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GI Malignancy

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https://www.readbyqxmd.com/read/28736636/biological-agents-in-gastrointestinal-cancers-adverse-effects-and-their-management
#1
REVIEW
Nivedita Arora, Arjun Gupta, Preet Paul Singh
Biological therapy comprises agents that by virtue of their unique mechanisms of action, are able to specifically incite a response against or target malignant cells. They differ from conventional chemotherapy with regard to mechanisms of action, indications and side effect profile. Biologic agents have revolutionized therapy for a number of malignancies. In the setting of gastrointestinal (GI) malignancies, agents targeting vascular endothelial growth factor (VEGF), human epidermal growth factor receptor 2 (Her2/Neu) and epidermal growth factor receptor (EGFR) have proven to be invaluable additions to chemotherapy...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736627/personalized-and-precision-medicine-integrating-genomics-into-treatment-decisions-in-gastrointestinal-malignancies
#2
REVIEW
Trang H Au, Kai Wang, David Stenehjem, Ignacio Garrido-Laguna
The advent of next generation sequencing (NGS) technologies has advanced our understanding of the intrinsic biology of different gastrointestinal (GI) tumor types. The use of novel, more efficient sequencing platforms has improved turnaround times of sequencing results. This is providing real time opportunities to put precision medicine to the test. A number of early phase clinical trials are testing targeted therapies in unique molecularly characterized subsets of patients (baskets). While basket studies are gaining momentum, treatment failures serve to remind us that shifting from a histology-driven to a histology-agnostic approach is unlikely to be a failure-free strategy for a number of tumor types as recently learnt from vemurafenib failure in BRAF mutated metastatic colorectal cancer (mCRC)...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28733730/comparison-of-pure-laparoscopic-versus-open-left-hemihepatectomy-by-multivariate-analysis-a-retrospective-cohort-study
#3
Hwui-Dong Cho, Ki-Hun Kim, Shin Hwang, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Sung-Gyu Lee
INTRODUCTION: To compare the outcomes of pure laparoscopic left hemihepatectomy (LLH) versus open left hemihepatectomy (OLH) for benign and malignant conditions using multivariate analysis. MATERIALS AND METHODS: All consecutive cases of LLH and OLH between October 2007 and December 2013 in a tertiary referral hospital were enrolled in this retrospective cohort study. All surgical procedures were performed by one surgeon. The LLH and OLH groups were compared in terms of patient demographics, preoperative data, clinical perioperative outcomes, and tumor characteristics in patients with malignancy...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733264/the-impact-of-toxicities-on-first-year-outcomes-after-ex-vivo-cd34-selected-allogeneic-hematopoietic-cell-transplantation-in-adults-with-hematologic-malignancies
#4
Satyajit Kosuri, Diego Adrianzen Herrera, Michael Scordo, Gunjan L Shah, Christina Cho, Sean M Devlin, Molly A Maloy, Jimmy Nieves, Taylor Borrill, Dean C Carlow, Scott T Avecilla, Richard C Meagher, Richard J O'Reilly, Esperanza B Papadopoulos, Ann A Jakubowski, Guenther Koehne, Boglarka Gyurkocza, Hugo Castro-Malaspina, Brian C Shaffer, Roni Tamari, Sergio A Giralt, Miguel-Angel Perales
Factors that impact first year morbidity and mortality in adults undergoing myeloablative allogeneic hematopoietic cell transplantation with ex-vivo CD34+ selection have not been previously reported. We assessed all toxicities ≥ grade 3 from the start of conditioning to date of death, relapse, or last contact in 200 patients during the first year post-transplantation, identifying 1885 individual toxicities among 17 organ-based toxicity groups. The most prevalent toxicities in the 1(st) year were of infectious, metabolic, hematologic, oral/GI, hepatic, cardiac and pulmonary etiologies...
July 18, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28718816/complex-dna-damage-a-route-to-radiation-induced-genomic-instability-and-carcinogenesis
#5
REVIEW
Ifigeneia V Mavragani, Zacharenia Nikitaki, Maria P Souli, Asef Aziz, Somaira Nowsheen, Khaled Aziz, Emmy Rogakou, Alexandros G Georgakilas
Cellular effects of ionizing radiation (IR) are of great variety and level, but they are mainly damaging since radiation can perturb all important components of the cell, from the membrane to the nucleus, due to alteration of different biological molecules ranging from lipids to proteins or DNA. Regarding DNA damage, which is the main focus of this review, as well as its repair, all current knowledge indicates that IR-induced DNA damage is always more complex than the corresponding endogenous damage resulting from endogenous oxidative stress...
July 18, 2017: Cancers
https://www.readbyqxmd.com/read/28717373/diagnostic-value-of-alarm-symptoms-for-upper-gi-malignancy-in-patients-referred-to-gi-clinic-a-7-years-cross-sectional-study
#6
Mohammad Hasan Emami, Masoud Ataie-Khorasgani, Nasim Jafari-Pozve
BACKGROUND: Early upper gastrointestinal (UGI) cancer detection had led to organ-preserving endoscopic therapy. Endoscopy is a suitable method of early diagnosis of UGI malignancies. In Iran, exclusion of malignancy is the most important indication for endoscopy. This study is designed to see whether using alarm symptoms can predict the risk of cancer in patients. MATERIALS AND METHODS: A total of 3414 patients referred to a tertiary gastrointestinal (GI) clinic in Isfahan, Iran, from 2009 to 2016 with dyspepsia, gastroesophageal reflux disease (GERD), and alarm symptoms, such as weight loss, dysphagia, GI bleeding, vomiting, positive familial history for cancer, and anorexia...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28697317/management-of-malignant-bowel-obstruction-associated-with-gi-cancers
#7
Aaron J Franke, Atif Iqbal, Jason S Starr, Rajesh M Nair, Thomas J George
For many patients with GI malignancies, the seeding of the abdominal cavity with tumor cells, called peritoneal carcinomatosis, is a common mode of metastases and disease progression. Prognosis for patients with this aspect of their disease remains poor, with high disease-related morbidity and complications. Uniform and proven practices that provide optimal palliative care and quality of life for these patients are needed. The objective of this review is to critically assess the current literature regarding palliative strategies in the management of peritoneal carcinomatosis and associated symptoms in patients with advanced GI cancers...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28689639/regulation-of-inflammation-by-members-of-the-formyl-peptide-receptor-family
#8
REVIEW
Keqiang Chen, Zhiyao Bao, Wanghua Gong, Peng Tang, Teizo Yoshimura, Ji Ming Wang
Inflammation is associated with a variety of diseases. The hallmark of inflammation is leukocyte infiltration at disease sites in response to pathogen- or damage-associated chemotactic molecular patterns (PAMPs and MAMPs), which are recognized by a superfamily of seven transmembrane, Gi-protein-coupled receptors (GPCRs) on cell surface. Chemotactic GPCRs are composed of two major subfamilies: the classical GPCRs and chemokine GPCRs. Formyl-peptide receptors (FPRs) belong to the classical chemotactic GPCR subfamily with unique properties that are increasingly appreciated for their expression on diverse host cell types and the capacity to interact with a plethora of chemotactic PAMPs and MAMPs...
July 6, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28669651/frailty-in-major-oncologic-surgery-of-upper-gastrointestinal-tract-how-to-improve-postoperative-outcomes
#9
M Mazzola, C Bertoglio, M Boniardi, C Magistro, P De Martini, P Carnevali, L Morini, G Ferrari
INTRODUCTION: Certain surgical interventions, especially those involving upper GI tract remain challenging, due to high morbidity and mortality rates. The study of frailty in the surgical population has allowed the identification of those patients with a higher risk of poor postoperative outcomes. There remains a lack of evidence regarding the possibility of improving these results through a preoperative holistic management of the patients. The aim of this study is to evaluate whether preoperative treatment, in carefully selected patients, can improve the outcome following surgery...
