Pub Date : 2025-12-01Epub Date: 2025-11-12DOI: 10.1016/j.esmogo.2025.100212
T. Hashimoto , H. Hirano , A. Takashima , S. Sekine , K. Kanato , J. Mizusawa , H. Fukuda , S. Tsukamoto , Y. Kanemitsu
JCOG2010A1 is a multi-institutional prospective observational study evaluating circulating tumor DNA (ctDNA) as a biomarker for minimal residual disease (MRD) detection in rectal cancer patients undergoing total neoadjuvant therapy (TNT) with active surveillance. This companion study to the JCOG2010 phase II/III trial addresses a critical clinical challenge: determining optimal treatment pathways between surgery and non-operative management following TNT. While TNT with active surveillance represents a promising organ-preserving strategy for patients achieving clinical complete response, reliable biomarkers for residual disease assessment remain lacking. ctDNA has emerged as a highly sensitive biomarker for MRD detection across multiple cancer types. The Signatera™ personalized tumor-informed assay will be utilized for ctDNA analysis throughout the treatment journey, potentially enabling more precise, individualized decision making.
•
Collect baseline tumor tissue and blood samples, followed by serial plasma collection at predetermined timepoints throughout the protocol treatment period, including post-TNT assessment and during active surveillance.
•
Analyze ctDNA using the Signatera™ personalized tumor-informed assay to detect minimal residual disease after TNT, with results correlated to clinical and radiological findings.
•
Compare recurrence-free survival, organ preservation rates, and overall survival based on ctDNA status at multiple timepoints to assess its utility as a prognostic and predictive biomarker for treatment decision making.
{"title":"Circulating tumor DNA as a predictor of response and prognosis in rectal cancer treated with total neoadjuvant therapy (JCOG2010A1-ctTNT study)","authors":"T. Hashimoto , H. Hirano , A. Takashima , S. Sekine , K. Kanato , J. Mizusawa , H. Fukuda , S. Tsukamoto , Y. Kanemitsu","doi":"10.1016/j.esmogo.2025.100212","DOIUrl":"10.1016/j.esmogo.2025.100212","url":null,"abstract":"<div><div>JCOG2010A1 is a multi-institutional prospective observational study evaluating circulating tumor DNA (ctDNA) as a biomarker for minimal residual disease (MRD) detection in rectal cancer patients undergoing total neoadjuvant therapy (TNT) with active surveillance. This companion study to the JCOG2010 phase II/III trial addresses a critical clinical challenge: determining optimal treatment pathways between surgery and non-operative management following TNT. While TNT with active surveillance represents a promising organ-preserving strategy for patients achieving clinical complete response, reliable biomarkers for residual disease assessment remain lacking. ctDNA has emerged as a highly sensitive biomarker for MRD detection across multiple cancer types. The Signatera™ personalized tumor-informed assay will be utilized for ctDNA analysis throughout the treatment journey, potentially enabling more precise, individualized decision making.<ul><li><span>•</span><span><div>Collect baseline tumor tissue and blood samples, followed by serial plasma collection at predetermined timepoints throughout the protocol treatment period, including post-TNT assessment and during active surveillance.</div></span></li><li><span>•</span><span><div>Analyze ctDNA using the Signatera™ personalized tumor-informed assay to detect minimal residual disease after TNT, with results correlated to clinical and radiological findings.</div></span></li><li><span>•</span><span><div>Compare recurrence-free survival, organ preservation rates, and overall survival based on ctDNA status at multiple timepoints to assess its utility as a prognostic and predictive biomarker for treatment decision making.</div></span></li></ul></div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528857","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}
Pub Date : 2025-12-01Epub Date: 2025-11-10DOI: 10.1016/j.esmogo.2025.100264
S.H.R. Kim, M.K. Harrison
Stereotactic ablative radiotherapy (SABR), which is already used as the standard-of-care treatment in other cancers such as lung, is being increasingly used in the treatment of liver metastases in the oligometastatic setting in unresectable, pre-treated patients. Various phase I/II trials and retrospective series have demonstrated its efficacy in terms of local control (LC), progression-free and overall survival. Tumour characteristics of <6 cm, <3 tumours and absence of extrahepatic disease, and favourable histologies including colorectal, breast and renal primaries have been associated with favourable outcomes. Radiation dose is also important, with a biological effective dose ≥120 Gy giving optimal LC. To be determined in SABR is the exact dose and fractionation employed, which is variable without evidence from randomised controlled trials to date. The aforementioned trials have established that SABR is well-tolerated. In the short-term, it can cause gastrointestinal disturbances, transaminitis and radiation-induced liver disease. In the longer-term, gastrointestinal bleeding and bone fractures have been rarely reported, though follow-up periods for studies were limited. Other treatments such as radiofrequency ablation (RFA) and surgery are also standard-of-care. There have been no prospective randomised trials to date comparing these treatments. Smaller trials demonstrated no survival differences between SABR and RFA, though these studies favour better LC in SABR for larger tumours (>3 cm). To summarise, SABR for liver metastases leads to good LC and survival and is well-tolerated, especially with favourable tumour characteristics. Prospective studies will need to help establish its exact role in comparison with other localised therapies.
