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Gastric/Stomach Cancer

Relevant Articles About Gastric/Stomach Cancer Research and Clinical Trials

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Targeted Therapy Directed by Genetic Testing in Treating Patients With Advanced Refractory Solid Tumors, Lymphomas, or Multiple Myeloma (The MATCH Screening Trial)

Targeted Therapy Directed by Genetic Testing in Treating Patients With Advanced Refractory Solid Tumors, Lymphomas, or Multiple Myeloma (The MATCH Screening Trial)

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Impact of PORT on Outcomes in Advanced TESCC

KEY TAKEAWAYS

  • The study aimed to investigate the long-term outcomes of locally advanced TESCC with and without postoperative radiotherapy.
  • Researchers noticed that postoperative radiotherapy improves survival and reduces recurrence in patients with advanced T3-4 TESCC without neoadjuvant treatment.

Ya Zeng and the team aimed to define the long-term outcomes and recurrence patterns of patients with locally advanced thoracic esophageal squamous cell carcinoma (TESCC) treated with or without postoperative radiotherapy (PORT).

They performed an inclusive analysis of a retrospective cohort from 2 academic centers, encompassing patients who initially underwent esophagectomy and were pathologically staged T3-4. Survival outcomes were constructed using the Kaplan-Meier method, and survival significance was evaluated using the log-rank test. Propensity score matching (PSM) was utilized to balance potential selection bias among patients.

About 506 patients were analyzed, with 251 undergoing surgery alone and 255 receiving radiotherapy following radical surgery. With a median follow-up of 49.1 months, PORT significantly improved 5-year overall survival (53.8% vs. 25.3%; P < 0.001) and 5-year disease-free survival rates (45.3% vs. 8.5%; P < 0.001) compared to surgery alone.

These differences in survival outcomes persisted even after PSM (P < 0.001 for both). Treatment failure was significantly less frequent in the PORT group (46.7%) compared to the surgery-only group (90.0%; P < 0.001), with corresponding reductions in locoregional recurrence (9.4% vs. 54.1%; P < 0.001). This underscores the significant association between PORT and disease control.

The study concluded that the absence of neoadjuvant chemoradiotherapy emphasizes the critical role of postoperative radiotherapy in enhancing survival and minimizing recurrence in advanced T3-4 patients with TESCC, underscoring its significance as a salvage treatment for those without prior neoadjuvant therapy.

This study was funded by the Emerging advanced technology joint research project of Shanghai Shenkang Hospital Development Center (SHDC12017103) and Shanghai Science and Technology Fund (21Y11913000).

Source: https://pubmed.ncbi.nlm.nih.gov/39334405/

Zeng Y, Su X, Zhou T, et al. (2024). “Propensity-matched study on locally advanced esophageal cancer: surgery versus post-operative radiotherapy.” Radiat Oncol. 2024;19(1):130. Published 2024 Sep 27. doi:10.1186/s13014-024-02528-0

Inhibition of NF-κB/HIF-1α Pathway by Tyrosol in CRC

KEY TAKEAWAYS

  • The study aimed to investigate the role of IVIM and DCE perfusion imaging in predicting treatment response in patients with CRC.
  • Researchers noted that IVIM and DCE imaging are promising for predicting treatment response in patients with CRC after Neo-CRT.

A complex malignancy that necessitates multimodal treatment strategies is Colorectal cancer (CRC), including neoadjuvant chemoradiation therapy (Neo-CRT), to enhance patient outcomes. However, individual responses to Neo-CRT can vary significantly, highlighting the need for reliable predictors of treatment response.

Hayder Jasim Taher and the team aimed to investigate the role of intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) perfusion in predicting treatment response in patients with CRC following Neo-CRT.

They performed an inclusive analysis on patients diagnosed with locally advanced CRC who received Neo-CRT. IVIM and DCE perfusion imaging were conducted before and after CRT.

