Gastrointestinal Cancer

As we look forward, we suggest that the priority should be to further our understanding of the tumor’s interactions with its microenvironment and with the immune system. We think that such an understanding will be critical for advances in locally advanced rectal cancer therapy.

The preferred integrated treatment modality for locally advanced rectal cancer is preoperative radio(chemo)therapy followed by total mesorectal excision, though certain aspects of this standard are still debated.

The FDA has approved aflibercept (Zaltrap) to be used with the chemotherapy regimen FOLFIRI in the treatment of adults with metastatic colorectal cancer.

CancerNetwork discusses the diagnosis and treatment of metastatic pancreatic cancer with Dr. Diane Simeone, who is involved in both pancreatic cancer clinical trials as well as research to better characterize important pancreatic cancer pathways and identify biomarkers for the disease.

Schrader and colleagues provide four compelling examples of the power of genetic testing to impact medical management for probands and their family members.

In 2002, the American Society of Clinical Oncology (ASCO) established the Cancer Prevention Committee (CAPC), which was formed in the hope of ensuring the integration of cancer prevention into oncology practice and research.[1]

In this article, we use a case-based approach to focus on the hereditary aspects of the most common GI cancers, including pancreatic, gastric, and colon cancer.

Though the calcium-dependent chloride channel DOG1 is strongly expressed in gastrointestinal stromal tumors (GIST), a new laboratory study suggests that methods targeting it for therapies in treating these cancers are still a ways off.

Treatment with tremelimumab stabilized patients with advanced hepatocellular carcinoma due to chronic hepatitis C infection for more than 12 months, according to data from a phase II clinical trial presented at the AACR annual meeting.

Three papers published today show that aspirin, taken daily, may prevent cancer, and could even treat certain cancers.

This article reviews the main issues that must be considered in metastatic colorectal cancer from the surgical oncology and medical oncology perspectives, respectively.

Combined-modality therapy has rendered disease-free an increasing number of patients who were previously considered to be incurable. Still, despite myriad advances in imaging, and in surgical and therapeutic modalities, many patients who undergo resection of limited metastatic disease with curative intent ultimately relapse.

In their article in this issue of ONCOLOGY, authors Bartlett and Chu discuss a very provocative suggestion that the possibility exists to cure patients with advanced colorectal cancer.

A multi-institutional, NCI-funded retrospective study in the New England Journal of Medicine highlights the significant long-term benefit of colonoscopic polypectomy in preventing death from colon cancer, with polypectomy cutting the incidence of colon cancer–related mortality in half compared with the general population.

In this interview, Dr. David Ahlquist, gastroenterologist and professor of medicine at the Mayo Clinic in Rochester in Minnesota, discusses early detection methods of colorectal cancer, touching on sigmoidoscopy, colonoscopies, fecal blood testing, and in particular, stool DNA screening.

The FDA has granted imatinib full approval as an adjuvant treatment following surgical removal of CD117-positive gastrointestinal stromal tumors in adult patients. This comes after results from a phase III trial showed that patients taking imatinib for 36 months had a 5-year overall survival of 92%, compared to 82% for those patients who took the drug for the standard 12 months of treatment.

Researchers in Sweden who analyzed several prospective studies found an increased risk of pancreatic cancer associated with processed meat consumption. They also found that eating red meat is linked to pancreatic cancer among men.

Inherited mutations in the ataxia telangiectasia mutated (ATM) gene increase the odds of developing pancreatic cancer according to a new study. While there is predisposition for pancreatic cancer with up to 10% of cases occurring among families with a history of the disease, the genetic basis for this had not been previously discovered.

Treatment for patients with locally advanced, resectable rectal cancer has clearly evolved, with significant refinements in preoperative assessment, surgical technique, and use of preoperative chemoradiation.

The exact role of combined-modality therapy and TAE of rectal cancer remains to be defined. Certainly the stakes are high, as studies have shown that the recurrence of locally excised rectal cancer is associated with worse long-term survival outcomes.

Advances in the treatment of rectal cancer, such as TME and CMT, have lengthened survival time and enhanced the quality of life. However, radiation therapy may have a negative impact on quality of life, especially in males. Future research needs to focus not only on survival but also on postoperative quality of life.

Blase Polite, MD, assistant professor of medicine at the University of Chicago and the track leader for the GI Colorectal Scientific Program Committee at ASCO, discusses the latest research in the field of colorectal cancer.

David Ryan, MD, discusses his debate with Paul H. Sugarbaker, MD, from the ASCO session “Intraperitoneal Chemotherapy and Cytoreductive Surgery in Colon Cancer” and how in his view this type of treatment, as presented to the patient, creates a certain dynamic between the surgeon and medical oncologist, one of hope vs reality.

This phase I/II trial assessed the efficacy of mFOLFOX6 with either BIBF 1120, an oral anti-angiogenesis agent, or with bevacizumab, an anti-angiogenesis antibody, in chemotherapy-naïve patients with metastatic colorectal cancer (mCRC). Patients were randomized 2:1 to the BIBF 1120 and bevacizumab arms, respectively.

A study published in Lancet Oncology shows that an AS04-adjuvanted HPV 16 and HPV 18 vaccine developed by GlaxoSmithKline Biologicals can offer protection against anal cancer.

The review of surgical management of neuroendocrine tumors (NETs) of the gastrointestinal tract, authored by Huang, Poultsides, and Norton, is both comprehensive and accessible for readers of all backgrounds.

This article reviews the surgical management of gastrointestinal neuroendocrine tumors, including the preoperative control of hormonal symptoms, extent of resection required, postoperative outcomes, and differing management strategies as determined by whether the tumor has arisen sporadically or as part of a familial disorder, such as multiple endocrine neoplasia type 1.

Tumors of neuroendocrine origin arising from the pancreas, luminal gastrointestinal tract, and other tissues differ greatly in their malignant potential.

A fairly simple and inexpensive fecal occult blood test (FOBT) that detects blood cells in a person's stool sample has been found to be an effective way to screen for colon cancer. The prospective, 2796 asymptomatic participants from Taiwan participated in the study that was published only on August 2, 2011 in the Canadian Medical Association Journal (DOI:10.1503/cmaj.101248).

In the majority of cases, hepatocellular carcinoma develops in the setting of cirrhosis. Treatment with curative intent is possible in only 20% to 25% of cases and consists of resection or liver transplantation.