Colorrectal Cancer
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Jun 01 – Jun 08, 2026
A randomised study of encorafenib, cetuximab, and FOLFIRI versus FOLFIRI with or without bevacizumab in BRAF V600E-mutant colorectal cancer: BREAKWATER Cohort 3.
ANN ONCOL · Q1 JOURNAL - RANK #4/326TOP-TIER
This randomized study (BREAKWATER Cohort 3) evaluated encorafenib, cetuximab, and FOLFIRI (EC+FOLFIRI) versus FOLFIRI with or without bevacizumab in 147 previously untreated BRAF V600E-mutant metastatic colorectal cancer patients. EC+FOLFIRI significantly improved objective response rate (64.4% vs 39.2%, P=0.0011) and progression-free survival (15.2 vs 8.3 months, HR=0.44, P=0.0002). Prolonged overall survival (HR=0.56) was also observed, with a manageable safety profile. These findings support EC+FOLFIRI as a new standard of care, enabling personalized treatment for this specific cancer subtype.
10.1016/j.annonc.2026.04.017
Cost-Effectiveness of Fecal Immunochemical Testing Alone vs Co-Testing With Helicobacter pylori Stool Antigen.
JAMA-J AM MED ASSOC · Q1 JOURNAL - RANK #4/332TOP-TIER
This Markov model cost-effectiveness analysis, based on a Taiwanese pragmatic trial, evaluated adding one-time Helicobacter pylori stool antigen testing to biennial FIT screening for colorectal cancer. Compared to FIT alone, co-testing was dominant (cost-saving) in Taiwan, with an incremental cost-effectiveness ratio of -$2,094 per QALY gained and a 5-fold return on investment. Co-testing remained cost-effective in US settings when H pylori prevalence exceeded 21.9%, preventing gastric and colorectal cancer mortality. For a clinician focused on cancer, this provides strong evidence that combined screening improves cancer outcomes and is economically favorable, particularly in populations with moderate H pylori prevalence.
10.1001/jama.2026.6908
International disruptions to cancer diagnosis and stage at presentation during the COVID-19 pandemic in 2020: an International Cancer Benchmarking Partnership (ICBP) population-based study.
LANCET ONCOL · Q1 JOURNAL - RANK #8/326TOP-TIER
This population-based study analyzed 2.6 million patients across seven countries to evaluate how the COVID-19 pandemic disrupted the incidence and staging of seven major cancer types in 2020. Researchers found that 16% (55,713) of expected cancer cases were missing between April and December 2020, with the highest deficits occurring in prostate (24%), breast (18%), and melanoma (18%) diagnoses. The data reveals significant regional variations, such as a 54% deficit in UK prostate cancer cases, highlighting critical gaps in screening and diagnostic access during lockdowns. These findings underscore a pressing clinical need to address diagnostic backlogs and monitor for potential stage shifts in patients whose diagnoses were delayed by pandemic-related healthcare barriers.
10.1016/S1470-2045(26)00089-6
Chemotherapy for patients with circulating tumour DNA positive, stage II colon cancer (CIRCULATE) - an AIO / ABCSG trial.
ANN ONCOL · Q1 JOURNAL - RANK #4/326TOP-TIER
This randomized trial (CIRCULATE) evaluated the efficacy of adjuvant chemotherapy versus observation in patients with stage II, pMMR/MSS colon cancer who tested positive for postoperative circulating tumor DNA (ctDNA). Results confirmed ctDNA as a potent prognostic marker, with ctDNA-positive patients showing significantly lower 3-year disease-free survival (DFS) compared to ctDNA-negative patients (52% versus 87%, HR 4.28). While the intention-to-treat analysis was underpowered due to early trial closure, per-protocol analysis demonstrated that chemotherapy significantly improved 3-year DFS (77% versus 38%, HR 0.31, P=0.021) in ctDNA-positive individuals. These findings suggest that ctDNA-guided adjuvant therapy decisions can identify high-risk stage II patients who benefit from chemotherapy, potentially refining current treatment paradigms in oncology.
