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  • ||||||||||  5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
    Retrospective data, Journal, BRCA Biomarker, Metastases:  A Novel HRD Signature Is Predictive of FOLFIRINOX Benefit in Metastatic Pancreatic Cancer. (Pubmed Central) -  Aug 7, 2023   
    Incorporating a biomarker like HRDsig could identify the right patients for platinum chemotherapy and potentially reduce FOLFIRINOX use by over 40%, minimizing toxicities with similar survival outcomes. Confirmatory studies should be performed.
  • ||||||||||  Enrollment change, Trial completion date, Trial withdrawal, Trial primary completion date:  H-9926-LCH III: Treatment Protocol of the Third International Study for Langerhans Cell Histiocytosis (clinicaltrials.gov) -  Aug 3, 2023   
    P3,  N=0, Withdrawn, 
    Therefore, we suggest Gem-Ox as potential first line treatment option for inoperable locally advanced or metastatic pancreatic cancer, especially if Gem-Nab is not available. N=476 --> 0 | Trial completion date: Feb 2010 --> Aug 2023 | Completed --> Withdrawn | Trial primary completion date: Feb 2010 --> Aug 2023
  • ||||||||||  Erbitux (cetuximab) / Eli Lilly
    Enrollment closed, Enrollment change, Trial completion date, Trial primary completion date, Metastases:  CLASSIC: Cetuximab Plus Capecitabine as Maintenance Treatment in RAS and BRAF wt Metastatic Colorectal Cancer (clinicaltrials.gov) -  Aug 2, 2023   
    P3,  N=80, Active, not recruiting, 
    Not yet recruiting --> Recruiting Not yet recruiting --> Active, not recruiting | N=348 --> 80 | Trial completion date: Mar 2024 --> Aug 2024 | Trial primary completion date: Dec 2023 --> Dec 2022
  • ||||||||||  Fruzaqla (fruquintinib) / Takeda
    Trial initiation date, Metastases:  Fruquintinib Plus FOLFIRI in RAS-mutated Metastatic Colorectal Cancer (clinicaltrials.gov) -  Aug 1, 2023   
    P2,  N=42, Not yet recruiting, 
    Clinicians and patients engaging in decision-making around treatment duration in this context should carefully consider the trade-off between treatment effectiveness and adverse effects of treatment. Initiation date: May 2023 --> Oct 2023
  • ||||||||||  Challenging Management of Unresectable Undifferentiated Osteoclast-Like Giant Cells Carcinoma of the Duodenum: A Case Report of Perforation Following Duodenal Stenting (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_4613;    
    Two months later, a follow-up CT scan showed the progression of the thrombus to the portal vein and splenic vein, leading to the initiation of Xarelto treatment...Treatment options including duodenal stenting and FOLFIRINOX were discussed, and the patient underwent duodenal stenting...However, further research is needed to determine the most effective management strategies for this rare disease, assess the long-term outcomes of duodenal stenting, and ensure awareness of potential complications associated with the procedure. Figure: Duodenal Stent Placement During Upper Endoscopy
  • ||||||||||  5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
    Beyond the Obstruction: Unveiling Signet Ring Cell Adenocarcinoma's Intriguing Presentation (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_4605;    
    However, this was ruled out by EGD and colonoscopy in our case, likely making the primary the appendix or small bowel, which are less common. We emphasize the importance of persistent investigation and collection of biopsies from various sites when a high suspicion for malignancy is present, despite repeated negative cytology/biopsies.
  • ||||||||||  5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
    Primary Duodenal Adenocarcinoma Manifesting as Gastric Outlet Obstruction (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_4597;    
    Recently, DA is being treated similarly to colorectal adenocarcinoma with oxaliplatin-based chemotherapy. Given the tendency of this disease to recur systemically, the role of adjuvant chemotherapy warrants further investigation.
  • ||||||||||  oxaliplatin / Generic mfg.
    The Cost of Curing Colon Cancer: Oxaliplatin-Induced NCPH-Related Colonic Bleeding (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_4433;    
    Bleeding was initially controlled with localized epinephrine injection, cautery and hemoclips (Figure 1a, 1b)...C&D) H&E stained liver biopsy sample showing portal tract with loss of portal vein. C&D) Trichrome stained liver samples showing the same in addition to injured and therefore congested and early fibrotic sinusoids, associated with atrophy of hepatocytes.
  • ||||||||||  Avastin (bevacizumab) / Roche, Feraheme (ferumoxytol injection) / Covis Pharma, Farxiga (dapagliflozin) / Ono Pharma, AstraZeneca
    Iron Deficiency Anemia: A Rare Trifecta (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3905;    
    She continues on a gluten-free diet, IV iron and Vit B12 injections. We would like to highlight the importance of investigating iron deficiency anemia with both laboratory and bidirectional endoscopy to ensure no etiologies are missed.
  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / Ono Pharma, BMS
    Exploring SMARCA4-Deficient Esophageal Carcinoma: A Rare and Aggressive Case Study (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3809;    
    We present a case of SMARC4-deficient esophageal cancer to provide a perspective on the management of these tumors Case Description/ An 82-year-old male with basal cell carcinoma post multiple resections, gastroesophageal reflux on omeprazole and no other significant social or family history presented with upper abdominal pain, dysphagia, and poor oral intake for 2 weeks...There is no effective treatment documented for SMARCA4 deficient esophageal carcinoma, however cases have reported successful treatments of other types of SMARCA4-deficient carcinomas with nivolumab and pembrolizumab...(B) Esophagogastroduodenoscopy - Fungating mass present in the lower third esophagus. (C) Esophagogastroduodenoscopy - Friable mass with active hemorrhage in the lower third esophagus.
  • ||||||||||  5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
    Dysphagia Caused by a Rare Case of Esophageal (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3785;    
    The two bottom images are hematoxylin-eosn stain on the right (400x) showing tumor cells with scant cytoplasm, small round to oval nuclei with dispersed chromatin, inconspicuous nucleoli and frequent mitoses. The image on the bottom left shows an immunohistochemical stain for synaptophysin (400x).
  • ||||||||||  When Cancer Takes a Flight: A Rare Case of Rectal Adenocarcinoma Metastasizing to the Orbit (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3684;    
    He completed 12 cycles of FOLFOXIRI, followed by a restaging scan that showed a mild increase in disease activity; he was then followed by maintenance therapy with Capecitabine and radiation therapy to the rectal lesion...In such cases, an accurate early diagnosis is pivotal to optimize management and improve outcomes to prevent future complications. Figure: Figure 1: MRI of the Orbit showing intramuscular lesion involving the right medial rectus muscle 1.8 x 1.5 x 1.6cm; enhanced peripherally with some internal nodularity and a cystic center.
  • ||||||||||  Tecentriq (atezolizumab) / Roche
    Mixed Adenoneuroendocrine Carcinoma of the Colon: A Challenging Entity From Diagnosis to Management (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3587;    
    Larger studies are needed to evaluate clinical behavior, prognostic factors, survival rates, and effective systemic chemotherapeutic regimens for colorectal MANEC, aiming to establish treatment guidelines for these heterogeneous lesions. Figure: Tumor showing a mixed poorly differentiated small cell neuroendocrine carcinoma (70%) and a moderately differentiated adenocarcinoma (30%).
  • ||||||||||  Avastin (bevacizumab) / Roche, Elitek (rasburicase) / Sanofi
    Tumor Lysis Syndrome in Metastatic Colon Carcinoma - A Rare Occurrence (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3565;    
    Case Description/ A 59-year-old male with recently diagnosed stage IV colon cancer complicated by hypercalcemia of malignancy with extensive hepatic metastasis presented to our hospital from an infusion center with hypotension and severe fatigue after receiving cycle one of FOLFOX and bevacizumab...He met the criteria for TLS and received IV fluids, rasburicase, allopurinol, and lactulose for hepatic encephalopathy...2011, 364: 1844-1854. 10.1056/NEJMra0904569 Figure: Image 1: MRI of the liver with and without contrast showing Diffuse bilobar hypoenhancing targetoid liver lesions with restricted diffusion compatible with known biopsy-proven metastases
  • ||||||||||  5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., oxcarbazepine / Generic mfg.
