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Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer
Among patients with endoscopically resected early gastric cancers who were infected with
Helicobacter pylori
, the incidence of metachronous gastric cancer was 50% lower among those who received active treatment with antibiotics than among controls.
Journal Article
The KEYNOTE-811 trial of dual PD-1 and HER2 blockade in HER2-positive gastric cancer
Human epidermal growth factor receptor 2 (
HER2
, also known as
ERBB2
) amplification or overexpression occurs in approximately 20% of advanced gastric or gastro-oesophageal junction adenocarcinomas
1
–
3
. More than a decade ago, combination therapy with the anti-HER2 antibody trastuzumab and chemotherapy became the standard first-line treatment for patients with these types of tumours
4
. Although adding the anti-programmed death 1 (PD-1) antibody pembrolizumab to chemotherapy does not significantly improve efficacy in advanced HER2-negative gastric cancer
5
, there are preclinical
6
–
19
and clinical
20
,
21
rationales for adding pembrolizumab in HER2-positive disease. Here we describe results of the protocol-specified first interim analysis of the randomized, double-blind, placebo-controlled phase III KEYNOTE-811 study of pembrolizumab plus trastuzumab and chemotherapy for unresectable or metastatic, HER2-positive gastric or gastro-oesophageal junction adenocarcinoma
22
(
https://clinicaltrials.gov
, NCT03615326). We show that adding pembrolizumab to trastuzumab and chemotherapy markedly reduces tumour size, induces complete responses in some participants, and significantly improves objective response rate.
Interim analysis of a phase III clinical trial of HER2-positive gastric adenocarinoma shows pembrolizumab plus trastuzumab and chemotherapy improves response rates compared with trastuzumab and chemotherapy alone.
Journal Article
My stomach
\"Tim insists on telling his sister Grace all about the digestive system while their father is sick with a stomachache\"-- Provided by publisher.
Book
Helicobacter pylori Eradication Prevents Metachronous Gastric Neoplasms after Endoscopic Resection of Gastric Dysplasia
There is insufficient data about the role of eradication of H. pylori after endoscopic resection (ER) for gastric dysplasia. The aim was to investigate the benefit of H. pylori eradication after ER in patients with gastric dysplasia to prevent metachronous gastric neoplasms.
We retrospectively reviewed 1872 patients who underwent ER of gastric dysplasia. We excluded patients with a follow-up period of <2 years or who had not undergone tests for active H. pylori infection. A total of 282 patients were enrolled. The patients were categorized into those without active H. pylori infection (H. pylori-negative group, n = 124), those who successfully underwent H. pylori eradication (eradicated group, n = 122), and those who failed or did not undergo H. pylori eradication (persistent group, n = 36).
Metachronous recurrence was diagnosed in 36 patients, including 19 in the H. pylori-negative group, 10 in the eradicated group, and 7 in the persistent group. The cumulative incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group in comparison with either of the H. pylori-persistent (non-eradicated or failed) groups (p = 0.039). Similarly, the incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group compared with the H. pylori-negative group (p = 0.041).
Successful H. pylori eradication may reduce the development of metachronous gastric neoplasms after ER in patients with gastric dysplasia.
Journal Article
Healthy gut cookbook : 150 stage-by-stage healing recipes to improve your digestive health
If you're seeking to alleviate Leaky Gut Syndrome--or if you follow a GAPS, Specific Carbohydrate Diet, Paleo, or gluten-free diet--you will find delicious relief within the pages of Healthy Gut Cookbook. With 120 recipes--and up to 30 variations--for bone broths, fermented foods, soups, yogurt, meat and fish dishes, appetizers, and desserts, you can heal yourself without having to compromise on flavor.
Book
Multicentric randomised study of Helicobacter pylori eradication and pepsinogen testing for prevention of gastric cancer mortality: the GISTAR study
IntroductionPopulation-based eradication of Helicobacter pylori has been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whether H pylori eradication combined with pepsinogen testing reduces mortality from gastric cancer among 40–64-year-old individuals. The secondary objectives include evaluation of H pylori eradication effectiveness in gastric cancer prevention in patients with precancerous lesions and evaluation of the potential adverse events, including effects on microbiome.Methods and analysisIndividuals are recruited from general population (50% men) in areas with high gastric cancer risk in Europe and undergo detailed lifestyle and medical history questionnaire before being randomly allocated to intervention or control groups. The intervention group undergoes H pylori testing and is offered eradication therapy if positive; in addition, pepsinogen levels are detected in plasma and those with decreased levels are referred for upper endoscopy. All participants are offered faecal occult blood testing as an incentive for study participation. Effectiveness of eradication and the spectrum of adverse events are evaluated in study subpopulations. A 35% difference in gastric cancer mortality between the groups is expected to be detectable at 90% power after 15 years if 30 000 individuals are recruited. Biological materials are biobanked for the main and ancillary studies. The study procedure and assumptions will be tested during the pilot phase.Ethics and disseminationThe study was approved by the respective ethics committees. An independent Data Safety and Monitoring Board has been established. The findings will be published in peer-reviewed journals and presented at scientific meetings.Trial registration numberNCT02047994
Journal Article
The plant paradox cookbook : 100 delicious recipes to help you lose weight, heal your gut, and live lectin-free
\"In [his book] The Plant Paradox, Dr. Steven Gundry introduced readers to the hidden toxins lurking in seemingly healthy foods like tomatoes, zucchini, quinoa, and brown rice: a class of plant-based proteins called lectins. Many people are familiar with one of the most predominant lectins--a substance called gluten, which is found in wheat and other grains. But while cutting out the bread and going gluten-free is relatively straightforward, going lectin-free is no small task. Now, in [this] cookbook, Dr. Gundry breaks down lectin-free eating step by step and shares one hundred of his favorite healthy recipes\"--Amazon.com.
Book
Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer
In resectable gastric and gastroesophageal junction cancer, adding durvalumab to perioperative chemotherapy improved event-free survival and pathological complete response, with no major increase in high-grade adverse events.
Journal Article