Difference between revisions of "Small bowel adenocarcinoma"
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=Guidelines= | =Guidelines= | ||
− | ==[https://www.nccn.org/ NCCN]== | + | '''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.''' |
− | *[https://www. | + | ==French Intergroup== |
+ | *'''2017:''' Locher et al. [https://doi.org/10.1016/j.dld.2017.09.123 Small bowel adenocarcinoma: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO)] [https://pubmed.ncbi.nlm.nih.gov/29174568/ PubMed] | ||
+ | ==NCCN== | ||
+ | *[https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1495 NCCN Guidelines - Small Bowel Adenocarcinoma] | ||
+ | |||
+ | =Subsequent lines of therapy= | ||
+ | ==Pembrolizumab monotherapy {{#subobject:e0d17a|Regimen=1}}== | ||
+ | <div class="toccolours" style="background-color:#eeeeee"> | ||
+ | ===Regimen {{#subobject:7b36e9|Variant=1}}=== | ||
+ | {| class="wikitable" style="color:white; background-color:#404040" | ||
+ | |<small>'''FDA-recommended dose'''</small> | ||
+ | |- | ||
+ | |} | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8184060/ Marabelle et al. 2019 (KEYNOTE-158)] | ||
+ | <!-- {| class="wikitable" style="margin:auto; color:white; background-color:#1B4F26" | ||
+ | |'''[https://www.esmo.org/guidelines/esmo-mcbs/esmo-mcbs-scorecards/scorecard-294-1 <span style="color:white;">ESMO-MCBS (3)</span>]''' | ||
+ | |- | ||
+ | |} --> | ||
+ | |2016-2018 | ||
+ | |style="background-color:#91cf61"|Phase 2 (RT) | ||
+ | |- | ||
+ | |} | ||
+ | ''Note: 7.4% of patients enrolled in KEYNOTE-158 cohort K had small intestine cancer.'' | ||
+ | <div class="toccolours" style="background-color:#fdcdac"> | ||
+ | ====Biomarker eligibility criteria==== | ||
+ | *MSI-H or dMMR | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Immunotherapy==== | ||
+ | *[[Pembrolizumab (Keytruda)]] 200 mg IV over 30 minutes once on day 1 | ||
+ | '''21-day cycle for up to 35 cycles (2 years)''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # '''KEYNOTE-158:''' Marabelle A, Le DT, Ascierto PA, Di Giacomo AM, De Jesus-Acosta A, Delord JP, Geva R, Gottfried M, Penel N, Hansen AR, Piha-Paul SA, Doi T, Gao B, Chung HC, Lopez-Martin J, Bang YJ, Frommer RS, Shah M, Ghori R, Joe AK, Pruitt SK, Diaz LA Jr. Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2020 Jan 1;38(1):1-10. Epub 2019 Nov 4. [https://doi.org/10.1200/jco.19.02105 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8184060/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/31682550/ PubMed] [https://clinicaltrials.gov/study/NCT02628067 NCT02628067] | ||
+ | ##'''Update:''' Maio M, Ascierto PA, Manzyuk L, Motola-Kuba D, Penel N, Cassier PA, Bariani GM, De Jesus Acosta A, Doi T, Longo F, Miller WH, Oh DY, Gottfried M, Xu L, Jin F, Norwood K, Marabelle A. Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study. Ann Oncol. 2022 Sep;33(9):929-938. Epub 2022 Jun 6. [https://doi.org/10.1016/j.annonc.2022.05.519 link to original article] [https://pubmed.ncbi.nlm.nih.gov/35680043/ PubMed] | ||
[[Category:Small bowel carcinoma regimens]] | [[Category:Small bowel carcinoma regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Gastrointestinal cancers]] | [[Category:Gastrointestinal cancers]] |
Latest revision as of 11:39, 13 May 2024
Section editor | |
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Travis Zack, MD, PhD University of California San Francisco San Francisco, CA, USA |
1 regimens on this page
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Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
French Intergroup
- 2017: Locher et al. Small bowel adenocarcinoma: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO) PubMed
NCCN
Subsequent lines of therapy
Pembrolizumab monotherapy
Regimen
FDA-recommended dose |
Study | Dates of enrollment | Evidence |
---|---|---|
Marabelle et al. 2019 (KEYNOTE-158) | 2016-2018 | Phase 2 (RT) |
Note: 7.4% of patients enrolled in KEYNOTE-158 cohort K had small intestine cancer.
Biomarker eligibility criteria
- MSI-H or dMMR
Immunotherapy
- Pembrolizumab (Keytruda) 200 mg IV over 30 minutes once on day 1
21-day cycle for up to 35 cycles (2 years)
References
- KEYNOTE-158: Marabelle A, Le DT, Ascierto PA, Di Giacomo AM, De Jesus-Acosta A, Delord JP, Geva R, Gottfried M, Penel N, Hansen AR, Piha-Paul SA, Doi T, Gao B, Chung HC, Lopez-Martin J, Bang YJ, Frommer RS, Shah M, Ghori R, Joe AK, Pruitt SK, Diaz LA Jr. Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2020 Jan 1;38(1):1-10. Epub 2019 Nov 4. link to original article link to PMC article contains dosing details in manuscript PubMed NCT02628067
- Update: Maio M, Ascierto PA, Manzyuk L, Motola-Kuba D, Penel N, Cassier PA, Bariani GM, De Jesus Acosta A, Doi T, Longo F, Miller WH, Oh DY, Gottfried M, Xu L, Jin F, Norwood K, Marabelle A. Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study. Ann Oncol. 2022 Sep;33(9):929-938. Epub 2022 Jun 6. link to original article PubMed