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Gastroesophagic junction cancer

H H Yoon, J C Bendell, F S Braiteh, I Firdaus, P A Philip, A L Cohn, N Lewis, D M Anderson, E Arrowsmith, J D Schwartz, L Gao, Y Hsu, Y Xu, D Ferry, S R Alberts, Z A Wainberg
BACKGROUND: We report the first randomized, Phase II trial of ramucirumab, an anti-vascular endothelial growth factor receptor-2 monoclonal antibody, as front-line therapy in patients with advanced adenocarcinoma of the esophagus or gastric/gastroesophageal junction (GEJ). PATIENTS AND METHODS: Patients from the USA with advanced esophageal, gastric, or GEJ adenocarcinoma randomly received (1:1) mFOLFOX6 plus ramucirumab (8 mg/kg) or mFOLFOX6 plus placebo every 2 weeks...
October 20, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Alexander W Phillips, Barry Dent, Maziar Navidi, Arul Immanuel, S Michael Griffin
OBJECTIVE: The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND: Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Esophagogastric cancer training is particularly vulnerable due to the publication of individual surgeon results and a perception that dual consultant operating improves patient outcomes...
October 17, 2016: Annals of Surgery
Jia-Bin Liao, Huai-Pao Lee, Hsiao-Ting Fu, Herng-Sheng Lee
Epidermal growth factor receptor 1 (EGFR) and erb-b2 receptor tyrosine kinase 2 (ERBB2/HER2) are frequently dysregulated in human cancers. We analyzed EGFR and ERBB2 status in 105 gastric and gastroesophageal junction carcinoma and their clinicopathologic features. For EGFR, 92 (88%) tumors were scored as 0, 2 (2%) as 1+, 7 (7%) as 2+, and 4 (3%) as 3+ by immunohistochemistry (IHC) and 4 (4%) tumors showed EGFR amplification by fluorescence in situ hybridization (FISH). For ERBB2, 90 (86%) tumors were scored as 0, 4 (4%) as 1+, 6 (6%) as 2+, and 5 (5%) as 3+ by IHC and 12 (12%) showed ERBB2 amplification by FISH...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Marina Borro, Andrea Botticelli, Federica Mazzuca, Elisa Concetta Onesti, Giovanna Gentile, Adriana Romiti, Bruna Cerbelli, Eva Mazzotti, Luca Marchetti, Luana Lionetto, Maurizio Simmaco, Paolo Marchetti
BACKGROUND: 5-fluorouracil (5-FU) based chemotherapy is the most common first line regimen used in gastric and gastroesophageal junction cancer, but development of severe toxicity is a main concern in the treatment. The present study is aimed to evaluate a novel pre-treatment assay, known as the 5-FU degradation rate (5-FUDR), as a predictive factor for 5-FU toxicity. METHODS: Pre-treatment 5-FUDR and gene polymorphisms related to 5-FU metabolism (DPYDIVS14+1G>A, MTHFRA1298T or C677T, TMYS TSER) were characterized in gastro-esophageal cancer patients...
October 11, 2016: Oncotarget
Stephen G Swisher, Jennifer Moughan, Ritsuko U Komaki, Jaffer A Ajani, Tsung T Wu, Wayne L Hofstetter, Andre A Konski, Christopher G Willett
INTRODUCTION: The impact of selective surgical resection for esophageal cancer patients treated with definitive chemoradiation has not been clearly evaluated long-term. METHODS: NRG Oncology RTOG 0246 was a multi-institutional, single arm, open-label, non-randomized phase II study, which enrolled forty-three patients from Sept 2003 to March 2008 with clinical stage T1-4N0-1M0 squamous cell or adenocarcinoma of the esophagus or gastroesophageal junction (GEJ) from 19 sites...
October 8, 2016: Journal of Thoracic Oncology
L Depypere, T Lerut, J Moons, W Coosemans, G Decker, H Van Veer, P De Leyn, P Nafteux
Recurrent disease after esophagectomy bears an infaust prognosis, especially when multiple recurrences are present. But little is known about survival in patients with limited recurrence (solitary locoregional recurrence or solid organ metastasis). Herein, we report our experience with these subgroups. We analyzed 1754 consecutive patients surgically treated with curative resection for esophageal cancer and cancer of the gastroesophageal junction between 1990 and 2012. Seven subgroups were defined according to the recurrence type (locoregional vs...
October 5, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Young Sun Kim, Nayoung Kim, Gwang Ha Kim
It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s...
October 30, 2016: Journal of Neurogastroenterology and Motility
Brian Badgwell
Surgical resection is the primary method of obtaining a potential cure for patients with gastric adenocarcinoma. However, chemotherapy or chemoradiotherapy offer significant improvement in survival over surgery alone. Much of the difficulty in deciding the optimal treatment strategy is choosing between perioperative chemotherapy or adjuvant chemoradiotherapy. Adding to the complexity is the potential for incorporating treatment strategies based on clinical trials performed in Asia. There is likely a difference in tumor biology between Eastern and Western patients with gastric adenocarcinoma, in addition to the clear differences in screening, pathologic assessment, and surgical technique...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
S A Rosenberg, A P Wojcieszynski, C R Hullett, M W Geurts, J Bayouth, P M Harari, M Bassetti
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
S K Kim, C Oromendia, P Christos, A G Wernicke, B Parashar
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Eisar Al-Sukhni, Emmanuel Gabriel, Kristopher Attwood, Moshim Kukar, Steven J Nurkin, Steven N Hochwald
BACKGROUND: Neoadjuvant treatment improves survival in resectable esophageal adenocarcinoma, but the optimal regimen has not been defined. Neoadjuvant chemoradiation (nCRT) is associated with higher pathologic complete response (pCR) relative to chemotherapy (nCTX) but has not been shown to improve survival; however, previous studies have been underpowered to demonstrate a survival difference. The objective of this study was to determine if nCRT is associated with increased survival relative to nCTX in patients with resectable esophageal adenocarcinoma...
September 15, 2016: Journal of the American College of Surgeons
David H Ilson
PURPOSE OF REVIEW: This article reviews the recent seminal studies in esophagogastric cancer. RECENT FINDINGS: Regular low aspirin use may reduce the risk of esophagogastric cancer. Laparoscopic resection of locally advanced gastric cancer appears equivalent to open resection. There is no survival benefit for the addition of postoperative radiation therapy to adjuvant chemotherapy after primary gastric cancer resection. For tumors of the esophagus and gastroesophageal junction, the combination of preoperative radiation therapy with concurrent chemotherapy may be required to ensure achievement of a negative surgical margin and to reduce local tumor recurrence...
November 2016: Current Opinion in Gastroenterology
Dionysios Dellaportas, James A Gossage, Andrew R Davies
Introduction. With the improving survival of cancer patients, the development of a secondary primary cancer is an increasingly common phenomenon. Extensive surgery during initial treatment may pose significant challenges to surgeons managing the second primary cancer. Case Presentation. A 69-year-old male, who had a pancreaticoduodenectomy three years ago for pancreatic head adenocarcinoma, underwent an uneventful extended total gastrectomy for gastroesophageal junctional adenocarcinoma. The reconstruction controversies and considerations are highlighted...
2016: Case Reports in Surgery
Charles S Fuchs, Josep Tabernero, Jiří Tomášek, Ian Chau, Bohuslav Melichar, Howard Safran, Mustapha A Tehfe, Dumitru Filip, Eldar Topuzov, Luis Schlittler, Anghel Adrian Udrea, William Campbell, Stephen Brincat, Michael Emig, Symantha A Melemed, Rebecca R Hozak, David Ferry, C William Caldwell, Jaffer A Ajani
BACKGROUND: Angiogenesis inhibition is an important strategy for cancer treatment. Ramucirumab, a human IgG1 monoclonal antibody that targets VEGF receptor 2 (VEGFR2), inhibits VEGF-A, -C, -D binding and endothelial cell proliferation. To attempt to identify prognostic and predictive biomarkers, retrospective analyses were used to assess tumour (HER2, VEGFR2) and serum (VEGF-C and -D, and soluble (s) VEGFR1 and 3) biomarkers in phase 3 REGARD patients with metastatic gastric/gastroesophageal junction carcinoma...
