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The PLCRC-PROTECT study: dietary intake after colorectal cancer diagnosis in relation to treatment outcomes

22 juni 2022

Previous research has mainly focused on the relationship between diet (lifestyle) and the risk of developing colorectal cancer. For example, it is known that a Western diet - high in red meat, processed meats, alcohol, and low in vegetables and fruits - increases the risk of colorectal cancer. Further, people with an increased BMI have an increased risk of getting colorectal cancer, while those who are more physically active have a reduced risk of developing this type of tumor.

Every year, approximately 13,000 people in the Netherlands are diagnosed with colon or rectal cancer. Treatment usually includes surgery, often in combination with radiation or systemic therapy. As a result of the disease and its treatment, a loss of appetite may occur which could alter body weight. It is hypothesized that maintaining a good nutritional status after diagnosis may contribute to better treatment outcomes.

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The PLCRC-PROTECT-Plus study: body composition and treatment toxicities in patients with colon cancer treated with adjuvant chemotherapy

22 juni 2022

Every year, approximately 9,000 people in the Netherlands are diagnosed with colon cancer. For patients with a stage II or III tumor, treatment may include surgery, possibly followed by adjuvant chemotherapy. As a result of the disease and its treatment, a change in body composition may occur. It is believed that maintaining muscle mass after diagnosis can contribute to better treatment outcomes.

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MEDOCC: Determining the prognostic value of ctDNA in patients with stage II and III colorectal cancer

22 juni 2022

Colorectal cancer recurrence after surgery

Almost all patients with colorectal cancer, without metastases in other organs, have surgery to remove the tumor. Its purpose is to cure the patient. In some patients, the disease returns at some point. In these patients, colon cancer cells remained somewhere in the body after the surgery. These colon cancer cells are too small to be visible on CT scans. To kill these remaining cancer cells, some of the patients receive chemotherapy after the surgery. Problem is, that we just don't know exactly who we should and who we should not give chemotherapy. In the MEDOCC study, we look at whether we can use circulating tumor DNA to predict which patients will benefit from additional chemotherapy and which patients do not need it.

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Improving clinical management of colon cancer through CONNECTION, a nationwide Colon Cancer Registry and Stratification effort

22 juni 2022

Colon cancer can be divided into four subtypes using the CMS classification. All four subtypes have different tumor cell properties. The aim of the CONNECTION-II study is to see whether there is a difference in the effect of chemotherapy between the different types of colorectal cancer.

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TIL-study: Targeting colorectal cancer with the next generation of engineered immune cells: TEGs

22 juni 2022

Aim of study

The aim of the TIL study is to investigate whether there is a subtype of immune cells that can be used as a new treatment for patients with colorectal cancer. The TIL study hopes to discover new possibilities in the field of immunotherapy for patients with colorectal cancer. Some colon cancer patients do not benefit from the existing therapies. Immunotherapy is promising for only a small group of patients and with this study we hope that eventually many more patients can be treated with some form of immunotherapy. Therefore, we would like to study the subtypes of immune cells in both blood and tumor of patients with colon cancer.

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PLCRC-UNITED: Uniform Noting for International Application of the Tumor-Stroma Ratio as an Easy Diagnostic Tool: Chemotherapy or not?

22 juni 2022

Background

The treatment of colon cancer is highly dependent on the stage at the time of diagnosis. The current stage classification is used as guideline for the selection of patients for chemotherapy after surgery, but it needs improvement. In recent years, the tumor microenvironment, such as the supporting tissue (stroma), has been extensively researched and it has been shown to have a major influence on the aggressiveness of cancer. Patients with a tumor with a high amount of stroma have a shorter survival than patients with a tumor with a low amount of stroma. This ratio, expressed in the so-called tumor-stroma ratio (TSR), can support the stage classification in the selection of patients who could benefit of chemotherapy or not.

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OPTIC: Organoids to Predict Treatment response In metastatic colorectal cancer

22 juni 2022

Primary objective
To validate the concept that organoids can predict treatment response in metastatic colorectal cancer.

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Perioperative Longitudinal stUdy of complications and long-Term Outcomes (PLUTO)

22 juni 2022

PLUTO aims to establish a comprehensive longitudinal data and biobank focusing on intermediate to high risk surgical patients.

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The MOMENTUM study – Evaluation of radiotherapy using the MR-Linac

22 juni 2022

The aim of the MOMENTUM study is to evaluate all patients treated on the MR-Linac, to collect medical and technical data. Medical data are, for example, characteristics of the illness and data about the treatment. The MR-Linac is the name of a new irradiation device in which an irradiation device (linear accelerator, abbreviated 'linac') is combined with an MRI scanner (abbreviated MR).

