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Medical Oncology

Giulia Marvaso, Giulia Riva, Delia Ciardo, Sara Gandini, Cristiana Fodor, Dario Zerini, Sarah Pia Colangione, Giorgia Timon, Stefania Comi, Raffaella Cambria, Federica Cattani, Ottavio De Cobelli, Roberto Orecchia, Barbara A Jereczek-Fossa
Ultra-hypofractionated radiotherapy (RT) is given over a shorter time with larger doses with respect to conventional fractionation in patients with localized prostate cancer (PCa). The use of hypofractionation is supported both from the radiobiological point of view (the low α/β-ratio in PCa and dose escalation) and from the rising number of clinical evidences. The aim of this study is to review our data regarding oncological outcomes, namely biochemical progression-free survival (b-PFS) and clinical progression-free survival (c-PFS), acute and long-term toxicities in patients treated with a ultra-hypofractionated RT...
May 10, 2018: Medical Oncology
Ikuko Hirai, Keiji Tanese, Yoshio Nakamura, Atsushi Otsuka, Yasuhiro Fujisawa, Yuki Yamamoto, Hiroo Hata, Taku Fujimura, Shigeto Matsushita, Koji Yoshino, Kaori Kameyama, Masayuki Amagai, Takeru Funakoshi
The human epidermal growth factor receptor 2 (HER2) is recognized as an oncogene as well as a therapeutic target in various cancers. Certain patients with advanced extramammary Paget's disease (EMPD) have also been reported to express HER2, which is therefore considered a therapeutic target for EMPD. However, an accurate methodology to determine HER2-positive EMPD has not been established. To assess the optimal methods for detection of HER2-positive EMPD, 73 EMPD samples were analyzed by immunohistochemical (IHC) staining, fluorescence in situ hybridization (FISH), and the HER2 testing algorithm for breast cancer of the American Society of Clinical Oncology/College of American Pathologists, which combined the results of IHC staining and FISH...
May 9, 2018: Medical Oncology
Jureeporn Chuerduangphui, Chamsai Pientong, Piyawut Swangphon, Sanguanchoke Luanratanakorn, Ussanee Sangkomkamhang, Thumwadee Tungsiriwattana, Pilaiwan Kleebkaow, Ati Burassakarn, Tipaya Ekalaksananan
Human papillomavirus (HPV) E2 and L1 proteins are expressed in cervical cells during the lytic stage of infection. Overexpression of p16INK4A is a biomarker of HPV-associated cervical neoplasia. This study investigated antibodies to HPV16 E2, HPV16 L1, and p16INK4A in sera from women with no squamous intraepithelial lesion (No-SIL) of the cervix, low-grade SIL, high-grade SIL, and cervical squamous cell carcinoma (SCC). HPV DNA was detected by polymerase chain reaction. Anti-E2, -L1, and -p16INK4A antibodies in sera were determined by western blot...
May 9, 2018: Medical Oncology
Michał Pędziwiatr, Judene Mavrikis, Jan Witowski, Alexandros Adamos, Piotr Major, Michał Nowakowski, Andrzej Budzyński
Enhanced Recovery After Surgery (ERAS) is an evidence-based paradigm shift in perioperative care, proven to lower both recovery time and postoperative complication rates. The role of ERAS in several surgical disciplines was reviewed. In colorectal surgery, ERAS protocol is currently well established as the best care. In gastric surgery, 2014 saw an establishment of ERAS protocol for gastrectomies with resulting meta-analysis showing ERAS effectiveness. ERAS has also been shown to be beneficial in liver surgery with many centers starting implementation...
May 9, 2018: Medical Oncology
Hiromichi Iwamura, Shingo Hatakeyama, Makoto Sato, Chikara Ohyama
For the management of muscle-invasive bladder cancer or upper tract urothelial carcinoma, the set guidelines recommend regular surveillance after radical cystectomy or radical nephroureterectomy. However, the prognostic benefit of regular oncological surveillance remains controversial in the absence of prospective studies although several retrospective studies with relatively large sample sizes have demonstrated the association between asymptomatic recurrence and better oncological outcomes. Seven out of eight studies reported that patients diagnosed with symptomatic recurrence showed significantly poorer prognosis in comparison to those diagnosed with asymptomatic recurrence...
May 9, 2018: Medical Oncology
Pawel Chrom, Maciej Kawecki, Rafal Stec, Lubomir Bodnar, Cezary Szczylik, Anna M Czarnecka
In order to facilitate long-term treatment decisions, we aimed to define biomarkers defining the probability of receiving second-line (SL) targeted therapy (TT) in patients with metastatic renal cell carcinoma (mRCC) based on their characteristics present at first-line TT initiation. We analysed 152 consecutive mRCC patients treated and used multivariable binominal logistic regression to identify factors contributing to the probability of receiving SL TT. Final model was assessed with bias-corrected indices (Nagelkerke's R2 and area under receiver operating characteristic curve [AUC]) and two bootstrap procedures were used for internal validation...
