Complete Response of a Patient with Squamous Cell Carcinoma of the Sigmoid Colon: A Case Report

Six cats with an advanced stage squamous cell carcinoma (SCC) of the nasal planum were treated with a combination of superficial radiotherapy and intralesional carboplatin therapy. This multimodality protocol was well tolerated by the majority of cats and resulted in complete responses in all cats (100%). Median follow-up for all cats is 268 days, and the median time-to-recurrence, time-to-progression and overall survival have not yet been reached. Our study, although limited in number of animals and with a relatively short median follow-up compared to other studies for this disease, suggests that a combination of radiotherapy and intralesional carboplatin is a useful treatment option for an advanced stage SCC of the nasal planum in cats and warrants further application of the multimodality approach presented here.

Concurrent chemoradiation (CCRT) and upfront surgery followed by adjuvant therapy both are recommended treatment options for patients with advanced stage squamous cell carcinoma (SCC) of the tonsil. To the authors' knowledge, the question of whether surgical-based treatments can achieve better survival compared with CCRT has never been compared in a clinical trial. The authors analyzed the National Cancer Data Base to measure the impact of different treatment modalities on overall survival (OS). All patients aged ≤70 years diagnosed with clinical stage III to IVB (excluding T4B) SCC of the tonsil from 1998 through 2011 were selected. Analysis was limited to patients receiving CCRT, surgery plus CCRT, or surgery followed by adjuvant radiotherapy (RT). OS was compared using the Kaplan-Meier method and log-rank test. Univariable and multivariable hazards analyses were performed to identify factors significant for survival. Propensity score matching was performed. There were 16,891 patients who met the inclusion criteria. The most common treatment was CCRT (8123 patients; 48.1%), followed by surgery plus CCRT (5249; 31.1%) and surgery plus RT (3519 patients; 20.8%). Patients treated with surgery plus CCRT were found to have the highest 3-year OS rate (88.5%) followed by those treated with surgery plus RT (84%) and CCRT (74.2%) (P<.0001). In a propensity score-matched subpopulation of 4962 patients, the 3-year OS rate was 90.2% for those treated with surgery plus CCRT, 84.9% for those treated with surgery plus RT, and 82.1% for those treated with definitive CCRT (P<.0001). Patients with advanced stage SCC of the tonsil who underwent surgery followed by CCRT had the greatest OS. Patients undergoing upfront surgery may avoid chemotherapy without jeopardizing survival. Triple-modality therapy may provide a survival benefit for a subset of patients with advanced stage tonsil cancer. Cancer 2017;123:3269-76. © 2017 American Cancer Society.

