Urinary Bladder Metastasis from Gastric Cancer: A Case Report and Review of the Literature

Bladder metastasis from gastric cancer is a unique clinical entity, which can be revealed infrequently in patients with metastatic gastric cancer. Secondary neoplasms to the bladder are also a less frequent clinical entity representing only 15% of all bladder neoplasms. Gastric cancers consist of an exceptionally small percentage of all secondary bladder neoplasms. Until now only 27 cases were recorded in the international medical literature. The current work analyzes a 65-year old male patient who presented initially with a locally advanced gastric adenocarcinoma. He was treated with a combination of total gastrectomy and perioperative chemotherapy. Eight months later presented a relapse with bladder metastasis, liver metastasis and peritoneal involvement. Furthermore, in this manuscript, we conducted a review of the recorded cases with bladder metastasis from gastric cancer. In the most of cases the diagnosis of bladder metastasis was metachronous with an average time of presentation in four years after the primary diagnosis of gastric cancer and most of the patients of our review presented with urinary symptoms at the time of diagnosis of bladder metastasis. Concerning the management of the metastatic disease surgical management with total or partial cystectomy was performed in 11% of patients and TUR was performed in 22% of patients. Palliative chemotherapy for the management of metastatic disease was initiated in 46% of patients.

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PCN94 Cost-Effectiveness of Trifluridine/Tipiracil (FTD/TPI) As a Third-LINE Treatment of Metastatic Gastric Cancer, Including Adenocarcinoma of the Gastroesophageal Junction, Among Patients WHO Have Received at Least Two PRIOR Therapies for Metastatic Disease in Greece

Value in Health ◽

10.1016/j.jval.2020.08.231 ◽

2020 ◽

Vol 23 ◽

pp. S439

Author(s):

G. Gourzoulidis ◽

M. Koulentaki ◽

A. Koumarianou ◽

E. Samantas ◽

N. Androulakis ◽

...

Keyword(s):

Gastric Cancer ◽

Cost Effectiveness ◽

Metastatic Disease ◽

Gastroesophageal Junction ◽

Metastatic Gastric Cancer ◽

Line Treatment ◽

Third Line ◽

Third Line Treatment

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A phase Ib/II, multicenter, open-label, dose-escalation, and dose-expansion study evaluating trastuzumab deruxtecan (T-DXd, DS-8201) monotherapy and combinations in patients with HER2-overexpressing gastric cancer (DESTINY-Gastric03).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.tps261 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. TPS261-TPS261

Author(s):

Yelena Y. Janjigian ◽

Natasha Viglianti ◽

Feng Liu ◽

Ariadna Mendoza-Naranjo ◽

Liz Croydon

Keyword(s):

Gastric Cancer ◽

Dose Escalation ◽

Topoisomerase I ◽

Gastroesophageal Junction ◽

Objective Response ◽

Locally Advanced ◽

Metastatic Gastric Cancer ◽

Her2 Status ◽

Open Label ◽

Phase 1B

TPS261 Background: For patients (pts) with HER2-overexpressing metastatic gastric cancer, trastuzumab + chemotherapy is a standard first-line option but provides only a modest overall survival (OS) benefit vs chemotherapy. T-DXd is an antibody-drug conjugate consisting of an anti-HER2 antibody, cleavable tetrapeptide-based linker, and a membrane-permeable topoisomerase I inhibitor payload. Results from a phase 1 trial showed promising antitumor activity (confirmed objective response rate [ORR], 43.2%) in pts with heavily pretreated HER2+ metastatic gastric cancer who received T-DXd (5.4 or 6.4 mg/kg; Shitara K, et al. Lancet Oncol. 2019;20:827-836). Here we describe the phase 1b/2 DESTINY-Gastric03 trial (NCT04379596) evaluating T-DXd monotherapy and combinations in pts with HER2-overexpressing gastric cancer. Methods: This is an open-label, multicenter, 2-part, phase 1b/2 study in pts with HER2-overexpressing (immunohistochemistry [IHC] 3+ or IHC 2+/in situ hybridization positive) locally advanced, unresectable or metastatic gastric or gastroesophageal junction cancer. In part 1 (dose escalation), pts who had received prior trastuzumab-containing therapy will be assigned to 1 of 5 arms: (1) T-DXd + 5-fluorouracil (5-FU); (2) T-DXd + capecitabine (C); (3) T-DXd + durvalumab; (4) T-DXd + 5-FU or C + oxaliplatin (Ox); or (5) T-DXd + 5-FU or C + durvalumab. In part 2 (dose expansion), pts with no prior treatment for metastatic disease will be randomized across 4 arms: (1) T-DXd; (2) trastuzumab + 5-FU or C + Ox or cisplatin; (3) T-DXd + 5-FU or C ± Ox; or (4) T-DXd + 5-FU or C + durvalumab. In part 2, pts will be stratified by HER2 status. Primary endpoints are safety, determination of recommended phase 2 doses (part 1), and investigator-assessed confirmed ORR per RECIST v1.1 (part 2). Secondary endpoints include confirmed ORR (part 1), disease control rate, duration of response, progression-free survival (all per investigator), OS, safety (part 2), pharmacokinetics, and immunogenicity. Clinical trial information: NCT04379596.

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Phase II Trial of 4′-Epi-Doxorubicin in Locally Advanced or Metastatic Gastric Cancer

Tumori Journal ◽

10.1177/030089168807400312 ◽

1988 ◽

Vol 74 (3) ◽

pp. 313-315 ◽

Cited By ~ 2

Author(s):

Eduardo Cazap ◽

Roberto Estevez ◽

Mario Bruno ◽

Daniel Levy ◽

Carlos Algamiz ◽

...

Keyword(s):

Gastric Cancer ◽

Gastric Adenocarcinoma ◽

Phase Ii ◽

Response Rate ◽

Phase Ii Trial ◽

Locally Advanced ◽

Metastatic Gastric Cancer ◽

Phase Iii ◽

Future Studies ◽

Phase Iii Trials

Patients with locally advanced or metastatic gastric adenocarcinoma received an i.v. bolus of 4′-epi-doxorubicin, 75/mg/m2/cycle, every 21 days. Partial responses were observed in 5 of 23 evaluable patients (21.7%). Treatment was generally well tolerated and toxicity was mild. The response rate to epirubicin appears to be very similar to that reported for doxorubicin. Larger doses of epirubicin could be safely used in future studies, and further evaluation of epirubicin in phase III trials is indicated.

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Oxaliplatin/CF/5-FU versus paclitaxel/CF/5-FU in patients with advanced gastric cancer: A phase II clinical trial

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14014 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14014-14014

Author(s):

T. Lin ◽

F. Xu ◽

S. Wang ◽

Y. He ◽

W. Tian ◽

...

Keyword(s):

Gastric Cancer ◽

Survival Time ◽

Advanced Gastric Cancer ◽

Median Survival ◽

Median Survival Time ◽

Performance Status ◽

Locally Advanced ◽

Metastatic Gastric Cancer ◽

Tumor Control ◽

Tumor Control Rate

14014 Background: Although many randomized trials of chemotherapy for advanced gastric cancer have been reported during the past two decades, no standard regimens worldwide have been established yet. Now Paclitaxel and Oxaliplatin have shown promising activity in advanced gastric cancer. We prospectively evaluated toxicity, efficacy and survival of Oxaliplatin /CF/5-FU versus Paclitaxel/CF/5-FU. Methods: Metastatic or locally advanced gastric cancer; performance status (PS) 0–2. Patients (pts) were enrolled and randomized into arm A with Oxaliplatin 100mg/m2, 5-FU 400 mg/m2 bolus, FA 200 mg/m2 2h, 5-FU 2500 mg/m2 46h, q2w or into arm B with Paclitaxel 80 mg/m2, 5-FU 400 mg/m2 bolus, FA 200 mg/m2 2h, 5-FU 2500 mg/m2 46h, q2w. Results: From 2000 to 2005, (A/B) 46/43 pts were enrolled into this study. Median age (52/50 y), gender, PS, localization and numbers of metastatic sites were comparable for both arms. Pts who were not chemotherapy naive in A/B (% of pts) were 41.3/33.3. All pts were eligible and evaluable for toxicity and response. Overall response (CR+PR) rate for A/B (% of pts): 37.0/47.2 (p<0.05), tumor control rate (CR+PR+SD) 76.1/69.4(p<0.05). Median time to progression (TTP) were for A/B: 6.0 and 3.2 months. And median survival time for A/B were 13.4 and 13.8 months. Grade 3/4 toxicities were for A/B (% of pts): neutropenia 10.9/5.6, thrombocytopenia 4.3/2.8, anemia 0/2.8, vomiting 8.7/2.8, neurotoxic 0/2. No treatment-related death occurred in A/B. Conclusions: Oxaliplatin /CF/5-FU and Paclitaxel/CF/5-FU are both effective and safe in advanced or metastatic gastric cancer. Though Oxaliplatin /CF/5-FU had better tumor control rate and median TTP, there was no difference between the arms in the median survival time. No significant financial relationships to disclose.

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Docetaxel, oxaliplatin, and capecitabine (TEX regimen) for patients with metastatic gastric cancer: Interim results from a phase II trial by the German AIO Group

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.4554 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 4554-4554 ◽

Cited By ~ 1

Author(s):

M. H. Moehler ◽

P. Thuss-Patience ◽

D. Arnold ◽

W. Grothe ◽

A. Stein ◽

...

