Key clinical point: Apatinib plus programmed cell death protein 1 (PD-1) inhibitors show promising response and acceptable tolerance in previously treated real-world patients with advanced gastric cancer.

Major finding: The median follow-up duration was 7.3 months. The objective response rate was 20.5% and disease control rate was 69.2%. The median progression-free survival (PFS) was 3.9 months (95% CI 2.74-5.06), and the median overall survival (OS) was 7.8 (95% CI 4.82-10.78) months. The most common adverse events were fatigue (61.5%), nausea and vomiting (56.4%), diarrhea (48.7%), hypertension (46.2%), hand-foot syndrome (38.5%), and rash (28.2%).

Study details: This was a real-world study of 39 previously treated patients with advanced gastric cancer who received apatinib plus PD-1 blockade treatment between August 2018 and October 2021.

Disclosures: This study was supported by the Natural Science Foundation of Henan Province, China. The authors declared no conflicts of interest.

Source: Li LH et al. Feasibility and tolerance of apatinib plus PD-1 Inhibitors for previously treated;advanced gastric cancer: A real-world exploratory study. Dis Markers. 2022; 4322404 (Apr 29). Doi: 10.1155/2022/4322404

Key clinical point: Apatinib plus programmed cell death protein 1 (PD-1) inhibitors show promising response and acceptable tolerance in previously treated real-world patients with advanced gastric cancer.

Major finding: The median follow-up duration was 7.3 months. The objective response rate was 20.5% and disease control rate was 69.2%. The median progression-free survival (PFS) was 3.9 months (95% CI 2.74-5.06), and the median overall survival (OS) was 7.8 (95% CI 4.82-10.78) months. The most common adverse events were fatigue (61.5%), nausea and vomiting (56.4%), diarrhea (48.7%), hypertension (46.2%), hand-foot syndrome (38.5%), and rash (28.2%).

Study details: This was a real-world study of 39 previously treated patients with advanced gastric cancer who received apatinib plus PD-1 blockade treatment between August 2018 and October 2021.

Disclosures: This study was supported by the Natural Science Foundation of Henan Province, China. The authors declared no conflicts of interest.

Source: Li LH et al. Feasibility and tolerance of apatinib plus PD-1 Inhibitors for previously treated;advanced gastric cancer: A real-world exploratory study. Dis Markers. 2022; 4322404 (Apr 29). Doi: 10.1155/2022/4322404

Key clinical point: Apatinib plus programmed cell death protein 1 (PD-1) inhibitors show promising response and acceptable tolerance in previously treated real-world patients with advanced gastric cancer.

Major finding: The median follow-up duration was 7.3 months. The objective response rate was 20.5% and disease control rate was 69.2%. The median progression-free survival (PFS) was 3.9 months (95% CI 2.74-5.06), and the median overall survival (OS) was 7.8 (95% CI 4.82-10.78) months. The most common adverse events were fatigue (61.5%), nausea and vomiting (56.4%), diarrhea (48.7%), hypertension (46.2%), hand-foot syndrome (38.5%), and rash (28.2%).

Study details: This was a real-world study of 39 previously treated patients with advanced gastric cancer who received apatinib plus PD-1 blockade treatment between August 2018 and October 2021.

Disclosures: This study was supported by the Natural Science Foundation of Henan Province, China. The authors declared no conflicts of interest.

Source: Li LH et al. Feasibility and tolerance of apatinib plus PD-1 Inhibitors for previously treated;advanced gastric cancer: A real-world exploratory study. Dis Markers. 2022; 4322404 (Apr 29). Doi: 10.1155/2022/4322404

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

SAN DIEGO – An analysis of a large, international cohort suggests that treatment with protease-inhibitor (PI)–based direct-acting antivirals (DAAs) may be safe for patients with hepatitis C virus (HCV) with cirrhosis and early-stage liver decompensation.

The study relied on data from the REAL-C registry, including 935 patients treated with oral DAAs at 27 centers in the U.S., Europe, and Asia Pacific countries. The researchers compared efficacy and tolerability outcomes from PI-based and non PI-based DAA regimens in patients deemed to have decompensated HCV cirrhosis.

The findings were encouraging. “It is something important because currently we are short of treatments for decompensated HCV patients. If the tolerability is similar, we perhaps should not withhold [PI] treatment for these patients that sometimes need them the most,” said Yu Jun Wong, MD, who presented the study at the annual Digestive Disease Week^® (DDW). Dr. Wong is a second-year consultant at Changchi General Hospital in Singapore.

“I think it was a very interesting study and something that needed to be done. It was encouraging that patients who did have some level of decompensated cirrhosis did not worsen compared to those who were on a non PI-based therapy,” said Meena Bansal, MD, who comoderated the session where the research was presented.

However, the study was limited by some uncertainty around the definition of decompensation among the study participants. During the Q&A session, audience members questioned whether patients categorized as decompensated were truly decompensated at the time of treatment initiation. Dr. Bansal noted, for example, that a patient might experience a variceal bleed in the context of heavy alcohol consumption, and therefore be considered decompensated, but might stop drinking afterward with a reduction in portal hypertension and recovery of liver function. “So it would be important to know if they were still decompensated at the time they initiated therapy. If that was the case, then these results are more promising,” said Dr. Bansal.

