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Nesbitt C, Van Der Walt A, Butzkueven H, Devitt B, Jokubaitis VG. Multiple sclerosis and cancer: Navigating a dual diagnosis. Mult Scler 2024:13524585241274523. [PMID: 39347791 DOI: 10.1177/13524585241274523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Healthcare breakthroughs are extending the lives of multiple sclerosis (MS) patients and cancer survivors, creating a growing cohort of individuals navigating a dual diagnosis. Determining the relationship between MS and cancer risk remains challenging, with inconclusive findings confounded by age, risk exposures, comorbidities, genetics and the ongoing introduction of new MS disease-modifying therapies (DMTs) across study periods.This research places significant emphasis on cancer survival, with less attention given to the impact on MS outcomes. Our review explores the existing literature on MS, cancer risk and the intersection of DMTs and cancer treatments. We aim to navigate the complexities of managing MS in cancer survivors to optimise outcomes for both conditions. Continuous research and the formulation of treatment guidelines are essential for guiding future care. Collaboration between neuro-immunology and oncology is crucial, with a need to establish databases for retrospective and ultimately prospective analysis of outcomes in these rapidly evolving fields.
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Affiliation(s)
- Cassie Nesbitt
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, MSNI Multiple Sclerosis and Neuro-Immunology, Alfred Health, Melbourne, VIC, Australia
- Department of Neuroscience, Monash University, The Alfred Centre, Melbourne, VIC, Australia
| | - Anneke Van Der Walt
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, MSNI Multiple Sclerosis and Neuro-Immunology, Alfred Health, Melbourne, VIC, Australia
| | - Helmut Butzkueven
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, MSNI Multiple Sclerosis and Neuro-Immunology, Alfred Health, Melbourne, VIC, Australia
| | - Bianca Devitt
- Department of Oncology, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
- Oncology Clinical Trials Unit, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Vilija G Jokubaitis
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, MSNI Multiple Sclerosis and Neuro-Immunology, Alfred Health, Melbourne, VIC, Australia
- Department of Neuroscience, Monash University, The Alfred Centre, Melbourne, VIC, Australia
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Wu JTY, Corrigan J, Su C, Dumontier C, La J, Khan A, Arya S, Harris AHS, Backhus L, Das M, Do NV, Brophy MT, Han SS, Kelley M, Fillmore NR. The performance status gap in immunotherapy for frail patients with advanced non-small cell lung cancer. Cancer Immunol Immunother 2024; 73:172. [PMID: 38954019 PMCID: PMC11219626 DOI: 10.1007/s00262-024-03763-w] [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: 01/23/2024] [Accepted: 06/13/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE In advanced non-small cell lung cancer (NSCLC), immune checkpoint inhibitor (ICI) monotherapy is often preferred over intensive ICI treatment for frail patients and those with poor performance status (PS). Among those with poor PS, the additional effect of frailty on treatment selection and mortality is unknown. METHODS Patients in the veterans affairs national precision oncology program from 1/2019-12/2021 who received first-line ICI for advanced NSCLC were followed until death or study end 6/2022. Association of an electronic frailty index with treatment selection was examined using logistic regression stratified by PS. We also examined overall survival (OS) on intensive treatment using Cox regression stratified by PS. Intensive treatment was defined as concurrent use of platinum-doublet chemotherapy and/or dual checkpoint blockade and non-intensive as ICI monotherapy. RESULTS Of 1547 patients receiving any ICI, 66.2% were frail, 33.8% had poor PS (≥ 2), and 25.8% were both. Frail patients received less intensive treatment than non-frail patients in both PS subgroups (Good PS: odds ratio [OR] 0.67, 95% confidence interval [CI] 0.51 - 0.88; Poor PS: OR 0.69, 95% CI 0.44 - 1.10). Among 731 patients receiving intensive treatment, frailty was associated with lower OS for those with good PS (hazard ratio [HR] 1.53, 95% CI 1.2 - 1.96), but no association was observed with poor PS (HR 1.03, 95% CI 0.67 - 1.58). CONCLUSION Frail patients with both good and poor PS received less intensive treatment. However, frailty has a limited effect on survival among those with poor PS. These findings suggest that PS, not frailty, drives survival on intensive treatment.
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Affiliation(s)
- Julie Tsu-Yu Wu
- VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
| | | | - Chloe Su
- Stanford University, Palo Alto, CA, USA
| | - Clark Dumontier
- VA Boston Healthcare System, Harvard Medical School, Boston, USA
| | - Jennifer La
- VA Boston Healthcare System, Harvard Medical School, Boston, USA
| | | | - Shipra Arya
- VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
| | - Alex H S Harris
- VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
| | - Leah Backhus
- VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
| | - Millie Das
- VA Palo Alto Healthcare System, Stanford University, Palo Alto, CA, USA
| | - Nhan V Do
- VA Boston Healthcare System, Boston University School of Medicine, Boston, USA
| | - Mary T Brophy
- VA Boston Healthcare System, Boston University School of Medicine, Boston, USA
| | | | - Michael Kelley
- Durham VA Healthcare System, Duke University, Durham, NC, USA
| | - Nathanael R Fillmore
- VA Boston Healthcare System, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.
