Topic: DDW(digestive disease week)2011 Chicago Report

Hi,
Thanks this foundation for providing me the opportunity for attending this conference. I have learned a lot  and next time I will have a better strategy to spend my time between speaker sessions and the poster sessions. I did not have enough time for the poster sessions because I think I can read them later.(I have marked down 20+ of the posters that I want to check out,but I have only time for 2 of them.)
The following is one of the few I have come across that is of interest and relate to CC.(It received DDW poster of distinction award)
Do not worry about the title,I will try my best to explain it in layman's terms.

Title; Prognostic impact of Thymidylate Synthase(TS) Expression in Adjuvant Gemcitabine plus S-1 chemotherapy after surgical resection for Bile Duct cancer.

Authors:Hironori Kobayashi MD and 9 other Md from the dept. of Surgery,Div. of Clinical Medicine Science,Graduate school of Biomedical sciences,Hiroshima University.

Objective:The aim of this study was to investigate whether the TS,DPD, or OPRT expression can predict survival of advanced CC patients treated with gemcitabine(GEM)+S-1(a novel oral 5FU combination including tegafur,which similar to Capecitabine-also a prodrug of 5FU,DPD inhibitor and OPRT inhibitor.

Study Samples included 106 CC patients (stage II,III,IV)who had R0,R1 resection between 1989-2010 at Hiroshima hospital.(single location,not multi-center study)

Conclusion: Low intratumoral TS expression was associated with INCREASE overall survival in CC patients who received adjuvant GEM+S-1 chemotherapy after surgical resection.
TS therefore is a relevant PREDICTIVE MARKER of benefit from adjuvant GEM+S-1 chemotherapy in  resected CC patients.

Following is my thinking about this study:

TS,DPD and OPRT are emzymes that related to the metabolism of the drug 5Fu and thus the effectiveness of the 5FU prodrugs like  capecitabine and the like.

The study indicated if TS marker is high(that is 30% or higher in expression)the 5 year survival rate is 25% as compare to low TS expression is 81% when  CC patients are on the GEM+S-1 chemo treatment.(If that is true, and if my TS marker is high,I will suggest to my oncologist to change Gemcitabine and Xeloda and use a different chemo agent that is different in  chemical structure to Gemzar and 5 FU. Again this is my personal point of view only and it can be wrong in terms of outcome. Remember this  study is the forefront of reseach and not the final phase III   clinical trial or approval of a drug or marker.)

The study also indicated that there is NO significant difference  in overall survival between the high TS group  treated with the GEM+S1   and  NO adjuvant chemo treatment group.
Therefore the TS  marker may be of value in choosing the appropriate chemo treatment before it starts. and it may be of value in future drug development as well.
DPD and OPRT expressions were also mentioned in the study but they did not make any conclusion about them as  potential markers for CC patients.So I presume both of them( the DPD and OPRT inhibitors in the S-1 regimen is not of value  as markers at this point .)
I will also try to find out where and how to get the TS marker test done if available. I appreciate if  our Gavin  can  provide his valuable research skill on this thymidylate synthase marker(TS).Gavin is an important resource  and asset  for information on the internet for this foundation.
I hope this is of interest to you in the research of treating CC .
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

2 (edited by marions Sat, 14 May 2011 17:12:44)

Re: DDW(digestive disease week)2011 Chicago Report

Thank you PCL...for sharing this important information with us. 
For those who don't know: 
Barbara and PCL attended Digestive Week, Chicago.  Thousands of physicians, researchers and academics from around the world this premiere scientific conference in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
Although, we have been trying for years to staff a booth for this event thanks to our Barbara (from New Hampshire) and PCL we finally were able to do so.  We are so grateful to both.
Thanks again,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: DDW(digestive disease week)2011 Chicago Report

Hi PCL,

Many thanks for your post and for sharing your information that you gained fom the conference, it will be of use to many. My thanks also go to you and to Barbara for attending the conference, it is much appreciated indeed. I will do some research into thymidylate synthase markers when I get a bit more time, but I don't have a lot of time right now. Unfortunately my mum had a heart attack and a small stroke 3 weeks ago brought on by a bout of pneumonia and an exacerbation of her COPD. She was in the hospital for 2 weeks and got out last Monday, but she needs a lot of care right now in her home. She is doing so much better now but I need to be with her a lot and am staying at her home each night. So right now my time is pretty limited and indeed that is the reason that I have not been around the site very much these last few weeks. But mum is making a great recovery now, slow steps but they all mount up and I will have more time available soon.

Hopefully I will be back around here a lot more very soon and I will have a look into TS markers when I get the time.

Many thanks once again for your posting and also for attending the conference in Chicago.

My best wishes to you,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: DDW(digestive disease week)2011 Chicago Report

Hi Gavin,

Sorry to her of your mum's problems but glad to hear she is doing better.   She is lucky to have you to support and help her as you do.  You are a wonderful son.  Glad you have had some time to post, as you are missed when you aren't on here.  You are so helpful and supportive to all of us here, too.  Take care Gavin.  Thinking of you and your mum.

Love & Hugs,
Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: DDW(digestive disease week)2011 Chicago Report

Hi Darla,

Thank you for that. Yes mum is doing so much better and is getting a bit stronger each day. It is one small step at a time, but these small steps sure do mount up after a while. And today her physio is coming to measure her prgoress since last week and she has made a lot of gains since then. I'm still staying in mums spare room each night right now but I am getting a bit more time as the days pass so I will be able to post more from now on in. And I missed all of you as well when I wasn't here too. Thanks Darla.

Hugs,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

6 (edited by PCL1029 Thu, 26 May 2011 14:59:17)

Re: DDW(digestive disease week)2011 Chicago Report

Hi,
additional info. related to thymidylate syntase (TS)as a marker for drug effectiveness.
http://www.ncbi.nlm.nih.gov/pubmed/20944490
http://www.ncbi.nlm.nih.gov/pubmed/15309542
http://www.ncbi.nlm.nih.gov/pubmed/14519634
http://www.ncbi.nlm.nih.gov/pubmed/20387074

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: DDW(digestive disease week)2011 Chicago Report

Thanks for these links Percy.

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.