araag2/TREC_Precision-Medicine huggingface dataset:
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Difference of Gastric Microbiota in the Process of Correa's Model.

Summary: Helicobater pylori plays an important role in the development of gastric cancer. Eradication therapy can reducing the morbidity of gastric cancer, but can't totally prevent it especially when atrophy and more serious precancerous lesions already happened. Prior studies found the gastric bacterial difference among gastritis, intestinal metaplasia and gastric cancer. However, they didn't reach an agreement. Correa's model is widely accepted in the development of gastric cancer. The pathological change makes a more suitable environment for bacteria to overgrowth. This study are designed to analyze the gastric microbial difference of non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, intraepithelial neoplasia and gastric cancer.


Eligibility: Inclusion Criteria:
  1. Patients go through a gastric endoscopy examination with non-atrophic gastritis, atrophic gastris, intestinal metaplasia, intraepithelial neoplasia and gastric cancer.
  2. Did not take any antibiotics,PPI,probiotics and chinese herbs in the past one month,and took less than one week in the past three months before the gastroscopy examination.
  3. Sign the informed consent.
  Exclusion Criteria:
  1. Had been taken Helicobacter pylori eradication therapy before.
  2. Previous gastrointestinal surgery.
  3. During the pregnancy and lactation period.
  4. With any serious diseases like liver failure,heart failure,renal failure,malignant tumor,alcoholism or any other disease that may effect the result.
  5. With any mental problems.

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Gene Expression Profiling in Human Gastric Intestinal Metaplasia Mucosa and Duodenal Mucosa

Summary: To analyze the genome pattern in human gastric Intestinal Metaplasia Mucosa and duodenal Mucosa.


Eligibility: Inclusion Criteria:
  -  Patients scheduled for gastroendoscopy examination
  Exclusion Criteria:
  -  Esophageal, gastric or duodenal cancer or other malignancy History of upper GI tract surgery Coagulopathy or bleeding disorders Allergy to fluorescein sodium

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Glycans Bound to Serum Haptoglobin: a Novel Gastric Cancer Tumor Biomarker

Summary: The purpose of this study is to evaluate sensitivity and specificity of newly defined tumor biomarker with gastric cancer pts and cancer-free healthy volunteers.

Detailed description: Measurements of specific glycosylation changes in serum haptoglobin.

Eligibility: Arm1 (Gastric cancer patient)
  1. Inclusion Criteria:
  -  Male or female over 19 years
  -  Patients with histologically Gastric Cancer (included Gastroesphageal junction)
  -  Primary gastric cancer or/and metastatic gastric cancer.
  -  Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted
  2. Exclusion Criteria:
  -  Prior or present history of malignancies other than gastric cancer
  -  Any condition that confounds the ability to interpret data from the study under the investigational confirmed.
  Arm2 (Cancer-free healthy volunteers)
  1. Inclusion Criteria:
  -  Male or female over 19 years
  -  Cancer-free status.
  -  Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted
  2. Exclusion Criteria:
  -  Prior or present history of malignancies (included gastric cancer)
  -  Any condition that confounds the ability to interpret data from the study under the investigational confirmed

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Metronomic Chemotherapy in Advanced Gastric Cancer

Summary: phase II study of weekly metronomic chemotherapy using weekly Paclitaxel, Oxaliplatin, Leucovorin and 5-FU (POLF) in patients with advanced gastric cancer

Detailed description: About 80% of patients with advanced gastric cancer are diagnosed at an advanced stage with limited treatment options including systemic chemotherapy with or without radiation. Commonly used maximally tolerated dose (MTD) chemotherapy such as DCT, ECF, FOLFOX regimens induce responses in the range of 20 to 50% with median survival in the range of 10 to 12 months. Metronomic chemotherapy has been found to have more consistent anti-tumor effects through anti-angiogenic and immunomodulating effects. Preliminary clinical studies of weekly POLF have found very encouraging clinical activities and low overall toxicities in pancreatic cancer and gastric cancer. Here we conduct a formal clinical trial to determine the clinical efficacy and side effect profiles of this regimen in patients with advanced gastric cancer.

