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The CRC Digest

Friday, October 23, 2026

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IMPORTANT: The CRC Digest curates and summarizes publicly available research for informational and educational purposes only. Nothing in this newsletter constitutes medical advice, diagnosis, or treatment recommendation. The information provided should not be used as a substitute for professional medical advice. Always seek the guidance of your physician or other qualified health provider with any questions regarding a medical condition or treatment. Content is generated with AI assistance and reviewed by the editorial team. We are not medical professionals. Individual results, treatments, and outcomes vary.

CRC Research Update

• ● REGULATORY

  FDA converts pembrolizumab approval for TMB-high tumors, raises threshold to ≥13 mutations/megabase

  The FDA granted traditional approval for pembrolizumab in unresectable or metastatic TMB-high solid tumors, updating the definition from ≥10 to ≥13 mutations/megabase after efficacy was not confirmed in the 10 to <13 range. (FDA)

• ▪ SCREENING

  Mailed FIT outreach raises screening rates to 39% in underserved populations after three years

  A randomized trial across 16 community health clinics found that annual mailed fecal immunochemical test kits with educational materials and phone reminders increased screening uptake to 39.4% at year three, compared to 36.5% in usual care; a statistically significant difference of 10.8 percentage points was observed at year two (37.8% vs 27.0%). Due to a resource constraint-related protocol modification, mailed FIT outreach began earlier in year 3, such that some individuals who completed screening in year 2 were not yet due for repeat FIT. (JAMA Network Open)

• ▸ TREATMENT

  Phase II trial tests anti-EGFR rechallenge in ctDNA-selected metastatic CRC

  The ROMANCE trial is randomizing 150 patients with circulating tumor DNA-negative hyperselected metastatic colorectal cancer to irinotecan plus cetuximab rechallenge versus trifluridine/tipiracil plus bevacizumab as third-line therapy, aiming to improve objective response rates. (Clinical Colorectal Cancer)

• ▸ TREATMENT

  Metastasis resection after biomarker-guided chemotherapy extends survival to 61 months

  In the IVOPAK II study, patients with initially nonresectable metastatic colorectal cancer who underwent secondary metastasis resection after biomarker-stratified first-line treatment had a median overall survival of 61 months versus 22 months for chemotherapy alone. (Oncology)

This week's research spans regulatory updates, screening strategies, and biomarker-guided treatment approaches in metastatic disease.