ESMO Gastrointestinal Oncology最新文献_第9页

Fertility and sexuality in early-onset colorectal cancer patients: a monocentric survey 早发性结直肠癌患者的生育和性行为：一项单中心调查

ESMO Gastrointestinal Oncology

Pub Date : 2025-08-01 DOI: 10.1016/j.esmogo.2025.100213

A. Spring , M.A. Calegari , G. Valente , G. Caira , D. Barone , F. Schietroma , L. Chiofalo , V. Beccia , G. Trovato , M. Chiaravalli , M. Bensi , M. Basso , C. Pozzo , G. Tortora , L. Salvatore

Background

Evidence concerning the impact of chemotherapy on sexual health and fertility in early-onset colorectal cancer (EO-CRC) patients is scarce.

Patients and methods

We aimed to assess through an anonymous online survey the effect of chemotherapy on sexual quality of life and fertility preservation management in patients with stage II-IV EO-CRC treated at our center. Sexual health was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Sexual Health (EORTC QLQ-SH22) questionnaire. Fertility issues were assessed through a structured survey form.

Results

From 2010 to 2022, 139 out of 6444 patients were diagnosed with EO-CRC at our center. A total of 84 patients (60.4%) completed the survey, while 55 (39.6%) did not participate; 50 (59.5%) were women and 42 (50%) had stage II-III disease. Only 11.9% (8/67) of patients reported having discussed sexual issues with their oncologist, while 45% (18/40) received specific counseling about fertility preservation, with no statistically significant differences between sexes. Libido decrease and sexual pain were reported more often by women compared with men in each setting; the difference was statistically significant (P < 0.05). A statistically significant correlation between age ≥45 years and persistent amenorrhea after adjuvant chemotherapy was reported (P < 0.05). Three women and three men underwent ovarian tissue or sperm cryopreservation, respectively.

Conclusions

Clinicians tend to discuss fertility issues more often than sexual health with patients, regardless of sex. Women seem to experience more libido decrease and sexual pain compared with men, and their risk of persistent amenorrhea increases with age. Both fertility and sexuality counseling should be improved in EO-CRC management.

背景：关于化疗对早发性结直肠癌（EO-CRC）患者性健康和生育能力影响的证据很少。患者和方法我们旨在通过匿名在线调查评估化疗对在我们中心治疗的II-IV期EO-CRC患者性生活质量和生育能力保存管理的影响。使用欧洲癌症研究和治疗组织生活质量问卷性健康（EORTC QLQ-SH22）问卷对性健康进行评估。生育问题通过结构化调查表格进行评估。结果2010 - 2022年，我中心6444例患者中有139例诊断为EO-CRC。84例患者（60.4%）完成调查，55例患者（39.6%）未参加调查；50例（59.5%）为女性，42例（50%）为II-III期疾病。只有11.9%（8/67）的患者报告曾与肿瘤科医生讨论过性问题，而45%（18/40）的患者接受过保留生育能力的专门咨询，性别差异无统计学意义。在每一种情况下，女性比男性更常报告性欲下降和性疼痛；差异有统计学意义(P <；0.05)。据报道，年龄≥45岁与辅助化疗后持续闭经有统计学意义(P <；0.05)。三名女性和三名男性分别接受了卵巢组织或精子冷冻保存。结论不论性别，临床医生更倾向于与患者讨论生育问题而不是性健康问题。与男性相比，女性似乎经历了更多的性欲下降和性疼痛，而且她们持续闭经的风险随着年龄的增长而增加。在EO-CRC管理中应加强生育咨询和性咨询。

{"title":"Fertility and sexuality in early-onset colorectal cancer patients: a monocentric survey","authors":"A. Spring , M.A. Calegari , G. Valente , G. Caira , D. Barone , F. Schietroma , L. Chiofalo , V. Beccia , G. Trovato , M. Chiaravalli , M. Bensi , M. Basso , C. Pozzo , G. Tortora , L. Salvatore","doi":"10.1016/j.esmogo.2025.100213","DOIUrl":"10.1016/j.esmogo.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Evidence concerning the impact of chemotherapy on sexual health and fertility in early-onset colorectal cancer (EO-CRC) patients is scarce.</div></div><div><h3>Patients and methods</h3><div>We aimed to assess through an anonymous online survey the effect of chemotherapy on sexual quality of life and fertility preservation management in patients with stage II-IV EO-CRC treated at our center. Sexual health was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Sexual Health (EORTC QLQ-SH22) questionnaire. Fertility issues were assessed through a structured survey form.</div></div><div><h3>Results</h3><div>From 2010 to 2022, 139 out of 6444 patients were diagnosed with EO-CRC at our center. A total of 84 patients (60.4%) completed the survey, while 55 (39.6%) did not participate; 50 (59.5%) were women and 42 (50%) had stage II-III disease. Only 11.9% (8/67) of patients reported having discussed sexual issues with their oncologist, while 45% (18/40) received specific counseling about fertility preservation, with no statistically significant differences between sexes. Libido decrease and sexual pain were reported more often by women compared with men in each setting; the difference was statistically significant (<em>P</em> < 0.05). A statistically significant correlation between age ≥45 years and persistent amenorrhea after adjuvant chemotherapy was reported (<em>P</em> < 0.05). Three women and three men underwent ovarian tissue or sperm cryopreservation, respectively.</div></div><div><h3>Conclusions</h3><div>Clinicians tend to discuss fertility issues more often than sexual health with patients, regardless of sex. Women seem to experience more libido decrease and sexual pain compared with men, and their risk of persistent amenorrhea increases with age. Both fertility and sexuality counseling should be improved in EO-CRC management.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750742","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

