Reviewer ’s report  
 
Title: Alterations in ERBB2 and BRCA and microsatellite instability as new personalized 
treatment options in small bowel carcinoma  
 
Version: 1 Date: 10 Aug 2018  
 
Reviewer: Michael J. Overman  
 
Reviewer's report:  
This is a retrospective analysis of 11 small bowel carcinomas.   
 
1. Methodlogy needs to include time -frame over which these cases where identified and 
were their eligibility applied to finding these cases?  
 
2. There is no mention of IRB approval for this r esearch. Especially with germline mutation 
identified this is needed.  Where pateints consented for this research?  
 
3. Please specifiy whether primariy tissue or mets were tested  
 
4. Why do two cases not have TNMstaging?  
 
5. This statement does not make sense  "In previous studies small -bowel adenocarcinomas 
are typically described as microsatellite -instable tumors (MSI)."  Most SBAs are MSS.  
 
6. The abstract result section should not have opinion, please state the facts. Ie. 
"interestingly" not needed.  
 
7. The a bstract conclusion is too strong.  Based on 11 pts one can not determine a testing 
plan for all pts.  
 
8. The discussion needs to have a limitation section, especially regarding the limited 
numbers of cases and need for validation of the novel findings.  
 
9. The discussion should put the alterations into better context of the Shrock paper as that 
paper sequenced similar genes —why are the rates from Shrock similar or different to this 
work?  A table comparing across different studies might be an interesting way to put rates 
from this study into context from other studies.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in yo ur comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statis tical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in  an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received  reimbursements, fees, funding, or salary from an organization that holds 
or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review po licy of the journal. I understan d that my  name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
respons es. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confid ential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Alterations in ERBB2 and BRCA and microsatellite instability as new personalized 
treatment options in small bowel carcinoma  
 
Version: 1 Date: 10 Aug 2018  
 
Reviewer: Michael J. Overman  
 
Reviewer's report:  
This is a retrospective analysis of 11 small bowel carcinomas.   
 
1. Methodlogy needs to include time -frame over which these cases where identified and 
were their eligibility applied to finding these cases?  
 
2. There is no mention of IRB approval for this r esearch. Especially with germline mutation 
identified this is needed.  Where pateints consented for this research?  
 
3. Please specifiy whether primariy tissue or mets were tested  
 
4. Why do two cases not have TNMstaging?  
 
5. This statement does not make sense  "In previous studies small -bowel adenocarcinomas 
are typically described as microsatellite -instable tumors (MSI)."  Most SBAs are MSS.  
 
6. The abstract result section should not have opinion, please state the facts. Ie. 
"interestingly" not needed.  
 
7. The a bstract conclusion is too strong.  Based on 11 pts one can not determine a testing 
plan for all pts.  
 
8. The discussion needs to have a limitation section, especially regarding the limited 
numbers of cases and need for validation of the novel findings.  
 
9. The discussion should put the alterations into better context of the Shrock paper as that 
paper sequenced similar genes —why are the rates from Shrock similar or different to this 
work?  A table comparing across different studies might be an interesting way to put rates 
from this study into context from other studies.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in yo ur comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statis tical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in  an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received  reimbursements, fees, funding, or salary from an organization that holds 
or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review po licy of the journal. I understan d that my  name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
respons es. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confid ential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Alterations in ERBB2 and BRCA and microsatellite instability as new personalized 
treatment options in small bowel carcinoma  
 
Version: 1 Date: 10 Aug 2018  
 
Reviewer: Michael J. Overman  
 
Reviewer's report:  
This is a retrospective analysis of 11 small bowel carcinomas.   
 
1. Methodlogy needs to include time -frame over which these cases where identified and 
were their eligibility applied to finding these cases?  
 
2. There is no mention of IRB approval for this r esearch. Especially with germline mutation 
identified this is needed.  Where pateints consented for this research?  
 
3. Please specifiy whether primariy tissue or mets were tested  
 
4. Why do two cases not have TNMstaging?  
 
5. This statement does not make sense  "In previous studies small -bowel adenocarcinomas 
are typically described as microsatellite -instable tumors (MSI)."  Most SBAs are MSS.  
 
6. The abstract result section should not have opinion, please state the facts. Ie. 
"interestingly" not needed.  
 
7. The a bstract conclusion is too strong.  Based on 11 pts one can not determine a testing 
plan for all pts.  
 
8. The discussion needs to have a limitation section, especially regarding the limited 
numbers of cases and need for validation of the novel findings.  
 
9. The discussion should put the alterations into better context of the Shrock paper as that 
paper sequenced similar genes —why are the rates from Shrock similar or different to this 
work?  A table comparing across different studies might be an interesting way to put rates 
from this study into context from other studies.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in yo ur comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statis tical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in  an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received  reimbursements, fees, funding, or salary from an organization that holds 
or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
none  
 
I agree to the open peer review po licy of the journal. I understan d that my  name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
respons es. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confid ential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant