cancer (CRC). CAR T-cells are a novel cell-based immunotherapy against cancer that is developed genetically. The application of CAR T-cells has transformed the treatment of hematological cancers. Before this therapy can be modified to treat solid tumors, such as CRC, extensive research is necessary as there is scarce clinical data available regarding CAR T-cell treatment for CRC.
Ongoing studies investigate the application of CEA-specific CAR T-cells in patients with CEA-positive CRC. Carcinoembryonic antigen (CEA) is a target of anti-CRC CAR T-cells that have been explored. CEA is an immunoglobulin glycoprotein overexpressed in various human malignancies, including prévenir le cancer du côlon, lung, gastric, pancreatic, and ovarian cancers. CEA is among the most significant prognostic and diagnostic tumor indicators and is overexpressed in over 98% of CRC tissue samples. Thus, CEA-targeted treatments have the potential to produce novel CRC therapy techniques. The goal of such studies is to verify efficacy and safety, as well as to determine the right doses and infusion schedule. Another objective of these investigations is to identify adverse effects, particularly cytokine release syndrome. Protocols for administration include hepatic and systemic transarterial delivery, vascular intervention, and intraperitoneal infusion, while the outcomes are awaited. Also under evaluation is a novel combinatorial technique involving human epidermal growth factor receptor 2 (HER2)-specific CAR T-cells along with an oncolytic adenovirus (CAdVEC). Oncolytic adenoviruses reproduce and propagate exclusively within tumors, augmenting their cytotoxicity, enhancing tumor penetration, and reverting immune suppression.
Overall, the study findings showed that CAR T-cells continue to garner evidence supporting their application as a viable immunological method of cancer treatment. This strategy has significantly improved patient treatment in hematological malignancies.
https://www.news-medical.net/news/20221121/CAR-T-cell-therapy-in-colorectal-cancer.aspx
19. Study Finds Positive Psychology Can Help Mediate Some Symptoms of CRC (Dec.19/22)
Findings from a recent study have found that positive psychology can help with symptom management and quality of life in patients diagnosed with colorectal cancer (CRC). Positive psychology may be helpful for patients who are processing their diagnosis and treatments and can involve techniques such as benefit finding and post-traumatic growth. Studies have confirmed that patients with CRC are at an increased risk for mood disorders such as depression, bipolar disorder, and anxiety, particularly if the follow-up time is greater than 1 year.
Data were collected using a demographic questionnaire, therapy-related symptom checklist, and quality of life inventory, and positive psychology was assessed using the Carver Benefit-Finding Scale and Post-Traumatic Growth Inventory. According to the study results, the most common symptoms were peripheral neuropathy, fatigue, skin changes, sleep disturbances, and weakness. Psychological distress symptoms were reported in 38.46% of participants and moderate-to-high positive psychology and quality of life levels were reported during acute cancer survivorship. Significant relationships were observed between quality of life and number of symptoms, psychological distress symptoms, benefit finding, post-traumatic growth, and positive psychology. Importantly, positive psychology partially mediated the relationship between symptom frequency and quality of life. According to the study, participants reported high quality of life and moderate-to-high positive psychology.
Based on these findings, the authors concluded that survivors of CRC cope positively with their cancer and treatment. Identifying how survivors adjust to their cancer may help health care providers to provide tailored self-management skills as well.
Source de l'image : https://www.conferencesforwomen.org/positive-psychology-traits-that-fuel-success-and-a-happier-life/
20. Comprehensive Analysis of the Differences Between Left- and Right-Ride CRC and Respective Prognostic Prediction (Nov.23/22)
In recent years, there has been a growing body of evidence demonstrating that the primary tumor location of CRC is an important prognostic factor. Researchers aimed to analyze the differences between left-sided colon cancer (L_cancer) right-sided colon cancer (R_cancer) in a set of 335 colon cancer patients.