Quantitative parameters, including perfusion fraction (f), diffusion coefficient (D), and transfer constant (Ktrans), were calculated from the imaging data. Treatment response was evaluated based on the pathological response following surgery. Statistical analyses were conducted using SPSS v. 26, employing the t-test and chi-square method.

About 51 patients (female: male = 22:29, mean age = 58.14±3.49) participated in the study. Among all the patients, 15 (29.4%) had good responses, while 36 (70.58%) did not respond to treatment. All DCE parameters demonstrated higher sensitivity and specificity than IVIM D*. Ve, Kep, and DCE Ktrans showed significant predictive power for treatment response, with Ktrans being the most accurate parameter for predicting response to treatment.

The overall sensitivity and specificity of DCE were 88.8% [95% CI: 80-95.6] and 80% [95% CI: 65-90], respectively, while those of IVIM were 65.5% and 81%, respectively. Sensitivity and specificity for the combination of DCE + IVIM were 79.5% and 93.5%, and for DCE + IVIM + standard magnetic resonance imaging, they were 80.2% and 86%, respectively.

The study concluded that IVIM and DCE perfusion imaging are promising tools for predicting treatment response in colorectal cancer patients following Neo-CRT.

The study was funded by the Interdisciplinary Integration and Innovation Project of JLU (JLUXKJC2021ZY08) and Jilin Provincial Healthcare Talent Special Program (JLSWSRCZX2023).

Source: https://pubmed.ncbi.nlm.nih.gov/39342580/

Taher HJ, Arian A, Aghili M, et al .(2024). “Role of Intravoxel Incoherent Motion and Dynamic-Contrast-Enhanced Perfusion in Response Prediction of Patients with Colorectal Cancer after Neoadjuvant Chemotherapy.” Asian Pac J Cancer Prev. 2024;25(9):3029-3037. Published 2024 Sep 1. doi:10.31557/APJCP.2024.25.9.3029

Optimizing HCC Prognostic Precision with PWR ALBI and PALBI

KEY TAKEAWAYS

  • The study aimed to investigate integrating PWR with ALBI and PALBI scores to enhance prognostic precision in patients with HCC.
  • Researchers noticed that integrating PWR with PALBI significantly improves prognostic accuracy for early-stage HCC.

Enhancing prognostic evaluation in Hepatocellular Carcinoma (HCC) remains an unmet need, particularly in patients with preserved live r function.

Maha Elsabaawy and the team aimed to integrate the Platelet-to-White Blood Cell Ratio (PWR) with albumin-bilirubin (ALBI) and platelets-albumin-bilirubin (PALBI) scores to improve the assessment of mortality and treatment responses in patients with HCC.

They performed an inclusive analysis involving 262 patients with HCC, collecting basic data and following up for 1 year or until death. All prognostic scores were calculated by integrating the Platelet-to-White Blood Cell Ratio (PWR) with the ALBI and PALBI scores, examining their relationship with treatment responses and mortality rates in the patients.

About 69.5% of the patients were males, with a mean age of 59.6 ± 8.09 years. The predictive power of the integrated PALBI+PWR score at different time points—1 month (P 0.004), 3 months, and 6 months (P 0.004)—outperformed all other scores.

However, at the 12-month follow-up, the ALBI score demonstrated superiority over PALBI+PWR (AUC 0.631, 0.617). Regression analyses confirmed the strong performance of PALBI+PWR factors in influencing treatment response (P 0.009; OR 0.562 (0.365 – 0.867)). In terms of mortality prediction, PALBI+PWR exhibited the highest efficacy in regression analysis (P < 0.001; OR 2.451 (1.555 – 3.862)).

The study concluded that integrating PWR with the PALBI score significantly enhances prognostic precision in patients with HCC, providing improved predictive power for treatment responses and mortality in the early stages of HCC with preserved liver function.

No funding information was given for this source.

Source: https://pubmed.ncbi.nlm.nih.gov/39342584/

Elsabaawy M, Badran H, Ragab A, et al. (2024). “Optimizing Prognostic Precision in Hepatocellular Carcinoma: Integrating PWR with ALBI and PALPI Scores.” Asian Pac J Cancer Prev. 2024;25(9):3067-3072. Published 2024 Sep 1. doi:10.31557/APJCP.2024.25.9.3067

PCGF2 Drives Colon Cancer via CENPE Upregulation

PCGF2 Drives Colon Cancer via CENPE Upregulation

KEY TAKEAWAYS

  • The study aimed to explore PCGF2’s role in colon cancer and its connection to CENPE.
  • The results showed that PCGF2 promotes colon cancer progression by upregulating CENPE.

Colon cancer is a common malignancy that significantly contributes to global health burdens. Researchers have linked polycomb group ring finger 2 (PCGF2) to poor outcomes in people with colon cancer. Centromere-associated protein E (CENPE) is also known to promote tumor growth and worsen survival rates in patients.

Qingwei Luo and their team aimed to clarify the role of PCGF2 in colon cancer and its relationship with CENPE.

The study involved normal human colon epithelial cells and colon cancer cells to assess the differences in PCGF2 and CENPE expression. The researchers used LOVO cells to manipulate PCGF2 levels and conducted cell viability, proliferation, and apoptosis assays. They also used transwell assays to measure cell migration and invasion. Gene expression linked to the cell cycle was evaluated to understand its activation, and in vivo experiments were performed using mice with altered PCGF2 levels. Additionally, GSK-923295 was applied to inhibit CENPE, followed by analysis of cell behavior.

The results demonstrated that both PCGF2 and CENPE were significantly upregulated in colon cancer cells (P< 0.001). Manipulation of PCGF2 levels directly affected CENPE expression, leading to changes in cell viability, proliferation, migration, invasion, and apoptosis in LOVO cells (P< 0.001). PCGF2 knockdown slowed tumor progression in mice (P< 0.001). Furthermore, inhibiting CENPE reversed PCGF2-driven effects on cell behavior, reducing viability, proliferation, and cell cycle activity while increasing apoptosis (P< 0.001).

The study concluded that PCGF2 drives colon cancer progression by upregulating CENPE, suggesting both as potential therapeutic targets.

No funding information was given.

Source: https://pubmed.ncbi.nlm.nih.gov/39327243/

Luo Q, Chen X, Tang J, et al. (2024). “PCGF2 Acts as an Oncogenic Driver in Colon Cancer through the Upregulation of CENPE.” Discov Med. 2024;36(188):1800-1810. doi:10.24976/Discov.Med.202436188.166

Prognostic Impact of Bone vs LM in mEAC

KEY TAKEAWAYS

  • The study aimed to investigate the prognostic differences between single BM and single LM in patients with mEAC.
  • Researchers noted that BM in mEAC leads to worse prognosis than LM, underscoring the value of surgical and chemotherapy interventions.

Half of the patients diagnosed with esophageal cancer present with metastasis at the time of initial diagnosis. However, there is limited research focused on the prognostic factors associated with metastatic esophageal adenocarcinoma (mEAC).

Xinglian Zhu and the team aimed to examine the impact of single bone metastasis (BM) and single liver metastasis (LM) on the prognosis of patients with mEAC.

They performed an inclusive analysis using data obtained from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program database. Patients with mEAC were evaluated to compare the effects of LM and BM on overall survival (OS), EAC-specific survival (CSS), and esophageal adenocarcinoma-specific death (EASD). This was accomplished through multivariate Cox regression, Kaplan-Meier analysis, and competing risk regression models.

About 1,278 patients with EAC were included in this study. Of these, 78.95% (1009/1278) experienced EASD, while 12.68% (162/1278) had non-EAC-specific death (non-EASD). In the multivariate Cox regression analysis, surgery, chemotherapy, and AJCC stage T2 (vs. T1) were identified as protective factors for OS and EAC-specific survival (CSS).

