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Tan CH, Sayegh Y, Fasih-Ahmad S, Tse DT, Karp CL, Dubovy SR. Periocular granulomatous inflammatory lesions mimicking conjunctival melanoma recurrence in the setting of systemic nivolumab treatment. Am J Ophthalmol Case Rep 2024; 36:102025. [PMID: 39175930 PMCID: PMC11338984 DOI: 10.1016/j.ajoc.2024.102025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/09/2024] [Indexed: 08/24/2024] Open
Abstract
Purpose Conjunctival melanoma is a rare neoplasm with high rates of recurrence and metastasis. Traditional management includes surgical excision and cryotherapy, followed by adjuvant therapy as needed. Immune checkpoint inhibitors, including nivolumab, are a targeted treatment option with improved survival rates. However, various immune-related adverse effects have been reported with these drugs. While systemic granulomatous inflammation is a documented systemic side effect, it has rarely been reported in the conjunctiva and ocular adnexa. Observation A patient with a history of recurrent metastatic conjunctival melanoma presented with both a left sub-conjunctival and upper eyelid lesion after the commencement of treatment with nivolumab. The lesions were excised with a clinical suspicion for metastasis and consisted of noncaseating granulomatous inflammation with no evidence of malignancy on histopathologic examination. Infectious and primary autoimmune etiologies were ruled out. Conclusion and importance This is a biopsy-proven case of periocular immune checkpoint inhibitor-associated granulomatous inflammation.
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Affiliation(s)
- Charissa H. Tan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yoseph Sayegh
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Johns Hopkins Hospital, Baltimore, MD, USA
| | - Sohaib Fasih-Ahmad
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David T. Tse
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carol L. Karp
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sander R. Dubovy
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Zhang H, Qi L, Cai Y, Gao X. Gastrin-releasing peptide receptor (GRPR) as a novel biomarker and therapeutic target in prostate cancer. Ann Med 2024; 56:2320301. [PMID: 38442298 PMCID: PMC10916925 DOI: 10.1080/07853890.2024.2320301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Aim: This comprehensive review aims to explore the potential applications of Gastrin-releasing peptide receptor (GRPR) in the diagnosis and treatment of prostate cancer. Additionally, the study investigates the role of GRPR in prognostic assessment for individuals afflicted with prostate cancer.Methods: The review encompasses a thorough examination of existing literature and research studies related to the upregulation of GRPR in various tumor types, with a specific focus on prostate. The review also evaluates the utility of GRPR as a molecular target in prostate cancer research, comparing its significance to the well-established Prostate-specific membrane antigen (PSMA). The integration of radionuclide-targeted therapy with GRPR antagonists is explored as an innovative therapeutic approach for individuals with prostate cancer.Results: Research findings suggest that GRPR serves as a promising molecular target for visualizing low-grade prostate cancer. Furthermore, it is demonstrated to complement the detection of lesions that may be negative for PSMA. The integration of radionuclide-targeted therapy with GRPR antagonists presents a novel therapeutic paradigm, offering potential benefits for individuals undergoing treatment for prostate cancer.Conclusions: In conclusion, this review highlights the emerging role of GRPR in prostate cancer diagnosis and treatment. Moreover, the integration of radionuclide-targeted therapy with GRPR antagonists introduces an innovative therapeutic approach that holds promise for improving outcomes in individuals dealing with prostate cancer. The potential prognostic value of GRPR in assessing the disease's progression adds another dimension to its clinical significance in the realm of urology.
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Affiliation(s)
- Honghu Zhang
- Department of Urology, Disorders of Prostate Cancer Multidisciplinary Team, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha City, P. R. China
| | - Lin Qi
- Department of Urology, Disorders of Prostate Cancer Multidisciplinary Team, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha City, P. R. China
| | - Yi Cai
- Department of Urology, Disorders of Prostate Cancer Multidisciplinary Team, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha City, P. R. China
| | - Xiaomei Gao
- Department of Pathology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha City, P. R. China
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3
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Ait Addi R. Metastatic clear cell sarcoma of the pancreas: An overview. World J Clin Cases 2024; 12:6262-6265. [DOI: 10.12998/wjcc.v12.i29.6262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 08/28/2024] Open
Abstract
Clear cell sarcoma (CCS) is a rare soft-tissue sarcoma that accounts for less than 1% of all cases and was originally reported in 1965. The incidence of CCS is estimated to be approximately 0.014/100000 depending on the surveillance, epidemiology and end results databases. CCS is a highly invasive type that mainly metastasizes to the lungs, followed by the bones and brain; however, pancreatic metastasis is relatively rare. It has a high probability of recurrence or metastasis and has a poor prognosis with a high mortality rate. Finally, even after recovery, it is fundamental to keep regular postoperative follow-up for CCS patients.
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Affiliation(s)
- Rachid Ait Addi
- Department of Biology, Independent Senior Researcher, Marrakesh 41020, Morocco
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4
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Hama Rashid AK, Salih RQ, Fakhralddin SS, Mohammed AA, Muhammed HM, Ameen Ahmed NH, Salih GM, Mustafa AM, Muhammed BO, Kakamad FH. Semen uric acid crystals in azoospermia linked to Sertoli cell‑only syndrome: A rare case report. Exp Ther Med 2024; 28:397. [PMID: 39171146 PMCID: PMC11336801 DOI: 10.3892/etm.2024.12686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/09/2024] [Indexed: 08/23/2024] Open
Abstract
The occurrence of crystals in semen is rare, with spermine phosphate crystals being the only type commonly described. Uric acid crystal formation is significantly influenced by pH levels. The present study reported a rare case of uric acid crystals in the semen of a patient with azoospermia associated with Sertoli cell-only syndrome (SCOS). A 28-year-old male with a four-year history of primary infertility underwent clinical assessment, including a normal physical examination with small testes. Seminal fluid analysis revealed abnormal uric acid crystals. Elevated follicle-stimulating hormone, luteinizing hormone and prolactin levels were observed. The diagnosis of SCOS was confirmed through testicular sperm aspiration. Azoospermia is a medical condition characterized by the absence of sperm in the semen, specifically the absence of sperm in the pellet obtained after centrifugation. It is classified into two primary types: Obstructive and non-obstructive azoospermia. Non-obstructive azoospermia is subdivided into three categories: SCOS, hypospermatogenesis and maturation arrest. The occurrence of SCOS in azoospermic males ranges from 26.3 to 57.8%. The diagnosis of azoospermia with SCOS can be achieved through the analysis of multiple semen samples, medical history, physical examination, hormonal analysis, histopathological examination and genetic testing. The presence of uric acid crystals in seminal fluid was first reported in patients with chronic prostatitis symptoms in 2005. Despite the rarity of crystals in semen, uric acid crystals were found in the semen of an azoospermic male with SCOS.
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Affiliation(s)
- Awara K. Hama Rashid
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Rawezh Q. Salih
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
- Biology Department, College of Science, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Saman S. Fakhralddin
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Ayoob A. Mohammed
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Huda M. Muhammed
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Obstetrics and Gynaecology, Sulaimani Maternity Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Nahidah H. Ameen Ahmed
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Department of Obstetrics and Gynaecology, Sulaimani Maternity Teaching Hospital, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Goran M. Salih
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Ayman M. Mustafa
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Bryar O. Muhammed
- Scientific Affairs Department, Smart Health Tower/Raparin, Sulaymaniyah, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Azadi Mall, Sulaymaniyah, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46001, Iraq
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Uozumi N, Oura S. Metastatic lymph nodes of occult breast cancer show very low internal echoes. Radiol Case Rep 2024; 19:4163-4166. [PMID: 39101019 PMCID: PMC11293507 DOI: 10.1016/j.radcr.2024.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/11/2024] [Accepted: 06/27/2024] [Indexed: 08/06/2024] Open
Abstract
A 62-year-old woman showed an elevation of carcinoembryonic antigen (CEA) level 15 years after the left breast cancer, i.e., tubule forming type luminal micro invasive cancer, operation. Positron emission tomography/computed tomography (PET/CT) showed avid radio-tracer uptake in her right axillary and supraclavicular lymph nodes. Mammography, ultrasound (US), PET/CT, and magnetic resonance imaging showed no abnormalities in her right breast. US of the enlarged lymph nodes showed very low internal echoes. Pathological study using a core needle biopsy specimen of a right axillary node showed human epidermal growth factor receptor type 2 (HER2) positive atypical cells growing in solid and trabecular fashions. Under the presumed diagnosis of right occult breast cancer, the patient received anti-HER2 agents-containing chemotherapy, leading to marked shrinkage of the enlarged lymph nodes with normalization of the elevated CEA level. To confirm the pathological efficacy, sentinel plus sampling node biopsy was done to the patient. Postoperative pathological study of the resected nodes showed fibrosis and no viable cancer cells. The patient further received radiotherapy both to the right breast and suprarclavicular region followed by adjuvant anti-HER2 agents therapy, and has been well without any recurrences for 39 months. Diagnostic physicians should note that metastatic lymph nodes of occult breast cancer show very low internal echoes.
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Affiliation(s)
- Nozomi Uozumi
- Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada-city, Osaka 596-8522, Japan
| | - Shoji Oura
- Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada-city, Osaka 596-8522, Japan
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Larrosa C, Mico S, Ramos M, Perez-Jaume S, Sánchez M, Castañeda A, Garraus M, Mora J. Radiation recall reaction induced by gemcitabine/docetaxel in children: A retrospective study on risk factors and outcomes. Pediatr Blood Cancer 2024; 71:e31221. [PMID: 39086114 DOI: 10.1002/pbc.31221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 05/22/2024] [Accepted: 07/10/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION Radiation recall reaction (RRR) is a rare inflammatory reaction developing in a previously irradiated field after a triggering agent. In pediatric patients, it is poorly understood and deficiently studied. Gemcitabine-docetaxel (G/D) in childhood cancer is mainly used as a salvage regimen for sarcomas. We aim to describe RRR triggered by G/D in children. PATIENTS AND METHODS Retrospective review of 21 patients receiving G/D along with radiotherapy at two hospitals from 2010 until 2022. RRR was considered as any toxicity occurring after G/D administration in a previously irradiated field. RRR features were described. Fisher's and Mann-Whitney tests were utilized to analyze the risk factors involved. RESULTS Sixteen episodes of RRR developed in 16 (76.2%) patients. RRR mainly involved deep layers of the skin (58%) and occurred predominantly after two G/D cycles. The mean time between radiotherapy and chemotherapy was 28.5 days (0-1359 days), and the mean radiation volume 391 mL (157-1810 mL) for RRR. RRR treatment was mainly systemic steroids, with partial responses in six of 11 (58%) patients. Re-exposure to G/D was associated with a high rate of recurrence in nine of 15 (56.2%), prompting drug discontinuation. The major risk factors for RRR after G/D include, without statistical significance, a larger volume of the irradiated field and a shorter interval between chemotherapy and radiotherapy. CONCLUSIONS The incidence of RRR after G/D in the pediatric population is higher than previously reported. Drug re-exposure is usually followed by recurrence. Higher irradiated volumes and a shorter time to the start of chemotherapy could be related with an increased risk of RRR.
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Affiliation(s)
- Cristina Larrosa
- Extracranial Solid Tumors Unit, Pediatric Cancer Center Barcelona, Barcelona, Spain
| | - Soraya Mico
- Radiation Oncology Unit, Vall d'Hebron Hospital, Barcelona, Spain
| | - Mónica Ramos
- Radiation Oncology Unit, Vall d'Hebron Hospital, Barcelona, Spain
| | | | - Mónica Sánchez
- Oncology Pharmacy Unit, Pediatric Cancer Center Barcelona, Barcelona, Spain
| | - Alicia Castañeda
- Extracranial Solid Tumors Unit, Pediatric Cancer Center Barcelona, Barcelona, Spain
| | - Moira Garraus
- Extracranial Solid Tumors Unit, Pediatric Cancer Center Barcelona, Barcelona, Spain
| | - Jaume Mora
- Extracranial Solid Tumors Unit, Pediatric Cancer Center Barcelona, Barcelona, Spain
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7
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Rida M, Chalhoub M, Mansour M, Younan T, Chahine G, Nassar J, Slaba S. Ectopic hepatocellular carcinoma, an unexpected diagnosis of a retroperitoneal mass: A case report and literature review. Radiol Case Rep 2024; 19:4429-4434. [PMID: 39185436 PMCID: PMC11343981 DOI: 10.1016/j.radcr.2024.06.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/15/2024] [Accepted: 06/30/2024] [Indexed: 08/27/2024] Open
Abstract
Ectopic hepatocellular carcinoma (HCC) is defined as HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue without any communication with the mother liver. It is very rare and difficult to diagnose by imaging alone. We report a case of a rare ectopic HCC mimicking a right para-aortic retroperitoneal mass and present a review of the literature. It is about a 79-year-old female patient, who presented with a progressive enlarged right paraaortic retroperitoneal mass, thought first to be leiomyosarcoma of vena cava on imaging. Subsequently, high alpha-fetoprotein (AFP) level and biopsy allowed the diagnosis of primary extrahepatic hepatocellular carcinoma.
