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PICO-SM was a prospective longitudinal study investigating the psychological impact of the COVID-19 pandemic on patients with colorectal cancer treated in a large UK tertiary cancer centre. Here, we present the impact of the third wave of the pandemic (December 2021 to February 2022), when the Omicron variant became prevalent in the UK, and the complete longitudinal comparison across the entire duration of this study. Patients were invited to complete a questionnaire, including screening psychometric tools. In total, n = 312 patients were included in the final analysis. Specifically, in this Omicron-predominant wave, n = 96 patients were studied in detail: the mean age was 64 years, 64% were male, 33% reported poor well-being, 27% anxiety, 11% depressive symptoms, and 3% trauma-related symptoms. The participants who had investigations cancelled (OR 9.22, 95% CI 1.09–77.85; p = 0.041) or felt that the pandemic would affect their mental health (OR 3.82, 95% CI 1.96–7.44; p < 0.001) had an increased risk of anxiety according to a multivariate analysis. Similarly, independent predictors of poor well-being included concern that the pandemic would affect their cancer treatment (OR 4.59, 95% CI 1.03–20.56; p = 0.046) or mental health (OR 3.90, 95% CI 1.38–11.03; p = 0.010). The psychological distress experienced by patients, particularly anxiety, remained high during the third wave of the COVID-19 pandemic. These results align with our previously reported findings, emphasising the importance of continuing cancer treatment amidst an ongoing humanitarian emergency. [ABSTRACT FROM AUTHOR]

Background Early onset Colorectal Cancer (EOCRC), defined as those diagnosed under the age of 50, has been increasing rapidly since 1970. UK data on EOCRC are currently limited and better understanding of the condition is needed. Materials and Methods A single-center retrospective study of patients with EOCRC treated over 9 years (2013-2021) at a large UK cancer center was performed. Clinicopathological features, risk factors, molecular drivers, treatment, and survival were analyzed. Results In total, 203 patients were included. A significant increase in cases was reported from 2018-2019 (n  = 33) to 2020-2021 (n  = 118). Sporadic EOCRC accounted for 70% of cases and left-sided tumors represented 70.9% (n  = 144). Median duration of symptoms was 3 months, while 52.7% of the patients had de-novo metastatic disease. Progression-free survival after first-line chemotherapy was 6 months (95% CI, 4.85-7.15) and median overall survival (OS) was 38 months (95% CI, 32.86-43.14). In the advanced setting, left-sided primary tumors were associated with a median OS benefit of 14 months over right-sided primaries (28 vs 14 months, P  = .009). Finally, primary tumor resection was associated with median OS benefit of 21 months compared with in situ tumors (38 vs 17 months, P  < .001). Conclusions The incidence of EOCRC is increasing, and survival outcomes remain modest. Raising public awareness and lowering the age for colorectal cancer screening are directions that could improve EOCRC clinical outcomes. There is also a need for large prospective studies to improve the understanding of the nature of EOCRC and the best therapeutic approaches. [ABSTRACT FROM AUTHOR]

Simple Summary: Approximately 10–15% of patients with epithelial ovarian cancer have an inherited (germline) BRCA1 or BRCA2 mutation. Following a diagnosis of epithelial ovarian cancer, patients are routinely tested for germline and/or somatic (tumour) BRCA1/2 mutations. Our study shows that if germline BRCA1/2 testing is only performed for patients with a positive tumour BRCA1/2 test result, and tumour testing is performed using Myriad's myChoice® companion diagnostic, a proportion of germline BRCA1/2 large rearrangements could be missed. If paired germline-tumour DNA testing is not possible for all patients, our data shows that it would be appropriate to test all patients with epithelial ovarian cancer aged < 79 years old for germline BRCA1/2 mutations, regardless of the tumour BRCA1/2 result, whilst only needing to test patients aged ≥ 80 years old for a germline BRCA1/2 mutation if they have a positive tumour BRCA1/2 result. Patients diagnosed with epithelial ovarian cancer may undergo reflex tumour BRCA1/2 testing followed by germline BRCA1/2 testing in patients with a positive tumour test result. This testing model relies on tumour BRCA1/2 tests being able to detect all types of pathogenic variant. We analysed germline and tumour BRCA1/2 test results from patients treated for epithelial ovarian cancer at our specialist oncological referral centre. Tumour BRCA1/2 testing was performed using the next-generation sequencing (NGS)-based myChoice® companion diagnostic (CDx; Myriad Genetics, Inc.). Germline BRCA1/2 testing was performed in the North West Genomic Laboratory Hub using NGS and multiplex ligation-dependent probe amplification. Between 11 April 2021 and 11 October 2023, 382 patients were successfully tested for tumour BRCA1 and BRCA2 variants. Of these, 367 (96.1%) patients were tested for germline BRCA1/2 variants. In those patients who underwent tumour and germline testing, 15.3% (56/367) had a BRCA1/2 pathogenic variant (36 germline and 20 somatic). All germline BRCA1/2 pathogenic small sequencing variants were detected in tumour DNA. By contrast, 3 out of 8 germline BRCA1/2 pathogenic large rearrangements were not reported in tumour DNA. The overall concordance of germline BRCA1/2 pathogenic variants detected in germline and tumour DNA was clinically acceptable at 91.7% (33/36). The myChoice® CDx was able to detect most germline BRCA1/2 pathogenic variants in tumour DNA, although a proportion of pathogenic large rearrangements were not reported. If Myriad's myChoice® CDx is used for tumour BRCA1/2 testing, our data supports a testing strategy of germline and tumour BRCA1/2 testing in all patients diagnosed with epithelial ovarian cancer aged < 79 years old, with germline BRCA1/2 testing only necessary for patients aged ≥ 80 years old with a tumour BRCA1/2 pathogenic variant. [ABSTRACT FROM AUTHOR]

Objective: The optimum sequencing of adjuvant treatment in patients with high-risk endometrial cancer remains contentious. Here, we report the outcomes of women treated in Manchester, United Kingdom, where sequential chemotherapy-radiotherapy is the standard adjuvant treatment approach for these patients. Methods: A retrospective analysis was carried out on 106 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk endometrial cancer was defined as: International Federation of Gynaecology and Obstetrics (2009) stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or lymphovascular space invasion, stage II-III endometrioid carcinoma, or any other histological subtype with stage I-III disease. Adjuvant treatment included carboplatin (AUC5) and paclitaxel (175 mg/m2) every 21 days for 4/6 cycles, followed by external beam pelvic radiotherapy (40 Gy in 20 fractions#) or vaginal brachytherapy (28 Gy in 2 fractions#) or both. Primary outcome measures were recurrence free survival (RFS), overall survival (OS) and treatment-related toxicity. Results: Seventy-nine percent of patients were treated with sequential chemotherapy-radiotherapy. After a median follow-up of 64.4 months, 5-year RFS was 70% (95% CI 60.8-80.6%) and 5-year OS was 71.4% (95% CI 62.3-81.7%). Single modality adjuvant therapy was given for patient choice or contra-indications to treatment. Patients tolerated sequential treatment well; 96% of patients completed all treatment and 20% of patients had=grade 3 adverse events. Conclusions: Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was tolerable and was associated with survival outcomes consistent with recent international phase III clinical trials. [ABSTRACT FROM AUTHOR]