Despite these limitations, the study is good news. “If you do not have access to non-PI based therapy, you might feel a little bit more secure starting a PI-based therapy, particularly the second generation PI-based therapies, if they’re at least on the earlier side of that decompensation scale. But it’s still unclear in true decompensated Child’s B or C whether or not PI-based therapy would have the same results,” said Dr. Bansal.

Dr. Wong acknowledged the limitation that the study doesn’t apply to more severely decompensated patients. “Whether it remains safe in patients with higher Child-Pugh scores is hard to extrapolate at this point of time. We still need to look further into the data,” said Dr. Wong.

Still, the results offer hope to physicians and patients who might find themselves in difficult circumstances. “If you’re resource limited, and you don’t even have access to transplant, these findings suggest that early decompensated patients may benefit from PI-based therapy. If I say to the patient, there’s a chance this could make you worse, but there’s a chance this could make you better, [this is an option] as long as the patient is aware of the possible outcomes,” said Dr. Bansal.

The study included patients with a history of ascites, variceal bleeding, jaundice, or hepatic encephalopathy 6 months before treatment with DAA, or baseline measures of Child-Turcotte-Pugh (CTP) score ≥7 or Model of End-Stage Liver Disease (MELD) score >10. The analysis included data between 2014 and 2021.

The mean age was 64, and 59.6% of participants were male. Overall, 70.8% had genotype 1, and 32% were treatment experienced. In total, 45.2% were treated with PI-based DAAs.

The PI cohort was older (64.6 versus 62.7; P = .01), and more likely to have genotype 1 (87.2% versus 56.3%; P < .001) and chronic renal disease (64.0% vs. 53.9%; P = .001).

The two groups had similar rates of sustained virologic response at 12 and 24 weeks, as well as similar rates of significant improvement or significant worsening, suggesting similar tolerability. There was a lower frequency of liver decompensation in the PI group at 12 weeks (4.4% vs. 7.9%; P = .04) and a trend at 24 weeks (8.8% versus 12.6%; P = .08).

Another limitation of the study is the potential for bias due to its retrospective nature.

Dr. Wong has been an invited speaker for AbbVie and Gilead. Dr. Bansal has no relevant financial disclosures.

SAN DIEGO – An analysis of a large, international cohort suggests that treatment with protease-inhibitor (PI)–based direct-acting antivirals (DAAs) may be safe for patients with hepatitis C virus (HCV) with cirrhosis and early-stage liver decompensation.

The study relied on data from the REAL-C registry, including 935 patients treated with oral DAAs at 27 centers in the U.S., Europe, and Asia Pacific countries. The researchers compared efficacy and tolerability outcomes from PI-based and non PI-based DAA regimens in patients deemed to have decompensated HCV cirrhosis.

The findings were encouraging. “It is something important because currently we are short of treatments for decompensated HCV patients. If the tolerability is similar, we perhaps should not withhold [PI] treatment for these patients that sometimes need them the most,” said Yu Jun Wong, MD, who presented the study at the annual Digestive Disease Week^® (DDW). Dr. Wong is a second-year consultant at Changchi General Hospital in Singapore.

“I think it was a very interesting study and something that needed to be done. It was encouraging that patients who did have some level of decompensated cirrhosis did not worsen compared to those who were on a non PI-based therapy,” said Meena Bansal, MD, who comoderated the session where the research was presented.

However, the study was limited by some uncertainty around the definition of decompensation among the study participants. During the Q&A session, audience members questioned whether patients categorized as decompensated were truly decompensated at the time of treatment initiation. Dr. Bansal noted, for example, that a patient might experience a variceal bleed in the context of heavy alcohol consumption, and therefore be considered decompensated, but might stop drinking afterward with a reduction in portal hypertension and recovery of liver function. “So it would be important to know if they were still decompensated at the time they initiated therapy. If that was the case, then these results are more promising,” said Dr. Bansal.

Despite these limitations, the study is good news. “If you do not have access to non-PI based therapy, you might feel a little bit more secure starting a PI-based therapy, particularly the second generation PI-based therapies, if they’re at least on the earlier side of that decompensation scale. But it’s still unclear in true decompensated Child’s B or C whether or not PI-based therapy would have the same results,” said Dr. Bansal.

Dr. Wong acknowledged the limitation that the study doesn’t apply to more severely decompensated patients. “Whether it remains safe in patients with higher Child-Pugh scores is hard to extrapolate at this point of time. We still need to look further into the data,” said Dr. Wong.

Still, the results offer hope to physicians and patients who might find themselves in difficult circumstances. “If you’re resource limited, and you don’t even have access to transplant, these findings suggest that early decompensated patients may benefit from PI-based therapy. If I say to the patient, there’s a chance this could make you worse, but there’s a chance this could make you better, [this is an option] as long as the patient is aware of the possible outcomes,” said Dr. Bansal.