Keyword(s):

Gastric Cancer ◽

Phase Ii ◽

Locally Advanced ◽

Progression Free Survival ◽

Distant Metastases ◽

Response Assessment ◽

Metastatic Gastric Cancer ◽

Phase Ii Trials ◽

Grade 3 ◽

Ecog Ps

4554 Background: Combination regimens of 3 drugs have shown promising activity as treatment for patients (pts) with metastatic gastric cancer (GC). Docetaxel combined with cisplatin and 5-FU (CF) improved overall survival and response rates when compared to standard CF. However, the identification of less toxic and more convenient variants of this regimen is still important. We have previously established a regimen with docetaxel (T) combined with oxaliplatin (E) and capecitabine (X) in a phase I trial [Grothe et al., Proc. ASCO 2006]. Results of a preplanned interim analysis of subsequent multicenter phase II trials of the TEX regimen are presented here. Methods: Pts with metastatic or locally advanced GC, adequate organ function, ECOG PS 0–2, and no prior chemotherapy for advanced disease (adjuvant allowed) were enrolled. TEX regimen was administered as defined: T 35 mg/m2 and E 70 mg/m2 on days (d) 1 and 8, with X 800 mg/m2 bid on d1–14 every 22 days Toxicity assessment was done 3-weekly while CT scans were repeated 9-weekly. Results: 35 of 48 pts were enrolled until 06/08: 28 male / 7 female, median age 59 (36–81) years, ECOG PS 0/1/2 69%/31%/0%, gastric / gastroesophageal cancer 60%/40%, distant metastases 96%, tumor in situ 37%. The most common toxicities reported were (CTC grade [gr] 3/4): diarrhea 20%/3%, vomiting 11%/3%, asthenia and neurotoxicity each 9%/0%. Mucositis and hand-foot-syndrome were observed in (grade 1+2 / grade 3) 29%/0% and 26%/3%, respectively. Hematoxicity was mild with grade 3 anemia in 10% and no other grade 3/4 toxicity except one episode of febrile neutropenia . Of 25 pts evaluable so far, first tumor response assessment revealed (RECIST criteria) partial response in 36% and stable disease in 40% of patients. Conclusions: TEX is a safe and tolerable regimen for patients with metastatic gastric cancer. Preliminary efficacy results indicate promising activity. Mature data including progression free survival will be presented at the meeting. [Table: see text]

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Maintenance therapy with avelumab (MSB0010718C; anti-PD-L1) vs continuation of first-line chemotherapy in patients with unresectable, locally advanced or metastatic gastric cancer: The phase 3 JAVELIN Gastric 100 trial.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.tps4134 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. TPS4134-TPS4134 ◽

Cited By ~ 6

Author(s):

Markus H. Moehler ◽

Julien Taïeb ◽

Jayne S. Gurtler ◽

Huiling Xiong ◽

Jenny Zhang ◽

...

Keyword(s):

Gastric Cancer ◽

Maintenance Therapy ◽

Locally Advanced ◽

Metastatic Gastric Cancer ◽

First Line ◽

Phase 3 ◽

Line Chemotherapy

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Comparison of efficacy of aspirin plus epirubicin, oxaliplatin, and capecitabine versus epirubicin, oxaliplatin, and capecitabine alone in patients with locally advanced and metastatic gastric cancer: A randomized clinical trial.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.384 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 384-384

Author(s):

Esha Jafa ◽

Biswajit Dubashi ◽

Smita Kayal ◽

Vikram Kate ◽

Rajesh Nachiappa Ganesh ◽

...

Keyword(s):

Gastric Cancer ◽

Clinical Trial ◽

Protocol Analysis ◽

Locally Advanced ◽

Progression Free Survival ◽

Response Rates ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Response To Treatment ◽

Significant Difference

384 Background: Aspirin was long known to prevent cancer, the last decade revealed its therapeutic role via varied mechanisms like inhibition of platelet activation, COX and PI3K pathway. Since PI3K/AKT/mTOR is one of the pathways activated in gastric cancer and Giampieri et al (2016) showed improved response rates, PFS and OS with addition of aspirin to capecitabine in heavily pretreated metastatic colorectal cancer,a cancer in which efficacy of aspirin is related to presence of PI3K mutations,we aimed to compare the efficacy of aspirin added to a standard regime EOX with EOX alone in locally advanced and metastatic gastric cancer. Methods: All patients with advanced gastric cancer coming to JIPMER,Department of Medical oncology between march 2017 to may 2019 were screened for eligibility in the trial.Those eligible were randomly assigned to standard EOX or standard EOX plus 150 mg of daily aspirin.Tumor measurements were performed at baseline,then after 3-4 cycles (interim response) and the response to treatment was assessed by the radiologist who was blinded to treatment arms according to RECIST1.1 criteria.Toxicity profiles were recorded as per CTCAE v 4.03.In per protocol analysis,response rates, PFS(progression free survival) and OS (overall analysis) were analysed for patients who received ≥3 cycles and had an evaluable interim response. Results: 95 patients were randomised.In per protocol analysis, 70 patients were included. The results are shown in table. Conclusions: No statistically significant difference was seen with respect to response rates, PFS, OS and toxicity, although there was a higher ORR (overall response rate=complete response,CR +partial response, PR) and OS seen in EOX plus aspirin arm. Clinical trial information: CTRI/2017/11/010651. JIPMER,Puducherry,India [Table: see text]

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