Gastrointestinal Disorders

Editorial

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3 pages, 194 KiB

Open AccessEditorial

New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers

by Michele Ghidini

Gastrointest. Disord. 2021, 3(4), 204-206; https://doi.org/10.3390/gidisord3040019 - 28 Oct 2021

Viewed by 2402

Abstract

Precision medicine aims at treating patients with the most tailored treatments based on individual biological and molecular features [...] Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

Research

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13 pages, 711 KiB

Open AccessArticle

Ureteral Stent and Percutaneous Nephrostomy in Managing Malignant Ureteric Obstruction of Gastrointestinal Origin: A 10 Years’ Experience

by Elisa De Lorenzis, Elena Lievore, Matteo Turetti, Andrea Gallioli, Barbara Galassi, Luca Boeri and Emanuele Montanari

Gastrointest. Disord. 2020, 2(4), 456-468; https://doi.org/10.3390/gidisord2040041 - 8 Dec 2020

Cited by 7 | Viewed by 3551

Abstract

Background: Malignant ureteral obstruction (MUO) is variable in presentation and there is no consensus on its management, especially when caused by gastrointestinal (GI) malignancies. Our aim was to describe our experience with this oncological complication. Methods: We retrospectively analyzed the outcomes of ureteral [...] Read more.

Background: Malignant ureteral obstruction (MUO) is variable in presentation and there is no consensus on its management, especially when caused by gastrointestinal (GI) malignancies. Our aim was to describe our experience with this oncological complication. Methods: We retrospectively analyzed the outcomes of ureteral stent and nephrostomy tube (NT) positioning for GI-related MUO from 2010 to 2020. We performed descriptive analysis, survival analysis, and uni- and multi-variate analysis. Results: We included 51 patients. NT was mainly used when bladder involvement occurred and when MUO revealed an ex novo cancer diagnosis. Survival was poorer in patients with new diagnoses and in those receiving no treatment after decompression. Moreover, MUO caused by upper-GI tumors was related to shorter overall survival. Conclusions: GI tumors causing MUO should be considered of poor prognosis. Treatment decisions should be weighted accurately by both specialists and the patient. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

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9 pages, 223 KiB

Open AccessArticle

Investigation of the Risk Factors and Associated Co-Morbid Conditions among Patients with Colorectal Cancer in Trinidad

by Vijay Kumar Chattu, Priya Gopie, Rajiv K. Singh, Kimberly Singh, Sachin Singh, Sarah Singh, Javanna Smith, Vitra Sookram, DeAngello Saunders and Krissi Thomas

Gastrointest. Disord. 2020, 2(3), 193-201; https://doi.org/10.3390/gidisord2030020 - 14 Jul 2020

Cited by 1 | Viewed by 3231

Abstract

Colorectal cancer (CRC) is the third most common cancer, and the fourth most common cause of cancer mortality worldwide. In Trinidad and Tobago, it is the third most common type of cancer in both sexes. Since there is scanty research on the risk [...] Read more.

Colorectal cancer (CRC) is the third most common cancer, and the fourth most common cause of cancer mortality worldwide. In Trinidad and Tobago, it is the third most common type of cancer in both sexes. Since there is scanty research on the risk factors associated with CRC, this study was conducted to determine the correlation between risk factors, including associated comorbid conditions, and CRC in Trinidad. A cross-sectional study was conducted amongst diagnosed CRC patients (>18 years) using a pre-tested questionnaire consisting of sections on demographic data, lifestyle before diagnosis, quality of life, and depression status. Additional information such as recurrence of cancer, Body Mass Index (BMI), Hypertension (HT), blood glucose levels and family history of cancer were collected from the medical records. Of the total participants, the majority were males (58%), and the mean age of diagnosis in both sexes was 65 years. The retrospective chart review showed that 68% were found to have a comorbid condition (Diabetes or HT). Upon review of the medical records, 93.2% of the subjects did not have a familial history. However, the questionnaire data showed that 73% of subjects had a family history. Around 50% of CRC patients were alcohol consumers and 30% were cigarette smokers prior to their cancer diagnosis. Interestingly, a majority of patients (91%) had never been screened for CRC prior to their diagnosis. Subjects with CRC displayed minimal depression, indicating that being diagnosed with CRC did not have a grave impact on their state of mind or quality of life. Our findings showed that prevalence of CRC was higher in males and amongst individuals of African descent. However, larger prospective studies may be warranted to fully demonstrate this effect. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

11 pages, 288 KiB

Open AccessCommunication

Hospital-Based Preliminary Observations of Dietary Intake and Physical Activity in Saudi Patients with Colorectal Polyps: A Call for Nutrition Care Integration after Polypectomy Procedure

by Areej Ali Alkhaldy

Gastrointest. Disord. 2020, 2(2), 96-106; https://doi.org/10.3390/gidisord2020009 - 22 Apr 2020

Cited by 1 | Viewed by 2781

Abstract

Aim: In Saudi Arabia, the incidence of colorectal cancer (CRC) is increasing. Lifestyle modification, including diet and physical activity, is as important as the standard procedure of colonoscopy screening in reducing CRC development. I explored the dietary intake, physical activity, and selected nutritional [...] Read more.

Aim: In Saudi Arabia, the incidence of colorectal cancer (CRC) is increasing. Lifestyle modification, including diet and physical activity, is as important as the standard procedure of colonoscopy screening in reducing CRC development. I explored the dietary intake, physical activity, and selected nutritional biomarkers in Saudi patients with colorectal polyps, a precursor of CRC. Methods: Thirty polypectomy patients (aged 35–84 years) were recruited from an endoscopy unit at King Abdulaziz University Hospital. Demographic, anthropometric, physical activity, and food frequency data were collected. Plasma C-reactive protein, serum 25-hydroxy vitamin D, and folate levels were measured. Results: The median body mass index (BMI) of the patients was within the overweight cut-off range. The median consumption of carbohydrate and protein was within the recommended dietary allowance (RDA). Median fat consumption was above the RDA, while median fiber intake was below the RDA. Patients met the recommended servings/day of fruits, vegetables, dairy products, and protein but exceeded the recommended intake of fats and sweets. Most patients were non-active, with an inadequate level of serum vitamin D. Conclusion: We observed several risk factors previously associated with CRC, including low levels of physical activity, serum vitamin D, and fiber intake, and high BMI and fat intake among polypectomy patients. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

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Review

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10 pages, 290 KiB

Open AccessReview

Clinical Impact of Sarcopenia on Gastrointestinal Tumors

by Ana Pereira, Joaquim Costa Pereira and Sandra F. Martins

Gastrointest. Disord. 2021, 3(1), 51-60; https://doi.org/10.3390/gidisord3010006 - 23 Mar 2021

Cited by 3 | Viewed by 3693

Abstract

Preoperative risk stratification in cancer surgery is important to improve treatment and outcome. Sarcopenia is defined by progressive and generalized loss of skeletal muscle mass and strength and is now getting attention as a poor prognostic factor. The purpose of this review was [...] Read more.

Preoperative risk stratification in cancer surgery is important to improve treatment and outcome. Sarcopenia is defined by progressive and generalized loss of skeletal muscle mass and strength and is now getting attention as a poor prognostic factor. The purpose of this review was to explore the impact of sarcopenia on short and long-term outcomes in patients undergoing surgical resection of gastrointestinal tumors. Recent studies suggest that sarcopenia contributes to postoperative complications and overall survival. The relatively simple evaluability, as well as its modifiable nature, provides an intriguing potential for sarcopenia to be included in standard preoperative clinical evaluation. Such evaluations can provide physicians with important information to target high-risk individuals with prophylactic measures and eventually improve surgical outcomes. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

22 pages, 379 KiB

Open AccessReview

Role of Her-2 in Gastrointestinal Tumours beyond Gastric Cancer: A Tool for Precision Medicine

by Csongor G. Lengyel, Baker Habeeb, Shah Z. Khan, Khalid El Bairi, Sara C. Altuna, Sadaqat Hussain, Syed Ayub Mazher, Dario Trapani and Angelica Petrillo

Gastrointest. Disord. 2021, 3(1), 1-22; https://doi.org/10.3390/gidisord3010001 - 22 Dec 2020

Cited by 7 | Viewed by 6068

Abstract

Gastrointestinal (GI) tumors account for a quarter of all the cancer burden and a third of the global cancer-related mortality. Among them, some cancers retain a dismal prognosis; therefore, newer and innovative therapies are urgently needed in priority disease areas of high-unmet medical [...] Read more.

Gastrointestinal (GI) tumors account for a quarter of all the cancer burden and a third of the global cancer-related mortality. Among them, some cancers retain a dismal prognosis; therefore, newer and innovative therapies are urgently needed in priority disease areas of high-unmet medical need. In this context, HER2 could be a relevant prognostic and predictive biomarker acting as a target for specific drugs. However, if the role of HER2 has been object of investigation for several years in gastric cancer, it is not well established in other GI malignancies. The aim of this narrative review was to portray the current landscape of the potential role of HER2 as a predictive biomarker for GI tumors beyond gastric cancer. In colon cancer, the benefit from anti-HER2 therapies is less clear than in gastric neoplasms for the lack of controlled studies. Pancreatic, biliary tract adenocarcinomas and hepatocarcinoma may derive a less clear clinical benefit by using anti-HER2 agents in HER2 positive tumors. Overall, the results are promising and seem to suggest that the integration of multiple modalities of therapies can optimize the cancer care. However, further prospective trials are needed to validate the use of personalized targeted therapies in this field. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

12 pages, 302 KiB

Open AccessReview

Assessment of Current Gene Therapy Practices in Hepatocellular Carcinoma

by Bryan Mckiver, Mohamad Imad Damaj and Devanand Sarkar

Gastrointest. Disord. 2020, 2(4), 469-480; https://doi.org/10.3390/gidisord2040042 - 10 Dec 2020

Cited by 6 | Viewed by 3090

Abstract

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and the fifth most common cancer worldwide. HCC is recognized as the fourth most common cause of cancer related deaths worldwide due to the lack of effective early diagnostic tools, which [...] Read more.

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and the fifth most common cancer worldwide. HCC is recognized as the fourth most common cause of cancer related deaths worldwide due to the lack of effective early diagnostic tools, which often leads to individuals going undiagnosed until the cancer has reached late stage development. The current FDA approved treatments for late stage HCC provide a minimal increase in patient survival and lack tumor specificity, resulting in toxic systemic side effects. Gene therapy techniques, such as chimeric antigen receptor (CAR)-T Cells, viral vectors, and nanoparticles, are being explored as novel treatment options in various genetic diseases. Pre-clinical studies using gene therapy to treat in vitro and in vivo models of HCC have demonstrated potential efficacy for use in human patients. This review highlights genetic targets, techniques, and current clinical trials in HCC utilizing gene therapy. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

12 pages, 1509 KiB

Open AccessReview

Mismatch Repair System Genomic Scars in Gastroesophageal Cancers: Biology and Clinical Testing

by Gianluca Lopez, Konstantinos Venetis, Elham Sajjadi and Nicola Fusco

Gastrointest. Disord. 2020, 2(4), 341-352; https://doi.org/10.3390/gidisord2040031 - 28 Sep 2020

Cited by 6 | Viewed by 3109

Abstract

Alterations in the mismatch repair (MMR) system result in genomic instability, neoantigen production, and immune response in cancer. There is evidence that gastroesophageal tumors with MMR deficiency may be susceptible to immune-checkpoint inhibitors treatment, especially in those presenting at advanced-stage disease. Although a [...] Read more.

