State-of-the-Art on Gastrointestinal Cancers in Italy

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 6661

Special Issue Editors


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Guest Editor
Unit of Internal Medicine Critical Area—ARNAS Garibaldi, Catania, Italy
Interests: colorectal cancer; elderly care; nutrition; quality of life; liquid biopsy; cancer biomarkers; microbiota
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Special Issue Information

Dear Colleagues,

This regional Special Issue aims to provide a wide overview of diagnostic and treatment tools available for gastrointestinal (GI) cancer patients in Italy. GI cancers, which mostly consist of colorectal, gastric, and esophageal cancer, represent the third most commonly diagnosed tumors worldwide, with a progressively growing burden, even in Italy. Novel diagnostic tools (such as biomarkers or liquid biopsy) and multimodality approaches have been reported to significantly improve the outcomes of GI cancers. We invite the submission of research articles that will consolidate our understanding in this area, with a specific focus on the state of the art in Italy. This Special Issue will publish original research and review articles. Potential topics include, but are not limited to:

  • Biomarkers;
  • Microbiota in the diagnosis and treatment of GI cancers;
  • Liquid biopsy;
  • Diagnosis and therapy of GI cancers;
  • Recent advances in GI cancers therapies.

Dr. Marco Vacante
Prof. Dr. Antonio Biondi
Guest Editors

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Keywords

  • colorectal cancer
  • gastric cancer
  • esophageal cancer
  • biomarkers
  • microbiota
  • liquid biopsy

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Published Papers (2 papers)

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Research

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13 pages, 1098 KiB  
Article
ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial
by Dario Ribero, Federica Mento, Valentina Sega, Domenico Lo Conte, Alfredo Mellano and Giuseppe Spinoglio
Biomedicines 2022, 10(3), 541; https://doi.org/10.3390/biomedicines10030541 - 24 Feb 2022
Cited by 18 | Viewed by 2834
Abstract
Lymphadenectomy is crucial for an optimal oncologic resection of colon and rectal cancers. However, without a direct visualization, an aberrant route of lymph node (LN) diffusion might remain unresected. Indocyanine-green (ICG) lymphatic mapping permits a real-time LNs visualization. We designed the GREENLIGHT trial [...] Read more.
Lymphadenectomy is crucial for an optimal oncologic resection of colon and rectal cancers. However, without a direct visualization, an aberrant route of lymph node (LN) diffusion might remain unresected. Indocyanine-green (ICG) lymphatic mapping permits a real-time LNs visualization. We designed the GREENLIGHT trial to explore in 100 patients undergoing robotic colorectal resection the clinical significance of a D3 ICG-guided lymphadenectomy. The primary endpoint was the number of patients in whom ICG changed the extent of lymphadenectomy. We report herein the interim analysis on the first 70 patients. After endoscopic ICG injection 24 h (n = 49) or 72 h (n = 21) ahead, 19, 20, and 31 patients underwent right colectomy, left colectomy, and anterior rectal resection. The extent of lymphadenectomy changed in 35 (50%) patients, mostly (29 (41.4%)) for the identification of LNs (median two) outside the standard draining basin. Identification of such LNs was less frequent in rectal tumors that had undergone chemoradiotherapy (26.3%) (p > 0.05). A non-significant correlation between time-to-ICG injection and identification of aberrant LNs was observed (48.9% at 24 h vs. 23.8% at 72 h). The presence of LN metastases did not affect a proper fluorescent mapping. These data indicate that ICG lymphatic mapping provides relevant information in 50% of patients, thus increasing the accuracy of potentially curative resections. Full article
(This article belongs to the Special Issue State-of-the-Art on Gastrointestinal Cancers in Italy)
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Review

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17 pages, 769 KiB  
Review
Colorectal Cancer Heterogeneity and the Impact on Precision Medicine and Therapy Efficacy
by Gerardo Rosati, Giuseppe Aprile, Alfredo Colombo, Stefano Cordio, Marianna Giampaglia, Alessandro Cappetta, Concetta Maria Porretto, Alfonso De Stefano, Domenico Bilancia and Antonio Avallone
Biomedicines 2022, 10(5), 1035; https://doi.org/10.3390/biomedicines10051035 - 30 Apr 2022
Cited by 8 | Viewed by 3239
Abstract
Novel targeted therapies for metastatic colorectal cancer are needed to personalize treatments by guiding specific biomarkers selected on the genetic profile of patients. RAS and BRAF inhibitors have been developed for patients who become unresponsive to standard therapies. Sotorasib and adagrasib showed promising [...] Read more.
Novel targeted therapies for metastatic colorectal cancer are needed to personalize treatments by guiding specific biomarkers selected on the genetic profile of patients. RAS and BRAF inhibitors have been developed for patients who become unresponsive to standard therapies. Sotorasib and adagrasib showed promising results in phase I/II basket trial and a phase III trial was planned with a combination of these RAS inhibitors and anti-EGFR monoclonal antibodies. Encorafenib and binimetinib were administered in phase II clinical trials for BRAF mutated patients. Pembrolizumab is now recommended in patients exhibiting microsatellite instability. Larotrectinib and entrectinib showed a fast and durable response with few and reversible adverse events in cases with NTRK fusions. Trastuzumab and trastuzumab deruxtecan exhibited promising and durable activity in HER-2-positive patients. In this review, the reasons for an extension of the molecular profile of patients were assessed and placed in the context of the advancements in the understanding of genetics. We highlight the differential effect of new targeted therapies through an ever-deeper characterization of tumor tissue. An overview of ongoing clinical trials is also provided. Full article
(This article belongs to the Special Issue State-of-the-Art on Gastrointestinal Cancers in Italy)
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