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	Travis Zack, MD, PhD University of California San Francisco San Francisco, CA, USA LinkedIn

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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

NCCN Guidelines - Small Bowel Adenocarcinoma

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
1. 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

@@ Line 11: / Line 11: @@
 {{TOC limit|limit=3}}
 =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.nccn.org/professionals/physician_gls/pdf/small_bowel.pdf NCCN Guidelines - Small Bowel Adenocarcinoma]
+==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=
@@ Line 28: / Line 31: @@
 |-
 |[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"
+<!-- {| 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)
@@ Line 47: / Line 50: @@
 </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] [https://pubmed.ncbi.nlm.nih.gov/31682550/ PubMed] [https://clinicaltrials.gov/study/NCT02628067 NCT02628067]
+# '''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]

Difference between revisions of "Small bowel adenocarcinoma"