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Jenna Berg, Rodolfo E Manosalva, Andrew Coughlin, Yungpo Bernard Su, Tien-Shew Huang, John Gentry
BACKGROUND: Primary intestinal-type adenocarcinoma (ITAC) of the oral tongue is an extremely uncommon malignancy with only 3 cases reported in the literature. This high-grade malignancy originates from metaplasia of minor salivary glands. METHODS: A 40-year-old man presented with a gradually enlarging midline oral tongue mass, odynophagia, and dysphagia. Management included a median lingual glossectomy, bilateral neck dissections, and adjuvant chemoradiation with 5-fluorouracil (5-FU)...
May 13, 2018: Head & Neck
Stéphanie M Zunder, Gabi W van Pelt, Hans J Gelderblom, Christoph Mancao, Hein Putter, Rob A Tollenaar, Wilma E Mesker
BACKGROUND: The tumour-stroma ratio (TSR) has proven to be an independent prognostic factor in colon cancer. METHODS: Haematoxylin eosin tissue slides of patients from the AVANT trial were microscopically scored for TSR and categorised as stroma -low or stroma -high. Scores were correlated to the primary and secondary endpoint disease-free survival (DFS) and overall survival (OS). RESULTS: Patients with stroma-high tumours (N = 339, 28%) had a significantly shorter DFS (p < 0...
May 14, 2018: British Journal of Cancer
Satya Das, Kristen K Ciombor, Sigurdis Haraldsdottir, Richard M Goldberg
Choosing the optimal treatment approach for patients with metastatic colorectal cancer (mCRC) demands that oncologists assess both clinical and genomic variables and individualize care based upon the findings. Clinically, choices depend on assessing the side of the colon in which the primary tumor originates, the sites and burden of metastatic disease, the patient's performance status, and their individual comorbidities. Genomic assessment of the tumor to discern the mutational status of genes such as RAS/RAF, HER2, and TRK, as well as assessing whether tumors have defective mismatch repair (dMMR) or high microsatellite instability (MSI-H), all factor in to potential treatment options and can determine clinical trial eligibility...
May 11, 2018: Current Treatment Options in Oncology
Angélica Morales-Miranda, Ismael Domínguez Rosado, Carlos Chan Núñez, Fredy Chable Montero
Approximately 15% of colorectal cancer (CRC) cases exhibit microsatellite instability (MSI), which appears to be associated with unique biological behavior. The present study presents a case of appendiceal carcinoma associated with MSI that responded well to adjuvant chemotherapy. Clinical, pathological and immunohistochemical (IHC) characteristics have been described. The 60-year-old male patient had suffered from recurrent lower abdominal pain associated with abdominal distention for 6 months; then, following an acute attack, he was subjected to laparoscopic appendectomy...
May 2018: Molecular and Clinical Oncology
Clizia Zichi, Marco Tampellini, Marcello Tucci, Cristina Sonetto, Chiara Baratelli, Maria P Brizzi, Giorgio V Scagliotti
BACKGROUND: Adenocarcinomas of the oral cavity are rare neoplasms, and only four cases of primary colonic adenocarcinoma of the tongue have ever been described in literature. Very few information about chemotherapy sensitiveness of this type of neoplasia is available, with only one regimen that showed some activity in a metastatic patient. CASE PRESENTATION: We describe the case of a patient bearing a metastatic colonic adenocarcinoma of the tongue submitted to a first-line chemotherapy with oxaliplatin, 5-fluorouracil and folinic acid (FOLFOX regimen)...
April 26, 2018: BMC Cancer
Stefan Munker, Michael Gerken, Petra Fest, Claudia Ott, Elisabeth Schnoy, Stefan Fichtner-Feigl, Philipp Wiggermann, Martin Vogelhuber, Wolfgang Herr, Christian Stroszczynski, Hans Jürgen Schlitt, Matthias Evert, Michael Reng, Monika Klinkhammer-Schalke, Andreas Teufel
BACKGROUND: 5-Fluorouracil (5FU), Folinic acid (FA), and Oxaliplatin (FOLFOX) or 5FU, FA, and Irinotecan (FOLFIRI) are standard regimens for palliative chemotherapy of metastatic colon cancer. Since data showing the influence of dose reduction in palliative treatment are rare, the objective of this single center, retrospective study was to further characterize the influence of dose reduction on efficacy of these therapeutic regimens. METHODS: One hundred nine patients, diagnosed with stage IV colon cancer between 2004 and 2012 and receiving palliative first-line chemotherapy with either FOLFOX or FOLFIRI regimens in our outpatient clinic were analyzed for treatment efficacy...
April 23, 2018: BMC Cancer
Domenico Ciliberto, Nicoletta Staropoli, Francesca Caglioti, Silvia Chiellino, Antonella Ierardi, Rossana Ingargiola, Cirino Botta, Mariamena Arbitrio, Pierpaolo Correale, Pierfrancesco Tassone, Pierosandro Tagliaferri
BACKGROUND: At present, there is uncertainty on the best systemic treatment in first-line setting for RAS wild-type (WT) metastatic colorectal cancer (mCRC) patients. Indeed, several chemotherapy and biologics combinations showed an improvement on survival. We performed a systematic review with a pair-wise and bayesan meta-analysis to rank the best strategy for these patients. METHODS: A systematic literature search through March 2017 was performed to evaluate the association between several treatment combinations and overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and toxicity rate (TR) in RAS WT mCRC patients...
May 2018: Critical Reviews in Oncology/hematology
Endale Gebreegziabher Gebremedhn, Peter John Shortland, David Anthony Mahns
BACKGROUND: Although acute oxaliplatin-induced neuropathy (OXIPN) is frequently regarded to be transient, recent studies have reported prolongation of infusion times, dose reduction and treatment cessation following the first dose of oxaliplatin in quarter of patients. Acute OXIPN is also a well-established risk factor for chronic neuropathy. However, there is underreporting of these parameters during the acute phase (≤ 14 days). This paper systematically reviews the incidence of acute OXIPN and its impact on treatment in the first cycle...
April 12, 2018: BMC Cancer
Dawon Park, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim
Purpose: An oxaliplatin-based regimen is the most common adjuvant chemotherapy for patients with stage II/III colorectal cancer, but many patients experience dose reduction or early termination of chemotherapy due to side effects. We conducted this study to verify the range of reduction with oncologic safety. Methods: Patients with stage II/III colorectal cancer who received adjuvant FOLFOX chemotherapy were enrolled in this study. The total amount of oxaliplatin administered per patient was calculated as a percentile based on 12 cycles of full-dose FOLFOX as a standard dose...
April 2018: Annals of Surgical Treatment and Research
Alberto Sobrero, Sara Lonardi, Gerardo Rosati, Maria Di Bartolomeo, Monica Ronzoni, Nicoletta Pella, Mario Scartozzi, Maria Banzi, Maria Giulia Zampino, Felice Pasini, Paolo Marchetti, Maurizio Cantore, Alberto Zaniboni, Lorenza Rimassa, Libero Ciuffreda, Daris Ferrari, Vittorina Zagonel, Evaristo Maiello, Sandro Barni, Eliana Rulli, Roberto Labianca
Purpose Given the cumulative neurotoxicity associated with oxaliplatin, a shorter duration of adjuvant therapy, if equally efficacious, would be advantageous for patients and health-care systems. Methods The Three or Six Colon Adjuvant trial is an open-label, phase III, multicenter, noninferiority trial randomizing patients with high-risk stage II or stage III colon cancer to receive 3 months or 6 months of FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine plus oxaliplatin). Primary end-point is relapse-free survival...
