The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2023

Cancer Communications, Journal Year: 2023, Volume and Issue: 44(1), P. 127 - 172

Published: Dec. 31, 2023

Abstract The 2023 update of the Chinese Society Clinical Oncology (CSCO) Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China, reflecting latest advancements evidence‐based medicine, healthcare resource availability, precision medicine. These updates address differences epidemiological characteristics, clinicopathological features, tumor biology, patterns, drug selections between Eastern Western gastric patients. Key revisions include a structured template imaging reports, updated standards molecular marker testing pathological diagnosis, an elevated recommendation neoadjuvant chemotherapy stage III cancer. For advanced metastatic cancer, guidelines introduce new recommendations immunotherapy, anti‐angiogenic therapy targeted drugs, along with management strategies human epidermal growth factor receptor 2 (HER2)‐positive deficient DNA mismatch repair (dMMR)/microsatellite instability‐high (MSI‐H) Additionally, offer detailed screening hereditary appendix listing regimens various stages CSCO are based both international clinical research expert consensus to enhance their applicability relevance practice, particularly heterogeneous landscape while maintaining commitment scientific rigor, impartiality, timely revisions.

Language: Английский

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Association between pathologic response and survival after neoadjuvant therapy in lung cancer

Nature Medicine, Journal Year: 2023, Volume and Issue: 30(1), P. 218 - 228

Published: Oct. 30, 2023

Abstract Neoadjuvant immunotherapy plus chemotherapy improves event-free survival (EFS) and pathologic complete response (0% residual viable tumor (RVT) in primary (PT) lymph nodes (LNs)), is approved for treatment of resectable lung cancer. Pathologic assessment after neoadjuvant therapy the potential analog to radiographic advanced disease. However, %RVT thresholds beyond major (≤10% RVT) have not been explored. was prospectively assessed randomized, phase 3 CheckMate 816 trial (NCT02998528), which evaluated nivolumab (anti-programmed death protein 1) patients with RVT, regression necrosis were quantified (0–100%) PT LNs using a pan-tumor scoring system tested association EFS prespecified exploratory analysis. Regardless LN involvement, improved 0% versus >0% RVT-PT (hazard ratio = 0.18). predicted (area under curve 0.74); 2-year rates 90%, 60%, 57% 39% 0–5%, >5–30%, >30–80% >80% respectively. Each 1% RVT associated 0.017 hazard increase EFS. Combining from helped differentiate outcomes. When compared circulating DNA clearance, best approximated These findings support as an emerging surrogate. Further full spectrum cancer other types warranted. ClinicalTrials.gov registration: NCT02998528 .

Language: Английский

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Advances in diagnosis and management of cancer of the esophagus

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e074962 - e074962

Published: June 3, 2024

Abstract Esophageal cancer is the seventh most common malignancy worldwide, with over 470 000 new cases diagnosed each year. Two distinct histological subtypes predominate, and should be considered biologically separate disease entities.1 These are esophageal adenocarcinoma (EAC) squamous cell carcinoma (ESCC). Outcomes remain poor regardless of subtype, patients presenting late stage disease.2 Novel strategies to improve early detection respective precursor lesions, dysplasia, Barrett’s esophagus offer potential outcomes. The introduction a limited number biologic agents, as well immune checkpoint inhibitors, resulting in improvements systemic treatment locally advanced metastatic cancer. developments, coupled minimally invasive surgical endoscopic approaches, adaptive precision radiotherapy technologies, outcomes still further. This review summarizes latest advances diagnosis management cancer, developments understanding biology this disease.

Language: Английский

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Neoadjuvant nivolumab or nivolumab plus LAG-3 inhibitor relatlimab in resectable esophageal/gastroesophageal junction cancer: a phase Ib trial and ctDNA analyses

Nature Medicine, Journal Year: 2024, Volume and Issue: 30(4), P. 1023 - 1034

Published: March 19, 2024

Abstract Gastroesophageal cancer dynamics and drivers of clinical responses with immune checkpoint inhibitors (ICI) remain poorly understood. Potential synergistic activity dual programmed cell death protein 1 (PD-1) lymphocyte-activation gene 3 (LAG-3) inhibition may help improve immunotherapy for these tumors. We report a phase Ib trial that evaluated neoadjuvant nivolumab (Arm A, n = 16) or nivolumab–relatlimab B, in combination chemoradiotherapy 32 patients resectable stage II/stage III gastroesophageal together an in-depth evaluation pathological, molecular functional responses. Primary endpoint was safety; the secondary feasibility; exploratory endpoints included pathological complete (pCR) major response (MPR), recurrence-free survival (RFS) overall (OS). The study met its primary safety Arm although B required modification to mitigate toxicity. pCR MPR rates were 40% 53.5% A 21.4% 57.1% B. Most common adverse events fatigue, nausea, thrombocytopenia dermatitis. Overall, 2-year RFS OS 72.5% 82.6%, respectively. Higher baseline ligand (PD-L1) LAG-3 expression associated deeper Exploratory analyses circulating tumor DNA (ctDNA) showed undetectable ctDNA post-ICI induction, preoperatively postoperatively had significantly longer OS; clearance reflective neoantigen-specific T Our findings provide insights into profile combined PD-1 blockade highlight potential analysis dynamically assess systemic burden during ICI open therapeutic window future intervention. ClinicalTrials.gov registration: NCT03044613 .

