scholarly journals Recent advances in the management of gastric adenocarcinoma patients

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1365 ◽  
Author(s):  
Kazuto Harada ◽  
Anthony Lopez ◽  
Namita Shanbhag ◽  
Brian Badgwell ◽  
Hideo Baba ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Metastatic Cancer ◽  
Locally Advanced ◽  
Survival Advantage ◽  
Cure Rate ◽  
Postoperative Adjuvant Chemotherapy ◽  
Dismal Prognosis ◽  
Significant Survival ◽  
The Us ◽  
Postoperative Chemoradiation

Gastric adenocarcinoma (GAC) is one of the most aggressive malignancies and has a dismal prognosis. Therefore, multimodality therapies to include surgery, chemotherapy, targeted therapy, immunotherapy, and radiation therapy are needed to provide advantage. For locally advanced GAC (>cT1B), the emerging strategies have included preoperative chemotherapy, postoperative adjuvant chemotherapy, and (occasionally) postoperative chemoradiation in various regions. Several novel therapies have been assessed in clinical trials, but only trastuzumab and ramucirumab (alone and in combination with paclitaxel) have shown overall survival advantage. Pembrolizumab has been approved by the US Food and Drug Administration on the basis of response rate only for patients with microsatellite instability (MSI-H) or if PD-L1 expression is positive (≥1% labeling index in tumor/immune cells in the presence of at least 100 tumor cells in the specimen). Nivolumab has been approved in Japan on the basis of a randomized trial showing significant survival advantage for patients who received nivolumab compared with placebo in the third or later lines of therapy. The cure rate of patients with localized GAC in the West is only about 40% and that for metastatic cancer is very poor (only 2–3%). At this stage, much more target discovery is needed through molecular profiling. Personalized therapy of patients with GAC remains a challenge.

THE RESULTS OF TREATMENT OF STAGE II-III DISTAL GASTRIC ADENOCARCINOMA UNDERWENT SURGERY AND POSTOPERATIVE CHEMORADIATION THERAPY

2018 ◽  
Vol 8 (6) ◽  
pp. 15-22
Author(s):  
Duy Phan Canh ◽  
Vu Pham Anh
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Gastric Adenocarcinoma ◽  
Locally Advanced ◽  
Chemoradiation Therapy ◽  
Stage Ii ◽  
Primary Tumors ◽  
Female Ratio ◽  
The Mean ◽  
Postoperative Chemoradiation

Objectives: To evaluate the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiation therapy in stages II-III of distal gastric cancer. Materials & methods: Prospective study on 58 patients with stages II-III gastric adenocarcinoma, underwent distal gastrectomy and D1 or D2 dissection, completed post operative chemoradiation therapy with capecitabine and 4-6 cycles with EOX regimen at Oncology center of Hue central hospital from 01/2013 to 12/2015. Results: Mean age was 55.16 ± 9.1, male/female ratio: 3/1, recurrence was common in the first year after treatment (62.5%), the average time of recurrence and metastasis were 13.50 ± 7.29 months and 18.75 ± 8.97 months, respectively. The mean overall survival was 41.21 ± 21.06 months. The mean disease free survival was 36.22 ± 22.64 months. The mean overall survival: stage II was 41.88 ± 20.78 months; stage III was 39.59 ± 22.27. The mean overall survival for extention of primary tumors: T3 was 40.79 ± 19.61 months; T4 was 41.33 ± 24.80 months. The mean overall survival for extensive of lymph nodes: N (-) was 41.16 ± 20.51 months, N (+) was 41.26 ± 22.06 months. Toxicity levels recorded as follow: leukopenia was mainly on grade 1 and 2 (33.6%), neutropenia was mostly on grade 1 and 2 (26.8%), as well as thrombocytopenia (8.6%); hemoglobin decrease was on grade 1 and 2 in most cases (41.4%); toxicity symptoms on digestive system like nausea-vomitting, diarrhea was mainly on grade 1 and 2. Conclusion: Postoperative chemoradiation therapy helps to improve local and regional recurrence in locally advanced gastric cancer with acceptable toxicities. Key words: Distal gastric adenocarcinoma, postoperative chemoradiation therapy

scholarly journals Drug Resistance in Osteosarcoma: Emerging Biomarkers, Therapeutic Targets and Treatment Strategies