{"title":"Stereotactic ablative radiotherapy (SABR) for liver metastases: where we currently stand","authors":"S.H.R. Kim, M.K. Harrison","doi":"10.1016/j.esmogo.2025.100264","DOIUrl":"10.1016/j.esmogo.2025.100264","url":null,"abstract":"<div><div>Stereotactic ablative radiotherapy (SABR), which is already used as the standard-of-care treatment in other cancers such as lung, is being increasingly used in the treatment of liver metastases in the oligometastatic setting in unresectable, pre-treated patients. Various phase I/II trials and retrospective series have demonstrated its efficacy in terms of local control (LC), progression-free and overall survival. Tumour characteristics of <6 cm, <3 tumours and absence of extrahepatic disease, and favourable histologies including colorectal, breast and renal primaries have been associated with favourable outcomes. Radiation dose is also important, with a biological effective dose ≥120 Gy giving optimal LC. To be determined in SABR is the exact dose and fractionation employed, which is variable without evidence from randomised controlled trials to date. The aforementioned trials have established that SABR is well-tolerated. In the short-term, it can cause gastrointestinal disturbances, transaminitis and radiation-induced liver disease. In the longer-term, gastrointestinal bleeding and bone fractures have been rarely reported, though follow-up periods for studies were limited. Other treatments such as radiofrequency ablation (RFA) and surgery are also standard-of-care. There have been no prospective randomised trials to date comparing these treatments. Smaller trials demonstrated no survival differences between SABR and RFA, though these studies favour better LC in SABR for larger tumours (>3 cm). To summarise, SABR for liver metastases leads to good LC and survival and is well-tolerated, especially with favourable tumour characteristics. Prospective studies will need to help establish its exact role in comparison with other localised therapies.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100264"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528859","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}
Pub Date : 2025-12-01Epub Date: 2025-09-12DOI: 10.1016/j.esmogo.2025.100238
I. Ben-Aharon , N. Fokter Dovnik , H.W.M. van Laarhoven , M.G. Guren , I. Baraibar , N. Gordon , T. Goshen-Lago , R. Verhoeven , T. Sokop , R. Obermannova , F. Lordick
Background
While the rising incidence of early-onset colorectal cancer has been documented worldwide, there is a paucity of data on the epidemiological changes in other gastrointestinal (GI) cancers in the young population in Europe. We sought to characterize incidence patterns of GI cancers in young patients in different European/Mediterranean countries.
Patients and methods
National cancer registries in several European countries were contacted to obtain the absolute number of GI cancer cases per age group (15-49 years) at 5-year intervals and the absolute population size for each of these age groups annually from 2008 to 2018. Data were analyzed to calculate year-to-year incidence rate change and average annual percentage change.
Results
Seven countries were included in the analysis: the Czech Republic, Germany, Israel, the Netherlands, Norway, Slovenia, and Spain. Different trends were observed for different GI cancers. For colorectal cancer, all countries except Germany showed increasing incidence rates in a similar pattern for males and females. An increasing trend in pancreatic cancer was documented in the Czech Republic, more in males, and in Slovenia and Israel significantly more in females. There was a slight increase in Spain and Germany, with no difference by sex. The incidence of early-onset gastric and esophageal cancer was very low and non-rising.
Conclusions
Early-onset cancers along the GI tract show different patterns in different European countries. For some types of GI tumors the incidence was fairly stable between 2008 and 2018 while some were increasing, in particular colorectal cancer in both sexes, and pancreatic cancer in females.
{"title":"Sex differences in the incidence trends of early-onset gastrointestinal cancer—the European/Mediterranean perspective","authors":"I. Ben-Aharon , N. Fokter Dovnik , H.W.M. van Laarhoven , M.G. Guren , I. Baraibar , N. Gordon , T. Goshen-Lago , R. Verhoeven , T. Sokop , R. Obermannova , F. Lordick","doi":"10.1016/j.esmogo.2025.100238","DOIUrl":"10.1016/j.esmogo.2025.100238","url":null,"abstract":"<div><h3>Background</h3><div>While the rising incidence of early-onset colorectal cancer has been documented worldwide, there is a paucity of data on the epidemiological changes in other gastrointestinal (GI) cancers in the young population in Europe. We sought to characterize incidence patterns of GI cancers in young patients in different European/Mediterranean countries.</div></div><div><h3>Patients and methods</h3><div>National cancer registries in several European countries were contacted to obtain the absolute number of GI cancer cases per age group (15-49 years) at 5-year intervals and the absolute population size for each of these age groups annually from 2008 to 2018. Data were analyzed to calculate year-to-year incidence rate change and average annual percentage change.</div></div><div><h3>Results</h3><div>Seven countries were included in the analysis: the Czech Republic, Germany, Israel, the Netherlands, Norway, Slovenia, and Spain. Different trends were observed for different GI cancers. For colorectal cancer, all countries except Germany showed increasing incidence rates in a similar pattern for males and females. An increasing trend in pancreatic cancer was documented in the Czech Republic, more in males, and in Slovenia and Israel significantly more in females. There was a slight increase in Spain and Germany, with no difference by sex. The incidence of early-onset gastric and esophageal cancer was very low and non-rising.</div></div><div><h3>Conclusions</h3><div>Early-onset cancers along the GI tract show different patterns in different European countries. For some types of GI tumors the incidence was fairly stable between 2008 and 2018 while some were increasing, in particular colorectal cancer in both sexes, and pancreatic cancer in females.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049850","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}
Pub Date : 2025-12-01DOI: 10.1016/j.esmogo.2025.100266
M. Yue , Y. Mao , F. Wang , Q. Yang , X. Yu , H. Tang , Y. Lan , L. Tan , W. Wang , S. Li , F. Wang
Background
Solid pseudopapillary neoplasm (SPN) of the pancreas is rare and indolent. However, some patients with malignant potential develop metastasis. We aimed to analyze current treatment status and explore optimized clinical management of metastatic SPNs.
