DOI: 10.37421/2157-7145.2022.7.156
DOI: 10.37421/2157-7145.2022.7.155
DOI: 10.37421/2157-7145.2022.7.158
DOI: 10.37421/2157-7145.2022.7.159
DOI: 10.37421/2157-7145.2022.7.157
Esra Muhimid*, Hala Omer, Esraa Al-Qasim, Omyma Ali, Saif El-Deen Al-Horani and Saad AL-Damaa
Context: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer worldwide, and it accounts for 30% of all cancer cases in children of Saudi Arabia. Relapsed leukemia is the fourth malignant disease in pediatrics.
Aim: This study aims to describe the clinical characteristics and outcomes of pediatric Relapsed ALL.
Settings and design: This retrospective study was conducted at a single tertiary hospital in Saudi Arabia.
Methods and data analysis: Clinical data and outcomes of all cases with relapsed acute lymphoblastic leukemia under age of 16 year diagnosed and treated from 1 January 2012 till 31 December 2020. All patients' data and information were retrieved from patients’ hard and electronic medical records and collected in REDCap system. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) program version.
Results: Within the first four years of the study period, 155 cases were diagnosed with acute leukemia. In this study the relapse rate for acute lymphoblastic leukemia was 13% with overall survival about 47%, and the disease progression related mortality was 54%, while the treatment related mortality was 45% with overall mortality of 52%.
Conclusion: Relapsed ALL becomes a serious problem in pediatric oncology with relatively poor outcomes. The difficulty in treating relapse disease with satisfying results compels us to enhance the therapy for the newly diagnosed patients at the front lines considering more effective and better treatment options. Promising new molecular and immunological targeted therapies and improved HSCT technologies should be rapidly integrated into trials for subsets of higher-risk patients at initial diagnosis. Further refining of the risk stratification with the increased focus on the importance of analyzing detailed cytogenetics and molecular data in the era of application of next-generation sequencing followed subsequently by tailored risk-adapted therapy is the cornerstone of modern relapse therapy. International collaboration is essential to serve as a platform for progress in the treatment of relapsed childhood ALL.
We have designed a nanoparticle drug delivery system. The system included PLGA, paclitaxel (PTX) and transferrin (TF). This system can specifically target to liver cancer cells through intravenously administration. The PLGA-PTX-TF nanoparticles show excellent liver cancer treatment effect (IC50 4.79 g/mL) and are dose dependent in vitro. The PLGA-PTX-TF nanoparticle also show noticeable anti-tumor efficacy in vivo compared to PLGA-PTX (anti-cancer rate: 79.09% vs. 35.47%). Therefore, PLGA-PTX-TF nanoparticles can be considered as an effective anticancer drug delivery system for liver cancer therapy for the clinical use.
Chris Larson, Bryan Oronsky*, Scott Caroen, Jeannie Williams, Meaghan Stirn and Tony Reid
DOI: 10.37421/2576-3857.2022.07.165
The reputation of checkpoint inhibitors as potential game changers in oncology is well-deserved as the the 14/14 complete responses recently reported with the PD-1 inhibitor, dostarlimab, in mismatch repair (MMR) deficient locally advanced rectal cancer demonstrates but comes with an important caveat: in most cases and in most cancers non-responders greatly outnumber responders. This begs the question of how to mimic the unprecedented result with dostarlimab in MMR-proficient and otherwise checkpoint inhibitor non-responsive cancers. Several strategies to sensitize tumors to checkpoint inhibitors are under active investigation. These include combinations with other checkpoint inhibitors, chemotherapy, angiogenesis inhibitors, targeted agents, DNA damage repair inhibitors, epigenetic modifiers, and TGF-β inhibitors. This short communication presents data on AdAPT-001, a Type 5 oncolytic adenovirus, currently in a Phase 1/2 clinical trial called BETA PRIME (NCT04673942), which encodes for a transforming growth factor-beta (TGF-β) trap, as an anti-PD-L1 sensitizer.