May 8, 2018: Medical Oncology
Maiko Abumiya, Akiko Mita, Saori Takahashi, Tomoko Yoshioka, Yoshihiro Kameoka, Naoto Takahashi, Masatomo Miura
We investigated the effects of polymorphisms in NR1I2 (7635A>G, 8055C>T), CYP3A4 (20230G>A), ABCB1 (1199G>A, 1236C>T, 2677G>T/A, 3435C>T), and ABCG2 (421C>A) on the mean plasma trough concentrations (C0 ) of bosutinib at the steady-state in 30 Japanese patients with chronic myeloid leukemia. Bosutinib C0 values were monitored using high-performance liquid chromatography. The median coefficient of variation (CV) value of the bosutinib C0 for one patient (intrapatient) during bosutinib therapy was 25...
May 7, 2018: Medical Oncology
Michelle H Townsend, Richard A Robison, Kim L O'Neill
Hypoxanthine guanine phosphoribosyltransferase (HPRT) is a common salvage housekeeping gene with a historically important role in cancer as a mutational biomarker. As an established and well-known human reporter gene for the evaluation of mutational frequency corresponding to cancer development, HPRT is most commonly used to evaluate cancer risk within individuals and determine potential carcinogens. In addition to its use as a reporter gene, HPRT also has important functionality in the body in relation to purine regulation as demonstrated by Lesch-Nyhan patients whose lack of functional HPRT leads to significant purine overproduction and further neural complications...
May 5, 2018: Medical Oncology
Vishal Jindal, Ena Arora, Sorab Gupta
Chimeric antigen receptor (CAR) T cell therapy is a novel and innovative immunotherapy. CAR-T cells are genetically engineered T cells, carrying MHC independent specific antigen receptor and co-stimulatory molecule which can activate an immune response to a cancer specific antigen. This therapy showed great results in hematological malignancies but were unable to prove their worth in solid tumors. Likely reasons for their failure are lack of antigens, poor trafficking, and hostile tumor microenvironment. Excessive amount of research is going on to improve the efficacy of CAR T cell therapy in solid tumors...
May 5, 2018: Medical Oncology
William Parker Stults, Yudan Wei
To examine ambient air pollutants, specifically polycyclic aromatic hydrocarbons (PAHs), as a factor in the geographic variation of breast cancer incidence seen in the US, we conducted an ecological study involving counties throughout the US to examine breast cancer incidence in relation to PAH emissions in ambient air. Age-adjusted incidence rates of female breast cancer from the surveillance, epidemiology, and end results (SEER) program of the US National Cancer Institute were collected and analyzed using SEER*Stat 8...
May 5, 2018: Medical Oncology
Luciana Lopes Manfredini, Gislene Padilha Dos Santos, Ana Fernanda Yamazaki Centrone, Nelson Hamerschlak
In emergency rooms, patients are usually classified using scales for predicting risk, resource usage, and the maximum time for receiving medical care. Emergency Severity Index (ESI) is a frequently used scale in this context. However, every patient with cancer is automatically classified as ESI level 3. In this study, patients with cancer seen at an emergency setting were reclassified using the ESI without the "cancer" parameter to verify whether there would be any change in the classification. Cross-sectional study...
May 4, 2018: Medical Oncology
Mohamed Alsharedi, Heather Katz
In the United States, the estimated number of new cases of renal cell carcinoma (RCC) is approximately 65,000 case with about 15,000 deaths in the year of 2018 (Siegel et al. in CA Cancer J Clin 68(1):7, 2018). RCC as an immunogenic malignancy is supported by many theories and facts which include tumor richness of lymphocytes infiltrate, the occurrence of spontaneous tumor regression, and the proved effect of traditional immunotherapy (Finke et al. in J Immunother 11(1):1-11, 1992), all these factors support the potential therapeutic effect of the novel immunotherapeutic agents in RCC...
May 4, 2018: Medical Oncology
Vishal Jindal, Ena Arora, Muhammad Masab, Sorab Gupta
Chimeric antigen receptor (CAR) T cell therapy is genetically engineered tumor antigen-specific anticancer immunotherapy, which after showing great success in hematological malignancies is currently being tried in advanced solid tumors like pancreatic cancer. Immunosuppressive tumor microenvironment and dense fibrous stroma are some of the limitation in the success of this novel therapy. However, genetic modifications and combination therapy is the topic of the research to improve its efficacy. In this article, we summarize the current state of knowledge, limitations, and future prospects for CAR T cell therapy in pancreatic cancer...
May 4, 2018: Medical Oncology
Vincenzo Formica, Michaela Benassi, Giovanna Del Vecchio Blanco, Elena Doldo, Laura Martano, Ilaria Portarena, Antonella Nardecchia, Jessica Lucchetti, Cristina Morelli, Emilia Giudice, Piero Rossi, Alessandro Anselmo, Pierpaolo Sileri, Giuseppe Sica, Augusto Orlandi, Riccardo Santoni, Mario Roselli
A platinum salt (oxaliplatin or cisplatin) is widely used to enhance chemoradation (CRT) response. The potential of cisplatin in neoadjuvant CRT for locally advanced rectal cancer (LARC) has not been fully investigated. Consecutive patients with histologically confirmed LARC were treated with standard pelvic radiotherapy and concurrent cisplatin plus capecitabine (CisCape CRT). Surgery and eight cycles of adjuvant FOLFOX4 were offered to all patients after CRT. Common biochemical variables and key germline genetic polymorphisms were analyzed as predictors of pathological complete response (pCR)...
