@article{7f40d0c931f24a7fa3ec5d0e7bad53ed,
title = "Small Bowel Adenocarcinoma",
abstract = "Small bowel adenocarcinoma is a clinically and anatomically distinct gastrointestinal cancer that lacks prospective data to support its optimal management. Patients with inflammatory bowel disease and inherited conditions that cause gastrointestinal polyps are at especially high risk. Due to a lack of effective surveillance programs resulting in missed or delayed diagnoses only when symptoms develop, this disease is generally discovered at an advanced stage. Surgical resection is the only treatment modality with a chance of cure. Currently accepted treatment considerations are often generalized from large bowel and pancreatic-biliary cancers, due to some anatomic and clinical parallels. Additional research, however, is desperately needed to characterize the unique molecular differences of this disease to better prognosticate patients and establish rational clinical trials that would improve their outcomes.",
keywords = "small bowel adenocarcinoma, small bowel cancer, small bowel malignancies, small intestinal adenocarcinoma, small intestinal cancer",
author = "Chen, {Emerson Y.} and Vaccaro, {Gina M.}",
note = "Funding Information: With regard to palliative chemotherapy, NCT00433550 is a phase II open-label, multicenter, dose-escalating study sponsored by the National Cancer Institute to optimize dosing, based on UGT1A1 genotype, using triple combination with capecitabine, oxaliplatin, and irinotecan for metastatic or unresectable SBA. Nab-paclitaxel is also being explored in SBA (NCT01730586). In addition, biologic therapy is being studied with traditional chemotherapy. NCT01202409 is a phase II, open-label, single-arm, prospective study at the MD Anderson Cancer Center that has enrolled KRAS wild-type patients with advanced small bowel or ampullary adenocarcinoma to undergo palliative chemotherapy with capecitabine, oxaliplatin, and panitumumab. Similarly, NCT01208103 is a phase II study at the same location that has enrolled patients with metastatic small bowel or ampullary adenocarcinoma to under undergo palliative chemotherapy with capecitabine, oxaliplatin, and bevacizumab. Furthermore, erlotinib is being studied in duodenal adenocarcinoma (NCT00987766), but its limited efficacy in pancreatic cancer likely has precluded continual efforts to apply the drug to SBA. Immunotherapy has not yet been evaluated in SBA, but upcoming treatment trials will be underway (NCT02949219, NCT03000179, and Publisher Copyright: {\textcopyright} 2018 by Thieme Medical Publishers, Inc.",
year = "2018",
doi = "10.1055/s-0038-1660482",
language = "English (US)",
volume = "31",
pages = "267--277",
journal = "Clinics in Colon and Rectal Surgery",
issn = "1531-0043",
publisher = "Thieme Medical Publishers",
number = "5",
}