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Affiliation(s)
- Mohammad Rida
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Mariam Chalhoub
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maryam Mansour
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Tonine Younan
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Georges Chahine
- Department of Hematology and Oncology, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Jinane Nassar
- Department of Radiology, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Sami Slaba
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
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8
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Zhou Y, Yang L. Large-cell neuroendocrine carcinoma of the bladder: A case report. World J Clin Oncol 2024; 15:1239-1244. [DOI: 10.5306/wjco.v15.i9.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/26/2024] [Accepted: 06/12/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness. The bladder is characterized by four distinct forms of neuroendocrine tumors. Among them, large-cell neuroendocrine carcinoma is the least prevalent, but has the highest level of aggressiveness. The 5-year survival rate for large-cell neuroendocrine carcinoma of the bladder is exceedingly poor. To date, only a few dozen cases have been reported.
CASE SUMMARY Here, we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder. The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology. During hospitalization, abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder. A cystoscopic non-radical resection of the bladder lesion was performed. The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer. Previous reports on cases of large-cell neuroendocrine carcinoma cases were retrieved from PubMed, and the present paper discusses the currently recognized best diagnostic and treatment options for large-cell neuroendocrine carcinoma based on the latest research progress.
CONCLUSION Large-cell neuroendocrine carcinoma of the bladder is an uncommon malignancy with a highly unfavorable prognosis. Despite ongoing efforts to prolong patient survival through multidisciplinary therapy, the prognosis remains unfavorable. Large-cell neuroendocrine carcinoma continues to be a subject of uncertainty.
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Affiliation(s)
- Yu Zhou
- Department of Urology, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing 402760, China
| | - Lin Yang
- Department of Urology, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing 402760, China
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9
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Sun MQ, Guo LN, You Y, Qiu YY, He XD, Han XL. Sclerosing epithelioid fibrosarcoma of the pancreas: A case report. World J Clin Cases 2024; 12:5983-5989. [DOI: 10.12998/wjcc.v12.i26.5983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND A sclerosing epithelioid fibrosarcoma (SEF) is a rare malignant fibroblastic soft tissue tumor that rarely occurs in intra-abdominal organs. A case of a SEF in the pancreatic head is reported herein, including its clinical manifestations, preoperative imaging features, gross specimen and pathological findings.
CASE SUMMARY A 33-year-old male patient was admitted to Peking Union Medical College Hospital in December 2023 due to a one-year history of intermittent upper abdominal pain and the discovery of a pancreatic mass. The patient underwent an enhanced computed tomography scan of the abdomen, which revealed a well-defined, round mass with clear borders and calcifications in the pancreatic head. The mass exhibited progressive, uneven mild enhancement, measuring approximately 6.6 cm × 6.3 cm. The patient underwent laparoscopic pylorus-preserving pancreaticoduodenectomy. Postoperative pathological examination revealed that the lesion was consistent with a SEF. At the 3-month postoperative follow-up, the patient did not report any short-term complications, and there were no signs of tumor recurrence.
CONCLUSION SEFs are rare malignant fibrous soft tissue tumors. SEFs rarely develop in the pancreas, and its preoperative diagnosis depends on imaging findings, with confirmation depending on pathological examination and immunohistochemistry. Currently, only four cases of pancreatic SEF have been reported in studies written in English. This case is the first reported case of a pancreatic SEF by a clinical physician.
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Affiliation(s)
- Meng-Qing Sun
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Li-Na Guo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yan You
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yan-Yu Qiu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiao-Dong He
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xian-Lin Han
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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Wang D, Zhang Y, Li Q, Li Y, Li W, Zhang A, Xu J, Meng J, Tang L, Lyu S. Epigenetics: Mechanisms, potential roles, and therapeutic strategies in cancer progression. Genes Dis 2024; 11:101020. [PMID: 38988323 PMCID: PMC11233905 DOI: 10.1016/j.gendis.2023.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/20/2023] [Accepted: 04/14/2023] [Indexed: 07/12/2024] Open
Abstract
Mutations or abnormal expression of oncogenes and tumor suppressor genes are known to cause cancer. Recent studies have shown that epigenetic modifications are key drivers of cancer development and progression. Nevertheless, the mechanistic role of epigenetic dysregulation in the tumor microenvironment is not fully understood. Here, we reviewed the role of epigenetic modifications of cancer cells and non-cancer cells in the tumor microenvironment and recent research advances in cancer epigenetic drugs. In addition, we discussed the great potential of epigenetic combination therapies in the clinical treatment of cancer. However, there are still some challenges in the field of cancer epigenetics, such as epigenetic tumor heterogeneity, epigenetic drug heterogeneity, and crosstalk between epigenetics, proteomics, metabolomics, and other omics, which may be the focus and difficulty of cancer treatment in the future. In conclusion, epigenetic modifications in the tumor microenvironment are essential for future epigenetic drug development and the comprehensive treatment of cancer. Epigenetic combination therapy may be a novel strategy for the future clinical treatment of cancer.
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Affiliation(s)
- Dong Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yan Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Qingbo Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yu Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Wen Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Ao Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jingxuan Xu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jingyan Meng
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Lin Tang
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shuhua Lyu
- Department of Pathology, Tianjin Union Medical Center, Tianjin 300121, China
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11
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Miao X, Guo Z, Zhang K, Chang J, Yang J, Miao G, Tian Y. Changes in mucosa‑associated lymphoid tissue 1 predicts therapeutic response and survival in patients with advanced melanoma receiving programmed cell death‑1 inhibitor monotherapy. Oncol Lett 2024; 28:433. [PMID: 39049986 PMCID: PMC11268090 DOI: 10.3892/ol.2024.14566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/19/2024] [Indexed: 07/27/2024] Open
Abstract
Advanced melanoma is an aggressive and dangerous form of skin cancer, and programmed cell death-1 (PD-1) inhibitors are recommended treatment options for patients with advanced melanoma. Mucosa-associated lymphoid tissue 1 (MALT1) impairs CD8+ T-cell activation to induce immune escape, leading to a reduction in the antitumor effect of PD-1 inhibitors. The present study aimed to assess the prognostic implication of MALT1 in patients with advanced melanoma receiving PD-1 inhibitor monotherapy. Blood MALT1 levels were assessed using reverse transcription-quantitative PCR in 20 healthy controls (HCs) after enrollment and in 49 patients with advanced melanoma before (T0), as well as 2 months (T1) and 4 months after (T2) PD-1 inhibitor monotherapy. The maximum level of MALT1 in HCs (3.100) was used as the cut-off in patients with advanced melanoma. MALT1 levels at T0 were significantly increased in patients with advanced melanoma compared with in HCs (P<0.001). In patients with advanced melanoma, MALT1 was significantly decreased from T0 to T2 (P<0.001). Objective response rate (ORR) and disease control rate (DCR) were 28.6 and 59.2%, respectively. MALT1 levels at T1 were significantly negatively associated with overall therapeutic response (P=0.001), ORR (P=0.009) and DCR (P=0.004). MALT1 levels at T2 were significantly inversely associated with overall therapeutic response (P=0.021) and ORR (P=0.036). Moreover, MALT1 levels >3.100 at T0 (P=0.027) and T1 (P=0.045) were significantly associated with shorter progression-free survival (PFS), and MALT1 levels >3.100 at T1 were significantly associated with a poor overall survival (OS; P=0.022). Multivariate Cox regression analysis demonstrated that MALT1 levels at T0 (>3.100 vs. ≤3.100) were significantly associated with a poor PFS [hazard ratio (HR)=2.248; P=0.037], and MALT1 levels at T1 (>3.100 vs. ≤3.100) were significantly associated with a poor OS (HR=4.332; P=0.007). In conclusion, MALT1 levels are reduced following PD-1 treatment, and a high MALT1 level is associated with a poor therapeutic response and shorter survival in patients with advanced melanoma receiving PD-1 inhibitor monotherapy.
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Affiliation(s)
- Xiaoyan Miao
- Department of Plastic Surgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei 056002, P.R. China
| | - Ziyi Guo
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Kai Zhang
- Department of Orthopedics 1, Handan Central Hospital, Handan, Hebei 056000, P.R. China
| | - Jin Chang
- Department of Plastic Surgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei 056002, P.R. China
| | - Jianmin Yang
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital, Beijing 102218, P.R. China
| | - Guoying Miao
- Department of Dermatology, Affiliated Hospital of Hebei Engineering University, Handan, Hebei 056002, P.R. China
| | - Yan Tian
- Department of Plastic Surgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei 056002, P.R. China
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Shiyanbola O, Nigdelioglu R, Dhall D, González IA, Warmke LM, Schechter S, Choi WT, Hu S, Voltaggio L, Zhang Y, Liang TZ, Ko HM, Charville GW, Longacre TA. Extraskeletal Ewing Sarcoma of the Gastrointestinal and Hepatobiliary Tract: Deceptive Immunophenotype Commonly Leads to Misdiagnosis. Am J Surg Pathol 2024; 48:1185-1194. [PMID: 38767576 PMCID: PMC11321603 DOI: 10.1097/pas.0000000000002236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Ewing sarcoma (ES) is an uncommon mesenchymal neoplasm that typically develops as a bone mass, although up to 30% arise in extraskeletal sites. ES of the gastrointestinal (GI) and hepatobiliary tract is rare and may be misdiagnosed as other, more common neoplasms that occur in these sites. However, the correct classification of extraskeletal ES is important for timely clinical management and prognostication. We reviewed our experience of ES in the GI and hepatobiliary tract in order to further highlight the clinicopathologic features of these neoplasms and document the potential for misdiagnosis in this setting. The archives and consultation files of 6 academic institutions were retrospectively queried for cases of ES occurring in the GI and hepatobiliary tract. The histologic slides and ancillary studies were reviewed and clinical data were retrieved for each case through the electronic medical records, when available. Twenty-three patients with ES in the GI and/or hepatobiliary tract were identified from 2000 to 2022. Of these, 11 were women and 12 were men with a median age of 38 years (range, 2 to 64). Tumor locations included the pancreas (n=5), liver (n=2), stomach (n=3), colorectum (n=3), and small intestine (n=5), as well as tumors involving multiple organs, pelvis and retroperitoneum (n=5). Tumor size varied between 2 cm and 18 cm. Twenty were primary and 3 were metastases. Of the 23 cases, only 17% were initially diagnosed as ES. The most common misdiagnoses involved various forms of neuroendocrine neoplasia due to expression of synaptophysin and other neuroendocrine markers (22%). A wide variety of diagnoses including GI stromal tumor was considered due to aberrant CD117 expression (4%). The diagnosis of ES was ultimately confirmed by detection of the EWSR1 rearrangement in 22 cases. The remaining case was diagnosed using traditional immunohistochemistry. Follow-up information was available in 20 cases, with follow-up time varying between 2 and 256 months. Six patients with follow-up died of disease between 6 and 60 months following initial presentation. Our data indicate ES in the GI and hepatobiliary tract is commonly misdiagnosed leading to a delay in therapy. In light of the attendant therapeutic and prognostic implications, ES should be considered in the differential diagnosis of any GI or hepatobiliary tumor with epithelioid and/or small round cell morphology.
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Affiliation(s)
| | | | - Deepti Dhall
- University of Alabama at Birmingham, Birmingham, AL
| | - Iván A. González
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Laura M. Warmke
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN
| | | | | | | | | | - Yujie Zhang
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Tom Z. Liang
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Huaibin M. Ko
- New York-Presbyterian/Columbia University Medical Center, New York City, NY
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Sideris G, Solomos P, Gogoulos P, Margaris I, Panagoulis E, Vlastarakos P, Karamagkiolas S, Tzagkaroulakis M, Nikolopoulos T, Delides A. Neuroendocrine and undifferentiated sinonasal and skull base tumors: An up-to-date narrative review. Oral Maxillofac Surg 2024; 28:1009-1017. [PMID: 38502274 DOI: 10.1007/s10006-024-01240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/17/2024] [Indexed: 03/21/2024]
Abstract
Tumors located in the nasal cavity, paranasal sinuses and the skull base comprise a wide range of histologic subtypes. Among them, neuroendocrine and undifferentiated tumors are rare but noteworthy, because of their distinctive features, aggressive nature, and diagnostic complexities. A literature search was conducted in the PubMed/MEDLINE and the Scopus databases from 2019 until inception. The keywords "neuroendocrine", "undifferentiated", "nose", "sinonasal", "paranasal", "skull base" were used. Thirty-eight articles referring to neuroendocrine and undifferentiated tumors of the nose, paranasal sinuses and the skull base were finally included and analyzed. Neuroendocrine and undifferentiated tumors of the nose, paranasal sinuses and the skull base are infrequent malignancies, most commonly affecting middle-aged men. They usually present with non-specific symptoms, even though ocular or neurologic manifestations may occur. Prognosis is generally poor; however, novel targeted and immunological therapies have shown promising results. Sinonasal Neuroendocrine Carcinomas (SNECs) carry distinct histological and immunohistochemical features. Management consists of surgical resection coupled with systematic therapy. Sinonasal Undifferentiated Carcinomas (SNUCs) lack specific squamous or glandular features. They typically stain positive for pancytokeratin and INI1 antibody. Treatment includes induction chemotherapy, followed by a combination of chemotherapy and radiotherapy. Olfactory neuroblastomas (ONBs) have neuroepithelial or neuroblastic features. They show diffuse positivity for various markers, including synaptophysin, chromogranin, and neuron-specific enolase (NSE). Surgical resection plus radiotherapy is considered the treatment of choice. In conclusion, neuroendocrine and undifferentiated tumors arising from the nose, paranasal sinuses and the skull base represent a unique group of malignancies. A thorough understanding of their clinical features, molecular changes, diagnostic approaches, treatment modalities, and prognostic factors is critical for providing optimal patient care. Still, continued research efforts and multidisciplinary collaboration are warranted, in order to improve outcomes for patients diagnosed with these rare and aggressive tumors.
