- |||||||||| Journal: Moving towards dawn: KRas signaling and treatment in pancreatic ductal adenocarcinoma. (Pubmed Central) - Sep 10, 2022
It is arduous to totally regulate KRascoordinated PDAC with traditional medicaments like "gemcitabine GEM" plus nabpaclitaxel/ FOLFIRINOX...For long-haul accomplishments aiming at KRas, future endeavors should be directed to combinatorial methodologies to adequately block KRas pathways at different standpoints, for currently, they are contributing to healing PDAC. In this review article, we outline the function of KRas in carcinogenesis in PDAC, its signaling cascade, former techniques utilized in hindering Kras, current and future possibilities for targeting Kras.
- |||||||||| galunisertib (LY2157299) / Eli Lilly
P2 data, Clinical Trial,Phase II, Journal: Galunisertib plus neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer: a single-arm, phase 2 trial. (Pubmed Central) - Sep 10, 2022
P2
This benign toxicological profile warrants further Phase I/II investigation of Bermekimab in combinatorial strategies, and the impact of anti-IL-1α antibodies on the gut microbiome.Clinical trials registration: NCT03207724 05/07/2017. The addition of galunisertib to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer improved the complete response rate to 32%, was well tolerated, and warrants further assessment in randomised trials.
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg., leucovorin calcium / Generic mfg.
Trial completion date, Trial primary completion date: NOM-ERA: Non-Operative Management and Early Response Assessment in Rectal Cancer (clinicaltrials.gov) - Sep 9, 2022
P=N/A, N=68, Recruiting,
The addition of galunisertib to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer improved the complete response rate to 32%, was well tolerated, and warrants further assessment in randomised trials. Trial completion date: Jul 2025 --> Dec 2025 | Trial primary completion date: Jan 2024 --> Jun 2024
- |||||||||| carboplatin / Generic mfg., irinotecan / Generic mfg.
Enrollment open, Trial completion date, Trial primary completion date, Metastases: Folfox+Irinotecan+Chemort In Esophageal Cancer (clinicaltrials.gov) - Sep 8, 2022
P2, N=40, Recruiting,
Trial completion date: Jul 2025 --> Dec 2025 | Trial primary completion date: Jan 2024 --> Jun 2024 Not yet recruiting --> Recruiting | Trial completion date: Dec 2026 --> Dec 2027 | Trial primary completion date: Dec 2021 --> Dec 2023
- |||||||||| Venclexta (venetoclax) / Roche, AbbVie, emilumenib succinate (DS-1594) / Daiichi Sankyo
Enrollment closed, Enrollment change, Combination therapy: DS-1594b With or Without Azacitidine, Venetoclax, or Mini-HCVD for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia (clinicaltrials.gov) - Sep 8, 2022
P1/2, N=20, Active, not recruiting,
Not yet recruiting --> Recruiting | Trial completion date: Dec 2026 --> Dec 2027 | Trial primary completion date: Dec 2021 --> Dec 2023 Recruiting --> Active, not recruiting | N=122 --> 20
- |||||||||| 5-fluorouracil / Generic mfg.
Journal: Is Weight Loss During Chemotherapy for Pancreatic Cancer Prognostic? (Pubmed Central) - Sep 7, 2022
Nal-IRI plus 5-FU/LV may be particularly beneficial for the survival of patients that maintain good general condition or those with favorable prior experience to irinotecan. In this small retrospective study, weight loss over 60 days did not predict poor survival.