Patients and methods
Clinical data of metastatic SPN patients were collected from literature and two hospitals. Gene set enrichment analysis of RNA expression profiles of tumor tissues versus normal pancreatic tissues from the GEO database was carried out to explore functionally enriched pathways. Fresh tumor tissues from 10 SPN patients were cultured and in vitro hormonal agent sensitivity testing was conducted. Six patients received endocrine therapy with tamoxifen and megestrol acetate.
Results
A total of 115 metastatic SPN patients were included. Eighty-four patients underwent local treatment, including surgery, interventional therapy, and radiotherapy. Cytoreductive therapy significantly improved overall survival (P < 0.05, hazard ratio 0.11, 95% confidence interval 0.02-0.68). Thirty-six patients received chemotherapy and only one achieved partial response. Concurrent enrichment of the Wnt signaling pathway and progesterone receptor signaling pathway in SPNs was revealed. Drug sensitivity testing showed inhibition rates (IRs) of 50% for megestrol acetate, 40% for tamoxifen, and 30% for testosterone propionate, and 20% for gemcitabine at 10 × peak plasma concentration (Cmax). There was a trend toward higher IR for megestrol acetate and tamoxifen in the 100% progesterone receptor expression subgroup. Six patients received endocrine therapy with tamoxifen plus megestrol acetate. Tumor regression was observed in two patients.
Conclusions
This largest-to-date retrospective study demonstrated the chemoresistant nature of SPN, survival benefits from cytoreductive therapy, and preliminary clinical response of endocrine therapy. The combination of tamoxifen and megestrol acetate is worthy of further exploration.
{"title":"Metastatic solid pseudopapillary neoplasms of the pancreas: current treatment status and exploration of endocrine therapy","authors":"M. Yue , Y. Mao , F. Wang , Q. Yang , X. Yu , H. Tang , Y. Lan , L. Tan , W. Wang , S. Li , F. Wang","doi":"10.1016/j.esmogo.2025.100266","DOIUrl":"10.1016/j.esmogo.2025.100266","url":null,"abstract":"<div><h3>Background</h3><div>Solid pseudopapillary neoplasm (SPN) of the pancreas is rare and indolent. However, some patients with malignant potential develop metastasis. We aimed to analyze current treatment status and explore optimized clinical management of metastatic SPNs.</div></div><div><h3>Patients and methods</h3><div>Clinical data of metastatic SPN patients were collected from literature and two hospitals. Gene set enrichment analysis of RNA expression profiles of tumor tissues versus normal pancreatic tissues from the GEO database was carried out to explore functionally enriched pathways. Fresh tumor tissues from 10 SPN patients were cultured and <em>in vitro</em> hormonal agent sensitivity testing was conducted. Six patients received endocrine therapy with tamoxifen and megestrol acetate.</div></div><div><h3>Results</h3><div>A total of 115 metastatic SPN patients were included. Eighty-four patients underwent local treatment, including surgery, interventional therapy, and radiotherapy. Cytoreductive therapy significantly improved overall survival (<em>P</em> < 0.05, hazard ratio 0.11, 95% confidence interval 0.02-0.68). Thirty-six patients received chemotherapy and only one achieved partial response. Concurrent enrichment of the Wnt signaling pathway and progesterone receptor signaling pathway in SPNs was revealed. Drug sensitivity testing showed inhibition rates (IRs) of 50% for megestrol acetate, 40% for tamoxifen, and 30% for testosterone propionate, and 20% for gemcitabine at 10 × peak plasma concentration (Cmax). There was a trend toward higher IR for megestrol acetate and tamoxifen in the 100% progesterone receptor expression subgroup. Six patients received endocrine therapy with tamoxifen plus megestrol acetate. Tumor regression was observed in two patients.</div></div><div><h3>Conclusions</h3><div>This largest-to-date retrospective study demonstrated the chemoresistant nature of SPN, survival benefits from cytoreductive therapy, and preliminary clinical response of endocrine therapy. The combination of tamoxifen and megestrol acetate is worthy of further exploration.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693516","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}
Pub Date : 2025-12-01Epub Date: 2025-09-22DOI: 10.1016/j.esmogo.2025.100235
I. Chau , J. Bridgewater , L. Wyrwicz , M. Greenwood , S.I. Blum , A. Moreno-Koehler , E. Martin , F. Taylor , C. Davis , P. Singh
Background
First-line nivolumab plus chemotherapy (NIVO + CHEMO) and nivolumab plus ipilimumab (NIVO + IPI) improves overall survival for patients with advanced esophageal squamous-cell carcinoma (ESCC). This analysis aimed to use quality-adjusted time without symptoms or toxicity (Q-TWiST) analyses to assess the overall risk–benefit profile of these treatments in the CheckMate 648 study.
Materials and methods
A post hoc analysis of CheckMate 648 assessed the association of quality-adjusted survival with treatment types (first-line NIVO + CHEMO, NIVO + IPI, or CHEMO alone) using the Q-TWiST methodology. The analysis included all randomized patients and those with tumor cell programmed death-ligand 1 (PD-L1) ≥1% at baseline, with a minimum follow-up of 45 months. Health-related quality of life was assessed using the EuroQoL 5-Dimension 3-Level (EQ-5D-3L) questionnaire. Differences in Q-TWiST exceeding 1.5 months were deemed clinically important.
Results
The analysis included 970 patients in the all-randomized population. Q-TWiST values were 12.8 and 12.9 months for NIVO + CHEMO and NIVO + IPI, respectively, compared with 10.8 months for CHEMO alone, showing gains of 2.0 and 2.1 months, respectively. In patients with tumor cell PD-L1 ≥1% (473 patients), Q-TWiST values were higher for NIVO + CHEMO (13.0 months) and NIVO + IPI (13.3 months) compared with CHEMO alone (9.1 months), with gains of 3.9 and 4.2 months, respectively. All gains surpassed the clinically important threshold.