    Colon Cancer: An Unexpected Cause of Dysphagia (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3551;    
    10.1056/NEJMra0904569 Figure: Image 1: MRI of the liver with and without contrast showing Diffuse bilobar hypoenhancing targetoid liver lesions with restricted diffusion compatible with known biopsy-proven metastases At time of presentation, the patient
  • ||||||||||  Avastin (bevacizumab) / Roche, Erbitux (cetuximab) / Eli Lilly, EMD Serono, Vectibix (panitumumab) / Amgen, Takeda
    Radiculopathy Uncovers Insidious Rectosigmoid Mass: An Atypical Presentation (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3546;    
    Advances in early detection screenings and treatment options have reduced CRC mortality. Figure: CRC Mets Imaging
  • ||||||||||  5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
    A Rare Presentation of Cholecystocolonic Fistula (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3463;    
    Figure: Fig 1.: Pneumobilia with air in the biliary tree and the gallbladder. Fig 2.: Choledochocolonic fistula with the apparent connection of gallbladder and the ascending colon.
  • ||||||||||  5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., prednisone / Generic mfg.
    It Started With Back Pain: A Rare Presentation of Metastatic Gastric Cancer (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3278;    
    She had been evaluated outpatient previously, and underwent CT showing bilateral ground-glass opacities and mediastinal lymphadenopathy; she was prescribed 10-days of prednisone at the time...Figure: Figure 1. (A) Bone scintigraphy showing innumerable foci of intense tracer labeling, of different sizes and shapes, involving skull bones, cervical, thoracic and lumbar spine, bones of the bilateral upper extremities, pelvic bones, sacrum and bilateral, consistent with extensive metastatic bone disease; (B) Endoscopic findings of a large mucosal lesion characterized by congestion, erythema, altered vascularity, and granularity in the gastric antrum.
  • ||||||||||  A Case of Rapidly Developing Small Bowel Adenomatous Polyposis Without Significant Colonic Polyposis (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_3124;    
    She had a history of IgA nephropathy with renal transplant on cyclosporine, mycophenolate and prednisone...She received postoperative 5-FU, leucovorin, and oxaliplatin...Figure: Figure 1. Gross small bowel resection demonstrating 2cm jejunal polyp, 1cm jejunal polyp, multiple mid jejunum polyps, 4mm distal jejunum polyp.
  • ||||||||||  irinotecan / Generic mfg.
    Irinotecan Toxicity With UGT1A Polymorphism in a Patient With Metastatic Rectal Adenocarcinoma (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_2203;    
    Most recently he received treatment with FOLFIRI and Cetuximab, with a FUDR hepatic arterial infusion pump...Broad spectrum antibiotics, scheduled diphenoxylate and loperamide were initiated with no improvement...Bowel movements improved with intravenous steroids which were transitioned to oral prednisone outpatient...Our case emphasizes standardized pre-therapeutic UGT1A1 testing due to the increased morbidity and mortality associated with IRI toxicity in these patients. It also highlights the need for closer monitoring for adverse drug events to reduce the overall healthcare burden and complications.
  • ||||||||||  5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
    A Rare Phenomenon of Ovarian Metastases From Moderately Differentiated Colorectal Adenocarcinoma (Exhibit Hall) -  Jul 29, 2023 - Abstract #ACG2023ACG_2169;    
    OM in primary CRC is a rare entity with poor prognostic implications and requires a multidisciplinary approach. Figure: Figure 1:Pelvic US showing a 7 cm complex cystic right ovarian mass Figure 2: Pathology showing moderately differentiated adenocarcinoma with mucinous differentiation, consistent with metastasis from colorectal adenocarcinoma