Language: Английский

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Advancements in immunotherapy for gastric cancer: Unveiling the potential of immune checkpoint inhibitors and emerging strategies

Biochimica et Biophysica Acta (BBA) - Reviews on Cancer, Journal Year: 2025, Volume and Issue: 1880(2), P. 189277 - 189277

Published: Feb. 10, 2025

Language: Английский

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Reshaping the immune microenvironment and reversing immunosenescence by natural products: prospects for immunotherapy in gastric cancer

Seminars in Cancer Biology, Journal Year: 2025, Volume and Issue: 110, P. 1 - 16

Published: Feb. 8, 2025

Language: Английский

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Neoadjuvant sintilimab in combination with concurrent chemoradiotherapy for locally advanced gastric or gastroesophageal junction adenocarcinoma: a single-arm phase 2 trial

Nature Communications, Journal Year: 2023, Volume and Issue: 14(1)

Published: Aug. 14, 2023

In this multicenter, single-arm phase 2 trial (ChiCTR1900024428), patients with locally advanced gastric/gastroesophageal junction cancers receive one cycle of sintilimab (anti-PD1) and chemotherapy (S-1 nab-paclitaxel), followed by 5 weeks concurrent chemoradiotherapy sintilimab, another thereafter. Surgery is preferably scheduled within to three weeks, cycles adjuvant are administrated. The primary endpoint the pathological complete response. Our results meet pre-specified endpoint. Thirteen 34 (38.2%) enrolled achieve response (95% CI: 22.2-56.4). secondary objectives include disease-free survival (DFS), major response, R0 resection rate, overall (OS), event-free (EFS), safety profile. median DFS EFS were 17.0 (95%CI: 11.1-20.9) 21.1 14.7-26.1) months, respectively, while OS was not reached, 1-year rate 92.6% 50.1-99.5%). Seventeen (50.0%) have grade ≥3 adverse events during preoperative therapy. prespecified exploratory biomarker analysis, CD3

Language: Английский

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Predictive Biomarkers for Immunotherapy in Gastric Cancer: Current Status and Emerging Prospects

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(20), P. 15321 - 15321

Published: Oct. 18, 2023

Gastric cancer presents substantial management challenges, and the advent of immunotherapy has ignited renewed hope among patients. Nevertheless, a significant proportion patients do not respond to immunotherapy, adverse events associated with also occur on occasion, underscoring imperative identify suitable candidates for treatment. Several biomarkers, including programmed death ligand-1 expression, tumor mutation burden, mismatch repair status, Epstein–Barr Virus infection, circulating DNA, tumor-infiltrating lymphocytes, have demonstrated potential in predicting effectiveness gastric cancer. However, quest optimal predictive biomarker remains challenging, as each carries its own limitations. Recently, multi-omics technologies emerged promising platforms discovering novel biomarkers that may help selecting likely immunotherapy. The identification reliable holds promise enhancing patient selection improving treatment outcomes. In this review, we aim provide an overview clinically established Additionally, introduce newly reported based studies context thereby contributing ongoing efforts refine stratification strategies.

Language: Английский

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Deep learning on tertiary lymphoid structures in hematoxylin-eosin predicts cancer prognosis and immunotherapy response

npj Precision Oncology, Journal Year: 2024, Volume and Issue: 8(1)

Published: March 22, 2024

Abstract Tertiary lymphoid structures (TLSs) have been associated with favorable immunotherapy responses and prognosis in various cancers. Despite their significance, quantification using multiplex immunohistochemistry (mIHC) staining of T B lymphocytes remains labor-intensive, limiting its clinical utility. To address this challenge, we curated a dataset from matched mIHC H&E whole-slide images (WSIs) developed deep learning model for automated segmentation TLSs. The achieved Dice coefficients 0.91 on the internal test set 0.866 external validation set, along intersection over union (IoU) scores 0.819 0.787, respectively. TLS ratio, defined as segmented area total tissue area, correlated lymphocyte levels expression CXCL13 , chemokine formation, 6140 patients spanning 16 tumor types Cancer Genome Atlas (TCGA). prognostic models overall survival indicated that inclusion ratio TNM staging significantly enhanced models’ discriminative ability, outperforming traditional solely incorporated staging, 10 out 15 TCGA types. Furthermore, when applied to biopsied treatment-naïve samples, higher ratios predicted positive response across multiple cohorts, including specific therapies esophageal squamous cell carcinoma, non-small lung cancer, stomach adenocarcinoma. In conclusion, our learning-based approach offers an reproducible method quantification, highlighting potential predicting informing cancer prognosis.

Language: Английский

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Immunotherapy and Cancer: The Multi-Omics Perspective

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(6), P. 3563 - 3563

Published: March 21, 2024

Immunotherapies have revolutionized cancer treatment approaches. Because not all patients respond positively to immune therapeutic agents, it represents a challenge for scientists who strive understand the mechanisms behind such resistance. In-depth exploration of tumor biology, using novel technologies as omics science, can help decode role microenvironment (TIME) in producing response blockade strategies. It also identify biomarkers patient stratification and personalized treatment. This review aims explore these new models highlight their possible pivotal changing clinical practice.

Language: Английский

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