Background: Immune checkpoint inhibitors (ICIs) are one of the major therapeutic advancements in cancer treatment. Anti-programmed cell death protein 1 (Anti-PD1)/PD-L1 ICIs have improved progression-free survival in patients with metastatic triple negative breast cancer (TNBC) and pathologic complete response (pCR) and event-free survival in patients with early TNBC. Nevertheless, some patients treated with anti-PD(L)1 ICIs experience recurrence or do not achieve sustained clinical benefit. In addition, very interesting data show the existence of a subgroup of patients with exceptional tumour responses to monotherapy with anti-PD(L)1 ICIs. These exceptional responses are observed in various tumour types, such as colorectal or breast cancer. Although in colorectal cancer, the determinants for this extreme sensitivity to immunotherapy treatment are identified (existence of MSI) in breast cancer, this is not the case. There is still a lack of knowledge about predictive biomarkers and mechanisms of action for ICIs. Trial Design: POP-Durva (NCT05215106) is a prospective, one-arm-only study aiming at determining the pCR rate after two administrations of Durvalumab monotherapy in patients with stage I TNBC. This window-of-opportunity study will recruit 195 consecutive cases of stage I TNBC (ER &amp;lt; 1%, PR &amp;lt; 1%, HER2 negative) and TILs≥5%, eligible for short-term treatment with durvalumab. Study treatment consists of two administrations of intravenous Durvalumab monotherapy, 10mg/kg, at two weeks intervals. After study treatment, patients will receive a standard treatment strategy (surgery or neoadjuvant systemic treatment) as per physician choice. The primary endpoint is the pCR rate after treatment with Durvalumab, defined as the absence of invasive disease in the breast and negative axillary nodes (ypT0/yTis ypN0). Assessment of the primary endpoint will be performed at the surgery or at the biopsy at the end of treatment) for patients undergoing neoadjuvant treatment. For patients in whom neo-adjuvant therapy is the first standard treatment strategy (i.e. after study treatment) a breast ultrasound-guided biopsy is mandatory at the end of the treatment visit. If the biopsy-proven residual disease is demonstrated, patients can receive standard neoadjuvant therapy at the discretion of the treating investigator. Patients with biopsy-proven residual disease will be considered as having no pCR. Those with a complete response may proceed directly to surgery. The expected pCR rate with Durvalumab monotherapy is 20%. The sample size of 195 patients will allow us to estimate this expected pCR rate with a 95% confidence interval of a precision of 6.2%. Secondary objectives are objective response rate and safety. Exploratory objectives are to: a. describe immune cell dynamics associated with exceptional responses to ICI (using spectral cytometry analysis), b. describe somatic genetic contributions to the determination of immune responsiveness (using whole exome sequencing (WES) and in a subset of patient's single-cell RNA-seq), c. characterize tumour cells – immune cells' interaction/spatial distribution(using imaging mass cytometry), d. explore the association between gut microbiome composition/signatures predictive of response to ICI (using 16s rRNA sequencing) and e. identify predictive tissue/blood-based biomarkers of response and to anti-PD(L)1 ICIs therapy. A total of two dedicated FFPE samples and two fresh biopsies will be collected at the time of inclusion and at the end of treatment biopsy or on the surgical specimen. In addition, we will collect stool samples pre and at the completion of all Durvalumab treatments and blood samples at the time of inclusion, during treatment (before each Durvalumab administration) and at the end of treatment for serum and plasma extraction and whole blood to serve as a control for WES. Citation Format: Joana Mourato Ribeiro, Isabelle Pic, Quentin Blampey, Elie Rassy, Nusaibah Ibrahimi, Laura Salabert, Olivier Trédan, Monica Arnedos, Semih Dogan, Kamar Serhal Serhal, Clementine Mahaut, Alessandro Viansone, Salim Laghouati, Barbara Pistilli, Charles-Antoine Dutertre, Magali Lacroix-Triki, Jean-Yves Scoazec, Lisa Derosa, Laurence Zitvogel, Corinne Balleyguier, Nadege Bercovici, Paul-Henry Cournede, Stefan Michiels, Fabrice André. Short-term Pre-OPerative Durvalumab (MEDI 4736) in early small triple negative breast cancer patients (POP-Durva) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-18-11.

Surveillance Guidelines Should Be Updated to Recognize the Importance of Serrated Polyps

Patient: Male, 56Final Diagnosis: Advanced stage squamous cell carcinoma of the head and neckSymptoms: Rapidly enlarging mass in left neckMedication: —Clinical Procedure: —Specialty: OncologyObjective:Unusual clinical courseBackground:Cancer is the second leading cause of death internationally, resulting in millions of deaths each year. While treatment in the past has heavily relied on surgery and radiotherapy, chemotherapy and immunotherapy are being increasingly utilized depending on disease presentation.Case Report:A 56-year-old male presented to the Emergency Department with a 3-week history of a rapidly enlarging left supraclavicular neck mass. Computed tomography scan revealed a 12×13 cm mass extending from the angle of the mandible to the supraclavicular area. A biopsy confirmed advanced stage squamous cell carcinoma of the head and neck. The patient was started on a chemotherapy regimen of docetaxel, cisplatin, and 5-fluorouracil (TCF). The tumor progressed through chemotherapy, which was switched to cetuximab; however, this therapy was discontinued after an anaphylactic reaction. Palliative radiation treatment was begun along with pembrolizumab. Pembrolizumab was continued, and after 9 cycles, the patient’s cancer was almost in complete remission. Three months later, disease progression was once again noted with pembrolizumab treatment, which was subsequently discontinued. The patient was started on paclitaxel and carboplatin chemotherapy regimen as a last resort, despite failure of prior TCF treatment, and the patient responded, this time with complete remission in 4 months.Conclusions:This case demonstrates a unique outcome in which a patient who previously was resistant to chemotherapy, later responded to chemotherapy after a trial of radiation therapy and immunotherapy. Immunotherapy may have a synergistic effect with radiation therapy and play a role in tumor sensitivity to chemotherapy in head and neck cancer treatment.

Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma

Screening, Surveillance, and Primary Prevention for Colorectal Cancer: A Review of the Recent Literature

WIN Symposium 2022 - Abstract Poster Presentations.

Rates of New or Missed Colorectal Cancers After Colonoscopy and Their Risk Factors: A Population-Based Analysis

UK Fifth National Colorectal Cancer Consensus Meeting 2010

Does Colon Polyp Surveillance Improve Patient Outcomes?

Colon Cancer Screening in 2005: Status and Challenges

Introduction: Chemotherapy plus immunotherapy is the standard treatment worldwide for advanced lung squamous cell carcinoma with high programmed cell death protein-1 (PD-1) expression. The use of immunotherapy alone against advanced lung squamous cell carcinoma is rarely reported, and data on PD-1 inhibitor camrelizumab are missing. We report the first case of camrelizumab monotherapy, which can be a reference for the clinical applications of camrelizumab in a wider context. Case Presentation: We herein present a 69-year-old male case of advanced squamous cell carcinoma with low PD-1 expression, in which camrelizumab monotherapy was administered every 3 weeks. Camrelizumab monotherapy reversed advanced lung squamous cell carcinoma without recurrence or obvious side effects during 26 months of follow-up. The patient is alive and in good conditions to date; thus, progression-free survival and overall survival are not determined. Conclusion: This case report provides evidence of the efficacy of camrelizumab monotherapy and highlights the feasibility of camrelizumab alone against advanced lung squamous cell carcinoma when chemotherapy is not applicable.

Background: Cancer continues to be a leading cause of mortality and morbidity globally. According to the Global Cancer Incidence Mortality and Prevalence (GLOBOCAN, 2018), Kenya has an estimated 47, 887 new cancer cases with 32, 987 deaths annually. The International Cancer Institute (ICI) is leading in the efforts to prevent and cure cancer in sub-Saharan Africa through innovative programs and multi-sectoral collaborations. Hence, the establishment of virtual tumor boards (VTBs) held biweekly across online platforms with the objective to improve patient outcomes by integrating multidisciplinary and expert discussion of cancer cases for application of standardized treatment protocols, management and greatly support decision making. Methods: ICI established the virtual tumor boards for case presentations and discussion with attendance of leading experts in Cancer care from across sub-Saharan countries and even globally. Standard case presentation templates and procedures are used by participants from different facilities and/or institutions when presenting the cases after which experts in Oncology and General medicine lead the discussions on the suitable and practical treatment protocols based on international guidelines, clinical trials and study findings relevant to the case. The final resolutions are shared in formal writing to the case presenters for documentation and execution of relevant treatments to manage cases in the low capacity hospitals. Subsequent virtual tumor boards include follow-up discussions on treatment outcomes for previously discussed cases. Feedback evaluation forms are sent to the VTB participants after every session for analysis. Findings: Between January 2020 and July 2020, ICI hosted 59 virtual tumor board sessions with case presentations made from 15 facilities across Kenya. The presenters were multi-cadre ranging from Medical Consultants, Medical Residents, General practitioners and Oncology clinical officers. The cases included: breast cancer, cervical cancer, lung cancer, esophageal cancer, neuroendocrine cancer, lymphomas, colorectal cancers, soft tissue sarcomas, germ cell tumors, breast cancer in pregnancy, Kaposi’s sarcoma among others. Feedback analysis showed most participants were extremely satisfied with the presentations and were very likely to attend future sessions as well as recommend the VTBs to their colleagues. Conclusion: Virtual tumor boards bridge the gap of access to specialized cancer care in rural settings by using the internet and positively impact fast expert decision making on the appropriate regimens to use. The involvement of a multi-disciplinary approach to treatment and patient care has been seen to improve overall patient outcomes with capacity building of healthcare providers (HCPs) also being enhanced through online mentorship and training in the process. Citation Format: Anthony Muchiri, Gloria Kitur, Hussein Elias, Andrew Koech, Chite Asirwa. The role of virtual tumor boards in improving patient outcomes in rural settings of sub-Saharan Africa [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-047.

AGA Medical Position Statement on the Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease