ESMO Gastrointestinal Oncology最新文献

{"title":"Prognostic factors and treatment response in HER2-positive gastric cancer patients receiving trastuzumab deruxtecan: secondary analysis of the EN-DEAVOR study","authors":"K. Nakanishi ,&nbsp;N. Sugimoto ,&nbsp;Y. Kodera ,&nbsp;H. Kawakami ,&nbsp;A. Makiyama ,&nbsp;H. Konishi ,&nbsp;S. Morita ,&nbsp;Y. Narita ,&nbsp;K. Minashi ,&nbsp;M. Imano ,&nbsp;R. Inamoto ,&nbsp;T. Nishina ,&nbsp;T. Kawakami ,&nbsp;M. Hagiwara ,&nbsp;H. Kume ,&nbsp;K. Yamaguchi ,&nbsp;W. Hashimoto ,&nbsp;K. Muro","doi":"10.1016/j.esmogo.2025.100184","DOIUrl":"10.1016/j.esmogo.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>EN-DEAVOR was a multi-institutional retrospective study evaluating the effectiveness and safety of trastuzumab deruxtecan (T-DXd) in gastric cancer patients. This secondary analysis investigated prognostic factors for real-world progression-free survival (rwPFS) and objective response rate (ORR) for T-DXd as third- or later-line treatment.</div></div><div><h3>Patients and methods</h3><div>Patients aged ≥20 years with histopathologically confirmed human epidermal growth factor receptor 2 (HER2)-positive unresectable advanced or recurrent gastric or gastroesophageal junction adenocarcinoma, who had worsened after chemotherapy, were included. Patients received T-DXd as third- or later-line therapy between September 2020 and September 2021. Univariate and multivariate analyses identified prognostic factors for rwPFS and ORR.</div></div><div><h3>Results</h3><div>Of the 307 patients, 75.6% were male and 69.1% were aged ≥65 years. The median duration of prior trastuzumab treatment was 6.5 months (range 0-81.5 months). Multivariate analysis showed HER2 immunohistochemistry (IHC) 3+ [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86], intestinal type lesions (HR 0.59, 95% CI 0.43-0.79), modified Glasgow Prognostic Score (mGPS) 0 and 1 (HR 0.71, 95% CI 0.53-0.95), and longer duration of prior trastuzumab treatment (≥ median) (HR 0.75, 95% CI 0.58-0.97) as positive prognostic factors for rwPFS. Longer prior trastuzumab treatment was also a positive prognostic factor for ORR (odds ratio 2.02, 95% CI 1.13-3.63).</div></div><div><h3>Conclusions</h3><div>Patients with clinical benefits from prolonged trastuzumab treatment are likely to benefit from T-DXd. Similarly, HER2 IHC 3+, intestinal type lesions, and better mGPS (0 or 1) are associated with longer rwPFS. However, T-DXd should not be withheld even in patients without these factors, as a median PFS of 3.42 months was observed in those with the shortest prior trastuzumab exposure.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in upper GI oncology: role of radiotherapy in non-metastatic gastroesophageal adenocarcinoma","authors":"A. Petrillo ,&nbsp;M. Verheij ,&nbsp;T. Leong","doi":"10.1016/j.esmogo.2025.100188","DOIUrl":"10.1016/j.esmogo.2025.100188","url":null,"abstract":"","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline genomic profiling of patients with early-onset colorectal cancer","authors":"G. Mauri ,&nbsp;M. Puzzono ,&nbsp;A. Mannucci ,&nbsp;F. Gaudioso ,&nbsp;H. Mittal ,&nbsp;L. Mosca ,&nbsp;V. Burgio ,&nbsp;S. Ghezzi ,&nbsp;M. Ronzoni ,&nbsp;S. Mariano ,&nbsp;R. Rosati ,&nbsp;L. Monti ,&nbsp;U. Cavallari ,&nbsp;A. Sartore-Bianchi ,&nbsp;S. Siena ,&nbsp;G.M. Cavestro","doi":"10.1016/j.esmogo.2025.100182","DOIUrl":"10.1016/j.esmogo.2025.100182","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of early-onset colorectal cancer (EO-CRC) is rising. While most cases of EO-CRC are sporadic, the prevalence of hereditary cancer predisposition syndromes remains a subject of debate. Moreover, genes not traditionally associated with EO-CRC development are rarely included in germline testing panels.</div></div><div><h3>Patients and methods</h3><div>Germline profiling data of patients with EO-CRC presenting to our clinics were collected at two Italian university institutions: IRCCS San Raffaele Scientific Institute and Grande Ospedale Metropolitano Niguarda. Multigene germline profiling analysis was carried out using next-generation sequencing and multiplex ligation probe amplification. Associations between germline alterations and clinicopathological variables were analyzed.</div></div><div><h3>Results</h3><div>A total of 130 patients with EO-CRC were screened. The median age at EO-CRC diagnosis was 42 years (range 22-49 years). Germline pathogenic or likely pathogenic variants (PVs/LPVs) associated with hereditary cancer predisposition syndromes were identified in 23 (18%) patients, while germline variants of unknown significance were found in 47 (36%) patients. No alterations in high-penetrance genes associated with cancer susceptibility were observed in 67 (52%) patients. No patients with microsatellite stable <em>BRAF</em>-mutant (<em>n</em> = 5) or signet ring cell CRC (<em>n</em> = 2) exhibited germline PVs/LPVs. No clinicopathological features were significantly enriched in hereditary compared with sporadic EO-CRC. Germline PVs in <em>FLCN</em> and <em>SDHAF2</em> were identified in two patients with EO-CRC.</div></div><div><h3>Conclusions</h3><div>While most EO-CRC cases are sporadic, approximately one-fifth arises within the context of hereditary cancer predisposition syndromes. As <em>FLCN</em> and <em>SDH</em> are not currently included in the current guidelines for EO-CRC, PVs/LPVs in these genes may be underestimated. To better understand their significance, we recommend including their assessment in all patients with EO-CRC.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MDM2 amplification in a real-world cohort of patients with biliary tract cancer from the Spanish RETUD gastrointestinal registry","authors":"A.J. Muñoz Martín ,&nbsp;F. Castet ,&nbsp;J. Soto Alsar ,&nbsp;J. Adeva ,&nbsp;P. Peinado ,&nbsp;B. Graña ,&nbsp;I. Alés Díaz ,&nbsp;R.M. Rodríguez-Alonso ,&nbsp;M. Lobo de Mena ,&nbsp;R. Vera ,&nbsp;I. Ruiz de Mena ,&nbsp;S. Aguilar ,&nbsp;S. Vega ,&nbsp;L. Ortega Morán ,&nbsp;T. Macarulla","doi":"10.1016/j.esmogo.2025.100187","DOIUrl":"10.1016/j.esmogo.2025.100187","url":null,"abstract":"<div><h3>Background</h3><div>Antagonist of mouse double minute 2 homolog (<em>MDM2</em>) represents a novel therapeutic strategy in biliary tract cancer (BTC). We aimed to characterize the epidemiology of <em>MDM2</em> amplifications in patients with BTC, associations of <em>MDM2</em> with other genetic alterations, and survival outcomes.</div></div><div><h3>Materials and methods</h3><div>A real-world cohort of patients diagnosed with BTC (1 January 2017 to 31 December 2022) was evaluated (RETUD NCT06711211). Next-generation sequencing (NGS) testing was carried out. Demographic and clinical characteristics, molecular profile, treatments, and effectiveness [overall response rate (ORR) and survival outcomes] were assessed. Progression-free survival (PFS), overall survival (OS), and ORR were estimated for patients receiving first-line therapy, using the Kaplan–Meier method. Descriptive analyses were used to assess demographic, clinical, and molecular features.</div></div><div><h3>Results</h3><div>A total of 301 patients were included. <em>MDM2</em> amplification was reported in 19 patients (6.3%); two of them (10.5%) had <em>TP53</em> mutations. Most patients (63.2%; 12/19) with <em>MDM2</em> amplification had intrahepatic tumors. However, <em>MDM2</em> amplification was more frequent in patients with gall-bladder carcinoma (12.9%; 4/31). Patients with/without <em>MDM2</em> amplification receiving first-line therapy [cisplatin and gemcitabine (CisGem)] showed a median OS [95% confidence interval (CI)] of 18.4 months (12.3-19.9 months) and 17.8 months (12.3-19.9 months, <em>P</em> = 0.247), a median PFS (95% CI) of 5.3 months (2.7-8.9 months) and 6.0 months (5.3-6.8 months, <em>P</em> = 0.423), and an ORR of 21.4% and 29.6% (<em>P</em> = 0.762), respectively.