10.1016/j.annonc.2026.05.001
Structured exercise program following adjuvant chemotherapy for colon cancer: A cost-utility analysis of the CHALLENGE trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This economic evaluation of the phase III CHALLENGE trial assessed the cost-utility of a three-year structured exercise program (SEP) versus health education materials in 889 patients with stage II/III colon cancer. Results demonstrated that the SEP was dominant over education, being less costly (-$1,589 CAD) and more effective (+0.05 life-years; +0.10 QALYs) over a five-year horizon. For clinicians treating colon cancer, these findings provide robust evidence that exercise interventions not only improve survival but also reduce overall healthcare costs by potentially mitigating cancer recurrence. The study supports the integration of structured exercise into routine post-chemotherapy oncology care as a high-value, cost-saving strategy for health systems.
10.1200/JCO-26-00765
May 25 – Jun 01, 2026
Colorectal cancer screening: An update to the American Cancer Society guideline, 2026.
CA-CANCER J CLIN · Q1 JOURNAL - RANK #1/326TOP-TIER
The American Cancer Society (ACS) updated its colorectal cancer (CRC) screening guideline, systematically reviewing new molecular-based tests and modeling studies to assess their impact on incidence and mortality. The ACS reaffirms screening at age 45. New next-generation mt-sDNA and mt-sRNA tests, showing high sensitivity for CRC and moderate for advanced precancerous lesions, are now preferred stool-based options every 3 years. Blood-based tests demonstrated lower sensitivity for advanced precancerous lesions and stage I cancers, predicting less effectiveness, and are recommended only for individuals declining preferred tests. This update provides critical guidance for clinicians on effective cancer screening strategies, emphasizing patient choice and timely colonoscopy follow-up for positive non-colonoscopy results to improve CRC detection.
10.3322/caac.70083
May 18 – May 25, 2026
Preclinical characterization and phase 1 results of TQB2102, a first-in-class HER2 biparatopic antibody-drug conjugate, in patients with advanced solid tumors.
ANN ONCOL · Q1 JOURNAL - RANK #4/326TOP-TIER
This phase 1, first-in-human trial evaluated the safety, efficacy, and pharmacokinetics of TQB2102, a novel HER2 biparatopic ADC, in 195 patients with advanced solid tumors, primarily metastatic breast, colorectal, and gastric/GEJ cancers. The study found a manageable safety profile with no DLTs and MTD not reached, establishing 6.0 and 7.5 mg/kg as RP2D. Preliminary antitumor activity was observed, with objective response rates of 52.4% in MBC, 38.7% in CRC, and 40.0% in G/GEJ adenocarcinoma, including 47.2% in HER2-low MBC. These findings suggest TQB2102 is a promising therapeutic agent for advanced HER2-expressing solid tumors, warranting further investigation in a phase 3 trial for HER2-low MBC.
10.1016/j.annonc.2026.05.003
May 11 – May 18, 2026
Long-term effects of colonoscopy screening on colorectal cancer incidence and mortality: a multicountry, population-based randomised controlled trial.
LANCET · Q1 JOURNAL - RANK #1/332TOP-TIER
This multicountry, population-based randomized controlled trial assessed the 13-year effects of colonoscopy screening on colorectal cancer (CRC) incidence and mortality in 84,583 individuals. Colonoscopy significantly reduced CRC incidence (1.46% vs. 1.80% in no-screening; RR 0.81 [0.71-0.90]), especially for distal CRC. However, it did not significantly reduce CRC mortality (0.41% vs. 0.47%; RR 0.88 [0.68-1.08]) over this period. This study provides critical evidence for cancer prevention, indicating colonoscopy’s role in reducing CRC incidence but highlighting the need for further investigation into its long-term mortality impact.