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Affiliation(s)
- Giorgos Sideris
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece.
| | - Panagiotis Solomos
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Panagiotis Gogoulos
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Ioannis Margaris
- 4Th Department of Surgery, "Attikon" University Hospital National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evangelos Panagoulis
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Petros Vlastarakos
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Sotirios Karamagkiolas
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Michael Tzagkaroulakis
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Thomas Nikolopoulos
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
| | - Alexander Delides
- 2Nd Otolaryngology Department, "Attikon" University Hospital, National & Kapodistrian University of Athens, School of Medicine, Rimini 1, 12462, Chaidari, Athens, Greece
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14
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Aragão HHR, Lima LBR, Cavalcante IL, da Silva Neto SS, Turatti E, Cavalcante RB, Gilligan G, Panico R, de Mendonça EF, de Albuquerque-Júnior RLC, Nonaka CFW, Alves PM, de Andrade BAB, Cunha JLS. Oral granular cell tumor: a collaborative clinicopathological study of 61 cases. Oral Maxillofac Surg 2024; 28:1383-1397. [PMID: 38904898 DOI: 10.1007/s10006-024-01272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management. METHODS All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated. RESULTS The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence. CONCLUSIONS The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent.
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Affiliation(s)
| | - Luana Beatriz Ribeiro Lima
- Department of Dentistry, Graduate Program in Dental Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
- School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil
| | - Israel Leal Cavalcante
- School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Eveline Turatti
- School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil
| | | | - Gerardo Gilligan
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba (UNC), Córdoba, Argentina
| | - Rene Panico
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba (UNC), Córdoba, Argentina
| | | | | | | | | | | | - John Lennon Silva Cunha
- Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Brazil.
- Department of Biological and Health Sciences, Federal University of Western Bahia (UFOB), Rua da Prainha, 1326 - Bairro Morada Nobre, Barreiras, BA, 47810-047, Brazil.
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15
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Liu YC, Schmidt RO, Kapadia NS, Phillips JD, Moen EL. Disparities in Access to Multidisciplinary Cancer Consultations and Treatment for Patients With Early-Stage Non-Small Cell Lung Cancer: A SEER-Medicare Analysis. Int J Radiat Oncol Biol Phys 2024; 120:102-110. [PMID: 38490619 PMCID: PMC11329352 DOI: 10.1016/j.ijrobp.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/08/2024] [Accepted: 03/07/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE Disparities in access to a multidisciplinary cancer consultation (MDCc) persist, and the role of physician relationships remains understudied. This study examined the extent to which multilevel factors, including patient characteristics and patient-sharing network measures reflecting the structure of physician relationships, are associated with an MDCc and receipt of stereotactic body radiation therapy versus surgery among patients with early-stage non-small cell lung cancer (NSCLC). METHODS AND MATERIALS In this cross-sectional study, we analyzed Surveillance, Epidemiology, and End Results (SEER)-Medicare data for patients diagnosed with stage I-IIA NSCLC from 2016 to 2017. We assembled patient-sharing networks and identified cancer specialists who were locally unique for their specialty, herein referred to as linchpins. The proportion of linchpin cancer specialists for each hospital referral region (HRR) was calculated as a network-based measure of specialist scarcity. We used multilevel multinomial logistic regression to estimate associations between study variables and receipt of an MDCc and multilevel logistic regression to examine the relationship between patient receipt of an MDCc and initial treatment. RESULTS Our study included 6120 patients with stage I-IIA NSCLC, of whom 751 (12.3%) received an MDCc, 1729 (28.3%) consulted only a radiation oncologist, 2010 (32.8%) consulted only a surgeon, and 1630 (26.6%) consulted neither specialist within 2 months of diagnosis. Compared with patients residing in an HRR with a low proportion of linchpin surgeons, those residing in an HRR with a high proportion of linchpin surgeons had a 2.99 (95% CI, 1.87-4.78) greater relative risk of consulting only a radiation oncologist versus receiving an MDCc and a 2.70 (95% CI, 1.68-4.35) greater relative risk of consulting neither specialist versus receiving an MDCc. Patients who received an MDCc were 5.32 times (95% CI, 4.27-6.63) more likely to receive stereotactic body radiation therapy versus surgery. CONCLUSIONS Physician networks are associated with receipt of an MDCc and treatment, underscoring the potential for leveraging patient-sharing network analysis to improve access to lung cancer care.
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Affiliation(s)
- You-Chi Liu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Rachel O Schmidt
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
| | - Nirav S Kapadia
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire; Dartmouth Cancer Center, Lebanon, New Hampshire; Department of Medicine, Dartmouth-Health, Lebanon, New Hampshire
| | - Joseph D Phillips
- Dartmouth Cancer Center, Lebanon, New Hampshire; Department of Surgery, Dartmouth-Health, Lebanon, New Hampshire
| | - Erika L Moen
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
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16
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Fotiou D, Solia E, Theodorakakou F, Nikolaou P, Gakiopoulou C, Psimenou E, Papanikolaou A, Dimopoulos MA, Kastritis E. TEMPI syndrome: difficult to diagnose, "easy" to treat? Ann Hematol 2024; 103:3787-3793. [PMID: 39078435 DOI: 10.1007/s00277-024-05893-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024]
Abstract
TEMPI syndrome is a rare, acquired disorder with multisystemic manifestations. It is classified as a plasma cell disorder and is characterized by telangiectasias, erythrocytosis, monoclonal gammopathy, perinephric fluid collections and intrapulmonary shunt. Even though TEMPI's pathophysiology remains elusive, it responds to anti-myeloma therapy indicating that the monoclonal protein or clone plays a key role. We present a challenging case of a 73-year-old man with erythrocytosis and deteriorating renal function with nephrotic-range proteinuria in whom after extensive work up, the diagnosis of TEMPI syndrome was made. He was received treatment with daratumumab-bortezomib-cyclophosphamide and dexamethasone (Dara-VCD) and achieved a hematological and clinical response. We also report preliminary data on a multiplex assay for cytokines and growth factors for two patients with TEMPI syndrome and note lower levels for non-specific innate immunity related cytokines. A direct link between renal impairment and TEMPI syndrome is not currently established; cytokine deregulation could potentially be involved in the ischemic changes observed in the renal biopsy of our patient.
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Affiliation(s)
- Despina Fotiou
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | - Eirini Solia
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | - Foteini Theodorakakou
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | - Panagiota Nikolaou
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | - Charikleia Gakiopoulou
- 1st Department of Pathology, National and Kapodistrian University of Athens, Athens, Greece
| | - Erasmia Psimenou
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | | | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vas Sofias 80, Athens, 11528, Greece.
- Laboratory of Pharmacology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, 15771, Greece.
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Grewal US, Gaddam SJ, Beg MS, Brown TJ. Targeted therapies in advanced biliary malignancies: a clinical review. Expert Rev Anticancer Ther 2024; 24:869-880. [PMID: 39083012 DOI: 10.1080/14737140.2024.2387612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/30/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION Despite several therapeutic advancements, the proportion of patients with advanced biliary tract cancers (BTC) surviving 5 years from diagnosis remains dismal. The increasing recognition of targetable genetic alterations in BTCs has ushered in a new era in the treatment of these patients. Newer therapeutic agents targeting mutations such as isocitrate dehydrogenase (IDH), fibroblastic growth factor receptor (FGFR), human epidermal growth factor receptor (HER), and so on have established a new standard of care for treatment upon progression on frontline therapy in patients with disease harboring these mutations. AREAS COVERED The current review aims to concisely summarize progress with various targeted therapy options for BTC. We also briefly discuss future directions in clinical and translational research for the adoption of a personalized approach for the treatment of unresectable or advanced BTC. EXPERT OPINION Several new agents continue to emerge as feasible treatment options for patients with advanced BTC harboring targetable mutations. There is a growing need to identify mechanisms to conquer primary and acquired resistance to these agents. The identification of potential biomarkers that predict response to targeted therapy may be helpful in adopting a more tailored approach. All patients receiving treatment for advanced BTC should undergo tissue genomic profiling at diagnosis.
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Affiliation(s)
- Udhayvir S Grewal
- Division of Hematology and Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Shiva J Gaddam
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | | | - Timothy J Brown
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Birtle AJ, Formisano L, Descamps V, Weisenseel P, Vilaseca A. Early Identification and Management of Patients with Rash on Apalutamide. Oncol Ther 2024; 12:609-620. [PMID: 39088147 PMCID: PMC11333394 DOI: 10.1007/s40487-024-00290-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 06/27/2024] [Indexed: 08/02/2024] Open
Abstract
Apalutamide is a selective androgen receptor signalling inhibitor that is used in the treatment of prostate cancer. Skin rash is one of the most common adverse events with apalutamide. Although the majority of rash events are grade 1 and 2, the appearance of skin rash during treatment can lead to dose reduction, a pause in treatment or even treatment discontinuation, especially if patients present late when the rash has become severe. This in turn can result in a significant delay or even a permanent discontinuation in the patient's treatment of prostate cancer. As apalutamide is a generally well tolerated and an effective treatment for many men with advanced prostate cancer, it is extremely important to make attempts to prevent skin problems or to manage them at the earliest stage possible. We therefore have developed practical guidance for the management of apalutamide-related rash, including an infographic with recommendations for rash management by grade. Central to this approach is patient education and awareness. Encouraging patients to proactively care for their skin from the start of treatment and informing them of the risk of rash with apalutamide therapy are essential. If the patient observes any skin changes, they should be advised to report it straight away to their cancer care team. Adopting this simple, proactive approach of patient education and increased vigilance from the care team is expected to lead to early identification of rash and subsequent intervention to allow for quicker resolution and enable patients to continue their cancer treatment with a drug that can delay disease progression and increase survival in patients with prostate cancer.
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Affiliation(s)
- Alison J Birtle
- The Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK.
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19
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Melrose J, Guilak F. Diverse and multifunctional roles for perlecan ( HSPG2) in repair of the intervertebral disc. JOR Spine 2024; 7:e1362. [PMID: 39081381 PMCID: PMC11286675 DOI: 10.1002/jsp2.1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 06/11/2024] [Accepted: 07/10/2024] [Indexed: 08/02/2024] Open
Abstract
Perlecan is a widely distributed, modular, and multifunctional heparan sulfate proteoglycan, which facilitates cellular communication with the extracellular environment to promote tissue development, tissue homeostasis, and optimization of biomechanical tissue functions. Perlecan-mediated osmotic mechanotransduction serves to regulate the metabolic activity of cells in tissues subjected to tension, compression, or shear. Perlecan interacts with a vast array of extracellular matrix (ECM) proteins through which it stabilizes tissues and regulates the proliferation or differentiation of resident cell populations. Here we examine the roles of the HS-proteoglycan perlecan in the normal and destabilized intervertebral disc. The intervertebral disc cell has evolved to survive in a hostile weight bearing, acidic, low oxygen tension, and low nutrition environment, and perlecan provides cytoprotection, shields disc cells from excessive compressive forces, and sequesters a range of growth factors in the disc cell environment where they aid in cellular survival, proliferation, and differentiation. The cells in mechanically destabilized connective tissues attempt to re-establish optimal tissue composition and tissue functional properties by changing the properties of their ECM, in the process of chondroid metaplasia. We explore the possibility that perlecan assists in these cell-mediated tissue remodeling responses by regulating disc cell anabolism. Perlecan's mechano-osmotic transductive property may be of potential therapeutic application.
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Affiliation(s)
- James Melrose
- Raymond Purves Bone and Joint Research Laboratory, Kolling InstituteNorthern Sydney Local Health DistrictSt. LeonardsNew South WalesAustralia
- Graduate School of Biomedical EngineeringUniversity of New South WalesSydneyNew South WalesAustralia
- Sydney Medical School, NorthernThe University of SydneySt. LeonardsNew South WalesAustralia
- Faculty of Medicine and HealthThe University of Sydney, Royal North Shore HospitalSt. LeonardsNew South WalesAustralia
| | - Farshid Guilak
- Department of Orthopaedic SurgeryWashington UniversitySt. LouisMissouriUSA
- Department of OrthopaedicsShriners Hospitals for ChildrenSt. LouisMissouriUSA
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20
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Wang L, Fang L, Shi H, Liu Y, Long C, Guo S, Yang X, Hu Q, Liu Z, Yang C, Chen M, Han B. Treatment of myelofibrosis with refractory anemia with luspatercept: a multicenter Chinese study. Ann Hematol 2024; 103:3605-3613. [PMID: 38907072 DOI: 10.1007/s00277-024-05847-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
Myelofibrosis is a rare and often fatal hematological neoplasm, and the treatment of myelofibrosis-associated anemia remains suboptimal, with no improved therapies. Luspatercept was shown to display some efficacy in a phase 2 clinical trial for Myelofibrosis with anemia, yet relevant research are limited. Threrfore, data from patients diagnosed with refractory anemic primary or post-essential thrombocythemia/polycythemia vera myelofibrosis, who were treated with luspatercept for at least 9 weeks, were retrospectively collected. Eighteen patients with myelofibrosis treated with luspatercept were enrolled. Median age was 68 years (range, 44-80 years), and 27.8% were males. Ten (55.6%) were transfusion-dependent. Ten (55.6%) were Dynamic International Prognostic Scoring System intermediate-1, and eight (44.4%) were intermediate-2. The median follow-up was 7 (4-16) months. Erythroid response occurred in eight patients (44.4%) at week 12, four patients (30.8%) at week 24, and nine (50%) at the end of follow-up. Patients who were transfusion-dependent and not transfusion-dependent had similar HI-E responses, at different time points (P > 0.05). Patients had a significantly higher hemoglobin level at 12 weeks, 24 weeks, and at the end of follow-up, than at baseline (P = 0.001, P = 0.021, and P = 0.005, respectively). Treatment-related adverse events occurred in five (16.7%) patients, with no serious adverse events. Two (11.1%) patients relapsed at weeks 15 and 31. One patient progressed to acute myeloid leukemia. No patients had died by the end of follow-up. Luspatercept induced a good response in patients with anemic myelofibrosis, with a low relapse rate and good tolerance.
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Affiliation(s)
- Leyu Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Liwei Fang
- State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Hongxia Shi
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yinghui Liu
- Department of Hematology, Yantai Yuhuangding Hospital, Yantai, China
| | - Chan Long
- Department of Hematology, Huizhou First People's Hospital, Huzhou, China
| | - Shuxia Guo
- Department of Hematology, People's hospital of Zhengzhou, Zhengzhou, China
| | - Xiuli Yang
- Department of Hematology, Harbin Institute of Hematology and Oncology, Harbin, China
| | - Qinglin Hu
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Ziwei Liu
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Chen Yang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Miao Chen
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Bing Han
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academe of Medical Science and Peking Union Medical College, Beijing, 100730, China.
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Tadmor T. Overcoming the unmet need of Richter transformation: the use of pirtobrutinib. Lancet Haematol 2024; 11:e636-e637. [PMID: 39033771 DOI: 10.1016/s2352-3026(24)00204-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 07/23/2024]
Affiliation(s)
- Tamar Tadmor
- Hematology Unit, Bnai-Zion Medical Center, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Jahanshahi F, Davani SZ, Naderi D, Parsaei A, Mirahmadi Eraghi M. Cardiac metastasis from gastric adenocarcinoma: A rare case report. Int J Surg Case Rep 2024; 122:110036. [PMID: 39043093 PMCID: PMC11318462 DOI: 10.1016/j.ijscr.2024.110036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION AND SIGNIFICANCE Cardiac dissemination of gastric adenocarcinoma represents an exceedingly uncommon clinical scenario. To date, there is an absence of documentation concerning the presence of tumor emboli within the cardiac chambers originating from gastric cancer, particularly following a possible transvenous migration. CASE PRESENTATION This report delineates the clinical journey of a 60-year-old female diagnosed with inoperable diffuse gastric adenocarcinoma, who developed cardiac metastases. CLINICAL DISCUSSION The prognostication of isolated cardiac metastasis in oncology patients is fraught with difficulty due to its infrequency and non-specific clinical manifestations. While systematic screening for cardiac metastasis is not part of standard oncological protocols, heightened vigilance is warranted in specific scenarios such as advanced-stage malignancies or in the presence of suggestive cardiac symptomatology, thereby prompting further exploration. CONCLUSION Cardiac metastasis, while infrequent, constitutes a dire clinical entity that must be contemplated in the differential diagnosis of cardiac mass presentations in individuals with a neoplastic history. Prompt recognition and deployment of appropriate diagnostic imaging are pivotal for informed therapeutic decision-making. An integrative, multidisciplinary strategy is imperative for the formulation of an optimal treatment paradigm, encompassing surgical and palliative care options. KEY CLINICAL MESSAGE Cardiac metastasis of gastric adenocarcinoma are extremely rare, however, in gastric cancer cases with cardiopulmonary manifestation should be considered as a probable differential diagnoses.
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Affiliation(s)
- Fatemeh Jahanshahi
- Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Sam ZeraatianNejad Davani
- Attending Professor of Cardiovascular Surgery and Dean of Faculty of Transplant and Organ Donation, Iran University of Medical Sciences, Tehran, Iran
| | - Delaram Naderi
- Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Parsaei
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mirahmadi Eraghi
- Student Research Committee, School of Medicine, Islamic Azad University, Qeshm International Branch, Qeshm, Iran
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23
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Werneburg GT, Fascelli M. Sexually transmitted infections and the vaginal microbiome after vaginoplasty. Curr Opin Urol 2024; 34:323-329. [PMID: 38903052 DOI: 10.1097/mou.0000000000001203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
PURPOSE OF REVIEW Transgender and gender-diverse individuals (TGD) are at risk for sexually transmitted infections. Gender affirmation surgery is a cornerstone of care for many TGD individuals. For genital gender affirmation, the surgical creation of a vagina may be performed through a number of techniques. Those who have undergone vaginoplasty have unique anatomical and biopsychosocial considerations, which we discuss. RECENT FINDINGS While sexually-transmitted infections including HPV, HSV, HIV, gonorrhea, and chlamydia, have been described in TGD individuals after vaginoplasty, the reports are very rare, and the provider should maintain an index of suspicion and maintain a broad differential for symptoms including neovaginal discharge. We discuss the association of the neovaginal microbiota composition with bacterial vaginosis, and how its modulation could potentially reduce bacterial vaginosis and sexually transmitted infection risk. SUMMARY We examine the literature regarding sexually-transmitted infections following vaginoplasty, and the neovaginal microbiome and its similarities and differences relative to the natal vaginal microbiome.
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Affiliation(s)
- Glenn T Werneburg
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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24
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Bugia L, Jungbauer F, Zaubitzer L, Hörner C, Merx K, Yasser AM, Germann T, Lammert A, Scherl C, Rotter N, Affolter A. Nivolumab as a Promising Treatment Option for Metastatic Salivary Duct Carcinoma. J Immunother 2024; 47:258-262. [PMID: 38545827 PMCID: PMC11299898 DOI: 10.1097/cji.0000000000000513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 08/07/2024]
Abstract
Salivary duct carcinomas (SDC) of the parotid gland are rarely occurring highly malignant tumors. A 65-year-old man presented with a preauricular mass. After surgical treatment and histologic examination, the findings were interpreted as a squamous cell carcinoma (SCC) metastasis of the parotid gland deriving from a cancer of unknown primary DD primary SCC of the parotid gland. Adjuvant platinum-based radiochemotherapy was administered in domo. However, re-staging revealed multiple size-progressive pulmonary round lesions. After resection and histological examination of a pulmonary mass and in synopsis with the primary tumor, the initial diagnosis of SCC was revised to SDC of the parotid gland. With positive HER-2 status, off-label trastuzumab/docetaxel was initiated in an individual healing attempt, during which the pulmonary metastases showed clear progression. Consequently, the patient received immunotherapy with nivolumab according to his negative PD-L1 status. After 57 cycles of nivolumab, the patient presents with partial remission and in good condition. We report, for the first time, a robust response of metastatic SDC to checkpoint inhibition with nivolumab without additional radiotherapy.
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Affiliation(s)
- Luis Bugia
- Departments of Otorhinolaryngology, Head and Neck Surgery
| | | | - Lena Zaubitzer
- Departments of Otorhinolaryngology, Head and Neck Surgery
| | - Christian Hörner
- Institute for Pathology, University Medical Faculty Mannheim, University of Heidelberg, Manheim, Germany
| | | | | | | | - Anne Lammert
- Departments of Otorhinolaryngology, Head and Neck Surgery
| | - Claudia Scherl
- Departments of Otorhinolaryngology, Head and Neck Surgery
| | - Nicole Rotter
- Departments of Otorhinolaryngology, Head and Neck Surgery
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25
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de Gennaro L, Messina R, Bruno MC, Bozzi MT, Speranzon L, Delvecchio C, Chibbaro S, Marani W, Montemurro N, Signorelli F. The role of neurosurgeon in the multidisciplinary approach to ectopic or bifocal intracranial germinoma: A systematic review and report of two illustrative cases. Clin Neurol Neurosurg 2024; 244:108408. [PMID: 38954867 DOI: 10.1016/j.clineuro.2024.108408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/18/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Pure germinoma typically originates from the midline and is usually found in the pineal and suprasellar regions in 76-90 % of cases. When it is in both regions, it is considered bifocal (10 % at diagnosis). If pure germinoma is located outside of the midline, it is considered ectopic, with a global incidence of about 0.7 %. The study aims to describe the clinical and surgical approach to patients with atypical intracranial ectopic germinoma (IEG) and bifocal germinoma (BG) through a literature review with the goal to delineate the correct diagnostic and therapeutic pathway, to reduce the diagnostic delay and improve the prognosis of these patients. METHODS A systematic review of the literature in most common electronic database (PubMed, Ovid MEDLINE and Ovid EMBASE) on IEG and BG, in according with the "PRISMA statement" criteria, from January 1990 to September 2022 was done. In addition, two rare cases of IEG and BG were reported. RESULTS This systematic review included 16 papers (20 patients) with a final diagnosis of IEG and 30 papers (121 patients) with a final diagnosis of BG. IEGs seems to involve primary basal ganglia (40 %) and corpus callosum (40 %). For IEGs, biopsy (70 %, 14 cases out of 20) was the most common surgical approach: open approach (35 %), stereotactic minimally invasive approach (30 %) or endoscopic trans-sphenoidal approach (5 %). Partial resection was performed in 10 % of cases, whereas a total resection was performed in 20 % of cases. Also for BGs, biopsy was the most common surgical approach in 80 % of patients, whereas surgical resection (partial or total) was performed in 5.3 % of patients. CONCLUSION IEG and BG are rare type of primary intracranial germ cell tumor, whose unusual location often can cause delays in diagnosis, which can have a significant impact on the patient's prognosis and requiring a multidisciplinary and timely approach.
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Affiliation(s)
- Luigi de Gennaro
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | - Raffaella Messina
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | | | - Maria Teresa Bozzi
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | - Luca Speranzon
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | - Carlo Delvecchio
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | - Salvatore Chibbaro
- Division of Neurosurgery, Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze, Università di Siena, Italy
| | - Walter Marani
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy.
| | - Francesco Signorelli
- Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Bari, Italy
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Jadallah RK, Al Sharie AH, Alzghoul SM, Al-Karaki JM, Amer MSB, Rawashdeh TH, Alshari O. Palbociclib and Fulvestrant Combined Regimen Induced Prolonged Bone Metastasis Control of Stage IV HR+/HER2- Breast Cancer: A Case Report. Radiol Case Rep 2024; 19:4049-4054. [PMID: 39076888 PMCID: PMC11284949 DOI: 10.1016/j.radcr.2024.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/23/2024] [Accepted: 06/08/2024] [Indexed: 07/31/2024] Open
Abstract
The management of advanced metastasized breast cancer (BC) is a clinically challenging entity with a wide spectrum of novel therapeutics being introduced to the market. Such agents have remodeled BC treatment landscape and prolonged patients' survival. Over the past decade, a growing body of literature has shed lights on CDK4/6 involvement in oncogenesis and the role of its inhibitors in clinical use with palbociclib being the prototype drug. We present a case of a 58-year-old post-menopausal Middle-Eastern woman diagnosed with stage IV HR+/HER2- breast cancer with extensive bone metastasis. The lesions were widely distributed across the axial skeleton including base of the skull, sternum, ribs, left iliac bone, right inferior pubic ramus, cervical, thoracic, and lumbosacral vertebrae. The patient was started on therapeutic doses of letrozole and zoledronic acid in conjunction with adjuvant radiotherapy. A significant partial response was achieved reaching 70% remission followed by sternum disease progression. A decision was made to switch letrozole for tamoxifen which resulted in disease stability. Due to postmenopausal bleeding, tamoxifen was held and letrozole was reintroduced leading to regimen failure and disease advancement. Palbociclib and fulvestrant were started accordingly, yielding a remarkable metabolic response of all bone metastatic lesions (stable disease) after three months of the regimen initiation. The aforementioned stable disease status continued for approximately three years up to this point.
