<i>Helicobacter pylori</i> Therapy for the Prevention of Metachronous Gastric Cancer

Choi, Il Ju; Kook, Myeong Cherl; Kim, Young Il; Cho, Soo‐Jeong; Lee, Jong Yeul; Kim, Chan Gyoo; Park, Boram; Nam, Byung Ho

doi:10.1056/nejmoa1708423

Cited by 573 publications

(520 citation statements)

References 35 publications

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“…Significant enrichment of Peptostreptococcus stomatis , Parvimonas micra , Streptococcus anginosus , Dialister pneumosintes , Slackia exigua, Clostridium colicanis and Fn and depletion of Helicobacterium was observed in gastric cancer, and alterations in bacterial diversity and abundance in patients with gastric cancer revealed a dysbiotic microbial community with prediction potential . Recently, incremental data has demonstrated that eradication treatment for H. pylori could reduce the risk of gastric cancer . Collectively, these studies indicate that gastric microbiota is involved in gastric carcinogenesis.With enormous microorganism at close proximity to the colonic epithelial cells, the involvement of gut microbiota in colorectal carcinogenesis is becoming clear.…”

Section: Fmt As a Possible Therapy For Various Type Of Cancers And Camentioning

confidence: 99%

Fecal microbiota transplantation in cancer management: Current status and perspectives

Chen

Jin

et al. 2018

Intl Journal of Cancer

236

161

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The human gut is home to a large and diverse microbial community, comprising about 1,000 bacterial species. The gut microbiota exists in a symbiotic relationship with its host, playing a decisive role in the host's nutrition, immunity and metabolism. Accumulating studies have revealed the associations between gut dysbiosis or some special bacteria and various cancers. Emerging data suggest that gut microbiota can modulate the effectiveness of cancer therapies, especially immunotherapy. Manipulating the microbial populations with therapeutic intent has become a hot topic of cancer research, and the most dramatic manipulation of gut microbiota refers to fecal microbiota transplantation (FMT) from healthy individuals to patients. FMT has demonstrated remarkable clinical efficacy against Clostridium difficile infection (CDI) and it is highly recommended for the treatment of recurrent or refractory CDI. Lately, interest is growing in the therapeutic potential of FMT for other diseases, including cancers. We briefly reviewed the current researches about gut microbiota and its link to cancer, and then summarized the recent preclinical and clinical evidence to indicate the potential of FMT in cancer management as well as cancer‐treatment associated complications. We also presented the rationale of FMT for cancer management such as reconstruction of intestinal microbiota, amelioration of bile acid metabolism, and modulation of immunotherapy efficacy. This article would help to better understand this new therapeutic approach for cancer patients by targeting gut microbiota.

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Section: Fmt As a Possible Therapy For Various Type Of Cancers And Camentioning

confidence: 99%

Fecal microbiota transplantation in cancer management: Current status and perspectives

Chen

Jin

et al. 2018

Intl Journal of Cancer

236

161

View full text Add to dashboard Cite

show abstract

“…It was also again confirmed in a mega Chinese controlled trial that after endoscopic resection of early gastric cancer patients there were lower rates of metachronous gastric cancer, together with more improvement of corpus mucosal atrophy if H. pylori was eradicated [6] (Fig. 2).…”

mentioning

confidence: 72%

Gastro Update Europe 2018

Tytgat

2019

Dig Dis

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“…Median follow-up time was 5.9 years with meta-chronous lesions occurring in 14 patients (7.2%) in the treatment group and 27 (13.4%) in the placebo group. This demonstrated a 50% risk reduction by eradication treatment (HR 0.50; 95% CI 0.26-0.94, p = 0.03) [121]. Knowledge of further relevant factors that influence the effect of H pylori eradication is expected from the interventional study that is currently being undertaken in the Chinese province of Linqu with international support [122].…”

Section: H Pylori Eradicationmentioning

confidence: 90%

“…This had been confirmed in a 2016 meta-analysis of 10 studies including 5,881 patients reporting a risk reduction of more than 60% (OR 0.39; 95% CI 0.259-0.593; p < 0.001) [120]. And final clarity on this issue was given by a recently published prospective double-blind, placebo-controlled randomised trial on 470 patients undergoing endoscopic resection of early gastric cancer or HGD [121]. Median follow-up time was 5.9 years with meta-chronous lesions occurring in 14 patients (7.2%) in the treatment group and 27 (13.4%) in the placebo group.…”

Section: H Pylori Eradicationmentioning

confidence: 91%

The Rationale and Efficacy of Primary and Secondary Prevention in Adenocarcinomas of the Upper Gastrointestinal Tract

Bornschein

Bird‐Lieberman

Malfertheiner

2019

Dig Dis

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While the primary risk factor for oesophageal adenocarcinoma (OAC) and its precursor lesion Barrett’s oesophagus (BO) is gastro-oesophageal reflux, the infection with Helicobacter pylori (H. pylori) is the dominant risk factor for gastric cancer. Reduction of reflux by dietary measures and proton pump inhibitors has some merits in OAC prevention, and the chemopreventive effect of Aspirin and statins is being widely investigated; however, improved outcome in OAC occurs primarily as the result of secondary prevention. Early detection of neoplastic lesions in Barrett’s metaplasia can be achieved by surveillance endoscopies. Novel endoscopic imaging modalities carry similar importance as the endoscopic treatment techniques as without detection of early lesions, therapy cannot be applied. Minimally invasive approaches are currently being investigated to identify patients with BO who are at particular risk of neoplastic progression. While dietary factors also play an important role in the prevention of gastric cancer and chemoprevention seems to be promising, the most beneficial effect has been shown for the eradication of H. pylori infection, which results in at least a one third reduction of gastric cancer risk. This effect can be further improved if the eradication takes place prior to the development of pre-neoplastic gastric conditions such as mucosal atrophy or intestinal metaplasia (IM). The definition of the “point of no return”, after which eradication is less effective, is of high importance, although H. pylori eradication can still be beneficial even at more advance stages of mucosal changes. For this reason, patients with advanced atrophy and IM should undergo endoscopic surveillance in the same way as patients with BO. There is also need for development of non-invasive tests to identify patients at high risk of progression to gastric cancer to improve outcome of these surveillance approaches.

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Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer

Cited by 573 publications

References 35 publications

Fecal microbiota transplantation in cancer management: Current status and perspectives

Fecal microbiota transplantation in cancer management: Current status and perspectives

Gastro Update Europe 2018

The Rationale and Efficacy of Primary and Secondary Prevention in Adenocarcinomas of the Upper Gastrointestinal Tract

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