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Because of local immunosuppressive responses, immunotherapy by immune checkpoint blockade and adoptive cell therapy with tumor-specific T cells is only partial or temporary in MTS from solid tumors. The investigators believe that a combination of: i direct cancer cell death by adoptively transplanting tumor-specific T cells and ii indirect control of tumor progression by reprogramming the tumor microenvironment will control hepatic MTS of CRC and PDAC. Experimental findings obtained from biological samples will be correlated, i with clinical data from patients at the time of enrollment and/or sequel; and ii for a subgroup of patients with biochemical and immunological results from peripheral blood samples routinely collected as part of their clinical follow-up, with the additional aim of identifying novel biological characteristics and/or signatures to aid in diagnosis of patients and treatment tailoring. Peripheral blood samples at the time of liver MTS diagnosis will also be collected and analysed. Both tumor niches will be examined at both sites simultaneously, allowing intra- and inter-patient analysis of both tumor niches. In addition, findings from multi-level research studies will be correlated with clinical data collected from all patients from the time of registration for a two-year follow-up period, as well as a three-year follow-up period in the case of CRC patients. The investigators intend to collect tissue/blood samples and medical information from at least 200 metastatic PDAC patients, 75 synchronous PDAC MTS patients, and about 20 metachronous PDAC MTS patients, the latter who were first non-metastatic patients for the longitudinal study, with 30 healthy volunteers as positive controls, with the remaining 95 metastatic PDAC patients enrolled as primary non-metastatic patients for the study. Patients' clinical information will be collected after the time of enrollment in the study for a second-up period of 2 years, for PDAC patients, and for CRC patients, respectively. CRC and PDAC metastatic liver MTS by high dimensional flow cytometry; assessment of the immune landscapes of CRC and PDAC liver MTS by high-dimensional flow cytometry; assessment of the clinical characteristics of the CRC and PDAC resectable PDAC liver MTS by high-dimensional flow cytometry; validation of the molecular results obtained in 2 and 4 samples; planning and integration of the study results in six work packages WPs; identification of the clinical and, cytomoe MTS Longitudinal PDAC primary tumor immunoenvironment analysis and characterization of CRC and PDAC liver MTS Longitudinal PDAC primary tumor immune microenvironment characterization MTS Longitudinal PDAC primary tumor immune microenvironment characterization Definition of the antigenic landscape and TCR repertoire of CRC and PDAC liver MTS Longitudinal PDAC liver MTS Longitudinal PDAC liver MTS Longitudinal PDAC primary tumor immune microenvironment.
Source link: https://clinicaltrials.gov/ct2/show/NCT04622423
Operability is determined by the patient's general health, the global liver function, and tumor-related causes such as the number, size, and distribution of the liver metastases. With an otherwise healthy liver, approximately 75% of the parenchyma can be removed, and the remaining 25% of the parenchyma will recover within a year, so that the total liver volume has equaled 89% of the original liver . Patients are typically in hospital after 5-14 days in hospital and are expected to be back to normal physical fitness in less than two weeks after open surgery and less after laparoscopic surgery, where the patient typically returns home after 2-7 days in hospital and with a rapid return to back to healthy physical fitness in less than two weeks. Patients with resection will have new liver metastases . Percutaneous ultrasound biopsy has been the most common method of implanting ablation devices in liver lesions until recently. Destroying lesions with ablative techniques saves liver parenchyma and allows for diagnosing patients who are not resectable in situations where multiple lesions involve either or both of the liver segments. When there are liver recurrences of metastatic disease, Sparing unaffected liver parenchyma also raises the flexibility. After major hepatectomies and ablations, in a third of patients after local resections and ablations, and in a third of patients after a concentrated ablative strategy, more functioning liver parenchyma can be saved, and the options for treating recurrences are wide. CLINICAL AND ECONOMICAL CONSEQUENCES If the study results are correct, there will be a significant effect on the treatment of colorectal liver metastases, where approximately half could be treated with a minimal invasive and low-complication ablation strategy, greatly lowering patient morbidity and raising the possibility of new treatment modalities in the case of tumor recurrences in the liver. With much shorter hospital stays and sick-leave, there is a great potential for major savings in health-related costs for health care providers. In 2008, a population-based cohort of 272 liver metastases from colorectal cancer was found in a population-based cohort of ten32 patients who were hospitalized with that primary in the greater Stockholm area. STUDY DESIGN (PT) A multicentre prospective cohort study with propensity score matching for number or tumours, age, gender, and reaction to chemotherapy. Patients with colorectal liver metastases are evaluated at a weekly liver multidisciplinary conference, and a treatment plan is established. The MDT will determine whether or not chemotherapy is used with neoadjuvant or adjuvant therapy with surgical resection. Procedural results will be archived alongside image series downloaded directly from the ablation target to the University of Bern's Artorg Centre, responsible for volumetric and precision data analysis in the research. All medical care of swedish patients will be administered at Danderyd Hospital in Stockholm Sweden.
Source link: https://clinicaltrials.gov/ct2/show/NCT02642185
The investigators want to know if a test will help determine if the ablation was successful. However, cancer cells may begin to grow in or near the treated region. The CT scan cannot tell us whether the cells are new cancer cells or healthy liver cells that are simply different because of the ablation.
Source link: https://clinicaltrials.gov/ct2/show/NCT01494324
Exercise training can be a potent modulator of immune function, systemic inflammation, and the neuroendocrine system, according to a possibility that perioperative exercise training can improve surgical stress response during and after surgery. The application of surgical oncology requires several factors, including preliminary results on treatment efficacy, but methodological robust trials investigating the safety and tolerability of perioperative exercise training are arguably the single most important consideration for the application perioperative exercise, as well as preliminary results on treatment efficacy are required. The primary trial aim and hypothesis are: To compare the effects of standard care and postoperative exercise vs. standard care alone on the incidence of postoperative complications in patients with CRLMundergoing surgery. In EX vs. CON, the key secondary research objectives and hypotheses are: To determine whether postoperative hospital admissions in patients with CRLM undergoing surgery are non-inferior. CONCEPT Hypotheses We hypothesize that the incidence of postoperative hospital admissions in patients with CRLM undergoing surgery is non-inferior. CONCEPT We hypothesize that the incidence of postoperative hospital admissions in patients with CRLM undergoing surgery is non-In EX versus CON In EX vs. CON, we hypothesize that the incidence of postoperative hospital admissions are non-inferior, while EX vs. CON is a measure of relative dose intensity of adjuvant chemotherapy and time from surgery to the introduction of adjuvant chemotherapy in patients with CRLM under surgery. To compare the effect of EX vs. CON on selected patient-reported symptomatic adverse events in patients with CRLM undergoing surgery. To determine the effect of EX vs. CON on surgical stress responses in patients with CRLM undergoing surgery.
Source link: https://clinicaltrials.gov/ct2/show/NCT04751773
This research is being done to learn more about the health of life factors in people undergoing colorectal liver metastasis surgery. The findings from this research will help the investigators determine the long-term effects that cancer therapy treatments have on patients's health and quality of life. This report will help us to see cancer therapy from the patient's perspective. After the procedure, it will also help cancer patients make informed decisions about their health and wellness, as well as assisting them in making the right decision.
Source link: https://clinicaltrials.gov/ct2/show/NCT02399995
Yttrium-DOTATOC is a radioactive compound used for peptide receptor radionuclide therapy. Patients with neuroendocrine tumors whose disease has spread to their tumor should be able to safely receive the drug 90Y-DOTATOC directly to the liver, according to this review. We want to know what the maximum safe dose is and what the side effects are related to that dose.
Source link: https://clinicaltrials.gov/ct2/show/NCT03724409
This clinical trial was designed to find out more about the side effects of immunotherapy with a form of radiation therapy for liver cancer called Yttrium-90 RadioEmbolization. Investigators are looking at which doses of durvalumab are safe for people in combination with this type of radiation therapy. The number of doses of the immunotherapy drug will vary according to the cohort patients.
Source link: https://clinicaltrials.gov/ct2/show/NCT04108481
During initial metastases, colorectal cancer, the second leading cause of cancer deaths, has a pattern of attacking the liver. The Comprehensive Genomic Profiling of Colorectal Cancer Patients with Isolated Liver Metastases to Learn Response and Resistance to Cancer Therapy aims to determine the disease course of CRC by collecting primary tumor and metastatic liver specimens following pre-operative chemotherapy.
Source link: https://clinicaltrials.gov/ct2/show/NCT03364621
The only curative treatment method, according to the survey, only 20% of patients are candidates for liver transplantation. In most studies, the 5-year survival rate after liver transplant for LM is around 40%, relative to ten-20% for chemotherapy alone. Most centers have liver transplantation, but recent reports of LT for colorectal LM from a single center in Oslo, Norway, showed a 5-year survival of 56%. The investigators are unable to use decease donor grafts for this research due to a shortage of deceased donor grafts for the investigators' current transplant patients. This research will offer live donor liver transplantation to select patients with unresectable metastases that are 1 limited to the liver and 2 stable non-progressing on standard chemotherapy.
Source link: https://clinicaltrials.gov/ct2/show/NCT02864485
Although the clinical evidence for radiation therapy and immunotherapy is more limited, numerous case reports, retrospective studies, early stage studies, and ongoing prospective trials show the benefits of merging radiation therapy and immunotherapy in improving the anti-tumor response.
Source link: https://clinicaltrials.gov/ct2/show/NCT04923776
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