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Affiliation(s)
- Rand K. Jadallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ahmed H. Al Sharie
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Saja M. Alzghoul
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Jawad M. Al-Karaki
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammad S. Bani Amer
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | | | - Osama Alshari
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
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27
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Komi K, Fujita M, Manabe N, Takaoka M, Kato K, Fujiwara H, Konishi T, Bukeo E, Misawa H, Nakamura J, Ayaki M, Murao T, Suehiro M, Akiyama T, Kawamoto H, Kamada T, Urakami A, Naomoto Y, Yamatsuji T, Moriya T, Haruma K, Hata J. Contrast-enhanced ultrasonography combined with superb microvascular imaging for preoperative diagnosis of sporadic intra-abdominal desmoid-type fibromatosis: A case report. Radiol Case Rep 2024; 19:3988-3993. [PMID: 39055107 PMCID: PMC11269867 DOI: 10.1016/j.radcr.2024.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/28/2024] [Accepted: 06/08/2024] [Indexed: 07/27/2024] Open
Abstract
We herein report a case of sporadic intra-abdominal desmoid-type fibromatosis in which contrast-enhanced ultrasonography (US) combined with superb microvascular imaging (SMI) was useful for preoperative diagnosis. 18-Fluorodeoxyglucose positron emission tomography performed for systematic screening for lung cancer revealed an abnormal accumulation in the abdominal cavity. Transabdominal US showed a tumor with a mixture of hypoechoic and hyperechoic areas. Contrast-enhanced US combined with SMI revealed dendritic blood flow signals and no abnormal vascular network within the tumor. Macroscopic examination of the resected specimen revealed a white tumor with relatively clear boundaries. Microscopic examination revealed spindle cells with poor atypia proliferating in bundles with collagenous stromal cells. Immunohistochemistry showed nuclear localization of beta-catenin within the tumor cells. From these findings, we finally diagnosed intra-abdominal desmoid-type fibromatosis. Contrast-enhanced US combined with SMI is useful for diagnosing intra-abdominal desmoid-type fibromatosis.
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Affiliation(s)
- Kazuhiro Komi
- Center for Doctors’ Career Development, Kawasaki Medical School Hospital, Kurashiki, Japan
- Department of Pathology, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Minoru Fujita
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Munenori Takaoka
- Department of General Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Katsuya Kato
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hideyo Fujiwara
- Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Takako Konishi
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of General Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Emiko Bukeo
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hiraku Misawa
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Jun Nakamura
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Maki Ayaki
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of Gastroenterology and Hepatology, HITO Medical Center, Shikokuchuou, Japan
| | - Takahisa Murao
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Mitsuhiko Suehiro
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Takashi Akiyama
- Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Atsushi Urakami
- Department of General Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Yoshio Naomoto
- Department of General Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Jiro Hata
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School Hospital, Kurashiki, Japan
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28
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Robak T, Puła A, Braun M, Robak E. Extramedullary and extranodal manifestations in chronic lymphocytic leukemia - an update. Ann Hematol 2024; 103:3369-3383. [PMID: 39052034 DOI: 10.1007/s00277-024-05854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/15/2024] [Indexed: 07/27/2024]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a common leukemia characterized by clonal expansion of mature CD5+/CD23 + B cells in the blood, bone marrow (BM) and lymphoid tissues. CLL can undergo extramedullary and extranodal infiltration, with one study noting an incidence of only 0.3 per 100,000 people, and in 17.6% of CLL patients in another report. The most common extranodal sites of leukemic involvement are the skin and central nervous system; however, other organs, including liver, lungs, kidney, gastrointestinal tract, bone, prostate and heart, are occasionally involved. The prognostic significance of extra-medullary CLL is still under debate, but the prognosis in such patients seems to be better in the era of novel targeted drugs. Following a diagnosis of extranodal CLL, survival appears to depend on the site of infiltration. This review presents an overview of CLL in patients with extramedullary and extranodal leukemic lesions, focusing on its epidemiology, pathogenesis, prognosis, clinical characteristics and treatment results.
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Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Ciołkowskiego 2, Lodz, 93-510, Poland.
- Department of General Hematology, Copernicus Memorial Hospital, Lodz, Poland.
| | - Anna Puła
- Department of Hematology, Medical University of Lodz, Ciołkowskiego 2, Lodz, 93-510, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland
| | - Marcin Braun
- Department of Pathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland
| | - Ewa Robak
- Department of Dermatology, Medical University of Lodz, Lodz, Poland
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29
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Srinivasan R, Cook GJR, Patel N, Subesinghe M. Prostate specific membrane antigen (PSMA) avid nonprostatic benign and malignant disease: a pictorial review. Clin Radiol 2024; 79:639-656. [PMID: 38926052 DOI: 10.1016/j.crad.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Prostate specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) is revolutionising the management of prostate cancer (PC) in primary staging and assessment of biochemical recurrence (BCR) through its higher diagnostic accuracy compared to both conventional imaging and previously available PET radiopharmaceuticals. PSMA is a transmembrane glycoprotein, highly expressed in prostate cancer, with its extracellular domain the target for PSMA PET radiopharmaceuticals. However, PSMA expression is not prostate specific and resultant PSMA uptake on PET-CT is not restricted to pathologies arising from the prostate gland. The increasing use of PSMA PET-CT has revealed PSMA uptake in a variety of non-prostatic benign and malignant diseases, which adds complexity to PET-CT interpretation and subsequent clinical management. This pictorial review will provide a thorough knowledge and understanding of the comprehensive range of PSMA avid non-prostatic benign and malignant diseases demonstrable on PSMA PET-CT, whilst highlighting the complimentary nature of other imaging modalities.
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Affiliation(s)
- R Srinivasan
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - G J R Cook
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - N Patel
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Subesinghe
- King's College London & Guy's and St Thomas' PET Centre, London, UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
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30
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Guzelis I, Kucukzeybek BB, Uyaroglu MA, Gokova MB, Sezgin G, Kucukzeybek Y. HER2-positive mucinous cystadenocarcinoma of the breast coexisting with invasive lobular carcinoma: A case report and review of the literature. Diagn Cytopathol 2024; 52:E208-E214. [PMID: 38837688 DOI: 10.1002/dc.25364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/23/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare variant of breast carcinoma. A 68-year-old female patient presented to the general surgery clinic with pain and swelling in the right breast. A mass was detected in the upper outer quadrant, and a fine-needle aspiration biopsy was performed. The May-Grünwald Giemsa stained slides showed aggregates of mucin-rich pleomorphic cells with large nuclei in a mucinous background containing discohesive single cells. The Papanicolaou stain revealed a papillary structure composed of malignant epithelial cells in a necrotic background. A modified radical mastectomy was performed, and upon gross examination, two tumors were discovered in the central and upper outer quadrants. The first tumor, located centrally, was identified as invasive lobular breast carcinoma. The second tumor was an MCA with cytokeratin 7(+) and cytokeratin 20(-), and was determined to be the primary MCA of the breast based on clinical and radiological information. Immunohistochemistry revealed that the tumor cells were negative for estrogen receptor and progesterone receptor, and HER2 was 2+. Fluorescence in situ hybridization analysis detected HER2 gene amplification. During the 72-month follow-up, there were no findings compatible with recurrence or new metastasis. Although primary MCA is rare, it causes differential diagnosis problems and has different biological behaviors.
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Affiliation(s)
- Ismail Guzelis
- Department of Pathology, Izmir Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - Betul Bolat Kucukzeybek
- Department of Pathology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Mehmet Ali Uyaroglu
- Department of Pathology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Melek Bekler Gokova
- Department of General Surgery, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Gulten Sezgin
- Deparment of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Yuksel Kucukzeybek
- Department of Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
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31
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Meckley AL, Martin K, Davis CL, Krishnamurthy K, Stepien AL. Longstanding red, lobular nodule on an elderly male's thigh. JAAD Case Rep 2024; 51:51-53. [PMID: 39165630 PMCID: PMC11334731 DOI: 10.1016/j.jdcr.2024.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024] Open
Affiliation(s)
- Abigail L. Meckley
- Department of Dermatology, HCA Healthcare/Mercer University School of Medicine/Orange Park Hospital, Orange Park, Florida
| | - Kiera Martin
- Department of Dermatology, HCA Healthcare/Mercer University School of Medicine/Orange Park Hospital, Orange Park, Florida
| | - Cindy L. Davis
- Bernhardt Laboratories (A Sonic Healthcare Anatomic Pathology Practice), Jacksonville, Florida
| | - Karthik Krishnamurthy
- Department of Dermatology, HCA Healthcare/Mercer University School of Medicine/Orange Park Hospital, Orange Park, Florida
| | - Angelia L. Stepien
- Department of Dermatology, HCA Healthcare/Mercer University School of Medicine/Orange Park Hospital, Orange Park, Florida
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32
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Zhou J, Wang J, Wang W, Sun L, Zhao S, Sun Q, Wang D. Pathological Complete Response Achieved with XELOX Chemotherapy, HIPEC, and Anti-PD-1 Immunotherapy in Stage IV Gastric Adenocarcinoma with Peritoneal Metastasis: A Case Report and Review of the Literature. J Gastrointest Cancer 2024; 55:1441-1447. [PMID: 38676903 DOI: 10.1007/s12029-024-01056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND The detection rates of early gastric cancer (GC) in China are approximately 20%; upon diagnosis, the majority of patients with GC are identified as having advanced stage disease, and in some cases, even metastatic advanced GC. Currently, the optimal treatment strategy for peritoneal metastasis (PM) in GC remains uncertain, and pathological complete response (pCR) is rare following conversion therapy. CASE PRESENTATION This case report details the management of a 66-year-old patient diagnosed with advanced stage IVB (T4N2M1c) adenocarcinomas of the gastric cardia with PM who received multimodal therapy comprised of hyperthermic intraperitoneal chemotherapy (HIPEC), XELOX chemotherapy, and anti-programmed cell death-1 (PD-1) therapy followed by radical gastrectomy. Through the multimodal management, the patient attained PCR and experienced long-term survival. CONCLUSION The conversion therapy protocol combined with HIPEC, XELOX chemotherapy, and anti-PD-1 therapy and our scientific, accurate, full-course management strategy may be propagable for potentially curing patients with advanced GC with PM.
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Affiliation(s)
- Jiajie Zhou
- Northern Jiangsu People's Hospital , Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, 225001, China
| | - Jie Wang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Wei Wang
- Northern Jiangsu People's Hospital, Yangzhou, 225001, China
| | - Longhe Sun
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- The Forth People's Hospital of Taizhou, Taizhou, 225300, China
| | - Shuai Zhao
- Northern Jiangsu People's Hospital , Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, 225001, China
| | - Qiannan Sun
- Northern Jiangsu People's Hospital, Yangzhou, 225001, China
| | - Daorong Wang
- Northern Jiangsu People's Hospital , Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, 225001, China.
- Northern Jiangsu People's Hospital, Yangzhou, 225001, China.
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Disease, Yangzhou, China.
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Nwachukwu CT, Henrichsen T. Radiation-associated breast angiosarcoma after strut-adjusted volume implant brachytherapy. Radiol Case Rep 2024; 19:3888-3894. [PMID: 39040825 PMCID: PMC11261268 DOI: 10.1016/j.radcr.2024.05.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/26/2024] [Indexed: 07/24/2024] Open
Abstract
Angiosarcoma is a rare malignancy that may classically occur in the post-treatment breast. Radiation and post-treatment edema have been identified in the literature as causative risk factors. Modern treatment innovations have provided patients with more targeted radiation therapy and more conservative surgical options, which may individually limit exposure to these risk factors. Advanced treatment options are also able to provide superior cosmetic outcomes that can positively impact patient quality of life. Despite the ability for modern treatment options to mitigate post-treatment morbidities, there is still long-term risk to the patient of developing treatment-related pathologies, such as breast angiosarcoma. Here we present a patient who underwent lumpectomy and received targeted brachytherapy through a strut-adjusted volume implant device to her lumpectomy site. Her initial post-treatment course was mildly complicated by localized breast lymphedema, which resolved and left the patient with favorable cosmetic results. She developed treatment-associated breast angiosarcoma after initial breast conservation therapy was completed approximately 6 and a half years prior. Her presenting physical exam and imaging findings are portrayed with a comprehensive discussion of the commonly described presenting clinical features and imaging findings of breast angiosarcoma. Factors related to radiation treatment planning and use of the strut-adjusted volume implant device are also discussed. Comparisons between primary and secondary breast angiosarcoma are made, and a review of treatment options is given.
