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Most advanced colorectal cancer patients with proficient DNA mismatch repair or microsatellite stability (MSS) are insensitive to immune checkpoint inhibitor therapy. This report describes a heavily pretreated refractory colon adenocarcinoma patient with MSS. After experiencing four lines of treatment, the patient received the fifth-line therapy with the combined sintilimab, bevacizumab and chemotherapy. She achieved a long-term clinical outcome. The patient's progression-free survival after the fifth-line therapy was approximately 9.3 months, and her overall survival was approximately 57 months. To the best of our knowledge, this case represents the first report of durable clinical benefit from combination of an immune checkpoint inhibitor, bevacizumab and chemotherapy in a heavily pretreated patient with refractory metastatic colon adenocarcinoma with MSS.

Background: Pancreatic cancer is common in elderly persons, and less than 20% of patients present with localized, potentially curable tumors. Methods: We compared the methylated sites and genes in pericarcinous tissues compared to cancer tissue, and blood compared to pericarcinous tissues in order to harvest methylation markers for putative diagnostic and therapy monitoring purposes. Results: Of 15,397 CpG sites detected in 7,440 genes, 5,605 (36.4%, 5,605 of 15,397) CpG sites were hypomethylated and 5,870 (38.12%, 5,870 of 15,397) CpG sites were hypermethylated. We then performed Gene Ontology (GO) and KEGG analysis to systematically characterize the ten significantly differentially methylated genes: PTPRN2, MAD1L1, TNXB, PRDM16, GNAS, KCNQ1, TSNARE1, HDAC4, TBCD , and DIP2C . Meanwhile, function analysis of genes with differentially methylated sites located in promoter regions of overlap group was also performed. According to previous studies, we further screened 22 pancreatic cancer related key genes. The results suggested that these key genes can influence methylation. GO and KEGG analysis indicated that these genes are involved in a wide range of functions. Conclusions: The identification of differentially methylated genes in this study provides valuable information for liquid biopsy methylation markers in pancreatic cancer.

Objective to study an in vitro accurate measurement method for the placement depth of PICC. Methods 270 patients undergoing PICC catheterization under ultrasound guidance in outpatient PICC catheterization from March to September 2019 were selected by convenient sampling. By using the random number table method, the subjects were divided into group A (horizontal L-type measurement method) and Group B (characteristic index measurement calculation) by 1:1, with 135 cases in each group. X-ray chest radiograph was taken after catheterization in both groups, and the indwelling position of the catheter was adjusted according to the X-ray chest radiograph. The correlation between PICC predicted length and ideal depth and patient satisfaction were compared between the two groups. Results The success rate of PICC catheter tip insertion in group B was 97.78%, while that in control group A was 82.22%, the difference was statistically significant (P < 0.05). The satisfaction degree of patients in group B was significantly higher than that in group A. The differences were statistically significant (P < 0.05). Conclusion Improving the success rate of the precise depth of PICC catheter placement can significantly reduce the incidence of complications, waste of human and material resources caused by adjusting the catheter position, and significantly improve patient satisfaction.

Background: Unlike patients with advanced colorectal cancer (CRC) with deficient DNA mismatch repair or microsatellite instability-high (dMMR/MSI-H) tumors, most patients with advanced CRC with proficient DNA mismatch repair or microsatellite-stability (pMMR/MSS) tumors are not sensitive to immune checkpoint inhibitor (ICI) therapy. The current challenge is to find out innovative therapeutic combinations with ICIs for such patients. Case Presentation: In this study, we report a case of heavily pretreated refractory colon cancer with MSS but high-tumor mutation burden (TMB-H) tumors. After experiencing five lines of therapy, including chemotherapy and targeted therapy with anti-angiogenic inhibitor as well as anti-EGFR antibody, she received sixth-line therapy with combination of Sintilimab, Bevacizumab and chemotherapy, and obtained a durable clinical benefit. The patient’s progression-free survival (PFS) of sixth line therapy was about 9 months and overall survival (OS) has been over 4.6 years. Conclusion: To the best of our knowledge, this study represented the longest PFS of response to combination of ICI with other agents with different mechanisms of action in a heavily pretreated refractory colon cancer patient with MSS. Citation Format: Zhi Cui, Qi Wang, Muhong Deng, Erhong Meng, Sheng Liu, Quanli Han. Case report: long-term response to combination of Sintilimab, Bevacizumab and chemotherapy in a heavily pretreated refractory colon cancer patient with microsatellite stability [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5190.

To investigate the effect of multidisciplinary interventions on pain management in cancer inpatients. Four hundred thirty eight patients with cancer pain, who performed the multidisciplinary intervention were recruited. Before and after intervention, the Brief Pain Inventory (BPI) and the MD Anderson Symptom Inventory (MDASI) score as the primary endpoints and QOL scores as the secondary endpoint were all evaluated. To investigate the factors that led to different responses to multidisciplinary interventions, patients were classified as non-responders or responders. Finally, 92 patients (63 male and 29 female) scheduled for cancer pain management by inter-professional team were studied. After individualized multidisciplinary therapy, both pain and symptom severity was improved, as demonstrated by lowered BPI worst and average pain scores, as well as symptom severity score measured by MDASI (P = .017, P = .003, and P = .011, respectively). The proportion of patients with mild pain increased regarding the BPI worst and average pain at baseline and after treatment (P

The natural killer cell line NK‑92 shows great cytotoxicity against various types of cancer. Several types of solid tumor cells, however, can effectively resist NK-mediated lysis by interaction of major histocompatibility complex (MHC) molecules with NK cell inhibitory receptors. To generate a eukaryotic expression vector encoding chimeric antigen receptor scFv anti-erbB2-CD28-ζ and to investigate the expression and action of this chimeric antigen receptor in cancer cells both in vitro and in vivo, NK‑92 cells were genetically modified with an scFv anti-erbB2-CD28-ζ chimeric recep-tor by optimized electro-poration using the Amaxa Nucleofector system. The expression of the chimeric receptor was evaluated by RT-PCR and immunofluorescence. The ability of the genetically modified NK‑92 cells to induce cell death in tumor targets was assessed in vitro and in vivo. The transduced NK‑92-anti-erbB2 scFv-CD28-ζ cells expressing high levels of the fusion protein on the cell surface were analyzed by fluorescence-activated cell-sorting (FACS) analysis. These cells specifically enhanced the cell death of the erbB2‑expressing human breast cancer cell lines MDA-MB-453 and SKBr3. Furthermore, adoptive transfer of genetically modified NK‑92 cells specifically reduced tumor size and lung metastasis of nude mice bearing established MDA-MB-453 cells, and significantly enhanced the survival period of these mice. The genetically modified NK‑92 cells significantly enhanced the killing of erbB2‑expressing cancer and may be a novel therapeutic strategy for erbB2‑expressing cancer cells.

Background: Brachytherapy with iodine125-labeled seeds (125I-seeds) implantation is increasingly being used to treat tumors because of its positional precision, minimal invasion, least damage to noncancerous tissue due to slow and continuous release of radioactivity and facilitation with modern medical imaging technologies. This study evaluates the survival and pain relief outcomes of the 125I-seeds implantation brachytherapy in advanced pancreatic cancer patients. Methods: Literature search was carried out in multiple electronic databases (Google Scholar, Embase, Medline/PubMed, and Ovid SP) and studies reporting I125 seeds implantation brachytherapy in pancreatic cancer patients with unresectable tumor were selected by following predetermined eligibility criteria. Random effects meta-analysis was performed to achieve inverse variance weighted effect size of the overall survival rate after the intervention. Sensitivity and subgroups analyses were also carried out. Results: Twenty-three studies (824 patients’ data) were included in the meta-analysis. 125I-seeds implantation brachytherapy alone was associated with 8.98 [95% confidence interval (CI): 6.94, 11.03] months (P

The objective of this study was to investigate the outcome and coping patterns of patients with stomach, colon, and rectal cancer in a hospital in China. Health-related quality of life was assessed in 118 stomach, colon, and rectal cancer patients in Chinese People's Liberation Army General Hospital, Beijing, China, using the generic version of the European Organization for Research and Treatment of Cancer Quality of Life (QOL) Questionnaire Core 30 Items, Self-rated Anxiety Scores (SAS), Self-rated Depression Scores (SDS), Medical Coping Modes of Questionnaire (MCMQ), and Social Support Requirement Scale (SSRS) questionnaires. The overall QOL was 50.7 ± 6.5, 48.1 ± 7.7, and 47.6 ± 6.4, respectively, for stomach, colon, and rectal cancer groups. Correlations between QOL and SAS and SDS in stomach cancer patients were significantly higher than observed in the cohort of colon or rectal cancer patients (Spearman coefficient of 0.366 and 0.129, respectively). Cluster analysis of MCMQ data revealed four identifiable patterns (resign, confront, avoid-confront, and avoid-resign) of coping in the study group. Subjective support was significantly higher than objective support (p < 0.05); however, extent of using the support was significantly lower than either objective (p < 0.05) or subjective support (p < 0.01). SAS and SDS were negatively correlated to SSRS scores (p < 0.01 and p < 0.05, respectively). Stomach, colon, and rectal cancer patients had anxiety and depression stemming from their cancer diagnosis and postdiagnosis treatment, and sex dependency was prevalent in SSRS response. Coping patterns were reliable indicators of psychosocial side effects in patients with stomach, colon, and rectal cancers.