The prognostic role of Claudin 18.2 in advanced gastric or gastroesophageal junction adenocarcinoma: a systematic literature review Claudin 18.2在晚期胃或胃食管交界处腺癌中的预后作用：一项系统的文献综述

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-31 DOI: 10.1016/j.esmogo.2025.100210

M. Fassan , I. Chau , H. Dasghaib , J. Hill , R. Pophale , K. Shitara

Claudin 18 isoform 2 (CLDN18.2) is a tight junction protein expressed in normal gastric tissue and retained in gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. The phase III trials SPOTLIGHT and GLOW demonstrated improved survival following the addition of the CLDN18.2-targeted antibody zolbetuximab to chemotherapy. In this systematic literature review, we summarize existing evidence for the prognostic role of CLDN18.2 and association of CLDN18.2 with patient demographic and clinicopathological characteristics in patients with advanced G/GEJ adenocarcinoma. MEDLINE, Embase, clinical trials databases, and congress abstracts were searched for interventional and noninterventional studies that evaluated CLDN18.2 for patient/disease characteristics, survival, or expression of programmed death-ligand 1 as primary outcomes. Of 742 records identified, 18 publications (17 studies) were included. CLDN18.2 expression was not consistently associated with specific patient/disease characteristics in most studies; two studies reported an association of CLDN18.2 expression with Lauren classification but differed on its association with diffuse or intestinal histology. Most studies reported that CLDN18.2 expression was not a statistically significant prognostic factor; among those that reported CLDN18.2 as a prognostic factor, studies differed regarding the association of CLDN18.2 with worsened or improved prognosis. One study reported an association of CLDN18.2 expression with programmed death-ligand 1 expression. The use of different antibodies and definitions of CLDN18.2 positivity in patients with advanced G/GEJ adenocarcinoma poses a challenge for drawing definitive conclusions on the prognostic value of CLDN18.2 and association of CLDN18.2 with patient/disease characteristics. Additional research using a standardized approach to assess CLDN18.2 expression is needed.

Claudin 18 isoform 2 （CLDN18.2）是一种紧密连接蛋白，在正常胃组织中表达，在胃或胃食管交界处（G/GEJ）腺癌中保留。III期临床试验SPOTLIGHT和GLOW显示，在化疗中加入cldn18.2靶向抗体zolbetuximab后，患者的生存率有所提高。在这篇系统的文献综述中，我们总结了CLDN18.2在晚期G/GEJ腺癌患者中预后作用的现有证据，以及CLDN18.2与患者人口学和临床病理特征的关系。我们检索了MEDLINE、Embase、临床试验数据库和国会摘要，以评估CLDN18.2患者/疾病特征、生存率或程序性死亡配体1表达为主要结局的介入性和非介入性研究。在确定的742份记录中，包括18份出版物（17项研究）。在大多数研究中，CLDN18.2的表达与特定的患者/疾病特征并不一致；两项研究报道了CLDN18.2表达与Lauren分类的关联，但其与弥漫性或肠道组织学的关联存在差异。大多数研究报道，CLDN18.2的表达不是一个具有统计学意义的预后因素；在报道CLDN18.2作为预后因素的研究中，关于CLDN18.2与预后恶化或改善的关系的研究存在差异。一项研究报道了CLDN18.2表达与程序性死亡配体1表达的关联。在晚期G/GEJ腺癌患者中使用不同的抗体和CLDN18.2阳性的定义，对得出关于CLDN18.2的预后价值和CLDN18.2与患者/疾病特征的关联的明确结论提出了挑战。需要使用标准化方法评估CLDN18.2表达的进一步研究。