10.1016/S0140-6736(26)00508-8
May 04 – May 11, 2026
Neoadjuvant Single-Cycle Pembrolizumab for Stage I-III MMR-Deficient Colon Cancer: The RESET-C Trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
The RESET-C trial investigated neoadjuvant single-cycle pembrolizumab for localized dMMR colon cancer, administering one cycle followed by endoscopy and surgery. Among 84 patients, 44% achieved pathologic complete response (pCR) and 57% major pathologic response (MPR), with 98% overall and 96% disease-free survival at 18.4 months. Grade 3 adverse events occurred in 11% of patients. Endoscopic images showed 77% sensitivity and 93% specificity for predicting pCR, suggesting utility for nonoperative management pathways in this cancer type.
10.1200/JCO-25-02274
Apr 27 – May 04, 2026
Phase I Study of Telisotuzumab Adizutecan (Temab-A, ABBV-400), a Novel c-Met Antibody-Drug Conjugate, in Patients With Late-Line Colorectal Cancer and Advanced Solid Tumors.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This phase I study evaluated the safety and efficacy of Temab-A, a novel c-Met antibody-drug conjugate, in patients with advanced solid tumors and late-line metastatic colorectal cancer (mCRC). Among 122 patients with mCRC, the overall response rate was 15.6% and the disease control rate reached 74.6%, with a median progression-free survival of 4.6 months. The treatment demonstrated a manageable safety profile at the 2.4 mg/kg dose, primarily involving gastrointestinal and hematologic toxicities, while showing promising antitumor activity in heavily pretreated populations. These results support the further development of Temab-A as a potential therapeutic option for c-Met-expressing solid tumors, particularly in refractory colorectal cancer settings.
10.1200/JCO-25-01525
An agentic framework for autonomous scientific discovery in cancer pathology.
NAT MED · Q1 JOURNAL - RANK #1/195TOP-TIER
This study introduces SPARK, an agentic AI framework that uses natural language to autonomously generate biologically driven analytical tools for tumor pathology without extra model training. Evaluated across 18 cohorts with over 5,400 patients spanning five cancer types, SPARK produced clinically relevant concepts correlated with prognosis, pathological variables, and predictive biomarkers, including inferred tumor progression from static images. The framework directly addresses the clinician’s interest in cancer-focused research by demonstrating applicability in lung, colorectal, breast, and oropharyngeal cancers, with evidence of prognostic and predictive value. Primary implications include potential to enhance diagnostic precision and biological insight, though prospective clinical validation is still needed before routine use.
10.1038/s41591-026-04357-y
Emerging trends in the global burden of colorectal cancer.
NAT REV CLIN ONCOL · Q1 JOURNAL - RANK #2/326TOP-TIER
This review examines the global epidemiology of colorectal cancer (CRC), currently the third most common cancer and second leading cause of cancer-related mortality worldwide. The study highlights a significant rise in early-onset CRC among individuals under 50, driven by a birth cohort effect starting in the 1960s rather than genetic susceptibility alone. Researchers identify shifting dietary patterns, gut microbiota changes, and environmental contaminants associated with urbanization as key emerging risk factors. These findings emphasize the need for expanded genomic research in non-Western populations to improve global early detection and interception strategies for younger cohorts.
10.1038/s41571-026-01149-8
Apr 20 – Apr 27, 2026
Colorectal cancer detection using non-contrast CT and deep learning: a multicenter and international cohort study.
ANN ONCOL · Q1 JOURNAL - RANK #4/326TOP-TIER
This multicenter, international cohort study developed COCA, a deep learning method utilizing non-contrast CT for colorectal cancer (CRC) screening, aiming for a non-invasive, cost-effective, and scalable solution. In validation across 2,053 patients, COCA achieved an AUC of 0.967-0.996 for CRC detection, improving sensitivity by 20.4% and specificity by 5.4% over radiologists. Real-world validations across 27,433 patients further demonstrated robust performance, maintaining high sensitivity (86.6-88.2%) and specificity (99.5-99.8%) for CRC detection. These findings indicate COCA’s strong potential as a practical tool for large-scale opportunistic CRC screening, directly aligning with the clinician’s interest in cancer research and early diagnosis.