Alterations in the mismatch repair (MMR) system result in genomic instability, neoantigen production, and immune response in cancer. There is evidence that gastroesophageal tumors with MMR deficiency may be susceptible to immune-checkpoint inhibitors treatment, especially in those presenting at advanced-stage disease. Although a number of biomarkers have been developed in histology-agnostic settings to assess MMR status, there is evidence that a tumor-specific testing approach would improve the selection of patients for immunotherapy. However, no testing methods have been developed specifically for gastroesophageal cancers so far. Here, we discuss the state of the art, current advances, and future perspectives of MMR-related biomarkers’ biologic and clinical role in gastroesophageal cancers. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

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8 pages, 227 KiB

Open AccessReview

Nutritional Assessment in Gastrointestinal Tumors: News from the 2020 ASCO and ESMO World GI Meetings

by Federica Mascaretti and Jessica Evangelista

Gastrointest. Disord. 2020, 2(3), 310-317; https://doi.org/10.3390/gidisord2030028 - 21 Sep 2020

Cited by 2 | Viewed by 2639

Abstract

Nutritional risk screening and assessment of general nutritional status are of primary importance in the management of gastrointestinal cancers (GIC). Indeed, a major problem in these patients is the involuntary weight loss leading eventually to cachexia. With our review, we aimed at collecting [...] Read more.

Nutritional risk screening and assessment of general nutritional status are of primary importance in the management of gastrointestinal cancers (GIC). Indeed, a major problem in these patients is the involuntary weight loss leading eventually to cachexia. With our review, we aimed at collecting the most recent advances in nutritional assessment of patients with GIC. All the abstracts presented both at the 2020 ASCO and ESMO World GI meetings were considered and a total number of 12 abstracts were selected, reporting colorectal, gastric, esophageal, and pancreatic cancer (PC) series. In some of the analyzed series, pathological conditions such as cachexia and sarcopenia had prognostic significance on clinical outcomes. One abstract reported the results of a phase I trial with the use of a novel interleukin-1-alpha antagonist, bermekimab. Its association with standard chemotherapy in advanced PC brought an improved patients’ performance during treatment. Insufficient attention is paid to the nutritional status of patients with GIC both at screening and during specific cancer treatment. The use of antropometric measurements, together with nutritional assessment tools, may facilitate the clinical evaluation of these patients. Large randomized trials are warranted in order to clarify the real impact of nutritional interventions on clinical outcomes. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

24 pages, 1041 KiB

Open AccessReview

Circulating Tumour DNAs and Non-Coding RNAs as Liquid Biopsies for the Management of Colorectal Cancer Patients

by Andrea Lampis, Michele Ghidini, Margherita Ratti, Milko B. Mirchev, Ali Fuat Okuducu, Nicola Valeri and Jens Claus Hahne

Gastrointest. Disord. 2020, 2(3), 212-235; https://doi.org/10.3390/gidisord2030022 - 22 Jul 2020

Cited by 9 | Viewed by 3473

Abstract

Circulating tumour DNAs and non-coding RNAs present in body fluids have been under investigation as tools for cancer diagnosis, disease monitoring, and prognosis for many years. These so-called liquid biopsies offer the opportunity to obtain information about the molecular make-up of a cancer [...] Read more.

Circulating tumour DNAs and non-coding RNAs present in body fluids have been under investigation as tools for cancer diagnosis, disease monitoring, and prognosis for many years. These so-called liquid biopsies offer the opportunity to obtain information about the molecular make-up of a cancer in a minimal invasive way and offer the possibility to implement theranostics for precision oncology. Furthermore, liquid biopsies could overcome the limitations of tissue biopsies in capturing the complexity of tumour heterogeneity within the primary cancer and among different metastatic sites. Liquid biopsies may also be implemented to detect early tumour formation or to monitor cancer relapse of response to therapy with greater sensitivity compared with the currently available protein-based blood biomarkers. Most colorectal cancers are often diagnosed at late stages and have a high mortality rate. Hence, biomolecules as nucleic acids present in liquid biopsies might have prognostic potential and could serve as predictive biomarkers for chemotherapeutic regimens. This review will focus on the role of circulating tumour DNAs and non-coding RNAs as diagnostic, prognostic, and predictive biomarkers in the context of colorectal cancer. Full article

(This article belongs to the Special Issue New Tools for Precision and Personalized Treatment in Gastrointestinal Cancers)

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