30-Second Takeaway
- Lowering CTE prestenotic dilation thresholds substantially increases Crohn’s stricture detection and identifies patients with clearly higher complication risk.
- FIT cutoffs drive large shifts in CRC screening sensitivity, specificity, and colonoscopy demand, requiring capacity‑conscious program design.
- Multi‑omics and genomics are beginning to translate into steroid‑free AIH regimens and actionable targets in refractory primary liver cancers.
Week ending March 28, 2026
Targeted diagnostics and precision biomarkers are reshaping GI and liver disease care
Lower CTE dilation threshold uncovers more clinically important Crohn small‑bowel strictures
Among 1022 Crohn’s patients without acute obstruction, 18.6% had prestenotic dilatation >3 cm and another 13.4% had 2.5–3 cm dilatation. Using the revised ≥2.5 cm threshold increased stricture prevalence to 32.0%, nearly doubling identified strictures. Both 2.5–3 cm and >3 cm groups had similarly higher risks of ED visits, small‑bowel surgery, obstruction, and penetrating complications versus non‑stricture. Patients meeting only the new 2.5–3 cm criterion still had markedly elevated adjusted hazard ratios for symptomatic obstruction and penetrating disease.
Program‑level FIT cutoffs cause major swings in CRC screening performance
Using data from 7398 screened adults with reference colonoscopy, investigators modeled FIT performance across 30 country‑specific thresholds. Cutoffs as low as 8.5 μg Hb/g produced positivity rates near 18% with CRC sensitivity around 98% but lower specificity for no advanced neoplasia. Cutoffs near 120 μg Hb/g reduced positivity to about 3%, with CRC sensitivity around 56% but specificity approaching 99%. Sensitivity for advanced precancerous lesions and any advanced neoplasia dropped steeply as thresholds increased, while specificity rose.
NIVACOR: chemo‑immunotherapy active but intensive in RAS/BRAF‑mutated MSS mCRC
The phase II NIVACOR trial evaluated first‑line FOLFOXIRI/bevacizumab plus nivolumab in 73 patients with RAS/BRAF‑mutated metastatic colorectal cancer, mostly pMMR/MSS. Objective response rate was 76.7%, with disease control in 97.3% and median progression‑free survival of 10.1 months; overall survival was not reached. Grade ≥3 treatment‑related adverse events occurred in 65.8% of patients, underscoring substantial toxicity with this intensified regimen. Genomic and RNA profiling linked alterations in PI3K/AKT, chemokine signaling, and DNA repair pathways with treatment activity in pMMR/MSS tumors.
TNF emerges as central AIH driver and viable steroid‑free target
Integrative multi‑omics and spatial mapping in autoimmune hepatitis showed IL‑15 from myeloid cells and hepatocytes expands auto‑aggressive CD8+ T cells. TNF from clonally expanded liver‑resident CD4+ T cells was required to fully license CD8+ cytotoxicity against hepatocytes. Hepatocytes upregulated adhesion molecules in response to TNF, increasing susceptibility to both CD4+ and CD8+ T‑cell attack. A steroid‑free, open‑label phase IIa trial of infliximab demonstrated biochemical efficacy as monotherapy in AIH patients.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.