Participants with locally advanced potentially resectable esophageal, gastric, or pancreatic cancer receiving neoadjuvant/perioperative treatment will undergo serial blood sampling for plasma isolation and circulating tumor DNA (ctDNA) analysis. Samples will be collected prior to initiation of neoadjuvant therapy, at the time of surgery, and subsequently at approximately 3-month intervals for 1-2 years after surgery or until disease progression. ctDNA analyses will be performed using a targeted next-generation sequencing (NGS) approach to evaluate longitudinal changes in tumor-specific genomic alterations and their association with treatment response and disease recurrence.

Sequencing of the primary tumor will be performed on a MiSeq instrument using the Accel-Amplicon panel, which covers the most common mutations. For deep sequencing of ctDNA, 2-3 genomic regions carrying mutations in the primary tumor will be selected for the patient. For these regions, sets of universal primers will be designed to amplify the mutations most commonly found in solid tumors (RAS, BRAF, TP53, EGFR, APC, etc.). Another set of universal primers will contain a sequence for indexing individual samples, enabling the parallel sequencing of up to 96 samples simultaneously. The sequencing library will be analyzed on a NextSeq 500 instrument, which allows for up to 400 million reads in a single sequencing run. The sequencing results will then be correlated with the clinical course of the disease.

NGS sequencing of mutations selected based on sequencing of primary tumors

Participants with esophageal, gastric, or pancreatic cancer receiving first-line palliative systemic therapy will undergo serial blood sampling for plasma isolation and ctDNA analysis. Samples will be collected prior to initiation of systemic treatment and subsequently at approximately 3-month intervals during first-line therapy. ctDNA analyses will be performed using the same targeted NGS methodology to assess longitudinal changes in tumor-specific genomic alterations during systemic treatment.

Participants who received and used the Nutrition in Cirrhosis guide

Patients in the intervention group received a paper copy of the Nutrition in Cirrhosis guide and were instructed to read and use it over the 6 months study period. The Nutrition in Cirrhosis guide consists 7 chapters, namely:

Chapter 1: Malnutrition - What is it and why is it so important?; Chapter 2: What should patients eat and what to avoid?; Chapter 3: Tips for when patients do not feel like eating; Chapter 4: Recipe list; Chapter 5: Using meal supplements; Chapter 6: Managing weight loss and cirrhosis; Chapter 7: What to expect in the hospital.

Nutrition in Cirrhosis guide

Participants who received standard of care

Centre hospitalier de l'Université de Montréal (CHUM)

Intrinsic subtype of primary breast tissue from metastatic breast cancer subject will be determined

Primary breast tissue will be sent for Nanostring PAM50 Testing to determine intrinsic subtype

Intrinsic Subtyping of Primary Breast Cancer

UNC Lineberger Comprehensive Cancer Center

Erin Kelly, MPH, RD, LDN

Terri Eubanks

Lisa A Carey, MD

Terri A Eubanks

JoEllen Speca

Providers in this arm will have access to the CirrhosisRx CDS system, which aggregates and organizes clinical data, presents them in clinically relevant/intuitive fashion for cirrhosis care, and linked to order sets consistent with national guidelines.

CirrhosisRx is a cirrhosis-specific CDS that organizes clinical data into clinically relevant groupings and links them to order sets consistent with national practice guidelines for inpatient cirrhosis care.

CirrhosisRx CDS

Providers in this arm will not have access to the CirrhosisRx CDS system.

Jin Ge, MD, MBA

Patients with ipsilateral axillary lymph node-negative disease, regardless of metastatic status (Stages T1-4 N0 M0-1)

Radiation with 26Gy to the whole breast and 40Gy simultaneous integrated boost to gross disease in the breast, in five fractions

Whole breast radiation with simultaneous integrated boost (WB-SIB) to primary breast tumor

Patients with ipsilateral axillary node-positive disease, regardless of metastatic status (Stages T1-4 N1-2 M0-1)

Radiation with 26Gy to the whole breast and regional nodes with a 40Gy simultaneous integrated boost to gross disease in breast and ipsilateral axillary nodal areas, in five fractions

Whole breast radiation with simultaneous integrated boost (WB-SIB) to primary breast tumor and ipsilateral axillary lymph nodes

Cancer Clinical Trials Office

Alexander Stessin, MD PhD

For patients positive for driver gene mutations, first-line targeted therapy with or without chemotherapy is recommended according to NCCN guidelines. For patients negative for driver gene mutations, first-line immunotherapy combined with chemotherapy is recommended according to NCCN guidelines.

For patients positive for driver gene mutations, first-line targeted therapy with or without chemotherapy is recommended according to NCCN guidelines. For patients negative for driver gene mutations, first-line immunotherapy combined with chemotherapy is recommended according to NCCN guidelines. Concurrent radiotherapy for the primary tumor in combination with drug therapy.

The experimental group received radical radiotherapy for the primary lung lesion in combination with first-line drug therapy recommended by the NCCN guidelines.

Three-Dimensional Radiotherapy for Primary lungTumors

Oncolytic Virus: Administered via intratumoral (metastatic lesions in the neck or supraclavicular lymph nodes) injection once every 3 weeks, for a total of two doses, or until disease progression, the occurrence of unacceptable toxicity, or death from any cause, whichever occurs first.Chemotherapy + Immune Checkpoint Inhibitor (ICI): Administered via intravenous infusion once every 3 weeks.