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IMARI study

22 juni 2022

Anastomotic leakage (AL) is one of the most feared complications after rectal cancer surgery. AL leads to a significant increase in postoperative morbidity, long-term surgical complications, negative impact on quality of life, higher permanent stoma rates and impaired oncological outcomes. Despite improvement in surgical and oncological outcomes in recent years, AL still occurs in up to 20% of all patient undergoing rectal cancer surgery in the Netherlands. Of all these leaks, half will not heal by conventional treatment and might require major salvage surgery.

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Feasibility and predictive value of minimally invasive circulating tumor DNA analyses in patients with hepatic metastatic colorectal carcinoma

22 juni 2022

Patients with liver metastases are sometimes eligible for surgery to remove the metastases. Some patients receive additional chemotherapy before or after surgery. The patient is followed for 5 years after the operation, in which  recurrence of disease is checked several times a year. The current standard is checks with imaging (including CT scans) and blood tests (CEA determination). Unfortunately, the CEA determination is not useful for everyone and very small tumor remnants / metastases cannot always be seen on imaging.

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preRADAR: towards Response ADAptive Radiotherapy for non-operative management of intermediate-risk rectal cancer

22 juni 2022

Clinical trial on a new treatment for patients with rectal cancer. The highest, safe irradiation dose for rectal cancer on the magnetic resonance-guided linear accelerator (MR-Linac; a new, more precise radiation device) is being investigated. Additionally, this trial evaluates whether this higher irradiation dose increases the probability of non-operative management.

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DISTANCE-trial: Towards patient-led follow-up after curative treatment of stage II and III colorectal cancer

14 april 2021

Colorectal cancer (CRC) is a common cancer type in the Netherlands. After surgical treatment, approximately 20% of stage II/III CRC patients develop a recurrent tumour or metastases. Patients are currently followed for five years after curative resection. However, intensified follow-up after curative resection has shown no effect on survival. Therefore, patient organisations and policy makers call for a more patient-centred, tailored follow-up.

Patient-led, home-based follow-up shows great potential as an alternative for the regular-in hospital follow-up. Implementation of patient-led, home-based follow-up at the Radboud University Medical Center in Nijmegen, the Netherlands led to a 70% decrease in patients having contact with the hospital, and a decrease of more than 60% in cost of CRC follow-up.

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PLCRC-ORCA: Liquid biOpsies in Ras wildtype non-liver limited metastasized colorectal CAncer patients: an exploratory study.

1 september 2019

01-01-2022: Inclusion closed

 

One of the treatment options for patients with metastatic colorectal cancer (mCRC) is an EGFR blocker. It is known that patients with a mutation in one of the RAS genes do not benefit from the treatment with an EGFR blocker. About 50% of patients with mCRC have a mutation in RAS. In addition to primary resistance, RAS mutations encourage induced resistance to anti-EGFR therapy. Apart from repeated biopsies, no other methods are currently available to track molecular changes during anti-EGFR treatment.

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PLCRC-QUALITAS: QUAlity of LIfe in meTAStatic colorectal cancer patients treated with trifluridine-tipiracil in late line in the PLCRC cohort

23 juni 2018

 

One of the most recent treatment options for metastatic colorectal cancer is trifluridine tipiracil (= TAS-102 = Lonsurf®). This is a combination tablet of two medicines that together prevent the growth of tumor cells. Previous research has shown that trifluridine tipiracil is effective in the treatment of colorectal cancer: treated patients live on average 1.8 months longer than patients who do not receive trifluridine tipiracil. Since February 2017, trifluridine tipiracil is available in the Netherlands. Only patients who are unresponsive to or intolerant to standard therapies are eligible for treatment with trifluridine tipiracil.

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Research on the outcomes of patients with rectal cancer

5 februari 2016

Every year, over 4,300 people in the Netherlands are diagnosed with rectal cancer, and more than 1,000 patients die from this disease. Treatment of rectal cancer consists of surgery, usually preceded by radiotherapy with or without chemotherapy. This treatment is associated with a substantial risk of short- and longterm side effects. Research into more effective treatment with fewer side effects is therefore of great importance.

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Improving clinical management of colon cancer through CONNECTION, a nation-wide Colon Cancer Registry and Stratification effort.

17 november 2015

Colorectal cancer is still a devastating disease with over 600.000 deaths per year worldwide. This is in part due to poor survival of patients with late stage disease where curative treatment options are limited, but even at stage II around 20% of the patients will develop a recurrence despite effective surgical resection of the primary tumor. Identification of these stage II patients at risk and optimization of the therapy provided is therefore an important goal to improve outcome in colon cancer.

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‘’Specialized nutrition to improve Clinical Outcomes in colorectal cancer PatiEnts (SCOPE)’’ project

9 november 2015

Approximately 15,000 patients per year are diagnosed with colorectal cancer (CRC) in the Netherlands. Treatment can consist of surgery, often complemented with radiation or systemic therapy. Patients with colorectal cancer often perceive weight loss, reduced muscle mass, fatigue and loss of appetite as a result of their disease and treatments. It is currently assumed that maintaining muscle mass and a well-balanced nutritional status after diagnosis contributes to the success of treatment.

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