Achieving sequential therapy in advanced gastric cancer: the importance of appropriate patient management for the elderly and/or those with ascites
AbstractTreatment options for patients with advanced gastric cancer (AGC) are limited. One approach to improving survival in patients with AGC is to optimize the available agents via sequential therapy. However, clinical trial reports of first-line chemotherapy indicate that elderly patients and patients with massive ascites are less likely to receive subsequent lines of therapy. In addition, clinical trials of second- and third-line chemotherapy generally exclude these two patient populations because they are likely to have poor performance status and additional issues that are difficult to manage. Good patient management is likely to be key to the successful use of sequential therapy in these two patient populations by minimizing adverse effects to allow patients to derive benefit from the additional treatment. This narrative review summarizes the available information on AGC treatment and patient management in elderly patients and patients with massive ascites. The available data suggest that elderly patients benefit from chemotherapy; however, monitoring toxicity is essential to avoid chemotherapy-related toxicities. Important aspects of patient management for elderly patients include symptom monitoring, nutritional support, and fall prevention. The available data for patients with massive ascites show limited success for a range of treatment approaches, including systemic chemotherapy. The management of ascites is also challenging, with no clear guidance on the preferred...
CONCLUSIONS: the NACT interval time prior gastrectomy for locally advanced GC is not associated with ypCR or DS and has no impact on overall survival. PMID: 32496120 [PubMed - as supplied by publisher]
ConclusionOur pooled analysis supports the use of SP in the first-line setting for patients with HER2-negative advanced or recurrent GC with a recurrence-free interval of ≥ 6 months.Clinical trial registrationThe HERBIS-2 trial was registered with UMIN-CTR as UMIN000006105.
Malnutrition frequently occurs and deteriorates in patients after surgery for gastric cancer, especially after hospital discharge, which has been consistently associated with negative outcomes. However, information regarding the impact of post-discharge nutritional interventions is poorly described. The aim of this study was thus to evaluate the impact of post-discharge oral nutritional supplements (ONS) with dietary advice compared with dietary advice alone on nutritional outcomes, including body mass index (BMI) and skeletal muscle index (SMI), sarcopenia prevalence, chemotherapy tolerance, the 90-day readmission rate, a...
Abstract Galectin-3 (gal-3) plays a crucial role in various cellular events associated to tumor metastasis and progression. In this direction, gal-3 binding core-shell glyco-nanoparticles based on citrus pectin (CP) have been designed for targeted trigger responsive combination drug delivery. Depolymerization via periodate oxidation in heterogeneous medium yielded low molecular weight dialdehyde oligomers (CPDA) of CP with gal-3 binding property (kd= 160.90 µM). CPDA based core-shell nanoparticles prepared to enhance the gal-3 binding specificity via multivalent ligand presentation have shown to reduce the h...
Conditions: Stomach Cancer; Gastric Cancer Intervention: Drug: PIPAC+SOX+OLAPARIB Sponsor: Ruijin Hospital Not yet recruiting
Gastric adenocarcinoma (GAC) is a leading cause of cancer-associated morbidity and mortality worldwide. Staging diagnostic laparoscopy (SL) and endoscopic ultrasound (EUS) are commonly employed for accurate staging of GAC to triage feasibility of surgical resection and may include port-placement for neoadjuvant chemotherapy. For GAC without evidence of metastasis on computed tomography (CT), the cost effectiveness of a SL-first compared to an EUS-first strategy for GAC staging has not been well established.
Condition: QOL; Quality of Life;Gastric Cancer; Gastrectomy;Neoadjuvant Chemotherapy Intervention: Drug: Neoadjuvant Chemotherapy Sponsor: Beijing Cancer Hospital Recruiting