April 5, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Timothy J Iveson, Rachel S Kerr, Mark P Saunders, Jim Cassidy, Niels Henrik Hollander, Josep Tabernero, Andrew Haydon, Bengt Glimelius, Andrea Harkin, Karen Allan, John McQueen, Claire Scudder, Kathleen Anne Boyd, Andrew Briggs, Ashita Waterston, Louise Medley, Charles Wilson, Richard Ellis, Sharadah Essapen, Amandeep S Dhadda, Mark Harrison, Stephen Falk, Sherif Raouf, Charlotte Rees, Rene K Olesen, David Propper, John Bridgewater, Ashraf Azzabi, David Farrugia, Andrew Webb, David Cunningham, Tamas Hickish, Andrew Weaver, Simon Gollins, Harpreet S Wasan, James Paul
BACKGROUND: 6 months of oxaliplatin-containing chemotherapy is usually given as adjuvant treatment for stage 3 colorectal cancer. We investigated whether 3 months of oxaliplatin-containing chemotherapy would be non-inferior to the usual 6 months of treatment. METHODS: The SCOT study was an international, randomised, phase 3, non-inferiority trial done at 244 centres. Patients aged 18 years or older with high-risk stage II and stage III colorectal cancer underwent central randomisation with minimisation for centre, choice of regimen, sex, disease site, N stage, T stage, and the starting dose of capecitabine...
April 2018: Lancet Oncology
Axel Grothey, Alberto F Sobrero, Anthony F Shields, Takayuki Yoshino, James Paul, Julien Taieb, John Souglakos, Qian Shi, Rachel Kerr, Roberto Labianca, Jeffrey A Meyerhardt, Dewi Vernerey, Takeharu Yamanaka, Ioannis Boukovinas, Jeffrey P Meyers, Lindsay A Renfro, Donna Niedzwiecki, Toshiaki Watanabe, Valter Torri, Mark Saunders, Daniel J Sargent, Thierry Andre, Timothy Iveson
BACKGROUND: Since 2004, a regimen of 6 months of treatment with oxaliplatin plus a fluoropyrimidine has been standard adjuvant therapy in patients with stage III colon cancer. However, since oxaliplatin is associated with cumulative neurotoxicity, a shorter duration of therapy could spare toxic effects and health expenditures. METHODS: We performed a prospective, preplanned, pooled analysis of six randomized, phase 3 trials that were conducted concurrently to evaluate the noninferiority of adjuvant therapy with either FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin) administered for 3 months, as compared with 6 months...
March 29, 2018: New England Journal of Medicine
Ming-Yii Huang, Hsin-Hua Lee, Hsiang-Lin Tsai, Ching-Wen Huang, Yung-Sung Yeh, Cheng-Jen Ma, Chun-Ming Huang, Chiao-Yun Chen, Joh-Jong Huang, Jaw-Yuan Wang
BACKGROUND: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemoradiation (NACRT) in locally advanced rectal cancer (LARC) in upper rectum versus middle/lower rectum. METHODS: The study included 173 patients with stage II or III (T2-4b, N0-2b) LARC who underwent NACRT followed by total mesorectal excision (TME) between January 2011 and October 2016. Cox regression, log-rank test, and Kaplan-Meier curves were calculated. RESULTS: Among the 173 patients, 58 had lesions in the upper rectum and 115 patients had lesions in middle/lower rectum...
March 27, 2018: Radiation Oncology
Amanda I Phipps, Qian Shi, Tyler J Zemla, Efrat Dotan, Sharlene Gill, Richard M Goldberg, Sheetal Hardikar, Balkrishna Jahagirdar, Paul J Limburg, Polly A Newcomb, Anthony Shields, Frank A Sinicrope, Daniel J Sargent, Steven R Alberts
BACKGROUND: Prior studies have supported an inverse association between physical activity and colon cancer risk, and suggest that higher physical activity may also improve cancer survival. Among participants in a phase III adjuvant trial for stage III colon cancer, we assessed the association of physical activity around the time of cancer diagnosis with subsequent outcomes. METHODS: Before treatment arm randomization (FOLFOX or FOLFOX+cetuximab), study participants completed a questionnaire including items regarding usual daily activity level and frequency of participation in recreational physical activity (N=1992)...
March 21, 2018: Cancer Epidemiology, Biomarkers & Prevention
Nelson S Yee
Progress has been made in the treatment of gastrointestinal cancers through advances in systemic therapies, surgical interventions, and radiation therapy. At the Multi-Disciplinary Patient Care in Gastrointestinal Oncology conference, the faculty members of the Penn State Health Milton S. Hershey Medical Center presented a variety of topics that focused on this sub-specialty. This conference paper highlights the new development in systemic treatment of various malignant diseases in the digestive system. Results of the recent clinical trials that investigated the clinical efficacy of pegylated hyaluronidase, napabucasin, and L-asparaginase in pancreatic carcinoma are presented...
March 16, 2018: Biomedicines
Helena S Gouveia, Sílvia O Lopes, Ana Luísa Faria
Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. After three cycles of first-line FOLFOX (folinic acid, 5-fluorouracil and oxaliplatin), she developed acute kidney injury and hyperkalaemia that did not respond to standard measures. High suspicion of TLS prompted further corroborating investigations and early intensive care unit admission...
March 15, 2018: BMJ Case Reports
Carmine Pinto, Maurizio Di Bisceglie, Francesca Di Fabio, Annamaria Bochicchio, Tiziana Latiano, Stefano Cordio, Gerardo Rosati, Carlo Aschele, Antonella Marino, Francesca Bergamo, Sara Bustreo, Luca Frassineti, Fortunato Ciardiello, Angela Damato, Stefania Giaquinta, Daniela Baldari, Luca Boni
BACKGROUND: Treatment with fluoropyrimidines and concomitant long-course external radiotherapy (RTE) is the standard of care in locally advanced rectal cancer (LARC) preoperative chemoradiation. A randomized phase II study (RaP/STAR-03) was conducted that aimed to evaluate the activity and safety of the monoclonal antibody anti-epidermal growth factor receptor panitumumab as a single agent in combination with radiotherapy in low-risk LARC preoperative treatment. MATERIALS AND METHODS: Patients had adenocarcinoma of the mid-low rectum, cT3N- or cT2-T3N+, KRAS wild-type status, and negative circumferential radial margin...
March 9, 2018: Oncologist
Datian Chen, Li Li, Xiang Zhang, Guangyi Gao, Lili Shen, Jing Hu, Mi Yang, Baorui Liu, Xiaoping Qian
BACKGROUND: The efficacy of oxaliplatin-based chemotherapy combined with anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) remains controversial in metastatic colorectal cancer (mCRC). This meta-analysis aims to estimate the effect of adding panitumumab or cetuximab to oxaliplatin-based chemotherapy in RAS wild type mCRC patients for the first-line treatment. The primary tumor location is also considered into this meta-analysis. METHODS: RCT studies were identified by a search of MEDLINE, EMBASE, Cochrane library to October 2017, supplemented by manually retrieving ASCO, ESMO conference abstracts...
March 2018: Medicine (Baltimore)
Maria João Marques Ribeiro, Teresa Alonso, Pablo Gajate, Javier Molina, Arantzazu Barquin, Cristian Perna, Enrique Grande
Chemotherapy is considered "state of the art" for the treatment of poorly differentiated neuroendocrine neoplasms. Unfortunately, there is no standard effective post-first-line treatment for relapsing high-grade gastroenteropancreatic neuroendocrine neoplasms. We report the case of a patient with a gastric neuroendocrine carcinoma stage IV, with massive gastrointestinal bleeding at diagnosis. After the first line of platin-based chemotherapy a major tumoral response was documented, but the patient relapsed after 4 months...
January 2018: Autopsy & Case Reports
Yoshinori Munemoto, Mitsuro Kanda, Koji Oba, Ho Min Kim, Hiroyoshi Takemoto, Tadamichi Denda, Naoki Nagata, Nao Takano, Mutsumi Fukunaga, Masato Kataoka, Yukihiko Tokunaga, Junichi Sakamoto, Hideyuki Mishima
PURPOSE: Fluorouracil monotherapy, instead of the FOLFOX or FOLFIRI regimen, is administered to patients intolerant to oxaliplatin or irinotecan because of their adverse effects. A prospective clinical trial was designed to evaluate the efficacy and safety of fluorouracil monotherapy combined with panitumumab administered to patients with KRAS wild-type (WT) metastatic colorectal cancer (mCRC) intolerant to oxaliplatin and irinotecan. Screening for potential serum biomarkers to predict early therapeutic responses was conducted...
May 2018: Cancer Chemotherapy and Pharmacology
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