Godwin Okoye*, Henry Antwi and Rachel vincent
DOI: 10.37421/2576-3857.2022.07.166
Objective: Previous studies have shown that older women are more likely to be diagnosed with gynecological cancers (GC) setting the precedent for more attention to be given to older women than younger women with GC. This study seeks to compare nationally representative healthcare use among younger women and older women diagnosed with gynecological cancer in the United States.
Methods: A retrospective cross-sectional repeated measures design was used to make comparisons between baseline characteristics of two age groups of women diagnosed with gynecological cancers. Data were extracted from the National Health Interview Survey (NHIS). A weighted sample of 2633569 responses who reported having at least one kind of GC was included from 2015 to 2018. GC was defined as those who reported having uterine, cervical, or ovarian cancer. Characteristics of patients were compared across two age groups. 1. Women less than 50 considered to be most likely premenopausal. 2. Women more than 50 considered to be most likely postmenopausal. Nine health services use were also quantified between both age groups and a multivariable logistic regression model was used to determine the likelihood of health care use among both age groups with the older women being the reference group.
Results: Among the baseline characteristics, alcohol use and smoking were seen to be most prevalent among the younger women with the following proportions 88% and 79.93% for alcohol use and 59.79% and 50.26% for smoking at p<0.01. Younger women had higher obstetrics and gynecologic visits OR 2.13 (1.59-2.84), Emergency room visits OR 1.55 (1.17-2.06), Hospitalization OR 1.57 (1.15-2.14), Preventive care OR 2.49 (1.88-3.31). Adjusting for Alcohol use and smoking yielded similar odds ratio. Patterns of hospitalization increased over time for younger women and use of surgery and surgical procedures wasn’t statistically significant among both age groups.
Conclusion: Based on this study, younger women tend to use comparable healthcare services as older women diagnosed with gynecologic cancer. Therefore, more studies should be conducted with the inclusion of younger women.
Monika Singh* and Rujuta Fuke
DOI: 10.37421/2576-3857.2022.07.167
Cervical cancer is a preventable disease. It is also curable if detected early and adequately treated. Yet it is the fourth most common cancer among women globally. In India cervical cancer is the second most common cancer among women between 15 and 44 years of age. The most common histologic type of cervical cancer is squamous, most common cause is by HPV infection. Cervical intraepithelial neoplasia (CIN) is a premalignant condition of the uterine cervix. Various screening methods are available for diagnosis including Pap smear and colposcopic directed biopsy. However, LEEP (Loop electrosurgical excision procedure) is used for treatment of CIN. Invasive cervical cancer has a long pre invasive phase and hence early diagnosis and treatment can be done.
Objective: This is a prospective observational study of correlation between colposcopic directed biopsy and LEEP in cervical intraepithelial neoplasia (CIN).
Methods: A longitudinal study was conducted on 150 subjects attending Gynecological Outpatient department at tertiary care centre and who met the inclusion and exclusion criteria of reproductive age group i.e., (22-55 years) those were screened for CIN (cervical intraepithelial neoplasia) by VIA(visual inspection via acetic acid) and/or cervical cytology by liquid based cytology. All the patients with positive VIA and abnormal cervical cytology findings were subjected/screened by colposcopy examination and patients with CIN were subjected to LEEP. Kappa statistics was used to determine agreement between 2 test procedures. Spearman’s correlation coefficient (rho) was used to measure strength and direction of association between 2 test procedures based on ordered variables. P value <0.05 was considered statistically significant.
Results: 111 patients were having cervicitis on colposcopy directed biopsy and 39 patients were diagnosed with CIN. The colposcopy directed biopsy and LEEP results were statistically significant in positive patients with CIN. No significant correlation between demographic indices and prevalence was noted in CIN patients
Conclusion: Colposcopic directed biopsy is the gold standard for diagnosis as confirmed by Loop Electrosurgical Excision Procedure (LEEP), also known as large loop excision of the transformation zone (LLETZ), a method used for excisional treatment of HSIL.