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2878
Author(s):  
Claudia Maria Hattinger ◽  
Maria Pia Patrizio ◽  
Leonardo Fantoni ◽  
Chiara Casotti ◽  
Chiara Riganti ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Therapeutic Targets ◽  
Treatment Strategies ◽  
Cure Rate ◽  
Acquired Drug Resistance ◽  
Unselected Patient ◽  
Dismal Prognosis ◽  
Non Coding Rnas ◽  
High Grade Osteosarcoma

High-grade osteosarcoma (HGOS), the most common primary malignant tumor of bone, is a highly aggressive neoplasm with a cure rate of approximately 40–50% in unselected patient populations. The major clinical problems opposing the cure of HGOS are the presence of inherent or acquired drug resistance and the development of metastasis. Since the drugs used in first-line chemotherapy protocols for HGOS and clinical outcome have not significantly evolved in the past three decades, there is an urgent need for new therapeutic biomarkers and targeted treatment strategies, which may increase the currently available spectrum of cure modalities. Unresponsive or chemoresistant (refractory) HGOS patients usually encounter a dismal prognosis, mostly because therapeutic options and drugs effective for rescue treatments are scarce. Tailored treatments for different subgroups of HGOS patients stratified according to drug resistance-related biomarkers thus appear as an option that may improve this situation. This review explores drug resistance-related biomarkers, therapeutic targets and new candidate treatment strategies, which have emerged in HGOS. In addition to consolidated biomarkers, specific attention has been paid to the role of non-coding RNAs, tumor-derived extracellular vesicles, and cancer stem cells as contributors to drug resistance in HGOS, in order to highlight new candidate markers and therapeutic targets. The possible use of new non-conventional drugs to overcome the main mechanisms of drug resistance in HGOS are finally discussed.

scholarly journals Carnobacterium inhibens isolated in blood culture of an immunocompromised, metastatic cancer patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carson Ka-Lok Lo ◽  
Prameet M. Sheth
Keyword(s):  
Metastatic Cancer ◽  
Immunocompromised Patients ◽  
Case Presentation ◽  
Gram Positive Bacteria ◽  
Disease Spectrum ◽  
The Us ◽  
History Of ◽  
Amoxicillin Clavulanic Acid ◽  
Live Bacteria ◽  
Health Canada

Abstract Background Carnobacterium species are lactic acid-producing Gram-positive bacteria that have been approved by the US Food and Drug Administration and Health Canada for use as a food bio-preservative. The use of live bacteria as a food additive and its potential risk of infections in immunocompromised patients are not well understood. Case presentation An 81-year-old male with a history of metastatic prostate cancer on androgen deprivation therapy and chronic steroids presented to our hospital with a 2-week history of productive cough, dyspnea, altered mentation, and fever. Extensive computed tomography imaging revealed multifocal pneumonia without other foci of infection. He was diagnosed with pneumonia and empirically treated with ceftriaxone and vancomycin. Blood cultures from admission later returned positive for Carnobacterium inhibens. He achieved clinical recovery with step-down to oral amoxicillin/clavulanic acid for a total 7-day course of antibiotics. Conclusions This is the fourth reported case of bacteremia with Carnobacterium spp. isolated from humans. This case highlights the need to better understand the pathogenicity and disease spectrum of bacteria used in the food industry for bio-preservation, especially in immunocompromised patients.

scholarly journals Distal Humerus as Delayed Site of Metastasis from Small Cell Carcinoma of Gallbladder