Conversely, being divorced or separated, single or unmarried (vs. married), having grade III-IV tumors (vs. grade I-II), and BM (vs. LM) were recognized as risk factors. Competing risk regression analysis further confirmed that surgery and chemotherapy provided benefits for patients with metastatic EAC, while BM (vs.LM) remained a significant risk factor when accounting for competitive risk events.

The study concluded that patients with mEAC who have BM experience a worse prognosis compared to those with LM. Additionally, it was found that surgical intervention and chemotherapy serve as protective factors for patients with mEAC. These findings provide crucial evidence-based insights for clinical management and contribute significantly to the field.

The study was funded by the National Key Research and Development Program of China.

Source: https://pubmed.ncbi.nlm.nih.gov/39321194/

Zhu X, Mo M, Zheng S, et al. (2024). “Comparing the prognosis of esophageal adenocarcinoma with bone and liver metastases: A competing risk analysis.” PLoS One. 2024;19(9):e0303842. Published 2024 Sep 25. doi:10.1371/journal.pone.0303842

Enhancing CRC Screening With Digital Tools for FQHC

KEY TAKEAWAYS

  • The study aimed to assess the usability and acceptability of a digital tool to boost colorectal cancer screening at FQHCs.
  • Researchers noticed that adapting the eNav tool based on user feedback improved its accessibility and usability for diverse FQHC patients.

Federally Qualified Health Centers (FQHCs) serve as critical healthcare access points for historically underserved populations, including providing screening for colorectal cancer (CRC), which remains one of the leading causes of cancer-related deaths in the United States.

Given the importance of increasing CRC screening rates among FQHC patients, Leah C. Savage and the team focused on developing and testing a digital patient navigation tool, eNav, designed to help patients better prepare for, request, and complete CRC screening tests.

They performed an inclusive analysis by recruiting 20 English- and Spanish-speaking patients at a Federally Qualified Health Center (FQHC) in New York City to user-test the eNav website. The study was conducted in 2 rounds, with 10 participants per user test. In each session, patients participated in a “think aloud” exercise and a qualitative interview to gather their feedback on the website. Baseline questionnaires were administered to collect demographic information, technology and internet use, medical history, and health literacy.

Additionally, patients completed surveys to assess the website’s acceptability and usability. Based on feedback from the first user test, researchers modified the eNav website before conducting a second round of testing. The final modifications were made after reviewing participant feedback from the second test, leading to the finalized version of the eNav website.

The survey results indicated strong overall usability and acceptability of the eNav website. The average System Usability Scale (SUS) score from the first user test was 75.25, and for the second test, it was 75.28. The average Acceptability E-scale score was 28.3 for the first test and 29.2 for the second, both meeting suggested benchmarks for usability and acceptability.

During the qualitative “think aloud” exercises in both user tests, many participants found the website to be motivating, interesting, informative, and user-friendly. Participants also provided valuable suggestions to improve the content, usability, accessibility, and overall appeal of the website. However, some participants faced challenges due to a lack of digital devices or internet access at home, limiting their ability to engage fully with the eNav website.

The study concluded that based on participant feedback and identified limitations in digital access, modifications were made to enhance the content and design of the eNav website. Alternative methods of engagement were developed to increase the tool’s usability, accessibility, and effectiveness for patients with diverse needs, particularly those with limited access to digital devices or the internet at home. Future plans include testing the eNav intervention in a randomized controlled trial to assess its efficacy in improving colorectal cancer screening rates among FQHC patients.

The study was funded by the National Cancer Institute of the National Institutes of Health under award (R01CA248981).

Source: https://pubmed.ncbi.nlm.nih.gov/39321451/

Savage LC, Soto-Cossio LE, Minardi F, et al. (2024). “The Development of a Digital Patient Navigation Tool to Increase Colorectal Cancer Screening Among Federally Qualified Health Center Patients: Acceptability and Usability Testing.” JMIR Form Res. 2024;8:e53224. Published 2024 Sep 25. doi:10.2196/53224

NIVO+IPI Shows OS Benefit vs LEN/SOR in 1L uHCC Treatment

KEY TAKEAWAYS

  • The CheckMate 9DW phase 3 trial aimed to investigate the OS benefit and safety profile of 1L NIVO + IPI compared to LEN/SOR in patients with uHCC.
  • The primary endpoint was to determine OS.
  • Researchers observed a significant OS benefit with NIVO + IPI, supporting its use as a 1L treatment for uHCC.