June 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28638461/current-status-of-immune-checkpoint-inhibitors-in-gastrointestinal-cancers
#10
REVIEW
Bum Jun Kim, Hyun Joo Jang, Hyeong Su Kim, Jung Han Kim
The expansion of our understanding of tumor immunity and the recent success of new cancer immunotherapy has reignited the hope that we can treat cancer effectively with immunotherapeutic approaches. Immune checkpoint inhibitors have shown significant efficacy in the treatment of some solid and hematologic malignancies. Encouraged by recent success in some other types of malignancies, many clinical trials are ongoing to evaluate the efficacy of immune checkpoint inhibitors in gastrointestinal (GI) malignancies...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#11
REVIEW
Paul M Moayyedi, Brian E Lacy, Christopher N Andrews, Robert A Enns, Colin W Howden, Nimish Vakil
We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28624647/comparing-eus-fine-needle-aspiration-and-eus-fine-needle-biopsy-for-solid-lesions-a-multicenter-randomized-trial
#12
Satish Nagula, Kamron Pourmand, Harry Aslanian, Juan Carlos Bucobo, Tamas Gonda, Susana Gonzalez, Adam Goodman, Seth A Gross, Sammy Ho, Christopher J DiMaio, Michelle Kim, Shireen Pais, John Poneros, David Robbins, Felice Schnoll-Sussman, Amrita Sethi, Jonathan M Buscaglia
BACKGROUND & AIMS: Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the GI tract. Fine needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. METHODS: This is a multicenter, prospective randomized clinical trial from six large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion...
June 14, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28621294/endoscopic-ultrasound-with-tissue-sampling-is-accurate-in-the-diagnosis-and-subclassification-of-gastrointestinal-spindle-cell-neoplasms
#13
Dalbir Singh Sandhu, Adrian N Holm, Rami El-Abiad, Carolyn Rysgaard, Chris Jensen, Henning Gerke
BACKGROUND AND OBJECTIVES: Mesenchymal (spindle cell) neoplasms (SCN) of the gastrointestinal (GI) tract are an important subtype of subepithelial lesions that need subclassification to assess their malignant potential. Reported success rates of accurate subclassification with endoscopic ultrasound (EUS)-guided biopsies are variable. Our goal was to analyze our experience using EUS-guided TruCut biopsy (EUS-TCB) in the majority of patients. METHODS: Retrospective analysis in patients who underwent EUS with biopsies for suspected SCN at our tertiary referral center between 2004 and 2013...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28621291/role-of-endoscopic-ultrasound-and-endoscopic-ultrasound-guided-fine-needle-aspiration-in-endoscopic-biopsy-negative-gastrointestinal-lesions
#14
Hussein Hassan Okasha, Mohamed Naguib, Mohamed El Nady, Reem Ezzat, Emad Al-Gemeie, Waleed Al-Nabawy, Wael Aref, Ahmed Abdel-Moaty, Karim Essam, Ahmed Hamdy
BACKGROUND AND OBJECTIVES: Many cases of gastrointestinal (GI) tumors as lymphoma, adenocarcinoma, and most of submucosal tumors (SMT) such as gastrointestinal stromal tumor (GIST) and leiomyoma are difficult to diagnose as they frequently yield negative endoscopic biopsies. We evaluated the accuracy of endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of endoscopic biopsy negative GI tumors. PATIENTS AND METHODS: One hundred and nine patients with biopsy negative GI tumors were included in this prospective study...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28615369/clinical-development-of-pd-1-pd-l1-immunotherapy-for-gastrointestinal-cancers-facts-and-hopes
#15
Ian Chau
Gastrointestinal (GI) cancers are among the most deadly malignancies. Whereas serial incremental survival benefits have been made with cytotoxic chemotherapy with metastatic disease, a plateau of achievement has been reached. Applying modern integrative genomic technology, distinct molecular subgroups have been identified in GI cancers. This not only highlighted the heterogeneity in tumours of each primary anatomical site, it also identified novel therapeutic targets in distinct molecular subgroups and might improve the yield of clinical success...