Results revealed that right-sided colon cancer had lower survival than left-sided colon cancer. R_cancer patients had higher immune scores and lower tumor purity. These patterns of expression of immune checkpoint-related genes and tumor mutation burden (TMB) level were higher in R_cancer than in L_cancer patients. Thus, significant differences were found between L_cancer and R_cancer patients, including clinical features, transcriptome, TMB, immune microenvironment landscape, suggesting that colon cancer can be classified and analyzed into different clinical types with respect to their differences in anatomical location and gene expression, thus aiding in the early diagnosis and prognosis of colon cancer. Researchers established two clinical predictive nomograms (a diagram depicting relationship between 3+ variables) in combination with clinical features to provide a basis for the personalized and precise treatment of L_cancer and R_cancer. These hub genes may become promising biomarkers for the diagnosis, treatment, and prognosis of colon cancer. Additionally, R_cancer patients in low-risk groups may be more beneficial from immunotherapy.
https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02585-3#Sec28
21. Cancer PEP – Patient Empowerment Program is Now Open (Dec.6/22)
CancerPEP (Patient Empowerment Program) is a free six-month home-based comprehensive program that aims to improve the physical and mental health, and overall quality of life of people diagnosed with cancer. The program is being offered by Oncologist Rob Rutledge and Psychology Professor Scientist Dr. Gabriela Ilie. Over 100 patients have already enrolled, and the team is looking to see more colorectal cancer patients included.
For 26 weeks, participants receive a daily email and short PEP video that teach and encourage home-based health-promoting activities:
- Aerobic exercise
- Strength training
- The anti-cancer diet
- Relaxation and stress reduction techniques
- Relationship and connection teaching
You may qualify for this program if you:
- have been given a cancer diagnosis of any type or stage, and at any time
- are expected to live for at least one year
- are safe to do mild to moderate aerobic exercise, and strength training or Yoga
- will commit to doing this program daily for six months, AND
- are willing to fill out four quality of life questionnaires over 2 years, and a weekly compliance survey during the program
Learn more by watching this 10-minute video:
If you’re interested please contact PEP@nshealth.ca , 902-473-7727 or (best) by filling out the contact form found on the Program Details page at CancerPEP.org . A call back can be expected within a few days.
22. News From AYA Can (Jan.9/23)
AYA Can, a national organization advocating for adolescents and young adults (AYA) affected by Cancer in Canada, has partnered with Dr. Perri Tutelman and Dr. Fiona Schulte at the University of Calgary to run a James Lind Alliance Priority Setting Partnership in the area of AYA cancer. The priority setting partnership (PSP) will bring together Canadian patients, caregivers, clinicians, and researchers to establish the top research priorities for AYAs facing cancer. The top research priorities will guide future research in Canada. More updates about the first PSP activity will be shared soon.
NUTRITION/MODE DE VIE SAIN
23. Exercise for Cancer to Enhance Living Well (EXCEL) Study (Dec.11/22)
Exercise for Cancer to Enhance Living Well (EXCEL) is a 5-year Canada-wide project, which offers free, 12-week exercise classes designed specifically for individuals undergoing or recovering from cancer treatment. Classes are online through a secure video-conferencing platform, and where possible, in-person (post-COVID). Physical activity can help overcome treatment-related side effects such as fatigue and pain, improve mental health by reducing anxiety and depression, and improve overall quality of life for individuals living with and beyond cancer. Studies show that physical activity may even reduce the risk of recurrence for some cancers. Many urban centres in Canada offer cancer-specific exercise programs, however, rural and remote areas tend to lack exercise resources to support cancer survivors, resulting in lower activity levels, poorer health, and diminished quality of life. Thus, EXCEL targets cancer survivors living in rural and remote regions across Canada, empowering them to move more and providing opportunities to benefit from physical activity.