- |||||||||| Primary Duodenal Adenocarcinoma: A Rare Malignancy (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_3928;
Due to metastatic malignancy, patient was started on folinic acid, fluorouracil and oxaliplatin without undergoing surgery...Pain was management with fentanyl patch and oral opioids...Lymphovascular invasion, lymph node metastasis and perineural invasion are features associated with poor prognosis and high mortality. For unresectable tumors, palliative surgery or endoscopic treatment is usually indicated.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Cardiac Metastasis From a Primary Esophageal Adenocarcinoma: A Rare Presentation (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_3441;
Oncology initiated systemic chemotherapy with Oxaliplatin, Leucovorin, 5-FU and Opdivo for which he received six cycles...Our case was diagnosed ante-mortem, without cardiac symptoms on presentation, and was an adenocarcinoma. This is an extremely rare and infrequently documented condition.
- |||||||||| Enhertu (fam-trastuzumab deruxtecan-nxki) / Daiichi Sankyo, AstraZeneca, Herceptin (trastuzumab) / Roche, Perjeta (pertuzumab) / Roche
A Unique Case of HER2 Positive Adenocarcinoma of the Small Bowel (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_3331;
In this case, we report an ongoing complete response to Her2-directed therapy in a patient with an ERBB2 mutation. HER2 positive adenocarcinoma of the small bowel is uncommon, and using next generation sequencing should be considered in all patients with metastatic disease to allow for targeted therapy.
- |||||||||| Avastin (bevacizumab) / Roche
Understanding Prolonged Survival in Advanced Colorectal Cancer Using Genomics: A Case Series (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_3096;
Identification of genomic signature is key to understanding the molecular mechanism of CRC and the development of novel therapeutics. Figure: Figure 1 (left) shows CT Chest for Case 1 with multiple pulmonary nodules few with cavitation, largest 9mm Figure 2(right) shows Bone Scan for Case 3 in February 2021 with intense uptake in the right distal tibia
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Scalp Biopsy Leading to New Diagnosis of Metastatic Signet Cell Carcinoma (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_2764;
Figure: Figure 1. This image showcases edematous, firm pink-colored plaques with surrounding alopecia located over the patient's left temporoparietal scalp region.
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Pseudomyxoma peritonei - “Jelly Belly”: To Tap or Not? (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_2590;
Figure: Above is the resected omental mass that led to fistula formation post percutaneous biopsy. Cytogenetics yielded that this tumor was of a different genotype than the patient's original cancer.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
Intrahepatic Biliary Colloid Carcinoma: A Rare Site for Recurrence (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_2075;
Pembrolizumab was started for disease progression and showed stable disease for 2 years but it was stopped due to neutropenia...A) MRCP with left intrahepatic BD dilation. B) Frondlike mass in the left hepatic main duct and C) normal right hepatic main duct under cholangioscopy
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
Initial Presentation of Primary Duodenal Adenocarcinoma (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_2054;
A & B showing mass in the second portion of the duodenum. C & D showing bleeding after biopsy of mass.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Hepatoid Gastric Adenocarcinoma (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1857;
There are currently no evidence-based recommendations for therapy. Current treatment strategies are extrapolated from other gastric cancers lending to a dismal prognosis.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Gastric Cancer Presenting With Bilateral Ureteral Obstruction (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1721;
The patient was started on FOLFOX chemotherapy regimen and Nivolumab...Figure: A) Computed Tomography scan image demonstrating the thickened ureters (yellow arrows) mainly on the right side with the double J-stents seen inside their lumen. Endoscopic images of the gastric body (B, C) demonstrate thickened, edematous gastric mucosal folds, with a waffle-like appearance, that did not flatten with insufflation consistent with linitis plastica.
- |||||||||| 5-fluorouracil / Generic mfg., oxaliplatin / Generic mfg.
Excellent Treatment Response of an Aggressive Primary Duodenal Neuroendocrine Carcinoma to Oxaliplatin-Based Chemotherapy (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1642;
Due to his poor performance status and concerns for intolerability to etoposide, he was started on FOLFOX chemotherapy...Due to excellent response and disease remission, he is currently on xeloda with omission of oxaliplatin...The prognosis is dismal due to presentation as advanced stage at diagnosis. Oxaliplatin based regiments have been shown to have promising anti-tumor activity in gastrointestinal neuroendocrine cancers, however the available data in duodenal gastrointestinal neuroendocrine cancers are very limited.
