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2. EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types

Author

Lisanne S. Rigter, Eva C. Rijkmans, Akin Inderson, Roy P.J. van den Ende, Ellen M. Kerkhof, Martijn Ketelaars, Jolanda van Dieren, Roeland A. Veenendaal, Baukelien van Triest, Corrie A.M. Marijnen, Uulke A. van der Heide, and Monique E. van Leerdam

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and study aims To facilitate image guidance during radiotherapy of rectal cancer, we investigated the feasibility of fiducial marker placement. This study aimed to evaluate technical success rate and safety of two endoscopic ultrasound (EUS)-guided placement strategies and four fiducial types for rectal cancer patients. Patients and methods This prospective multicenter study included 20 participants who were scheduled to undergo rectal cancer treatment with neoadjuvant short-course radiotherapy or chemoradiation. EUS-guided endoscopy was used for fiducial placement at the tumor site (n = 10) or in the mesorectal fat and in the tumor (n = 10). Four fiducial types were used (Visicoil 0.75 mm, Visicoil 0.50 mm, Cook, Gold Anchor). The endpoints were technical success rate and retention of fiducials, the latter of which was evaluated on cone-beam computed tomography scans during the first five radiotherapy fractions. Results A total of 64 fiducials were placed in 20 patients. For each fiducial type, at least three fiducials were successfully placed in all patients. Technical failure consisted of fiducial blockage within the needle (n = 2) and ejection of two preloaded fiducials at once (n = 4). No serious adverse events were reported. In three patients, one of the fiducials was misplaced without clinical consequences; two in the prostate and one in the intraperitoneal cavity. After a median time of 17 days after placement (range 7 – 47 days), a total of 42/64 (66 %) fiducials were still present (24/44 intratumoral vs. 18/20 mesorectal fiducials, P = 0.009). Conclusions Placement of fiducials in rectal cancer patients is feasible, however, retention rates for intratumoral fiducials were lower (55 %) than for mesorectal fiducials (90 %).

Published
2019
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3. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe

Author

Tiuri E. Kroese, Hanneke W.M. van Laarhoven, Sebastian F. Schoppman, Pieter R.A.J. Deseyne, Eric van Cutsem, Karin Haustermans, Philippe Nafteux, Melissa Thomas, Radka Obermannova, Hanna R. Mortensen, Marianne Nordsmark, Per Pfeiffer, Anneli Elme, Antoine Adenis, Guillaume Piessen, Christiane J. Bruns, Florian Lordick, Ines Gockel, Markus Moehler, Cihan Gani, Theodore Liakakos, John Reynolds, Alessio G. Morganti, Riccardo Rosati, Carlo Castoro, Francesco Cellini, Domenico D'Ugo, Franco Roviello, Maria Bencivenga, Giovanni de Manzoni, Mark I. van Berge Henegouwen, Maarten C.C.M. Hulshof, Jolanda van Dieren, Marieke Vollebergh, Johanna W. van Sandick, Paul Jeene, Christel T. Muijs, Marije Slingerland, Francine E.M. Voncken, Henk Hartgrink, Geert-Jan Creemers, Maurice J.C. van der Sangen, Grard Nieuwenhuijzen, Maaike Berbee, Marcel Verheij, Bas Wijnhoven, Laurens V. Beerepoot, Nadia H. Mohammad, Stella Mook, Jelle P. Ruurda, Piotr Kolodziejczyk, Wojciech P. Polkowski, Lucjan Wyrwicz, Maria Alsina, Manuel Pera, Tania F. Kanonnikoff, Andrés Cervantes, Magnus Nilsson, Stefan Monig, Anna D. Wagner, Matthias Guckenberger, Ewen A. Griffiths, Elizabeth Smyth, George B. Hanna, Sheraz Markar, M. Asif Chaudry, Maria A. Hawkins, Edward Cheong, Richard van Hillegersberg, Peter S.N. van Rossum, Tom Rozema, Joos Heisterkamp, Markus Schaefer, Esat-Mahmut Ozsahin, Jacco de Haan, Jan Willem van den Berg, Frederic Duprez, Eduard Callebout, Elke van Daele, Ulrich Hacker, Albrecht Hoffmeister, Thomas Kuhnt, Timm Denecke, Regine Kluge, Gerald Prager, A. Ilhan-Mutlu, Dajana Cuicchi, Andrea Ardizzoni, Camiel Rosman, Elske C. Gootjes, Heidi Rütten, Francesco Puccetti, Stefano Cascinu, Najla Slim, Maria Eugenia Barrios, Maria Carmen Fernandez, Roberto Martí-Oriol, Marisol Huerta Alvaro, Almudena Vera, Esther Jordá, Fernando L. Mozos, Anna Reig, Laura Visa, Bogumiła Ciseł, Joanna Czechowska, Magdalena Kwietniewska, Agnieszka Pikuła, Magdalena Skórzewska, Aleksandra Kozłowska, Karol Rawicz-Pruszyński, Internal medicine, Surgery, AII - Cancer immunology, CCA - Cancer biology and immunology, Radiation Oncology, Gastroenterology & Hepatology, Erasmus MC other, Institut Català de la Salut, [Kroese TE] Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. [van Laarhoven HWM] Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands. Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands. [Schoppman SF] Department of Surgery, Medical University of Vienna, Vienna University, Vienna, Austria. [Deseyne PRAJ] Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. [van Cutsem E] Department of Medical Oncology, KU Leuven, Leuven University, Leuven, Belgium. [Haustermans K] Department of Radiation Oncology, KU Leuven, Leuven University, Leuven, Belgium. [Alsina M] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias gástricas [ENFERMEDADES], Cancer Research, Oligometastasis, Stereotactic body radiotherapy, Oesophageal cancer, Metastasectomy, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias del esófago [ENFERMEDADES], Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Esophageal Neoplasms [DISEASES], Metastasis, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Esòfag - Càncer - Diagnòstic, Ciencias de la información::análisis de sistemas::técnica Delfos [CIENCIA DE LA INFORMACIÓN], Metàstasi, SDG 3 - Good Health and Well-being, Oncology, Estómac - Càncer - Diagnòstic, Decisió, Presa de, Information Science::Systems Analysis::Delphi Technique [INFORMATION SCIENCE], Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Stomach Neoplasms [DISEASES], Gastric cancer
Abstract

