Five Sessions to See at Digestive Disease Week 2021

The 2021 Digestive Disease Week® (DDW) is taking place from Friday, May 21 through Sunday, May 23—and for the first time in its 62-year history, will be held as a fully virtual meeting. At DDW, specialists from the Divisions of Gastroenterology and Gastrointestinal & Oncologic Surgery at Massachusetts General Hospital and the Mass General Cancer Center will present on leading research and innovative treatment approaches. Mass General doctors will participate in sessions covering a broad spectrum of gastroenterological care, including pancreatic oncology, inflammatory bowel disease (IBD), colitis and more. Here are five highlights from this year's meeting:

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Motaz Qadan, MD, PhD, and Roi Anteby, MD

Friday, May 21, 5:50 pm | SSAT Quick Shot Session

The Independent Impact of Race, Socioeconomic Status and Education on Completion of Adjuvant Therapy After Upfront Surgical Resection for Pancreatic Cancer

A multimodal approach of surgery and chemotherapy (with or without radiation) is the mainstay of therapy with curative intent for resectable pancreatic ductal adenocarcinoma. However, not all patients receive adjuvant therapy for various reasons including high postoperative morbidity, intolerance of side effects, and limited access and resources for postoperative treatment. This study aimed to compare the utilization trends and expected outcomes of surgery with adjuvant therapy, compared to surgery alone.

Andrew S. Liss, PhD

Sunday, May 23, 2:02 pm | Live Q&A

Stromal Subtypes of Pancreatic Cancer in Patient-Derived Xenograft Models

A dense desmoplastic stroma is a defining characteristic of pancreatic ductal adenocarcinoma (PDAC). This stroma promotes tumor progression and cancer cell invasion. Patient-derived xenograft models have been used to investigate PDAC tumor biology but a systematic characterization of PDAC PDX stroma has not been performed.

Braden Kuo, MD, and Helen Burton Murray, PhD

Sunday, May 23, 5:32 pm | Lecture

Neuropathic Pain Characteristics in Gastroparesis: Loss Of Protective Sensation To Somatic Stimulation Greater In Idiopathic Versus Diabetics

Abdominal pain is a common symptom in gastroparesis. Peripheral and central pain sensitization have been identified as target mechanisms in gastrointestinal pain. However, clinical and sensitization characteristics of gastroparesis-associated pain have not been studied.

Emily Lopes, MD

Saturday, May 22, 10:58 am | Lecture

Neuropathic Pain Characteristics in Gastroparesis: Loss Of Protective Sensation To Somatic Stimulation Greater In Idiopathic Versus Diabetics

Epidemiologic studies have identified several modifiable risk factors for inflammatory bowel diseases (IBD) including Crohn's disease (CD) and ulcerative colitis (UC). Yet, their combined risk and contribution in the population have not been assessed. Here, we estimate the population attributable risk (PAR) of disease-specific modifiable risk scores (MRS).

Molly Thomas, MD, PhD

Friday, May 21 5:46 pm | Lecture

Single-Cell RNA Sequencing Reveals Transcriptional Signatures of Immune and Epithelial Dysregulation that Define Colitis Associated with Immune Checkpoint Inhibitors

Antibodies targeting immune checkpoint inhibitors (ICIs) CTLA-4 and PD-1/PD-L1 have revolutionized the treatment of metastatic solid tumors. However, their use is limited by a high incidence of immune-related adverse events. The colon is a frequent target of this immune attack seen in up to 45% of patients on dual PD-1 and CTLA-4 blockade.To better understand the transcriptional alterations that define ICI-associated colitis (irColitis) we profiled 300,000 epithelial, mesenchymal and immune single cells by RNA sequencing (scRNAseq). Our patient cohort included 13 patients with irColitis, 6 controls on ICI therapy, and 8 healthy controls. scRNAseq expression libraries were generated from endoscopic colon mucosal biopsies and circulating immune cells from blood matched to the same patients. Analysis of tissue immune cells from patients with irColitis revealed marked expansion of T regulatory cells, effector CD4+ T cells and three transcriptionally distinct populations of CD8+ T cells. Single-cell T cell receptor (TCR) and B cell receptor profiling revealed polyclonal expansion of T and B cell subsets with unique transcriptional signatures. We further showed that based on the presence of identical TCRs in CD8+ T cells from cytotoxic effector and memory-like cells that tissue-resident T cells can transition between different cell states during active irColitis. scRNAseq analysis of matched blood revealed how transcriptional signatures and TCR clonotypes in the colon mucosal microenvironment were mirrored in circulating immune cells. Finally, scRNAseq analysis of colon epithelial and mesenchymal cells revealed inflammatory signatures shared by patients with ulcerative colitis.

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