Journal of gastrointestinal oncology最新文献

{"title":"Autoimmune enteropathy associated with T cell large granular lymphocytic leukemia in a patient with <i>BACH2</i> mutation: a case report.","authors":"Juwairiya Arshi, Andrew G Evans, Jane Liesveld, Yansheng Hao","doi":"10.21037/jgo-24-804","DOIUrl":"10.21037/jgo-24-804","url":null,"abstract":"<p><strong>Background: </strong>T cell large granular lymphocytic leukemia (T-LGL) is a rare indolent lymphoproliferative disorder caused by aberrantly clonal expansion of cytotoxic T lymphocytes. Active mutations of <i>STAT3</i> are the hallmark of this disease. It is commonly associated with autoimmune disorders involving multiple organ systems. However, its association with autoimmune enteropathy has been rarely reported.</p><p><strong>Case description: </strong>A 36-year-old female had a history of T-LGL and multiple autoimmune disorders, including type I diabetes mellitus, pure red cell aplasia, IgA deficiency, celiac disease and recurrent infection and bacteremia. She carries an HLA-DQ8 allele and a germline heterozygous mutation of <i>BACH2.</i> Bone marrow biopsy demonstrated T-LGL involvement. She presented with chronic diarrhea. Laboratory tests for viral and bacterial infections were negative. Colonoscopy showed diffuse edema with loss of vascular markings in the entire colon. Microscopically, absence of goblet cells and Paneth cells, as well as intraepithelial lymphocytosis and prominent crypt apoptosis, was present. Serology for an anti-enterocyte antibody was positive. A diagnosis of autoimmune enteropathy was made.</p><p><strong>Conclusions: </strong>We report an extremely rare case of autoimmune enteropathy associated T-LGL in a patient with non-<i>STAT</i> gene mutations. Further investigation of the functional changes and pathogenesis of the co-existent <i>BACH2</i> mutation in this clinical setting is warranted.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"738-742"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA using a plasma-only assay predicts survival in patients with oligometastatic colorectal cancer after definitive therapy.","authors":"Enrique Sanz-Garcia, Paloma Peinado, Adrián Peláez, Elena Gonzalez Lopez-Aranda, Rafael Álvarez-Gallego, César Muñoz, Carmen Toledano, Luka Mihic, Justo Ortega, Almudena Lazaro, Begoña Martinez Montesino, Cristina Bressel, Alicia Gonzalo, Ovidio Hernando, Mercedes Lopez, Carmen Rubio, Isabel Fabra, Yolanda Quijano, Emilio Vicente, Antonio Cubillo","doi":"10.21037/jgo-24-819","DOIUrl":"10.21037/jgo-24-819","url":null,"abstract":"<p><strong>Background: </strong>Patients with colorectal cancer (CRC) and oligometastases are usually treated with surgery and radiation. The addition of adjuvant chemotherapy is controversial. The detection of circulating tumor DNA (ctDNA) may provide further insight in prognosis as well as help in decision of adjuvant therapies. We aim to show that detection of ctDNA after definitive therapy in oligometastatic CRC is associated with worse outcomes.</p><p><strong>Methods: </strong>A single centre prospective study included patients with oligometastatic CRC treated with surgery or radiation with definitive intent. Plasma samples were collected before procedure and 4 weeks after, prior to adjuvant chemotherapy. Plasma samples were analyzed using a tumor-naive assay focusing on genomic and methylation alterations (Guardant Reveal). Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan Meier method.</p><p><strong>Results: </strong>A total of 25 patients were included: 19 were evaluated at baseline and post-treatment. ctDNA detection at baseline was not associated with any clinicopathological characteristics, neither OS nor DFS. In contrast, patients with ctDNA detection post-treatment had worse OS [hazard ratio (HR): 11.28; 95% confidence interval (CI): 1.31-97.05] and a trend to shorter DFS (HR: 2.97; 95% CI: 0.97-9.06). Patients who were persistently negative or cleared ctDNA had similar outcomes.</p><p><strong>Conclusions: </strong>ctDNA detection after surgery/radiation in oligometastatic CRC predicts worse OS and DFS. ctDNA could help to guide the decision regarding need of adjuvant chemotherapy in this population.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"580-590"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of tertiary lymphatic structures and their modulation by adjuvant FOLFOX in stage III colon cancer: a retrospective cohort study.","authors":"Chuang Zhang, Shao-Ke Wang, Nan Zun Teo, Matthew Yuan-Kun Wei, Hiroki Hashida, Chen-Feng Yu, Yan-Long Liu, Bin-Bin Cui","doi":"10.21037/jgo-2025-181","DOIUrl":"10.21037/jgo-2025-181","url":null,"abstract":"<p><strong>Background: </strong>Stage III colon cancer (CC) presents a critical therapeutic challenge due to its high recurrence risk. Identifying robust prognostic biomarkers to guide adjuvant therapy decisions is urgently needed in clinical practice. Tertiary lymphoid structures (TLSs), as immune aggregates within the tumor microenvironment, have emerged as potential indicators of immunological activity and treatment response. The objective of this study is to evaluate the role of TLSs in stage III CC, focusing on their potential as prognostic markers and their influence on patient outcomes, particularly in relation to chemotherapy response.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 613 patients with pathologically confirmed stage III CC from two cohorts: 374 from Harbin Medical University and 239 from The Cancer Genome Atlas Colon Adenocarcinoma (TCGA-COAD) external validation cohort. Overall survival (OS) was the primary outcome, with a median follow-up period of 62 months. TLSs were assessed via immunohistochemistry and categorized by density and location [intratumoral (T score), peritumoral (P score)]. Prognostic significance was evaluated using multivariate Cox regression. A murine model was used to assess the immunomodulatory effects of folinic acid, oxaliplatin, and 5-fluorouracil (FOLFOX) chemotherapy on TLS formation.</p><p><strong>Results: </strong>TLSs were present in 54.0% and 50.2% of patients in Cohorts 1 and 2, respectively. TLSs enriched with CD8⁺ T cells and CD20⁺ B cells were associated with improved OS. Multivariate analysis identified TLS presence as an independent predictor of better survival [hazard ratio (HR) =0.256, 95% confidence interval (CI): 0.093-0.707; P=0.009]. Higher intratumoral TLS density (T score) correlated with lower mortality risk (T2 <i>vs.</i> T0: HR =0.173, P=0.003), whereas higher peritumoral TLS density (P3) predicted worse prognosis (HR =5.887, P=0.04). <i>In vivo</i> experiments confirmed that FOLFOX treatment enhanced TLS formation and increased infiltration of immune cells including B cells, CD4⁺/CD8⁺ T cells, and dendritic cells.</p><p><strong>Conclusions: </strong>TLSs serve as a reliable, independent prognostic biomarker in stage III CC. Their spatial distribution carries distinct prognostic implications, and FOLFOX-induced TLS formation suggests a dual role in cytotoxicity and immune activation. Incorporating TLS assessment into clinical workflows may improve risk stratification and guide personalized treatment, especially in designing immunochemotherapy strategies.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"386-403"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between apparent diffusion coefficient values and clinicopathologic features in rectal cancer: a cross-sectional study.","authors":"Chunyu Zhang, Ting Lu, Hongyu Zhang, Yuting Zhang, Long Yuan, Junlin Zhou","doi":"10.21037/jgo-24-831","DOIUrl":"10.21037/jgo-24-831","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of rectal cancer is closely related to its clinicopathologic features. Accurate preoperative assessment of these features is crucial for treatment planning and prognosis prediction. The apparent diffusion coefficient (ADC), derived from diffusion-weighted imaging (DWI), has shown potential as a noninvasive imaging biomarker for evaluating tumor characteristics. This study aimed to explore the relationship between ADC values and the clinicopathological features of rectal cancer.</p><p><strong>Methods: </strong>We retrospectively recruited 97 eligible patients with rectal adenocarcinoma who underwent magnetic resonance imaging (MRI) and surgical resection at our institution between January 2023 and December 2023. Each patient was evaluated for the presence of extramural vascular invasion (EMVI) or circumferential resection margin (CRM) on MRI, and the mean (ADC_mean), minimum (ADC_min), and maximum (ADC_max) ADC values were calculated. Moreover, the relationship between the ADC values and clinicopathological features, including tumor stage, histologic grade, lymphovascular invasion, perineural invasion, and lymph node metastasis, were statistically analyzed.