We aimed to investigate whether there is a difference between intrahepatic cholangiocarcinoma (IHCC) and liver metastases of gastrointestinal system (GIS) adenocarcinoma in terms of apparent ...diffusion coefficient (ADC) values.
From January 2018 to January 2020, we retrospectively examined 64 consecutive patients with liver metastases due to gastrointestinal system adenocarcinomas and 13 consecutive IHCC in our hospital's medical records. After exclusions, fifty-three patients with 53 liver metastases and 10 IHCC were included in our study. We divided the patients into two groups as IHCC and liver metastases of GIS adenocarcinoma. For mean apparent diffusion coefficient (ADC
) values, the region of interests (ROI) was placed in solid portions of the lesions. ADC
values of groups were compared.
The mean age of IHCC group was 62.50 ± 13.49 and mean age of metastases group was 61.15 ± 9.18. ADC
values were significantly higher in the IHCC group compared to the metastatic group (p < 0.001). ROC curves method showed high diagnostic accuracy (AUC = 0.879) with cut-off value of < 1178 x 10
mm
/s for ADC
(Sensitivity = 90.57, Specificity = 70.0, positive predictive value PPV = 94.1, negative predictive value NPV = 58.3) in differentiating adenocarcinoma metastases from IHCC.
The present study results suggest that ADC values have a potential role for differentiation between IHCC and GIS adenocarcinoma liver metastases which may be valuable for patient management.
A 43-year-old male patient presented with a mass lesion on the right liver lobe, segment 5, in radiological imaging and elevated
alpha-fetoprotein levels (323 ng/mL) compatible with hepatocellular ...carcinoma (HCC). Positron emission tomography/
computed tomography (PET/CT) images showed background level 18F-FDG uptake in the mass lesion. In addition, a secondary
focus of increased 18F-FDG uptake was detected on the left liver lobe, segment 2, approximately 1,5 cm in diameter.
Histopathological examination revealed HCC in the larger mass lesion with a lower 18F-FDG uptake, and cholangiocellular
carcinoma in the smaller mass lesion with a higher 18F-FDG uptake. To our knowledge, this is the first case report of two
histopathologically different primary malignant liver tumors in two distinct segments of the liver detected by PET/CT.
The purpose of the study was to determine DTI properties of brain metastases in subjects with Non-Small Cell Lung Carcinoma (NSCLC) to evaluate whether there was a correlation between DTI findings ...and Programmed Cell Death Ligand-1 (PD-L1).
The study population (n:22) was assigned to PD-L1 negative (Group 1: PD-L1 expression<% 50) (n=11) or positive (Group 2: PD-L1 expression ≥%50) (n=11). We compared ADC and FA values measured from the enhanced solid metastases and peritumoral edema area with PD-L1 protein status.
The mean ADC values were lower in group 2 compared to group 1. The peritumoral ADC values were higher in group 2 compared to group 1. Mean peritumoral edema FA values were lower in group 2 compared to group 1. The peritumoral edema nADC values were higher in group 2 compared to group 1. As PD-L1 expression frequency increased, ADC values in the peritumoral edema area increased and FA values decreased.
We thought that the existence of PD-L1 protein does not affect ADC and FA values of brain metastasis (BM) originating from NSCLC. DTI characteristics of the peritumoral edema area could be a guide in determining the PD-L1 protein status of brain metastases of NSCLC. The relationship between PD-L1 expression status and DTI features in BM from NSCLC could help us to have an idea regarding the response to immunotherapy.
•Analyzing KRAS mutation is essential for colorectal liver metastases.•DWI is widely used in the detection and follow-up of CRLM.•ADC values were significantly decreased in KRAS mutation positive ...group.•ADC values of the CRLM can be used for predicting the KRAS mutation status.
We aimed to investigate whether there are any differences in apparent diffusion coefficient (ADC) values obtained from colorectal liver metastases (CRLM) according to Kirsten rat sarcoma (KRAS) gene mutation status.
In this retrospective study, we included 22 patients with 65 liver metastases due to colorectal cancer and performed KRAS gene mutation tests. We divided the patients into two groups as KRAS mutation positive (+) (n:10, 30 lesions) and the wild-type group (n:12, 35 lesions). Mann-Whitney U test was used to compare ADC and ADC mean values of the two groups. In addition, we performed receiver-operating characteristic (ROC) analysis to discriminate the two groups in terms of their ADC and ADCmean values.
The ADC and ADCmean values were found to be statistically significantly lower in the KRAS (+) group compared to the wild-type group. ROC curve analysis revealed a statistically significant difference in terms of ADC and ADCmean with area under the curve (AUC) values of 0.680 and 0.760, respectively. The cut-off values for ADC and ADCmean were 986 × 10−6 mm2/s and 823 × 10−6 mm2/s, respectively.
In our study, the lower ADC and ADCmean values of CRLM are associated with presence of KRAS mutation. ADC and ADCmean values derived from liver metastases due to the colorectal cancer can be used to differentiate KRAS mutation status.
To compare anticholinergic burden (ACB) in older patients with and without cancer and evaluate the effects of ACB on geriatric syndromes.
A total of 291 patients from the geriatric clinic and 301 ...patients from the oncology clinic were evaluated. ACB <2 was categorized as low ACB and ACB ≥2 was categorized as high ACB. A comprehensive geriatric assessment was performed on patients from the geriatric clinic.
