Cancer Research and Treatment

Original Article

Gastrointestinal cancer

Trastuzumab Combined with Irinotecan in Patients with HER2-Positive Metastatic Colorectal Cancer: A Phase II Single-Arm Study and Exploratory Biomarker Analysis: Ting Xu, Xicheng Wang, Ying Xin, Zhenghang Wang, Jifang Gong, Xiaotian Zhang, Yanyan Li, Congcong Ji, Yu Sun, Feilong Zhao, Depei Huang, Yuezong Bai, Jian Li, Lin Shen; Cancer Res Treat. 2023;55(2):626-635. Published online December 23, 2022; DOI: https://doi.org/10.4143/crt.2022.1058

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Purpose
The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC).
Materials and Methods
An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m² days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate.
Results
Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC.
Conclusion
Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.

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Special Article

Asian Consensus Guidelines for the Diagnosis and Management of Gastrointestinal Stromal Tumor: Dong-Hoe Koo, Min-Hee Ryu, Kyoung-Mee Kim, Han-Kwang Yang, Akira Sawaki, Seiichi Hirota, Jie Zheng, Bo Zhang, Chin-Yuan Tzen, Chun-Nan Yeh, Toshirou Nishida, Lin Shen, Li-Tzong Chen, Yoon-Koo Kang; Cancer Res Treat. 2016;48(4):1155-1166. Published online June 24, 2016; DOI: https://doi.org/10.4143/crt.2016.187

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors originating in the gastrointestinal tract. With the introduction of molecular-targeted therapy for GISTs which has yielded remarkable outcomes, these tumors have become a model of multidisciplinary oncological treatment. Although Western clinical guidelines are available for GISTs, such as those published by the National Comprehensive Cancer Network (NCCN) and the European Society of Medical Oncology (ESMO), the clinical situations in Asian countries are different from those in Western countries in terms of diagnostic methods, surgical approach, and availability of new targeted agents. Accordingly, we have reviewed current versions of several GIST guidelines published by Asian countries (Japan, Korea, China, and Taiwan) and the NCCN and ESMO and discussed the areas of dissensus. We here present the first version of the Asian GIST consensus guidelines that were prepared through a series of meetings involving multidisciplinary experts in the four countries. These guidelines provide an optimal approach to the diagnosis and management of GIST patients in Asian countries.

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International Journal of General Medicine.2021; Volume 14: 5149. CrossRef
Factors predicting technical difficulties during endoscopic submucosal excavation for gastric submucosal tumor
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Journal of Clinical Medicine.2021; 10(19): 4423. CrossRef
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Seong Jung Kim, Yun Jung, Ran Hong, Jun Lee
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Shun-Wen Hsiao, Mei-Wen Chen, Chia-Wei Yang, Kuo-Hua Lin, Yang-Yuan Chen, Chew-Teng Kor, Siou-Ping Huang, Hsu-Heng Yen
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Building Radiomics Models Based on Triple-Phase CT Images Combining Clinical Features for Discriminating the Risk Rating in Gastrointestinal Stromal Tumors
Meihua Shao, Zhongfeng Niu, Linyang He, Zhaoxing Fang, Jie He, Zongyu Xie, Guohua Cheng, Jian Wang
Frontiers in Oncology.2021;[Epub] CrossRef
Gastrointestinal stromal tumor of the rectum resected by transanal total mesorectal excision after neoadjuvant imatinib treatment: A case report
Takuya Yano, Masahiro Nakahara, Hiroshi Okuda, Toshihiko Nishidate, Ichiro Takemasa, Masahiko Fujimori, Hirofumi Nakatsuka, Hironobu Amano, Hideki Ohdan, Toshio Noriyuki
Asian Journal of Endoscopic Surgery.2020; 13(4): 574. CrossRef
Wedge gastrectomy: Robot-assisted with a hand-sewn repair versus a laparoscopic linear stapler technique for gastric subepithelial tumors
Chairat Supsamutchai, Thitipong Setthalikhit, Chumpon Wilasrusmee, Pornraksa Ovartchaiyapong, Jakrapan Jirasiritham, Pattawia Choikrua, Pitichote Hiranyatheb
Laparoscopic, Endoscopic and Robotic Surgery.2020; 3(1): 17. CrossRef
Impact of l-carnitine on imatinib-related muscle cramps in patients with gastrointestinal stromal tumor
Heejung Chae, Min-Hee Ryu, Jungeun Ma, Moyeol Beck, Yoon-Koo Kang
Investigational New Drugs.2020; 38(2): 493. CrossRef
Preoperative imatinib treatment in patients with locally advanced and metastatic/recurrent gastrointestinal stromal tumors
Jian Wang, Yuan Yin, Chaoyong Shen, Xiaonan Yin, Zhaolun Cai, Lin Pu, Wei Fu, Yaxuan Wang, Bo Zhang
Medicine.2020; 99(9): e19275. CrossRef
Multiple Intra-abdominal Leiomyosarcoma in a Single Patient
Rajshekhar C. Jaka, N. Chandra Mouli, T. Ravi Kumar, Akshay V. Gokak
Indian Journal of Surgical Oncology.2020; 11(S1): 63. CrossRef
Development and validation of a nomogram based on CT images and 3D texture analysis for preoperative prediction of the malignant potential in gastrointestinal stromal tumors
Caiyue Ren, Shengping Wang, Shengjian Zhang
Cancer Imaging.2020;[Epub] CrossRef
Gastrointestinal Stromal Tumors of the Small Intestine: Progress in Diagnosis and Treatment Research