Eligibility: Inclusion Criteria:
  1. pathologically confirmed gastric cancer AJCC stage III or IV
  2. measurable disease based on CT or endoscopy exam
  3. non-surgical candidates or patients who declined surgery
  4. non-radiation candidates or patients who declined radiation
  5. patients who are able to sign informed consent
  6. patients who are 2 weeks out and recovered from surgery
  7. patients who have completed radiation to relieve obstructive symptoms
  8. patient who previously received Oxaliplatin and 5-FU in other MTD regimens
  9. adequate marrow function: neutrophil >1000/ul, Hgb >10g/dl, Plt>50,000
  Exclusion Criteria:
  1. allergic to any of the drugs involved
  2. concurrent malignancies
  3. severe co-morbidities of heart, lungs, kidneys and bone marrow
  4. severe psychological disorder
  5. severe malnutrition
  6. difficult to heal or unhealed wound
  7. ECOG performance status equal or over 3
  8. uncontrolled complications from the malignancy
  9. uncontrolled CNS metastasis
  10. peripheral neuropathy grade 3 or above
  11. pregnancy or breast feeding

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Efficacy Study of Nivolumab Plus Ipilimumab or Nivolumab Plus Chemotherapy Against Chemotherapy in Stomach Cancer or Stomach/Esophagus Junction Cancer

Summary: The main purpose of this study is to compare how long patients with gastric or gastroesophageal junction cancer live after receiving nivolumab and ipilimumab or nivolumab and chemotherapy compared with patients receiving chemotherapy alone.


Eligibility: For more information regarding Bristol-Myers Squibb Clinical Trial participation, please visit www.BMSStudyConnect.com
  Inclusion Criteria:
  -  Male or Female at least 18 years of age
  -  Must have gastric cancer or gastroesophageal junction cancer that cannot be operated on and that is advanced or has spread out
  -  Did not receive neoadjuvant or adjuvant treatment (chemotherapy, radiotherapy, or both) for their disease within the last 6 months
  -  Must have full activity or, if limited, must be able to walk and carry out light activities such as light house work or office work
  -  Must agree to provide tumor tissue sample, either from a previous surgery or biopsy within 6 months or fresh, prior to the start of treatment in this study
  Exclusion Criteria:
  -  Presence of tumor cells in the brain or spinal cord that have not been treated
  -  Active known or suspected autoimmune disease
  -  Any serious or uncontrolled medical disorder or active infection
  -  Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
  -  Any positive test result for hepatitis B or C indicating acute or chronic infection
  Other protocol defined inclusion/exclusion criteria could apply

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Comparison of Mini Gastric Bypass and Roux-en-Y Gastric Bypass

Summary: This study compares Roux-en-Y gastric bypass with single anastomosis gastric bypass in a randomized prospective setting. This study also adresses the issue of bile reflux after MGB.

Detailed description: Roux-en-Y gastric bypass (RYGB) and single anastomosis gastric bypass (SAGB or mini gastric bypass, MGB) have both shown excellent weight-loss and effect on comorbidities such as type 2 diabetes.
  In this study eligible patients are randomized for either of the operations. Effects on glucose homeostasis as well as weight-loss and the effect on comorbidities are recorded during the follow-up. Interim analysies will be done for the first 60 patients (30 per group) after the first month and at 6 months. In the first interim analysis perioperative outcomes and continuos glucose monitoring will be analyzed. In the second interim analysis nutritional deficiencies and early complications as well as early weight-loss data will be analyzed.
  At 12 months, all outcomes for all patients will be analyzed. Follow-up continues at 24months, 4years, 7years and 10 years after the surgery and follow-up data will be analyzed accordingly.
  Also, MGB has been feared to cause bile reflux. The first 30 MGB patients will undergo a gastroscopy and a hepatobiliary scintigraphy for bile reflux detection at 6 months.

Eligibility: Inclusion Criteria:
  -  BMI>35
  Exclusion Criteria:
  -  Pregnancy
  -  Previous bariatric surgery
  -  Anemia
  -  esophagitis (LA B-D)
  -  esophageal intestinal metaplasia

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: NBI for Identifying Resection Margin Status in Gastric Cancer

Summary: As the proportion of early gastric cancer has been steadily increased in Korea, so has function-preserving surgery. The function preserving surgery is characterized by the minimized extent of gastrectomy, so this implies that bilateral margins are getting shorter than those of standard gastrectomies.
  Currently, there is only one way to identify resection margin status in gastric cancer, 'frozen biopsy'. However, it is labor-intensive and time-consuming procedure. In addition, the results rely on the pathologist's expertise, thereby it showed limitation of its accuracy; high false negative rate of signet ring cell carcinoma was reported in a previous study.
  Recently, many studies on magnifying endoscopy with narrow band imaging(NBI) demonstrated that this emerging technique is useful to identify the gastric tumor margin more clearly in vivo, compared with conventional indigocarmine chromoendoscopy. So it was hypothesized that NBI may allow reliable delineation of tumor and identification of resection margin status in the specimen after gastrectomy for gastric cancer.

Detailed description: 1. Tumor delineation and identification of resection margin:
  After specimen delivery from the abdomen, frozen biopsy is performed before checking tumor margin. After inspection with NBI, the tumor margin is marked with electrocauterization. The tumor size and the lengths of both resection margins are evaluated using a ruler.
  2. Pathologic examination:
  The specimen is sliced as 4mm interval paralleled to the markings. Tumor size, the status of both resection margins, and microvessel density are evaluated under the 200 magnified view.

Eligibility: Inclusion Criteria:
  -  The patient from over 20 to under 90 years
  -  The patient who is diagnosed as gastric cancer clinically by endoscopy or computed tomography
  -  The patient who is informed and consent about the purpose and contents of this study prior to the participation in this study
  Exclusion Criteria:
  -  The patient who shows far advanced gastric cancer preoperatively or intraoperatively
  -  The patient with previous medical history of other treatment for gastric caner such as endoscopic resection, chemotherapy, radiation, immunotherapy, and so on

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Association Between Mitochondrial DNA Content and Risk of Gastric Cancer

Summary: Compelling epidemiological evidence indicates that alterations of mitochondrial DNA, including mutations and abnormal content of mitochondrial DNA (mtDNA), are associated with the initiation and development of gastric cancer.The aim of this study was to explore association between mtDNA content in peripheral blood cells could be used as a risk predictor for gastric cancer.


Eligibility: Inclusion Criteria:
  -  1.histological confirmed gastric adenocarcinoma; 2.receiving surgical resection; 3.no preoperative anticancer treatment; 4.alive at least 1 months after surgery.
  Exclusion Criteria:
  -  1.history of other malignancy; 2.blood transfusion within one month or prior bone marrow transplantation; 3.patients who reluctant to sign informed consent.

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Perioperative Chemotherapy Combined With HIPEC for High-risk Advanced Gastric Cancer

Summary: The investigators intend to conduct a randomized controlled study to find if combining HIPEC (hyperthermic intraperitoneal perfusion chemotherapy) with post-neoadjuvant chemotherapy D2 resection could improve survival for patients with advanced gastric cancer, while comparing with the traditional approach of D2 resection after neoadjuvant chemotherapy.

Detailed description: Gastric cancer, as the second common malignant tumors in china, is marked by its poor prognosis and high recurrent rate. Although R0 resection could be achieved in most advanced gastric cancer(AGC) patients without metastasis, age-standardized 5-years survival rate was no more than 27.4%. Peritoneal metastasis accounts for 50% of the recurrent case and remain to be the most fatal recurrence pattern.
  Hyperthermic intraperitoneal perfusion chemotherapy ( HIPEC ), has been proved as one of the most efficient approach against peritoneal carcinomatosis from gastric cancer and recommended in the guideline for gastric cancer published by the health committee of china. However, its role as prophylactic treatment after curative has never been determined. HIPEC works by delivering heat and cytotoxic drug to the cancer cell and is more effective on the tumor with small size. As present study suggest that Peritoneal metastasis is related to lymph node dissection during surgery while opening lymphatic channels and spreading viable cancer cells into the peritoneal cavity, HIPEC might be a reasonable approach to destroy the remaining cancer cells after curative surgery. Thus this research aim to explore the efficacy and safety of combining HIPEC (hyperthermic intraperitoneal perfusion chemotherapy) with post-neoadjuvant chemotherapy D2 resection.

Eligibility: Inclusion Criteria:
  1. First diagnosed as gastric cancer by pathological examination;
  2. No previous chemotherapy or radiotherapy;
  3. T stage:3-4, N stage: 1-3, M stage: 0, assessed by CT or ultrasound endoscope;
  4. Eastern Cooperative Oncology Group performance status (ECOG PS): 0-1;
  5. Informed consent signed;
  Exclusion Criteria:
  1. Other malignancy within 5 years.
  2. Peritoneal metastasis detected during surgery.
  3. Pregnant or lactating women;
  4. Patients with conditions requiring emergency surgery;
  5. Tumor progress during neo-adjuvant chemotherapy
  6. Severe, uncontrolled physical or metal disease.
  7. Poor compliance.
  8. Uncontrolled infection

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Treatment Strategy for Stage IV Gastric Cancer With Positive Peritoneal Cytology as the Only Non-curable Factor

Summary: Gastric cancer with positive is defined as stage IV disease in 7th AJCC/UICC TNM staging system. Controversy exists on the treatment of this part of patients. This trial aimed to explore the optimal treatment strategy for stage IV gastric cancer with positive peritoneal cytology as the only non-curable factor.

Detailed description: In the 7th AJCC/UICC TNM staging system, gastric cancer with positive peritoneal cytology (CY+) is defined as stage IV disease. In NCCN clinical practice guidelines, it is suggested that positive peritoneal cytology in the absence of visible peritoneal implants should be considered as M1 disease and surgery as initial treatment is not recommended for patients with positive peritoneal cytology. However, in the Japanese gastric cancer treatment guidelines 2014, it is suggested that standard gastrectomy can be proposed for patients with no other non-curative factors and if the CY+ status was revealed after surgery, postoperative treatment with S-1 can be recommended as the tentative standard. Previous studies have also proved that extensive intraperitoneal lavage(EIPL) and Hyperthermic Intraperitoneal Chemotherapy(HIPEC) are effective methods for the treatment of peritoneal metastasis.
  In order to optimize the treatment strategy of this part of patients, this trial is designed to compare the effectiveness of 2 treatment strategies.

Eligibility: Inclusion Criteria:
  -  Pathologically diagnosed gastric adenocarcinoma with endoscopic biopsy;
  -  Pretreatment clinical stage with computed tomography and/or endoscopic ultrasonography;
  -  Clinical stage cT2-4 N0-3 M0;
  -  Standard gastrectomy with D2 lymphadenectomy is needed according to the clinicians' evaluation;
  -  ECOG performance score ≤2, with tolerance of standard gastrectomy and D2 lymphadenectomy;
  -  Positive peritoneal cytology;
  -  Signed informed consent.
  Exclusion Criteria:
  -  Remnant gastric cancer, recurrence gastric cancer or multi-primary cancers;
  -  Intraoperative identified other unresectable factors including other metastasis except positive peritoneal cytology;
  -  Postoperative pathologically diagnosed as non adenocarcinoma;
  -  Pregnant or lactate women;
  -  Child-bearing period adults who refuse to birth control during the trial;
  -  Uncontrolled epilepsy, CNS disease or mental disorder that may influence the compliance of the patient;
  -  Severe/active heart disease, including but not limited to acute coronary syndrome, congestive heart failure with less than NYHA II cardiac function, severe arrhythmia that needs drug control, cardiac infarction within 12 month;
  -  Organ transplantation patients who needs immune suppression therapy;
  -  Patients who needs emergency surgery because of bleeding, perforation or obstruction.