{"title":"The prognostic role of Claudin 18.2 in advanced gastric or gastroesophageal junction adenocarcinoma: a systematic literature review","authors":"M. Fassan , I. Chau , H. Dasghaib , J. Hill , R. Pophale , K. Shitara","doi":"10.1016/j.esmogo.2025.100210","DOIUrl":"10.1016/j.esmogo.2025.100210","url":null,"abstract":"<div><div>Claudin 18 isoform 2 (CLDN18.2) is a tight junction protein expressed in normal gastric tissue and retained in gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. The phase III trials SPOTLIGHT and GLOW demonstrated improved survival following the addition of the CLDN18.2-targeted antibody zolbetuximab to chemotherapy. In this systematic literature review, we summarize existing evidence for the prognostic role of CLDN18.2 and association of CLDN18.2 with patient demographic and clinicopathological characteristics in patients with advanced G/GEJ adenocarcinoma. MEDLINE, Embase, clinical trials databases, and congress abstracts were searched for interventional and noninterventional studies that evaluated CLDN18.2 for patient/disease characteristics, survival, or expression of programmed death-ligand 1 as primary outcomes. Of 742 records identified, 18 publications (17 studies) were included. CLDN18.2 expression was not consistently associated with specific patient/disease characteristics in most studies; two studies reported an association of CLDN18.2 expression with Lauren classification but differed on its association with diffuse or intestinal histology. Most studies reported that CLDN18.2 expression was not a statistically significant prognostic factor; among those that reported CLDN18.2 as a prognostic factor, studies differed regarding the association of CLDN18.2 with worsened or improved prognosis. One study reported an association of CLDN18.2 expression with programmed death-ligand 1 expression. The use of different antibodies and definitions of CLDN18.2 positivity in patients with advanced G/GEJ adenocarcinoma poses a challenge for drawing definitive conclusions on the prognostic value of CLDN18.2 and association of CLDN18.2 with patient/disease characteristics. Additional research using a standardized approach to assess CLDN18.2 expression is needed.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750292","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

Research training, barriers, and career development needs of early-career investigators in oncology: an EORTC survey-based study 肿瘤学早期研究人员的研究培训、障碍和职业发展需求：一项基于EORTC调查的研究

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-31 DOI: 10.1016/j.esmogo.2025.100208

A. Cammarota , A.R. Siebenhüner , C. Olungu , P. Szturz , D.C. Güven , A. Puccini , J.P. Silva , E.C. Smyth , F. Sclafani , H. Van Laarhoven

Background

The increasing complexity of cancer research presents significant challenges for early-career oncologists in establishing independent research careers. Although dedicated support platforms have emerged in recent years, a thorough evaluation of the research training needs and barriers faced by the current generation of trainees and early-career oncologists has been lacking. This study aimed to assess the research backgrounds, needs, and career aspirations of early-career researchers in oncology.

Methods

An online survey was distributed between September and October 2024 among young and early-career investigator (Y-ECI) members of the European Organisation for Research and Treatment of Cancer (EORTC) and other professionals meeting the EORTC Y-ECI criteria. The questionnaire collected information on research experience, challenges, and expectations from the newly launched EORTC Y-ECI community.

Results

Among 301 respondents, 200 (66.7%) met Y-ECI criteria and participated in the survey. Most were female (62.4%), aged 31-35 years (38.7%), medical oncologists (69.6%), and working in academic settings (58.8%). While 73.7% had published research, 75.8% reported challenges in conducting and publishing their work. The main barriers included lack of protected research time (77.0%), limited funding (48.2%), and insufficient grant application support (47.1%). Female researchers were seven times more likely to report gender-related barriers (odds ratio 7.14, 95% confidence interval 1.14-79.22). Most (84.3%) expressed interest in joining the EORTC Y-ECIs community, with research training, mentorship, and funding opportunities rated as the most valuable initiatives.

Conclusions

This study provides comprehensive insights into the research needs of early-career oncologists and supports the EORTC investment in structured training programmes to cultivate a strong, next-generation research workforce.

癌症研究的复杂性日益增加，对早期职业肿瘤学家在建立独立研究事业方面提出了重大挑战。尽管近年来出现了专门的支持平台，但对当前一代实习生和早期职业肿瘤学家面临的研究培训需求和障碍的全面评估一直缺乏。本研究旨在评估肿瘤学早期研究人员的研究背景、需求和职业抱负。方法于2024年9月至10月对欧洲癌症研究与治疗组织（EORTC）的年轻和早期职业研究者（Y-ECI）成员以及符合EORTC Y-ECI标准的其他专业人员进行在线调查。问卷收集了新成立的EORTC Y-ECI社区关于研究经验、挑战和期望的信息。结果301名被调查者中，有200名（66.7%）符合Y-ECI标准并参与了调查。大多数是女性（62.4%），年龄在31-35岁（38.7%），内科肿瘤学家（69.6%），在学术机构工作（58.8%）。73.7%的人发表过研究成果，75.8%的人表示在进行和发表研究成果方面遇到了挑战。主要障碍包括缺乏受保护的研究时间（77.0%）、资金有限（48.2%）和资助申请支持不足（47.1%）。女性研究人员报告性别相关障碍的可能性是男性的7倍（优势比7.14,95%可信区间1.14-79.22）。大多数人（84.3%）表示有兴趣加入EORTC Y-ECIs社区，研究培训、指导和资助机会被评为最有价值的举措。结论：本研究为早期职业肿瘤学家的研究需求提供了全面的见解，并支持EORTC在结构化培训计划上的投资，以培养一支强大的下一代研究队伍。