The study included patients with a history of ascites, variceal bleeding, jaundice, or hepatic encephalopathy 6 months before treatment with DAA, or baseline measures of Child-Turcotte-Pugh (CTP) score ≥7 or Model of End-Stage Liver Disease (MELD) score >10. The analysis included data between 2014 and 2021.

The mean age was 64, and 59.6% of participants were male. Overall, 70.8% had genotype 1, and 32% were treatment experienced. In total, 45.2% were treated with PI-based DAAs.

The PI cohort was older (64.6 versus 62.7; P = .01), and more likely to have genotype 1 (87.2% versus 56.3%; P < .001) and chronic renal disease (64.0% vs. 53.9%; P = .001).

The two groups had similar rates of sustained virologic response at 12 and 24 weeks, as well as similar rates of significant improvement or significant worsening, suggesting similar tolerability. There was a lower frequency of liver decompensation in the PI group at 12 weeks (4.4% vs. 7.9%; P = .04) and a trend at 24 weeks (8.8% versus 12.6%; P = .08).

Another limitation of the study is the potential for bias due to its retrospective nature.

Dr. Wong has been an invited speaker for AbbVie and Gilead. Dr. Bansal has no relevant financial disclosures.

SAN DIEGO – An analysis of a large, international cohort suggests that treatment with protease-inhibitor (PI)–based direct-acting antivirals (DAAs) may be safe for patients with hepatitis C virus (HCV) with cirrhosis and early-stage liver decompensation.

The study relied on data from the REAL-C registry, including 935 patients treated with oral DAAs at 27 centers in the U.S., Europe, and Asia Pacific countries. The researchers compared efficacy and tolerability outcomes from PI-based and non PI-based DAA regimens in patients deemed to have decompensated HCV cirrhosis.

The findings were encouraging. “It is something important because currently we are short of treatments for decompensated HCV patients. If the tolerability is similar, we perhaps should not withhold [PI] treatment for these patients that sometimes need them the most,” said Yu Jun Wong, MD, who presented the study at the annual Digestive Disease Week^® (DDW). Dr. Wong is a second-year consultant at Changchi General Hospital in Singapore.

“I think it was a very interesting study and something that needed to be done. It was encouraging that patients who did have some level of decompensated cirrhosis did not worsen compared to those who were on a non PI-based therapy,” said Meena Bansal, MD, who comoderated the session where the research was presented.

However, the study was limited by some uncertainty around the definition of decompensation among the study participants. During the Q&A session, audience members questioned whether patients categorized as decompensated were truly decompensated at the time of treatment initiation. Dr. Bansal noted, for example, that a patient might experience a variceal bleed in the context of heavy alcohol consumption, and therefore be considered decompensated, but might stop drinking afterward with a reduction in portal hypertension and recovery of liver function. “So it would be important to know if they were still decompensated at the time they initiated therapy. If that was the case, then these results are more promising,” said Dr. Bansal.

Despite these limitations, the study is good news. “If you do not have access to non-PI based therapy, you might feel a little bit more secure starting a PI-based therapy, particularly the second generation PI-based therapies, if they’re at least on the earlier side of that decompensation scale. But it’s still unclear in true decompensated Child’s B or C whether or not PI-based therapy would have the same results,” said Dr. Bansal.

Dr. Wong acknowledged the limitation that the study doesn’t apply to more severely decompensated patients. “Whether it remains safe in patients with higher Child-Pugh scores is hard to extrapolate at this point of time. We still need to look further into the data,” said Dr. Wong.

Still, the results offer hope to physicians and patients who might find themselves in difficult circumstances. “If you’re resource limited, and you don’t even have access to transplant, these findings suggest that early decompensated patients may benefit from PI-based therapy. If I say to the patient, there’s a chance this could make you worse, but there’s a chance this could make you better, [this is an option] as long as the patient is aware of the possible outcomes,” said Dr. Bansal.

The study included patients with a history of ascites, variceal bleeding, jaundice, or hepatic encephalopathy 6 months before treatment with DAA, or baseline measures of Child-Turcotte-Pugh (CTP) score ≥7 or Model of End-Stage Liver Disease (MELD) score >10. The analysis included data between 2014 and 2021.

The mean age was 64, and 59.6% of participants were male. Overall, 70.8% had genotype 1, and 32% were treatment experienced. In total, 45.2% were treated with PI-based DAAs.

The PI cohort was older (64.6 versus 62.7; P = .01), and more likely to have genotype 1 (87.2% versus 56.3%; P < .001) and chronic renal disease (64.0% vs. 53.9%; P = .001).

The two groups had similar rates of sustained virologic response at 12 and 24 weeks, as well as similar rates of significant improvement or significant worsening, suggesting similar tolerability. There was a lower frequency of liver decompensation in the PI group at 12 weeks (4.4% vs. 7.9%; P = .04) and a trend at 24 weeks (8.8% versus 12.6%; P = .08).

Another limitation of the study is the potential for bias due to its retrospective nature.

Dr. Wong has been an invited speaker for AbbVie and Gilead. Dr. Bansal has no relevant financial disclosures.