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  1. Article ; Online: Changing patterns of care for pancreas cancer in Victoria: the 2022 Pancreas Tumour Summit.

    Pilgrim, Charles H C / Finn, Norah / Stuart, Ella / Philip, Jennifer / Steel, Simone / Croagh, Dan / Lee, Belinda / Tebbutt, Niall C

    ANZ journal of surgery

    2023  Volume 93, Issue 11, Page(s) 2638–2647

    Abstract: Background: The Victorian Government convened the second Pancreas Cancer Summit in 2021 to identify unwarranted variation in care 2016-2019, and to assess trends compared with the first Summit 2017 (reporting 2011-2015). State-wide administrative data ... ...

    Abstract Background: The Victorian Government convened the second Pancreas Cancer Summit in 2021 to identify unwarranted variation in care 2016-2019, and to assess trends compared with the first Summit 2017 (reporting 2011-2015). State-wide administrative data were assessed at population level in alignment with optimal care pathways across all stages of the cancer care continuum.
    Methods: Data linkage performed by Centre for Victorian Data Linkage combined data from Victorian Cancer Registry with other administrative data sets including Victorian Admitted Episodes Dataset, Victorian Radiotherapy Minimum Data Set, Victorian Emergency Minimum Dataset and Victorian Death Index. A Cancer Service Performance Indicator audit was carried out providing an in-depth analysis of identified areas of interest.
    Results: Of 3138 Victorians diagnosed with pancreas ductal adenocarcinoma 2016-2019, 63% were metastatic at diagnosis. One-year survival increased between time periods, from 29.7% overall 2011-2015 (59.1% for non-metastatic, and 15.1% metastatic) to 32.5% overall 2016-2019 (P < 0.001), 61.2% non-metastatic (P = 0.008), 15.7% metastatic (P = NS). A higher proportion of non-metastatic patients progressed to surgery (35% vs. 31%, P = 0.020), and more received neoadjuvant therapy (16% vs. 4%, P < 0.001). Postoperative mortality following pancreatectomy at 30 and 90 days remained low at 2%. Utilization of 5FU-based chemotherapy regimens increased between 2016 and 2020. Multidisciplinary Meeting (MDM) presentation was still below the 85% target (74%) as was supportive care screening (39%, target 80%).
    Conclusions: Surgical outcomes remain world-class and there has been an appropriate shift in chemotherapy administration towards neoadjuvant timing with increasing use of 5FU-based regimens. MDM presentation rates, supportive care and overall care coordination remain areas of deficiency.
    MeSH term(s) Humans ; Hospitalization ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/therapy ; Fluorouracil ; Pancreatic Neoplasms
    Chemical Substances Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2023-05-23
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.18522
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 180: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  2. Article ; Online: BRAFV600E Mutations Arising from a Left-Side Primary in Metastatic Colorectal Cancer: Are They a Distinct Subset?

    Wong, Vanessa / Lee, Margaret / Wong, Rachel / Tie, Jeanne / Shapiro, Jeremy / Desai, Jayesh / Nott, Louise / Steel, Simone / Burge, Matthew / Ma, Brigette / Khattak, Adnan / Hong, Wei / Gibbs, Peter

    Targeted oncology

    2021  Volume 16, Issue 2, Page(s) 227–236

    Abstract: Background: B-Raf proto-oncogene (BRAF)-V600E mutations (BRAFmt) in colorectal cancer (CRC) predominantly occur in right-side (RS) primaries. In metastatic CRC (mCRC), there is substantial overlap between the reported features of BRAFmt and of an RS ... ...

    Abstract Background: B-Raf proto-oncogene (BRAF)-V600E mutations (BRAFmt) in colorectal cancer (CRC) predominantly occur in right-side (RS) primaries. In metastatic CRC (mCRC), there is substantial overlap between the reported features of BRAFmt and of an RS primary.
    Objectives: To explore the significance of BRAFmt in a left-side (LS) primary, we analysed data from a multi-site mCRC registry. Tumours distal to the splenic flexure were considered LS.
    Results: Of 3380 patients enrolled from June 2009 to June 2020, 214 (13%) of 1657 with known status were BRAFmt: 127 (24%) of 524 RS and 87 (8%) of 1133 LS. LS versus RS BRAFmt were younger (mean 59.5 vs. 65.1 years; p = 0.01), whereas sex (48 vs. 59% female; p = 0.13), mismatch repair-deficiency (dMMR) (16 vs. 21%; p = 0.47), and overall survival (OS) (median 15.1 vs. 17.7 months; p = 0.98) were similar. LS BRAFmt versus LS BRAF wildtype (wt) were of similar age (59.5 vs. 61.3 years; p = 0.28) with more females (48 vs. 37%; p = 0.04), more dMMR (16 vs. 1%; p < 0.0001), and inferior OS (median 15.1 vs. 36.6 months; p < 0.0001). Initial treatment with chemotherapy plus an epidermal growth factor receptor inhibitor produced median progression-free survival (PFS) of 4.3 versus 12.3 months (p = 0.20) for LS BRAFmt (n = 9) versus LS BRAFwt (n = 104). Initial chemotherapy and bevacizumab produced a median PFS of 7.6 versus 11.6 months (p = 0.02) for LS BRAFmt (n = 36) versus LS BRAFwt (n = 438), respectively.
    Conclusion: LS BRAFmt cancers share many features with RS BRAFmt cancers, including poor survival outcomes. Mature data on the activity of BRAF-targeted therapies in the first-line setting are eagerly awaited.
    MeSH term(s) Colorectal Neoplasms/enzymology ; Colorectal Neoplasms/genetics ; Colorectal Neoplasms/pathology ; Female ; Humans ; Male ; Mutation ; Neoplasm Metastasis ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins B-raf/metabolism
    Chemical Substances BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1)
    Language English
    Publishing date 2021-02-18
    Publishing country France
    Document type Journal Article
    ZDB-ID 2222136-0
    ISSN 1776-260X ; 1776-2596
    ISSN (online) 1776-260X
    ISSN 1776-2596
    DOI 10.1007/s11523-021-00793-7
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  3. Article ; Online: Patient demographics and management landscape of metastatic colorectal cancer in the third-line setting: Real-world data in an australian population.

    Min, Sandy Tun / Roohullah, Aflah / Tognela, Annette / Jalali, Azim / Lee, Margaret / Wong, Rachel / Shapiro, Jeremy / Burge, Matthew / Yip, Desmond / Nott, Louise / Zimet, Allan / Lee, Belinda / Dean, Andrew / Steel, Simone / Wong, Hui-Li / Gibbs, Peter / Lim, Stephanie Hui-Su

    Asia-Pacific journal of clinical oncology

    2021  Volume 18, Issue 2, Page(s) e56–e63

    Abstract: Background: Colorectal cancer is the third most common cancer and second leading cause of cancer mortality in Australia, thus carrying a significant disease burden.: Aims: This analysis aims to explore real-world treatment landscape of metastatic ... ...

    Abstract Background: Colorectal cancer is the third most common cancer and second leading cause of cancer mortality in Australia, thus carrying a significant disease burden.
    Aims: This analysis aims to explore real-world treatment landscape of metastatic colorectal cancer in the third-line setting.
    Methods: We retrospectively analysed treatment of recurrent and advanced colorectal cancer (TRACC) registry database from 2009 onwards. Patients treated with palliative intent who progressed after two lines of therapies were included. One treatment line was defined as any combination of systemic therapy given until progression.
    Results: Out of 1820 patients treated palliatively, 32% (590 patients) met study criteria. Of these, 43% (254 patients) proceeded to third-line therapy, equating to 14% of all metastatic patients. In KRAS mutant or unknown tumours (97 patients), fluoropyrimidine (FP)-oxaliplatin combination was the most common choice (51%), followed by FP-irinotecan (15%), trifluridine/tipiracil (11%), mono-chemotherapy (10%), regorafenib (5%) and others (7%). Majority of FP-doublet (83%) was given as rechallenge. In 157 patients with KRAS wildtype disease, monotherapy with EGFR inhibitor was most commonly used (41%), followed by EGFR inhibitor with chemotherapy (20%), FP-doublet (18%), mono-chemotherapy (6%), trifluridine/tipiracil (6%), regorafenib (1%) and others (8%). Median overall survival was 7.1 months (range 0.4-41.2), and median time on third-line treatment was 3 months (range 0.1-40).
    Conclusions: In real-world Australian population, treatment choices differed based on KRAS status and will likely change with the availability of newer drugs on the pharmaceutical benefits scheme. Survival outcomes are comparable to newer agents in clinical trials for select patients.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Australia/epidemiology ; Colonic Neoplasms/drug therapy ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/genetics ; Demography ; ErbB Receptors ; Humans ; Neoplasm Recurrence, Local/drug therapy ; Proto-Oncogene Proteins p21(ras) ; Rectal Neoplasms/drug therapy ; Retrospective Studies ; Trifluridine/therapeutic use
    Chemical Substances ErbB Receptors (EC 2.7.10.1) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2) ; Trifluridine (RMW9V5RW38)
    Language English
    Publishing date 2021-04-18
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2187409-8
    ISSN 1743-7563 ; 1743-7555
    ISSN (online) 1743-7563
    ISSN 1743-7555
    DOI 10.1111/ajco.13553
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  4. Article ; Online: Right versus left sided metastatic colorectal cancer: Teasing out clinicopathologic drivers of disparity in survival.

    Mendis, Shehara / Beck, Sophie / Lee, Belinda / Lee, Margaret / Wong, Rachel / Kosmider, Suzanne / Shapiro, Jeremy / Yip, Desmond / Steel, Simone / Nott, Louise / Jennens, Ross / Lipton, Lara / Burge, Matthew / Field, Kathryn / Ananda, Sumitra / Wong, Hui-Li / Gibbs, Peter

    Asia-Pacific journal of clinical oncology

    2019  Volume 15, Issue 3, Page(s) 136–143

    Abstract: Background: Metastatic colorectal cancer (mCRC) patients with a right-sided primary (RC) have an inferior survival to mCRC arising from a left-sided primary (LC). Previous analyses have suggested multiple factors contribute.: Methods: The Treatment ... ...

    Abstract Background: Metastatic colorectal cancer (mCRC) patients with a right-sided primary (RC) have an inferior survival to mCRC arising from a left-sided primary (LC). Previous analyses have suggested multiple factors contribute.
    Methods: The Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) Registry prospectively captured data on consecutive mCRC patients. RC were defined as tumors proximal to the splenic flexure; LC were those at and distal to the splenic flexure and included rectal cancers. Patient, tumor, treatment, and survival data were analyzed stratified by side.
    Results: Of 2306 patients enrolled from July 2009-March 2018, 747 (32%) had an RC. Patients with RC were older, more likely to be female and have a Charlson score ≥3. RC were more frequently BRAF mutated, deficient in mismatch repair, associated with peritoneal metastases, and less likely to receive chemotherapy. Progression-free survival on first-line systemic therapy was inferior for RC patients (8.1 vs. 10.8 months, hazard ratio [HR] for progression in RC 1.38, P < 0.001). Median overall survival for all RC patients was inferior (19.6 vs. 27.5 months, HR for death in RC 1.44, P < 0.001), and inferior within the treated (21 vs. 29.5 months, HR 1.52, P < 0.001) and untreated subgroups (5.9 vs. 10.3 months, HR 1.38, P = 0.009). Primary side remained a significant factor for overall survival in multivariate analysis.
    Conclusion: Our data from a real-world population confirms the poorer prognosis associated with RC. Primary tumor location remains significantly associated with overall survival even when adjusting for multiple factors, indicating the existence of further side-based differences that are as yet undefined.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies
    Language English
    Publishing date 2019-02-13
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2187409-8
    ISSN 1743-7563 ; 1743-7555
    ISSN (online) 1743-7563
    ISSN 1743-7555
    DOI 10.1111/ajco.13135
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  5. Article ; Online: Previous Bevacizumab and Efficacy of Later Anti-Epidermal Growth Factor Receptor Antibodies in Metastatic Colorectal Cancer: Results From a Large International Registry.

    Burge, Matthew / Semira, Christine / Lee, Belinda / Lee, Margaret / Kosmider, Suzanne / Wong, Rachel / Shapiro, Jeremy / Ma, Brigette / Dean, Andrew P / Zimet, Allan S / Steel, Simone A / Lok, Sheau Wen / Torres, Javier / Eastgate, Melissa / Wong, Hui-Li / Gibbs, Peter

    Clinical colorectal cancer

    2018  Volume 17, Issue 3, Page(s) e593–e599

    Abstract: Background: The FIRE-3 [5-fluorouracil, folinic acid, and irinotecan (FOLFIRI) plus cetuximab versus FOLFIRI plus bevacizumab in first line treatment colorectal cancer (CRC)] study reported that first-line FOLFIRI plus cetuximab versus FOLFIRI plus ... ...

    Abstract Background: The FIRE-3 [5-fluorouracil, folinic acid, and irinotecan (FOLFIRI) plus cetuximab versus FOLFIRI plus bevacizumab in first line treatment colorectal cancer (CRC)] study reported that first-line FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab resulted in similar progression-free survival (PFS) but improved overall survival (OS). A potential explanation is that the initial biologic agent administered in metastatic CRC (mCRC) affects later line efficacy of the other treatments. We sought to test this hypothesis.
    Materials and methods: We interrogated our mCRC registry (Treatment of Recurrent and Advanced Colorectal Cancer) regarding treatment and outcome data for RAS wild-type patients receiving epidermal growth factor receptor inhibitors (EGFRIs) in second and subsequent lines. Survival outcomes from the beginning of EGFRI use were determined as a function of previous bevacizumab use and the interval between ceasing bevacizumab and beginning EGFRI use.
    Results: Of 2061 patients, 222 eligible patients were identified, of whom 170 (77%) had received previous bevacizumab and 52 (23%) had not. PFS and OS from the start of EGFRIs did not differ by previous bevacizumab use (3.8 vs. 4.2 months; hazard ratio [HR], 1.12; P = .81; 9.0 vs. 9.2 months; HR, 1.19; P = .48, respectively) for the whole cohort or when analyzed by the primary tumor side (HR for left side, 1.07; P = .57; HR for right side, 1.2; P = .52). PFS was significantly shorter with right-sided primary tumors when the interval between bevacizumab and EGFRI use was < 6 versus > 6 months (median, 2.2 vs. 6 months; HR, 2.23; P = .01) but not with left-sided tumors (median, 4.2 vs. 5.5 months; HR, 1.12; P = .26).
    Conclusion: Previous bevacizumab use had no effect on the activity of subsequent EGFRIs. The apparent effect of time between biologic agents in right-sided tumors might reflect patient selection.
    MeSH term(s) Aged ; Antineoplastic Combined Chemotherapy Protocols/pharmacology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bevacizumab/pharmacology ; Bevacizumab/therapeutic use ; Camptothecin/analogs & derivatives ; Camptothecin/pharmacology ; Camptothecin/therapeutic use ; Cetuximab/pharmacology ; Cetuximab/therapeutic use ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Datasets as Topic ; ErbB Receptors/antagonists & inhibitors ; Female ; Fluorouracil/pharmacology ; Fluorouracil/therapeutic use ; Humans ; Leucovorin/pharmacology ; Leucovorin/therapeutic use ; Male ; Progression-Free Survival ; Registries/statistics & numerical data
    Chemical Substances Bevacizumab (2S9ZZM9Q9V) ; EGFR protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; Cetuximab (PQX0D8J21J) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT) ; Camptothecin (XT3Z54Z28A)
    Language English
    Publishing date 2018-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2112638-0
    ISSN 1938-0674 ; 1533-0028
    ISSN (online) 1938-0674
    ISSN 1533-0028
    DOI 10.1016/j.clcc.2018.05.009
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5798: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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    Zs.MO 435: Show issues

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  6. Article: Type 2 diabetes mellitus, smoking, and colorectal cancer.

    Gibbs, Peter / Steel, Simone / McLaughlin, Steven / Jones, Ian / Faragher, Ian / Skinner, Iain / Croxford, Matthew / Johns, Julie / Chapman, Matthew / Lipton, Lara

    The American journal of gastroenterology

    2007  Volume 102, Issue 4, Page(s) 909–910

    MeSH term(s) Australia/epidemiology ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/etiology ; Comorbidity ; Diabetes Mellitus, Type 2/complications ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Minnesota/epidemiology ; Risk Factors ; Sex Factors ; Smoking/adverse effects
    Language English
    Publishing date 2007-04
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.1111/j.1572-0241.2007.01090_7.x
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    Ui V Zs.36: Show issues Location:
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