DOI: 10.37421/2576-3857.2022.07.168
DOI: 10.37421/2576-3857.2022.07.169
DOI: 10.37421/2157-7145.2022.7.160
Cancer patients now have hope thanks to chemotherapy, radiation, targeted therapy, and immunotherapy. Cancer-therapy-induced cardiovascular damage has garnered interest as cancer patient survival times have increased and clinical experience has grown. Deeper understanding of the molecular biology underlying the disease is necessary to develop appropriate preventative and treatment strategies for the side effects of cancer therapy that can be fatal or cause long-term morbidity. Traditional Chinese medicine formulations are effective in addition to the common cardioprotection medications and can be expected to achieve "tailored treatment" from a variety of angles. Furthermore, "reverse cardio-oncology" has emerged as a result of the rising incidence of cancer in people with cardiovascular disease, underscoring the urgent need for collaboration between cardiologists and oncologists.
DOI: 10.37421/2157-7145.2022.7.161
DOI: 10.37421/2157-7145.2022.7.162
In this study, patients with locally advanced cervical cancer were evaluated for their response to definitive chemo radiation therapy in relation to quantitative metabolic and volumetric FDG PET/CT characteristics. Ninety patients with newly diagnosed locally advanced cervical cancer underwent research. At staging and following treatment, PET/CT was performed on all patients. Patients with and without a complete metabolic response were compared with regard to metabolic and volumetric markers, Total Lesion Glycolysis, and Metabolic Tumor Volume (MTV), of the primary tumour and metastatic lymph nodes. In a subset of FIGO IB2-IIB patients, a similar study was carried out; Results: SUVmax and SUVmean of the primary tumour as well as those of metastatic lymph nodes and TLG were found to be considerably higher than those of the primary tumour. Patients with locally advanced cervical cancer who will not respond to definitive chemo radiation therapy have higher levels of quantitative metabolic and volumetric markers assessed from PET/CT. In particular, MTV and TLG values can be used to predict therapy response in individuals who are not metastatic at staging, which may change the course of treatment.
DOI: 10.37421/2157-7145.2022.7.163
DOI: 10.37421/2157-7145.2022.7.164
DOI: 10.37421/2576-3857.2023.08.204
Akhil Agarwal*, Amitabha Dey, Ishan Patel, Shashank Srinivasan and Ankita Jain
DOI: 10.37421/2576-3857.2023.8.490
Background: Cancer patients navigate through complex and dynamic health services/systems after diagnosis to receive high-quality and effective care. An understanding of a cancer patient’s journey will help in improving the quality of care. A survey was conducted on patients and medical oncologists across India with an objective to map various aspects of patient journey from diagnosis to treatment and follow-up for advanced Breast Cancer (BC) and Lung Cancer (LC).
Methods: A multidimensional survey was shared with adult patients diagnosed with advanced stage (stage III B and stage IV) breast or lung cancer who were undergoing therapy and medical oncologists who have more than 10-years of experience in treating breast or lung cancer.
Results: A total of 100 patients with a diagnosis of Stage III B/IV breast cancer (BC), 100 patients with Stage III B/IV Lung Cancer (LC), and 55 medical oncologists participated in the survey. It was noted that similar numbers of BC (49%) and LC (50%) patients were not aware about cancer symptoms and treatments while the surveyed medical oncologists believed only 11% and 20% patients were not aware of cancer symptoms and treatment, respectively. Selecting the right specialist was reported to be the primary challenge faced by patients. As per surveyed medical oncologists, only 5% of them discuss support from Patient Advocacy Groups (PAGs) with all their patients. The majority of medical oncologists (79%) reported that less than 30% of patients join PAGs. Most patients were expecting empathy and time for counselling from their medical oncologists.