Conclusion
These findings support NIVO + CHEMO and NIVO + IPI as first-line treatments for patients with advanced ESCC, particularly those with tumor cell PD-L1 ≥1%.
{"title":"A quality-adjusted time without symptoms and toxicity (Q-TWiST) analysis comparing nivolumab plus ipilimumab or nivolumab plus chemotherapy versus chemotherapy in patients with advanced esophageal squamous-cell carcinoma in CheckMate 648","authors":"I. Chau , J. Bridgewater , L. Wyrwicz , M. Greenwood , S.I. Blum , A. Moreno-Koehler , E. Martin , F. Taylor , C. Davis , P. Singh","doi":"10.1016/j.esmogo.2025.100235","DOIUrl":"10.1016/j.esmogo.2025.100235","url":null,"abstract":"<div><h3>Background</h3><div>First-line nivolumab plus chemotherapy (NIVO + CHEMO) and nivolumab plus ipilimumab (NIVO + IPI) improves overall survival for patients with advanced esophageal squamous-cell carcinoma (ESCC). This analysis aimed to use quality-adjusted time without symptoms or toxicity (Q-TWiST) analyses to assess the overall risk–benefit profile of these treatments in the CheckMate 648 study.</div></div><div><h3>Materials and methods</h3><div>A <em>post hoc</em> analysis of CheckMate 648 assessed the association of quality-adjusted survival with treatment types (first-line NIVO + CHEMO, NIVO + IPI, or CHEMO alone) using the Q-TWiST methodology. The analysis included all randomized patients and those with tumor cell programmed death-ligand 1 (PD-L1) ≥1% at baseline, with a minimum follow-up of 45 months. Health-related quality of life was assessed using the EuroQoL 5-Dimension 3-Level (EQ-5D-3L) questionnaire. Differences in Q-TWiST exceeding 1.5 months were deemed clinically important.</div></div><div><h3>Results</h3><div>The analysis included 970 patients in the all-randomized population. Q-TWiST values were 12.8 and 12.9 months for NIVO + CHEMO and NIVO + IPI, respectively, compared with 10.8 months for CHEMO alone, showing gains of 2.0 and 2.1 months, respectively. In patients with tumor cell PD-L1 ≥1% (473 patients), Q-TWiST values were higher for NIVO + CHEMO (13.0 months) and NIVO + IPI (13.3 months) compared with CHEMO alone (9.1 months), with gains of 3.9 and 4.2 months, respectively. All gains surpassed the clinically important threshold.</div></div><div><h3>Conclusion</h3><div>These findings support NIVO + CHEMO and NIVO + IPI as first-line treatments for patients with advanced ESCC, particularly those with tumor cell PD-L1 ≥1%.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109178","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}
Alpha-fetoprotein is commonly used for hepatocellular carcinoma (HCC) screening in at-risk populations, but its effectiveness is limited. Routine blood tests offer insights into cancer-related conditions and improve detection in other cancers. This study explores the postulated changes in routine blood tests of HCC patients, allowing the development of routine blood-based artificial intelligence for early HCC detection.
Patients and methods
This population-based retrospective study analyzed patient records from 2000 to 2018 from the Hong Kong Hospital Authority Data Collaboration Laboratory. Patients with chronic liver disease (CLD), both with and without HCC, were identified using ICD codes, antiviral drug history, virology tests, and radiology reports. Those with decompensated CLD were excluded. Routine blood tests included complete blood count, liver function test, renal function test, and clotting profiles, with records collected within 1 month before HCC diagnosis. Statistical analyses included descriptive statistics and the Mann–Whitney U (MWU) test.
Results
The cohort comprised 223 862 patients, including 31 149 with HCC (13.9%). Statistical analysis revealed a distinct blood signature for HCC patients, characterized by significant liver function derangement (elevated alanine aminotransferase, alkaline phosphatase, bilirubin, aspartate aminotransferase; decreased albumin), signs of systemic inflammation (lower lymphocyte count, red cell distribution width), bleeding tendencies (prolonged prothrombin time, activated partial thromboplastin time; low platelet count), and indications of cachexia (lower albumin, creatinine, urea)—all statistically significant (P < 0.05).
Conclusions
This study presents a novel blood signature for HCC detection based on extensive clinical data. The unique spectral characteristics effectively differentiate HCC from CLD controls, supporting the potential for machine learning models in HCC detection.