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Affiliation(s)
- Chidi T. Nwachukwu
- Mayo Clinic Department of Radiology, 200 First St. SW, Rochester, MN 55905, USA
| | - Tara Henrichsen
- Mayo Clinic Department of Radiology, 200 First St. SW, Rochester, MN 55905, USA
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Dai Y, Zhang Y, Lin H, Zang C. Primary cutaneous mucinous carcinoma of the cheek: a case report. J Med Case Rep 2024; 18:404. [PMID: 39192320 DOI: 10.1186/s13256-024-04712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/09/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Primary cutaneous mucinous carcinoma is a rare neoplasia of the sweat gland. The age-adjusted incidence was 0.024 tumors per 100,000 person-years. It is possible that the actual number of tumors may be slightly higher than previously estimated as some cases of primary cutaneous mucinous carcinoma may have been mistaken for benign tumors and removed by laser therapy without histologic examination. CASE PRESENTATION We report a 58-year-old Chinese man with primary cutaneous mucinous carcinoma. The patient presented to our care with an indolent nodule on the left cheek, which was proven to be a mucinous adenocarcinoma by excisional biopsy and immunohistochemical staining. Following a comprehensive evaluation, including whole-body computed tomography and positron emission tomography, metastases from other sites were ruled out and the patient was diagnosed with primary cutaneous mucinous carcinoma. The patient underwent an additional wide resection surgery to ensure a safe margin and was then recommended to undergo regular follow-up. CONCLUSION This case is one of the few published Chinese cases in literature of primary cutaneous mucinous carcinoma. Diagnosis of primary cutaneous mucinous carcinoma is challenging, and treatment options are limited. Collaboration between clinicians and pathologists is crucial for optimal outcomes. Further studies with longer follow-up periods are necessary to provide evidence for the management of this disease.
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Affiliation(s)
- Ying Dai
- Department of Radiation Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, Anhui, China
- Department of Radiation Oncology, Anhui Provincial Cancer Hospital, Hefei, 230031, Anhui, China
| | - Yufei Zhang
- Department of Radiation Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, Anhui, China
- Department of Radiation Oncology, Anhui Provincial Cancer Hospital, Hefei, 230031, Anhui, China
| | - Hongxiao Lin
- Department of Radiation Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, Anhui, China
- Department of Radiation Oncology, Anhui Provincial Cancer Hospital, Hefei, 230031, Anhui, China
| | - Chunbao Zang
- Department of Radiation Oncology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, Anhui, China.
- Department of Radiation Oncology, Anhui Provincial Cancer Hospital, Hefei, 230031, Anhui, China.
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Shen YC, Liu TH, Nicholas A, Soyama A, Yuan CT, Chen TC, Eguchi S, Yoshizumi T, Itoh S, Nakamura N, Kosaka H, Kaibori M, Ishii T, Hatano E, Ogawa C, Naganuma A, Kakizaki S, Cheng CH, Lin PT, Su YY, Chuang CH, Lu LC, Wu CJ, Wang HW, Rau KM, Hsu CH, Lin SM, Huang YH, Hernandez S, Finn RS, Kudo M, Cheng AL. Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab. J Clin Oncol 2024:JCO2400645. [PMID: 39197119 DOI: 10.1200/jco.24.00645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 08/30/2024] Open
Abstract
PURPOSE Durable partial response (PR) and durable stable disease (SD) are often seen in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab (atezo-bev). This study investigates the outcome of these patients and the histopathology of the residual tumors. PATIENTS AND METHODS The IMbrave150 study's atezo-bev group was analyzed. PR or SD per RECIST v1.1 lasting more than 6 months was defined as durable. For histologic analysis, a comparable real-world group of patients from Japan and Taiwan who had undergone resection of residual tumors after atezo-bev was investigated. RESULTS In the IMbrave150 study, 56 (77.8%) of the 72 PRs and 41 (28.5%) of the 144 SDs were considered durable. The median overall survival was not estimable for patients with durable PR and 23.7 months for those with durable SD. The median progression-free survival was 23.2 months for patients with durable PR and 13.2 months for those with durable SD. In the real-world setting, a total of 38 tumors were resected from 32 patients (23 PRs and nine SDs) receiving atezo-bev. Pathologic complete responses (PCRs) were more frequent in PR tumors than SD tumors (57.7% v 16.7%, P = .034). PCR rate correlated with time from atezo-bev initiation to resection and was 55.6% (5 of 9) for PR tumors resected beyond 8 months after starting atezo-bev, a time practically corresponding to the durable PR definition used for IMbrave150. We found no reliable radiologic features to predict PCR of the residual tumors. CONCLUSION Durable PR patients from the atezo-bev group showed a favorable outcome, which may be partly explained by the high rate of PCR lesions. Early recognition of PCR lesions may help subsequent treatment decision.
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Affiliation(s)
- Ying-Chun Shen
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsung-Hao Liu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chang-Tsu Yuan
- Department of Pathology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Tse-Ching Chen
- Department of Pathology, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Hisashi Kosaka
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - Masaki Kaibori
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - Takamichi Ishii
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Etsuro Hatano
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikara Ogawa
- Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan
| | - Atsushi Naganuma
- Department of Gastroenterology, NHO Takasaki General Medical Center, Takasaki, Japan
| | - Satoru Kakizaki
- Department of Clinical Research, NHO Takasaki General Medical Center, Takasaki, Japan
| | - Chih-Hsien Cheng
- Department of Liver and Transplantation Surgery, Chang-Gung Transplantation Institute, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Po-Ting Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Yeh Su
- National Institute of Cancer Research, National Health Research Institutes, Taipei, Taiwan
| | - Chien-Huai Chuang
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Li-Chun Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Jung Wu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Wei Wang
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kun-Ming Rau
- Department of Hematology and Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Healthcare and Service Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | | | - Richard S Finn
- Division of Hematology/Oncology, Department of Medicine, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan
| | - Ann-Lii Cheng
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
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Wang X, Niu Y, Bian F. The progress of tumor vaccines clinical trials in non-small cell lung cancer. Clin Transl Oncol 2024:10.1007/s12094-024-03678-z. [PMID: 39179939 DOI: 10.1007/s12094-024-03678-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) remains a significant global health challenge, with high mortality rates and limited treatment options. Tumor vaccines have emerged as a potential therapeutic approach, aiming to stimulate the immune system to specifically target tumor cells. METHODS This study screened 283 clinical trials registered on ClinicalTrials.gov through July 31, 2023. After excluding data that did not meet the inclusion criteria, a total of 108 trials were assessed. Data on registered number, study title, study status, vaccine types, study results, conditions, interventions, outcome measures, sponsor, collaborators, drug target, phases, enrollment, start date, completion date and locations were extracted and analyzed. RESULTS The number of vaccines clinical trials for NSCLC has continued to increase in recent years, the majority of which were conducted in the United States. Most of the clinical trials were at stages ranging from Phase I to Phase II. Peptide-based vaccines accounted for the largest proportion. Others include tumor cell vaccines, DNA/RNA vaccines, viral vector vaccines, and DC vaccines. Several promising tumor vaccine candidates have shown encouraging results in early-phase clinical trials. However, challenges such as heterogeneity of tumor antigens and immune escape mechanisms still need to be addressed. CONCLUSION Tumor vaccines represent a promising avenue in the treatment of NSCLC. Ongoing clinical trials are crucial for optimizing vaccine strategies and identifying the most effective combinations. Further research is needed to overcome existing limitations and translate these promising findings into clinical practice, offering new hope for NSCLC patients.
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Affiliation(s)
- Xiaomu Wang
- Department of Pharmacy, Xiangyang Key Laboratory of Special Preparation of Vitiligo, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yunping Niu
- Department of Laboratory Medicine, The First People's Hospital of Xiangyang, Xiangyang, Hubei, China
| | - Fang Bian
- Department of Pharmacy, Xiangyang Key Laboratory of Special Preparation of Vitiligo, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
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Abu Rached N, Dervenis V, Scheel C, Stücker M, Baues C, Mauch C, Doerler M. Excellent response to cemiplimab and radiotherapy in advanced metastatic porocarcinoma. J Eur Acad Dermatol Venereol 2024. [PMID: 39171450 DOI: 10.1111/jdv.20304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Nessr Abu Rached
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Vasileios Dervenis
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Christina Scheel
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Markus Stücker
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Christian Baues
- Department of Radiooncology, Marienhospital Herne, Ruhr University Bochum, Herne, Germany
| | - Cornelia Mauch
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Martin Doerler
- Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
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Nielsen DL, Juhl CB, Nielsen OH, Chen IM, Herrmann J. Immune Checkpoint Inhibitor-Induced Cardiotoxicity: A Systematic Review and Meta-Analysis. JAMA Oncol 2024:2822706. [PMID: 39172480 PMCID: PMC11342217 DOI: 10.1001/jamaoncol.2024.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/17/2024] [Indexed: 08/23/2024]
Abstract
Importance Immune checkpoint inhibitors (ICIs) improve outcomes in a wide range of cancers; however, serious adverse effects, including cardiovascular adverse effects (CVAEs), can occur. Objective To determine the incidence of CVAEs and analyze data on the management of myocarditis in patients exposed to ICIs. Data Sources PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception were searched on April 4, 2023. Study Selection Two separate studies were performed. Key inclusion criteria for study 1 were phases 1 to 4 trials involving adults with malignant neoplasms treated with an ICI and toxicity data; for study 2, publications (case reports and retrospective analyses) on clinical manifestations and treatment of patients with ICI-induced CVAEs. Studies with dose escalation or fewer than 11 patients in each group and all case reports, retrospective analyses, letters, reviews, and editorials were excluded from study 1. Studies not published in English were excluded from study 2. Data Extraction and Synthesis The PRISMA guidelines and Cochrane Handbook for Systematic Reviews were followed. Data were extracted independently by 2 researchers. A meta-analysis of the incidence of CVAEs in clinical trials and a systematic review of the evidence for the management of myocarditis were performed. Data were pooled using a random-effects model. Main Outcomes and Measures In study 1, the primary outcome was incidence CVAEs in clinical trials with ICIs and ICI combination therapies. Study 2 examined evidence supporting specific management strategies that may decrease the mortality rate of myocarditis. The primary outcomes were planned before data collection began. Results In study 1, a total of 83 315 unique participants in 589 unique trials were included in the meta-analysis. Incidence of CVAEs induced by anti-programmed cell death 1 and/or programmed cell death ligand 1 was 0.80% (95% CI, 0%-1.66%) in clinical trials, with no differences between the compounds, except for cemiplimab, which was associated with a higher risk of CVAEs. Incidence of CVAEs following ipilimumab treatment was 1.07% (95% CI, 0%-2.58%). The incidence of myocarditis was significantly higher following treatment with dual ICIs. However, CVAE incidence was not higher with dual ICIs, ICI combination with chemotherapy, or tyrosine kinase inhibitors. Evidence from randomized clinical trials on recommended monitoring and treatment strategies for ICI-induced myocarditis was lacking. Study 2 showed that myocarditis-associated mortality occurred in 83 of 220 patients (37.7%). Prospective data from 40 patients with myocarditis indicated that systematic screening for respiratory muscle involvement, coupled with active ventilation, prompt use of abatacept, and the addition of ruxolitinib, may decrease the mortality rate. Conclusions and Relevance Immune checkpoint inhibitor-induced CVAEs and/or myocarditis were recorded in 1.07% of patients in clinical trials. The CVAE mortality risk remains high, justifying the need for monitoring and management strategies for which evidence from randomized clinical trials is absent. Early recognition, ICI therapy cessation, prompt initiation of corticosteroid therapy, and escalation of therapy are all crucial elements for achieving optimal outcomes. Prospective clinical trials or at least prospective registration of treatments and outcomes are highly warranted.
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Affiliation(s)
- Dorte Lisbet Nielsen
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Bogh Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ole Haagen Nielsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Inna Markovna Chen
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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Tsujinaka H, Imoto S, Ueda T, Wakuta M, Yamada Y, Sugisawa T, Murao F, Hirano T, Yoshida S, Kato K, Sasaki M, Matsumoto R, Ishigooka G, Ogata N. Incidence and prognosis of taxane-induced macular edema: a retrospective study from the Japan Clinical REtina Study Group (J-CREST). Sci Rep 2024; 14:19530. [PMID: 39174604 PMCID: PMC11341814 DOI: 10.1038/s41598-024-69775-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 08/08/2024] [Indexed: 08/24/2024] Open
Abstract
Macular edema is a known side effect of taxane-based anticancer drugs. We retrospectively investigated data from 11 centers between January 2016 and December 2021. Among 14,260 patients, 30 (0.21%) developed macular edema; from these, the number of cases associated with nab-paclitaxel was 16 (0.43%), significantly higher than the number of cases associated with paclitaxel or docetaxel (P < 0.01). Visual acuity (VA) and retinal choroidal change were examined in 27 patients, with a follow-up of at least 3 months. The patients' mean age was 67.2 years; 14 (51.3%) were male and four (14.8%) had unilateral onset. The mean interval between anticancer drug initiation and the first ophthalmology visit was 290.1 days. Among the 20 patients who discontinued anticancer drugs, VA and edema significantly improved 2 months after discontinuation (LogMAR VA: 0.50 vs. 0.28, central retinal thickness: 472.7 µm vs. 282.5 µm, both P < 0.01). No significant changes were observed in the central choroidal thickness. A correlation was found between duration of taxane treatment and VA immediately before discontinuation of anticancer drugs (β = 0.00050; 95% confidence interval: 0.00036-0.00097; P < 0.05). Although taxane-induced macular edema is reversible, slower anticancer drug discontinuation worsened VA, highlighting the need for regular ophthalmologic evaluation during treatments.
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Affiliation(s)
- Hiroki Tsujinaka
- Department of Ophthalmology, Nara Medical University, Kashihara, 6348521, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Sho Imoto
- Department of Ophthalmology, Nara Medical University, Kashihara, 6348521, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University, Kashihara, 6348521, Japan.
