Gastrointestinal Cancer

Here, we review the studies that have explored different treatment regimens, therapeutic sequencing, and biologic inclusions for the treatment of these patients, with neoadjuvant intent. We also describe how we have established our own treatment paradigm for the management of potentially curable metastatic colorectal cancer.

Although immunotherapy is not yet approved for the treatment of gastrointestinal cancers, it is already clear that many gastrointestinal cancers can be sensitive to it. We will review recent clinical trial results demonstrating this, and offer our perspective on the role that immunotherapy might play in the treatment of advanced gastrointestinal malignancies in the years ahead.

Advanced gastrointestinal malignancies are a major oncologic challenge for which successful durable personalized therapies are currently lacking.

It remains difficult to decipher which patients are appropriate candidates for conversion therapy vs upfront surgery. Therefore, in predicting potential outcomes, several factors should be considered. Here, we will attempt to address such factors and provide insights.

In all other settings, giving chemotherapy just to make us feel better emotionally in exchange for potential harm to the patient is not the right strategy. We need to find better treatments for this new clinical indication.

There is clear proof of principle for adjuvant therapy in patients at high risk for tumor recurrence, such as those with resected metastatic colorectal cancer. For that reason, this strategy has been largely adopted, especially using 5-FU– and oxaliplatin-based regimens, thereby mirroring the approach in resected stage III colon cancer.

The use of a reduced preparation CT colonography increased participation in colonography as a method of population screening for colorectal cancer, according to the results of a large Italian study.

Paid sick leave benefits could alleviate some of the financial burden patients with colorectal cancer incur during treatment and boost their job retention.

The developer of evofosfamide announced that two phase III trials of the agent in advanced soft-tissue sarcoma and in advanced pancreatic cancer did not meet their primary endpoints.

The addition of lapatinib to capecitabine/oxaliplatin did not prolong overall survival among patients with previously untreated HER2-amplified gastroesophageal adenocarcinoma.

Both radiofrequency ablation and stereotactic body radiotherapy are effective in the treatment of inoperable, non-metastatic hepatocellular carcinoma.

A program implemented in New York City successfully increased colorectal cancer screening rates and diminished racial and ethnic disparities in screening.

A retrospective cohort study showed that socioeconomic variables including race, marital status, insurance status, and geography are associated with rates of resection for early-stage pancreatic cancer. Most of these factors, however, were not associated with survival following resection.

A meta-analysis found that a number of dietary factors play a role in the risk of developing gastric cancer, with protective effects seen with fruit and certain vegetables and increased risk seen with high-salt foods and certain forms of alcohol.

Imatinib had no impact on failure-free or overall survival in patients with gastrointestinal stromal tumor, but it did have an effect on relapse-free survival.

Reaching out to underserved populations about colorectal cancer screening using mailed invitations resulted in significantly improved colorectal cancer screening rates in a recently published study.

Adding the EGFR-targeting drug panitumumab to chemotherapy had no effect on survival in a group of patients with wild-type KRAS status advanced biliary tract cancer.

This article reviews the current treatment paradigms for metastatic disease, focusing on ways to ameliorate symptoms and lengthen survival. We then summarize recent advances in our understanding of the molecular and cellular aspects of pancreatic cancer.

The ultimate benefit to patients will come from a demonstration of clinically worthwhile benefits of new drugs that have been tested in well-designed and adequately powered clinical trials performed in an expedited fashion.

Patients with metastatic colorectal cancer and a low BMI were at higher risk for disease progression and death; this risk did not affect those with a high BMI.

The FDA has approved the combination of irinotecan liposome injection plus 5-fluorouracil and leucovorin for the treatment of metastatic pancreatic cancer in patients who previously progressed on gemcitabine-based chemotherapy.

Patients with a prior history of colorectal adenomas saw no reduction in the risk for recurrence with the use of a daily supplement of vitamin D, calcium, or both.

Minimally invasive laparoscopic-assisted surgery did not result in better outcomes compared to open surgery for rectal cancer, according to two clinical trials.

A study showed that tumors of younger patients with early-onset colorectal cancer differ from the tumors of those diagnosed later in life, both genetically and epigenetically.

Blocking the MAPK pathway through treatment with dabrafenib and trametinib resulted in meaningful clinical activity in a subset of patients with BRAF V600-mutated metastatic colorectal cancer.

The USPSTF recently issued a draft recommendation advising the use of aspirin to prevent cardiovascular disease and colorectal cancer in certain patients aged 50 to 69 years.

A payment system for colonoscopies offering full insurance coverage at low-priced facilities and cost sharing at high-priced alternatives reduced spending with no increase in complications.

Treatment with the PARP inhibitor olaparib plus paclitaxel resulted in an overall survival benefit in patients with metastatic gastric cancer.

Consumption of four or more cups of coffee a day was associated with a reduced risk for colon cancer recurrence and death in patients with stage III disease.

Five randomized trials involving patients with locally advanced pancreatic cancer illustrate most clearly the substantial degree to which standard therapies are limited in their effectiveness.