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mutahir A. Tunio ◽  
Mushabbab AlAsiri ◽  
Asma Mohammed F. Ali ◽  
Eyad Fawzi AlSaeed ◽  
Muhammad Shuja ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
World Literature ◽  
Case Reports ◽  
Locally Advanced ◽  
Distal Humerus ◽  
Small Cell ◽  
Rare Entity ◽  
Dismal Prognosis ◽  
Advanced Stages

Background. Small cell carcinoma (SCC) of the gallbladder is a rare entity and is often seen in elderly women. SCC of gallbladder is typically a nonsecretory carcinoid tumor without overt clinical symptoms and is often discovered at advanced stages. SCC of gallbladder carries a dismal prognosis as compared to SCC of lung and adenocarcinoma of gallbladder. To date, only 73 case reports have been published in the world literature.Case Presentation. Herein, we report a case of a 73-year-old Saudi woman who presented with one week history of right upper quadrant abdominal pain and obstructive jaundice and was found to be a case of locally advanced, metastatic SCC of gallbladder cT4N1M1 (liver, para-aortic lymph nodes, and bone). The patient was treated with neoadjuvant etoposide and cisplatin (EP) chemotherapy three cycles after biliary stenting followed by radical cholecystectomy, lymphadenectomy, and adjuvant EP chemotherapy and then one year later developed distal humerus osseous metastasis.Conclusion. SCC of the gallbladder is very rare entity and is often seen at advanced stages. Osseous metastases of peripheral skeleton from SCC gallbladder are rarely reported. Surgery is curative option but only for early stage tumors. Incorporation of chemotherapy along with radical resection increases the survival.

An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer

2005 ◽  
Vol 24 (5) ◽  
pp. 801-814 ◽  
Author(s):  
Angel Segura ◽  
Josep Pardo ◽  
Carlos Jara ◽  
Luis Zugazabeitia ◽  
Joan Carulla ◽  
...  
Keyword(s):  
Metastatic Cancer ◽  
Locally Advanced ◽  
Epidemiological Evaluation

Liver Toxicity with Cancer Checkpoint Inhibitor Therapy

2018 ◽  
Vol 38 (04) ◽  
pp. 366-378 ◽  
Author(s):  
Brian Nadeau ◽  
Leslie Fecher ◽  
Scott Owens ◽  
Nataliya Razumilava
Keyword(s):  
Liver Toxicity ◽  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Immunosuppressive Agents ◽  
Inhibitor Therapy ◽  
Significant Survival ◽  
The Us ◽  
Checkpoint Inhibitor Therapy ◽  
Clinically Significant

AbstractImmune checkpoint inhibition targeted against cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1) has shown clinically significant survival benefit when used to treat multiple types of advanced cancer. These drugs have gained approval by the US Food and Drug Administration and their indications continue to increase. Checkpoint inhibitor therapy is associated with a unique side-effect profile characterized as immune-related adverse events (irAEs), which can result in significant morbidity and rarely mortality. Hepatotoxicity from checkpoint inhibitors is a less common irAE and often mild, while its incidence and severity vary based on the class and dose of checkpoint inhibitor, monotherapy versus combination therapy, and the type of cancer. Histological assessment of suspected irAEs is nonspecific and can show a variety of features. Hepatic irAEs can require discontinuation of checkpoint inhibitor therapy and treatment with immunosuppressive agents.

scholarly journals Nosocomial infections in the Intensive care unit: global problem of modern medicine

2018 ◽  
Vol 1 (2) ◽  
pp. 5-19
Author(s):  
Zara Vezirova
Keyword(s):  
Nosocomial Infections ◽  
Metastatic Cancer ◽  
Intensive Therapy ◽  
Treatment Modalities ◽  
Critical Conditions ◽  
Special Treatment ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
The Us ◽  
Hospital Acquired