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan.
| | - Makiko Wakuta
- Department of Ophthalmology, Yamaguchi University, Ube, 7558505, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Yutaka Yamada
- Department of Ophthalmology, Fukui University, Eiheiji, 9101193, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Takaaki Sugisawa
- Department of Ophthalmology, Hyogo Medical University, Nishinomiya, 6638501, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Fumiko Murao
- Department of Ophthalmology, Tokushima University, Tokushima, 7708503, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University, Matsumoto, 3908621, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University, Kurume, 8300011, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Kumiko Kato
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, 5148507, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Mariko Sasaki
- Department of Ophthalmology, Tachikawa Hospital, Tachikawa, 1908531, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 1608582, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Riko Matsumoto
- Department of Ophthalmology, Shiga University of Medical Science, Otsu, 5202192, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Gaku Ishigooka
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki, 5698686, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Kashihara, 6348521, Japan
- Japan Clinical REtina Study Group (J-CREST), Kagoshima, Japan
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Tong J, Vogiatzakis N, Andres MS, Senechal I, Badr A, Ramalingam S, Rosen SD, Lyon AR, Nazir MS. Complementary use of cardiac magnetic resonance and 18 F-FDG positron emission tomography imaging in suspected immune checkpoint inhibitor myocarditis. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:53. [PMID: 39175028 PMCID: PMC11340117 DOI: 10.1186/s40959-024-00250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 07/19/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Immune checkpoint inhibitor (ICI) myocarditis is an uncommon but potentially fatal complication of immunotherapy. Cardiac imaging is essential to make timely diagnoses as there are critical downstream implications for patients. OBJECTIVE To determine the agreement of cardiac magnetic resonance (CMR) and 18 F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in patients with suspected ICI myocarditis. METHODS Patients with suspected ICI myocarditis, who underwent CMR and 18 F-FDG-PET imaging at a single cardio-oncology service from 2017 to 2023, were enrolled. CMR was performed according to recommended guidelines for assessment of myocarditis. 18 F-FDG-PET imaging was performed following 18 h carbohydrate-free fast. Imaging was analysed by independent reviewers to determine the presence or absence of ICI myocarditis. RESULTS Twelve patients (mean age 60 ± 15 years old, 7 [58%] male) underwent both CMR and 18 F-FDG-PET imaging. Three (25%) met the 2018 Lake Louise Criteria for CMR diagnosis of myocarditis; 4 (33%) had evidence of myocardial inflammation as determined by 18 F-FDG-PET. Amongst those with positive 18 F-FDG-PET, mean standard uptake value (SUV) was 3.5 ± 1.7. There was agreement between CMR and PET in 7 cases (CMR and PET positive (n = 1), CMR and PET negative (n = 6)) and discordance in 5 cases (CMR positive and PET negative (n = 2), CMR negative and PET positive (n = 3)). CONCLUSION Both CMR and PET provide complementary clinical information in diagnostic of ICI myocarditis. CMR informs on myocardial oedema, whilst 18 F-FDG-PET provides information on glucose metabolism reflecting monocyte and lymphocytic activity. Future studies should investigate the role of hybrid PET-CMR for the timely diagnosis of ICI myocarditis.
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Affiliation(s)
- Jieli Tong
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Nikolaos Vogiatzakis
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Maria Sol Andres
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Isabelle Senechal
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Ahmed Badr
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Sivatharshini Ramalingam
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Stuart D Rosen
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Alexander R Lyon
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Muhummad Sohaib Nazir
- Cardio-Oncology Service, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
- School of Biomedical Engineering and Imaging Sciences, King's College London, Guy's and St Thomas' Hospital, London, UK.
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Hajjaj OI, Corke L, Strahlendorf C, Hamilton SN, Feng X, Simmons CE. Treatment differences and long-term outcomes in adults and children with Ewing sarcoma. Cancer Epidemiol 2024:102653. [PMID: 39179493 DOI: 10.1016/j.canep.2024.102653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 08/09/2024] [Accepted: 08/16/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION Ewing sarcoma is an aggressive malignancy primarily affecting children and adolescents. Limited research is available on treatment practices, clinical course, and survival in adults. METHODS A multi-institution retrospective cohort study of all adults (>18 years) and children (≤18 years) with Ewing sarcoma treated in British Columbia, Canada between January 01, 2000 and December 31, 2018. RESULTS One-hundred seven individuals (66 adults, 41 children) were included in the analysis. 5-year OS was 58 % in adults and 75 % in children. For individuals with local disease, 5-year OS was 74 % in adults and 84 % in children. Adult status was associated with impaired PFS (HR, 1.8; 95 % CI, 1.0 - 3.1, p=0.04) and OS (HR, 1.8; 95 % CI, 0.9 - 3.5; p=0.088). A Charlson Comorbidity Index (CCI) ≥3 was associated with impaired survival in adults and children (HR, 3.9, 95 % CI, 2.0 - 7.5; p=<0.001); baseline CCIs were not significantly different between groups. Most adults (61/66; 92 %) and all children (41/41; 100 %) received systemic treatment with no significant difference in mean lines of therapy, treatment modalities or agents. Most children received interval-compressed chemotherapy (35/41; 85 %) compared to adults (19/61; 29 %; p=<0.001). Interval-compression was not significantly associated with improved survival in adults with local disease (HR, 0.51; 95 % CI 0.1 - 2.3; p=0.373). Children more often initiated treatment within 28 days of diagnosis (31/33; 94 %) compared to adults (41/64; 64 %, p=0.001). Treatment within 28 days was associated with improved survival in the entire cohort (HR, 2.04 95 % CI, 1.1 - 3.9; p = 0.03). This association was preserved in subanalysis of individuals with local disease (HR, 5.4; 95 % CI, 1.9 - 15; p = 0.001) and only adults (HR, 5.3, 95 % CI, 1.7 - 17; p = 0.005). DISCUSSION Survival for adults with Ewing sarcoma is inferior to children despite similarities in presentation, tumour characteristics and treatments. Further studies on the value of interval-compression in adults are required. Timely initation of treatment should be a priority for this disease.
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Affiliation(s)
- Omar I Hajjaj
- Department of Medicine, Queen's University, Kingston, ON, Canada; Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Lauren Corke
- Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Caron Strahlendorf
- Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarah Nicole Hamilton
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada
| | - Xiaolan Feng
- Department of Medical Oncology, Tom Baker Cancer Center, Calagary, AB, Canada; Department of Medicine, Cumming School of Medicine, Calagary, AB, Canada
| | - Christine E Simmons
- Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Onozawa Y, Koizumi M, Nakagawa Y, Ogura G, Oki M, Wada T, Fukagawa M. A case of ANCA-negative pauci-immune crescentic glomerulonephritis with lung adenocarcinoma with mediastinal involvement successfully treated by corticosteroid and radiation therapy. CEN Case Rep 2024:10.1007/s13730-024-00925-8. [PMID: 39162947 DOI: 10.1007/s13730-024-00925-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 08/07/2024] [Indexed: 08/21/2024] Open
Abstract
Pauci-immune crescentic glomerulonephritis (PICGN) is one of the pathologies causing rapidly progressive glomerulonephritis, often associated with anti-neutrophil cytoplasmic antibody (ANCA); however, in 10-30% of cases, ANCAs are negative. While a relatively large number of cases of ANCA-positive PICGN complicated with malignancy have been previously reported, the number of cases of ANCA-negative PICGN with malignancy is limited. The prognosis for such cases was poor, and many patients died within a relatively short period. Here, we report the case of ANCA-negative PICGN complicated with malignancy successfully treated by corticosteroid and radiation therapy. A 63-year-old Japanese man was admitted to our hospital due to spiking fevers in the previous 3 months. Based on the findings of imaging and pathological tests, he was diagnosed with locally advanced lung adenocarcinoma with mediastinal involvement. After admission, his renal function rapidly deteriorated, and urinalysis showed heavy proteinuria. In serological tests, serology for autoantibodies, including ANCAs, was negative. The kidney biopsy revealed PICGN with prominent endocapillary proliferation. We administered corticosteroid therapy for glomerulonephritis and subsequent radiation therapy for lung carcinoma, both of which were effective. He has been alive without progression of malignancy or kidney disease for 5 years after discharge. In patients with malignancy presenting with acute deterioration of kidney function, although infrequent, one of the conceivable pathological conditions to consider is ANCA-negative PICGN associated with malignancy. In such cases, even with negative antibodies such as ANCA, pathological examination is warranted, and a combination of anti-tumor therapy and immunosuppressive therapy is expected to be effective.
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Affiliation(s)
- Yuna Onozawa
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Masahiro Koizumi
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan.
| | - Yosuke Nakagawa
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Go Ogura
- Division of Pathology, Tokai University School of Medicine, Isehara City, Kanagawa, Japan
| | - Masayuki Oki
- Division of General Internal Medicine, Tokai University School of Medicine, Isehara City, Kanagawa, Japan
| | - Takehiko Wada
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
- Department of Nephrology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
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Mat E, Keles E, Dereli ML, Sucu ST, Kartal Ö, Solmaz U, Yıldız P, Yıldız G. Comparison of laparoscopy and vNOTES in early-stage endometrial cancer. J Obstet Gynaecol Res 2024. [PMID: 39160113 DOI: 10.1111/jog.16054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 08/01/2024] [Indexed: 08/21/2024]
Abstract
AIM To compare the demographic, clinical, surgical, histopathological, and oncological outcomes of vNOTES and conventional laparoscopy (CL)for early-stage endometrial cancer. METHODS A retrospective study was carried out in the Gynecologic Clinic of a tertiary hospital from January 2019 to November 2020. Patient demographic characteristics, surgical outcomes, histopathological characteristics, visual analog scale (VAS) pain scores at postoperative 6th, 12th, and 24th, intra- and postoperative complications, and follow-up results were noted. RESULTS A total of 45 patients enrolled, of which 16 underwent CL and 29 were vNOTES. The operative time and decrease in hemoglobin levels were similar for both groups (p = 0.202, p = 0.699). Postoperative hospital stay did not differ between the vNOTES group and the CL group (p = 0.549). VAS pain scores at postoperative 6th, 12th, and 24th h were significantly lower in vNOTES group than in the CL group (p < 0.001). The requirement for additional opioid/narcotic analgesic was lower in the vNOTES group than in the CL group (p = 0.037). CONCLUSION vNOTES may be a safe and feasible option in early-stage endometrial cancer, having less postoperative pain and less requirement of opioid/narcotic analgesic compared with laparoscopy.
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Affiliation(s)
- Emre Mat
- Department of Gynecologic Oncology, University of Health Sciences, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Esra Keles
- Department of Gynecologic Oncology, University of Health Sciences, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Murat Levent Dereli
- Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Serap Topkara Sucu
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Özgür Kartal
- Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ulaş Solmaz
- Department of Obstetrics and Gynecology, Izmir Tınaztepe University Faculty of Medicine, Izmir, Turkey
| | - Pınar Yıldız
- Department of Perinatology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Gazi Yıldız
- Kartal Lütfi Kırdar City Hospital, Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Istanbul, Turkey
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Hasik PN, Thomas C, Hazarika M, Undela K. Ocular adverse events associated with platins: a disproportionality analysis of pharmacovigilance data and extensive systematic review of case reports. Expert Opin Drug Saf 2024:1-14. [PMID: 39137273 DOI: 10.1080/14740338.2024.2392860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Anti-cancer drugs, particularly platinum-based chemotherapy drugs, have been showing ocular adverse events (OAEs) in patients undergoing chemotherapy, which is concerning due to the potential impact on patient's quality of life and the ability to continue effective cancer treatment. RESEARCH DESIGN AND METHODS A retrospective case/non-case study was conducted using spontaneous reports on OAEs by platins from the FDA Adverse Event Reporting System (FAERS) database. A disproportionality analysis was performed by calculating the Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and the Information Component (IC) to identify OAE signals for platinum-based chemotherapy drugs. In parallel, a review of case reports for OAEs from platins was conducted by a systematic literature search in PubMed and Google Scholar. RESULTS Using disproportionality analysis, 69 signals were identified for platinum-based chemotherapy drugs and OAEs (carboplatin: 42, oxaliplatin: 16, cisplatin: 11). Choroidal infarction [PRR = 215.1; χ2 = 4527.1; lower bound (LB) ROR = 140.7; IC025 = 5.1] and orbital hemorrhage [PRR = 120.0; χ2 = 300.5; LB ROR = 35.1; IC025 = 1.3] were the strong signals identified for carboplatin. Optic disc hyperemia [PRR = 208.2; χ2 = 742.5; LB ROR = 74.1; IC025 = 2.2] and blindness cortical [PRR = 23.7; χ2 = 382.5; LB ROR = 14.8; IC025 = 3.1] were the signals identified for oxaliplatin and cisplatin, respectively. A total of 32 case reports of OAEs from platinum-based chemotherapy drugs were identified through a systematic search in PubMed and Google Scholar, strengthening the association. CONCLUSION The study revealed a potential risk of OAEs when using platinum-based chemotherapy drugs as an anticancer medication.