</p><p><strong>Results: </strong>Among 97 patients with rectal cancer, the mean age was 61.40±10.46 years and 60 (61.9%) were males. ADC_mean, ADC_min, and ADC_max were significantly lower in patients with EMVI or CRM than in those without EMVI or CRM (P<0.05). Pathologic T1-2 staging exhibited higher ADC_mean (0.79±0.26 <i>vs.</i> 0.61±0.22, P=0.001), ADC_min (0.71±0.26 <i>vs.</i> 0.55±0.22, P=0.002) and ADC_max (0.89±0.26 <i>vs.</i> 0.75±0.22, P=0.004) compared with T3-4 staging. Highly and moderately differentiated tumors had higher ADC_mean, ADC_min, and ADC_max than less-differentiated tumors (P<0.05). Patients with lymphovascular invasion, perineural invasion, and lymph node metastasis showed significantly lower ADC_mean, ADC_min, and ADC_max than those without these conditions (P<0.05). ADC_mean, ADC_min and ADC_max were negatively correlated with EMVI (r=-0.334, -0.340, -0.302), CRM (r=-0.362, -0.414, -0.276), pathologic T-stage (r=-0.324, -0.313, -0.276), histologic grade (r=-0.353, -0.352, -0.289), lymphovascular invasion (r=-0.405, -0.384, -0.421), perineural invasion (r=-0.428, -0.407, -0.265), and lymph node metastasis (r=-0.347, -0.316, -0.268) in rectal cancer.</p><p><strong>Conclusions: </strong>ADC values were negatively associated with different clinicopathological features of rectal cancer, suggesting their potential role as noninvasive imaging markers for preoperative tumor assessment.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"528-541"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unique role of cuproptosis in the prognosis and treatment of rectum adenocarcinoma.","authors":"Jun Ma, Huangwei Lin, Ying Wang, Yaming Zhang, Chaoping Zhou, Daibin Tang, Yoshinori Kagawa, Daorong Hou, Guoqin Jiang","doi":"10.21037/jgo-2025-105","DOIUrl":"10.21037/jgo-2025-105","url":null,"abstract":"<p><strong>Background: </strong>The incidence of digestive system cancers has increased significantly in recent years. Among these, rectum adenocarcinoma (READ), which exhibits distinct features compared to colon adenocarcinoma, has emerged as a unique subtype. Cuproptosis, a recently identified form of non-apoptotic programmed cell death, plays a pivotal role in tumorigenesis; however, its relationship with READ and its potential effect on prognosis remains poorly understood. This study innovatively explores the role of cuproptosis related genes (CRGs) in READ development and identifies potential therapeutic targets.</p><p><strong>Methods: </strong>This study used consensus clustering to classify READ samples into three distinct clusters based on their survival status and enriched biological pathways. A cuproptosis-related score (CRS) was developed to examine the association between cuproptosis subtypes and patient prognosis. Immune infiltration was analyzed using multiple deconvolution algorithms to explore the immune landscape across different cuproptosis subtypes. A principal component analysis (PCA) was conducted to construct a prognostic score that reflects the clinical significance of cuproptosis in READ. Further investigations focused on lipoic acid synthetase (LIAS) as a key gene with prognostic implications for READ patients.</p><p><strong>Results: </strong>Consensus clustering of the READ samples revealed three clusters with varying survival outcomes and distinct biological pathways. The CRS successfully predicted patient prognosis, and was found to be correlated with overall survival (OS) and tumor characteristics. The immune infiltration analysis revealed significant differences in immune profiles across the subtypes, with certain subtypes exhibiting immunosuppressive characteristics. LIAS was identified as a favorable prognostic marker for READ patients, and thus could serve as a potential therapeutic target.</p><p><strong>Conclusions: </strong>CRGs play a critical role in the development and prognosis of READ. The established CRS could serve as a valuable tool for predicting patient outcomes. Further, LIAS emerged as a potential therapeutic target. Our findings may provide new avenues for targeted cancer treatment in READ.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"367-385"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of hepatocellular carcinoma progression by artesunate via modulation of the TLR4/MyD88/NF-κB signaling pathway.","authors":"Yongchao Wu, Jianhua Wu, Zhigang Li, Zhonglin Wu, Shunzong Li, Guang Yang, Xiaocui Rong, Qi Wang, Yazhou Li, Qingqing Xia, Gaofeng Shi","doi":"10.21037/jgo-2025-95","DOIUrl":"10.21037/jgo-2025-95","url":null,"abstract":"<p><strong>Background: </strong>Liver cancer remains a frequent cause of cancer-related death, and thus targeted drugs urgently need to be developed. Artesunate (ART) inhibits the progression of liver cancer; however, its mechanism of action remains unclear. The primary aim of this study is to clarify whether ART inhibits the progression of hepatocellular carcinoma (HCC) cells by suppressing the Toll-like receptor 4 (TLR4)/MyD88/nuclear factor (NF)-κB pathway.</p><p><strong>Methods: </strong><i>In vitro</i> studies demonstrated the effects on cell proliferation, invasion, and migration through a series of phenotypic experiments. Specifically, the CCK8 was used to assess the impact on cell proliferation, while the Transwell assay was employed to evaluate the effect on cell invasion. A xeno-inhibitory tumor model was established <i>in vivo</i> to verify the therapeutic effects of ART. Western blotting was used to detect changes in the TLR4/MyD88/NF-κB pathway.</p><p><strong>Results: </strong>The study showed that ART inhibits HCC cell proliferation, invasion, and migration and induces apoptosis in a dose-dependent manner. <i>In vivo</i> studies indicated shown that ART treatment in xenograft tumor models could consistently reduce tumor growth. Moreover, ART inhibited the viability, colony formation, migration, and invasion ability of HCC cells while promoting their apoptosis in a dose-dependent manner. The treatment of xenograft models with ART consistently reduced tumor growth. Furthermore, Western blot analysis demonstrated that the levels of TLR4 and its known downstream effectors (TRAF6, MyD88, and NF-κB) were markedly downregulated after ART treatment in Huh-7 and liposaccharide-stimulated Huh-7 cells.</p><p><strong>Conclusions: </strong>These results indicate that ART has a potent effect on the development of HCC cells, the underlying mechanisms of which may be associated with alterations in the TLR4/MyD88/NF-κB signaling pathway in HCC. Therefore, further development of ART as a therapeutic agent is warranted.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"599-614"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prognostic nomogram based on desmoplastic reaction/tumor deposit modified lymph node staging in colorectal cancer.","authors":"Longting Geng, Li Wang, Xiaoming Jiang, Changxian Chen, Yunbin Yuan, Weijun Liu, Weimin Bao","doi":"10.21037/jgo-2024-865","DOIUrl":"10.21037/jgo-2024-865","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tumor metastasis within the tumor microenvironment (TME) is a primary driver of tumor progression, with tumor deposit (TD) being one pathway of metastasis. However, the mechanisms underlying TD as a prognostic indicator in colorectal cancer (CRC) remain unclear. The 8&lt;sup&gt;th&lt;/sup&gt; edition of the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) stage system does not account for the impact of TD quantity on prognosis in TD-positive patients. This study aims to integrate TD numbers into the existing N-stage system, develop a novel nomogram prediction model (newN), and validate its prognostic significance. Desmoplastic reaction (DR), including immature, intermediate, and mature types, is a critical indicator of TME status and a prognostic factor. While immature DR has been associated with TD presence, the relationship between TD quantity and DR type changes (mature-intermediate-immature) remains unexplored, this study seeks to elucidate this relationship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study enrolled 171 patients with TNM stage II or III pT3 or pT4 colorectal adenocarcinoma who underwent complete tumor resection. DR was evaluated, and TD numbers were recorded. Clinicopathological factors related to TD formation, multiple TD, and DR changes were analyzed to explore their relationships. Kaplan-Meier curves and log-rank tests were used to assess recurrence-free survival (RFS). Univariate and multivariate Cox