- |||||||||| Vectibix (panitumumab) / Amgen
A Case of Prolonged Generalized Weakness in a Patient With Metastatic Rectal Cancer 6 Weeks After Last Dose of Panitumumab (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_4374;
This case highlights the need for vigilant monitoring and replacement of serum potassium and magnesium in metastatic colorectal cancer patients on Panitumumab, extending from initiation of agent to at least 8 weeks post-therapy. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
- |||||||||| An Atypical Presentation of Colorectal Adenocarcinoma With Signet Cell Features (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_4307;
He is currently on cycle 7 of FOLFOX (folinic acid, fluorouracil, and oxaliplatin) chemotherapy...FOLFOX has become the standard therapy for SRCC of the colon with CAPOX (capecitabine and oxaliplatin) also demonstrating efficacy...Figure: Figure 1A: 10.6 x 8.1 x 11.7 cm heterogeneous ascending colon mass with surrounding pericolonic inflammatory changes seen on CT Abdomen/Pelvis Figure 1B: Circumferential, friable, polypoid mass in the ascending colon seen during colonoscopy Figure 1C: Histologic examination of the biopsy material showed a proliferation of single and clustered cells with hyperchromatic, irregular nuclei and eccentric mucinous cytoplasm, characteristic of signet-ring cells. The background shows abundant extracellular pale mucin.
- |||||||||| Eosinophilic Colitis: A Novel Aggressive Endoscopic Presentation and Its Successful Therapeutic Management (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_4258;
Case Description/ A 57-year-old male with a history of invasive adenocarcinoma of the appendix, post-appendectomy, right hemicolectomy, and treatment with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) two years ago...Initially, he was treated with mesalamine 4.8 g daily plus loperamide and diphenoxylate with limited clinical benefit...While confirming corticosteroid therapy's high sensitivity and patient response, it also demonstrates the potential benefits of combining mesalamine and PureStat. Therefore, this case emphasizes two key points: the presence of aggressive endoscopic findings associated with EoC, and the potential benefits of incorporating PureStat and mesalamine with corticosteroid therapy to achieve rapid and sustained clinical and endoscopic response.
- |||||||||| High-Grade Neuroendocrine Tumor With Local Duodenal Invasion: A Case Report (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_4107;
He reported daily aspirin and occasional ibuprofen use but not recently...Surgical resection has been proposed as the definitive treatment. Figure: EGD revealed extensive ulceration with surrounding polypoid tissue in the second portion of the duodenum
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Invasive Mucinous "Colloid" Adenocarcinoma of the Pancreas in Lynch Syndrome (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_4086;
She started adjuvant chemotherapy with a modified FOLFIRINOX regimen and currently follows with Oncology...Our case features a rare pancreatic cancer, which is also rarely associated with Lynch syndrome. Moreover, her colloid-type carcinoma expressed a genetic phenotype not typically seen, characterized by high MSI and loss of MMR genes.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Breaking Barriers: Therapeutic Strategies for Thrombotic Microangiopathy in Gastric Adenocarcinoma (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_3919;
By staying abreast of these developments, healthcare professionals can optimize patient management and improve outcomes for individuals facing this complex clinical scenario. Keywords: metastatic gastric adenocarcinoma, thrombotic microangiopathy, FOLFOX chemotherapy, tailored therapy, treatment response Figure: CT Abdomen/Pelvis with contrast: Showed thickening of the gastric antrum suggestive of neoplasm, abdominal lymphadenopathy, and osseous lesions Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
- |||||||||| Avastin (bevacizumab) / Roche
An Unusual Case of Gastric Outlet Obstruction: A Case Report (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_3781;
The regimen was subsequently changed to FOLFIRI plus bevacizumab...Change in anticancer drug regimen demonstrates the dynamic nature of cancer management and the importance of tailored therapeutic approach in managing gastrointestinal cancers. Figure: EGD showing an ulcerative mass in the second part of the duodenum
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Minimally Invasive Diagnosis of Linitis Plastica With EUS-FNA (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2941;
The ascites fluid displays a classic signet ring cell with the nucleus pushed to the periphery. Figure 4: EUS guided FNA.
