Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Published: July 2024
AI Article Synopsis
Article Abstract
Background/aim: Irinotecan monotherapy was the most widely used third-line chemotherapy for unresectable advanced or recurrent gastric cancer in Japan until the approval of nivolumab in September 2017 and trifluridine/tipiracil in August 2019. The benefit of continuing ramucirumab with irinotecan, an anti-VEGFR-2 monoclonal antibody, after the failure of paclitaxel plus ramucirumab (PTX+RAM) as second-line chemotherapy, has been under debate.
Patients And Methods: A single-center phase II study was conducted in patients with unresectable advanced or recurrent gastric cancer previously treated with fluoropyrimidines and platinum, who received PTX+RAM as second-line therapy and irinotecan plus ramucirumab (IRI+RAM) as third-line therapy after treatment failure (UMIN000022956).
Results: Eleven patients were enrolled from July 2016 to July 2018. Enrolment was discontinued due to difficulties in case ascertainment because of expanded third-line treatment options (originally planned for 53 patients). The median progression-free survival (the primary endpoint) of the IRI+RAM was 3.98 months [95% confidence interval (CI)=1.78-NA]. Among secondary endpoints, the transition rate to IRI+RAM was 45%, the rate of 8-week treatment continuation for IRI+RAM was 100%, the response rate for IRI+RAM was 0%, the median overall survival (OS) for PTX+RAM was 13.53 months (95%CI=1.61-24.36), and the median OS for IRI+RAM was 9.99 months (95CI=4.5-NA).
Conclusion: The transition rate from PTX+RAM to IRI+RAM was reasonable. Ramucirumab beyond progressive disease may be beneficial for patients who are able to transition to IRI+RAM.
Background: Single-slice computed tomography (CT) body composition has been studied extensively for prognostication in patients with cancer. New software packages can also provide multi-slice volumetric measurements, but the clinical utility of these remains under explored. This study aimed to evaluate the agreement between single- and multi-slice body composition analyses in patients with oesophagogastric cancer and to explore the association between these measures and overall survival.
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; General and Oncologic Surgery, Department of Surgery, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy.
Gastric cancer is a significant health concern worldwide, and its diagnosis and management are of paramount importance. Ectopic pancreas (EP) refers to an embryological abnormality where healthy pancreatic tissue develops without anatomical, vascular, or neural communication with the normal pancreas. We report the case of a patient whose initial endoscopic evaluation suggested early gastric cancer, but computed tomography scan (CT scan) and endoscopic ultrasound (EUS) indicated a locally advanced tumor.
Aim: Patients with gastric malignant tumors usually undergo surgical treatment when indicated. Surgical intervention causes significant trauma and can lead to considerable stress responses in patients. These patients experience increased malnutrition along with reduced immune function, which ultimately leads to the occurrence of postoperative complications.
Gastric mixed adenoneuroendocrine carcinoma (MANEC) is a rare and highly aggressive malignancy characterized by both exocrine and neuroendocrine components. Treatment options for metastatic cases are limited, with typical therapeutic approaches involving a combination of chemotherapy and immunotherapy. A 68-year-old male with metastatic gastric MANEC was treated with targeted therapy, immunotherapy, and chemotherapy, including S-1, apatinib, cadonilimab, and paclitaxel.