Conclusion: Coordinated and comprehensive cancer care is essential for patients with advanced LC and BC. The survey results also highlight the importance of screening high risk populations, importance of educational material for patients, counseling on treatment plan, information about financial support programs, counseling on mental well-being, nutritional support, and information about PAGs.
DOI: 10.37421/2576-3857.2023.08.199
Heterochromatin Protein 1α (HP1α) is a critical player in chromatin organization and gene regulation, and its dysregulation has been implicated in various cellular processes, including cell proliferation and cancer development. This review focuses on the role of HP1α as a characteristic of cell proliferation that is pertinent to clinical oncology. Extensive research has demonstrated that HP1α plays a dual role in regulating cell proliferation. On one hand, it functions as a transcriptional repressor, modulating the expression of genes involved in cell cycle control and DNA replication. On the other hand, HP1α has also been found to interact with numerous signaling pathways and transcription factors, thereby promoting cell proliferation under certain conditions. Aberrant expression and localization of HP1α have been observed in various types of cancer, including breast, prostate, lung, and colorectal cancer. Furthermore, studies have shown that altered HP1α expression is associated with poor prognosis and resistance to conventional therapies in cancer patients. Understanding the molecular mechanisms underlying HP1α's involvement in cell proliferation is of significant interest in clinical oncology. Targeting HP1α and its associated pathways may offer promising therapeutic opportunities for cancer treatment. In addition, HP1α expression levels and subcellular localization can potentially serve as diagnostic and prognostic biomarkers in clinical practice.
DOI: 10.37421/2576-3857.2023.08.198
This study aims to compare the clinical efficacy of posaconazole and fluconazole as antifungal prophylaxis in the field of hematology. Antifungal prophylaxis plays a crucial role in preventing invasive fungal infections, which are a significant cause of morbidity and mortality in immunocompromised patients, particularly those undergoing Hematopoietic Stem Cell Transplantation (HSCT) or intensive chemotherapy. A comprehensive literature review was conducted to identify relevant studies comparing the clinical outcomes of posaconazole and fluconazole prophylaxis in hematology patients. The primary endpoints assessed were the incidence of IFIs, overall survival, and adverse events associated with each antifungal agent. The results of the reviewed studies demonstrated that posaconazole had superior efficacy compared to fluconazole in preventing IFIs in hematology patients. Posaconazole prophylaxis was associated with a significantly lower incidence of IFIs, including invasive aspergillosis and candidiasis, when compared to fluconazole. Additionally, posaconazole showed a favorable impact on overall survival, suggesting its potential as a more effective antifungal prophylactic agent in this patient population.
DOI: 10.37421/2576-3857.2023.08.196
Angiogenesis, the tumour microenvironment, and proteoglycans play pivotal roles in cancer biology. Angiogenesis, the formation of new blood vessels, is a critical process for tumour growth and metastasis. The tumor microenvironment, consisting of various cellular and non-cellular components, provides a supportive niche for cancer progression. Proteoglycans, a class of complex molecules, are involved in modulating both angiogenesis and the tumour microenvironment. Angiogenesis in cancer is driven by a delicate balance of pro-angiogenic and anti-angiogenic factors. Tumour cells release pro-antigenic factors, such as Vascular Endothelial Growth Factors (VEGFs), to stimulate the sprouting of new blood vessels from existing vasculature. The tumour microenvironment, including immune cells, fibroblasts, and extracellular matrix components, also contributes to angiogenesis through the secretion of angiogenic factors and remodelling of the surrounding vasculature. Disrupting angiogenesis has emerged as a promising therapeutic strategy in cancer treatment, with the development of anti-antigenic drugs targeting VEGF signalling.
