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Journal of Gastrointestinal Oncology

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https://www.readbyqxmd.com/read/27747094/summary-of-emerging-personalized-medicine-in-neuroendocrine-tumors-are-we-on-track
#1
REVIEW
Michael S Lee, Bert H O'Neil
Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies, with differences in prognosis and effective therapies. Traditionally, NETs have been characterized by tumor grade, site of primary tumor, functional status, and presence of underlying familial syndrome. However, increased feasibility and utilization of next-generation sequencing and other methodologies have revealed new genomic and epigenetic aberrations. In the last decade, treatment options available for metastatic well-differentiated gastroenteropancreatic (GEP) NETs have expanded, with approval of antiangiogenic and mTOR-directed targeted therapies, and our armamentarium of active therapies is likely to further increase...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747093/molecular-profiling-of-biliary-tract-cancer-a-target-rich-disease
#2
Apurva Jain, Milind Javle
Biliary tract cancers (BTCs) are relatively uncommon orphan tumors that have an aggressive disease course and a poor clinical outcome. Surgery is the only curative treatment, but most patients present with advanced disease and therefore have a limited survival. Gemcitabine and cisplatin based chemotherapy has been the only widely accepted standard systemic therapy regimen in these patients but these tumors can be chemoresistant, further complicating their management. In recent times, there has been considerable research in the genetics of BTC and with the advent of new, advanced technologies like next-generation sequencing (NGS) we are achieving a greater understanding of its disease biology...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747092/the-rise-of-the-fgfr-inhibitor-in-advanced-biliary-cancer-the-next-cover-of-time-magazine
#3
REVIEW
Sumera Rizvi, Mitesh J Borad
Cholangiocarcinomas (CCAs) are heterogeneous tumors arising from the biliary tract with features of cholangiocyte differentiation. CCAs are aggressive tumors with limited treatment options and poor overall survival. Only a subset of CCA patients with early stage disease can avail potentially curative treatment options. For advanced biliary tract tumors, currently there are limited effective treatment modalities. Recent advances have provided greater insight into the genomic landscape of CCAs. The fibroblast growth factor receptor (FGFR) pathway is involved in key cellular processes essential to survival and differentiation...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747091/the-promise-of-pd-1-inhibitors-in-gastro-esophageal-cancers-microsatellite-instability-vs-pd-l1
#4
REVIEW
Zhaohui Jin, Harry H Yoon
Preliminary clinical studies of anti-programmed cell death-1 (anti-PD-1) therapy in gastro-esophageal cancers have suggested promising single-agent activity. In patients who received prior treatment for advanced disease, pembrolizumab has been associated with a response rate of 20% in programmed cell death-1 ligand 1 (PD-L1)-positive tumors, and nivolumab with a response rate of 12% in unselected tumors. Both agents yielded a median duration of response lasting ~6-7 months. PD-L1 expression and microsatellite instability (MSI) have emerged as potential predictive markers for PD-1/PD-L1 blockade...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747090/beyond-her2-recent-advances-and-future-directions-in-targeted-therapies-in-esophagogastric-cancers
#5
Jimmy Hwang
Esophagogastric cancers (EGCa) are a leading cause of cancer related mortality worldwide. It has been recognized that they represent heterogenous diseases based on histology and anatomy. However, it is also increasingly evident that these are diverse malignancies based on genetic alterations, and this is increasingly making these diseases amenable to targeted therapies. While epidermal growth factor receptor (EGFR) and mTOR inhibitors have failed to prove effective in the treatment of advanced EGCa, vascular endothelial growth factor (VEGF) inihibitor have now been demonstrated to improve survival, at least in the 2nd line setting of adenocarcinomas...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747089/the-genomics-and-therapeutics-of-her2-positive-gastric-cancer-from-trastuzumab-and-beyond
#6
REVIEW
Ciara M Kelly, Yelena Y Janjigian
Gastric cancer is a biologically heterogeneous tumor. The identification of human epidermal growth factor receptor-2 (HER2) biomarker overexpression in gastric cancer represented a significant step towards unraveling the molecular complexity of this disease. Trastuzumab in combination with chemotherapy, in the first-line setting of patients with metastatic, HER2-positive gastric and gastroesophageal, represents the first targeted therapeutic to demonstrate improvement in response rate and survival in gastric cancer...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747088/is-it-time-to-split-strategies-to-treat-homologous-recombinant-deficiency-in-pancreas-cancer
#7
REVIEW
Min Yuen Teo, Eileen M O'Reilly
Pancreatic cancer is a highly lethal malignancy which tends to present with late stage disease. To date, identification of oncogenic drivers and aberrations has not led to effective targeted therapy. Approximately 5-15% of pancreatic cancer has an inheritable component. In fact, pancreatic adenocarcinoma is now recognized as a BRCA1/2-related cancer. Germline BRCA1/2 mutations can be found in up to 3.6-7% of unselected pancreatic cancer patients although the rates are significantly higher amongst patients with Ashkenazi Jewish ancestry...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747087/personalized-medicine-in-sporadic-pancreatic-cancer-without-homologous-recombination-deficiency-are-we-any-closer