To learn more about the EXCEL study:
To hear about participant experiences: https://www.youtube.com/watch?v=c01oo4Yd3oA
24. Dietary Change Could be a Key to Enhancing Colon Cancer Treatment (Nov.20/22)
A new study from the University of Michigan Rogel Cancer Center finds that dietary change could be a key to enhancing colon cancer treatment.Researchers found in mice cells that a low-protein diet blocked the nutrient signaling pathway that fires up a master regulator of cancer growth. The regulator, mTORC1, controls how cells use nutritional signals to grow and multiply. It’s highly active in cancers with specific mutations, such as colon cancer, and is known to cause cancer to become resistant to standard treatments. A low-protein diet, and specifically a reduction in two key amino acids, changed the nutritional signals through a complex called GATOR. GATOR1 and GATOR2 work together to keep mTORC1 in business. When a cell has plenty of nutrients, GATOR2 activates mTORC1. When nutrients are low, GATOR1 deactivates mTORC1. Researchers found that mice on a low protein diet displayed less early tumor growth and more cancer cell death than controls. These mice also had reduced mTORC1 activation and proliferation.
The researchers noted that this suggests that amino acids regulate mTORC1 activity and that limiting amino acids may inhibit early tumor growth. Putting cancer patients on a protein-deficient diet long-term is not ideal. But if you can find key windows – like at the start of chemotherapy or radiation – when patients could go on a low protein diet for a week or two, we could potentially increase the efficacy of those treatments.
25. New Evidence Links Healthy Plant-Based Diets with Lower CRC Risk (Nov.30/22)
Several studies have investigated the relationship between diet and colorectal cancer (CRC), finding that the typical Western diet that is high in fat, red meat, and processed meat increases the risk. Reducing these foods and increasing foods high in dietary fibre is associated with a reduction in risk. Plant-based foods tend to be high in dietary fiber, but only in an unprocessed state. Now, a study that appears in BMC Medicine has found that a diet high in healthy plant-based foods — whole grains, fresh fruit, and vegetables — is associated with a lower risk of CRC in men. Unhealthy plant-based foods — refined grains, fruit juices, and added sugars — had no beneficial effect on cancer risk.
Source de l'image : https://www.everydayhealth.com/diet-nutrition/plant-based-diet-food-list-sample-menu/
26. Ultraprocessed Foods Linked to Greater Risk for Colon Cancer, Heart Disease and Death (Dec.2/22)
Ultraprocessed foods like packaged snacks, factory-made breads, soft drinks, breakfast cereal and other ready-to-eat items, can be more affordable and convenient, however, they are also linked to poor health outcomes. Two recent studies find that such foods are linked to an increased risk for colorectal cancer (CRC) as well as cardiovascular and all-cause mortality.
The first study indicated that men who ate the most ultraprocessed food had a 29% higher risk for CRC, especially in the distal colon, compared with men who ate the least ultraprocessed foods. The link persisted even after adjusting for body mass index and dietary nutrition. However, the association between ultraprocessed food and CRC was not seen in women. Eating more ready-to-eat meals made from meat, poultry or seafood and drinking sugary beverages were linked to a greater risk of CRC in men. Ready-to-eat meals were also associated with a higher rate of CRC in women, while yogurt and yogurt-based desserts were linked to a lower risk.
In the other study, people with the least healthy diet had a 32% higher risk for death from cardiovascular conditions and a 19% higher mortality risk from any cause compared to people with healthier diets. People who ate the most ultraprocessed foods had a 27% higher risk for cardiovascular death and a 19% higher risk for death from any cause compared with people who ate the least amount of ultraprocessed foods. A significant proportion of the higher mortality risk associated with an elevated intake of nutrient-poor foods was explained by a high degree of food processing. In contrast, the relation between a high ultraprocessed food intake and mortality was not explained by the poor quality of these foods. These studies bolster calls for improvements in food policies to limit the consumption of overly processed foods.
27. Regular Exercise Improves Outcomes in Patients with CRC (Dec.13/22)
According to a study published in the American Journal of Cancer Research, getting regular exercise was found to improve the survival of patients with colorectal cancer (CRC). The study was the first to find a positive association between the impact of exercise on the gut microbiome of patients with cancer, according to the authors. Additionally, the study found that physical activity is also beneficial to obese patients with cancer, who generally have a less healthy gut microbiome. Study authors added that their findings represent an important step in understanding the impact of a healthy gut on outcomes in patients with CRC.
