Articles related to Gastroenterology

Sixty patients with EGFR-amplified gastroesophageal adenocarcinoma(GEA) received EGFRi, including 31 of 60 patients (52%) with concurrent chemotherapy. Across treatment lines, patients achieved a 43% objective response rate with a median PFS of 4.6 months. Typical OS with first-line initiation of non-EGFRi therapy in patients with EGFR-amplified GEA is 11.2 months, as determined by analysis of a deidentified clinicogenomic database. Despite this benefit, analysis of that database for January 2011 through December 2020 suggests that only 5% of patients with EGFR-amplified GEA received EGFRi.

A potentially practice-changing clinical trial for first line therapy is the first to show that the combination of two immunotherapy medications is an effective treatment for hepatocellular carcinoma (HCC). The HIMALAYA study evaluated combination immunotherapy (IO-IO), durvalumab with tremelimumab, as frontline therapy in patients with unresectable HCC. Overall survival was significantly improved with the IO-IO combination compared with sorafenib monotherapy (16.4 vs 13.8 months; hazard ratio [HR], 0.78; 96% CI, 0.65-0.92; P =.0035). Early results of the phase three LAUNCH trial are also promising. This trial compared the combination of lenvatinib with transarterial chemoembolization (TACE) to lenvatinib alone in an Asian population with advanced HCC. The lenvatinib-TACE group achieved a higher median overall survival (17.8 vs. 11.5 months and median progression-free survival (10.6 vs. 6.4 months). Muhammad Shaalan Beg, MD, director for GI Medical Oncology at UT Southwestern Medical Center in Dallas summarizes these and other takeaways from emerging research on advanced HCC presented at the recent ASCO GI Symposium.

A 56-year-old man has had right-upper-quadrant abdominal pain for several months but is otherwise healthy. He does not drink alcohol, has not been exposed to other hepatotoxins, and takes no medications. On physical examination, vital signs are normal. Abdominal examination reveals hepatosplenomegaly. The remainder of the physical exam is normal. What would you do?

Thinking of starting the new year off with a diet? According to U.S. News and World Report, the Mediterranean diet is the best overall diet for adults. The diet was ranked first in the categories of best diets for healthy eating, easiest diets to follow, and best diets for diabetes, among other measurable categories.

A systematic review identified 204 eligible publications from 2000 through 2017, with much of the evidence consisting of systematic reviews of observational data, consensus guidelines, case series, and case reports. Due to the paucity of high-quality evidence on management of immune-related adverse events, recommendations are based on expert consensus.

Studies suggest that G12C mutations occur in 3% to 8% of total colorectal cancer (CRC) cases and constitute 6% to 17% of KRAS mutations. Having a G12C mutation may be an adverse prognostic factor in mCRC, but confounding factors may be more responsible for differences in treatment outcomes than the G12C mutation itself. The two conflicting presentations at the ESMO World Congress on Gastrointestinal Cancer highlight the critical need to define the prognostic significance of the G12C mutation and the resulting treatment implications more precisely.