#8
REVIEW
Namrata Vijayvergia, Steven J Cohen
Pancreatic adenocarcinoma is the fourth leading cause of cancer related death in the United States. Most patients are diagnosed at a late stage and despite recent advances in chemotherapeutic approaches, outcomes are poor. With the introduction of combination chemotherapy, novel biomarkers are clearly needed to identify subsets of patients likely to benefit from these therapies. Advances in our understanding of the molecular drivers of pancreatic cancer offer the hope of personalized therapy that may benefit our patients...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747086/summary-of-emerging-targets-in-anal-cancer-the-case-for-an-immunotherapy-based-approach
#9
REVIEW
Van Morris, Cathy Eng
Squamous cell carcinoma of the anal canal (SCCA) remains a less common gastrointestinal malignancy despite a continued increase in the annual incidence in the United States and globally. The vast majority of all cases are attributed to persistent infection and integration into host cell DNA by human papillomavirus (HPV). For patients with metastatic anal cancer, there is currently no accepted consensus standard of care. Given the viral etiology associated with the oncogenesis of this tumor, great interest exists for the development of immunotherapy as a novel approach to improving clinical outcomes for patients afflicted with this disease...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747085/biomarkers-for-immune-therapy-in-colorectal-cancer-mismatch-repair-deficiency-and-others
#10
Manojkumar Bupathi, Christina Wu
Colorectal cancer (CRC) is a heterogeneous disease for which the treatment backbone has primarily been cytotoxic chemotherapy. With better understanding of the involved molecular mechanisms, it is now known that there are a number of epigenetic and genetic events, which are involved in CRC pathogenesis. Specific biomarkers have been identified which can be used to determine the clinical outcome of patients beyond tumor staging and predict for treatment efficacy. Molecular testing is now routinely performed to select for patients that will benefit the most from targeted agents and immunotherapy...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747084/beyond-ras-and-braf-a-target-rich-disease-that-is-ripe-for-picking
#11
REVIEW
Tyler Friedrich, Stephen Leong, Christopher H Lieu
Despite numerous breakthroughs in the understanding of colorectal cancer and identification of many oncogenic mutations, the treatment of metastatic colorectal cancer remains relatively more empiric than targeted. Testing for mutations in rat sarcoma virus (RAS) and rapidly growing fibrosarcoma (RAF) are routinely performed, though identification of these mutations currently offers little more than a negative predictive marker for response to EGFR inhibitor treatment and, in the case of RAF mutation, a poor prognostic indicator...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747083/ras-and-braf-in-metastatic-colorectal-cancer-management
#12
Jun Gong, May Cho, Marwan Fakih
The treatment of metastatic colorectal cancer (mCRC) has been further refined with the development of monoclonal antibodies, cetuximab and panitumumab, towards the epidermal growth factor receptor (EGFR). Anti-EGFR therapy has afforded improved survival in those with wild-type RAS mCRC but provides no benefit and even harm in those with RAS-mutant tumors. BRAF mutations have also been shown to predict lack of clinically meaningful benefit to anti-EGFR therapy in mCRC. Mechanisms of resistance to EGFR blockade in wild-type RAS or BRAF metastatic colorectal tumors appear to converge on the mitogen-activated protein kinase (MAPK) signaling pathway...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747082/clinical-applications-of-liquid-biopsies-in-gastrointestinal-oncology
#13
Jason Zhu, John H Strickler
"Liquid biopsies" are blood based assays used to detect and analyze circulating tumor products, including circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating messenger RNA (mRNA), circulating microRNA (miRNA), circulating exosomes, and tumor educated platelets (TEP). For patients with gastrointestinal (GI) malignancies, blood based biopsies may offer several advantages. First, tumor tissue samples are often challenging to procure, and when obtainable, are often insufficient for genomic profiling...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27747081/taking-aim-at-the-genomic-diversity-of-gastrointestinal-cancers-a-changing-landscape
#14
Tanios Bekaii-Saab, Bassel El-Rayes
No abstract text is available yet for this article.
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563458/a-comparison-between-5-fluorouracil-mitomycin-and-capecitabine-mitomycin-in-combination-with-radiation-for-anal-cancer
#15
Renata D'Alpino Peixoto, Dante D Wan, Devin Schellenberg, Howard J Lim
BACKGROUND: There are no randomized phase III trials comparing 5-fluorouracil/mitomycin (FM) versus capecitabine/mitomycin (CM) in combination with radiotherapy (RT) for locally advanced anal cancer. We aim to evaluate the outcomes of patients treated with FM and CM at our institution. METHODS: Patients with stage I-III anal cancer who initiated curative-intent RT (50-54 Gy) with either CM or FM between 1998 and 2013 at the BC Cancer Agency were reviewed. Cox proportional models were used to analyze the impact of regimen on disease-free survival (DFS) and anal cancer-specific survival (ACSS)...
