Citations 2
Long-Term Outcomes and Surgical Conversion After Immunotherapy in Microsatellite Instability-H Biliary Tract Cancers
Shah, Priyanshi , Peersen, Anina, Sahai, Vaibhav , Mahipal, Amit , Naleid, Nikolas , Borad, Mitesh J. , Bekaii‐Saab, Tanios , Sonbol, Mohamad Bassam , Majeed, Umair , Babiker, Hani M. , O’Donnell, Conor, Malla, Midhun , Conboy, Caitlin B. , Fonkoua, Lionel Kankeu, Washburn, L. , Peterson, Nicole , Carr, Ryan M., Starlinger, P, Smoot, Rory, Warner, Susanne, Ilyas, Sumera L., Heimbach, Julie, Borad, Mitesh J , O'Donnell, Conor D J , Conboy, Caitlin B , Washburn, Leslie A , Halfdanarson, Thorvardur R , Peterson, Nicole , McWilliams, Robert R , Graham, Rondell P , Gores, Gregory J. , Roberts, Lewis R , Ou, Fang-Shu , Tran, Nguyen , Mahipal, Amit , Sonbol, Mohamad B , Bekaii-Saab, Tanios S , Babiker, Hani , Majeed, Umair , Sahai, Vaibhav , Peersen, Anina, Gupta, Garima , Fonkoua, Lionel Aurelien Kankeu , Hálfdánarson, Þorvarður R. , McWilliams, Robert R. , Carr, Ryan M , Graham, Rondell P. , Starlinger, Patrick, Warner, Susanne, Ilyas, Sumera I. , Gores, Gregory J. , Roberts, Lewis R. , Heimbach, Julie K. , Ou, Fang‐Shu , Tran, Nguyen H.
JCO Precision Oncology | July 10, 2026 | Volume: 10 | Issue: 7 | Pages: No page available
PURPOSE Deficient mismatch repair/microsatellite instability (dMMR, MSI-H) in biliary tract cancers (BTCs) is observed in 1%-5% of tumors. MSI-H across solid tumors has demonstrated durable response to immune checkpoint inhibitors (ICIs) regardless of the anatomic location. Here, we describe clinical outcomes and surgical conversion of MSI-H BTC treated with ICIs. Patients and Methods We conducted a multicenter, retrospective analysis of BTC patients with dMMR/MSI-H between 2017 and 2024 at Mayo Clinic, University of Michigan, and University Hospitals Seidman Cancer Center. Outcomes of interest were surgical resection rate, rate of pathologic response, 2-year overall survival (OS; time from initiation of treatment to death/last follow-up), and time to treatment discontinuation (TTD; time from initiation of treatment to cessation because of any cause). Analyses were descriptive. RESULTS Thirty patients with MSI-H BTC were identified: 19 with cholangiocarcinoma, three with gallbladder cancer, and 8 with BTC undefined. The median age at diagnosis was 61.5 years (range, 26-86). Twenty-six (86.7%) patients had advanced stage at diagnosis. Twenty-seven patients (90%) received first-line systemic therapy, and 13 (48.1%) continued onto second line. Six patients (23.1%) were restaged to resectable from advanced disease after ICI therapy and underwent resection; all remained recurrence-free at last follow-up. Of these six patients, 3 (50%) achieved a pathologic complete response. Among those receiving first-line therapy, the median TTD was 9.9 months (95% CI, 5.7 to 14.5 months) and the 2-year OS was 73% (95% CI, 56% to 94%). CONCLUSION ICI therapy in patients with MSI-H BTC demonstrated durable response and downstaged some BTC to a resectable stage. dMMR/MSI-H should be performed up-front to guide treatment decisions.
Gastric Cancer, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology
Ajani, Jaffer A. , D’Amico, Thomas A., Bentrem, David J., Corvera, Carlos U. , Das, Prajnan , Enzinger, Peter C. , Enzler, Thomas , Gerdes, Hans, Grierson, Patrick , Hofstetter, Wayne L. , Ilson, David H. , Jalal, Shadia I. , Kleinberg, Lawrence , Lacy, Jill , Lee, Byrne , Licciardi, Frank, Ly, Quan P. , Matsukuma, Karen , McNamara, Michael, Mukherjee, Sarbajit , Mulcahy, Mary F. , Reddi, Deepti , Reznik, Scott I. , Roses, Robert E. , Strong, Vivian E. , Su, Stacey, Uboha, Nataliya V. , Willett, Christopher G. , Yoon, Harry H. , McMillian, Nicole R., Stein, MaryElizabeth , Gupta, Garima , Ajani, Jaffer A , Bentrem, David J. , Gibson, Michael K. , Gupta, Garima , Kim, Sunnie S. Y. , Klempner, Samuel J. , Lloyd, Shane , Merkow, Ryan P. , Perry, Kyle A. , Pimiento, José M. , Reddi, Deepti , Wainberg, Zev A. , Woo, Yanghee
Journal of the National Comprehensive Cancer Network | May 8, 2025 | Volume: 23 | Issue: 5 | Pages: 169-191
Gastric cancer is the fifth leading cause of cancer-related deaths worldwide. Over 95% of gastric cancers are adenocarcinomas, which are typically classified based on anatomic location and histologic type. Gastric cancer generally carries a poor prognosis because it is often diagnosed at an advanced stage. Systemic therapy can provide palliation, improve survival, and enhance the quality of life in patients with locally advanced or metastatic disease. The implementation of biomarker testing has had a significant impact on clinical practice and patient care. Targeted therapies have demonstrated encouraging results in clinical trials for the treatment of patients with locally advanced or metastatic disease. This selection from the NCCN Clinical Practice Guidelines in Oncology for Gastric Cancer highlights recommendations for biomarker testing and discusses updates for the treatment of advanced disease, including peritoneal carcinoma as only disease and unresectable locally advanced, recurrent, or metastatic disease.