CAR T-cells target gastric cancers expressing CLDN18.2 

Claudin18.2 (CLDN18.2)-redirected CAR T cell therapy is showing promise against advanced GI cancers and particularly in gastric cancer.

In interim results from a phase 1 clinical trial, all 37 patients with diagnoses including gastric cancer, gastroesophageal junction cancer and pancreatic cancer experienced expected transient Grade 3 or higher haematologic toxicities mainly related to the preconditioning regimens.

Most patients (94.6%) also experienced grade 1 or 2 cytokine release syndrome but no grade 3 or higher CRS or neurotoxicities, treatment-related deaths or dose-limiting toxicities were reported.

The overall response rate (ORR) and disease control rate (DCR) reached 48.6% and 73.0%, respectively but higher in gastric cancer patients (57.1% and 75%).

Read more in Nature Medicine

Poor symptom awareness may impact GI cancer diagnoses

Increased awareness of pancreatic and oesophagogastric (OG) cancer symptoms could lead to more urgent investigations and earlier diagnoses, Australian researchers say.

A review of 27 surveys and 13 interviews revealed patients had little cognisance of pancreatic or OG cancer symptoms prior to diagnosis.

This led patients to normalise, dismiss or misattribute symptoms, such as fatigue or unusual tiredness, stomach pain, unexplained weight loss and a general feeling of being unwell.

“Pancreatic and OG cancer symptoms are often subtle and did not cause alarm” — leading some patients to self-manage symptoms and/or delay help-seeking until they got worse or had jaundice, the authors wrote in the European Journal of Cancer Care.

“Competing priorities, beliefs about illnesses and difficulties accessing healthcare delayed help-seeking,” they added.

When patients did seek help, some reported being dismissed by their GP and while some pushed for further investigation, others “trusted and followed their long-term GP’s guidance”.

While more research is needed to identify modifiable patient and relationship factors that could reduce diagnostic delays, the authors saw some evidence that patient assertiveness and health literacy may play important roles in timely identification.

Further, “increased awareness of insidious pancreatic and [OG] cancer symptoms in patients and general practitioners may prompt more urgent investigations and lead to earlier diagnosis,” they concluded.

Rethink diagnostic imaging to cut carbon footprint

Clinicians can help reduce the healthcare carbon footprint by adopting a three-pronged strategy to make more efficient use diagnostic imaging, according to Australian researchers.

Diagnostic imaging and pathology testing account for almost 10% of the hospital carbon footprint, with MRI and CT scans accounting for a high proportion of it, a Melbourne University study found.

The carbon emissions from an MRI are equivalent to driving a car for 145 km, while a CT scan carbon emission are equal to driving 76 km, the findings in Lancet Regional Health showed.

Much of the large carbon footprint was due to electricity use by scanners, and in particular, their standby power use, said the researchers, who recommended that clinicians and administrators make efforts to reduce unnecessary imaging and/or switch imaging to a lower carbon modality such as X-rays.

Other carbon footprint reduction tips include turning scanners off when they are not required rather than leaving them in standby and ensuring existing scanners have high utilisation rates, they suggested.