October 11, 2016: British Journal of Cancer
Yoku Hayakawa, Wenju Chang, Guangchun Jin, Timothy C Wang
Gastrin was initially identified as the hormone primarily responsible for gastric acid secretion, but was subsequently shown to be a growth factor for the proximal stomach, acting through the gastrin receptor CCK2R. Studies in the past several decades have explored the role of gastrin, along with its incompletely processed precursors, in cancer development. The growth in long-term PPI use has frequently led to elevations in serum gastrin levels in patients with upper GI disease, including GERD, peptic ulcers, and chronic gastritis...
August 31, 2016: Current Opinion in Pharmacology
Weijing Sun, Li Yan
Gastric (including gastroesophageal junction) cancer is the third leading cause of cancer-related death in the world. In China, an estimated 420,000 patients were diagnosed with gastric cancer in 2011, ranking this malignancy the second most prevalent cancer type and resulting in near 300,000 deaths. The treatment landscape of gastric cancer has evolved in recent years. Although systemic chemotherapy is still the mainstay treatment of metastatic disease, the introduction of agents targeting human epidermal growth factor receptor 2 and vascular endothelial growth factor/vascular endothelia growth factor receptor has brought this disease into the molecular and personalized medicine era...
2016: Chinese Journal of Cancer
Oliver M Fisher, Angelique J Levert-Mignon, Christopher W Lehane, Natalia K Botelho, Jesper L V Maag, Melissa L Thomas, Melanie Edwards, Sarah J Lord, Yuri V Bobryshev, David C Whiteman, Reginald V Lord
BACKGROUND: Esophageal and gastroesophageal junctional (GEJ) adenocarcinoma is one of the most fatal cancers and has the fastest rising incidence rate of all cancers. Identification of biomarkers is needed to tailor treatments to each patient's tumor biology and prognosis. METHODS: Gene expression profiling was performed in a test cohort of 80 chemoradiotherapy (CRTx)-naïve patients with external validation in a separate cohort of 62 CRTx-naïve patients and 169 patients with advanced-stage disease treated with CRTx...
August 30, 2016: Annals of Surgical Oncology
Juha Kauppi, Jari Räsänen, Eero Sihvo, Urpo Nieminen, Perttu Arkkila, Markku Ahotupa, Jarmo Salo
OBJECTIVES: Oxidative stress (OS) is an essential element in the pathogenesis of Barrett's esophagus (BE) and its transformation to adenocarcinoma (EAC). The state of OS in the proximal stomach of patients with BE and EAC is unknown. Isoprostanes are a specific marker of OS not previously used to determine OS from BE/EAC tissue samples. PATIENTS AND METHODS: OS was measured in 42 patients with BE (n = 9), EAC (n = 9), or both (n = 24) and 15 control patients. A STAT-8-Isoprostane EIA Kit served to identify 8-Isoprostanes (8-IP), and a Glutathione Assay Kit was used to measure glutathione reduced form (GSH) and glutathione oxidized form...
August 2016: Translational Oncology
Elizabeth Won, Manish A Shah, Heiko Schöder, Vivian E Strong, Daniel G Coit, Murray F Brennan, David P Kelsen, Yelena Y Janjigian, Laura H Tang, Marinela Capanu, Nabil P Rizk, Peter J Allen, Manjit S Bains, David H Ilson
BACKGROUND: Early metabolic response on 18-fluorodeoxyglucose-positron emission tomography (FDG-PET) during neoadjuvant chemotherapy is PET non-responders have poor outcomes whether continuing chemotherapy or proceeding directly to surgery. Use of PET may identify early treatment failure, sparing patients from inactive therapy and allowing for crossover to alternative therapies. We examined the effectiveness of PET directed switching to salvage chemotherapy in the PET non-responders. METHODS: Patients with locally advanced resectable FDG-avid gastric or gastroesophageal junction (GEJ) adenocarcinoma received bevacizumab 15 mg/kg, epirubicin 50 mg/m(2), cisplatin 60 mg/m(2) day 1, and capecitabine 625 mg/m(2) bid (ECX) every 21 days...
August 2016: Journal of Gastrointestinal Oncology
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