- |||||||||| Is It Time to Panic?: A Rare Case of MANEC at the Gastroesophageal Junction (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2781;
In the outpatient setting, the patient underwent esophageal dilation and chemotherapy with leucovorin calcium, fluorouracil, and irinotecan (FOLFIRI)...The National Comprehensive Cancer Network suggests the use of cisplatin/carboplatin and etoposide...Biopsies were positive for synaptophysin and focal gland forming areas were positive for AE1/AE3 supporting a diagnosis of MANEC. Immunohistochemistry testing for MLH1, MSH2, MSH6, and PMS2 were negative.
- |||||||||| Enbrel (etanercept) / Pfizer, Amgen, Opdivo (nivolumab) / BMS
A Rare Case of Dual Pathogen Infectious Esophagitis (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2770;
Case Description/ A 39 year old male with a history of metastatic colon cancer on FOLFOX and Nivolumab and GERD presented with a full body blistering rash...He was treated with Etanercept, IVIG, pulse dose steroids with steroid taper...He was treated with Acyclovir in addition to Fluconazole...Without biopsy this patient may have required repeat interventions and delay in proper treatment. Figure: Figure A and B: White plaques and exudates throughout the esophagus
- |||||||||| Avastin (bevacizumab) / Roche
Jaw Pain - A Rare Presentation of Metastatic Colon Cancer (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2508;
He was started on FOLFOX/Avastin after discharge and his CEA was trending down to 873 ng/mL on follow up visits...Figure: Figure A: Jaw biopsy with malignant cells Figure B: CT abdomen showing thickening with stranding of sigmoid colon (blue arrow) Figure C: Colonoscopy showing a 10cm fungating partially obstructing mass in the sigmoid colon. Figure D: Sigmoid biopsy with invasive poorly differentiated adenocarcinoma
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
A Rare Case of Metastatic Adenosquamous Cell Carcinoma of the Cecum (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2479;
This case underscores a unique presentation of metastatic adenosquamous cell carcinoma and the lack of clinical therapeutics for its treatment. Here, we present a possible therapeutic option for a patient and demonstrate the high morbidity associated with the condition.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Rare Duodenal Metastasis of Colon Cancer: Management Challenges and Therapeutic Strategies (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2461;
The patient started FOLFIRI chemotherapy and after a few months, the duodenal mass had decreased in size; however, a PET scan indicated increased FDG avidity three months later, leading to an extension to 12 cycles of FOLFIRI...However, there remains insufficient data regarding the management of solitary duodenal metastases, warranting further research and tailored clinical strategies. Figure: CT and PET CT of the abdomen showing duodenal mass with increased FDG activity
- |||||||||| Tecentriq (atezolizumab) / Roche
The Small but Mighty Tumor: Small Cell Neuroendocrine Carcinoma of Pancreas (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2410;
The patient started chemoimmunotherapy with carboplatin, etoposide, and atezolizumab...During a recent visit with oncology, there was ongoing discussion regarding the patient's enrollment in CAPTEM versus FOLFIRI clinical trial as second-line therapy...Ki-67 index was > 50%, Loss of RB, and overexpression of P53 in tumor cells. Pancreatic NECs are extremely rare and treatment should be established by a multidisciplinary team, while closely monitoring for side effects.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
A Rare Case of Eosinophilic Hepatitis as the Presenting Sign in Pancreatic Adenocarcinoma (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2384;
The patient was started on the FOLFIRINOX regimen with improvement in CA 19-9 and his eosinophilia...It is unclear whether eosinophilia contributes to the development of pancreatic cancer or is a secondary effect. Therefore, it may be beneficial to conduct further investigation for pancreatic malignancy in patients presenting with abdominal symptoms and unexplained eosinophilia.
- |||||||||| Pancreatic Doppelg (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_2301;
He was started on chemotherapy with FOLFOXIRI, a regimen that also included dexamethasone and patient felt symptomatically better...Around this time, the patient again presented to the ED with abdominal pain and cholestatic liver injury and this time he was started on 60mg prednisone daily and patient's symptoms and labs improved rapidly...Currently the patient is doing well and is on a steroid taper as well as azathioprine 100mg daily...Atypical cells with overlapping nuclei, large nuclei, and clumping of cells noted which were thought to be inflammatory changes; no mitotic features or abnormal appearing cells suggestive of adenocarcinoma. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
- |||||||||| oxaliplatin / Generic mfg.