- Massachusetts Veterans Epidemiology Research and Information Center, 150 S Huntington Ave, Boston, MA, 02141, USA.
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Cosma S, Borella F, Grimaudo I, Seminara Y, Annalisa T, Bertero L, Goia M, Preti M, Benedetto C. Comedo-like growth pattern in invasive early-stage cervical cancer: A new feature related to parametrial involvement. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108438. [PMID: 38815333 DOI: 10.1016/j.ejso.2024.108438] [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: 03/24/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION The standard surgical treatment for early-stage cervical cancer includes hysterectomy and bilateral oophorectomy along the removal of parametrial tissue to achieve surgical radicality. However, in recent years, the role of simple hysterectomy for cervical cancer with favorable prognostic characteristics has been re-evaluated. One of the challenges in early-stage cervical cancer is identifying predictive factors for neoplastic parametrial infiltration and lymph node metastases that cannot be detected during the preoperative assessment. We hypothesized that histological tumor growth patterns may be associated with these features and could thus be useful for the management of apparent early-stage cervical cancer. METHOD We identified 3 different histological patterns: the comedo-like, the infiltrative, and the expansive. We analyzed a series of clinic-pathological characteristics to determine the association of eachpatternwith aggressive features. Furthermore, we estimated odd ratios (ORs) in univariate and multivariate analyses for parametrial infiltration and lymph node metastasis. RESULTS We found that comedo-like pattern is associated to advanced FIGO stages, larger tumor size, lymphovascular space invasion, deeper invasion depth, parametrium involvement, and lymph node metastases. By univariate analysis, comedo-like pattern was statistically associated with both parametrial involvement (OR: 19.3, CI 5.47-68.6, p-value = < 0.001) and lymph node metastases (OR: 4.98, CI 1.71-14.5, p-value = 0.003). By multivariate analysis, the association between comedo-like pattern and parametrial involvement was confirmed (OR: 8.76, CI 2.34-32.75, p-value = 0.01). CONCLUSION The specific growth pattern of cervical cancer, assessed in a conization specimen before hysterectomy, can be useful to tailor surgical radicality.
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Affiliation(s)
- Stefano Cosma
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy.
| | - Ida Grimaudo
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
| | - Ylenia Seminara
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
| | - Tancredi Annalisa
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Margherita Goia
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mario Preti
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
| | - Chiara Benedetto
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy
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Knowles R, Kemp E, Miller M, Koczwara B. Reducing the impact of cardiovascular disease in older people with cancer: a qualitative study of healthcare providers. J Cancer Surviv 2024; 18:818-827. [PMID: 36648743 PMCID: PMC11081978 DOI: 10.1007/s11764-023-01331-2] [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: 08/15/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE Cancer survivors are at greater risk of cardiovascular disease (CVD) than cancer-free controls. Despite evidence-based guidelines recommending CVD risk factor assessment, surveillance and risk-reduction, many people with cancer do not receive adequate CVD care. To address potential barriers and enablers of care, we examined healthcare professionals' (HCPs) perceptions and experiences of CVD risk assessment and management in people with cancer. METHODS We conducted one focus group and 12 individual interviews to examine HCPs' perceptions and experiences of CVD care in care. We used reflexive thematic analysis to collect and analyse the qualitative data to construct and understand themes. RESULTS Twenty-one HCPs participated (8 oncologists, 5 nurses, 3 general practitioners, 2 dietitians, 1 cardiologist, 1 haematologist and 1 physiotherapist). Majority of HCPs were aware of CVD risk in cancer but were concerned they could not deliver CVD care alone due to system-level barriers including lack of time and training. HCPs also perceived patient-level barriers including socioeconomic disadvantage and fatalistic outlook. Despite barriers, HCPs suggested diverse solutions for improving CVD care in cancer including new models-of-care, clinical pathways, risk assessment/management tools and education. CONCLUSIONS The diversity of perceived barriers and suggested solutions identified by HCPs suggests the need for a multilevel approach tailored to context. Future research involving people with cancer is needed to co-design acceptable interventions. IMPLICATIONS FOR CANCER SURVIVORS Improved understanding of HCP's perceptions can inform the development of new interventions to deliver CVD care to people with cancer to reduce morbidity and mortality.
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Affiliation(s)
- Reegan Knowles
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
| | - Emma Kemp
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Michelle Miller
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
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Jafry BH, Buhaya MH, Milsap A, Jones AL, Goksu SY, Verma N, Brown TJ, Hughes A, Nair R, