Digestive medicine research最新文献_第10页

A BEACON of hope for BRAF-mutant metastatic colorectal cancer BRAF突变转移性癌症的希望之战

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-22-20

J. Mooi, Belinda Lee

{"title":"A BEACON of hope for BRAF-mutant metastatic colorectal cancer","authors":"J. Mooi, Belinda Lee","doi":"10.21037/dmr-22-20","DOIUrl":"https://doi.org/10.21037/dmr-22-20","url":null,"abstract":"CRC is the second leading cause of cancer-related death, and the third most common cancer globally (1). Approx imate ly 10–15% of CRC harbor a BRAF mutat ion (2) . This molecular subtype of CRC is more commonly associated with right-sided tumours, more advanced stage at presentation, and mucinous histopathology (3). BRAF-mutant CRC are more frequently found in microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) tumours compared to microsatellite stable (MSS) tumours (4) and are associated with higher mutation burden and CpG island methylator phenotype (CIMP)-high status (5). The presence of a BRAF mutation results in activation of BRAF kinase and sustained downstream activation of the RAS-RAF-mitogen-activated protein kinase (MAPK) signaling pathway. This disruption to key cellular responses drives cancer cell proliferation and survival, which in turn leads to more aggressive tumour biology (2). The presence of a BRAF mutation is considered a poor prognostic biomarker, translating to poor patient outcomes. Compared to BRAF-wildtype CRC, BRAF-mutant CRC are associated with a 70% increase in mortality (6) and a median overall survival (mOS) of 12 vs. 25 months in patients with BRAFwildtype CRC (7).","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":"60 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41316260","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}

引用次数: 0

Minimally invasive total pancreatectomy for treatment of pancreatic neoplasms: a narrative review 微创全胰切除术治疗胰腺肿瘤的文献综述

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-70

M. de Pastena, G. Montagnini, C. Filippini, E. Andreotti, R. Montorsi, A. Esposito

{"title":"Minimally invasive total pancreatectomy for treatment of pancreatic neoplasms: a narrative review","authors":"M. de Pastena, G. Montagnini, C. Filippini, E. Andreotti, R. Montorsi, A. Esposito","doi":"10.21037/dmr-21-70","DOIUrl":"https://doi.org/10.21037/dmr-21-70","url":null,"abstract":"Objective: The review aims to summarize and describe surgical techniques and outcomes of a minimally invasive total pancreatectomy (MITP). Background: The minimally invasive approach has gained popularity in the last decades, even in complex abdominal surgery such as pancreatic resections. Currently, many meta-analyses focused on the benefit and advantages of the minimally invasive approach compared to open surgery, especially during distal pancreatectomy. Methods: Literature research in PubMed was performed on 1 st July 2021, using minimally invasive, laparoscopic, or robotic total pancreatectomy (TP) keywords. Case reports, case series on chronic pancreatitis, and no English language manuscripts were excluded. Considering the different MI approaches, laparoscopic or robotic, the literature research identified 416 and 221 manuscripts, respectively. After Authors’ revision, 8 papers for each technique were included. The MITP is safe, feasible, and reproducible. The conversion rate was slightly higher in the laparoscopic approach (26% vs. 7%) than the robotic. Major postoperative complication, mortality, and length of hospital stay were higher in laparoscopic series compared to the robotic ones. However, the MI technique seems to offer better intraoperative and postoperative outcomes, reducing intraoperative blood loss, major postoperative complications, and length of hospital stay compared to an open approach. Conclusions: Considering the widespread of the MI approach and the increased indication for TP, further studies, including randomized controlled trials, should be performed to assess the safety and feasibility of the MITP.","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46886076","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}

引用次数: 1

Diagnostic conundrum of hepatobiliary ascariasis: catch me if you can—case report and literature review 肝胆蛔虫病的诊断难题:有本事就抓我——病例报告及文献综述

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-22-10

K. Chiam, R. Muthukaruppan

引用次数: 0

The effects of exercise prehabilitation in upper gastrointestinal oncology patients undergoing surgical resection: a systematic review 运动康复对上消化道肿瘤手术患者的影响:一项系统综述