{"title":"Research training, barriers, and career development needs of early-career investigators in oncology: an EORTC survey-based study","authors":"A. Cammarota , A.R. Siebenhüner , C. Olungu , P. Szturz , D.C. Güven , A. Puccini , J.P. Silva , E.C. Smyth , F. Sclafani , H. Van Laarhoven","doi":"10.1016/j.esmogo.2025.100208","DOIUrl":"10.1016/j.esmogo.2025.100208","url":null,"abstract":"<div><h3>Background</h3><div>The increasing complexity of cancer research presents significant challenges for early-career oncologists in establishing independent research careers. Although dedicated support platforms have emerged in recent years, a thorough evaluation of the research training needs and barriers faced by the current generation of trainees and early-career oncologists has been lacking. This study aimed to assess the research backgrounds, needs, and career aspirations of early-career researchers in oncology.</div></div><div><h3>Methods</h3><div>An online survey was distributed between September and October 2024 among young and early-career investigator (Y-ECI) members of the European Organisation for Research and Treatment of Cancer (EORTC) and other professionals meeting the EORTC Y-ECI criteria. The questionnaire collected information on research experience, challenges, and expectations from the newly launched EORTC Y-ECI community.</div></div><div><h3>Results</h3><div>Among 301 respondents, 200 (66.7%) met Y-ECI criteria and participated in the survey. Most were female (62.4%), aged 31-35 years (38.7%), medical oncologists (69.6%), and working in academic settings (58.8%). While 73.7% had published research, 75.8% reported challenges in conducting and publishing their work. The main barriers included lack of protected research time (77.0%), limited funding (48.2%), and insufficient grant application support (47.1%). Female researchers were seven times more likely to report gender-related barriers (odds ratio 7.14, 95% confidence interval 1.14-79.22). Most (84.3%) expressed interest in joining the EORTC Y-ECIs community, with research training, mentorship, and funding opportunities rated as the most valuable initiatives.</div></div><div><h3>Conclusions</h3><div>This study provides comprehensive insights into the research needs of early-career oncologists and supports the EORTC investment in structured training programmes to cultivate a strong, next-generation research workforce.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750474","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

Temporal dynamics of CLDN18.2 expression following zolbetuximab treatment in advanced gastric cancer 唑仑妥昔单抗治疗晚期胃癌后CLDN18.2表达的时间动态

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-17 DOI: 10.1016/j.esmogo.2025.100206

K. Yamamoto , I. Nakayama , N. Sakamoto , Y. Matsubara , Y. Miyashita , A. Kobayashi , U. Okazaki , D. Okemoto , K. Seguchi , T. Hosokai , T. Ogura , S. Mishima , D. Kotani , A. Kawazoe , T. Hashimoto , Y. Kuboki , H. Bando , T. Kojima , T. Yoshino , T. Kuwata , K. Shitara

Background

Zolbetuximab plus chemotherapy is the standard of care for unresectable advanced gastric cancer that is human epidermal growth factor receptor 2-negative and claudin-18 isoform 2 (CLDN18.2)-positive (2+/3+ staining intensity in ≥75% of tumor cells). The dynamics of CLDN18.2 expression after zolbetuximab remain poorly understood.

Materials and methods

Using immunohistochemistry, we retrospectively assessed CLDN18.2 expression in tumor samples from CLDN18.2-positive advanced gastric cancer collected before and after zolbetuximab-containing chemotherapy. Expression levels were evaluated based on the proportion of cells with ≥2+ staining intensity using multiple cut-off values (75%, 40%, and 25%).

Results

Among 65 patients who received zolbetuximab-containing therapy, CLDN18.2 status was assessable at both baseline and disease progression in 15 patients. At disease progression, 53.3% of cases converted to CLDN18.2-negative. CLDN18.2 positivity was retained in 66.7% and 73.3% of patients when applying 40% and 25% cut-off levels, respectively.

Conclusions

CLDN18.2 expression above the ≥75% cut-off declined after zolbetuximab, but lower-level expression was often preserved, supporting the potential for subsequent targeted therapy.

背景唑贝昔单抗联合化疗是不可切除的晚期胃癌的标准治疗方案，患者为人表皮生长因子受体2阴性和CLDN18.2阳性（2+/3+染色强度≥75%的肿瘤细胞）。唑贝昔单抗后CLDN18.2表达的动态尚不清楚。材料与方法采用免疫组化方法，回顾性分析了晚期胃癌患者CLDN18.2阳性肿瘤样本在唑苯妥昔单抗化疗前后的表达情况。根据≥2+染色强度的细胞比例，使用多个截止值（75%、40%和25%）评估表达水平。结果在65例接受含唑苯妥昔单抗治疗的患者中，15例患者的CLDN18.2状态在基线和疾病进展时均可评估。在疾病进展时，53.3%的病例转化为cldn18.2阴性。当应用40%和25%临界值时，CLDN18.2阳性分别在66.7%和73.3%的患者中保留。结论在≥75%临界值后，唑贝昔单抗治疗后，CLDN18.2的表达水平下降，但通常保留较低水平的表达，支持后续靶向治疗的可能性。