May 2, 2018: Medical Oncology
Yuko Kanbayashi, Takeshi Ishikawa, Motohiro Kanazawa, Yuki Nakajima, Yusuke Tabuchi, Rumi Kawano, Tomoko Yoshioka, Naohisa Yoshida, Toyoshi Hosokawa, Koichi Takayama, Tetsuya Taguchi
Cholinergic syndrome is an acute adverse reaction associated with irinotecan. Development of cholinergic syndrome can be ameliorated or prevented by administering various anticholinergics, including atropine sulfate or scopolamine butylbromide. Although many of the side effects are transient and non-life-threatening, their onset is painful and can lower a patient's quality of life (QoL). This retrospective study was performed to identify predictive factors of the development of irinotecan-related cholinergic syndrome in order to develop future strategies for improving the QoL of patients undergoing chemotherapy...
April 28, 2018: Medical Oncology
Yuki Maruyama, Takuya Sadahira, Yosuke Mitsui, Motoo Araki, Koichiro Wada, Ryuta Tanimoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu
Bleomycin pulmonary toxicity (BPT) has been well described in patients with germ cell tumors treated with bleomycin etoposide and cisplatin chemotherapy (BEP). To assess the prognostic impact of BPT, we retrospectively identified 52 patients who underwent bleomycin etoposide and cisplatin chemotherapy from 2008 to 2017 in our institution, and evaluated the risk factors of BPT and its effect on prognosis. Patients who had received chemotherapy at another institution were excluded. BPT was defined as bleomycin discontinuation in response to pulmonary function test decline, pulmonary symptoms, or interstitial pneumonia on computed tomography without infection...
April 26, 2018: Medical Oncology
Raman Preet Kaur, Gowhar Shafi, Raja Paramjeet Singh Benipal, Anjana Munshi
In this study, we evaluated the incidence of pathogenic germline mutations in 30 breast cancer susceptibility genes in breast cancer patients. Our aim was to understand the involvement of the inherited mutations in these genes in a breast cancer cohort. Two hundred ninety-six female breast cancer patients including 4.5% of familial breast cancer cases were included in the study. 200 ng of genomic DNA was used to evaluate the pathogenic mutations, detected using Global Screening Array (GSA) microchip (Illumina Inc...
April 26, 2018: Medical Oncology
Gabriel Afram, Jose Antonio Pérez Simón, Mats Remberger, Teresa Caballero-Velázquez, Rodrigo Martino, Jose Luis Piñana, Olle Ringden, Albert Esquirol, Lucia Lopez-Corral, Irene Garcia, Oriana López-Godino, Jordi Sierra, Dolores Caballero, Per Ljungman, Lourdes Vazquez, Hans Hägglund
Chronic graft-versus-host disease (cGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Aim is to identify risk factors for the development of cGVHD in a multicenter setting. Patients transplanted between 2000 and 2006 were analyzed (n = 820). Donors were HLA-identical siblings (57%), matched unrelated donors (30%), and HLA-A, B or DR antigen mismatched (13%). Reduced intensity conditioning (RIC) was given to 65% of patients. Overall incidence of cGVHD was 46% for patients surviving more than 100 days after HSCT (n = 747)...
April 25, 2018: Medical Oncology
Kana Iwamoto, Hiroki Ishihara, Toshio Takagi, Tsunenori Kondo, Kazuhiko Yoshida, Junpei Iizuka, Kazunari Tanabe
Sunitinib treatment with a 2-week-on/1-week-off schedule (Schedule 2/1) is a common alternative regimen with high relative dose intensity (RDI) and superior tolerability for patients with metastatic renal cell carcinoma (mRCC). The prognostic impact of RDI is reported only in 4-week-on/2-week-off or mixed regimens. Herein, we evaluated the prognostic impact of RDI during early-phase sunitinib treatment using Schedule 2/1. Seventy-four patients who received first-line sunitinib treatment using Schedule 2/1 were evaluated...
April 23, 2018: Medical Oncology
Alexander Lukez, Lauren O'Loughlin, Mashhood Bodla, Jennifer Baima, Janaki Moni
PURPOSE: Pelvic radiation treatment demands precision and consistency in patient setup for efficacy of therapy and to limit radiation dosage to normal tissue. Despite the use of immobilization devices and positioning techniques, there is still concern for variation in daily setup. The purpose of this retrospective study was to determine the presence and degree of variation in sacral slope in 20 subjects receiving radiation therapy for pelvic malignancies. METHODS: Each of the 20 subjects received between 20 and 25 fractions of external beam radiation treatment to the pelvis...
April 21, 2018: Medical Oncology
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