8 months. Among the
110 synchronous cancers, 21 were missed at the time of the initial ESD and the miss rate was associated with the endoscopist’s inexperience (<500 esophagogastroduodenoscopy cases). The cumulative incidence of metachronous cancers increased linearly, and the mean annual incidence rate was 3.5%. Local recurrence was seen in five cases with an incidence rate of 0.40%. Only four lesions (0.32%) were detected as massively invading cancers during the follow-up. The incidence rate did not differ between patients with or without H. pylori eradication. find more Among 385 H. pylori-positive patients, 322 patients (84%) received H. pylori eradication treatment, while 63 patients (16%) did not. Eradication was successful in 263 of 322 (82%) patients. The incidence of multiple cancers in patients following successful H. pylori eradication was not decreased compared with those who did not receive eradication or in whom eradication had failed. Nineteen percent of synchronous cancers were not detected in the initial ESD. Thus, scheduled endoscopic surveillance detects almost all recurrent lesions at an early stage and should therefore be recommended. The addition of a monoclonal antibody to the “backbone” chemotherapy, a strategy that has been shown to improve the outcome in patients with different malignant diseases, has now also been tested in patients
with GC. An international, randomized, double-blind, placebo-controlled, phase 3 trial (REGARD) was performed to assess whether ramucirumab, a vascular endothelial growth factor receptor-2 (VEGFR-2) www.selleckchem.com/products/ink128.html antagonist, prolonged survival in patients with advanced GC [14]. Patients with advanced gastric or gastroesophageal junction adenocarcinoma and disease progression after first-line platinum-containing or fluoropyrimidine-containing chemotherapy (n = 355) were randomly assigned (2 : 1) to receive the best supportive care plus either 8 mg/kg of ramucirumab (n = 238) or a placebo (n = 117), intravenously once every 2 weeks. Median overall survival was 5.2 months Liothyronine Sodium (IQR 2.3–9.9) in patients in the ramucirumab group and 3.8 months (1.7–7.1) in those in the placebo group (HR 0.776, 95% CI 0.603–0.998;
p = .047). Rates of hypertension were higher in the ramucirumab group (16%) than in the placebo group (8%), whereas rates of other adverse events were mostly similar between groups (94 vs 88%). In the phase III RAINBOW trial, second-line therapy with ramucirumab plus paclitaxel compared with paclitaxel only also significantly improved both progression-free and overall survival in patients with metastatic gastric or gastroesophageal junction adenocarcinoma who experienced disease progression while on or within 4 months of standard first-line platinum-based and fluoropyrimidine-based combination chemotherapy [15]. Patients (n = 665) were randomly assigned to receive paclitaxel alone (80 mg/m2 on days 1, 8, 15) or with ramucirumab (8 mg/kg IV every 2 weeks) in 4-week cycles indefinitely.
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