{"title":"Temporal dynamics of CLDN18.2 expression following zolbetuximab treatment in advanced gastric cancer","authors":"K. Yamamoto , I. Nakayama , N. Sakamoto , Y. Matsubara , Y. Miyashita , A. Kobayashi , U. Okazaki , D. Okemoto , K. Seguchi , T. Hosokai , T. Ogura , S. Mishima , D. Kotani , A. Kawazoe , T. Hashimoto , Y. Kuboki , H. Bando , T. Kojima , T. Yoshino , T. Kuwata , K. Shitara","doi":"10.1016/j.esmogo.2025.100206","DOIUrl":"10.1016/j.esmogo.2025.100206","url":null,"abstract":"<div><h3>Background</h3><div>Zolbetuximab plus chemotherapy is the standard of care for unresectable advanced gastric cancer that is human epidermal growth factor receptor 2-negative and claudin-18 isoform 2 (CLDN18.2)-positive (2+/3+ staining intensity in ≥75% of tumor cells). The dynamics of CLDN18.2 expression after zolbetuximab remain poorly understood.</div></div><div><h3>Materials and methods</h3><div>Using immunohistochemistry, we retrospectively assessed CLDN18.2 expression in tumor samples from CLDN18.2-positive advanced gastric cancer collected before and after zolbetuximab-containing chemotherapy. Expression levels were evaluated based on the proportion of cells with ≥2+ staining intensity using multiple cut-off values (75%, 40%, and 25%).</div></div><div><h3>Results</h3><div>Among 65 patients who received zolbetuximab-containing therapy, CLDN18.2 status was assessable at both baseline and disease progression in 15 patients. At disease progression, 53.3% of cases converted to CLDN18.2-negative. CLDN18.2 positivity was retained in 66.7% and 73.3% of patients when applying 40% and 25% cut-off levels, respectively.</div></div><div><h3>Conclusions</h3><div>CLDN18.2 expression above the ≥75% cut-off declined after zolbetuximab, but lower-level expression was often preserved, supporting the potential for subsequent targeted therapy.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653305","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

Dietary and lifestyle inflammation scores in relation to colon cancer recurrence in subgroups of patients based on common molecular tumour characteristics 基于共同分子肿瘤特征的患者亚组中饮食和生活方式炎症评分与结肠癌复发的关系

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-17 DOI: 10.1016/j.esmogo.2025.100202

E. Wesselink , D.E. Kok , K.C. Smit , A.-S. van Lanen , J.W.G. Derksen , M. Koopman , M. Ligtenberg , I.D. Nagtegaal , P.D.M. Rombout , J.H.W. de Wilt , E. Kampman , A.M. May , F.J.B. van Duijnhoven

Background

The aim of this study was to investigate associations between the inflammatory potential of diet and lifestyle in relation to colon cancer recurrence in subgroups of patients based on molecular tumour characteristics that also influence the inflammatory tumour microenvironment.

Patients and methods

A nested case-control study was implemented in two prospective cohort studies of colon cancer patients. Participants who developed a recurrence were included as cases (n = 167). Matched controls (n = 668) were selected based on incidence density sampling. Lifestyle factors were assessed at diagnosis using self-administered questionnaires and dietary intake was assessed using a food frequency questionnaire. The dietary inflammation score (DIS) and the lifestyle inflammation score (LIS) were constructed. High-throughput next-generation sequencing of tumour tissue was used for mutation and microsatellite instability (MSI) analysis. Associations between the DIS and LIS and recurrence were assessed with conditional logistic regression analyses in all patients, as well as in subgroups based on MSI. For patients with microsatellite stable (MSS) tumours, further stratification based on mutation status of KRAS, BRAF, PIK3CA, TP53 and APC was performed.

Results

A more pro-inflammatory diet was not associated with risk of recurrence [incidence rate ratio (IRR) 1.04, 95% confidence interval (CI) 0.96-1.12]. Persons who have a more pro-inflammatory lifestyle may have an increased recurrence risk (IRR 1.21, 95% CI 0.97-1.52), which was most pronounced for persons with MSS and KRAS or PIK3CA wildtype tumours (IRR 1.31, 95% CI 0.90-1.90 and IRR 1.30, 95% CI 0.98-1.71, respectively).

Conclusion

Our results suggest that associations between the LIS and recurrence might differ based on molecular tumour characteristics.