proportional hazards analyses were performed to identify independent risk factors for overall survival (OS), and a nomogram prediction model was developed. The association between TD, DR, and the TME was investigated, along with the mechanisms underlying TD formation and DR changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;DR classification and the number of TD-positive cases were assessed using the Gamma test, yielding a statistically significant result (statistic =11.419, P&lt;0.001) and a strong positive correlation (correlation coefficient =0.836) between TD-positive numbers and DR classification. Abnormal carcinoembryonic antigen (CEA) levels, T stage, lymph node (LN) metastasis count, vascular invasion, TD numbers, poor histologic grade, immature DR, newN stage, contrastN stage, and existing N stage were associated with reduced RFS. DR, TD, and newN stage were identified as independent risk factors for CRC prognosis. The C-index values for the newN stage model (0.759), contrastN stage model (0.748), and existing N stage model (0.742) confirmed the superior prognostic accuracy of the newN stage model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study confirmed a significant correlation between immature DR and TD, as well as an association between DR types and TD quantities. We hypothesize that tumor-cancer-associated fibroblasts (CAFs)-Twist/DR-epithelial-mesenchymal transition (EMT)-tumor budding (TB)-TD interactions within the TME are involved in the mec","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"485-502"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of pemigatinib in patients with cholangiocarcinoma: a systematic review.","authors":"Warda Rasool, Yassine Alami Idrissi, Owais Ahmad, Shree Rath, Fatima Saeed, Mohamed Saad Sayed, Bhavya Sharma, Arwa Amer Ibrahim, Ajanta Kumari, Irfan Ullah, Anwaar Saeed","doi":"10.21037/jgo-2024-923","DOIUrl":"10.21037/jgo-2024-923","url":null,"abstract":"<p><strong>Background: </strong>Cholangiocarcinoma (CCA) is an aggressive bile duct cancer with limited therapeutic options and poor prognosis. pemigatinib, a selective <i>FGFR</i> inhibitor, has emerged as a promising targeted therapy for CCA patients harboring <i>FGFR2</i> fusions or rearrangements. This systematic review evaluated the safety and efficacy of pemigatinib in this patient population.</p><p><strong>Methods: </strong>A comprehensive systematic review was conducted across PubMed, Scopus, Embase, Cochrane Library, and Web of Science to identify studies investigating pemigatinib in CCA patients. Five studies involving a total of 459 patients met the inclusion criteria.</p><p><strong>Results: </strong>Pemigatinib demonstrated an overall objective response rate (ORR) of 43.2%, with a complete response (CR) achieved in 3% of patients. Stable disease was observed in 36.9% of patients, while 14.9% experienced disease progression. Median progression-free survival (PFS) varied across studies, due to differences in patient cohorts. The most common adverse effects (AEs) included hyperphosphatemia (48%), diarrhea (28.6%), fatigue (33%), and dry eyes (20.1%).</p><p><strong>Conclusions: </strong>This systematic review suggests that pemigatinib has modest therapeutic efficacy in CCA patients, with a considerable proportion achieving disease control. However, the ORR of less than 50% highlights the potential need for combination or sequential therapies to improve outcomes. Close monitoring and management of AEs, particularly hyperphosphatemia, are crucial for optimizing treatment. Further large-scale randomized trials and research are warranted to identify predictive biomarkers and optimize pemigatinib-based treatment strategies for CCA patients with FGFR2 alterations.