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Affiliation(s)
- P N Hasik
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Kamrup, India
| | - Christy Thomas
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Kamrup, India
| | - Munlima Hazarika
- Department of Medical Oncology, Dr. Bhubaneswar Borooah Cancer Institute, Guwahati, India
| | - Krishna Undela
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Kamrup, India
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Xie M, Wang XH, Yang JJ, Su ZX, Huang JH, Li PC, Jiang FG. Rapid progress of an iris metastasis from esophageal cancer: a case report and review of literature. Int J Ophthalmol 2024; 17:1557-1567. [PMID: 39156770 PMCID: PMC11286432 DOI: 10.18240/ijo.2024.08.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/04/2024] [Indexed: 08/20/2024] Open
Abstract
This case report details a rare instance of rapid iris metastasis from esophageal cancer in a 59-year-old man. A literature review was conducted to explore recent advances in detecting, diagnosing, and treating intraocular metastatic malignancies. Positron emission tomography-computed tomography played a crucial role in identifying primary sites and systemic metastases. Local treatment combined with systemic therapy effectively reduced tumor size, preserved useful vision, and improved the patient's survival rate. A comparison was made of the characteristics of iris metastases from esophageal cancer and lung cancer, including age, gender, tumor characteristics, and treatment. The challenges associated with diagnosis and treatment are discussed, highlighting the implications for clinical practice.
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Affiliation(s)
- Meng Xie
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Xing-Hua Wang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Jun-Jie Yang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Zi-Xuan Su
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Jia-Hui Huang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Peng-Cheng Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Fa-Gang Jiang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
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Yamada S, Orisaka M, Kurokawa T, Onuma T, Shinagawa A, Yoshida Y. Combination therapy with paclitaxel and trastuzumab for human epidermal growth factor receptor 2-positive recurrent serous carcinoma of the uterine cervix: A case report. J Obstet Gynaecol Res 2024. [PMID: 39155404 DOI: 10.1111/jog.16055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 08/02/2024] [Indexed: 08/20/2024]
Abstract
Recent studies show increased expression of human epidermal growth factor receptor 2 (HER2) in cervical cancer, but the efficacy of anti-HER2 therapy remains under-researched. Here, we present a case of recurrent HER2-positive serous carcinoma, presumably arising in the cervix, diagnosed by comprehensive genomic profiling, which responded to trastuzumab. The patient underwent a radical hysterectomy with concurrent adjuvant chemoradiotherapy. One year after surgery, the patient experienced recurrence (multiple lymph node metastases). She underwent chemotherapy and subsequent comprehensive genomic profiling, which revealed HER2 positivity. Despite treatment, the lymph node and peritoneal metastases progressed. Therefore, combination chemotherapy with paclitaxel and trastuzumab was initiated. Subsequently, the patient's clinical symptoms improved considerably, and good health was maintained for 8 months. This report highlights the importance of comprehensive genomic profiling and targeted therapies when standard treatments fail.
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Affiliation(s)
- Shizuka Yamada
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Makoto Orisaka
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Kurokawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Toshimichi Onuma
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akiko Shinagawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Dentoni M, Florean I, Farina A, Joubert B, Do LD, Honnorat J, Damato V, Fabris M, Gigli GL, Valente M, Vogrig A. Immune Checkpoint Inhibitor-Related Cerebellar Toxicity: Clinical Features and Comparison with Paraneoplastic Cerebellar Ataxia. CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01727-5. [PMID: 39153058 DOI: 10.1007/s12311-024-01727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 08/19/2024]
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, and the association with immune-related adverse events (irAEs) is well-established. However, cerebellar irAEs are poorly defined and their relationship with paraneoplastic disorders remains unclear. Our aim was (i) to characterize cerebellar irAE; (ii) to compare it with paraneoplastic cerebellar ataxia (PCA). We performed a multicenter, retrospective, cohort study of patients developing new-onset, immune-mediated, isolated/predominant cerebellar dysfunction after ICI administration. In addition, a systematic review following PRISMA guidelines was performed. Cerebellar irAE cases were compared with a consecutive cohort of patients with PCA. Overall, 35 patients were included, of whom 12 were original cases (males: 25/35 (71%), median age: 65 [range: 20-82]). The most frequent tumor was non-small cell lung cancer (12/35, 34%). Anti-PD1 were adopted in 19/35 (54%). Symptoms developed at a median of 11 weeks after ICI onset. Neuronal antibodies were detected in 15/31 patients tested (48%). Cerebrospinal fluid was inflammatory in 25/30 (83%). Magnetic resonance imaging showed cerebellar hyperintensities in 8/35 (23%). Immunotherapy was applied in 33/35 cases (94%), and most patients improved with residual disability (16/35, 46%). When compared with a series of PCA (n = 15), the cerebellar irAE group was significantly more associated with male sex, lung cancer (rather than gynecological/breast cancers), isolated ataxia, and a better outcome. We provide a detailed characterization of cerebellar irAE. Compared to PCA, differences exist in terms of tumor association, clinical features, and outcome. Clinical presentation-antibody-tumor triad in the ICI group only partially reflects the associations described in paraneoplastic disorders.
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Affiliation(s)
- Marta Dentoni
- Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy
- Clinical Neurology, Department of Head-Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Irene Florean
- Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy
- Clinical Neurology, Department of Head-Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Antonio Farina
- French Reference Centre for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Lyon, France
- MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Bastien Joubert
- French Reference Centre for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Lyon, France
- MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Le-Duy Do
- French Reference Centre for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Lyon, France
- MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Jérôme Honnorat
- French Reference Centre for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Lyon, France
- MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314, Université Claude Bernard Lyon 1, Lyon, France
| | - Valentina Damato
- Department of Neurosciences, Drugs and Child Health, University of Florence, Firenze, Italy
| | - Martina Fabris
- Laboratory of Immunopathology, Institute of Clinical Pathology, Department of Laboratory Medicine, University Hospital of Udine, Udine, Italy
- Institute of Clinical Pathology, Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy
- Clinical Neurology, Department of Head-Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy
- Clinical Neurology, Department of Head-Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alberto Vogrig
- Clinical Neurology, Department of Medicine (DMED), University of Udine, Udine, Italy.
- Clinical Neurology, Department of Head-Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
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Kazemi KS, Kazemi P, Mivehchi H, Nasiri K, Eshagh Hoseini SS, Nejati ST, Pour Bahrami P, Golestani S, Nabi Afjadi M. Photodynamic Therapy: A Novel Approach for Head and Neck Cancer Treatment with Focusing on Oral Cavity. Biol Proced Online 2024; 26:25. [PMID: 39154015 PMCID: PMC11330087 DOI: 10.1186/s12575-024-00252-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/31/2024] [Indexed: 08/19/2024] Open
Abstract
Oral cancers, specifically oral squamous cell carcinoma (OSCC), pose a significant global health challenge, with high incidence and mortality rates. Conventional treatments such as surgery, radiotherapy, and chemotherapy have limited effectiveness and can result in adverse reactions. However, as an alternative, photodynamic therapy (PDT) has emerged as a promising option for treating oral cancers. PDT involves using photosensitizing agents in conjunction with specific light to target and destroy cancer cells selectively. The photosensitizers accumulate in the cancer cells and generate reactive oxygen species (ROS) upon exposure to the activating light, leading to cellular damage and ultimately cell death. PDT offers several advantages, including its non-invasive nature, absence of known long-term side effects when administered correctly, and cost-effectiveness. It can be employed as a primary treatment for early-stage oral cancers or in combination with other therapies for more advanced cases. Nonetheless, it is important to note that PDT is most effective for superficial or localized cancers and may not be suitable for larger or deeply infiltrating tumors. Light sensitivity and temporary side effects may occur but can be managed with appropriate care. Ongoing research endeavors aim to expand the applications of PDT and develop novel photosensitizers to further enhance its efficacy in oral cancer treatment. This review aims to evaluate the effectiveness of PDT in treating oral cancers by analyzing a combination of preclinical and clinical studies.
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Affiliation(s)
- Kimia Sadat Kazemi
- Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Kazemi
- Faculty of Dentistry, Ilam University of Medical Sciences, Ilam, Iran
| | - Hassan Mivehchi
- Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Kamyar Nasiri
- Faculty of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | | | | | - Shayan Golestani
- Department of Oral and Maxillofacial Surgery, Dental School, Islamic Azad University, Isfahan, Iran.
| | - Mohsen Nabi Afjadi
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran.
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Li YM, Zhu HH, Wang XQ, Shi MZ, ShangGuan CL. Giant mucinous liposarcoma of the abdominal cavity: A case report. Medicine (Baltimore) 2024; 103:e39282. [PMID: 39151522 PMCID: PMC11332703 DOI: 10.1097/md.0000000000039282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024] Open
Abstract
RATIONALE Mucinous liposarcoma myxoid liposarcoma is a malignant mucoid soft tissue tumor derived from undifferentiated stromal cells in perivascular, subbody cavity and intermuscular space, and composed of cells at different stages of differentiation from preadipocytes to mature cells. In rare cases, it may change from lipoma malignancy. The main manifestations is painless mass, relatively slow growth, the course can last decades, the prevalence of liposarcoma in the population is 14% to 18%, mainly in adults, male prevalence is higher than women, but not significant. The main good hair part is the thigh, have mucinous sex, high differentiation type, dedifferentiation type, polymorphic type. Clinical diagnosis is difficult, and there are no obvious symptoms in the early stage, so the diagnosis should be combined with B ultrasound, MRI, CT, and other auxiliary examinations. The gold standard is pathological examination. In December 2023, our department admitted a patient with a mucinous abdominal mass. The report is as follows. PATIENT CONCERNS Does liposarcoma metastasize? Is any chemotherapy required after surgery? Will it ever relapse in the future? What is the survival period after surgery? DIAGNOSIS Mucinous liposarcoma. INTERVENTIONS Surgical resection of the sarcoma. RESULTS The nodule sample was 33 * 28 * 13 cm, with complete capsule, gray and yellow sections, fine texture, soft, gray, red, grayish, and yellow mucoid nodules in some areas, and the maximum diameter of the nodules was 21cm. Immunohistochemistry was: CD34 (+), CDK 4 (+), CK (-), Desmin (weak +), Ki67 (index 5%), MDM 2 (-), p16 (weak +), S-100P (+), Vimentin (+), BCL-2 (+). He was also sent to the Department of Pathology of Peking Union Medical College Hospital for consultation with Professor Lu Zhaohui, whose consultation opinion was in line with myxoliposarcoma. CONCLUSION Retroperitoneal liposarcoma is a common retroperitoneal tumor, but it is relatively rare in clinical practice; the overall morbidity is low, mainly manifested as abdominal pain and abdominal distension, abdominal distension, and a long course of disease; it is not sensitive to radiotherapy and chemotherapy, and should be closely follow up by CT examination to understand the recurrence and metastasis.
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Affiliation(s)
- Yi-Ming Li
- The Graduate School, Qinghai University, Xining, PR China
| | - Hai-Hong Zhu
- Qinghai Provincial People’s Hospital, Xining, PR China
| | | | - Meng-Zhen Shi
- The Graduate School, Qinghai University, Xining, PR China
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Diaz R, Murelli F, Cuniolo L, Cornacchia C, Depaoli F, Margarino C, Boccardo C, Gipponi M, Franchelli S, Pesce M, Massa B, Bozzano S, Barbero V, Cian FD, Fregatti P. A Rare Case of Breast Metastasis from a Primary Lung Tumor: Case Report. Curr Oncol 2024; 31:4695-4703. [PMID: 39195333 DOI: 10.3390/curroncol31080350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Abstract
Breast metastasis originating from a primary lung tumor is exceedingly rare and can present challenges in distinguishing it from primary breast cancer. This case report discusses the management of a 64-year-old woman who initially presented with a nodule in her left breast. A biopsy revealed an infiltrating ductal carcinoma. Despite negative BRCA genetic testing, her significant family history of cancer and the presence of a newly detected right breast lesion led to a bilateral mastectomy. Post-operative imaging identified multiple hypodense nodules and a spiculated pulmonary nodule, necessitating further investigation. An endoscopic lung biopsy confirmed a primary pulmonary carcinoma with histological features similar to the breast carcinoma, suggesting the lung as the primary source. This case highlights the complexity of differentiating breast metastasis originating from a lung tumor and primary breast cancer. It underscores the importance of comprehensive diagnostic evaluations and the consideration of extramammary origins in metastatic cases. The findings emphasize the role of multidisciplinary teams in managing such rare and challenging cases and highlight the necessity for thorough and repeated assessments in atypical breast cancer presentations.
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Affiliation(s)
- Raquel Diaz
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
| | - Federica Murelli
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Letizia Cuniolo
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
| | - Chiara Cornacchia
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Francesca Depaoli
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Cecilia Margarino
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Chiara Boccardo
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Marco Gipponi
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | | | - Marianna Pesce
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Barbara Massa
- Anatomic Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Silvia Bozzano
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
| | - Valentina Barbero
- Department of Internal Medicine and Medical Specialties, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Franco De Cian
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Piero Fregatti
- Department of Surgical and Diagnostic Integrated Sciences-DISC, University of Genova, 16132 Genova, Italy
- Breast Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
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