10.1016/j.annonc.2026.04.009
Postoperative Hepatic Arterial Infusion With Oxaliplatin After Surgery of Four or More Colorectal Liver Metastases: A Randomized Phase II Trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This randomized phase II trial evaluated the efficacy of adjuvant hepatic arterial infusion (HAI) of oxaliplatin versus intravenous (IV) chemotherapy in 99 patients following surgery for four or more colorectal liver metastases. Results demonstrated a significant improvement in median hepatic recurrence-free survival (25 vs. 12 months; HR 0.63; p=0.047) and median recurrence-free survival (14 vs. 9 months; HR 0.63; p=0.03) favoring the HAI group. Although Grade 3-4 adverse events were higher in the HAI arm (58% vs. 32%), the five-year overall survival reached 62% compared to 47% in the IV arm. These findings suggest that adjuvant HAI oxaliplatin effectively reduces regional recurrence in high-risk cancer patients, supporting its consideration in specialized surgical oncology settings pending phase III validation.
10.1200/JCO-25-01737
Cibisatamab and FAP-4-1BBL in microsatellite-stable colorectal cancer: a phase 1b trial.
NAT MED · Q1 JOURNAL - RANK #1/195TOP-TIER
This phase 1b dose-escalation study evaluated the safety and efficacy of cibisatamab, a CEA-directed T cell-engager, combined with FAP-4-1BBL co-stimulation in 52 patients with microsatellite-stable metastatic colorectal cancer. Results demonstrated a manageable safety profile with a 13.5% confirmed partial response rate and dose-limiting toxicities occurring in only 3.8% of participants. The study directly addresses the clinician’s interest in cancer by exploring novel immunotherapy combinations for treatment-refractory colorectal malignancies. These findings support the feasibility of tumor-localized co-stimulation to enhance T cell engagement, providing a potential therapeutic pathway for immunologically “cold” tumors.
10.1038/s41591-026-04380-z
Epigenetic fingerprints link early-onset colon and rectal cancer to pesticide exposure.
NAT MED · Q1 JOURNAL - RANK #1/195TOP-TIER
This study utilized weighted methylation risk scores as proxies for environmental exposures to investigate the rising incidence of early-onset colorectal cancer (EOCRC) compared to late-onset cases. Researchers identified the herbicide picloram as a significant risk factor (adjusted P = 1.5 × 10⁻² in meta-analysis), a finding validated across nine cohorts and 94 US counties (P = 4.52 × 10⁻⁴). The results provide a molecular link between specific pesticide exposure and the development of colorectal malignancies in patients under age 50, addressing a critical gap in oncological epidemiology. These findings suggest that environmental ‘epigenetic fingerprints’ can identify high-risk populations, supporting the need for targeted screening and policy-level interventions to mitigate pesticide-related cancer risks.
10.1038/s41591-026-04342-5
Apr 13 – Apr 20, 2026
Efficacy of Perioperative Pembrolizumab in Mismatch Repair Deficient/Microsatellite Unstable Localized Colorectal Cancers: Results of the Phase II Trial IMHOTEP.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This prospective phase II trial (IMHOTEP) evaluated the efficacy and safety of perioperative pembrolizumab in 81 patients with localized, resectable mismatch repair deficient (dMMR) or microsatellite unstable (MSI) colorectal cancer. The study reported a pathologic complete response (pCR) rate of 52.7% (95% CI, 41.4 to 63.9), with pCR rates significantly increasing from 46% after one neoadjuvant cycle to 68.2% after two cycles. For clinicians treating gastrointestinal malignancies, these results highlight a potent neoadjuvant strategy that achieves high rates of tumor eradication before surgery in a specific molecular phenotype. While grade ≥3 immune-related toxicities occurred in 15.7% of patients, the findings support the feasibility of using short-course neoadjuvant immunotherapy to improve surgical outcomes in localized dMMR/MSI colorectal cancers.