Oxaliplatin-Induced Non-Cirrhotic Portal Hypertension (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_1900;
Case Description/ 50 year old female with a history of metastatic rectal cancer treated with partial liver resection, radiation therapy and with 12 cycles of FOLFOXIRI, who presented to ED with hematochezia with clots...She was started on PPI, octreotide drip, carvedilol twice daily and had IR guided liver biopsy...Treatment is the same as for cirrhosis and may include TIPS procedure for refractory ascites/variceal bleeding. Figure: Figures A & B. CTA showing rectal varices with extravasation Figures C & D. Esophageal varices, with red wale sign present Figure E. Evidence of portal hypertensive gastropathy Figure F. Rectal varices on flexible sigmoidoscopy
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg.
Noncirrhotic Portal Hypertension: A Rare Complication of Oxaliplatin-Based Chemotherapy (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_1773;
Case Description/ A 67-year-old female with invasive moderately differentiated adenocarcinoma of the sigmoid colon with liver metastasis treated with neoadjuvant FOLFOX and bevacizumab for 9 cycles was switched to irinotecan/capecitabine/bevacizumab due to neuropathy with favorable response...Figure: (A) CT imaging at the time of starting OX-based chemotherapy with normal spleen size. (B) Development of splenomegaly 6 months after starting OX-based chemotherapy.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Cecal Adenocarcinoma Masquerading as Perforated Appendicitis (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_852;
1 In those with coexistent cecal malignancy, prior appendectomy portends a poor prognosis in terms of survival. 1 Therefore, prompt and accurate diagnostic evaluation is critical; treatment selection should consider cecal adenocarcinoma as part of the differential in older patients presenting with acute appendicitis in an effort to optimize patient survival outcomes.
- |||||||||| Avastin (bevacizumab) / Roche
A Rare Case of Colon Cancer With Hepatic Metastasis and Soft Tissue Metastasis to the Breast (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_836;
In near obstructive colonic tumors, studies have shown that bevacizumab may increase risk of perforation and thus may not be a recommended treatment...Once PET scans are done for further clarification of findings, treatment may be optimized to limit toxicities and immune suppression. Figure: Image 1: Partially Obstructive Colonic Mass
- |||||||||| Pancreatic Metastasis from Primary Colon Adenocarcinoma Presenting as a Newly Diagnosed Type 2 Diabetic with Obstructive Symptoms (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_822;
The patient was started on FOLFOXIRI for metastatic colon cancer...In our case, careful analysis & tissue sampling identified a primary colon adenocarcinoma with multiple metastatic lesions, ensuring targeted therapy . Figure: Figure 1: fungating & obstructive mass 20 cm from the anal verge, endoscopic view; Figure 2: EUS image of the mass in the body of the pancreas (BOP), with the splenic vein running under the lesion; Figure 3: CT image of Sigmoid colon mass (black arrows), causing upstream bowel obstruction (white arrows); Figure 4: CT image of right adrenal mass (black arrow), normal left adrenal gland (white areas), pancreatic body mass (dashed arrow) causing upstream duct dilatation; Figure 5: histologic sections from obstructing colon mass, consistent with primary adenocarcinoma; Figure 6: histologic sections from pancreatic mass, consistent with metastatic adenocarcinoma from colon primary
- |||||||||| Imfinzi (durvalumab) / AstraZeneca, Opdivo (nivolumab) / BMS, Yervoy (ipilimumab) / BMS
Unusual Cause of Hematochezia in a Patient With Metastatic Gallbladder Carcinoma: A Case Report and Review of Literature (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_672;
She had initially been treated with cisplatin, gemcitabine, and durvalumab followed by durvalumab monotherapy...Due to progression of her disease with invasion to the liver Ipilimumab/nivolumab therapy was initiated a month before presentation...Comprehensive evaluation of any new gastrointestinal symptoms, including hematochezia, is imperative in patients with a history of GBC. Figure: Colonoscopy image showing large, obstructing submucosal mass in the proximal transverse colon with diffuse submucosal hematoma and localized ulceration.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Defying the Prognostic Odds: A Case of Unpredicted Survival in Stage IV Ampullary Carcinoma (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_667;
In our case, only a chemotherapeutic regime of FOLFIRINOX was offered due to hepatic metastasis...Figure: Pictures A and B: Demonstrating Ampullary Mass (A) and abrupt cut off of CBD with ductal dilation (B). PIcture C/D: Demonstrating absence of Ampullary Mass three years later post chemotherapy on surveillance imaging
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Pancreatic Adenocarcinoma Diagnosed in a Young Adult Male With Chronic Pancreatitis (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_585;
Following a multidisciplinary tumor board discussion, it was concluded that his malignancy was unresectable, and he was initiated on FOLFIRINOX therapy...Our case is unique in that the diagnosis was made via celiac lymph node biopsy as no pancreatic mass was identified. This case highlights the importance of considering pancreatic adenocarcinoma as a differential diagnosis in patients who present with chronic pancreatitis of unknown etiology.
