Small Intestinal Carcinoma

P2, N=54, Recruiting, Yale University | Not yet recruiting --> Recruiting

A novel genetically engineered mouse model that mimics gastric-type and intestinal-type adenomas and gastric-type SIAC/EDA is reported. Spatial transcriptomics provided a detailed understanding of cellular differentiation lineages, cancer microenvironment related to SIAC subtypes and driving pathways that may be leveraged to identify new molecular tools for pathologic diagnosis and potential targets for precision cancer therapies.

Prompt recognition, SMARCA4 testing, and referral to specialized centers are essential. Prospective studies are needed to guide therapy and explore targeted approaches in this challenging carcinoma subtype.

P=N/A, N=360, Recruiting, Cedars-Sinai Medical Center | Trial completion date: Jun 2026 --> Mar 2027 | Trial primary completion date: Apr 2026 --> Jan 2027

Based on this he received adjuvant chemotherapy and immunotherapy (carboplatin, pemetrexed and pembrolizumab) and a CT scan performed two months after the small bowel resection demonstrated no evidence of tumour recurrence. He, however, developed chemotherapy-related nausea and vomiting, and with further deterioration was placed on a palliative care pathway and died 3 months after the bowel resection. This case highlights the role of integrating histopathology, immunohistochemistry, and molecular genetics in distinguishing metastatic from primary small intestinal adenocarcinomas.

P1, N=18, Not yet recruiting, Thomas Jefferson University

Strong positive nuclear labelling for thyroid transcription factor-1 of the pulmonary neoplasm and neoplastic cells within the small intestinal lymphatics of the original biopsy were consistent with disseminated primary pulmonary carcinoma (PPC). This is the first report describing disseminated PPC presenting primarily with gastrointestinal signs.

Initial chemotherapy with FOLFOX (oxaliplatin, fluorouracil, and folinic acid) was initiated; however, a microsatellite instability-high (MSI-H) status was identified, and the treatment was promptly switched to pembrolizumab. Additionally, a brief meta-analysis of 10 studies comprising 72 patients with MSI-H/mismatch repair-deficient SBA revealed an objective response rate to immune checkpoint inhibitors of 65.3%. This case highlights the potential of pembrolizumab for the curative resection of an initially unresectable MSI-H SBA.

P2, N=78, Recruiting, Masonic Cancer Center, University of Minnesota | Trial completion date: Jan 2026 --> Jan 2028 | Trial primary completion date: Jan 2026 --> Jan 2027

Although extremely rare, the possibility of isolated duodenal recurrence after surgery for colon cancer exists. With a brief review of the literature, we report here a rare recurrence case of transverse colon cancer which was discovered at 6 years postoperatively and resulted in curative resection.

Encorafenib, cetuximab, and binimetinib are targeted therapies developed for metastatic colorectal cancer with a BRAF V600E mutation. The case highlights the potential use of BRAF V600E targeted therapy in BRAF V600E-mutated duodenal cancer and the importance of molecular profiling in rare cancers. Further research is needed on the effect and safety of targeted therapy for small bowel adenocarcinoma.

Extended, risk-adapted surveillance may be reasonable for small-bowel GISTs, and it may be beneficial to incorporate Ki-67 (≥5%) into site-based risk stratification. These observations remain hypothesis-generating and require validation in larger, multicenter cohorts and prospective studies.