</div></div><div><h3>Conclusions</h3><div>Incidence of <em>MDM2</em> amplification was similar to that described in other BTC cohorts. Comparable results in demographic/clinical characteristics, molecular profile, and survival outcomes between patients with/without <em>MDM2</em> amplification was observed.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-arterial hepatic chemotherapy in metastatic colorectal cancer: differences between oxaliplatin-naive versus oxaliplatin-pretreated patients","authors":"E. El Rawadi ,&nbsp;B. Bonnet ,&nbsp;L. Pierotti ,&nbsp;V. Boige ,&nbsp;L. Tselikas ,&nbsp;C. Smolenschi ,&nbsp;M. Valéry ,&nbsp;T. Pudlarz ,&nbsp;A. Fuerea ,&nbsp;T. De Baere ,&nbsp;A. Tarabay ,&nbsp;M. Gelli ,&nbsp;E. Fernandez-de-Sevilla ,&nbsp;D. Malka ,&nbsp;A. Hollebecque ,&nbsp;M. Ducreux ,&nbsp;A. Boilève","doi":"10.1016/j.esmogo.2025.100173","DOIUrl":"10.1016/j.esmogo.2025.100173","url":null,"abstract":"<div><h3>Background</h3><div>Oxaliplatin-based hepatic arterial infusions (HAI) combined with intravenous therapy is a therapeutic option for colorectal cancer with liver-only metastasis, notably in the palliative setting, either initially or after failure of systemic chemotherapy. Our study aimed to assess efficacy and tolerance between oxaliplatin-naive patients and oxaliplatin-pretreated patients.</div></div><div><h3>Methods</h3><div>Between 2008 and 2022, single-center consecutive patients presenting with liver metastasis secondary to colorectal cancer who received at least one cycle of HAI-oxaliplatin combined with systemic therapy were included.</div></div><div><h3>Results</h3><div>The oxaliplatin-naive arm included 63 patients (median age 58 years) and the pretreated arm included 244 patients (median age 53 years). Patient characteristics were well balanced between the groups. All patients in the oxaliplatin-naive arm received HAI-oxaliplatin while 13% of the pretreated patients received HAI-FOLFIRINOX. After a median follow-up of 36 months, median progression-free survival was 14 months in the oxaliplatin-naive group (range 11.8-24 months) and 10.1 months in the pretreated group (range 9.4-12.5 months) (<em>P</em> = 0.016). The objective response rate was 66.7% and the disease control rate was 79.4% in the oxaliplatin-naive group, versus 32.4% and 77.5% (<em>P</em> &lt; 0.001) in the pretreated group. Grade 3-4 toxicities were comparable between the two groups, including neuropathy. Secondary resection/ablation rate was 22.2% in oxaliplatin-naive patients and 17.6% in pretreated patients.</div></div><div><h3>Conclusion</h3><div>Oxaliplatin use as an intra-arterial hepatic infusion is feasible and efficient after previous systemic oxaliplatin; it showed significant response rates without increased toxicities. It can provide alternative treatments and spare late-setting drugs such as regorafenib and tipiracil–trifluridine for a further palliative intent treatment.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome after perioperative chemotherapy and surgery for gastro-esophageal adenocarcinoma","authors":"S. Shim ,&nbsp;A.C. Larsen ,&nbsp;L. Bæksgaard ,&nbsp;P. Pfeiffer ,&nbsp;M. Nordsmark ,&nbsp;J.R. Sørensen ,&nbsp;A.K. Motavaf ,&nbsp;M. Ladekarl","doi":"10.1016/j.esmogo.2025.100183","DOIUrl":"10.1016/j.esmogo.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>The long-term fate of patients treated for resectable gastro-esophageal adenocarcinoma with perioperative chemotherapy outside randomized clinical trials (RCTs) is poorly described. In this national cohort, we report on outcomes after 12 years.