- |||||||||| leucovorin calcium / Generic mfg.
Journal: Universality of critical active site glutamate as an acid-base catalyst in serine hydroxymethyltransferase function. (Pubmed Central) - Aug 16, 2024
Here we report the analysis of TthSHMT, with PLP in the internal aldimine form and bound THF-analog, folinic acid (FA), by neutron crystallography to reveal H atom positions in the active site, including PLP and FA...Furthermore, we obtained X-ray structures of TthSHMT-Gly/FA, TthSHMT-l-Ser/FA, and hSHMT2-Gly/FA ternary complexes with the PLP-Gly or PLP-l-Ser external aldimines to analyze the active site configuration upon PLP reaction with an amino acid substrate and FA binding. Accurate mapping of the active site protonation states together with the structural information gained from the ternary complexes allow us to suggest an essential role of the gating loop conformational changes in the SHMT function and to propose Glu53 as the universal acid-base catalyst in both THF-independent and THF-dependent activities of SHMT.
- |||||||||| Enrollment open, Trial initiation date: Neoadjuvant chemotherapy in resectable pancreatic cancer (EUDRACT) - Aug 16, 2024
P3, N=100, Recruiting,
Accurate mapping of the active site protonation states together with the structural information gained from the ternary complexes allow us to suggest an essential role of the gating loop conformational changes in the SHMT function and to propose Glu53 as the universal acid-base catalyst in both THF-independent and THF-dependent activities of SHMT. Not yet recruiting --> Recruiting
- |||||||||| GVAX Pancreas (allogeneic GM-CSF-secreting tumor cells) / Novartis
Trial completion, Phase classification, Trial completion date, Trial primary completion date, Tumor cell: Pancreatic Tumor Cell Vaccine (GVAX), Cyclophosphamide, SBRT, and FOLFIRINOX in Patients With Resected Adenocarcinoma of the Pancreas (clinicaltrials.gov) - Aug 14, 2024
P2, N=19, Completed,
Not yet recruiting --> Withdrawn | N=20 --> 0 Active, not recruiting --> Completed | Phase classification: PN/A --> P2 | Trial completion date: Sep 2024 --> Oct 2023 | Trial primary completion date: Sep 2024 --> Oct 2023
- |||||||||| BOLD-100 / Bold Therap
Enrollment open, Phase classification, Enrollment change, Trial completion date, Trial primary completion date, Combination therapy, Metastases: BOLD-100-001: BOLD-100 in Combination with FOLFOX for the Treatment of Advanced Solid Tumours (clinicaltrials.gov) - Aug 13, 2024
P1/2, N=220, Recruiting,
Active, not recruiting --> Completed | Phase classification: PN/A --> P2 | Trial completion date: Sep 2024 --> Oct 2023 | Trial primary completion date: Sep 2024 --> Oct 2023 Active, not recruiting --> Recruiting | Phase classification: P1b/2a --> P1/2 | N=117 --> 220 | Trial completion date: Sep 2024 --> Sep 2026 | Trial primary completion date: Dec 2023 --> Jun 2026
- |||||||||| Ziihera (zanidatamab-hrii) / Jazz
Trial completion date, Trial primary completion date: ZWI-ZW25-201: A Safety and Efficacy Study of ZW25 (Zanidatamab) Plus Combination Chemotherapy in HER2-expressing Gastrointestinal Cancers, Including Gastroesophageal Adenocarcinoma, Biliary Tract Cancer, and Colorectal Cancer (clinicaltrials.gov) - Aug 13, 2024
P2, N=74, Active, not recruiting,
Active, not recruiting --> Recruiting | Phase classification: P1b/2a --> P1/2 | N=117 --> 220 | Trial completion date: Sep 2024 --> Sep 2026 | Trial primary completion date: Dec 2023 --> Jun 2026 Trial completion date: Oct 2026 --> Jul 2025 | Trial primary completion date: Nov 2025 --> Aug 2024
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