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Cancers
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Patient-Adapted Multidisciplinary Approaches in Gastrointestinal Tract Tumors
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Patient-Adapted Multidisciplinary Approaches in Gastrointestinal Tract Tumors

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 6743

Special Issue Editors

Dr. Javier Rodriguez

E-Mail Website
Guest Editor
Department of Medical Oncology, Clínica Universidad de Navarra, Pamplona, 31008 Navarra, Spain
Interests: gastrointestinal oncology; gastric cancer; colorectal cancer; pancreatic cancer; immunotherapy; clinical trials; neuroendocrine tumors
Special Issues, Collections and Topics in MDPI journals
Dr. Diego Salas-Benito

E-Mail Website
Guest Editor
Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA 02114, United States
Interests: Adoptive cell therapy; CAR-T cell therapy

Special Issue Information

Dear Colleagues,

Although gastrointestinal (GI) cancers are among the most common cancer types and represent a leading cause of cancer-related deaths worldwide, there is a clear need for more effective therapies. The management of GI cancers is evolving, due to a better understanding of the molecular underpinnings of each of these diseases, and the integration of genomics into clinical practice has allowed an in-depth characterization of tumors to deliver targeted treatment based on genetic variants. A huge amount of effort is being directed towards the development of more sensitive and specific molecular profiling, including blood-based biomarkers for real-time monitoring. Moreover, immunotherapy is being actively incorporated into the treatment of GI cancers, particularly with the use of ICIs in certain molecular subtypes.

This approach has led to survival improvements in different tumor types, but the outcomes of genomically guided treatments in GI cancers remain undetermined. It is anticipated that additional aspects beyond genomic signatures should be considered to create combined models that better define individual patients' needs. Among them, adoptive cell therapy and gene therapy, therapeutic drug monitoring, radiomics or intratumoral microbiota will likely soon be integrated as components of precision medicine in GI cancer patients. In this Special Issue, we aim to provide an overview of some of these emerging strategies.

Dr. Javier Rodríguez Rodríguez
Dr. Diego Salas-Benito
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • CART therapy
  • radiomics
  • therapeutic drug monitoring
  • microbiome
  • artificial intelligence
  • immunostimulatory viral vectors
  • adoptive cell therapy
  • colorectal cancer
  • gastric cancer

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Published Papers (3 papers)

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Research

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16 pages, 5118 KiB  
Article
Endoscopic Ultrasound-Guided Gastroenterostomy versus Enteral Stenting for Malignant Gastric Outlet Obstruction: A Retrospective Propensity Score-Matched Study
by Maria Cristina Conti Bellocchi, Enrico Gasparini, Serena Stigliano, Daryl Ramai, Laura Bernardoni, Francesco Maria Di Matteo, Antonio Facciorusso, Luca Frulloni and Stefano Francesco Crinò
Cancers 2024, 16(4), 724; https://doi.org/10.3390/cancers16040724 - 8 Feb 2024
Cited by 7 | Viewed by 1808
Abstract
Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen apposing metal stent has emerged as a minimally invasive treatment for the management of malignant gastric outlet obstruction (mGOO). We aimed to compare EUS-GE with enteral stenting (ES) for the treatment of mGOO. Methods: Patients who [...] Read more.
Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen apposing metal stent has emerged as a minimally invasive treatment for the management of malignant gastric outlet obstruction (mGOO). We aimed to compare EUS-GE with enteral stenting (ES) for the treatment of mGOO. Methods: Patients who underwent EUS-GE or ES for mGOO between June 2017 and June 2023 at two Italian centers were retrospectively identified. The primary outcome was stent dysfunction. Secondary outcomes included technical success, clinical failure, safety, and hospital length of stay. A propensity score-matching analysis was performed using multiple covariates. Results: Overall, 198 patients were included (66 EUS-GE and 132 ES). The stent dysfunction rate was 3.1% and 16.9% following EUS-GE and ES, respectively (p = 0.004). Using propensity score-matching, 45 patients were allocated to each group. The technical success rate was 100% for both groups. Stent dysfunction was higher in the ES group compared with the EUS-GE group (20% versus 4.4%, respectively; p = 0.022) without differences in clinical efficacy (p = 0.266) and safety (p = 0.085). A significantly shorter hospital stay was associated with EUS-GE compared with ES (7.5 ± 4.9 days vs. 12.5 ± 13.0 days, respectively; p = 0.018). Kaplan–Meier analyses confirmed a higher stent dysfunction-free survival rate after EUS-GE compared with ES (log-rank test; p = 0.05). Conclusion: EUS-GE offers lower rates of stent dysfunction, longer stent patency, and shorter hospital stay compared with ES. Full article
(This article belongs to the Special Issue Patient-Adapted Multidisciplinary Approaches in Gastrointestinal Tract Tumors)
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15 pages, 1712 KiB  
Article
Predicting Severe Haematological Toxicity in Gastrointestinal Cancer Patients Undergoing 5-FU-Based Chemotherapy: A Bayesian Network Approach
by Oskitz Ruiz Sarrias, Cristina Gónzalez Deza, Javier Rodríguez Rodríguez, Olast Arrizibita Iriarte, Angel Vizcay Atienza, Teresa Zumárraga Lizundia, Onintza Sayar Beristain and Azucena Aldaz Pastor
Cancers 2023, 15(17), 4206; https://doi.org/10.3390/cancers15174206 - 22 Aug 2023
Cited by 2 | Viewed by 1855
Abstract
Purpose: Severe toxicity is reported in about 30% of gastrointestinal cancer patients receiving 5-Fluorouracil (5-FU)-based chemotherapy. To date, limited tools exist to identify at risk patients in this setting. The objective of this study was to address this need by designing a predictive [...] Read more.
Purpose: Severe toxicity is reported in about 30% of gastrointestinal cancer patients receiving 5-Fluorouracil (5-FU)-based chemotherapy. To date, limited tools exist to identify at risk patients in this setting. The objective of this study was to address this need by designing a predictive model using a Bayesian network, a probabilistic graphical model offering robust, explainable predictions. Methods: We utilized a dataset of 267 gastrointestinal cancer patients, conducting preprocessing, and splitting it into TRAIN and TEST sets (80%:20% ratio). The RandomForest algorithm assessed variable importance based on MeanDecreaseGini coefficient. The bnlearn R library helped design a Bayesian network model using a 10-fold cross-validation on the TRAIN set and the aic-cg method for network structure optimization. The model’s performance was gauged based on accuracy, sensitivity, and specificity, using cross-validation on the TRAIN set and independent validation on the TEST set. Results: The model demonstrated satisfactory performance with an average accuracy of 0.85 (±0.05) and 0.80 on TRAIN and TEST datasets, respectively. The sensitivity and specificity were 0.82 (±0.14) and 0.87 (±0.07) for the TRAIN dataset, and 0.71 and 0.83 for the TEST dataset, respectively. A user-friendly tool was developed for clinical implementation. Conclusions: Despite several limitations, our Bayesian network model demonstrated a high level of accuracy in predicting the risk of developing severe haematological toxicity in gastrointestinal cancer patients receiving 5-FU-based chemotherapy. Future research should aim at model validation in larger cohorts of patients and different clinical settings. Full article
(This article belongs to the Special Issue Patient-Adapted Multidisciplinary Approaches in Gastrointestinal Tract Tumors)
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Review

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21 pages, 1251 KiB  
Review
Local Delivery of Immunomodulatory Antibodies for Gastrointestinal Tumors
by Noelia Silva-Pilipich, Ángela Covo-Vergara and Cristian Smerdou
Cancers 2023, 15(8), 2352; https://doi.org/10.3390/cancers15082352 - 18 Apr 2023
Cited by 2 | Viewed by 2440
Abstract
Cancer therapy has experienced a breakthrough with the use of immune checkpoint inhibitors (ICIs) based on monoclonal antibodies (mAbs), which are able to unleash immune responses against tumors refractory to other therapies. Despite the great advancement that ICIs represent, most patients with gastrointestinal [...] Read more.
Cancer therapy has experienced a breakthrough with the use of immune checkpoint inhibitors (ICIs) based on monoclonal antibodies (mAbs), which are able to unleash immune responses against tumors refractory to other therapies. Despite the great advancement that ICIs represent, most patients with gastrointestinal tumors have not benefited from this therapy. In addition, ICIs often induce adverse effects that are related to their systemic use. Local administration of ICIs in tumors could concentrate their effect in the malignant tissue and provide a higher safety profile. A new and attractive approach for local delivery of ICIs is the use of gene therapy vectors to express these blocking antibodies in tumor cells. Several vectors have been evaluated in preclinical models of gastrointestinal tumors to express ICIs against PD-1, PD-L1, and CTLA-4, among other immune checkpoints, with promising results. Vectors used in these settings include oncolytic viruses, self-replicating RNA vectors, and non-replicative viral and non-viral vectors. The use of viral vectors, especially when they have replication capacity, provides an additional adjuvant effect that has been shown to enhance antitumor responses. This review covers the most recent studies involving the use of gene therapy vectors to deliver ICIs to gastrointestinal tumors. Full article
(This article belongs to the Special Issue Patient-Adapted Multidisciplinary Approaches in Gastrointestinal Tract Tumors)
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