Increased volume of surgical interventions, improvement of efficiency of special treatment modalities and modes of respiratory support, as well as development of new generation antibiotic medications has led to significant improvement of clinical outcomes of intensive therapy for critical conditions. At the same time, introduction of innovative and largely invasive interventions resulted in the emergence of new disease entities. Presently, the development of hospital-acquired infections (HAI) has become one of the riveting and serious problems of modern hospitals. These infections often lead to prolonged hospital stay, which in turn adds to the morbidity and mortality, worsen patient quality of life and also has significant economic consequences [1-5]. There are number of varying definitions of infections related to medical care [6]. According to the WHO, infections that develop 48 hours after hospitalization, excluding the incubation period, are called hospital-acquired or nosocomial infections. Some authors also include here infections that develop 4 weeks after patient’s discharge from hospital or 30 days after surgical interventions are also included in this category. Infections that develop within 30 days after last chemotherapy in patients with metastatic cancer are also included as additional criteria according to a medical literature [7]. Other authors conclude that readmission of patients with established infection that was the result of previous hospitalization as well as any infectious diseases of hospital employee that develops secondary to the work in the hospital, irrespective to the time of onset of symptoms (during or after the hospital visit or stay) shall also be regarded as the hospital-acquired infections (HAI) [8-10]. The average prevalence of HAI is around 3.5-10.5% or 9.0-91.7 cases per 1000 patient-days [11]. It is estimated that the probability of infectious complications increases after five days of hospitalization [12]. According to the modern medical knowledge, the prevalence of HAI of various causes among the hospitalized patients in North America and Europe is around 5-10% and those in Latin America and Asia is around 40% [13,14]. The mortality among patients with HAI is seven times higher than among other patients aligned based on age, sex, main disease and comorbidities and severity of disease. According to the official statistics, HAIs are fourth most common cause of mortality in the US leading to 90.000 deaths annually. Annual economic burden and additional costs associated with the treatment of HAIs in the US is about 2.4-4.5 billion US dollars [15-17].

scholarly journals IMMUNOHISTOCHEMICAL EXPRESSION OF HER2 IN ADENOCARCINOMA OF THE STOMACH

2015 ◽  
Vol 52 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Diego Michelon DE CARLI ◽  
Marta Pires da ROCHA ◽  
Luis Carlos Moreira ANTUNES ◽  
Renato Borges FAGUNDES
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Immunohistochemical Analysis ◽  
Anatomical Site ◽  
Her2 Expression ◽  
Immunohistochemical Expression ◽  
Her2 Gene ◽  
Cross Sectional ◽  
Dismal Prognosis ◽  
Location Methods

Background Worldwide, gastric cancer is the fourth cancer in incidence and the second most common cause of cancer death. Gastric cancer is asymptomatic in the early stages and very often diagnosed at advanced stages, determining a dismal prognosis. Expression of the HER2 gene has been identified in about 20% of gastric cancer cases, and its hyper-expression is associated with poor prognosis. Objective To investigate HER2 immunohistochemical expression in gastric adenocarcinoma and its relationship to the histological type and anatomic location. Methods A cross-sectional retrospective study analyzed the immunohistochemical expression of HER2 in a sample of 48 specimens of gastric cancer. Immunohistochemical analysis were performed using avidin-biotin-peroxidase method with C-erb B2 (clone EP1045Y), as a primary antibody (Biocare Medical, USA). Standardized gastric adenocarcinoma‘s HER2 expression criteria has been used in the analysis of samples. Results There were seven cases with reactivity for HER2. Five were of intestinal-type while two cases were of mixed-type in which the expression occurred in the intestinal component. It was identified a significant association of HER2 expression in the intestinal subtype of gastric adenocarcinoma (P=0.003). Regarding the anatomical site, HER2 was positive in only one (16.6%) of the six proximal cases and six (14.28%) of the 42 distal cases (P=0.88). Conclusion HER2 immunoexpression was identified in 14.6% of the samples, and the expression was significantly associated to Lauren’s intestinal subtype.

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