August 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563457/clinical-outcomes-and-toxicities-of-proton-radiotherapy-for-gastrointestinal-neoplasms-a-systematic-review
#16
Vivek Verma, Steven H Lin, Charles B Simone, Minesh P Mehta
BACKGROUND: Proton beam radiotherapy (PBT) is frequently shown to be dosimetrically superior to photon radiotherapy (RT), though supporting data for clinical benefit are severely limited. Because of the potential for toxicity reduction in gastrointestinal (GI) malignancies, we systematically reviewed the literature on clinical outcomes (survival/toxicity) of PBT. METHODS: A systematic search of PubMed, EMBASE, abstracts from meetings of the American Society for Radiation Oncology, Particle Therapy Co-Operative Group, and American Society of Clinical Oncology was conducted for publications from 2000-2015...
August 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563456/pazopanib-in-metastatic-multiply-treated-progressive-gastrointestinal-stromal-tumors-feasible-and-efficacious
#17
Anant Ramaswamy, Nikhil Pande, Omshree Shetty, Nitin Shetty, Sudeep Gupta, Vikas Ostwal
BACKGROUND: A median progression free survival (PFS) of 18-20 months and median overall survival (OS) of 51-57 months can be achieved with the use of imatinib, in metastatic or advanced gastrointestinal stromal tumor (GIST). Sunitinib and regorafenib are approved options for patients progressing on imatinib, but with markedly decreased survival. pazopanib is a broad spectrum TKI targeting KIT, PDGFR and VEGFR receptors and has shown promising activity in phase 2 trials in GIST. METHODS: All patients who received pazopanib for GIST between March 2014 and September 2015 in our institution were reviewed...
August 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563455/treatment-of-non-resectable-and-metastatic-gastrointestinal-stromal-tumors-experience-with-the-use-of-tyrosine-kinase-inhibitors-in-a-third-level-hospital-in-mexico
#18
Abdel Karim Dip Borunda, Alberto Pimentel Renteria, Miguel Pluma Jiménez, Mario Pérez Martínez, Gloria Martínez Martínez, Samuel Rivera Rivera, Rocío Grajales Álvarez, Yolanda Bautista Aragón, Miguel Quintana Quintana, Juan Alejandro Silva
BACKGROUND: Stromal tumors of the digestive tract are uncommon malignant diseases, are subclassified as leiomyosarcomas and Gastrointestinal Stromal Tumors (GIST) depending on the molecular expression of tyrosine kinase receptor KIT (CD117). GISTs represent 1% of malignant tumors affecting this anatomical site. Localized tumours diseases are reasonably well controlled by surgical resection and several criteria define the need for adjuvant therapy. In the case of metastatic disease a poor prognosis has been reported with systemic treatment based on chemotherapy...
August 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563454/neoadjuvant-imatinib-longer-the-better-need-to-modify-risk-stratification-for-adjuvant-imatinib
#19
Anant Ramaswamy, Deepak Jain, Arvind Sahu, Joydeep Ghosh, Priya Prasad, Kedar Deodhar, Nitin Shetty, Shripad Banavali, Shailesh Shrikhande, Vikas Ostwal
BACKGROUND: Multimodality treatment of gastrointestinal stromal tumor (GIST) with surgery and adjuvant imatinib mesylate (IM), along with an emerging role for neoadjuvant IM prior to evaluation for resectability has resulted in high survival rates. METHODS: We conducted a retrospective analysis of prospectively collected data of patients who underwent surgery for GIST, prior to or followed by IM therapy. A total of 112 patients underwent surgery between January 2009 and March 2015 at our centre...
August 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27563453/the-prognostic-role-of-lactate-dehydrogenase-serum-levels-in-patients-with-hepatocellular-carcinoma-who-are-treated-with-sorafenib-the-influence-of-liver-fibrosis
#20
Masayoshi Yada, Masayuki Miyazaki, Kenta Motomura, Akihide Masumoto, Makoto Nakamuta, Motoyuki Kohjima, Rie Sugimoto, Yoshifusa Aratake, Nobuhiko Higashi, Shusuke Morizono, Shinichiro Takao, Naoki Yamashita, Takeaki Satoh, Shinsaku Yamashita, Masami Kuniyoshi, Kazuhiro Kotoh
BACKGROUND: Serum lactate dehydrogenase (LDH) levels could be a prognostic factor for sorafenib-treated patients with several types of solid tumor because it reflects hypoxic circumstances in aggressive tumors. For hepatocellular carcinoma (HCC), however, the prognostic role of LDH has been controversial. Liver fibrosis can potentially cause hypoxia in the liver, which has not been previously studied in the patients with advanced HCC. Thus, we aimed to analyze the prognostic role of LDH based on the degree of fibrosis...
August 2016: Journal of Gastrointestinal Oncology
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