A patient who is active has a more diverse microbiome and lower abundances of CRC-promoting bacteria, and higher amounts of bacteria that protect against CRC. Nobody needs to be an athlete to get the benefits. It can be easy activities. Just staying active is very beneficial. In fact, regular exercise helps to facilitate a healthy gut microbiome and lowers inflammation, which were observed in patients independent of body mass index, including those considered severely overweight or obese. Inflammation is a key process that drives CRC and it is known that a high BMI causes inflammation around the body. Thus, If BMI is reduced, one will have lower levels of inflammation. Lower inflammation then means risk of death is reduced.
Source de l'image : https://info.totalwellnesshealth.com/blog/health-benefits-of-exercise
MISES À JOUR COVID-19
28. Frequently Asked Questions for COVID-19
Q: What is COVID-19 (or novel Coronavirus Disease – 19)?
A: Coronaviruses are a large family of viruses that can cause illnesses in humans and animals. Coronaviruses can cause illnesses that range in severity from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and most recently, COVID-19. COVID-19 or novel coronavirus originated from an outbreak in Wuhan, China in December 2019. The most common symptoms associated with COVID-19 can include fever, fatigue, and a dry cough. Though additional symptoms have now been linked with the disease, which may include aches and pains, nasal congestion, runny nose, sore throat, diarrhea, skin rash and vomiting. It is also possible to become infected with COVID-19 and not experience any symptoms or feeling ill. The spread of COVID-19 is mainly through the transmission of droplets from the nose or mouth when a person coughs, exhales or sneezes. These droplets land on surfaces around a nearby person. COVID-19 can be transmitted to that nearby person who may end up touching the surface contaminated with COVID-19 and then end up touching their nose, mouth, or eyes. A person can also contract COVID-19 through inhaling these droplets from someone with COVID-19. Although research is still ongoing, it is important to note that older populations (over the age of 65), those with a compromised immune system and those with pre-existing conditions including heart disease, high blood pressure, lung disease, diabetes or cancer may be at a higher risk of severe illness due to COVID-19.
https://www.who.int/news-room/q-a-detail/q-acoronaviruses
Q: What can I do to avoid getting Coronavirus?
A: There are various ways in which we can reduce our risk of contracting COVID-19. Below are some measures suggested by the World Health Organization
1. Keep at least 2 metres (or 6 feet) between yourself and other people. This will reduce the risk of inhaling droplets from those infected with COVID-19.
2. Regularly clean your hands for at least 20 seconds with warm water and soap, or an alcohol-based hand rub. This will kill any viruses on your hands.
3. Avoid touching your eyes, nose and mouth. If the virus is on your hands, it can enter the body through these areas.
4. Follow good respiratory hygiene by covering your mouth and nose with a tissue or elbow when you cough and sneeze. This prevents the droplets from settling on surfaces or being released into the air around you.
5. Stay home as much as possible, especially if you are feeling unwell. If you think you may have the Coronavirus, please see “What should I do if I think I have Coronavirus?” section.
6. Please wear a face covering or mask in public when physical distancing is not possible.
https://www.who.int/news-room/q-adetail/q-a-coronaviruses
Y a-t-il des précautions particulières que les personnes atteintes d'un cancer peuvent prendre ?
R : Les personnes atteintes de cancer (et d'autres maladies chroniques telles que les maladies cardiaques, le diabète, l'hypertension et les maladies pulmonaires) sont plus exposées à une maladie grave en raison de la COVID-19, le cancer étant considéré comme un problème de santé préexistant. Certains traitements contre le cancer, notamment la chimiothérapie, les radiations et la chirurgie, peuvent affaiblir le système immunitaire, ce qui rend l'organisme plus difficile à combattre les infections et les virus, comme le Coronavirus. Il est important de suivre avec diligence les recommandations de l'Organisation mondiale de la santé ci-dessus pour réduire le risque de contracter le COVID-19. Si vous avez des inquiétudes quant à votre risque, il est préférable de contacter votre médecin ou votre équipe de soins.