Fangxing Peng, Yao Liu
Cancer Management and Research.2020; Volume 12: 3877. CrossRef
Comparison of endoscopic versus laparoscopic resection for gastric gastrointestinal stromal tumors: A preliminary meta‐analysis
Hanlong Zhu, Si Zhao, Ruonan Jiao, Jian Zhou, Chunmei Zhang, Lin Miao
Journal of Gastroenterology and Hepatology.2020; 35(11): 1858. CrossRef
Laparoscopy‑assisted endoscopic full‑thickness resection of upper gastrointestinal subepithelial tumors: A single‑center early experience
Prasit Mahawongkajit, Pakkavuth Chanswangphuvana
Molecular and Clinical Oncology.2020;[Epub] CrossRef
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Peng Liu, Fengbo Tan, Heli Liu, Jie Ge, Sheng Liu, Tianxiang Lei, Xianhui Zhao
Cancer Management and Research.2020; Volume 12: 7681. CrossRef
Laparoscopic Transabdominal Dissection and Transection of the Distal Rectum Followed by Local Excision Through the Anus for Rectal Gastrointestinal Stromal Tumor
Shin Emoto, Takashi Akiyoshi, Koji Fukata, Toshiya Nagasaki, Yosuke Fukunaga
Diseases of the Colon & Rectum.2020; 63(11): e542. CrossRef
Laparoscopic resectional oesophago-gastroplasty: a novel technique for minimally invasive treatment of large high gastric lesser curve GIST involving gastroesophageal junction
Mang Yik Foo, Baldwin P M Yeung, Jeremy T H Tan
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Chen Li, Ke-Lu Yang, Quan Wang, Jin-Hui Tian, Yang Li, Zhi-Dong Gao, Xiao-Dong Yang, Ying-Jiang Ye, Ke-Wei Jiang
World Journal of Gastroenterology.2020; 26(47): 7550. CrossRef
Application of NOTES combined with ESD for the treatment of an exogenous gastric stromal tumor: A case report and review of the literature
Xiao-Bo Liu, Zi-Ye Gao, Sandeep Pandey, Bao-Zhen Shan, Ping Liu, Chuan-Tao Sun, Sheng-Bao Li, Shu Jin
World Academy of Sciences Journal.2020;[Epub] CrossRef
Laparoscopic versus open resection of gastrointestinal stromal tumors: survival outcomes from the NCDB
Colette S. Inaba, Austin Dosch, Christina Y. Koh, Sarath Sujatha-Bhaskar, Marija Pejcinovska, Brian R. Smith, Ninh T. Nguyen
Surgical Endoscopy.2019; 33(3): 923. CrossRef
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Surgical Endoscopy.2019; 33(4): 1326. CrossRef
Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience
Jwa Hoon Kim, Min‐Hee Ryu, Changhoon Yoo, Heejung Chae, Hana Na, Moyoul Beck, Beom Su Kim, Moon‐Won Yoo, Jeong Hwan Yook, Byung Sik Kim, Ki‐Hun Kim, Chan Wook Kim, Yoon‐Koo Kang
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PRE-OPERATIVE GASTRIC GIST DOWNSIZING: THE IMPORTANCE OF NEOADJUVANT THERAPY
João Bernardo Sancio Rocha RODRIGUES, Renato Gomes CAMPANATI, Francisco NOLASCO, Athos Miranda BERNARDES, Soraya Rodrigues de Almeida SANCHES, Paulo Roberto SAVASSI-ROCHA
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Value of contrast‐enhanced harmonic endoscopic ultrasonography in differentiating between gastrointestinal stromal tumors: A meta‐analysis
Jia Yue Tang, Ke Gong Tao, Li Yuan Zhang, Kai Ming Wu, Jian Shi, Xin Zeng, Yong Lin
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Jwa Hoon Kim, Min-Hee Ryu, Young Soo Park, Hyun Jin Kim, Hyojung Park, Yoon-Koo Kang
World Journal of Gastroenterology.2019; 25(16): 2010. CrossRef
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The Oncologist.2019; 24(12): e1443. CrossRef
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MohammadEzzedien Rabie, Abdelelah Hummadi, Mohammad Bazeed, Ismail El Hakeem, AbdullaSaad Al Qahtani, Hesham Haroon, Abbas Al Zain
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The Oncologist.2019; 24(11): e1212. CrossRef
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Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2018; 28(1): e1. CrossRef
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Der Gastroenterologe.2018; 13(2): 113. CrossRef
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Cochrane Database of Systematic Reviews.2018;[Epub] CrossRef
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Xuechao Liu, Haibo Qiu, Zhiming Wu, Peng Zhang, Xingyu Feng, Tao Chen, Yong Li, Kaixiong Tao, Guoxin Li, Xiaowei Sun, Zhiwei Zhou
Journal of Gastrointestinal Surgery.2018; 22(12): 2150. CrossRef
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Cirugía Española (English Edition).2017; 95(9): 547. CrossRef
Adjuvant imatinib for patients with high-risk gastrointestinal stromal tumors: a retrospective cohort study
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Scientific Reports.2017;[Epub] CrossRef

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