背景：甲胎蛋白通常用于高危人群的肝细胞癌（HCC）筛查，但其有效性有限。常规血液检查可以深入了解癌症相关疾病，并提高对其他癌症的检测。本研究探讨了HCC患者常规血液检查的假设变化，从而开发基于常规血液的人工智能用于早期HCC检测。患者和方法这项基于人群的回顾性研究分析了香港医院管理局数据协作实验室2000年至2018年的患者记录。通过ICD代码、抗病毒药物史、病毒学试验和放射学报告确定慢性肝病（CLD）患者，无论有无HCC。排除失代偿性CLD患者。血常规检查包括全血细胞计数、肝功能检查、肾功能检查、凝血情况，收集HCC诊断前1个月内的记录。统计分析包括描述性统计和Mann-Whitney U （MWU）检验。结果该队列共纳入223 862例患者，其中肝癌31 149例（13.9%）。统计分析显示HCC患者具有明显的血液特征，其特点是肝功能明显紊乱(谷丙转氨酶、碱性磷酸酶、胆红素、天冬氨酸转氨酶升高；白蛋白减少)，全身性炎症的迹象（淋巴细胞计数降低，红细胞分布宽度），出血倾向(凝血酶原时间延长，部分凝血活酶时间活化；血小板计数低)，以及恶病质的适应症（白蛋白、肌酐、尿素含量低）——所有这些都具有统计学意义(P <；0.05)。结论基于广泛的临床数据，本研究提出了一种新的检测HCC的血液特征。独特的光谱特征有效地区分HCC和CLD控制，支持机器学习模型在HCC检测中的潜力。
{"title":"Novel blood signature for HCC screening","authors":"K.-M. Chueng , K.-N. Kwok , S.J.-L. Lam , H.-S. Lam , S.-M. Yip , S. Lam , O.-P. Chiu , A.K.-Y. Chan , H.H.-W. Liu , S.K.-K. Ng , L. Sutanto , J.C.K. Yung , H.-L. Leung , P.Y.-M. Woo , H.H.-Y. Yiu , D.C.C. Lam","doi":"10.1016/j.esmogo.2025.100185","DOIUrl":"10.1016/j.esmogo.2025.100185","url":null,"abstract":"<div><h3>Background</h3><div>Alpha-fetoprotein is commonly used for hepatocellular carcinoma (HCC) screening in at-risk populations, but its effectiveness is limited. Routine blood tests offer insights into cancer-related conditions and improve detection in other cancers. This study explores the postulated changes in routine blood tests of HCC patients, allowing the development of routine blood-based artificial intelligence for early HCC detection.</div></div><div><h3>Patients and methods</h3><div>This population-based retrospective study analyzed patient records from 2000 to 2018 from the Hong Kong Hospital Authority Data Collaboration Laboratory. Patients with chronic liver disease (CLD), both with and without HCC, were identified using ICD codes, antiviral drug history, virology tests, and radiology reports. Those with decompensated CLD were excluded. Routine blood tests included complete blood count, liver function test, renal function test, and clotting profiles, with records collected within 1 month before HCC diagnosis. Statistical analyses included descriptive statistics and the Mann–Whitney <em>U</em> (MWU) test.</div></div><div><h3>Results</h3><div>The cohort comprised 223 862 patients, including 31 149 with HCC (13.9%). Statistical analysis revealed a distinct blood signature for HCC patients, characterized by significant liver function derangement (elevated alanine aminotransferase, alkaline phosphatase, bilirubin, aspartate aminotransferase; decreased albumin), signs of systemic inflammation (lower lymphocyte count, red cell distribution width), bleeding tendencies (prolonged prothrombin time, activated partial thromboplastin time; low platelet count), and indications of cachexia (lower albumin, creatinine, urea)—all statistically significant (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>This study presents a novel blood signature for HCC detection based on extensive clinical data. The unique spectral characteristics effectively differentiate HCC from CLD controls, supporting the potential for machine learning models in HCC detection.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306795","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}
Pub Date : 2025-09-01Epub Date: 2025-07-15DOI: 10.1016/j.esmogo.2025.100205
R. Garcia-Carbonero , E. Elez , P. García-Alfonso , A. Cubillo Gracían , R. López López , P. Jimenez-Fonseca , M.L. Limón Mirón , A. Dasari , S. Lonardi , H. Zhu , L. Chen , Z. Yang , W.R. Schelman , J. Tabernero
Background
In the phase III FRESCO-2 study, overall survival (OS) was significantly improved with fruquintinib plus best supportive care (BSC) versus placebo plus BSC in patients with refractory metastatic colorectal cancer (mCRC). Here, we present data from a FRESCO-2 subanalysis of patients enrolled in Spain.
Patients and methods
In FRESCO-2, patients had received all standard chemotherapies, anti-vascular endothelial growth factor and anti-epidermal growth factor receptor therapies, if indicated, and had progressed on or were intolerant to trifluridine/tipiracil (TAS-102) and/or regorafenib. Patients were randomized 2 : 1 to receive fruquintinib 5 mg orally or matching placebo once daily for 21 days in 28-day cycles, plus BSC. The primary endpoint was OS; secondary endpoints included progression-free survival (PFS), safety, and health-related quality of life.
Results
Of the 180 patients enrolled across 16 sites in Spain (26% of the global study population), 116 received fruquintinib and 64 received placebo. Baseline characteristics were balanced between arms. Patients treated with fruquintinib versus placebo had a median OS of 7.6 versus 4.6 months [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.44-0.91] and a median PFS of 3.7 versus 1.8 months (HR 0.24, 95% CI 0.17-0.36). Grade ≥3 treatment-emergent adverse events were reported in 60% versus 47% of patients treated with fruquintinib versus placebo. Median time to deterioration to an Eastern Cooperative Oncology Group performance status of two or more or death was 5.1 versus 2.9 months (HR 0.59, 95% CI 0.42-0.84) with fruquintinib versus placebo.
Conclusions
Results were consistent with the global FRESCO-2 study population, therefore supporting fruquintinib as a new treatment option for patients with refractory mCRC.