June 14, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28611935/gastrointestinal-amyloidosis-review-of-the-literature
#16
REVIEW
Kyle Rowe, Jon Pankow, Fredy Nehme, William Salyers
Gastrointestinal amyloidosis (GIA), a protein deposition disorder, represents a complex common pathway that encompasses multiple etiologies and presentations. It represents a significant diagnostic and treatment challenge. The disease results from the deposition of insoluble extracellular protein fragments that have been rendered resistant to digestion. GIA can be acquired or genetic, and most commonly results from chronic inflammatory disorders (AA amyloidosis), hematologic malignancy (AL amyloidosis), and end-stage renal disease (Beta-2 amyloidosis)...
May 8, 2017: Curēus
https://www.readbyqxmd.com/read/28611823/genetic-variability-as-a-regulator-of-tlr4-and-nod-signaling-in-response-to-bacterial-driven-dna-damage-response-ddr-and-inflammation-focus-on-the-gastrointestinal-gi-tract
#17
REVIEW
Evagelia Spanou, Polyxeni Kalisperati, Ioannis S Pateras, Alexandros Papalampros, Alexandra Barbouti, Athanasios G Tzioufas, Athanassios Kotsinas, Stavros Sougioultzis
The fundamental role of human Toll-like receptors (TLRs) and NOD-like receptors (NLRs), the two most studied pathogen recognition receptors (PRRs), is the protection against pathogens and excessive tissue injury. Recent evidence supports the association between TLR/NLR gene mutations and susceptibility to inflammatory, autoimmune, and malignant diseases. PRRs also interfere with several cellular processes, such as cell growth, apoptosis, cell proliferation, differentiation, autophagy, angiogenesis, cell motility and migration, and DNA repair mechanisms...
2017: Frontiers in Genetics
https://www.readbyqxmd.com/read/28608155/pathophysiology-of-gastric-nets-role-of-gastrin-and-menin
#18
REVIEW
Sinju Sundaresan, Anthony J Kang, Juanita L Merchant
PURPOSE OF REVIEW: Neuroendocrine tumors (NETs) were initially identified as a separate entity in the early 1900s as a unique malignancy that secretes bioactive amines. GI-NETs are the most frequent type and represent a unique subset of NETs, because at least 75% of these tumors represent gastrin stimulation of the enterochromaffin-like cell located in the body of the stomach. The purpose of this review is to understand the specific role of gastrin in the generation of Gastric NETs (G-NETs)...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28594718/risk-of-ovarian-involvement-in-advanced-colorectal-or-appendiceal-tumors-involving-the-peritoneum
#19
Akash M Mehta, Mark B Bignell, Sue Alves, Sanjeev P Dayal, Faheez Mohamed, Tom D Cecil, Brendan J Moran
BACKGROUND: Ovarian metastases of GI tumors grow rapidly and are relatively resistant to systemic chemotherapy. They may be unilateral or bilateral and macroscopic or occult. The risk of macroscopic ovarian involvement or occult involvement of macroscopically normal ovaries is unquantified. OBJECTIVE: This study aims to quantify the risks of ovarian involvement in patients with peritoneal malignancy undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28565893/positron-emission-tomography-computer-tomography-in-gastrointestinal-malignancies-current-potential-and-challenges
#20
Sofie Tind, Sys Vestergaard, Ziba A Farahani, Søren Hess
The use of 18F-Fluoro-D-deoxy-glucose -positron emission tomography/computed tomography (FDG-PET/CT) in gastrointestinal (GI)-malignancies may not be as straightforward as in many other cancers, but the potential is clearly there in select clinical settings. The challenges include the relative non-specificity of FDG, the variable degrees of physiologic FDG-uptake, and the heterogeneous FDG-uptake in different cell types within the GI-domain, which all together hamper the use in primary diagnostics. In general, the literature is older, heterogeneous, and based on stand-alone PET, which is now largely considered obsolete...
October 2017: Minerva Chirurgica
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