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Zhu YJ, Wu XY, Wang W, Chang XS, Zhan DD, Diao DC, Xiao J, Li Y, Ma D, Hu M, Li JC, Wan J, Wu GN, Ke CF, Sun KY, Huang ZL, Cao TY, Zhai XH, Chen YD, Peng JJ, Mao JJ, Zhang HB. Acupuncture for Quality of Life in Gastric Cancer Patients Undergoing Adjuvant Chemotherapy. J Pain Symptom Manage 2022; 63:210-220. [PMID: 34563627 DOI: 10.1016/j.jpainsymman.2021.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 12/23/2022]
Abstract
CONTEXT Patients with gastric cancer experience health-related quality of life (HRQOL) decline during adjuvant chemotherapy following gastrectomy. OBJECTIVES This pilot study aimed to evaluate the preliminary effect and feasibility of electro-acupuncture (EA) for HRQOL and symptom burden in these patients. METHODS In this open-label, multicenter, parallel controlled trial, gastric cancer patients who planned to receive adjuvant chemotherapy were randomly assigned to receive high-dose EA (seven times each chemotherapy cycle for three cycles), low-dose EA (three times each chemotherapy cycle), or usual care only. The acupoints prescription consisted of bilateral ST36, PC6, SP4, and DU20, EX-HN3, and selected Back-shu points. Patients completed the Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) weekly, and the Edmonton Symptom Assessment System (ESAS). The primary outcome was the difference among the groups on the gastric cancer subscale (GaCS) of the FACT-Ga. RESULTS Of the 66 randomized patients, 58 were analyzed according to intention-to-treat principle, and 45 were in the per-protocol set (PPS). The average scores in PPS of GaCS were 52.12±9.71, 51.85±12.36, and 45.37±8.61 in high-dose EA, low-dose EA, and control groups, respectively. EA was significantly associated with improved average GaCS scores when compared with control group (51.98±10.91 vs. 45.37±8.61, P = 0.039). EA treatment also produced ESAS relief at the end of intervention (14.36 ± 12.28 vs. 23.91 ± 15.52, P = 0.027). Participants in EA groups had fewer grade ≥3 leukopenia (0% vs. 15.79%, P = 0.031) and neutropenia (2.56% vs. 26.31%, P = 0.012). CONCLUSION EA showed promising effects in improving HRQOL, controlling symptom burden, and reducing toxicity during adjuvant chemotherapy in gastric cancer patients. Future adequately powered trials are feasible and needed to confirm the specific effect of EA.
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Affiliation(s)
- Yan-Juan Zhu
- Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome (Y.J.Z., H.B.Z.), Guangzhou, China; Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research (Y.J.Z., H.B.Z.), Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Yu Wu
- Gastrointestinal Surgery (X.Y.W., G.N.W.), Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Wei Wang
- Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine (W.W., D.C.D., J.W.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xue-Song Chang
- Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dan-Dan Zhan
- Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - De-Chang Diao
- Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine (W.W., D.C.D., J.W.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian Xiao
- Medical Oncology, the Sixth Affiliated Hospital (J.X., T.Y.C., X.H.Z.), Sun Yat-sen University, Guangzhou, China
| | - Yong Li
- Gastrointestinal Surgery (Y.L.), Guangdong Provincial People's Hospital, Guangzhou, China
| | - Dong Ma
- Gastrointestinal Oncology (D.M.), Guangdong Provincial People's Hospital, Guangzhou, China
| | - Ming Hu
- Gastrointestinal Surgery (M.H., C.F.K.), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jian-Chang Li
- Gastrointestinal Surgery (J.C.L., Z.L.H.), Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Jin Wan
- Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine (W.W., D.C.D., J.W.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guan-Nan Wu
- Gastrointestinal Surgery (X.Y.W., G.N.W.), Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Chuan-Feng Ke
- Gastrointestinal Surgery (M.H., C.F.K.), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai-Yu Sun
- Gastrointestinal Surgery (K.U.S., J.J.P.), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Liang Huang
- Gastrointestinal Surgery (J.C.L., Z.L.H.), Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Tai-Yuan Cao
- Medical Oncology, the Sixth Affiliated Hospital (J.X., T.Y.C., X.H.Z.), Sun Yat-sen University, Guangzhou, China
| | - Xiao-Hui Zhai
- Medical Oncology, the Sixth Affiliated Hospital (J.X., T.Y.C., X.H.Z.), Sun Yat-sen University, Guangzhou, China
| | - Ya-Dong Chen
- Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian-Jun Peng
- Gastrointestinal Surgery (K.U.S., J.J.P.), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Jun J Mao
- Department of Medicine (J.J.M.), Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Hai-Bo Zhang
- Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome (Y.J.Z., H.B.Z.), Guangzhou, China; Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research (Y.J.Z., H.B.Z.), Guangzhou University of Chinese Medicine, Guangzhou, China; State Key Laboratory of Dampness Syndrome of Chinese Medicine (H.B.Z.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou China.