In the phase 3 CheckMate 9DW study, first-line (1L) nivolumab (NIVO) plus ipilimumab (IPI) demonstrated a statistically significant and clinically meaningful overall survival (OS) advantage compared to lenvatinib (LEN) or sorafenib (SOR) in patients with unresectable hepatocellular carcinoma (uHCC) (NCT04039607). This abstract presents additional exploratory analyses based on the preplanned interim results of the study.

Thomas Decaens and the team aimed to assess the efficacy, safety, and response durability of NIVO + IPI versus LEN/SOR as a 1L treatment option in previously untreated patients with uHCC.

They performed an inclusive analysis in patients with previously untreated hepatocellular carcinoma (HCC) who were not eligible for curative surgical or locoregional therapies. Eligible patients had a Child-Pugh score of 5 or 6 and an ECOG performance status of 0 or 1.

Participants were randomized in a 1:1 ratio to receive either NIVO 1 mg/kg combined with IPI 3 mg/kg every 3 weeks (up to 4 cycles, followed by NIVO 480 mg every 4 weeks) or LEN 8 mg or 12 mg daily, or SOR 400 mg twice daily, continuing until disease progression or unacceptable toxicity. NIVO treatment was limited to a maximum duration of 2 years.

The primary endpoint was OS, while secondary endpoints included objective response rate (ORR) and duration of response (DOR) as evaluated by blinded independent central review (BICR) using RECIST v1.1 criteria.

About 668 patients were randomized to receive either NIVO + IPI (n = 335) or LEN/SOR (n = 333). With a median follow-up of 35.2 months (range 26.8–48.9 months), the median OS was 23.7 months (95% CI 18.8–29.4) for patients treated with NIVO + IPI, compared to 20.6 months (95% CI 17.5–22.5) for those receiving LEN/SOR (HR 0.79; 95% CI 0.65–0.96; P = 0.0180). The 24-month OS rates were 49% (95% CI 44–55) with NIVO + IPI and 39% (95% CI 34–45) with LEN/SOR. The OS benefit was generally consistent across patient subgroups.

The ORR was significantly higher with NIVO + IPI compared to LEN/SOR (36% [95% CI 31–42] vs 13% [95% CI 10–17]; P < 0.0001), with a higher complete response rate observed in the NIVO + IPI group (7% vs 2%) and more durable responses (median DOR: 30.4 months [95% CI 21.2–not estimable] vs 12.9 months [95% CI 10.2–31.2] with LEN/SOR).

Any-grade treatment-related adverse events (TRAEs) were reported in 84% of patients treated with NIVO + IPI compared to 91% of those receiving LEN/SOR, with grade 3–4 TRAEs occurring in 41% and 42% of patients, respectively. Additional exploratory efficacy and safety analyses will be presented.

The study concluded that in patients with previously untreated uHCC, NIVO + IPI demonstrated a statistically significant OS benefit compared to LEN/SOR. This was accompanied by higher ORR, durable responses, and manageable safety profiles. These findings reinforce NIVO + IPI as a promising 1L treatment option for uHCC.

The trial was sponsored by the Bristol-Myers Squibb.

Source: https://cslide.ctimeetingtech.com/esmo2024/attendee/confcal/show/session/234

Clinical Trial: https://clinicaltrials.gov/study/NCT04039607

Decaens T, Yau T, Kudo M, et al. (2024). “Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line (1L) treatment for unresectable hepatocellular carcinoma (uHCC): Expanded analyses from CheckMate 9DW.” Presented at ESMO 2024 (Abstract 965MO).

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