Journal of Gastrointestinal Cancer最新文献

{"title":"Third-Line Treatment Timing After Second-Line Discontinuation in Advanced Pancreatic Cancer: A 30-Day Landmark Analysis.","authors":"Kohei Nagata, Shinya Kajiura, Miho Sakumura, Yurika Nakayama, Yuko Ueda, Iori Motoo, Takayuki Ando, Banri Ogino, Hiroki Kawanaka, Jun Sakamoto, Toshiki Entani, Nobuhiko Hayashi, Ichiro Yasuda","doi":"10.1007/s12029-026-01565-0","DOIUrl":"10.1007/s12029-026-01565-0","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence for third-line systemic therapy in advanced pancreatic cancer is limited, and observational comparisons risk time-related and selection biases. We evaluated third-line initiation after second-line discontinuation using a 30-day landmark strategy, focusing on treatment timing and patient selection.</p><p><strong>Methods: </strong>This single-center retrospective cohort included patients with advanced pancreatic cancer discontinuing second-line systemic therapy between October 2014 and October 2025. The primary analysis included ECOG performance status (ECOG PS) 0-1 patients alive and under observation at day 30. Exposure was initiation within 30 days versus no initiation by day 30, with overall survival (OS) measured from the landmark. Complementary analyses included a 45-day landmark, overlap weighting, time-dependent Cox models, and 60-day mortality after initiation.</p><p><strong>Results: </strong>Among 130 patients, 53 received third-line therapy. The primary 30-day landmark cohort included 48 patients. Early initiation showed a directionally favorable but imprecise association with OS (aHR 0.40, 95% CI 0.15-1.04). Findings were similar at the 45-day landmark (aHR 0.33, 95% CI 0.11-1.02) and attenuated with overlap weighting (aHR 0.68, 95% CI 0.38-1.20). Death within 60 days after initiation occurred in 18.9% of recipients and was associated with ECOG PS ≥ 2.</p><p><strong>Conclusion: </strong>Among selected patients with preserved ECOG PS alive and observed at day 30, early third-line initiation showed directionally favorable but imprecise OS. This contrast should be interpreted as early versus deferred-or-no initiation within a 30-day decision window, supporting time-bound patient selection and supportive care-integrated decision-making, not definitive causal inference.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726127","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":"Comparative Analysis of Lesion Detection and Uptake Characteristics of ⁶⁸Ga-FAPI PET/CT Versus ¹⁸F-FDG PET/CT in Gastric Cancer.","authors":"Ebuzer Kalender, Edanur Eki̇nci̇ Yildirim, Enes Yerdeş, Buket Eren Saribaş, Umut Elboğa, Ertan Şahi̇n, Vuslat Mumcu Çi̇men","doi":"10.1007/s12029-026-01563-2","DOIUrl":"10.1007/s12029-026-01563-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare lesion detection and uptake characteristics of ⁶⁸Ga-FAPI PET/CT and ¹⁸F-FDG PET/CT in patients undergoing imaging for gastric cancer (GC) staging.</p><p><strong>Methods: </strong>A total of 24 patients with histopathologically confirmed GC were retrospectively evaluated. All patients underwent ¹⁸F-FDG PET/CT followed by ⁶⁸Ga-FAPI PET/CT within a short interval as part of their clinical staging workup. Lesion detection rates and semi-quantitative parameters, including SUVmax and tumor-to-background ratio (TBR), were compared between the two modalities.</p><p><strong>Results: </strong>⁶⁸Ga-FAPI PET/CT demonstrated significantly higher SUVmax values than ¹⁸F-FDG PET/CT across primary tumors and metastatic lesions (p < 0.05). TBRs were also markedly higher for FAPI due to lower physiological background activity. In patient-based analysis, ⁶⁸Ga-FAPI PET/CT identified a higher number of nodal and distant metastases compared to ¹⁸F-FDG PET/CT; however, these differences did not reach statistical significance (p = 0.25). Notably, discordant findings were observed in three patients, in whom lesions-particularly peritoneal and bone metastases-were detected by ⁶⁸Ga-FAPI PET/CT but not by ¹⁸F-FDG PET/CT.</p><p><strong>Conclusion: </strong>⁶⁸Ga-FAPI PET/CT provides higher tracer uptake and improved TBR compared to ¹⁸F-FDG PET/CT in GC. Although lesion detection rates were numerically higher with FAPI, statistical significance was not reached in this cohort. These findings suggest a potential complementary role of FAPI PET/CT, particularly in detecting peritoneal and bone metastases and in cases with low FDG avidity. Larger prospective studies are warranted to clarify its clinical impact.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701523","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":"Capmatinib for High-Level MET-Amplified Metastatic Gastric Cancer Identified by Comprehensive Genomic Profiling: A Case Report and Literature Review.","authors":"Yasuyoshi Sato, Kousuke Watanabe, Mana Matsuoka, Yurina Yamada, Koichi Yagi, Kuniko Sunami, Miho Ogawa, Katsutoshi Oda, Yoshifumi Baba","doi":"10.1007/s12029-026-01561-4","DOIUrl":"10.1007/s12029-026-01561-4","url":null,"abstract":"<p><p>High-level MET gene amplification is a rare but potentially actionable alteration in gastric cancer. Previous phase III trials of MET-targeted therapies enrolled broadly MET-positive populations without prospective selection for high-level MET amplification, and no MET-directed therapy is currently established for this disease. Here, we report a 74-year-old woman with heavily pretreated metastatic gastric adenocarcinoma harboring high-level MET amplification (copy number 21) identified by comprehensive genomic profiling. Following expert panel review, the patient received capmatinib through the BELIEVE trial (NCCH1901; jRCTs031190104) and achieved a confirmed partial response at 8 weeks, with a 43.7% reduction in the sum of target lesion diameters. The response was maintained at 16 weeks; disease progression was observed at 24 weeks, with a progression-free survival of approximately 5.5 months. In the context of a literature review of MET-targeted therapies in gastric cancer, this case supports further investigation of selective MET inhibition in gastric cancer with high-level MET amplification, a rare molecular subset not prospectively enriched in previous clinical trials.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unimodal to Multimodal Prehabilitation in Gastric Cancer Surgery: Systematic Review of Randomised Controlled Trials.","authors":"Maria Wobith, Emer Guinan, Edward Cheong, David Mockler, Linda O'Neill","doi":"10.1007/s12029-026-01519-6","DOIUrl":"10.1007/s12029-026-01519-6","url":null,"abstract":"<p><strong>Purpose: </strong>Prehabilitation prior to gastric cancer resection aims to optimise pre-operative physical and nutritional status to improve perioperative resilience. However, the current evidence-base is fragmented. This review synthesized randomized controlled trial (RCT) evidence evaluating effectiveness of prehabilitation interventions prior to gastric cancer resection and characterized reported outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines (PROSPERO registration -CRD420251233981). MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL were searched up to August 2025. Eligible studies were RCTs investigating unimodal or multimodal prehabilitation interventions (minimum duration 7 days) prior to gastric cancer resection. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Heterogeneity precluded meta-analysis and results were synthesized narratively.</p><p><strong>Results: </strong>Fourteen RCTs were included: four multimodal, and ten unimodal interventions (nutritional (n = 9), spirometry (n = 1)), duration range (7-days to 15-weeks). Fifty-three unique outcomes were reported across five domains: clinician/observer-reported outcomes, performance outcomes, patient-reported outcomes, biomarkers, and non-health outcomes. Multimodal prehabilitation programs suggest potential benefits; fewer postoperative complications, and improved functional capacity. Short-duration unimodal nutritional interventions demonstrated mixed effects, although immune-nutrition and targeted supplementation reduced infectious complications in malnourished patients. Findings were limited by risk-of-bias (some concerns (n = 7), high (n = 7)).</p><p><strong>Conclusion: </strong>Prehabilitation in gastric cancer surgery demonstrated a potential benefit, particularly when delivered as multimodal interventions. However, the evidence base is limited by substantial heterogeneity, variable methodological quality, and inconsistent outcome reporting. Development of a disease-specific core outcome set is urgently required, in addition to adequately powered, risk-stratified trials to advance evidence synthesis and implementation of gastric cancer prehabilitation.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678764","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":"Dedifferentiated Liposarcoma Presenting as Primary Diffuse Peritoneal Sarcomatosis: A Case Report and Literature Review.","authors":"Jiongyuan Wang, Quan Jiang, Weiqi Lu, Jinglei Li","doi":"10.1007/s12029-026-01559-y","DOIUrl":"10.1007/s12029-026-01559-y","url":null,"abstract":"<p><strong>Background: </strong>Dedifferentiated liposarcoma (DDLPS) typically presents as a solitary retroperitoneal mass; diffuse granular and nodular peritoneal sarcomatosis as the inaugural manifestation is exceptional. We report such a case to highlight a critical diagnostic consideration: distinguishing primary sarcomatous peritoneal dissemination from the more common epithelial peritoneal carcinomatosis.</p><p><strong>Case presentation: </strong>A 72-year-old Chinese man with no prior abdominal surgery presented with incidentally discovered multifocal intra-abdominal masses. CT demonstrated multiple peritoneal and retroperitoneal masses with encasement of the jejunum and transmural infiltration of the descending colon, and a retroperitoneal plaque abutting the left kidney. CT-guided biopsy confirmed DDLPS via MDM2 and CDK4 amplification on fluorescence in situ hybridization. Multidisciplinary team consensus directed surgical exploration for impending dual-site bowel obstruction. Laparotomy revealed diffuse granular and nodular peritoneal deposits (Peritoneal Cancer Index 28/39); cytoreductive surgery achieved a completeness of cytoreduction score of 2. Histopathology confirmed FNCLCC Grade III DDLPS. Postoperative next-generation sequencing demonstrated high-level co-amplification of CDK4, MDM2, TSPAN31, CCND2, MDM4, and RAC1, with microsatellite stability and tumor mutational burden of 0 mutations/Mb.</p><p><strong>Conclusion: </strong>DDLPS can present with primary diffuse peritoneal sarcomatosis even with a retroperitoneal component. When diffuse peritoneal implants yield an epithelial-marker-negative spindle cell neoplasm on biopsy, sarcoma must be considered in the differential diagnosis and FISH for MDM2/CDK4 should be performed to avoid misdiagnosis as peritoneal carcinomatosis from gastric, colorectal, or ovarian cancer.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678735","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":"Redefining First-Line HER2-Positive Advanced Gastric Cancer: From Trastuzumab-Based Chemoimmunotherapy to Zanidatamab and Next-Generation HER2 Targeting.","authors":"Tamotsu Sagawa, Masahiro Hirakawa, Hiroyuki Nagashima, Koshi Fujikawa","doi":"10.1007/s12029-026-01560-5","DOIUrl":"10.1007/s12029-026-01560-5","url":null,"abstract":"<p><strong>Background: </strong>For more than a decade after the ToGA trial, trastuzumab plus platinum-fluoropyrimidine chemotherapy remained the only established first-line HER2-targeted standard for unresectable or metastatic HER2-positive gastric or gastroesophageal junction adenocarcinoma. The treatment landscape is now changing rapidly through pembrolizumab-based chemoimmunotherapy, zanidatamab-based therapy, and antibody-drug conjugate strategies.</p><p><strong>Methods: </strong>This narrative review summarizes pivotal and emerging evidence for first-line HER2-positive advanced gastric and gastroesophageal junction adenocarcinoma. PubMed/MEDLINE was searched through June 2026 using combinations of the terms HER2, gastric cancer, gastroesophageal junction, first-line treatment, trastuzumab, pembrolizumab, zanidatamab, tislelizumab, and trastuzumab deruxtecan. Priority was given to phase III trials, peer-reviewed reports, major conference updates, and guideline documents relevant to clinical practice.</p><p><strong>Results: </strong>ToGA established trastuzumab plus chemotherapy as a first-line standard, but subsequent attempts to improve outcomes by adding or substituting HER2-directed agents, including lapatinib, high-dose trastuzumab, pertuzumab, and trastuzumab emtansine, did not displace trastuzumab-based therapy. KEYNOTE-811 demonstrated that pembrolizumab added to trastuzumab and chemotherapy improves response, progression-free survival, and overall survival, particularly in PD-L1-positive disease. The phase III HERIZON-GEA-01 trial has now shown that zanidatamab plus chemotherapy, with or without tislelizumab, improves progression-free survival compared with trastuzumab plus chemotherapy, and that zanidatamab plus tislelizumab and chemotherapy improves overall survival. Trastuzumab deruxtecan is also moving from later-line therapy into first-line development through platinum-free combinations with fluoropyrimidine and immune checkpoint blockade.</p><p><strong>Conclusions: </strong>First-line treatment of HER2-positive advanced gastric cancer is entering a second transformation. The central clinical question is shifting from whether HER2 blockade should be combined with chemotherapy to which HER2-targeted platform should anchor first-line therapy, how immune checkpoint inhibition should be integrated, and how HER2 heterogeneity and biomarker evolution should guide treatment sequencing.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678748","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":"Gastric Cancer Incidence in Iran: Trends and Projections to 2030 based on Global Burden of Disease 2021 Estimates.","authors":"Fatemeh Shahbazi, Faezeh Heidari, Ali Khezriyan, Erfan Ayubi, Salman Khazaei, Ali Shojaeian","doi":"10.1007/s12029-026-01550-7","DOIUrl":"10.1007/s12029-026-01550-7","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is a leading contributor to cancer-related illness and death globally, presenting a significant public health concern in Iran. There is a lack of extensive data regarding long-term trends at both national and regional levels for GC incidence and its anticipated future impact. This research aimed to investigate the changes in gastric cancer rates in Iran from 1990 to 2021 and to forecast incidence rates through 2030 by gender, age groups, and provinces.