10.1200/JCO-25-02169
Apr 06 – Apr 13, 2026
Colorectal Cancer and Mortality Risk Among Older Adults With vs Without Adenoma on Prior Colonoscopy.
JAMA-J AM MED ASSOC · Q1 JOURNAL - RANK #4/332TOP-TIER
This retrospective cohort study of 91,952 older adults within the US Department of Veterans Affairs evaluated the 10-year cumulative incidence of colorectal cancer (CRC) and mortality among individuals aged 75 or older with versus without a history of adenoma. Results showed that while those with prior adenoma had a higher 10-year CRC incidence (1.1% vs. 0.7%, P < .001) and CRC death rate (0.5% vs. 0.4%, P = .005), these absolute risks were minimal compared to non-CRC mortality rates, which ranged from 46.9% to 48.4%. For clinicians focused on oncology, this evidence highlights that even in patients with a history of precancerous lesions, the absolute risk of developing or dying from CRC in late seniority is low and heavily outweighed by competing causes of death across all frailty levels. These findings suggest that for patients over 75, deprioritizing surveillance colonoscopy may be appropriate as the potential benefit in cancer prevention is likely offset by overall mortality risk.
10.1001/jama.2026.3414
Mar 30 – Apr 06, 2026
Interpretation of constitutional cancer predisposition gene variants in 14 765 individuals in the 100 000 Genomes Project cancer arm: a retrospective cohort analysis.
LANCET ONCOL · Q1 JOURNAL - RANK #8/326TOP-TIER
This retrospective cohort study assessed the frequency and nature of constitutional variants in 109 cancer predisposition genes among 14,765 patients with cancer in the UK health-care system. Key findings revealed that 711 (5%) participants harbored a pathogenic or likely pathogenic variant, with CHEK2 (0.82%) and BRCA2 (0.75%) being the most common, and ovarian cancer showing the highest proportion (9%) among specific tumor types. These results are highly relevant for clinicians as they provide a comprehensive understanding of the genetic landscape in cancer patients, informing genetic testing strategies and risk stratification. The study underscores the implications of more expansive genetic testing and the necessity of robust variant interpretation to optimize patient benefit and guide clinical service planning.
10.1016/S1470-2045(25)00766-1
Mar 23 – Mar 30, 2026
Atezolizumab plus FOLFOX for Stage III Mismatch Repair-Deficient Colon Cancer.
NEW ENGL J MED · Q1 JOURNAL - RANK #2/332TOP-TIER
This phase 3 trial investigated whether adding atezolizumab to mFOLFOX6 adjuvant therapy improves outcomes for patients with resected stage III mismatch repair-deficient (dMMR) colon cancer, randomizing patients 1:1 to either combination therapy or mFOLFOX6 alone. At a median follow-up of 40.9 months, the 3-year disease-free survival was significantly higher in the atezolizumab-mFOLFOX6 group (86.3%; 95% CI, 81.8 to 89.8) compared to the mFOLFOX6 alone group (76.2%; 95% CI, 70.9 to 80.6), with a hazard ratio of 0.50 (95% CI, 0.35 to 0.73; P<0.001). This study demonstrates that the addition of atezolizumab substantially improves disease-free survival for a specific high-risk subset of colon cancer patients, directly addressing a critical need in cancer treatment. These findings suggest that atezolizumab plus mFOLFOX6 should be considered a new standard adjuvant therapy for stage III dMMR colon cancer, potentially altering current clinical practice guidelines.
10.1056/NEJMoa2507874
Mar 16 – Mar 23, 2026
Tumor Debulking in Combination With Chemotherapy in Multiorgan Metastatic Colorectal Cancer: The ORCHESTRA Randomized Clinical Trial.