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Lin Z, Wang R, Zhou Y, Wang Q, Yang CY, Hao BC, Ke CF. Prediction of distant metastasis and survival prediction of gastric cancer patients with metastasis to the liver, lung, bone, and brain: research based on the SEER database. Ann Transl Med 2022; 10:16. [PMID: 35242861 PMCID: PMC8825534 DOI: 10.21037/atm-21-6295] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/08/2021] [Indexed: 12/04/2022]
Abstract
Background Gastric cancer (GC) is a globally important disease. It is the 5th most common malignancy and the 4th most common cause of death from cancer in the world. Patients with GC are often at an advanced stage when they are first diagnosed, and their overall prognosis is poor due to locally advanced and distant metastasis. This study sought to establish a predictive model of GC distant metastasis and survival that can be used to guide individualized treatment. Methods Patients diagnosed with GC from the Surveillance, Epidemiology, and End Results database were enrolled in the study. Univariate and multivariate logistic regression analyses were used to identify risk and prognostic factors for GC patients with distant metastasis. The factors were then used to construct nomograms to predict the probability of distant metastasis and the survival time of GC patients. Receiver operating characteristic (ROC) curve and decision curve analyses were used to verify the prediction ability of the nomograms. Results We established a comprehensive nomogram to predict the survival time of GC patients and 4 nomograms to predict distant metastasis. Nomograms could help oncologists to formulate treatment strategies and provide hospice care under an overall management model. Conclusions Establishing a prediction model for distant metastasis and the survival of GC patients is of great clinical significance. The prediction of distant metastasis could help clinicians to make individualized assessments of patients and formulate individualized examination measures. Survival prediction models could help oncologists to formulate good treatment strategies and provide hospice care.
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Affiliation(s)
- Zikai Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Runchen Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Youtao Zhou
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- The First Clinical Medical School of Guangzhou Medical University, Guangzhou, China
| | - Qixia Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Cui-Yan Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bo-Cun Hao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chuan-Feng Ke
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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3
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Zhou YT, Lin ZK, Shi MJ, Yang CY, Wei JL, Ke CF. The establishment of a hub differential gene model to predict prognosis in stage II and III right- and left-sided colon cancer patients. Ann Transl Med 2021; 9:1763. [PMID: 35071457 PMCID: PMC8756243 DOI: 10.21037/atm-21-6163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/08/2021] [Indexed: 11/06/2022]
Affiliation(s)
- You-Tao Zhou
- The First Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Zi-Kai Lin
- The First Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Man-Jie Shi
- The First Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Cui-Yan Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jia-Liang Wei
- Department of General Surgery, the Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chuan-Feng Ke
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Jiang W, Li L, Ke CF, Wang W, Xiao BY, Kong LH, Tang JH, Li Y, Wu XD, Hu Y, Guo WH, Wang SZ, Wan DS, Xu RH, Pan ZZ, Ding PR. Universal germline testing among patients with colorectal cancer: clinical actionability and optimised panel. J Med Genet 2021; 59:370-376. [PMID: 33563768 DOI: 10.1136/jmedgenet-2020-107230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE Universal germline testing in patients with colorectal cancer (CRC) with a multigene panel can detect various hereditary cancer syndromes. This study was performed to understand how to choose a testing panel and whether the result would affect clinical management. METHODS We prospectively enrolled 486 eligible patients with CRC, including all patients with CRC diagnosed under age 70 years and patients with CRC diagnosed over 70 years with hereditary risk features between November 2017 and January 2018. All participants received germline testing for various hereditary cancer syndromes. RESULTS The prevalence of germline pathogenic variants (PVs) in cancer susceptibility genes was 7.8% (38/486), including 25 PVs in genes with high-risk CRC susceptibility (the minimal testing set) and 13 PVs in genes with moderate-risk CRC susceptibility or increased cancer risk other than CRC (the additional testing set). All the clinically relevant PVs were found in patients diagnosed under age 70 years. Among them, 11 patients would not have been diagnosed if testing reserved to present guidelines. Most (36/38) of the patients with PVs benefited from enhanced surveillance and tailored treatment. PVs in genes from the minimal testing set were found in all age groups, while patients carried PVs in genes from the additional testing set were older than 40 years. CONCLUSION Universal germline testing for cancer susceptibility genes should be recommended among all patients with CRC diagnosed under age 70 years. A broad panel including genes from the additional testing set might be considered for patients with CRC older than 40 years to clarify inheritance risks. TRIAL REGISTRATION NUMBER NCT03365986.