</p><p><strong>Methods: </strong>This research used secondary ecological data from the GBD 2021 research to investigate the incidence of GC in Iran from 1990 to 2021. Temporal trends were assessed with Joinpoint Regression to determine the Average Annual Percent Change (AAPC). Also, a Bayesian age-period-cohort model was then applied to project new cases and incidence rates up to 2030. We used from R and Joinpoint software for all analyses.</p><p><strong>Results: </strong>From 1990 to 2021, Iran saw nearly a twofold increase in new GC instances; however, the age-standardized incidence rate (ASIR) significantly fell from 23.12 to 14.37 per 100,000 individuals. The most significant decreases were observed in the northwestern provinces and among females. Forecasts for 2030 show that the absolute number of cases will likely increase to around 12,070, yet the ASIR is predicted to see a slight drop to 13.44, with a stagnation in decrease for individuals over 80 years old, suggesting a gradual slowdown in the overall trend.</p><p><strong>Conclusions: </strong>Although there has been a persistent reduction in the age-standardized incidence rate of GC in Iran over the last thirty years, the sheer number of cases is still increasing owing to demographic growth and an aging population. To combat this rising challenge, future initiatives should focus on implementing targeted screening in high-risk areas and for elderly populations, improving geriatric healthcare, and addressing inequalities in healthcare access through better collaboration across sectors.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669396","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":"Concordance Among Radiological, Laparoscopic and Laparotomic Peritoneal Cancer Index Assessments in Patients Undergoing Cytoreductive Surgery for Peritoneal Metastases.","authors":"Silvia Guerrero-Macías, Vaneza Ávila-Rodríguez, Jorge Andrés Urrutia-Gómez, Daniel Upegui, Carlos Bonilla, Álvaro Arjona-Sánchez","doi":"10.1007/s12029-026-01538-3","DOIUrl":"10.1007/s12029-026-01538-3","url":null,"abstract":"<p><strong>Background: </strong>Accurate estimation of the Peritoneal Cancer Index (PCI) is essential for selecting patients with peritoneal metastases who may benefit from cytoreductive surgery (CRS). Although cross-sectional imaging is routinely used for preoperative staging, its ability to reflect intraoperative tumor burden remains imperfect. Diagnostic laparoscopy may provide additional information in selected cases.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients who underwent CRS for peritoneal metastases at a tertiary cancer center between August 2023 and February 2025. Radiologic PCI (rPCI) was compared with intraoperative PCI assessed during open surgery (crsPCI). In patients who underwent diagnostic laparoscopy, laparoscopic PCI (lapPCI) was also compared with crsPCI. Agreement between methods was evaluated using correlation and concordance analyses.</p><p><strong>Results: </strong>Fifty-six patients were included in the radiologic analysis, and 16 underwent diagnostic laparoscopy before CRS. Radiologic PCI demonstrated good agreement with intraoperative PCI but tended to underestimate the extent of peritoneal disease. Laparoscopic PCI showed closer agreement with surgical PCI than radiologic assessment. However, the laparoscopic subgroup was small and predominantly composed of patients with gastric cancer, limiting the generalizability of these findings.</p><p><strong>Conclusions: </strong>In this selected surgical cohort, radiologic PCI provided a reasonable estimate of intraoperative tumor burden but consistently underestimated disease extent. Diagnostic laparoscopy appeared to improve concordance with surgical PCI and may offer complementary staging information in selected high-risk or borderline cases, particularly when imaging findings are equivocal. Given the limited size and selected nature of the laparoscopic subgroup, these results should be interpreted cautiously and viewed as supportive rather than definitive evidence for the routine use of laparoscopy across all tumor types.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653968","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":"Pathological Complete Response in a Patient With HER2-Negative Esophagogastric Junction Cancer Undergoing Conversion-Intent Surgery After Ramucirumab Plus Paclitaxel Following Nivolumab-Based Chemotherapy: A Case Report.","authors":"Yuki Yamasaki, Kentaro Miyazaki, Yuta Fujiwara, Yukari Yamaguchi, Keishi Nakamura, Kaname Ishii, Katsunobu Oyama","doi":"10.1007/s12029-026-01553-4","DOIUrl":"10.1007/s12029-026-01553-4","url":null,"abstract":"<p><strong>Background: </strong>Nivolumab and other immune checkpoint inhibitors (ICIs) have improved survival in advanced gastric cancer. However, optimal management after progression on ICI-containing therapy remains uncertain. We report a case of HER2-negative esophagogastric junction (EGJ) cancer that showed a marked radiological and metabolic response to second-line ramucirumab plus paclitaxel (RAM + PTX) after nivolumab-based chemotherapy, allowing conversion-intent surgery, after which pathological complete response (pCR) was confirmed in the resected specimen.</p><p><strong>Case presentation: </strong>A 76-year-old woman was diagnosed with advanced HER2-negative EGJ adenocarcinoma with para-aortic lymph node metastases (cT3N3bM1[Lym], Stage IVB according to the 15th edition of the Japanese Classification of Gastric Carcinoma). The tumor was classified as Siewert type III with minimal esophageal invasion. First-line SOX plus nivolumab was administered, but disease progression with mediastinal lymph node enlargement and suspected pulmonary metastases was observed after five cycles. Second-line RAM + PTX was subsequently initiated and resulted in marked regression of the primary tumor and metastatic lesions on computed tomography and endoscopy, with metabolic complete response on positron emission tomography-computed tomography. Although chemotherapy was temporarily interrupted because of immune-related type 1 diabetes mellitus, metabolic complete response was maintained after glycemic control with insulin therapy. Following multidisciplinary evaluation of treatment response and resectability, robot-assisted proximal gastrectomy with D2 lymphadenectomy and double-flap reconstruction was performed. Histopathological examination demonstrated no residual viable tumor cells (ypT0N0), consistent with pCR. The postoperative course was uneventful, and the patient remains clinically recurrence-free 10 months after surgery.</p><p><strong>Conclusions: </strong>This case suggests that RAM + PTX after nivolumab-based chemotherapy may achieve substantial tumor regression in selected patients with advanced EGJ cancer and may provide an opportunity for conversion surgery. Robot-assisted proximal gastrectomy with double-flap reconstruction was feasible after successful systemic therapy. Careful multidisciplinary assessment and accumulation of further clinical evidence are needed to clarify the role of sequential systemic therapy and surgical intervention in this setting.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653922","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":"Management of Primary Hepatic Angiosarcoma: A Comprehensive Review.","authors":"Mohsin Murshid, Abrar Nawawi","doi":"10.1007/s12029-026-01552-5","DOIUrl":"10.1007/s12029-026-01552-5","url":null,"abstract":"<p><strong>Background: </strong>Primary hepatic angiosarcoma (PHA) is the most common primary malignant mesenchymal tumour of the liver in adults, accounting for only 0.1-2% of all primary hepatic malignancies. It carries a median overall survival of 6-9 months, driven by aggressive biology, non-specific presentation, and almost universal late-stage diagnosis. No disease-specific tumour markers, pathognomonic imaging features, or PHA-exclusive prospective trials exist.</p><p><strong>Methods: </strong>A comprehensive narrative review was performed using PubMed, Embase, Cochrane Library, and Scopus. Search terms encompassed epidemiology, pathology, molecular biology, imaging, surgical and systemic management, and prognosis of PHA. Studies published up to June 2026 were included, with preference given to systematic reviews, multicenter cohorts, and prospective trials.</p><p><strong>Results: </strong>ERG is the most sensitive and specific immunohistochemical marker for PHA (100% sensitivity vs. 79-87% for CD31/CD34). Surgical R0 resection - achievable in fewer than 25% of patients - is the only potentially curative modality, with median overall survival of 17.2 months post-resection versus 3.7 months without surgery. Liver transplantation is an absolute contraindication. For unresectable disease, cabozantinib plus nivolumab (Alliance A091902) produced an overall response rate of 59% in taxane-pretreated patients. Gemcitabine demonstrates second-line activity with an overall response rate of 38% and median overall survival of 9.9 months. Recurrent alterations in TP53, KDR, PIK3CA, PTPRB, and PLCG1 provide a rationale for routine molecular profiling, though no actionable target has been prospectively validated.</p><p><strong>Conclusion: </strong>Surgical resection where feasible, ICI-TKI combination therapy for unresectable disease, and routine molecular profiling represent the current cornerstones of PHA management. Progress requires international collaborative registries, multi-institutional trials, and specialist multidisciplinary care for all patients.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630605","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}