- |||||||||| Colon Cancer Presenting as an Aortic Thrombus, Common Things Can Present Uncommonly (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1207;
She was admitted and started on intravenous heparin, bridged to warfarin, and discharged on hospital day 3...Figure: Coronal (A) and sagittal (B) views of CTA abdomen/pelvis. Arrows pointing to intraluminal thrombi in the distal abdominal aorta just proximal to the aortic bifurcation
- |||||||||| Closing the Gap: First Report of Endoscopic Suture Closure of Malignant Gastric Hemorrhage (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1182;
Case Description/ A 60-year-old male with a past history of primary thrombocytopenia, and recent diagnosis of signet ring gastric adenocarcinoma/linitis plastica (T2, N2, M0) on FLOT chemotherapy (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) presented with hematemesis and acute on chronic anemia...Initial attempts with bipolar cautery and epinephrine injection were unable to achieve hemostasis...2)B: Endoscopic image of suture device during closure. 3)C: Endoscopic image of successful approximating edges of ulcer after endoscopic suturing without evidence of bleeding.
- |||||||||| An Unusual Cause of Gastric Outlet Obstruction (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_915;
She reported 20 episodes of coffee-ground emesis and taking up to 8 200mg ibuprofen daily for months to treat her OA...She was started on intravenous pantoprazole given concern for upper gastrointestinal bleed...Proper management of symptomatic CDF is important for preventing further morbidity. Figure: Figure 1 Abdominal CT demonstrating choledochoduodenal fistula and associated abscess
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg., irinotecan / Generic mfg.
An Unusual Case of Large Bowel Obstruction Secondary to Metastatic Pancreatic Adenocarcinoma (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_910;
Due to the involvement of the celiac axis exceeding 180 degrees, the tumor was deemed unresectable, and patient was started on FOLFIRINOX chemotherapy Pancreatic adenocarcinoma (PAC) is a rare but ominous diagnosis with less than 20% of patients presenting with an operable tumor and a 5-year survival approaching 5% [3]...Since patients with PAC are diagnosed after the disease has spread, palliative chemotherapy remains one of the few viable options for treatment. Figure: Figure 1 and 2- Focal transmural thickening of the sigmoid colon wall with associated luminal narrowing (apple core lesion).
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
An Extremely Rare Case of Primary Duodenal Bulb Adenocarcinoma Presenting as Epigastric Abdominal Pain (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_876;
This is an intriguing phenomenon and raises the question if the duodenal bulb mucosa is inherently advantaged environmentally or physiologically to resist to malignant transformation. Figure: Figure A: Endoscopic imaging finding of 3 cm cratered ulcer in the posterior duodenal bulb Figure B: PET CT scan showing 2.9x1.8cm eccentric mass of the first portion duodenum Figure C: PET CT scan showing non-measurable left lobe hepatic hypodensity
- |||||||||| An Extraordinary Case of Gallbladder Small Cell Carcinoma (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_875;
The patient was started on chemotherapy with carbo-etoposide...The patient was subsequently started on FOLFIRINOX...Tumor cells are hyperchromatic with a high nucleus to cytoplasmic ratios and show evidence of molding and crush artifact. C: Core needle biopsy of the gallbladder immunohistochemical stain for RB1 shows loss of tumor cell nuclear expression of the Rb protein, characteristic for small cell carcinoma
- |||||||||| 5-fluorouracil / Generic mfg., leucovorin calcium / Generic mfg.
A Rare Case of Medullary Carcinoma of the Colon With Lymphatic Metastasis (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_669;
Although MACs have been sporadically reported in case reports, further studies are required to determine guidelines for both diagnosis and treatment of this rare disease. Figure: Endoscopic Visualization with Final Needle Aspiration of Abnormal Lymph Node
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