DOI: 10.37421/2576-3857.2023.08.197
A core of several tetraspanin proteins organizes other membrane proteins like growth factor receptors, integrins, and Human Leukocyte Antigen (HLA) antigens in these complexes. Albeit most tetraspanin proteins have been concentrated separately, tetraspanin proteins and their edifices can affect cell grip and motility, associations with stroma or influence announcing development factors, and for the greater part of them no ligand has been distinguished. Although they are found in all cell types, these proteins have primarily been studied functionally in lymphoid cells. Tetraspanins have been identified as metastasis suppressors in some tumors, but their significance is still unclear. Data are also available for these tumors. They are outlined, along with some of their implications for tumor biology and areas that require additional research. The biological properties of tumor cells, particularly those pertaining to tumor adhesion and dissemination, can be significantly affected by membrane proteins that are involved in cellular interactions with other cells or the stroma as well as signaling pathways. The tetraspanins, a brand-new class of membrane proteins, are beginning to gain importance in cell biology but have received very little attention in the context of cancer biology up until this point.
DOI: 10.37421/2576-3857.2023.08.202
DOI: 10.37421/2576-3857.2023.08.200
DOI: 10.37421/2576-3857.2023.08.201
DOI: 10.37421/2576-3857.2023.08.203
DOI: 10.37421/2576-3857.2023.08.190
DOI: 10.37421/2576-3857.2023.8.185
The purpose of establishing Clinical Quality Registries (CQRs) was to compare clinical outcomes between hospitals or regions within a nation. The purpose of this study was to identify these CQRs for gynaecological oncology, to summarize their characteristics, processes, and QIs, and to determine whether it would be feasible to conduct future international comparisons in order to obtain a global overview of these CQRs.
DOI: 10.37421/2576-3857.2023.8.188
This paper explores the lessons learned from mentoring in radiation oncology from a remote setting. It discusses the challenges faced by mentors and mentees in maintaining effective communication, establishing trust, and fostering professional development in a virtual environment. The paper highlights the importance of leveraging available technologies and platforms to facilitate mentorship activities, such as video conferencing, online learning platforms, and virtual tumor boards. Drawing from experiences and best practices, the paper provides practical recommendations for successful remote mentoring in radiation oncology. It emphasizes the need for structured mentorship programs, clear communication channels, and goal-oriented mentoring relationships. Strategies for promoting engagement, building mentor-mentee rapport, and ensuring continued professional growth are explored.
DOI: 10.37421/2576-3857.2023.8.189
DOI: 10.37421/2576-3857.2023.8.191
DOI: 10.37421/2576-3857.2023.8.192
DOI: 10.37421/2576-3857.2023.8.193
DOI: 10.37421/2576-3857.2023.8.186
Urological cancers, including prostate, bladder, and kidney cancers, pose a significant healthcare challenge worldwide. To address this challenge, effective research and clinical management require comprehensive and accurate data collection. However, traditional manual data collection methods are time-consuming, error-prone, and limited in their ability to handle large-scale datasets. In this paper, we present the Cancer Research Uro-Oncology Database (CRUOD), a novel automated system designed to streamline the collection and management of uro-oncology data. CRUOD leverages advanced technologies such as natural language processing, machine learning, and cloud computing to automate data extraction, standardization, and storage processes.
DOI: 10.37421/2576-3857.2023.08.187
The increasing reliance on digital technologies and interconnected systems in radiation oncology practices has introduced new vulnerabilities and risks associated with cyber security attacks. These attacks can have severe consequences, including compromising patient data, disrupting critical treatment processes, and causing financial losses. Therefore, it is crucial for radiation oncology practices to implement robust cyber security measures to safeguard their operations and protect patient information. This paper presents a comprehensive overview of the strategies and best practices for protecting radiation oncology practices from cyber security attacks. It explores the unique challenges and vulnerabilities specific to this field, such as the interconnectedness of treatment planning systems, electronic medical records, and medical devices. The paper discusses the potential consequences of cyber threats and emphasizes the importance of proactive risk assessment and mitigation.
DOI: 10.37421/2576-3857.2023.8.194
Journal of Oncology Medicine & Practice received 136 citations as per Google Scholar report