Oncolytic Virus: Administered via intratumoral injection(metastatic lesions in the neck or supraclavicular lymph nodes) once every 3 weeks, for a total of two to four doses, or until disease progression, the occurrence of unacceptable toxicity, or death from any cause, whichever occurs first. Chemotherapy + Immune Checkpoint Inhibitor (ICI): Administered via intravenous infusion once every 3 weeks.

Oncolytic Virus: Administered via intratumoral injection (metastatic lesions in the neck or supraclavicular lymph nodes) once every 3 weeks, for a total of two to four doses.

Oncolytic Virus: Administered via intratumoral (primary lesion of ESCC) injection once every 3 weeks, for a total of two doses, or until disease progression, the occurrence of unacceptable toxicity, or death from any cause, whichever occurs first.Chemotherapy + Immune Checkpoint Inhibitor (ICI): Administered via intravenous infusion once every 3 weeks.

Oncolytic Virus: Administered via intratumoral injection (primary lesions) once every 3 weeks, for a total of two to four doses, , or until disease progression, the occurrence of unacceptable toxicity, or death from any cause, whichever occurs first. Chemotherapy + Immune Checkpoint Inhibitor (ICI): Administered via intravenous infusion once every 3 weeks.

Oncolytic Virus: Administered via intratumoral injection (primary lesions) once every 3 weeks, for a total of two to four doses.

Zhenyu Ding, MD

Participants received a structured physiotherapy program in addition to conventional treatment for 12 weeks. The intervention consisted of supervised sessions three times per week, with each 50-minute session including general stretching, specific pelvic stretching (Billig protocol), moderate-intensity aerobic jogging, Kegel exercises, and progressive muscle relaxation. The program was designed to reduce dysmenorrhea symptoms and improve health-related quality of life.

Participants received a supervised structured physiotherapy program three times per week for 12 weeks in addition to conventional treatment. Each 50-minute session consisted of five components: general stretching, specific pelvic stretching (Billig protocol), moderate-intensity aerobic jogging (60-70% of age-predicted maximum heart rate), Kegel exercises, and progressive muscle relaxation. The intervention was designed to reduce the severity of primary dysmenorrhea and improve health-related quality of life.

Structured Physiotherapy Program

Participants received conventional treatment for primary dysmenorrhea according to routine clinical practice for 12 weeks. They continued their usual daily activities and did not participate in the structured physiotherapy program. This arm served as the active comparator to evaluate the effectiveness of the structured physiotherapy intervention.

Participants received conventional medical treatment for primary dysmenorrhea according to routine clinical practice throughout the 12-week study period. Conventional management included the use of standard analgesic or nonsteroidal anti-inflammatory medications as prescribed by the treating physician. Participants continued their usual daily activities and did not receive the structured physiotherapy intervention.

Conventional Treatment for Primary Dysmenorrhea

Muhammad Nawaz Sharif University of Agriculture Multan

The study was restricted to self-identified female participants because primary dysmenorrhea occurs in menstruating females. Only female Doctor of Physical Therapy students meeting the eligibility criteria were enrolled.

The recurrent, progressive, or refractory primary malignant non-brainstem CNS tumor patients will be treated with APX005M.

APX005M dosing will begin at 0.1 mg/kg, the APX005M dose may be increased (0.3, 0.45, 0.6 mg/kg) or decreased (0.03 mg/kg) in subsequent cohorts until the maximum tolerated dose (MTD) is reached or until dose level 3 (0.6 mg/kg) is complete without the MTD being defined.

APX005M will be administered at the assigned dose level every 21 days (3 weeks). Patients may continue to receive APX005M for 36 courses (approximately 2 years) or until disease progression, unacceptable toxicity or death, whichever occurs first.

APX005M treatment for recurrent or refractory primary malignant CNS tumor patients

The newly diagnosed diffuse intrinsic pontine gliomas (DIPGs) patients will be treated with APX005M.

The starting dose of APX005M for the DIPG patients will be one dose level below the recommended phase II dose (RP2D) determined in Stratum 1 patients. The dose may be decreased or increased to the RP2D established in Stratum 1.

APX005M will be administered at the assigned dose level every 21 days (3 weeks). Patients may continue to receive APX005M for 36 courses (approximately 2 years) or until disease progression, unacceptable toxicity or death, whichever occurs first.

원발성 종양의 시퀀싱 결과를 기반으로 선택된 돌연변이에 대한 NGS 시퀀싱

간경변증의 영양 가이드

원발성 유방암의 내재적 아형 분류

간경변증Rx CDS

원발성 유방 종양에 대한 동시 통합 부스트(WB-SIB)를 포함한 전체 유방 방사선 치료, 원발성 유방 종양 및 동측 겨드랑이 림프절에 대한 동시 통합 부스트(WB-SIB)를 포함한 전체 유방 방사선 치료

원발성 폐종양에 대한 3차원 방사선 치료

용종용해성 바이러스: 3주에 한 번씩 종양 내 주사(목이나 쇄골 위 림프절의 전이성 병변)를 통해 총 2~4회 투여합니다. 용종용해성 바이러스: 3주에 한 번씩 종양 내 주사(원발성 병변)를 통해 총 2~4회 투여합니다.

구조화된 물리치료 프로그램, 원발성 월경통에 대한 기존 치료법

재발성 또는 불응성 원발성 악성 중추신경계 종양 환자에 대한 APX005M 치료, 새로 진단된 DIPG 환자에 대한 APX005M 치료