在III期FRESCO-2研究中，在难治性转移性结直肠癌（mCRC）患者中，氟喹替尼加最佳支持治疗（BSC）比安慰剂加BSC的总生存期（OS）显著提高。在这里，我们提供了来自西班牙入组患者的FRESCO-2亚分析数据。患者和方法在FRESCO-2中，患者接受了所有标准化疗，抗血管内皮生长因子和抗表皮生长因子受体治疗（如果有指示），并且对trifluridine/tipiracil （TAS-102）和/或reorafenib有进展或不耐受。患者被随机分为2组：1组接受fruquininib 5mg口服或匹配的安慰剂，每天1次，共21天，28天为一个周期，外加BSC。主要终点为OS；次要终点包括无进展生存期（PFS）、安全性和与健康相关的生活质量。在西班牙16个研究地点的180名患者中（占全球研究人口的26%），116名患者接受fruquininib治疗，64名患者接受安慰剂治疗。各组间平衡基线特征。接受fruquininib和安慰剂治疗的患者的中位OS分别为7.6和4.6个月[风险比（HR） 0.63, 95%可信区间（CI） 0.44-0.91]，中位PFS分别为3.7和1.8个月（HR 0.24, 95% CI 0.17-0.36）。氟喹替尼组和安慰剂组治疗后出现≥3级不良事件的比例分别为60%和47%。fruquininib组与安慰剂组的中位时间分别为5.1个月和2.9个月（HR 0.59, 95% CI 0.42-0.84）。结论：结果与FRESCO-2全球研究人群一致，因此支持fruquininib作为难治性mCRC患者的新治疗选择。
{"title":"Analysis of fruquintinib in patients with metastatic colorectal cancer who were enrolled in Spain: results from the global FRESCO-2 study","authors":"R. Garcia-Carbonero , E. Elez , P. García-Alfonso , A. Cubillo Gracían , R. López López , P. Jimenez-Fonseca , M.L. Limón Mirón , A. Dasari , S. Lonardi , H. Zhu , L. Chen , Z. Yang , W.R. Schelman , J. Tabernero","doi":"10.1016/j.esmogo.2025.100205","DOIUrl":"10.1016/j.esmogo.2025.100205","url":null,"abstract":"<div><h3>Background</h3><div>In the phase III FRESCO-2 study, overall survival (OS) was significantly improved with fruquintinib plus best supportive care (BSC) versus placebo plus BSC in patients with refractory metastatic colorectal cancer (mCRC). Here, we present data from a FRESCO-2 subanalysis of patients enrolled in Spain.</div></div><div><h3>Patients and methods</h3><div>In FRESCO-2, patients had received all standard chemotherapies, anti-vascular endothelial growth factor and anti-epidermal growth factor receptor therapies, if indicated, and had progressed on or were intolerant to trifluridine/tipiracil (TAS-102) and/or regorafenib. Patients were randomized 2 : 1 to receive fruquintinib 5 mg orally or matching placebo once daily for 21 days in 28-day cycles, plus BSC. The primary endpoint was OS; secondary endpoints included progression-free survival (PFS), safety, and health-related quality of life.</div></div><div><h3>Results</h3><div>Of the 180 patients enrolled across 16 sites in Spain (26% of the global study population), 116 received fruquintinib and 64 received placebo. Baseline characteristics were balanced between arms. Patients treated with fruquintinib versus placebo had a median OS of 7.6 versus 4.6 months [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.44-0.91] and a median PFS of 3.7 versus 1.8 months (HR 0.24, 95% CI 0.17-0.36). Grade ≥3 treatment-emergent adverse events were reported in 60% versus 47% of patients treated with fruquintinib versus placebo. Median time to deterioration to an Eastern Cooperative Oncology Group performance status of two or more or death was 5.1 versus 2.9 months (HR 0.59, 95% CI 0.42-0.84) with fruquintinib versus placebo.</div></div><div><h3>Conclusions</h3><div>Results were consistent with the global FRESCO-2 study population, therefore supporting fruquintinib as a new treatment option for patients with refractory mCRC.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632383","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}
Pub Date : 2025-09-01Epub Date: 2025-06-09DOI: 10.1016/j.esmogo.2025.100189
K. Shimozaki , K. Hirata , H. Hayashi , Y. Sato , Y. Komatsu , S. Taniguchi , N. Takahashi , K. Yamaguchi , M. Furuta , T. Kawakami , Y. Narita , T. Ando , A. Makiyama , S. Mitani , T. Ogata , N. Takegawa , W. Okamoto , T. Nishina , M. Komoda , A. Hosokawa , K. Muro
Background
Fibroblast growth factor receptor 2b (FGFR2)-overexpressing advanced gastric cancer (AGC) is associated with poor prognosis and limited treatment options. Bemarituzumab, which selectively binds to FGFR2b, is being investigated in combination with chemotherapy as a first-line treatment. Dual inhibition of the vascular endothelial growth factor–vascular endothelial growth factor receptor and FGF–FGFR pathways may improve the survival of FGFR2b-positive AGC through synergistic inhibition of angiogenesis and the downstream signals for tumor proliferation.
Design
The WJOG18524G trial (RAINBIRD) is a single-arm, multicenter phase II trial to evaluate the safety and efficacy of bemarituzumab in combination with paclitaxel plus ramucirumab in patients with FGFR2b-positive AGC who are intolerant or refractory to first-line fluoropyrimidine-based chemotherapy. The main inclusion criteria are unresectable or metastatic FGFR2b-positive gastric adenocarcinoma, refractoriness or intolerance to fluoropyrimidine-based chemotherapy, measurable lesions, and performance status of 0 or 1. The primary endpoint is the objective response rate, which is assessed by a blinded independent central review. Translational research is planned to explore the predictive biomarkers and mechanisms of resistance to bemarituzumab by sequencing tumor DNA (PleSSiSion-Neo) and circulating tumor DNA (Guardant360), which are collected at multiple time points.