Gastric cancer; Metastasectomy; Oligometastasis Cáncer gástrico; Metastasectomía; Oligometástasis Càncer gàstric; Metastasectomia; Oligometàstasi Background Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer. Methods In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (2 years, either upfront local treatment or systemic treatment followed by restaging was considered as treatment (fair agreement). Conclusion The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials.

Published
2023
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5. Neoadjuvant atezolizumab plus docetaxel/oxaliplatin/capecitabine in non-metastatic gastric and gastroesophageal junction adenocarcinoma: The PANDA trial

Author

Yara L. Verschoor, Liudmila Kodach, José van den Berg, Johanna W. van Sandick, Jolanda van Dieren, Sara Balduzzi, Cecile Grootscholten, Xander Veenhof, Koen Hartemink, Marieke A. Vollebergh, E.C. Owers, Annemarieke Bartels-Rutten, Peggy den Hartog, Monique E van Leerdam, Ton Schumacher, Emile E. Voest, John B. A. G. Haanen, and Myriam Chalabi

Subjects
Cancer Research, Oncology
Abstract

4059 Background: Immune checkpoint blockade improves clinical outcomes for patients with gastric and gastro-esophageal junction (GEJ) cancers, but its efficacy and impact on the tumor microenvironment in non-metastatic, resectable disease remains largely unknown. Peri-operative FLOT, the current standard-of-care, leads to pathologic complete responses (pCR) and major pathologic responses (MPR) in 16% and 37% of patients, respectively. An important open question is whether PDL-1 blockade monotherapy can prime the tumor microenvironment in a favorable manner, prior to combination with chemotherapy. Methods: We report results from the phase 2 PANDA trial (NCT03448835) of neoadjuvant atezolizumab (anti-PDL-1) plus docetaxel, oxaliplatin, and capecitabine (DOC) in patients with resectable gastric or GEJ adenocarcinoma. Patients received a single cycle of atezolizumab monotherapy, followed by 4 cycles of atezolizumab+DOC. Tumor tissue was collected at baseline, after atezolizumab monotherapy, the first atezolizumab+DOC, and at resection. The primary endpoints were safety and feasibility in 20 patients, and secondary endpoints included MPR (

Published
2022
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