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Affiliation(s)
- Wu Jiang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lin Li
- Genetron Health (Beijing) Technology, Co. Ltd, Beijing, China
| | - Chuan-Feng Ke
- Department of General Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Wang
- Department of Gastrointestinal Surgery, Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Bin-Yi Xiao
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling-Heng Kong
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jing-Hua Tang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuan Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Dan Wu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ying Hu
- Genetron Health (Beijing) Technology, Co. Ltd, Beijing, China
| | - Wei-Hua Guo
- Genetron Health (Beijing) Technology, Co. Ltd, Beijing, China
| | - Si-Zhen Wang
- Genetron Health (Beijing) Technology, Co. Ltd, Beijing, China
| | - De-Sen Wan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Rui-Hua Xu
- Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhi-Zhong Pan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Pei-Rong Ding
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
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5
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Jiang W, Sui QQ, Li WL, Ke CF, Ling YH, Liao LE, Zhu Z, Cai MY, Luo J, Mao LL, Zhang HZ, Wan DS, Pan ZZ, Ju HX, Ding PR. Low prevalence of mismatch repair deficiency in Chinese colorectal cancers: a multicenter study. Gastroenterol Rep (Oxf) 2020; 8:399-403. [PMID: 33163196 PMCID: PMC7603866 DOI: 10.1093/gastro/goaa006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although universal testing for mismatch repair deficiency (dMMR) has been recommended to all colorectal cancer (CRC) patients, related evidence for the Chinese population is lacking. Here, we investigated the prevalence and clinicopathological features of dMMR patients in a large Chinese CRC cohort. METHODS We included 7,373 CRC patients treated at four Chinese medical centers between August 2010 and September 2016. Patients' baseline characteristics and pathological features were recorded. The clinicopathological features were compared between patients with MLH1/PMS2 deficiency (dMLH1/PMS2) and MSH2/MSH6 deficiency (dMSH2/MSH6). RESULTS Among the investigated patients, 654 (8.9%) were identified with dMMR CRCs and, of them, 401 (61.3%) were males, with a median age of 55 years (range, 22-87 years); 355 (54.3%) had stage II CRC based on American Joint Committee on Cancer 8th edition. The prevalence of the dMLH1/PMS2 group and the dMSH2/MSH6 group were 51.5% (337/654) and 25.1% (164/654), respectively. Compared with dMSH2/MSH6 patients, those with dMLH1/PMS2 were older (57 vs 52 years, P < 0.001), more likely to be female (45.7% vs 31.5%, P = 0.004), prone to having tumors located in the right-hand side of the colon (59.0% vs 47.6%, P = 0.015), and less likely to have a family history of tumors (29.7% vs 43.3%, P = 0.003). CONCLUSIONS The prevalence of dMMR in Chinese CRC patients was low, especially in the dMLH1/PMS2 group. The clinicopathological features were different between dMMR subgroups.
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Affiliation(s)
- Wu Jiang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Qiao-Qi Sui
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Wen-Liang Li
- Department of Surgical Oncology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P. R. China
| | - Chuan-Feng Ke
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P. R. China
| | - Yi-Hong Ling
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
| | - Le-En Liao
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Zhu Zhu
- Department of Surgical Oncology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P. R. China
| | - Mu-Yan Cai
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
| | - Jun Luo
- Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, P. R. China
| | - Lin-Lin Mao
- Department of Clinical Genome Center, Guangzhou KingMed Diagnostics Group Co., Ltd, Guangzhou, Guangdong, P. R. China
| | - Hui-Zhong Zhang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
| | - De-Sen Wan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Zhi-Zhong Pan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Hai-Xing Ju
- Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, P. R. China
| | - Pei-Rong Ding
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
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Liu DX, Li DD, He W, Ke CF, Jiang W, Tang JH, Kong LH, Li Y, Sui QQ, Xiao BY, Li WR, Hong ZG, Xu RH, Pan ZZ, Zhang XS, Ding PR. PD-1 blockade in neoadjuvant setting of DNA mismatch repair-deficient/microsatellite instability-high colorectal cancer. Oncoimmunology 2020; 9:1711650. [PMID: 32042474 PMCID: PMC6984585 DOI: 10.1080/2162402x.2020.1711650] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/31/2019] [Accepted: 12/05/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Although PD-1 blockade has significantly improved the survival of metastatic colorectal cancer with DNA Mismatch Repair-Deficient/Microsatellite Instability-High (MSI-H), the data on neoadjuvant setting is limited. Methods: In this retrospective study, we enrolled eight patients with advanced MSI-H colorectal cancer from three hospitals. Four patients are locally advanced and four are metastatic. All the patients received at least two doses of PD-1 antibody with or without chemotherapy as neoadjuvant therapy. The aim of the present study was to evaluate the short-term efficacy and toxicities of this strategy. Results: All the enrolled eight patients had a major response in imaging and/or pathological evaluation. Five of the seven resected patients were evaluated as pathological complete response. One patient without surgery has a clinical complete response (cCR) tumor response. Conclusions: Neoadjuvant PD-1 blockade induced tumor regression with a major clinical and pathological response in advanced dMMR/MSI-H colorectal cancer. Further studies are required to evaluate the long-term effect of this strategy.
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Affiliation(s)
- Ding-Xin Liu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Dan-Dan Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Biotherapy Center, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Wan He
- Department of Oncology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Chuan-Feng Ke
- Department of General Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wu Jiang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Jing-Hua Tang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Ling-Heng Kong
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yuan Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qiao-Qi Sui
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Bin-Yi Xiao
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Wei-Rong Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zhi-Gang Hong
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Rui-Hua Xu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China
| | - Zhi-Zhong Pan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Xiao-Shi Zhang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Biotherapy Center, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Pei-Rong Ding
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
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7
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Zhang RX, Lin JZ, Lei J, Chen G, Li LR, Lu ZH, Ding PR, Huang JQ, Kong LH, Wang FL, Li C, Jiang W, Ke CF, Zhou WH, Fan WH, Liu Q, Wan DS, Wu XJ, Pan ZZ. Safety of intraoperative chemotherapy with 5-FU for colorectal cancer patients receiving curative resection: a randomized, multicenter, prospective, phase III IOCCRC trial (IOCCRC). J Cancer Res Clin Oncol 2017; 143:2581-2593. [PMID: 28849265 DOI: 10.1007/s00432-017-2489-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/01/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE The safety and efficacy of intraoperative chemotherapy in colorectal cancer have not yet been extensively investigated. This randomized control trial was designed to compare the safety and efficacy of intraoperative chemotherapy in combination with surgical resection to those of traditional surgical resection alone. METHODS From January 2011 to January 2016, 696 colorectal cancer patients were enrolled in this study: 341 patients were randomly assigned to the intraoperative chemotherapy, which consist of portal vein chemotherapy, intraluminal chemotherapy and intraperitoneal chemotherapy, plus surgery group, whereas 344 patients were randomized to the control group to undergo surgery alone. Eleven patients withdrew consent. RESULTS Intraoperative chemotherapy did not increase the rate of surgical complications, and no severe chemotherapy-associated side effects were observed. Four patients in each of the intraoperative chemotherapy and the control groups experienced anastomotic leakage and underwent a second operation (1.2 vs. 1.2%, P = 0.99). There were no deaths within 90 days after surgery in the chemotherapy group, whereas one patient died in the control group. Intraoperative chemotherapy did not decrease the rate of patients who received postoperative chemotherapy between the intraoperative group and control group (29.3 vs. 30.2%, P = 0.795). CONCLUSIONS Intraoperative chemotherapy can be safely performed during colorectal surgery; however, follow-up is necessary for a better assessment of its efficacy. ClinicalTrial.gov Register Number: NCT01465451.
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Affiliation(s)
- Rong-Xin Zhang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jun-Zhong Lin
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jian Lei
- Department of General Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Gong Chen
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Li-Ren Li
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Zhen-Hai Lu
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Pei-Rong Ding
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Jiong-Qiang Huang
- Department of General Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Ling-Heng Kong
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Fu-Long Wang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Cong Li
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Wu Jiang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Chuan-Feng Ke
- Department of General Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Wen-Hao Zhou
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Wen-Hua Fan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Qing Liu
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China
| | - De-Sen Wan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.
| | - Xiao-Jun Wu
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.
| | - Zhi-Zhong Pan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.
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