{"title":"WJOG18524G: a single-arm phase II study evaluating bemarituzumab combined with ramucirumab and paclitaxel in fibroblast growth factor receptor 2b (FGFR2b)-positive advanced gastric or gastroesophageal junction cancer (RAINBIRD)","authors":"K. Shimozaki , K. Hirata , H. Hayashi , Y. Sato , Y. Komatsu , S. Taniguchi , N. Takahashi , K. Yamaguchi , M. Furuta , T. Kawakami , Y. Narita , T. Ando , A. Makiyama , S. Mitani , T. Ogata , N. Takegawa , W. Okamoto , T. Nishina , M. Komoda , A. Hosokawa , K. Muro","doi":"10.1016/j.esmogo.2025.100189","DOIUrl":"10.1016/j.esmogo.2025.100189","url":null,"abstract":"<div><h3>Background</h3><div>Fibroblast growth factor receptor 2b (FGFR2)-overexpressing advanced gastric cancer (AGC) is associated with poor prognosis and limited treatment options. Bemarituzumab, which selectively binds to FGFR2b, is being investigated in combination with chemotherapy as a first-line treatment. Dual inhibition of the vascular endothelial growth factor–vascular endothelial growth factor receptor and FGF–FGFR pathways may improve the survival of FGFR2b-positive AGC through synergistic inhibition of angiogenesis and the downstream signals for tumor proliferation.</div></div><div><h3>Design</h3><div>The WJOG18524G trial (RAINBIRD) is a single-arm, multicenter phase II trial to evaluate the safety and efficacy of bemarituzumab in combination with paclitaxel plus ramucirumab in patients with FGFR2b-positive AGC who are intolerant or refractory to first-line fluoropyrimidine-based chemotherapy. The main inclusion criteria are unresectable or metastatic FGFR2b-positive gastric adenocarcinoma, refractoriness or intolerance to fluoropyrimidine-based chemotherapy, measurable lesions, and performance status of 0 or 1. The primary endpoint is the objective response rate, which is assessed by a blinded independent central review. Translational research is planned to explore the predictive biomarkers and mechanisms of resistance to bemarituzumab by sequencing tumor DNA (PleSSiSion-Neo) and circulating tumor DNA (Guardant360), which are collected at multiple time points.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241892","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}
Pub Date : 2025-09-01Epub Date: 2025-08-27DOI: 10.1016/j.esmogo.2025.100231
H. Ueno , N.K. Kim , J.C. Kim , P. Tsarkov , W. Hohenberger , R. Grützmann , N.E Samalavičius , A. Dulskas , J.-T. Liang , P. Quirke , N. West , A. Shiomi , M. Ito , M. Shiozawa , K. Komori , K. Matsuda , Y. Kinugasa , T. Sato , K. Yamada , Y. Hashiguchi , K. Sugihara
Background
Substantial variations in the extent of lymphadenectomy are acknowledged internationally in colon cancer surgery because essential data for standardization, including the anatomical distribution of metastatic lymph nodes (LN), are lacking.
Materials and methods
Pre-specified LN mappings based on in vivo bowel measurements were conducted for stages I-III colon cancer patients treated at 31 leading hospitals in six countries. The extent of lymphadenectomy was classified from levels A (pericolic) to C (central LNs) according to the pre-specified anatomical landmarks. The primary outcome was the extent of pericolic lymphatic spread and the incidence of metastasis in central LNs, and secondary ones included the real-world status of central radicality and its association with short-term outcomes.
Results
Among 3647 patients, pericolic spread beyond 10 cm (0.2%) and absence of feeding arteries supplying the bowel within 10 cm from the primary tumor (0.3%) were rare, irrespective of nationality. The incidence of metastasis in central LNs was ∼3% (range: 0.2% in T1 to 7% in T4 tumors) and was lower in tumors located at the splenic flexure (0.5%). The proportion of patients with level C radicality was ∼76%, which was statistically significantly associated with T stage only in one country. A higher radicality level conferred no adverse impact on either the incidence of Clavien–Dindo grade ≥III or 30-day mortality.
Conclusions
The ‘10-cm rule’ could be an international criterion for determining the bowel-resection margin. Central lymphadenectomy is feasible internationally, though the indication should be selective, not routine, depending on the stage and location of the primary tumor.
{"title":"Lymph node mapping-based optimal bowel-resection margin and central radicality in colon cancer surgery: an international, prospective, observational cohort study","authors":"H. Ueno , N.K. Kim , J.C. Kim , P. Tsarkov , W. Hohenberger , R. Grützmann , N.E Samalavičius , A. Dulskas , J.-T. Liang , P. Quirke , N. West , A. Shiomi , M. Ito , M. Shiozawa , K. Komori , K. Matsuda , Y. Kinugasa , T. Sato , K. Yamada , Y. Hashiguchi , K. Sugihara","doi":"10.1016/j.esmogo.2025.100231","DOIUrl":"10.1016/j.esmogo.2025.100231","url":null,"abstract":"<div><h3>Background</h3><div>Substantial variations in the extent of lymphadenectomy are acknowledged internationally in colon cancer surgery because essential data for standardization, including the anatomical distribution of metastatic lymph nodes (LN), are lacking.</div></div><div><h3>Materials and methods</h3><div>Pre-specified LN mappings based on <em>in vivo</em> bowel measurements were conducted for stages I-III colon cancer patients treated at 31 leading hospitals in six countries. The extent of lymphadenectomy was classified from levels A (pericolic) to C (central LNs) according to the pre-specified anatomical landmarks. The primary outcome was the extent of pericolic lymphatic spread and the incidence of metastasis in central LNs, and secondary ones included the real-world status of central radicality and its association with short-term outcomes.</div></div><div><h3>Results</h3><div>Among 3647 patients, pericolic spread beyond 10 cm (0.2%) and absence of feeding arteries supplying the bowel within 10 cm from the primary tumor (0.3%) were rare, irrespective of nationality. The incidence of metastasis in central LNs was ∼3% (range: 0.2% in T1 to 7% in T4 tumors) and was lower in tumors located at the splenic flexure (0.5%). The proportion of patients with level C radicality was ∼76%, which was statistically significantly associated with T stage only in one country. A higher radicality level conferred no adverse impact on either the incidence of Clavien–Dindo grade ≥III or 30-day mortality.</div></div><div><h3>Conclusions</h3><div>The ‘10-cm rule’ could be an international criterion for determining the bowel-resection margin. Central lymphadenectomy is feasible internationally, though the indication should be selective, not routine, depending on the stage and location of the primary tumor.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908094","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}
Pub Date : 2025-09-01Epub Date: 2025-07-07DOI: 10.1016/j.esmogo.2025.100194
T. Jayakrishnan , N. Sangwan , K.G. Nair , S.D. Kamath , M.H. Patel , D. Joyce , M. Walsh , R. Simon , D. Vadehra , R.V. Iyer , C. Fountzilas , A.A. Khorana
Background
Compelling evidence supports the biomarker potential of microbiome in pancreatic adenocarcinoma. Given the knowledge gap on the characteristics and significance of microbiome in early-onset pancreatic ductal adenocarcinoma (eoPDAC, age <50 years), we aimed to evaluate microbiome profiles in resected specimens from individuals with eoPDAC and average-onset PDAC (aoPDAC, age >50 years).