ACB scores were significantly higher in patients without cancer compared with those with cancer (p < 0.005). Number of falls and Geriatric Depression Scale 15 scores were higher and Mini-Nutritional Assessment and Barthel/Lawton activities of daily living scores were lower in geriatric patients with high ACB scores compared with those with low ACB scores (p < 0.005).
It is crucial to understand the potential effects of ACB for rational drug use and optimum cancer management in older patients with cancer.
Outcomes are poor in patients with HER2-negative, advanced gastric or gastro-oesophageal junction adenocarcinomas. In this study, we investigated efficacy and safety of the first-in-class, ...afucosylated, humanised IgG1 anti-fibroblast growth factor receptor 2 isoform IIb (FGFR2b) monoclonal antibody bemarituzumab with modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) in patients with FGFR2b-selected gastric or gastro-oesophageal junction adenocarcinoma.
In the randomised, double-blind, placebo-controlled phase 2 trial (FIGHT), patients aged 18 years and older with HER2 non-positive, FGFR2b-selected gastric or gastro-oesophageal junction adenocarcinoma, and an Eastern Cooperative Oncology Group performance status of 0–1 were recruited from 144 clinical sites across 17 countries. Patients with previous treatment with any selective inhibitor of the FGF–FGFR pathway were excluded. Eligible patients were randomly assigned (1:1), using permuted-block randomisation (block size of four) and a central interactive voice-web-based response system, stratified by geographical region, previous treatment with curative intent, and administration of mFOLFOX6 while being screened for FGFR2b status, to either bemarituzumab (15 mg/kg of bodyweight) or matched placebo intravenously every 2 weeks. All patients also received mFOLFOX6 (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, and 5-fluorouracil as a 400 mg/m2 bolus followed by 2400 mg/m2 over approximately 46 h) intravenously every 2 weeks. Patients were given treatment until disease progression (defined by Response Evaluation Criteria in Solid Tumours RECIST version 1.1), unacceptable toxicity, withdrawal of consent, or death. The primary endpoint was progression-free survival in the intention-to-treat population (defined as all patients randomly assigned to treatment). Safety was assessed in all patients who received at least one dose of assigned treatment. This study is registered with ClinicalTrials.gov, NCT03694522, and is now complete.
Between Nov 14, 2017, and May 8, 2020, 910 patients were screened and 155 were randomly assigned to the bemarituzumab (n=77) or placebo group (n=78). Median age was 60·0 years (IQR 51·0–67·0), 44 (28%) participants were women, 111 (72%) were men, 89 (57%) were Asian, and 61 (39%) were White. At the time of the primary analysis and at a median follow-up of 10·9 months (IQR 6·3–14·2), median progression-free survival was 9·5 months (95% CI 7·3–12·9) in the bemarituzumab group and 7·4 months (5·8–8·4) in the placebo group (hazard ratio HR 0·68 95% CI 0·44–1·04; p=0·073). Common grade 3 or worse adverse events were decreased neutrophil count (23 30% of 76 in the bemarituzumab group vs 27 35% of 77 in the placebo group), cornea disorder (18 24% vs none), neutropenia (ten 13% vs seven 9%), stomatitis (seven 9% vs one 1%), and anaemia (six 8% vs ten 13%). Serious treatment-emergent adverse events were reported in 24 (32%) patients in the bemarituzumab group and 28 (36%) in the placebo group. Serious mFOLFOX6 treatment-related adverse events occurred in nine (12%) patients in the bemarituzumab group and in 15 (19%) patients in the placebo group. All-grade corneal events (adverse events of special interest) occurred in 51 (67%) patients in the bemarituzumab group and eight (10%) in the placebo group; grade 3 corneal events were reported only in 18 (24%) patients in the bemarituzumab group. Treatment-related deaths occurred in three patients in the bemarituzumab group (two due to sepsis, one due to pneumonia) and none in the placebo group.
In this exploratory phase 2 study, despite no statistically significant improvement in progression-free survival, treatment with bemarituzumab showed promising clinical efficacy. Confirmatory phase 3 trials of bemarituzumab plus mFOLFOX6 powered to demonstrate statistical significance are being investigated in patients with previously untreated, FGFR2b-overexpressing, advanced gastric or gastro-oesophageal junction adenocarcinoma.
Five Prime Therapeutics.
Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could ...predict the histopathological types of the primary lung cancer.Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated.Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10-3 mm2/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC.Conclusion: DTI parameters of brain metastasis can discriminate SCLC and NSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer.
Objective
We aimed to evaluate cardiac safety profile of ribociclib with 24-h rhythm Holter ECG.
Material and method
Forty-two female metastatic breast cancer patients were included in the study. ...Rhythm Holter ECG was performed before starting treatment with ribociclib and after 3 months of the treatment initiation.
Results
The mean age of the patients was 56.36 ± 12.73. 52.4% (
n
= 22) of the patients were using ribociclib in combination with fulvestrant and 47.6% (
n
= 20) with aromatase inhibitors. None of the patients developed cardiotoxicity. When the rhythm Holter results before and in third month of the treatment were compared, there was no statistically significant difference.
Conclusion
This is the first study evaluating effects of ribociclib treatment on cardiac rhythm with Holter ECG. The findings suggested ribociclib has a low risk of causing early cardiotoxicity.
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