</div></div><div><h3>Materials and methods</h3><div>Baseline clinicopathological factors and blood tests were collected in 285 patients treated from May 2008 to June 2010, and postsurgical factors were collected in the 202 patients that were radically resected. Response to preoperative chemotherapy was assessed by postsurgical restaging. Additional information on second cancers, comorbidities, and competing causes of death was obtained.</div></div><div><h3>Results</h3><div>Overall survival (OS) at 5 and 10 years was 31.9% and 24.2%, respectively. Multivariate analysis (MA) showed prognostic value of clinical T- and N-stage, dysphagia, and Charlson Comorbidity Index. Elevated leucocytes and lactate dehydrogenase, and low lymphocytes were additional adverse prognostic factors. Ten-year incidence rate of second cancers was 10.1%.</div><div>OS at 5 and 10 years from radical surgery was 43.1% and 32.1%, respectively. MA showed prognostic value of postneoadjuvant pathological (yp) Union for International Cancer Control (UICC) stage and downstaging. However, downstaging was strongly correlated with clinical stage. At the 5-year landmark, marginally significant trends toward a favorable recurrence-free survival were associated with ypT0 and age &lt;70 years, but only 3.4% experienced late recurrences. Postoperative complications caused a quarter of deaths in the half of radically resected patients who died without recurrence.</div></div><div><h3>Conclusions</h3><div>Five-year OS was 4%-6% points inferior to RCTs. Pretreatment white blood cell counts, but not postoperative, could supplement clinical prognostic factors. Downstaging by preoperative chemotherapy was prognostic but correlated strongly with pretreatment clinical stage.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset enriches the identification of actionable alterations in patients with KRAS wild-type pancreatic ductal adenocarcinoma","authors":"E. Scarlato ,&nbsp;S. Casalino ,&nbsp;L. Mendo ,&nbsp;A. Sordo ,&nbsp;V. De Vita ,&nbsp;E. San Lorenzo ,&nbsp;A. Quinzii ,&nbsp;C. Zecchetto ,&nbsp;G. Butturini ,&nbsp;D. Melisi","doi":"10.1016/j.esmogo.2025.100179","DOIUrl":"10.1016/j.esmogo.2025.100179","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 10% of pancreatic ductal adenocarcinoma (PDAC) cases are <em>KRAS</em> wild-type (<em>KRAS</em>-wt). Among these, only a small subgroup harbors druggable genomic alterations, raising the question of when to apply broader next-generation DNA sequencing testing. Early-onset (EO) PDAC is increasing globally, with recent evidence suggesting an enrichment of <em>KRAS</em>-wt cases in younger patients.</div></div><div><h3>Patients and methods</h3><div>This retrospective observational study analyzed secondary data from a predefined database. Genomic alterations were identified using FoundationOne CDx or Liquid gene panels in patients who had failed standard treatments. Cases were classified by <em>KRAS</em> status, and <em>KRAS</em>-wt patients were stratified into EO (≤52.5 years) and late-onset (LO) (&gt;52.5 years) groups. Alterations were evaluated according to the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets (ESMO ESCAT).</div></div><div><h3>Results</h3><div>Next-generation sequencing was carried out on 224 PDAC and 10 pancreatic acinar cell carcinoma (PACC) patients. Within PDAC patients, 23.2% (52/224) were <em>KRAS</em>-wt. Actionable TIER I-III alterations were more frequent in <em>KRAS</em>-wt cases (23.1% versus 11.6%, <em>P</em> = 0.04), with gene fusion events exclusively found in <em>KRAS</em>-wt (9.6% versus 0%, <em>P</em> = 0.0006). Among <em>KRAS</em>-wt PDACs, significantly higher frequencies of druggable TIER I-III were identified across EO-PDAC (6 versus 6, or 54.5% versus 14.6%, <em>P</em> = 0.006). Notably, actionable gene fusions were found to be significantly enriched in <em>KRAS</em>-wt EO-PDACs compared with LO counterparts (4 versus 1, or 36.4% versus 2.4%, <em>P</em> = 0.005).