Multicenter Retrospective Study of 132 Patients with Unresectable Small Bowel Adenocarcinoma Treated with Chemotherapy

“…Tsushima et al [16] are to be commended for performing such a study. In their retrospective multicenter study, the survival of patients with advanced SBA receiving first-line therapy was compared among five different treatment groups.…”

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confidence: 99%

Establishing a Standard of Care for Small Bowel Adenocarcinomas: Challenges and Lessons Learned

Halfdanarson

Grothey

2012

The Oncologist

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“…SBA is more similar to colorectal cancer than gastric cancer based on genome-wide DNA copy number aberrations (14); therefore, chemotherapy regimens used to treat colorectal cancer are typically selected for the treatment of SBA. Previous retrospective studies have demonstrated that chemotherapy, including oxaliplatin with fluorouracil and folinic acid (FOLFOX) chemotherapy, and oxaliplatin and capecitabine (CAPOX) chemotherapy, contributes to a longer survival time in patients with SBA (15)(16)(17)(18)(19). The overall survival (OS) time of patients who received chemotherapy was 15.1-22.2 months (15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Clinical use of molecular targeted agents for primary small bowel adenocarcinoma: A multicenter retrospective cohort study by the Osaka Gut Forum

et al. 2017

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Abstract. Primary small bowel adenocarcinoma (SBA) is a rare cancer for which effective treatment strategies have not yet been established. The results of previous retrospective studies suggest that chemotherapy contributes to a longer survival time in patients with SBA. However, there are few case reports about the efficacy of molecular targeted agent-containing chemotherapy for SBA. In the present study, the treatment and follow-up data of patients with SBA who received chemotherapy with or without molecular targeted agents were retrospectively analyzed. Each patient was treated in one of ten hospitals participating in the Osaka Gut Forum between April 2006 and March 2014. The following factors were evaluated: Age, sex, Eastern Cooperative Oncology Group performance status (PS), tumor location, tumor differentiation, chemotherapy regimen, resection of primary tumor, tumor biomarker expression, distant metastasis, best response under chemotherapy, time to disease progression, subsequent treatments, survival status and treatment toxicity. A total of 27 patients (17 males and 10 females; mean age, 63.4 years old; range, 36-83 years old) received chemotherapy due to non-curative tumor resection, unresectable tumor or post-operative recurrence. The median overall survival time was 14.8 months (range, 2-58 months). A univariate analysis revealed a PS of 0 (P=0.0228) and treatment with platinum-based chemotherapy (P=0.0048) were significant factors for an improved prognosis. An age-adjusted multivariate analysis also revealed that a platinum-based regimen was a significant positive prognostic factor (P=0.0373). Molecular targeted agents were administered to 8 patients, for whom it was their first-or second-line therapy. Among the 17 patients who received oxaliplatin-based chemotherapy as a first-line chemotherapy, a PS of 0 (P= 0.0255) and treatment with bevacizumab (P= 0.0121) were significant positive prognostic factors. Toxicities higher than Grade 3 occurred in 8/27 patients with SBA; however, serious side effects due to the molecular targeted agents were not experienced. The results of the present study indicate that chemotherapy containing molecular targeted agents is a well-tolerated and effective treatment option for SBA.

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“…Several phase II studies examining a variety of protocols with different OS have been published [21][22][23][24][25]. There are also retrospective single centre experiences comparing different regimens [5,15,16,20,[26][27][28][29][30]. Current expert opinion favors use of a fluoropyrimidine-platinum combination in the first line [20,26,27].…”

Section: Discussionmentioning

confidence: 99%

“…There are also retrospective single centre experiences comparing different regimens [5,15,16,20,[26][27][28][29][30]. Current expert opinion favors use of a fluoropyrimidine-platinum combination in the first line [20,26,27]. However, definitive data for treatment selection are lacking.…”

Section: Discussionmentioning

confidence: 99%

A retrospective review of chemotherapy for patients with small bowel adenocarcinoma in British Columbia.

Duerr

Ellard

Cormier

et al. 2013

JCO

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Background: Small bowel adenocarcinoma (SBA) is associated with a poor prognosis. It is an uncommon malignancy and therefore difficult to study. Randomized phase III trials are not available to guide best approaches. The Provincial Cancer Registry of the British Columbia Cancer Agency contains long-term data on patients with SBA. The authors analyzed characteristics and treatment outcomes for SBA patients diagnosed between 1990 and 2008. Material and methods: Charts of 150 patients with a histological diagnosis of SBA were retrospectively analyzed. Epidemiological and treatment data were collected. Disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: Baseline characteristics, such as median age at diagnosis (64.5 years), tumor stage (I-II 33%, III-IV 58%, unknown 9%), and location (duodenum 48%, jejunum 31%, ileum 21%) were consistent with published data. 55% of patients had a positive family history of cancer. DFS and OS of 29 patients treated with adjuvant chemotherapy were not significantly different to that of 47 patients without (p = 1 and p = 0.211, respectively). In the palliative setting patients treated with polychemotherapy (21 patients) had statistically better OS than patients treated with monochemotherapy (12 patients) (p = 0.0228). Conclusions: Our study suggests a survival benefit for advanced-stage SBA patients treated with poly-versus monochemotherapy. This, however, was a retrospective analysis with several potential confounders. Nevertheless, our study adds to the evidence suggesting that chemotherapy may be beneficial for patients with SBA, at least in the palliative setting.

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Multicenter Retrospective Study of 132 Patients with Unresectable Small Bowel Adenocarcinoma Treated with Chemotherapy

Cited by 65 publications

References 33 publications

Establishing a Standard of Care for Small Bowel Adenocarcinomas: Challenges and Lessons Learned

Establishing a Standard of Care for Small Bowel Adenocarcinomas: Challenges and Lessons Learned

Clinical use of molecular targeted agents for primary small bowel adenocarcinoma: A multicenter retrospective cohort study by the Osaka Gut Forum

A retrospective review of chemotherapy for patients with small bowel adenocarcinoma in British Columbia.

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