Y a-t-il des changements en ce qui concerne mes visites médicales liées au cancer ? Chaque patient et chaque plan de traitement étant uniques, il est toujours préférable de contacter votre prestataire de soins de santé pour obtenir des informations actualisées sur votre plan de traitement. Dans certains cas, il est possible de retarder le traitement du cancer jusqu'à ce que le risque de pandémie ait diminué. Dans d'autres cas, il peut être sûr de se rendre dans une clinique distincte de celle où sont traités les patients COVID-19. Les options de traitement oral pourraient être prescrites par votre prestataire de soins de manière virtuelle, sans qu'il soit nécessaire de se rendre à la clinique. Enfin, certains rendez-vous ou discussions de suivi pourraient être organisés virtuellement (via skype ou zoom par exemple) ou par téléphone pour minimiser votre risque. Comme nous le savons, les conditions et les protocoles changent quotidiennement en raison de la nature de l'épidémie de COVID-19 et varient en fonction du lieu, par conséquent, la meilleure première étape consiste à demander conseil à votre prestataire de soins.
https://www.cancer.gov/contact/emergencypreparedness/coronavirus
Si vous souhaitez contacter votre agence locale de santé publique, veuillez voir ci-dessous.
Alberta
Informations COVID-19 pour Alberta
Les médias sociaux : Instagram @albertahealthservices, Facebook @albertahealthservices, Twitter @GoAHealth
Numéro de téléphone : 811
Colombie-Britannique
Informations COVID-19 pour Colombie-Britannique
Les médias sociaux : Facebook @ImmunizeBC, Twitter @CDCofBC
Numéro de téléphone : 811
Manitoba
Informations COVID-19 pour Manitoba
Les médias sociaux : Facebook @manitobagovernment, Twitter @mbgov
Numéro de téléphone : 1-888-315-9257
Nouveau Brunswick
Informations COVID-19 pour Nouveau-Brunswick
Les médias sociaux : Facebook @GovNB, Twitter @Gov_NB, Instagram @gnbca
Numéro de téléphone : 811
Terre-Neuve et Labrador
Informations COVID-19 pour Terre-Neuve-et-Labrador
Les médias sociaux : Facebook @GovNL, Twitter @GovNL, Instagram @govnlsocial
Numéro de téléphone : 811 ou 1-888-709-2929
Territoires du Nord-Ouest
Informations COVID-19 pour Territoires du Nord-Ouest
Les médias sociaux : Facebook @NTHSSA
Numéro de téléphone : 811
Nouvelle-Écosse
Informations COVID-19 pour Nouvelle-Écosse
Les médias sociaux : Facebook @NovaScotiaHealthAuthority , Twitter @healthns, Instagram @novascotiahealthauthority
Numéro de téléphone : 811
Nunavut
Informations COVID-19 pour Nunavut
Les médias sociaux : Facebook @GovofNunavut , Twitter @GovofNunavut, Instagram @gouvernement du Nunavut
Numéro de téléphone : 1-888-975-8601
Ontario
Informations COVID-19 pour Ontario
Les médias sociaux : Facebook @ONThealth, Twitter @ONThealth , Instagram @ongov
Numéro de téléphone : 1-866-797-0000
Île-du-Prince-Édouard
Informations COVID-19 pour Île-du-Prince-Édouard
Social media: Facebook @GovPe, Twitter @InfoPEI, 16
Québec
Informations COVID-19 pour Québec
Les médias sociaux : Facebook @GouvQc, Twitter @sante_qc
Numéro de téléphone : 1-877-644-4545
Saskatchewan
Informations COVID-19 pour Saskatchewan
Les médias sociaux : Facebook @SKGov, Twitter @SKGov
Numéro de téléphone : 811
Yukon
Informations COVID-19 pour Yukon
Les médias sociaux : Facebook @yukonhss, Twitter @hssyukon
Numéro de téléphone : 811
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