</div></div><div><h3>Conclusions</h3><div><em>KRAS</em>-wt PDAC diagnosed at a younger age more frequently harbors actionable mutations, highlighting the importance of comprehensive genomic profiling to guide targeted therapeutic interventions in this patient population.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal microbiome correlates with post-esophagectomy anastomotic leak in cancer patients","authors":"R. Naddaf ,&nbsp;H. Shmilovich ,&nbsp;S. Carasso ,&nbsp;R. Keshet-David ,&nbsp;R. Herren ,&nbsp;T. Gefen ,&nbsp;T. Goshen-Lago ,&nbsp;Y. Zwang ,&nbsp;I. Livyatan ,&nbsp;N. Shental ,&nbsp;O. Haberfeld ,&nbsp;R. Straussman ,&nbsp;S.R. Markar ,&nbsp;M. Nilsson ,&nbsp;H. Kashtan ,&nbsp;I. Ben-Aharon ,&nbsp;N. Geva-Zatorsky","doi":"10.1016/j.esmogo.2025.100172","DOIUrl":"10.1016/j.esmogo.2025.100172","url":null,"abstract":"<div><h3>Background</h3><div>Despite continuous improvement in long-term survival after esophagectomy, potential serious post-operative complications, such as anastomotic leaks (ALs), still occur. Several risk factors for ALs have been proposed, including environmental factors. Our main objective was to examine the correlation of esophageal tumor microbiome composition and functional profile with ALs. Additionally, we analyzed the microbiome of esophageal tumors and their potential correlation with clinical features of the patients.</div></div><div><h3>Materials and methods</h3><div>Surgical specimens of esophageal tumors and adjacent normal tissues were collected from consecutive patients who underwent an esophagectomy. Formalin-fixed paraffin-embedded (FFPE) tissue samples were processed using 16S ribosomal DNA multiple fragments amplicon sequencing to characterize bacterial microbiome composition. The tumor and normal tissue microbiome and bacterial functional profile were analyzed based on the clinical outcome of ALs.</div></div><div><h3>Results</h3><div>Out of 60 patients who met the inclusion criteria, 52 (86.7%) patients had both normal adjacent tissue (NAT) and tumor (T) FFPE samples included with sufficient bacterial DNA extracted for analysis. A total of 28% of participants had esophageal ALs. Proportion tests [<em>P</em> &lt; 0.05, false discovery rate (FDR) &lt; 0.25] revealed operational taxonomic units (OTUs) significantly present in T samples as opposed to NAT samples, as well as significantly present OTUs in patients with AL as opposed to patients without AL complication.</div></div><div><h3>Conclusions</h3><div>In this study, we provide a profile of the understudied esophageal microbiome and its connection to ALs. Our results can provide potential clues on how to avoid ALs by considering a patient’s personal microbiome when providing perioperative care.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors for overall survival in advanced digestive neuroendocrine carcinoma treated with first-line cisplatin-based chemotherapy: a post hoc analysis of JCOG1213","authors":"H. Hirano ,&nbsp;K. Hirata ,&nbsp;Y. Honma ,&nbsp;C. Morizane ,&nbsp;N. Machida ,&nbsp;K. Kato ,&nbsp;T. Okusaka ,&nbsp;N. Boku ,&nbsp;S. Sekine ,&nbsp;N. Hiraoka ,&nbsp;J. Mizusawa ,&nbsp;Y. Sano ,&nbsp;Y. Shibuya ,&nbsp;M. Takahashi ,&nbsp;N. Fujimori ,&nbsp;M. Nomura ,&nbsp;Y. Doki ,&nbsp;M. Ueno ,&nbsp;T. Yoshikawa ,&nbsp;H. Takeuchi","doi":"10.1016/j.esmogo.2025.100178","DOIUrl":"10.1016/j.esmogo.2025.100178","url":null,"abstract":"<div><h3>Background</h3><div>There is no consensus on prognostic factors for advanced digestive neuroendocrine carcinoma (ADNEC). JCOG1213 was a phase III randomized trial that demonstrated equivalent overall survival (OS) between cisplatin plus etoposide and cisplatin plus irinotecan as first-line chemotherapy for ADNEC. We aimed to retrospectively explore prognostic factors for OS in patients with ADNEC using data from JCOG1213.