Materials and methods
We carried out shotgun metagenomic sequencing in resected specimens from individuals with eoPDAC (n = 24) and aoPDAC (n = 20). Statistical tests included Wilcoxon test, permutational analysis of variance, multiomic classifier modeling, differential abundance analysis, and linear regression. All P values were adjusted for multiple testing and P < 0.05 was considered statistically significant.
Results
We successfully sequenced several bacteria and fungi in the tumor specimens from 44 individuals with resected PDAC (24 eoPDAC and 20 aoPDAC). The alpha diversity of the bacterial microbiome was higher in eoPDAC tumor tissue compared with aoPDAC (P = 0.04). In contrast, the fungal mycobiome’s alpha diversity was higher for aoPDAC tumor tissue (P = 0.02). Key organisms with differential abundance between tumor tissue from individuals with eoPDAC and aoPDAC included Bacillus, Candida, Collimonas, Cupriavidus, Enterobacter, Escherichia, Klebsiella, Malasseiza, Mucilaginibacter, Neisseria, and Sphingomonas. Higher bacterial diversity in tumor tissue was associated with better overall survival for individuals with eoPDAC (R = 0.26, P = 0.02).
Conclusions
Shotgun metagenomic sequencing identified bacterial microbiome and fungal mycobiome in tumors from individuals with eoPDAC and aoPDAC. We observed significant differences in alpha and beta diversity and relative abundances of organisms suggesting distinct microbiome signatures. Microbiome associations with survival were observed in eoPDAC indicating unique potential as prognostic biomarker.
{"title":"Tumor microbiome differences in early-onset versus average-onset pancreatic adenocarcinoma☆","authors":"T. Jayakrishnan , N. Sangwan , K.G. Nair , S.D. Kamath , M.H. Patel , D. Joyce , M. Walsh , R. Simon , D. Vadehra , R.V. Iyer , C. Fountzilas , A.A. Khorana","doi":"10.1016/j.esmogo.2025.100194","DOIUrl":"10.1016/j.esmogo.2025.100194","url":null,"abstract":"<div><h3>Background</h3><div>Compelling evidence supports the biomarker potential of microbiome in pancreatic adenocarcinoma. Given the knowledge gap on the characteristics and significance of microbiome in early-onset pancreatic ductal adenocarcinoma (eoPDAC, age <50 years), we aimed to evaluate microbiome profiles in resected specimens from individuals with eoPDAC and average-onset PDAC (aoPDAC, age >50 years).</div></div><div><h3>Materials and methods</h3><div>We carried out shotgun metagenomic sequencing in resected specimens from individuals with eoPDAC (<em>n</em> = 24) and aoPDAC (<em>n</em> = 20). Statistical tests included Wilcoxon test, permutational analysis of variance, multiomic classifier modeling, differential abundance analysis, and linear regression. All <em>P</em> values were adjusted for multiple testing and <em>P</em> < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>We successfully sequenced several bacteria and fungi in the tumor specimens from 44 individuals with resected PDAC (24 eoPDAC and 20 aoPDAC). The alpha diversity of the bacterial microbiome was higher in eoPDAC tumor tissue compared with aoPDAC (<em>P</em> = 0.04). In contrast, the fungal mycobiome’s alpha diversity was higher for aoPDAC tumor tissue (<em>P</em> = 0.02). Key organisms with differential abundance between tumor tissue from individuals with eoPDAC and aoPDAC included <em>Bacillus</em>, <em>Candida</em>, <em>Collimonas</em>, <em>Cupriavidus</em>, <em>Enterobacter</em>, <em>Escherichia</em>, <em>Klebsiella</em>, <em>Malasseiza</em>, <em>Mucilaginibacter</em>, <em>Neisseria</em>, and <em>Sphingomonas</em>. Higher bacterial diversity in tumor tissue was associated with better overall survival for individuals with eoPDAC (R = 0.26, <em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Shotgun metagenomic sequencing identified bacterial microbiome and fungal mycobiome in tumors from individuals with eoPDAC and aoPDAC. We observed significant differences in alpha and beta diversity and relative abundances of organisms suggesting distinct microbiome signatures. Microbiome associations with survival were observed in eoPDAC indicating unique potential as prognostic biomarker.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570721","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}
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