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"699-710"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of multi- and single-cancer blood-based early detection tests in liver cancer screening.","authors":"Won Jin Choi, Nima Nabavizadeh","doi":"10.21037/jgo-24-686","DOIUrl":"10.21037/jgo-24-686","url":null,"abstract":"<p><p>Liver cancer is one of the most common causes of cancer deaths worldwide. Although fatal when diagnosed at an advanced stage, liver cancer has a favorable prognosis when identified at an earlier stage. Guidelines for liver cancer screening do exist, currently recommending the use of ultrasound with or without hematologic markers for early detection of liver cancer. However, studies have revealed shortcomings in the current state of liver cancer screenings such as underutilization stemming from lack of primary care education and logistical barriers for patients, suboptimal sensitivity of current screening methods, and lack of screening for lower risk individuals. A multitude of liquid biopsy tests that use circulating genomic analytes for early detection of cancers are currently under development and have the potential clinical implications in the early detection of liver cancer. In this overview, we highlight limitations of current liver cancer screenings and the ongoing development of multicancer early detection tests as well as cancer specific blood tests for liver cancer. As these multi-analyte blood tests hold promise in filling the gaps of current shortcomings of liver cancer screenings, it is imperative for primary care physicians, oncologists, and hepatologists involved in the screening process to be aware of ongoing studies and the further research necessary to ascertain several parameters such as the cost-benefit ratio, mortality reduction, and sensitivities of the blood tests.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"711-718"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of multiple deep learning models for colorectal tumor differentiation with endoscopic ultrasound images: a dual-center study.","authors":"Hang Men, Cong Yan, Xi Peng, Shao-Qin Jin, Yu-Hao Du, Zhong-Shun Tang, Hao Li, Ting Ou-Yang, Shuo Zhang, Li-Shan Ding, Jin Deng, Zhe Xu, Guan-Bin Li, Hong-Yu Luo, Zhou Li, Fang Xie, Shuai Han","doi":"10.21037/jgo-2024-1024","DOIUrl":"10.21037/jgo-2024-1024","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is one of the most common malignancies worldwide. Differentiating adenomas and cancers in colorectal lesions is essential for reducing morbidity and mortality associated with CRC. Endoscopic ultrasound (EUS) is crucial in the diagnosis of CRC, and artificial intelligence (AI) offers a promising approach for identifying colorectal lesions without the need for histopathological confirmation. The objective of this study was to validate the efficacy of EUS combined with AI for the diagnosis of colorectal adenoma and cancer and to compare it with that of conventional endoscopic diagnosis.</p><p><strong>Methods: </strong>This retrospective study included 554 patients (167 with CRC, 136 with adenomas, and 251 controls) from two independent centers. The dataset was randomly divided into training and test sets in a 2:1 ratio (360 for the training dataset; 194 for the testing dataset). A model was developed using a \"feature extractor + multilayer perceptron (MLP) classifier\" framework, incorporating Residual Network 50 (ResNet50), EfficientNet-B0, Visual Geometry Group 11_BN (VGG_11_BN), and Vision Transformer (ViT) as feature extractors. Four AI systems were trained and validated, and the model with the highest F1 scores was subsequently compared to four endoscopists using the test dataset, and interobserver agreement measured by Fleiss' kappa.</p><p><strong>Results: </strong>The accuracies for three-category classification (CRC, adenoma and controls) were 70.62% for ResNet50, 68.56% for EfficientNet-B0, 63.4% for ViT, and 70.10% for VGG_11_BN. ResNet50 achieved the highest F1 scores (70.37%) and diagnostic accuracy and was selected for comparison with endoscopists. For CRC diagnosis, ResNet50 outperformed endoscopists with an accuracy of 80.93%, sensitivity of 72.88%, and specificity of 84.44%, which were significantly higher than those of all endoscopists (P<0.05). For adenoma diagnosis, ResNet50 had a sensitivity of 47.92%, which was significantly higher than that of nonexpert endoscopists (P<0.05). The interobserver agreement was fair among AI systems (Fleiss' κ =0.674) and among experts (Fleiss' κ =0.557) and was slight among nonexperts (Fleiss' κ =0.284).</p><p><strong>Conclusions: </strong>EUS-AI has high diagnostic accuracy for CRC and adenoma as compared to non-expert endoscopists. ResNet50 is a promising tool for enhancing diagnostic accuracy in clinical practice using EUS.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"16 2","pages":"435-452"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}