- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
Tumer Lysis Syndrome - A Rare Complication of Gastric Cancer After Initiation of Keytruda (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2164; He was treated with 2 cycles of FOLFOX followed by 6 cycles of capecitabine plus oxaliplatin via port-a-cath, after his diagnosis...Management of TLS focuses on prevention with extensive hydration, correction of electrolyte disturbances and preservation of renal function. We are reporting this case to highlight the importance of considering this rare complication after initiating immunotherapy in advanced gastric cancer patients especially that it has been reported to have very high mortality.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Primary Gastric Squamous Cell Carcinoma: A Once in a Lifetime Diagnosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1839; doi: 10.1155/2016/3062547. Figure: A) Large fungating and ulcerated mass of greater curvature of stomach and B) posterior wall of stomach C) Malignant-appearing, intrinsic moderate stenosis at the pylorus D) The stenosis was traversed and a stent was placed
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
Appendiceal Mucinous Adenocarcinoma Presenting as Small Bowel Obstruction: A Rare Tumor With Rarer Presentation (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1766; Patient was initiated on mFOLFOX6 chemotherapy...Right hemicolectomy should be considered in cases of increased mitotic activity, involvement of appendix base, lymph node metastasis, or tumour size > 2 cm, considering high recurrence rates in this subset. Treatment of AMN with peritoneal metastasis, like in our patient, consists of debulking surgeries, cytoreduction, hyperthermic intraperitoneal chemotherapy, and systemic chemotherapy.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
A Rare Case of Duodenal Adenocarcinoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1745; Figure: Mixed cystic and solid mass involving the pancreatic tail and adjacent bowel at the ligament of Treitz. Measures 5.0 cm transverse, 3.4 cm AP, and 3 cm cephalocaudal.
- |||||||||| A Rare Case of Primary Duodenal Adenocarcinoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1742;
Our case highlights the unique presentation of PDA mimicking biliary obstruction due to the periampullary location of the malignant ulcer. Figure: Magnetic resonance imaging of the abdomen showing irregular wall thickening of the second part of the duodenum abutting the IVC
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Obstructive Jaundice: Lurking Between Two Zebras (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1595; Figure 2. ERCP showing inflammatory stricture occupying right and common hepatic duct (A-C), also visualized on fluoroscopy(D).
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
A Rare Case of Adenocarcinoma With Neuroendocrine Features Spreading to Liver and Lymph Nodes: A Compelling Case Report (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1567; A chest port was inserted, and the patient received a total of two cycles of FOLFOX (5FU 400mg/m2, 5FU 2400mg/m2, Leucovorin 400mg/m2, Oxaliplatin 85mg/m2)...Figure: Images(MRI, CT), Immunohistochemistry(Ki67, chromogranin, H&E indicating by green marker) of rare metastatic liver cancer with neuroendocrine features. Table: Results of Malignant tumor markers.
- |||||||||| Late Presentation of Recurrent Solid Pseudopapillary Pancreatic Neoplasm With Liver Metastasis During Pregnancy (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1516;
Less than one month later, patient was started on a gemcitabine regimen...Due to discomfort and mass effect with vascular compression, she received five sessions of radiation therapy and was started on systemic therapy with folinic acid, fluorouracil, irinotecan, hydrochloride, and oxaliplatin (FOLFIRINOX), now considered safer in her post-partum state...2015;53(9):685-689. Figure: Figure1: A/B) Magnetic resonance imaging of original pancreatic solid pseudopapillary epithelial neoplasm (SPEN); C/D) Eight years after initial diagnosis and resection, magnetic resonance imaging of hepatic metastases of pancreatic SPEN
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
A Difficult Diagnosis of Leptomeningeal Carcinomatosis Arising From Esophageal and Gastric Adenocarcinoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_942; He was initially diagnosed 3 years prior and treated with FLOT but was followed by palliative chemotherapy with FOLFOX plus nivolumab as his condition progressed...The patient was then started on high dose steroids and acetazolamide to reduce intracranial pressure...Both LMC and oxaliplatin toxicity commonly present with headaches, weakness, nausea, and emesis, but oxaliplatin toxicity more commonly presents with peripheral neuropathy, fevers and/or GI symptoms. Since chemotoxicity and LMC metastasis may have overlapping presentations, this case shows the importance of further evaluation for progression of primary GI cancers to LMC in the presence of neurologic changes.
- |||||||||| Avastin (bevacizumab) / Roche
A Rare Case of Large Cell Neuroendocrine Carcinoma of the Colon Masquerading as Adenocarcinoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_736; Management with a bimonthly chemotherapy regimen of FOLFOXIRI, bevacizumab and 5-fluorouracil infusions was planned accordingly...Moreover, the 10-year screening interval for patients of average risk is inefficient for the detection of rapidly dividing neuroendocrine tumors with the potential to metastasize within days. Earlier detection for a better prognosis requires improved screening methods that are performed more frequently.
- |||||||||| Avastin (bevacizumab) / Roche
Primary Signet Cell Carcinoma of the Ileum: A Rare Differential Diagnosis of Acute Abdominal Pain (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_733; Two months after, the disease recurred on CT imaging, so he received 8 cycles of FOLFIRI/Avastin...Figure: CT of the Abdomen showing extensive thickening of the terminal ileum and the ascending colon (arrow) with pericolic fat stranding and lymphadenopathy. Table: CEA level at different times of the clinical course.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Recurrent AML Found in the Pancreas (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_555; IHC staining of the atypical cells showed positivity for CD45, CD34, CD117, CD20, and Ki-67, showing 20-30% cells in the cycle with some pan-cytokeratin-positive cells and therapy with FOLFIRINOX was initiated...doi:10.12998/wjcc.v11.i6.1385 Figure: Figure 1 is without any mass. Figure 2 shows the growth of new pancreatic mass around the splenic vein 20 months later.
- |||||||||| Vectibix (panitumumab) / Amgen
Enrollment closed, Trial completion date, Trial primary completion date: FOLFOXIRI Plus Panitumumab in Metastatic RAS Wild-type, Left-sided Colorectal Cancer (clinicaltrials.gov) - Jul 27, 2023 P2, N=27, Active, not recruiting, N=220 --> 114 Recruiting --> Active, not recruiting | Trial completion date: Mar 2023 --> Jan 2025 | Trial primary completion date: Mar 2023 --> Dec 2024
- |||||||||| 5-fluorouracil / Generic mfg.
Chemotherapy priming leads to hypermutability and immune surveillance in colorectal cancer () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3666; We have previously reported that temozolomide (TMZ) is able to induce MMR defects and hypermutability leading to immunotherapy clinical benefit in the subset of CRCs characterized by inactivation of O6-methylguanine methyltransferase (MGMT)...Methods We studied the impact of commonly used cytotoxic agents such as 5-fluorouracil, irinotecan, oxaliplatin, cisplatin (CDDP) and TMZ on the immunogenomic features of CRC cells...The same effect is not observed when CDDP and TMZ are given as monotherapy or when CRC cells are primed with the 5-fluorouracil-oxaliplatin-irinotecan (FOLFOXIRI) triplet. Conclusions These results indicate that rational combinations of commonly used cytotoxic agents can be exploited to promote cancer cell hypermutability and immunogenicity, and have implications in the design of new chemo-immunotherapy approaches in CRC.
- |||||||||| War and the fragility of anticancer drug supply networks in Ukraine () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3203;
10 (32%) were limited per 9-12: ibrutinib, mercaptopurine, eltrombopag, erythropoietin, thrombopoietin, ruxolitinib, venetoclax, brentuximab, gemtuzumab, obinutuzumab...Conclusions Shortages of essential anticancer drugs are a continued challenge in Ukraine during the war. Results are limited by small sample size and limited sampling from regions affected by active hostilities.
- |||||||||| 5-fluorouracil / Generic mfg.
Comparison of first-line chemotherapy regimens in unresectable locally advanced or metastatic pancreatic cancer: A systematic review and network meta-analysis () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3164; Background In patients with unresectable locally advanced (LAPC) or metastatic pancreatic cancer (MPC) gemcitabine-nab-paclitaxel (GEM-NAB) and FOLFIRINOX are standard first-line treatments...No difference was observed between NALIRIFOX and PAXG (PFS HR 1.25, 95% CI 0.72-2.17; OS HR 1.40, 95% CI 0.87-2.24) and between FOLFIRINOX and PAXG (PFS HR: 1.26, 95% CI 0.72-2.22; OS HR: 1.38, 95% CI 0.84-2.27). Conclusions With the limitations of a network meta-analysis, our results suggest that combinations with three or four drugs, when feasible, could provide a greater survival benefit compared to GEM-NAB in unresectable LAPC or MPC.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Clinical outcomes of FOLFIRINOX as front-line therapy in patients with localized pancreatic adenocarcinoma: Asian retrospective study of 781 patients () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3128; In multivariate analysis, female gender, RPC, baseline CA 19-9 < median (118.7 U/mL), objective response (CR or PR), and curative-intent surgery were significantly associated with better OS. Conclusions This large retrospective cohort study provides the realistic key clinical outcome data such as resection rates, survival outcomes and prognostic factors in RPC, BRPC and LAPC treated with front-line (m)FOLFIRINOX.
- |||||||||| The prognostic and predictive role of class III ?-tubulin and hENT1 expression in patients with advanced pancreatic ductal adenocarcinoma () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3123;
Background FOLFIRINOX and gemcitabine-nabpaclitaxel (GnP) are both standard first-line treatment regimens for advanced pancreatic ductal adenocarcinoma (PDAC), however, predictive biomarkers are currently lacking to guide treatment selection...However, there was no difference in response rates or PFS based on TUBB3 and hENT1 expression among patients receiving FOLFIRINOX regimen. Conclusions Our findings suggest that tumor TUBB3 and hENT1 expression may predict the efficacy of GnP regimen, and low TUBB3 and high hENT1 expression are associated with a higher DCR and longer PFS in patients with advanced PDAC.
- |||||||||| irinotecan / Generic mfg.
Development and clinical validation of news transcriptomic tools for predicting the response to individual drug of the mfolfirinox regimen in patients with pancreatic ductal adenocarcinoma () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3118; Background Current therapeutic options for patients with a pancreatic ductal adenocarcinoma (PDAC) implicate monotherapy (gemcitabine) or combined therapies (modified FOLFIRINOX)...Methods To extract biologically relevant signatures for 5FU, oxaliplatin and irinotecan, we integrated transcriptomic data from patient-derived primary cell cultures (PDC), patients-derived organoids (PDO) and patient-derived xenografts (PDX) with their corresponding chemo-response profiles to capture the biological components responsible for the response to each drug...However, we observed in a multivariate Cox regression that our model based on independent signatures displayed higher predictive value for the OS and PFS. Conclusions We developed three novel transcriptome-based signatures which define sensitivity for each mFFX components that can be used to rationalize the administration of the mFFX regimen and could help to avoid unnecessary toxic effects.
- |||||||||| Lynparza (olaparib) / Merck (MSD), AstraZeneca
Organoids as tools for functional precision oncology in advanced pancreatic cancer () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3117; P1 Main identified hits were gemcitabine (n=17/50), docetaxel (n=16/50), olaparib (n=15/50), and vinorelbine (n=15/50)...In a clinically relevant turnaround time, at least one putative hit was identified in 89% of cases with good sensitivity and specificity. The benefit of PDO-based FPO warrant to be confirmed in a prospective randomized trial.
- |||||||||| Onivyde (nanoliposomal irinotecan) / Servier, Ipsen, Takeda
Predictive factors for treatment success of second-line Nal-IRI/5-FU/FA in patients with metastatic pancreatic ductal adenocarcinoma (PDAC) (AIO-PAK-0216) () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3109; P3 Background Second line nanoliposomal irinotecan/5-FU/folinic acid (Nal-IRI/5-FU/FA) increases survival of unselected patients (pts) with metastatic PDAC after gemcitabine-based 1st-line therapy...Methods In this prospective trial, 151 pts with locally advanced or metastatic PDAC were enrolled for treatment with biweekly Nal-IRI/5-FU/FA (70 mg/m2, 2400 mg/m2, 400 mg/m2) after failure of gemcitabine/nab-paclitaxel...Significant predictive factors are CA19-9 levels and leucocytes, which correlated with TTF2 and OS. During 2nd line treatment CA19-9 response and reduced pain indicate a benefit from treatment.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
Total neoadjuvant chemotherapy with FOLFIRINOX regimen in patients with resectable locally advanced gastric and gastroesophageal junction cancer () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3069; Regional lymph node involvement (ypN2), lymphatic, vascular and perineural invasion negatively affected DFS (p=0,046; p=0,014; p=0,0021; p=0,04, respectively). Conclusions The total neoadjuvant chemotherapy with FOLFIRINOX regimen in patients with locally advanced gastric and GEJ cancer demonstrated comparable to the perioperative FLOT one-year DFS rate regardless of pCR and manageable safety profile.
- |||||||||| zolbetuximab (IMAB362) / Astellas
Health-related quality of life (hrqol) in patients with claudin-18 isoform 2-positive (CLDN18.2+) locally advanced (LA) unresectable or metastatic gastric or gastroesophageal junction (mg/GEJ) adenocarcinoma: Results from SPOTLIGHT and GLOW () - Jul 27, 2023 - Abstract #ESMO2023ESMO_3018; P3 Background In the randomized, double-blind, global SPOTLIGHT (NCT03504397) and GLOW (NCT03653507) trials, first-line zolbetuximab + chemo (mFOLFOX6 [SPOTLIGHT]; CAPOX [GLOW]) showed improved PFS (SPOTLIGHT, HR 0.75 [95% CI 0.60, 0.94], P = 0.0066; GLOW, HR 0.69 [95% CI 0.54, 0.87], P = 0.0007) and OS (SPOTLIGHT, HR 0.75 [95% CI 0.60, 0.94], P = 0.0053; GLOW, HR 0.77 [95% CI 0.62, 0.97], P = 0.0118) compared with placebo + chemo in patients with CLDN18.2+, HER2?, LA unresectable or mG/GEJ adenocarcinoma at data cutoff...Table: 1530P Conclusions There were not overall clinical HRQoL differences between patients in the zolbetuximab and placebo arms. Zolbetuximab + chemo improved clinical outcomes without negatively affecting HRQoL in key PROs in both SPOTLIGHT and GLOW.
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