Precision-targeted Appendix Cancer Treatment Options Are One Call Away
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Early Stage, Late Stage, and Metastatic Appendix Cancer Treatment
Options
Powerful Targeted Therapies Designed to Go Beyond the Scope of
Standard Oncology for Attacking the Appendiceal Cancer Cells
The rarity of the disease, its grade, location, or the extent of cancer spread, should not limit options for appendix
cancer patients. At Envita Medical Centers, an integrative Center of Excellence for Precision Oncology, appendiceal
cancer care goes beyond appendectomy, hemicolectomy, other invasive surgeries, and regional or systemic
chemotherapies.
Disclaimer: Individual results will vary. Envita makes no guarantees for outcomes. Each patient case is unique. Please
consult your doctor before making any changes to your medical treatment. Not every patient is a candidate for care or
achieves these results. Treatments used in this case may not all be FDA approved for the treatment of this condition.
Despite experiencing a high-grade cancer which had metastasized to her abdominal cavity, Melissa benefited tremendously from
our proprietary treatments like CIPI™ (Chemo Immuno Precision Injections), GTFC™ (Genetically Targeted Fractionated
Chemotherapy), and personalized immunotherapies. These powerful combination treatments integrate the latest in
conventional medicine with evidence-based natural therapies to precisely target the patient's cancerous cell, without
impacting the rest of their body.
Combining the best of both worlds of medicine and personalizing it to precisely-target each patient's cancer at its
core potentiates responses in patients, many of whom were refractory to care in other specialized cancer centers of
the country. Even when resection is not an option, cancer patients may still aim for lasting outcomes with Envita's
personalized precision oncology treatment plans.
Our advanced personalized precision oncology approach is based on detailed bioinformatics data of each
individual patient, which is crucial for cancer treatment and is especially insightful when dealing with
rare cancers like appendiceal cancer. Its histological diversity can be accurately addressed by
custom-developing treatment protocols for each individual appendiceal cancer patient to potentiate responses
and reduce chances of recurrence or further metastatic spread.
This article covers the following facts about Appendiceal Cancer, including:
How to Overcome the Challenges of Standard Appendiceal Cancer Treatment Options
According to the National
Cancer Institute, appendiceal cancer is very rare but studies show that it is becoming more common and when
cancer of the appendix cannot be removed completely with surgery, the standard treatment is to give patients the same
chemotherapy regimens used to treat colorectal cancer. However, this approach may lead to suboptimal outcomes as
scientific studies indicate
that mutational profiles of appendiceal neoplasms are distinct from CRC (colorectal cancer) and other gastrointestinal
cancers [1].
Appendiceal cancers show considerable heterogeneity with high levels
of drug resistance. proteins (BCRP and MRP1), which highlight the difficulty in treating these tumors and
suggest an individualized approach to treatment [2]. To overcome these challenges and administer individualized
patient-specific treatments for early-stage as well as late-stage appendiceal cancer patients, the specially
trained team at Envita delve deep into not just the molecular characterization but the genomic analysis of each
patient's individual tumors, which is a crucial step, often missed in standard oncology care! Genomic analysis
is a hallmark of personalized precision oncology, which may be a gamechanger, especially when dealing with rare
cancers.
At Envita, every patient gets access to Precision Oncology Options, right at the beginning of
care!
Not every patient gets access to precision oncology treatments in standard cancer centers because the NCCN (National
Comprehensive Cancer Network) guidelines recommend precision oncology, as a follow-up to failed first-line treatments.
This delay in accessing precision care, especially when dealing with a rare cancer, may lead to catastrophic
consequences. The handful of patients who are able to access precision care in standard cancer centers receive a
watered-down version of Envita's detailed precision appendiceal cancer care program.
Envita Precision Algorithm vs. Standard Oncology Precision Testing
Envita Medical Centers
Standard Oncology Precision Testing
RNA Transcriptome Genes
Envita Medical Centers:20,000+
Standard Oncology:Unchecked
SNV/CNV Genes
Envita Medical Centers:452
Standard Oncology:309
Rearrangements/Fusion Genes
Envita Medical Centers:51
Standard Oncology:27
Microsatellite Instability (MSI)
Envita Medical Centers:Checked
Standard Oncology:Checked
Tumor Mutation Burden (TMB)
Envita Medical Centers:Checked
Standard Oncology:Checked
BRCA 1/2
Envita Medical Centers:Checked
Standard Oncology:Checked
Immunohistochemistry
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Chemosensitivity
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Concurrent Liquid Biopsy
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Exosomal miRNA Analysis
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Circulating Tumor Cells Enumeration
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Pharmacogenomics
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Individualized Therapy Recommendation
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Carcinogenic Exposure - Root Causes
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Inflammation Markers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Metabolic Target Drivers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
Latest in Cancer Care With Advanced Personalized Precision Oncology
Being able to access the latest in cancer research enhances the chances of optimal responses, especially when dealing
with rare and life-threatening diseases like adenocarcinomas of the appendix. Recent scientific studies show how epigenetics-based
biomarkers may be the key to a deeper understanding of epithelial appendiceal cancer pathophysiology and aid in
uncovering actionable targets for disease monitoring in appendiceal cancers [3]. Ultimately this could enable
clinicians to prognosticate responses to various therapy approaches, estimate the risk of progression or relapse, and
predict overall survival in their patients, thereby making personalized oncology a reality in managing and treating
appendiceal neoplasms, which is exactly what the Envita team is working towards.
Our physicians utilize this 4-step process to custom-develop a unique medical blueprint for each individual
appendiceal cancer patient aiming to optimize their quality of life, increase longevity, and reduce toxicities and
side effects.
Step 1
Genomic Identification to Address Risk Factors of Disease Growth
Addressing the unique set of risk factors, which contribute to the growth and proliferation of appendiceal cancer in
each individual patient, is crucial to help them sustain lasting outcomes. Envita's in-depth genomic identification is designed to unravel the specific factors
influencing the mutations, which trigger disease growth and spread.
Clinical studies
show how unraveling genetic alterations and involved pathways can direct efforts to design novel therapeutic
modalities [4], and the Envita team is focused on emulating this approach to improve responses. A deeper understanding
of the root causative factors of each patient's appendiceal cancer equips our team to formulate a more comprehensive
protocol.
Step 2
Immuno Targeting to Mitigate Chances of Metastasis or Disease Relapse
Most appendiceal cancer patients are diagnosed incidentally during surgical exploration for appendicitis or late when
peritoneal or systemic dissemination has already occurred. Studies show that the common pathway of all
appendiceal tumors regardless of grade and cell of origin involves invasion of the appendiceal wall, luminal
obstruction, and perforation with subsequent dissemination of malignant epithelial cells throughout the peritoneal
cavity [5]. The peritoneum and regional lymph nodes are the most common
metastatic sites. followed by liver and lung [6].
To mitigate chances of peritoneal metastasis, spread to other distant parts of the body, or disease recurrence, we
utilize advanced immuno targeting through our proprietary liquid biopsies. These biopsies capture the latest mutations
of the cancer by analyzing the Circulating Tumor Cells (CTCs), which break away from a growing tumor and enter the
patient's blood stream. Detailed investigation of these CTCs guides proactive treatment of early signs of micro
metastasis, potentially minimizing chances of peritoneal metastasis, commonly associated with appendiceal cancers.
Peritoneal metastasis, also known as peritoneal carcinomatosis (PC), is a refractory cancer that is typically resistant to
conventional treatment methods such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy
(HIPEC) [7]. Clinical trials of intraperitoneal immunotherapy are underway, and there is hope that it will become a
standard of care for PC in the future, but Envita's proprietary immunotherapies have been formulated to work towards this
end, now!
Step 3
Personalized Drug Design for Debulking Tumors
Patients are not confined to the limited drugs available on the market, as Envita's pharmacy partner
custom-develops adjuvants to target the root causes of each individual patient's appendiceal cancer. Based on
advanced phytotherapeutics, these custom compounded adjuvants can be potentially utilized for debulking tumors
as well.
FDA Approved Drugs
Optimized for your cancer mutations.
Repurposed Drugs
Off-label use of approved medications
Custom Compounded Adjuvants
Genetically typed for each patient.
Appendiceal cancer patients at Envita benefit from our advanced personalized drug design, which includes a
combination of FDA (Food and Drug Administration) approved drugs, repurposed drugs, as well as custom
compounded adjuvants.
The toxic side effects of cancer treatments may sometimes prevent patients from continuing with the treatment plan.
To overcome these challenges of regional or systemic chemotherapies, and radiation therapies, we utilize proprietary
treatments like CIPI™ (Chemo Immuno Precision Injections) and GTFC™ (Genetically Targeted Fractionated Chemotherapy).
CIPI™ (Chemo Immuno Precision Injection)
CIPI™ is our proprietary image guided interventional radiology procedure for deploying personalized anti-cancer
medications at the site of the tumor. This minimally invasive method of tumor chemoembolization has proved beneficial
for many appendiceal cancer patients, as their tumors are often difficult to reach. CIPI™ utilizes a catheter, thinner than a strand of
hair, to reach the tumor site and deactivate it, while utilizing their neoantigens to train the immune system for
identifying cancer cells elsewhere in the body.
Envita's CIPI™ vs. Standard Surgery
Envita Medical Centers
Standard Surgery
Minimally invasive so it can be performed within 40-50 minutes, without the need for large surgical
incisions.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Can be performed multiple times, even at close intervals, because there is minimal risk of post-op
complications.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
No need for general anesthesia, reducing the health risks that can result from being put into a
medically induced coma to perform an invasive surgery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Faster recovery time as compared to traditional surgery, due to the minimally invasive administration.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Provides direct tumor targeting, which delivers patient-specific genomic agents into the tumor.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Causes a systemic immune response where the immune system is reactivated to find and attack other
metastatic cancer sites in the body.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Performed by highly trained medical professionals in an outpatient setting, so there is no need of
hospital stays for recovery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
GTFC™ is our proprietary low-dose, genetically targeted
chemotherapy, administered intravenously. It is formulated to intensify the mechanisms of action against the cancerous
cells, without impacting the surrounding healthy cells. This precision-targeted approach of deploying anti-cancer
medications is one of the many reasons why our patients generally experience negligible side effects while going
through appendiceal cancer treatment, even for late-stage disease.