</div></div><div><h3>Patients and methods</h3><div>The patients included in this <em>post hoc</em> analysis had ADNEC (2019 World Health Organization classification system) that was histologically confirmed by a central pathological review whose records included all clinical data required for multivariable analysis using a Cox proportional hazards model.</div></div><div><h3>Results</h3><div>Among 170 patients enrolled in JCOG1213, a total of 129 patients with ADNEC were included in this analysis. Multivariable analysis identified elevated serum lactate dehydrogenase (LDH; &gt;222 IU/l) as a significantly unfavorable prognostic factor for OS [hazard ratio (HR) 1.721, 95% confidence interval (CI) 1.144-2.589, <em>P</em> = 0.0092]. OS of patients with elevated serum LDH was shorter than that of patients without elevated serum LDH [median 9.5 months (95% CI 8.1-10.7 months) versus 15.6 months (95% CI 11.4-19.7 months); HR 1.799, 95% CI 1.242-2.604, <em>P</em> = 0.0019]. There were no distinct differences either in objective response rates or progression-free survival between patients with and without elevated serum LDH.</div></div><div><h3>Conclusion</h3><div>Serum LDH may serve as a simple, non-invasive, and clinically informative biomarker for prognostic evaluation in patients with ADNEC undergoing first-line platinum-based chemotherapy.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility of an mGPS and SII combined score in patients with advanced gastric cancer treated with nivolumab monotherapy","authors":"S. Udagawa,&nbsp;A. Ooki,&nbsp;H. Osumi,&nbsp;K. Yoshino,&nbsp;M. Tamba,&nbsp;K. Shimozaki,&nbsp;S. Fukuoka,&nbsp;T. Wakatsuki,&nbsp;M. Ogura,&nbsp;E. Shinozaki,&nbsp;K. Chin,&nbsp;K. Yamaguchi","doi":"10.1016/j.esmogo.2025.100177","DOIUrl":"10.1016/j.esmogo.2025.100177","url":null,"abstract":"<div><h3>Background</h3><div>Several nutritional and inflammatory indices can predict the efficacy of immune checkpoint inhibitors and the prognosis in various cancers. However, indices that are useful for patients with advanced gastric cancer (AGC) remain unclear.</div></div><div><h3>Materials and methods</h3><div>This retrospective study was conducted at a single cancer center. Patients with AGC who received nivolumab as a third- or later-line treatment between June 2017 and May 2023 were selected. The association between nutritional and inflammatory indices and clinical outcomes was analyzed.</div></div><div><h3>Results</h3><div>In total, 277 patients were analyzed. Multivariate analysis revealed that several indices were significantly associated with time to treatment failure (TTF) and overall survival (OS) after adjustment for clinicopathological factors. The modified Glasgow prognostic score (mGPS) and systemic immune-inflammation index (SII) were identified as the most promising indices. A combined score (CS) developed by summing the SII and mGPS was associated with a shorter TTF and OS in CS 1 or 2 than in CS 0 [TTF: hazard ratio (HR) 1.39, 95% confidence interval (CI) 1.04-1.87, <em>P</em> = 0.03 for CS 1 and HR 2.04, 95% CI 1.49-2.80, <em>P</em> &lt; 0.01 for CS 2; OS: HR 1.45, 95% CI 1.08-1.96, <em>P</em> &lt; 0.01 for CS 1 and HR 2.81, 95% CI 2.06-3.82, <em>P</em> &lt; 0.01 for CS 2]. CS 2 had a positive predictive value of 78.1% for detecting the first progressive disease. The clinical significance of CS was also confirmed in the first-line cohort.</div></div><div><h3>Conclusion</h3><div>CS may be useful for predicting treatment efficacy and prognosis in nivolumab-treated patients with AGC.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}