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: The Efficacy of Surgical Treatment After Neoadjuvant Chemotherapy Plus Intraperitoneal Immunotherapy Versus Chemotherapy Alone for Patients With Positive Wash Cytology Gastric Cancer

Summary: The purpose of this study is to determine whether intraperitoneal immunotherapy (with interleykin-2 - human cytokine reaction activator) with systemic chemotherapy will be more effective than systemic chemotherapy alone in patients with gastric cancer and verified free cancer cells in abdominal cavity in improving the long term outcomes and overall survival of further surgical treatment.


Eligibility: Inclusion Criteria:
  -  ECOG 0-2
  -  Histologically proven gastric cancer T2-3 N+, T4a with any N (0,+) with free cancer cells in the abdominal cavity and no macroscopic canceromathosis and no other distant metastases (TNM classification 7th edition)
  -  Histological forms: gastric adenocarcinoma and signet ring cancer
  -  Blood characteristics (creatinine <150 mg/l, total bilirubin < 50 mkmol/l, neutrophils < 1500/mkl, hemoglobin >90 g/l, thrombocytes > 100000/mkl)
  Exclusion Criteria:
  -  Clinically apparent distant metastasis (besides free cancer cells)
  -  Synchronic or metachronic malignant tumors
  -  Previous systemic or surgical or combined therapy for gastric cancer
  -  Complications of gastric cancer (obstruction 0-1 GOOSS scale and/or gastric bleeding)
  -  Adhesions in abdominal cavity
  -  Gastrooesophageal junction cancer or gastric cancer with spreading on oesophagus.

Relevance to patient case: not relevant
Patient case: 54-year-old male with Gastric cancer. Genetic variant: PIK3CA (E545K). Other conditions: Depression.

Clinical trial: Laparoscopic Versus Open Gastrectomy With Splenic Hilum Lymph Nodes Dissection

Summary: Splenic hilum remains challenging during total gastrectomy with D2 lymphadenectomy.The application of minimally invasive surgery for advanced gastric cancer is gaining popularity. The investigators aim to compare the safety and feasibility of LTG and OTG for advanced proximal gastric cancer.

Detailed description: Total gastrectomy with D2 lymphadenectomy remains the standard surgical therapy for patients with advanced proximal gastric cancer. Although lymph nodes dissection along with the splenic hilum (No.10) is recommended by the Japanese Gastric Cancer Treatment Guidelines, however, complete removal of the No. 10 is technically challenging due to the tortuous splenic vessels and the high possibility of injury to the parenchyma of the spleen and pancreas. Recently, the application of minimally invasive surgery for advanced gastric cancer is gaining popularity. However, laparoscopic total gastrectomy (LTG) with standard D2 lymphadenectomy was still not widely performed, because pancreas- and spleen-preserving splenic hilum lymph node dissection were mainly challenging manipulations for laparoscopic surgeons. Therefore,the investigators aim to investigate the safety and feasibility of LTG with spleen-preserving splenic hilum lymph node dissection for proximal advanced gastric cancer and compare the early results of this procedure with open total gastrectomy (OTG).

Eligibility: Inclusion Criteria:
  1. Primary proximal gastric adenocarcinoma confirmed pathologically by endoscopic biopsy;
  2. cT2-4aN0-3M0 at preoperative evaluation according to American Joint Committee On Cancer (AJCC) Cancer Staging Manual, 7th Edition.
  3. Eastern Cooperative Oncology Group (ECOG): 0 or 1;
  4. American Society of Anesthesiologists （ASA） score: Ⅰto Ⅲ;
  5. Written informed consent.
  Exclusion Criteria:
  1. Pregnant or breast-feeding women;
  2. Severe mental disorder;
  3. Previous upper abdominal surgery (except laparoscopic cholecystectomy);
  4. Previous gastrectomy, endoscopic mucosal resection, or endoscopic submucosal dissection;
  5. Enlarged or bulky regional lymph node diameter larger than 3 cm based on preoperative imaging;
  6. Other malignant disease within the past 5 years;
  7. Previous neoadjuvant chemotherapy or radiotherapy;
  8. Contraindication to general anesthesia (severe cardiac and/or pulmonary disease);
  9. Emergency surgery due to a complication (bleeding, obstruction, or perforation) caused by gastric cancer.

Relevance to patient case: not relevant