Envita's GTFC™ vs. Standard Chemotherapy
Envita Medical Centers
Standard Chemotherapy
Helps to improve chemotherapy delivery to the tumor using a "Trojan Horse" delivery mechanism.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses genetic molecular profiling to understand all the facets of each patient's specific cancer.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses targeted treatment to enhance the mechanism of cancer kill.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses microdosed (fractionated) chemotherapies, reducing the chances of impacting healthy cells.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Minimizes toxicity to normal cells, lowering the chance of side-effects related to administration.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses patient-specific supportive immunotherapy to strengthen the immune system.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Aims to reduce multidrug resistance by administering 10 - 20% of the medication delivered in maximum dose
chemo.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Allows custom-compounded medications to be readministered in tandem to suit each patient's individual cancer
mutations.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
Appendix Cancers are divided and sub-divided into various types depending on the cell type where the cancer
originates. The following types of appendix cancers can be low-grade or high-grade, which is also one of the
determinant factors of disease stage:
Appendiceal Neuroendocrine Tumors/ Neuroendocrine Carcinoma/ Carcinoid Tumors: It is one of the most common types
of appendiceal cancer and it starts in the neuroendocrine cells of the appendix.
Appendiceal Adenocarcinoma: These adenocarcinomas of the appendix start in the epithelial cells lining this small
organ attached to the intestine. Appendiceal adenocarcinomas may show signet ring cell carcinoma features, making
them high-grade cancers. They are sub-divided as follows:
Mucinous adenocarcinoma: This type of cancerous cells secrete mucin, a jelly-like substance and is another
common type of appendiceal cancer. Excess mucin may fill the peritoneal cavity, which is the space within the
abdomen that houses various organs like the intestines, leading to a complex condition called pseudomyxoma
peritonei (PMP).
Colonic-type adenocarcinoma: This type of adenocarcinoma starts in the epithelial cells near the base of the
appendix, exhibiting colorectal cancer like characteristics and symptoms.
Goblet Cell Tumors/ Goblet Cell Adenocarcinoma/ Goblet Cell Carcinoma: This rare and aggressive adenocarcinoma of
the appendix impacts the neuroendocrine cells as well as the cells on the epithelial lining of the appendix.
Symptoms of Appendiceal Cancer
Typically, appendiceal cancer patients do not experience any symptoms in the early stages, but in later stages they
may experience some of the following symptoms, when healthcare providers generally order CT scan, other imaging, or
lab tests to confirm malignancy:
Envita's team consists of medical oncologists, interventional radiologists, and other board-certified physicians, who
undergo extensive training surpassing 1,500 hours to harness the potential of this advanced personalized precision
oncology approach. If you or your loved ones have any questions regarding appendiceal cancer or any other types of
cancer, please feel free to reach out to us at: 866-830-4576. May God bless you on your journey to recovery!
References
[1] Ang CS, Shen JP, Hardy-Abeloos CJ, et al. Genomic Landscape of Appendiceal Neoplasms. JCO Precis Oncol.
2018;2:PO.17.00302. Published 2018 Aug 8. doi:10.1200/PO.17.00302
[2] Borazanci E, Millis SZ, Kimbrough J, Doll N, Von Hoff D, Ramanathan RK. Potential actionable targets in
appendiceal cancer detected by immunohistochemistry, fluorescent in situ hybridization, and mutational analysis. J
Gastrointest Oncol. 2017;8(1):164-172. doi:10.21037/jgo.2017.01.14
[3] Ladel L, Tan WY, Jeyakanthan T, Sailo B, Sharma A, Ahuja N. The Promise of Epigenetics Research in the
Treatment of Appendiceal Neoplasms. Cells. 2023;12(15):1962. Published 2023 Jul 29. doi:10.3390/cells12151962
[4] Moaven O, Su J, Jin G, et al. Clinical Implications of Genetic Signatures in Appendiceal Cancer Patients with
Incomplete Cytoreduction/HIPEC. Ann Surg Oncol. 2020;27(13):5016-5023. doi:10.1245/s10434-020-08841-8
[5] Votanopoulos KI, Shen P, Skardal A, Levine EA. Peritoneal Metastases from Appendiceal Cancer. Surg Oncol Clin
N Am. 2018;27(3):551-561. doi:10.1016/j.soc.2018.02.007
[6] Mackel C, Rosenberg H, Varma H, Vega R, Stippler M. Cerebral Metastases in Appendiceal Cancer: Comprehensive
Review and Report of Rare Medullary Carcinoma Histology. Brain Tumor Res Treat. 2022;10(3):200-205.
doi:10.14791/btrt.2022.0019
[7] Ornella MSC, Badrinath N, Kim KA, et al. Immunotherapy for Peritoneal Carcinomatosis: Challenges and
Prospective Outcomes. Cancers (Basel). 2023;15(8):2383. Published 2023 Apr 20. doi:10.3390/cancers15082383
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