(1) Background: Local therapies offer a potentially curative approach for patients with oligometastatic colorectal cancer (CRC). An evidence-based consensus recommendation for systemic therapy following definitive locoregional therapy is lacking. Tumor-informed circulating tumor DNA (ctDNA) might provide information to help guide management in this setting. (2) Methods: A multi-institutional retrospective study was conducted, including patients with CRC that underwent curative-intent locoregional therapy to an isolated site of metastatic disease, followed by tumor-informed ctDNA assessment. The Kaplan–Meier method and log-rank tests were used to compare disease-free survival based on ctDNA results. ctDNA test performance was compared to carcinoembryonic antigen (CEA) test results using McNemar’s test. (3) Results: Our study cohort consisted of 87 patients treated with locoregional interventions who underwent ctDNA testing. The initial ctDNA test post-intervention was positive in 28 patients and negative in 59 patients. The median follow-up time was 14.0 months. Detectable ctDNA post-intervention was significantly associated with early disease recurrence, with a median disease-free survival (DFS) of 6.63 months compared to 21.30 months in ctDNA-negative patients (p < 0.001). ctDNA detected a numerically higher proportion of recurrences than CEA (p < 0.097). Post-intervention systemic therapy was not associated with improved DFS (p = 0.745). (4) Conclusions: ctDNA results are prognostically important in oligometastatic CRC, and further prospective studies are urgently needed to define its role in guiding clinical decisions.

Acquired von Willebrand syndrome (AVWS) is a bleeding disorder in which an underlying condition induces a quantitative or qualitative deficiency in the von Willebrand factor. This case demonstrates the rare diagnosis of AVWS due to an Immunoglobulin G monoclonal gammopathy in an elderly woman who presented with significant gastrointestinal bleeding. Originally thought to be type 1 von Willebrand disease, this case provides a cautious example to clinicians that without a detailed history or an understanding of the associated laboratory work‐up, AVWS may be missed with potentially fatal consequences. Fortunately, AVWS was recognized and treated with intravenous immunoglobulin with a resolution of bleeding.

Purpose: Immune checkpoint inhibitors (ICIs) improve recurrence outcomes in stage III melanoma but can cause immune-related adverse events (irAEs) of varying severity. While some studies suggest irAEs correlate with improved survival, findings remain inconsistent. Optimal management of recurrent stage III melanoma after adjuvant ICI therapy is also unclear. Here, we evaluate the impact of irAEs on survival and describe subsequent treatments in patients with recurrent stage III melanoma. Patients and Methods: We identified 171 patients with stage III melanoma treated with adjuvant ICIs since 2017. Clinical endpoints included overall survival, progression-free survival, distant metastasis-free survival, melanoma-specific survival, and time-to-irAE, which were analyzed using Kaplan–Meier method, Cox model, and Fine–Gray’s method. Cox model with time-varying covariate modeling addressed immortal-time bias. Subgroup analysis examined survival by irAE type, grade, and treatment resumption. Results: irAEs occurred in 43.86% of patients, with dermatitis (17.64%), colitis (16.67%), and hypothyroidism (15.69%) the most common. irAE presence did not impact survival outcomes. Thirty-one grade 3+ irAEs occurred, which were linked to increased short-term melanoma-specific mortality. Immune-related hepatitis was associated with higher mortality risk in multivariable modeling. Recurrence or progression occurred in 28.65% of patients, with 38.78% located at a distal site. Among those who started additional medical treatment, 42.86% received dual-checkpoint inhibitor therapy and 14.29% enrolled in clinical trials. Conclusion: Our findings do not support an association between irAEs and survival in patients with stage III melanoma. However, specific types of events, particularly hepatitis, may increase mortality. Prospective studies are needed to clarify optimal treatment after recurrence.

Congenital dyserythropoietic anemia is a group of hereditary disorders characterized by erythroid hyperplasia and ineffective erythropoiesis, resulting in anemia of varying severity. Congenital dyserythropoietic anemia Type 1 (CDA‐1) is classically associated with biallelic mutations in the CDAN1 gene. Here, we report the first case of compound heterozygous CDAN1 mutations p.(D1043V) and p.(S1036F) in clinical practice, presenting in a 24‐year‐old woman with mild, asymptomatic macrocytic anemia and hyperferritinemia. These variants are currently classified as variants of uncertain significance; however, this report represents the first clinical case of this compound heterozygous CDAN1 variant combination in a patient with a phenotype consistent with CDA‐1. As the phenotypic boundaries of CDA‐1 continue to expand, clinicians should consider CDA‐1 in the differential diagnosis of unexplained macrocytic anemia, even in the absence of severe anemia.

Background: Elderly patients have low utilization of adjuvant ICIs, although they achieve similar RFS benefits as younger patients. It remains unclear why elderly patients use adjuvant ICIs less frequently and whether toxicity impacts treatment utilization. Methods: Adult patients with stage III melanoma treated from 2017 to 2023 at a single academic cancer center were retrospectively identified. Multivariable logistic regressions evaluated the association of age with receipt of adjuvant ICIs and toxicity. RFS was assessed using Kaplan–Meier and multivariable Cox proportional hazards regression. Results: Among 240 patients, those aged ≥ 75 years were less likely to receive adjuvant ICI than those aged 18–74 years (aOR: 0.30; 95% CI: 0.11–0.80). Among 53 (22.1%) patients who did not receive adjuvant ICI, 58% declined treatment, 15% were not offered adjuvant ICI by provider, 9% had a comorbid autoimmunity, and 6% had another comorbidity. A total of 12% of patients aged 75–80 years old declined treatment versus 33% of those aged 80–90 years old. Older age was not associated with toxicity, treatment interruption, or discontinuation from adjuvant ICI. Adjuvant ICI was associated with low recurrence (aHR: 0.76; 95% CI: 0.63–0.92), whereas age ≥ 75 years was associated with higher recurrence risk (aHR: 1.79; 95% CI: 1.04–3.10) and low overall survival (aHR: 3.07; 95% CI: 1.43–6.57) compared to patients aged 18–74 years. Conclusions: Older patients with stage III melanoma were less likely to receive adjuvant ICIs, despite similar toxicity, treatment interruption, and discontinuation rates across age groups. Because adjuvant therapy is associated with lower recurrence risk, efforts to better understand and address age-related differences in treatment use are warranted.