Evaluation of Bevacizumab in Advanced Small Bowel Adenocarcinoma

Aydın, Dinçer; Şendur, Mehmet Ali Nahit; Kefeli, Umut; Ustaalioglu, Basak Bala; Aydin, Özhan; Yıldırım, Emre; Işik, Deniz; Özçelik, Melike; Sürmeli, Heves; Oyman, Abdilkerim; Işık, Selver; Sener, Nur; Ercelep, Özlem; Odabaş, Hatice; Aliustaoğlu, Mehmet; Gümüş, Mahmut

doi:10.1016/j.clcc.2016.04.013

Cited by 22 publications

(31 citation statements)

References 25 publications

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“…Bevacizumab has also been studied in the metastatic setting but has not shown statistically significant better response rates or survival benefit; this is largely due, however, to insufficient power. 65 The FOLFIRI regimen is considered a reasonable second-line option, with an expected response rate of 20 to 25%, and progression-free survival (PFS) of 3.2 to 5.6 months. 61,63,66 Other agents, such as cetuximab in KRAS wild-type patients, 67 and gemcitabine in tumors that reflect more pancreatic-biliary subtypes, have been reported in case series, or as part of larger clinical trials.…”

Section: Medical Therapymentioning

confidence: 99%

Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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Small bowel adenocarcinoma is a clinically and anatomically distinct gastrointestinal cancer that lacks prospective data to support its optimal management. Patients with inflammatory bowel disease and inherited conditions that cause gastrointestinal polyps are at especially high risk. Due to a lack of effective surveillance programs resulting in missed or delayed diagnoses only when symptoms develop, this disease is generally discovered at an advanced stage. Surgical resection is the only treatment modality with a chance of cure. Currently accepted treatment considerations are often generalized from large bowel and pancreatic-biliary cancers, due to some anatomic and clinical parallels. Additional research, however, is desperately needed to characterize the unique molecular differences of this disease to better prognosticate patients and establish rational clinical trials that would improve their outcomes.

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Section: Medical Therapymentioning

confidence: 99%

Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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“…On scrutiny, only four articles were relevant studies. 2,5,24,25 All four were cohort studies. No randomized controlled trials were available to date.…”

Section: Resultsmentioning

confidence: 99%

“…1 This disease is slightly more common in men with an estimated incidence of 2.3 new cases per 100,000 population. 2,3 The median age at diagnosis is 66 years. Among diagnosed cases, mortality increases with age at an estimated rate of 0.4 deaths per 100,000.…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab in metastatic small-bowel adenocarcinoma: A systematic review and meta-analysis

et al. 2019

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Cancers of the small bowel could account for less than 5% of all gastrointestinal malignancies. Of these tumors, adenocarcinomas were the major histologic subtype and generally carried a poor prognosis. High expression of vascular epithelial growth factor (VEGF) could be seen in small bowel adenocarcinomas. A systematic review was conducted here to determine if bevacizumab, a recombinant humanized antibody against VEGF, could offer clinical benefit among patients with metastatic small bowel adenocarcinoma when combined with chemotherapy. A search for relevant published and unpublished studies was performed using PubMed, ScienceDirect, Google Scholar, the American Society of Clinical Oncology meetings library, ClinicalTrials.gov, and ISRCTN registry. Information on study design, methods, intervention, and outcomes were extracted from selected eligible studies. Methodological quality was then assessed using the Newcastle-Ottawa Scale. There was a significant improvement in mean overall survival with the addition of bevacizumab with chemotherapy versus chemotherapy alone. The use of bevacizumab with chemotherapy, likewise improved progression-free survival and objective response rate compared to chemotherapy alone. Continued use of bevacizumab beyond first progression also appeared to show benefit. The conduct of prospective controlled studies by consortia to offset the rarity of small bowel adenocarcinomas could further elucidate the efficacy of bevacizumab in the treatment of this disease.

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“…125 Retrospective analyses have supported these results, reporting favorable outcomes in patients treated with bevacizumab-containing chemotherapy regimens without adding significant toxicity. 116,126 Based on these data, FOLFOX, CAPEOX, or FOLFOXIRI may be given with or without bevacizumab as first-line therapy for advanced SBA.…”

Section: Folfox Capeox or Folfoxiri Plus Bevacizumab As First-line mentioning

confidence: 99%

Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology

Benson

Venook

Al-Hawary

et al. 2019

Journal of the National Comprehensive Cancer Network

106

128

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Small bowel adenocarcinoma (SBA) is a rare malignancy of the gastrointestinal tract that has increased in incidence across recent years. Often diagnosed at an advanced stage, outcomes for SBA are worse on average than for other related malignancies, including colorectal cancer. Due to the rarity of this disease, few studies have been done to direct optimal treatment, although recent data have shown that SBA responds to treatment differently than colorectal cancer, necessitating a separate approach to treatment. The NCCN Guidelines for Small Bowel Adenocarcinoma were created to establish an evidence-based standard of care for patients with SBA. These guidelines provide recommendations on the workup of suspected SBA, primary treatment options, adjuvant treatment, surveillance, and systemic therapy for metastatic disease. Additionally, principles of imaging and endoscopy, pathologic review, surgery, radiation therapy, and survivorship are described.

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Evaluation of Bevacizumab in Advanced Small Bowel Adenocarcinoma

Cited by 22 publications

References 25 publications

Small Bowel Adenocarcinoma

Small Bowel Adenocarcinoma

Bevacizumab in metastatic small-bowel adenocarcinoma: A systematic review and meta-analysis

Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology

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