本研究的目的是基于影响炎症性肿瘤微环境的分子肿瘤特征，调查饮食和生活方式与结肠癌复发相关亚组患者炎症潜力之间的关系。患者和方法在两项结肠癌患者前瞻性队列研究中实施巢式病例对照研究。复发的参与者被纳入病例（n = 167）。根据发病率密度抽样选择匹配对照（n = 668）。生活方式因素在诊断时使用自我管理问卷进行评估，饮食摄入使用食物频率问卷进行评估。构建饮食炎症评分（DIS）和生活方式炎症评分（LIS）。肿瘤组织的高通量下一代测序用于突变和微卫星不稳定性（MSI）分析。在所有患者以及基于MSI的亚组中，通过条件logistic回归分析评估DIS和LIS与复发之间的关系。对于微卫星稳定型（MSS）肿瘤患者，根据KRAS、BRAF、PIK3CA、TP53和APC的突变状态进行进一步分层。结果促炎饮食与复发风险无相关性[发病率比（IRR） 1.04, 95%可信区间（CI） 0.96 ~ 1.12]。具有更促炎生活方式的人可能有更高的复发风险（IRR 1.21, 95% CI 0.97-1.52），这在MSS和KRAS或PIK3CA野生型肿瘤患者中最为明显（IRR 1.31, 95% CI 0.90-1.90和IRR 1.30, 95% CI 0.98-1.71）。结论：LIS与复发的关系可能因肿瘤分子特征而异。

{"title":"Dietary and lifestyle inflammation scores in relation to colon cancer recurrence in subgroups of patients based on common molecular tumour characteristics","authors":"E. Wesselink , D.E. Kok , K.C. Smit , A.-S. van Lanen , J.W.G. Derksen , M. Koopman , M. Ligtenberg , I.D. Nagtegaal , P.D.M. Rombout , J.H.W. de Wilt , E. Kampman , A.M. May , F.J.B. van Duijnhoven","doi":"10.1016/j.esmogo.2025.100202","DOIUrl":"10.1016/j.esmogo.2025.100202","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to investigate associations between the inflammatory potential of diet and lifestyle in relation to colon cancer recurrence in subgroups of patients based on molecular tumour characteristics that also influence the inflammatory tumour microenvironment.</div></div><div><h3>Patients and methods</h3><div>A nested case-control study was implemented in two prospective cohort studies of colon cancer patients. Participants who developed a recurrence were included as cases (<em>n</em> = 167). Matched controls (<em>n</em> = 668) were selected based on incidence density sampling. Lifestyle factors were assessed at diagnosis using self-administered questionnaires and dietary intake was assessed using a food frequency questionnaire. The dietary inflammation score (DIS) and the lifestyle inflammation score (LIS) were constructed. High-throughput next-generation sequencing of tumour tissue was used for mutation and microsatellite instability (MSI) analysis. Associations between the DIS and LIS and recurrence were assessed with conditional logistic regression analyses in all patients, as well as in subgroups based on MSI. For patients with microsatellite stable (MSS) tumours, further stratification based on mutation status of <em>KRAS, BRAF, PIK3CA, TP53</em> and <em>APC</em> was performed.</div></div><div><h3>Results</h3><div>A more pro-inflammatory diet was not associated with risk of recurrence [incidence rate ratio (IRR) 1.04, 95% confidence interval (CI) 0.96-1.12]. Persons who have a more pro-inflammatory lifestyle may have an increased recurrence risk (IRR 1.21, 95% CI 0.97-1.52), which was most pronounced for persons with MSS and <em>KRAS</em> or <em>PIK3CA</em> wildtype tumours (IRR 1.31, 95% CI 0.90-1.90 and IRR 1.30, 95% CI 0.98-1.71, respectively).</div></div><div><h3>Conclusion</h3><div>Our results suggest that associations between the LIS and recurrence might differ based on molecular tumour characteristics.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653304","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

Analysis of fruquintinib in patients with metastatic colorectal cancer who were enrolled in Spain: results from the global FRESCO-2 study fruquininib在西班牙转移性结直肠癌患者中的应用分析：来自FRESCO-2研究的结果

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-15 DOI: 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":"2025-07-15","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}

引用次数: 0

Tumor microbiome differences in early-onset versus average-onset pancreatic adenocarcinoma☆ 早期和平均发病胰腺腺癌的肿瘤微生物组差异

ESMO Gastrointestinal Oncology

Pub Date : 2025-07-07 DOI: 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.