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-84

E. Tyson, Muzaffar Malik, Christy W. Jones

引用次数: 0

Occult hepatitis B virus infection and the risk of hepatocellular carcinoma: a systematic review and meta-analysis 隐匿性乙型肝炎病毒感染与肝细胞癌风险的系统综述和荟萃分析

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-50

Chao Weng, Rajneesh Kumar, R. Sultana, W. Chow

引用次数: 2

Narrative review on alcoholic liver disease: from fibrosis to cancer 酒精性肝病的叙述综述:从纤维化到癌症

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-91

H. Seitz, M. Neuman

引用次数: 0

Neuraxial anaesthesia and its role in enhanced recovery after surgery: a narrative review 神经轴麻醉及其在术后恢复中的作用：叙述性综述

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-86

R. Agarwala, Ben L Morrison

引用次数: 2

The evolving landscape of BRAF inhibitors in BRAF mutant colorectal cancer and the added value of cytotoxic chemotherapy BRAF抑制剂在BRAF突变型结直肠癌中的发展前景和细胞毒性化疗的附加价值

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-99

Barbara Geerinckx, Annabel Smith, T. Price

{"title":"The evolving landscape of BRAF inhibitors in BRAF mutant colorectal cancer and the added value of cytotoxic chemotherapy","authors":"Barbara Geerinckx, Annabel Smith, T. Price","doi":"10.21037/dmr-21-99","DOIUrl":"https://doi.org/10.21037/dmr-21-99","url":null,"abstract":"Our understanding of the molecular profile and associated targeted therapies has revolutionised the approach to treatment of metastatic colorectal cancer (mCRC). Approximately 10% (range, 8–21%) of mCRC carry a BRAF mutation which occurs primarily (>90%) at the V600E codon and leads to overactivation of the RAS/RAF/MEK/ ERK signalling [mitogen-activated protein kinases (MAPK)] pathway (1). BRAF mutant (MT) mCRC are renowned for their poor prognosis with a median overall survival (OS) inferior ranging from 10 to 20 months with resistance to standard systemic therapy, often not even reaching secondline treatment (2,3). The exception is the subset of MSI-H/ dMRR patients (up to 30% of BRAF MT CRC) who benefit from immunotherapy with checkpoint inhibitors (CPI) following the recent Keynote-177 trial (4). Unlike melanoma, previous trials with BRAF inhibition monotherapy (or combination with MEK inhibition) for BRAF MT mCRC show only minimal activity. This is due to feedback upregulation of epidermal growth factor receptor (EGFR) that re-activates the oncogenic pathway bypassing BRAF. Benefit of combining BRAF and EGFR inhibitors to overcome this pharmacological escape has been seen in several trials now. The BEACON phase 3 trial (5) is the pivotal study of this approach showing that the combination of the BRAF inhibitor encorafenib with anti-EGFR treatment (cetuximab) with or without a MEKinhibitor (binimetinib) led to significantly better OS and overall response rates (ORR) compared to irinotecan (FOLFIRI) or irinotecan with cetuximab. One strategy to ameliorate outcomes of these patients might be to combine multiple mitogen-activated protein kinases (MAPK) targeting agents with cytotoxic agents. Encouraging preclinical data combining irinotecan with anti-BRAF molecules (6,7), led Kopetz et al. (8) to explore the addition of the BRAF inhibitor vemurafenib to a backbone of irinotecan and cetuximab in previously treated BRAF MT mCRC.","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44553103","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}

引用次数: 0

Robotics as the natural evolution for minimally invasive surgery liver surgery: technological advances for patient and surgeon benefit 机器人作为肝脏微创手术的自然进化:技术进步造福患者和外科医生

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-71

Y. Fong, T. Gall, Abigail J. Fong

引用次数: 0

Robotic liver surgery: advantage beyond pure laparoscopic approach? 机器人肝脏手术：超越单纯腹腔镜手术的优势？

Digestive medicine research Pub Date : 2021-01-01 DOI: 10.21037/dmr-21-69

H. Lok, Kit-fai Lee

引用次数: 0