JAMA-J AM MED ASSOC · Q1 JOURNAL - RANK #4/332TOP-TIER
The ORCHESTRA randomized clinical trial investigated whether adding tumor debulking to palliative chemotherapy improves survival in patients with multiorgan metastatic colorectal cancer (mCRC). After a median follow-up of 32.3 months, median overall survival was 27.5 months with chemotherapy alone versus 30.0 months with debulking plus chemotherapy (adjusted HR, 0.88; P = .26), showing no significant benefit. Progression-free survival also showed no significant difference (10.4 vs 10.5 months; P=.08), while serious adverse events were significantly higher in the debulking group (53% vs 39%; P = .006). This study directly addresses a critical question in cancer management, specifically for advanced colorectal cancer, by evaluating the efficacy and safety of a combined treatment strategy. Tumor debulking in addition to first-line palliative systemic treatment should not be considered standard care for patients with multiorgan mCRC due to lack of survival benefit and increased adverse events.
10.1001/jama.2026.1929
Mar 09 – Mar 16, 2026
Romiplostim versus Placebo for Chemotherapy-Induced Thrombocytopenia.
NEW ENGL J MED · Q1 JOURNAL - RANK #2/332TOP-TIER
This phase 3, international, double-blind, randomized, placebo-controlled trial evaluated romiplostim for persistent chemotherapy-induced thrombocytopenia (CIT) in patients receiving oxaliplatin-based chemotherapy for gastrointestinal cancers. Romiplostim significantly reduced CIT-induced chemotherapy dose modifications, with 84% (92 of 109 patients) in the romiplostim group experiencing no modifications compared to 36% (20 of 56 patients) in the placebo group (odds ratio 10.16; P<0.001). This finding is highly relevant to cancer care as it enables patients with gastrointestinal cancers to maintain optimal chemotherapy dose intensity, which is crucial for treatment efficacy. Romiplostim offers a promising strategy to manage CIT, potentially improving the delivery and outcomes of chemotherapy for patients with gastrointestinal malignancies.
10.1056/NEJMoa2511882
Mar 02 – Mar 09, 2026
Disruptive Analysis of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Clinical and Therapeutic Distinctions Between Low- and Mid-Rectal Cancers.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This review synthesizes data from over 80 clinical trials to evaluate the efficacy of Total Neoadjuvant Therapy (TNT) and argues for differentiating treatment protocols based on tumor location in locally advanced rectal cancer. The analysis highlights that low-rectal tumors, defined as being less than 1 cm from the anal ring, face higher risks of positive margins and complex lymphatic drainage compared to mid-rectal tumors which may allow for radiotherapy de-escalation. For clinicians focused on oncology, the study provides an evidence-based rationale for tailoring treatment intensity to specific anatomic locations to optimize both oncologic control and functional outcomes like sphincter preservation. The findings suggest a shift away from a homogeneous treatment approach toward a location-specific, patient-centered strategy that prioritizes quality of life alongside survival.
10.1200/JCO-25-01861
Trastuzumab Rezetecan in Human Epidermal Growth Factor Receptor 2-Expressing Advanced Gastric Cancer or Gastroesophageal Junction Adenocarcinoma and Colorectal Cancer: A Multicenter, Open-Label, Phase I Trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This multicenter, open-label, phase I trial evaluated the safety and efficacy of trastuzumab rezetecan, a novel HER2-targeted antibody-drug conjugate, in 100 patients with advanced HER2-expressing gastric, gastroesophageal junction (GC/GEJ), or colorectal cancer (CRC). Results showed an objective response rate (ORR) of 45.0% and median overall survival (OS) of 16.3 months in HER2-positive GC/GEJ, while HER2-positive CRC patients achieved an ORR of 40.5% and a median OS of 22.7 months. The study demonstrates that trastuzumab rezetecan provides a viable therapeutic option for heavily pre-treated patients with HER2-expressing gastrointestinal malignancies, showing manageable toxicity with only 5% of patients discontinuing due to adverse events. These findings support the further clinical development of trastuzumab rezetecan as a potent treatment strategy for HER2-expressing solid tumors that have progressed on standard therapies.
10.1200/JCO-25-00716