背景：令人信服的证据支持微生物组在胰腺腺癌中的生物标志物潜力。鉴于对早发性胰腺导管腺癌（eoPDAC，年龄50岁）中微生物组的特征和意义的知识差距，我们旨在评估eoPDAC和平均发病PDAC （aoPDAC，年龄50岁）患者切除标本中的微生物组谱。材料和方法我们对eoPDAC （n = 24）和aoPDAC （n = 20）患者的切除标本进行鸟枪宏基因组测序。统计检验包括Wilcoxon检验、置换方差分析、多组分类器建模、差异丰度分析和线性回归。所有P值经多次检验和P <；0.05认为有统计学意义。结果我们成功地对44例PDAC切除患者（24例eoPDAC和20例aoPDAC）肿瘤标本中的几种细菌和真菌进行了测序。与aoPDAC相比，eoPDAC肿瘤组织中细菌微生物组的α多样性更高（P = 0.04）。相比之下，aoPDAC肿瘤组织的真菌群落α多样性更高（P = 0.02）。eoPDAC和aoPDAC患者肿瘤组织中丰度差异的关键生物包括芽孢杆菌、念珠菌、Collimonas、Cupriavidus、肠杆菌、埃希氏菌、克雷伯氏菌、Malasseiza、Mucilaginibacter、Neisseria和鞘单胞菌。肿瘤组织中较高的细菌多样性与eoPDAC患者更好的总生存率相关（R = 0.26, P = 0.02）。结论霰弹枪宏基因组测序鉴定了eoPDAC和aoPDAC患者肿瘤的细菌微生物组和真菌菌群。我们观察到α和β多样性和相对丰度的显著差异，表明不同的微生物组特征。在eoPDAC中观察到微生物组与生存的关联，表明作为预后生物标志物的独特潜力。

{"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":"2025-07-07","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}

引用次数: 0

Systemic adjuvant and perioperative chemotherapy following curative-intent liver metastasectomy in colorectal cancer—is it justified? 结直肠癌肝转移切除术后的全身辅助和围手术期化疗是否合理？

ESMO Gastrointestinal Oncology

Pub Date : 2025-06-30 DOI: 10.1016/j.esmogo.2025.100190

R.D. Peixoto , J.M. Loree , T.A. Miranda , J.P. Solar Vasconcelos , D.J. Renouf , J.M. Davies , K. Gill , S. Gill , V. Poon , C. Metcalf , M. Chahal , M.S. Bleszynski , M. Segedi , P.T.W. Kim , H.J. Lim

Colorectal liver metastases (CRLM) pose a significant challenge in oncological care, with surgical resection offering the best chance for long-term survival. Despite curative-intent liver metastasectomy, recurrence rates remain high, underscoring the need for effective adjuvant therapies. While adjuvant chemotherapy (AC) improves disease-free survival (DFS), evidence supporting its overall survival (OS) benefit is limited. This manuscript critically evaluates the role of AC following CRLM resection, with a focus on patient-specific factors influencing treatment outcomes across distinct clinical scenarios. The lack of stratification by molecular biomarkers in prior trials highlights a critical gap in current evidence. Future research should integrate biomarker-driven approaches, leverage circulating tumor DNA (ctDNA) for treatment stratification, and explore novel therapies, including immunotherapies and targeted agents, in both perioperative and adjuvant settings.

结直肠肝转移（CRLM）对肿瘤治疗提出了重大挑战，手术切除提供了长期生存的最佳机会。尽管有治疗目的的肝转移切除术，复发率仍然很高，强调需要有效的辅助治疗。虽然辅助化疗（AC）可提高无病生存期（DFS），但支持其总生存期（OS）益处的证据有限。本文批判性地评估了CRLM切除术后AC的作用，重点关注不同临床情况下影响治疗结果的患者特异性因素。在先前的试验中缺乏分子生物标志物的分层，这突出了当前证据的一个关键差距。未来的研究应整合生物标志物驱动的方法，利用循环肿瘤DNA （ctDNA）进行治疗分层，并在围手术期和辅助治疗中探索新的治疗方法，包括免疫治疗和靶向药物。

{"title":"Systemic adjuvant and perioperative chemotherapy following curative-intent liver metastasectomy in colorectal cancer—is it justified?","authors":"R.D. Peixoto , J.M. Loree , T.A. Miranda , J.P. Solar Vasconcelos , D.J. Renouf , J.M. Davies , K. Gill , S. Gill , V. Poon , C. Metcalf , M. Chahal , M.S. Bleszynski , M. Segedi , P.T.W. Kim , H.J. Lim","doi":"10.1016/j.esmogo.2025.100190","DOIUrl":"10.1016/j.esmogo.2025.100190","url":null,"abstract":"<div><div>Colorectal liver metastases (CRLM) pose a significant challenge in oncological care, with surgical resection offering the best chance for long-term survival. Despite curative-intent liver metastasectomy, recurrence rates remain high, underscoring the need for effective adjuvant therapies. While adjuvant chemotherapy (AC) improves disease-free survival (DFS), evidence supporting its overall survival (OS) benefit is limited. This manuscript critically evaluates the role of AC following CRLM resection, with a focus on patient-specific factors influencing treatment outcomes across distinct clinical scenarios. The lack of stratification by molecular biomarkers in prior trials highlights a critical gap in current evidence. Future research should integrate biomarker-driven approaches, leverage circulating tumor DNA (ctDNA) for treatment stratification, and explore novel therapies, including immunotherapies and targeted agents, in both perioperative and adjuvant settings.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514246","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

Novel blood signature for HCC screening 用于HCC筛查的新型血液标记

ESMO Gastrointestinal Oncology

Pub Date : 2025-06-18 DOI: 10.1016/j.esmogo.2025.100185

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

Background

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":"2025-06-18","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}

引用次数: 0

Managing adverse events in patients with metastatic colorectal cancer receiving trifluridine/tipiracil in combination with bevacizumab 管理转移性结直肠癌患者接受曲氟定/替吡拉西联合贝伐单抗的不良事件

ESMO Gastrointestinal Oncology

Pub Date : 2025-06-16 DOI: 10.1016/j.esmogo.2025.100191

M. Fakih , F. Ciardiello , G.W. Prager , E. Élez , E. Calleja , N. Caussé-Amellal , J. Taieb , E. Van Cutsem

For patients with metastatic colorectal cancer (mCRC) that is refractory to standard chemotherapy, a recommended standard-of-care treatment in the third-line setting is trifluridine/tipiracil (FTD/TPI) alone or in combination with bevacizumab; other treatment options include fruquintinib or regorafenib. The safety profiles of FTD/TPI and bevacizumab as individual agents are well characterized. Common adverse events (AEs) associated with FTD/TPI include neutropenia, anemia, nausea, and diarrhea, and AEs frequently observed with bevacizumab include hypertension, proteinuria, hemorrhage, venous thromboembolism, and gastrointestinal perforation. Approval of the combination of FTD/TPI plus bevacizumab for the treatment of patients with refractory mCRC in the United States and Europe was based on results from the phase III SUNLIGHT trial. There is clinical value in developing a specific set of recommendations for the prevention or management of the key AEs associated with the combination regimen to inform clinical care and improve patient benefit. In this review, we summarize the safety profile of combination treatment with FTD/TPI plus bevacizumab in patients with refractory mCRC who were enrolled in the SUNLIGHT trial, with a focus on the key AEs of neutropenia, anemia, nausea or vomiting, diarrhea, fatigue, hypertension, and hemorrhage. In addition, we provide recommendations for the management or prevention of these key AEs in clinical practice, based on published literature and expert opinions on effective strategies.

对于标准化疗难治性转移性结直肠癌（mCRC）患者，推荐的三线标准治疗方案是trifluridine/tipiracil （FTD/TPI）单用或联合贝伐单抗；其他治疗方案包括fruquininib或regorafenib。FTD/TPI和贝伐单抗作为单独药物的安全性已经得到了很好的表征。与FTD/TPI相关的常见不良事件（ae）包括中性粒细胞减少症、贫血、恶心和腹泻，贝伐单抗经常观察到的不良事件包括高血压、蛋白尿、出血、静脉血栓栓塞和胃肠道穿孔。美国和欧洲批准FTD/TPI联合贝伐单抗治疗难治性mCRC患者是基于III期sunshine试验的结果。为预防或管理与联合治疗方案相关的主要不良事件制定一套具体的建议具有临床价值，从而为临床护理提供信息并提高患者利益。在这篇综述中，我们总结了FTD/TPI +贝伐单抗联合治疗纳入SUNLIGHT试验的难治性mCRC患者的安全性，重点关注中性粒细胞减少症、贫血、恶心或呕吐、腹泻、疲劳、高血压和出血等关键不良事件。此外，我们根据已发表的文献和专家对有效策略的意见，为临床实践中这些关键ae的管理或预防提供建议。

{"title":"Managing adverse events in patients with metastatic colorectal cancer receiving trifluridine/tipiracil in combination with bevacizumab","authors":"M. Fakih , F. Ciardiello , G.W. Prager , E. Élez , E. Calleja , N. Caussé-Amellal , J. Taieb , E. Van Cutsem","doi":"10.1016/j.esmogo.2025.100191","DOIUrl":"10.1016/j.esmogo.2025.100191","url":null,"abstract":"<div><div>For patients with metastatic colorectal cancer (mCRC) that is refractory to standard chemotherapy, a recommended standard-of-care treatment in the third-line setting is trifluridine/tipiracil (FTD/TPI) alone or in combination with bevacizumab; other treatment options include fruquintinib or regorafenib. The safety profiles of FTD/TPI and bevacizumab as individual agents are well characterized. Common adverse events (AEs) associated with FTD/TPI include neutropenia, anemia, nausea, and diarrhea, and AEs frequently observed with bevacizumab include hypertension, proteinuria, hemorrhage, venous thromboembolism, and gastrointestinal perforation. Approval of the combination of FTD/TPI plus bevacizumab for the treatment of patients with refractory mCRC in the United States and Europe was based on results from the phase III SUNLIGHT trial. There is clinical value in developing a specific set of recommendations for the prevention or management of the key AEs associated with the combination regimen to inform clinical care and improve patient benefit. In this review, we summarize the safety profile of combination treatment with FTD/TPI plus bevacizumab in patients with refractory mCRC who were enrolled in the SUNLIGHT trial, with a focus on the key AEs of neutropenia, anemia, nausea or vomiting, diarrhea, fatigue, hypertension, and hemorrhage. In addition, we provide recommendations for the management or prevention of these key AEs in clinical practice, based on published literature and expert opinions on effective strategies.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296997","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