Most advanced colorectal cancer patients with proficient DNA mismatch repair or microsatellite stability (MSS) are insensitive to immune checkpoint inhibitor therapy. This report describes a heavily pretreated refractory colon adenocarcinoma patient with MSS. After experiencing four lines of treatment, the patient received the fifth-line therapy with the combined sintilimab, bevacizumab and chemotherapy. She achieved a long-term clinical outcome. The patient's progression-free survival after the fifth-line therapy was approximately 9.3 months, and her overall survival was approximately 57 months. To the best of our knowledge, this case represents the first report of durable clinical benefit from combination of an immune checkpoint inhibitor, bevacizumab and chemotherapy in a heavily pretreated patient with refractory metastatic colon adenocarcinoma with MSS.To date, little information is available on the efficacy of combination of immunotherapy, antiangiogenic therapy and chemotherapy in heavily pretreated refractory colon cancer patients with microsatellite stability (MSS). Here, we describe a heavily pretreated refractory colon adenocarcinoma patient with MSS. After experiencing four lines of prior treatment, the patient received the fifth-line therapy with the combined immunotherapy, an antiangiogenetic inhibitor and chemotherapy. She achieved a durable clinical outcome. To our knowledge, this case is the first report of successful treatment of a heavily pretreated refractory metastatic colon adenocarcinoma patient with MSS receiving the combined immunotherapy, antiangiogenic therapy and chemotherapy.
Objective To discuss the improved method of implantable infusion port puncture fixing technique.Methods A total of 87 cases requiring implantable infusion port puncture maintenance patients were randomly divided into two groups,49 cases in experimental group used the improved four fingers to the fixed method of puncture,38 cases in the control group used the traditional three fingers to fixed puncture.The one-time success rate of puncture in two groups was evaluated.Results One-time success rate of puncture in the experimental group was higher than that in the control group.Conclusions The success rate of four fingers fixed puncture was significantly higher than that of three fingers fixing method.Four fingers fixation method is worth to popularize in the clinical application.
Key words:
Implantable infusion port; Puncture ; Technique
Objective To evaluate the effect of ice-made compound drug liquid on serious oral ulcer caused by chemotherapy.Methods Selecting sixty cases of Ⅲ～Ⅳ degree oral ulcer caused by chemotherapy in our department,and randomly dividing them into a control group and an experimental group.In the control patients were offered an ice-made compound drug liquid to cue the oral ulcer.The effect of each of the therapy was divided into three degrees, i.e., ineffective, effective and excellent, and the effects of the two different ways were compared.Results In the control group, the number of patients that got ineffective, effective and excellent results was 4, 18 and 8, separately; and in experimental group, the number of patients that got ineffective, effective and excellent result was 1, 3 and 26, separately.The difference on the effect between the two groups was significant (u = 4.476,P＜0.01 ).Conclusions The therapeutic effect of ice-made compound compound drug liquid is easy to be made and rapidly come into effect.It is worthy of recommending widely.
Key words:
Ice-made compound drug liquid; Chemotherapy; Oral ulcer
Abstract To investigate the effect of multidisciplinary interventions on pain management in cancer inpatients. Four hundred thirty eight patients with cancer pain, who performed the multidisciplinary intervention were recruited. Before and after intervention, the Brief Pain Inventory (BPI) and the MD Anderson Symptom Inventory (MDASI) score as the primary endpoints and QOL scores as the secondary endpoint were all evaluated. To investigate the factors that led to different responses to multidisciplinary interventions, patients were classified as non-responders or responders. Finally, 92 patients (63 male and 29 female) scheduled for cancer pain management by inter-professional team were studied. After individualized multidisciplinary therapy, both pain and symptom severity was improved, as demonstrated by lowered BPI worst and average pain scores, as well as symptom severity score measured by MDASI ( P = .017, P = .003, and P = .011, respectively). The proportion of patients with mild pain increased regarding the BPI worst and average pain at baseline and after treatment ( P < .05). The QOL analyses showed multidisciplinary interventions could significantly improve the function and symptom scores ( P < .001). More patients in responder group received chemotherapy (58, 70.7%, P = .003), while fewer received mini-invasive therapy (6, 7.32%, P = .011). Multidisciplinary interventions had certain beneficial effect on cancer pain management, especially in patients with moderate or severe pain.
344 Background: Esophageal squamous cell carcinoma (ESCC) is the primary type of esophageal cancer with poor prognosis in China. Chemotherapy plus immunotherapy as first-line standard treatment has limited benefit in advanced ESCC patients. Nimotuzumab, a humanized anti-EGFR antibody, exhibited favorable efficacy in advanced ESCC with good safety profile. We explored the efficacy and safety of nimotuzumab as first-line therapy for patients with advanced ESCC. Methods: In this retrospective study, patients were aged ≥ 18 years with histologically diagnosed advanced ESCC, ECOG of 0-3, given nimotuzumab (400 mg, Q3W) combined with chemotherapy (paclitaxel: 300-400mg and platinum: 400-500mg or tegafur: 60mg/bid, Q3W) plus immunotherapy (PD-(L)1: 200-240 mg, Q3W). They assigned into two groups: metastasis group and locally advanced group. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate (ORR) and safety. Results: As of July 2024, 58 patients were enrolled (metastasis group: n=20, locally advanced group: n=38). The median age was 59.5 years (range: 44-80). The median follow-up was 32.59 months (95% CI: 23.0, 36.7). The ORR was 74.1% (95% CI: 0.6, 0.8). Survival analysis showed that the 1-year OS was 79.16% (95% CI: 64.5, 88.3) and 2-year OS was 57.38% (95% CI: 41.3, 70.5), 1-year PFS and 2-year PFS was 64.41% (95% CI: 49.4, 76.0) and 32.80% (95% CI: 19.7, 46.5), respectively. The median OS (mOS) was 31.01months, the median PFS (mPFS) was 17.84 months. Nimotuzumab plus chemotherapy and immunotherapy displayed a favorable survival outcomes both in metastasis group and locally advanced group with OS (1-year OS: 77.76% and 80.37%; 2-year OS: 62.21% and 55.91%) and PFS (1-year PFS: 53.46% and 69.99%; 2-year PFS: 25.06% and 36.66%), the mOS was not reached and 31.01 months, mPFS was 18.27 months and 16.69 months, respectively. There were 74.1% patients occurred grade 1-2 adverse events (AEs), and 13.8% occurred grade 3-5 AEs. The most common AEs included nausea (60.3%), myelosuppression (51.7%), leukopenia (41.4%), thrombocytopenia (29.3%), and neutropenia (24.1%). No serious treatment-related AEs or death recorded. Conclusions: This study demonstrated a favorable survival profile and acceptable toxicity in first-line treatment of advanced ESCC patients with nimotuzumab regimen. Further prospective study needed to certify in order to benefit more patients.
The objective of this study was to investigate the outcome and coping patterns of patients with stomach, colon, and rectal cancer in a hospital in China. Health-related quality of life was assessed in 118 stomach, colon, and rectal cancer patients in Chinese People's Liberation Army General Hospital, Beijing, China, using the generic version of the European Organization for Research and Treatment of Cancer Quality of Life (QOL) Questionnaire Core 30 Items, Self-rated Anxiety Scores (SAS), Self-rated Depression Scores (SDS), Medical Coping Modes of Questionnaire (MCMQ), and Social Support Requirement Scale (SSRS) questionnaires. The overall QOL was 50.7 ± 6.5, 48.1 ± 7.7, and 47.6 ± 6.4, respectively, for stomach, colon, and rectal cancer groups. Correlations between QOL and SAS and SDS in stomach cancer patients were significantly higher than observed in the cohort of colon or rectal cancer patients (Spearman coefficient of 0.366 and 0.129, respectively). Cluster analysis of MCMQ data revealed four identifiable patterns (resign, confront, avoid-confront, and avoid-resign) of coping in the study group. Subjective support was significantly higher than objective support (p < 0.05); however, extent of using the support was significantly lower than either objective (p < 0.05) or subjective support (p < 0.01). SAS and SDS were negatively correlated to SSRS scores (p < 0.01 and p < 0.05, respectively). Stomach, colon, and rectal cancer patients had anxiety and depression stemming from their cancer diagnosis and postdiagnosis treatment, and sex dependency was prevalent in SSRS response. Coping patterns were reliable indicators of psychosocial side effects in patients with stomach, colon, and rectal cancers.
Metastasis of pancreatic cancer to the colon is rare and the features need to be further elucidated. Herein, we report a rare case of pancreatic cancer with simultaneous liver and colon metastases.A 48-year-old man with intrahepatic space-occupying lesions based on a computed tomography scan was admitted to our hospital for further treatment. Abdominal magnetic resonance imaging revealed a 6.4 cm × 4.2 cm mass in the tail of the pancreas and multiple low-density masses in the liver parenchyma. In addition, a mass of 2.2 cm × 1.6 cm with surface congestive erosions in the sigmoid colon was detected by colonoscopy. Histopathological examination of biopsies from both the liver and colon lesions revealed a moderately to poorly differentiated adenocarcinoma. Immunohistochemical staining of the colon tumor was positive for cytokeratin (CK) 7 and CK, but negative for colorectal adenocarcinoma-related markers CK 20, CDX2, and SATB2, thus indicating that the metastasis originated from the pancreas. Next-generation sequencing for genomic profiling of the liver and colon metastases both found mutations in KRAS (p.G12D) and TP53 (c.376-1delG), with microsatellite stable and low tumor mutational burden without actionable or cancer-predisposing gene mutations detected. The patient was subsequently treated with 12 cycles of FOLFIRINOX which led to a sustainable response, followed by ongoing maintenance treatment with irinotecan plus fluorouracil.For this rare case, careful evaluation of histopathological and immunohistochemical staining results are required. The genomic profiling of colon lesions was revealed for the first time, and FOLFIRINOX showed good treatment efficacy in this patient.
Objective to study an in vitro accurate measurement method for the placement depth of PICC. Methods 270 patients undergoing PICC catheterization under ultrasound guidance in outpatient PICC catheterization from March to September 2019 were selected by convenient sampling. By using the random number table method, the subjects were divided into group A (horizontal L-type measurement method) and Group B (characteristic index measurement calculation) by 1:1, with 135 cases in each group. X-ray chest radiograph was taken after catheterization in both groups, and the indwelling position of the catheter was adjusted according to the X-ray chest radiograph. The correlation between PICC predicted length and ideal depth and patient satisfaction were compared between the two groups. Results The success rate of PICC catheter tip insertion in group B was 97.78%, while that in control group A was 82.22%, the difference was statistically significant (P < 0.05). The satisfaction degree of patients in group B was significantly higher than that in group A. The differences were statistically significant (P < 0.05). Conclusion Improving the success rate of the precise depth of PICC catheter placement can significantly reduce the incidence of complications, waste of human and material resources caused by adjusting the catheter position, and significantly improve patient satisfaction.
Abstract Background: Unlike patients with advanced colorectal cancer (CRC) with deficient DNA mismatch repair or microsatellite instability-high (dMMR/MSI-H) tumors, most patients with advanced CRC with proficient DNA mismatch repair or microsatellite-stability (pMMR/MSS) tumors are not sensitive to immune checkpoint inhibitor (ICI) therapy. The current challenge is to find out innovative therapeutic combinations with ICIs for such patients. Case Presentation: In this study, we report a case of heavily pretreated refractory colon cancer with MSS but high-tumor mutation burden (TMB-H) tumors. After experiencing five lines of therapy, including chemotherapy and targeted therapy with anti-angiogenic inhibitor as well as anti-EGFR antibody, she received sixth-line therapy with combination of Sintilimab, Bevacizumab and chemotherapy, and obtained a durable clinical benefit. The patient’s progression-free survival (PFS) of sixth line therapy was about 9 months and overall survival (OS) has been over 4.6 years. Conclusion: To the best of our knowledge, this study represented the longest PFS of response to combination of ICI with other agents with different mechanisms of action in a heavily pretreated refractory colon cancer patient with MSS. Citation Format: Zhi Cui, Qi Wang, Muhong Deng, Erhong Meng, Sheng Liu, Quanli Han. Case report: long-term response to combination of Sintilimab, Bevacizumab and chemotherapy in a heavily pretreated refractory colon cancer patient with microsatellite stability [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5190.
Background: Pancreatic cancer is common in elderly persons, and less than 20% of patients present with localized, potentially curable tumors. Methods: We compared the methylated sites and genes in pericarcinous tissues compared to cancer tissue, and blood compared to pericarcinous tissues in order to harvest methylation markers for putative diagnostic and therapy monitoring purposes. Results: Of 15,397 CpG sites detected in 7,440 genes, 5,605 (36.4%, 5,605 of 15,397) CpG sites were hypomethylated and 5,870 (38.12%, 5,870 of 15,397) CpG sites were hypermethylated. We then performed Gene Ontology (GO) and KEGG analysis to systematically characterize the ten significantly differentially methylated genes: PTPRN2, MAD1L1, TNXB, PRDM16, GNAS, KCNQ1, TSNARE1, HDAC4, TBCD, and DIP2C. Meanwhile, function analysis of genes with differentially methylated sites located in promoter regions of overlap group was also performed. According to previous studies, we further screened 22 pancreatic cancer related key genes. The results suggested that these key genes can influence methylation. GO and KEGG analysis indicated that these genes are involved in a wide range of functions. Conclusions: The identification of differentially methylated genes in this study provides valuable information for liquid biopsy methylation markers in pancreatic cancer.
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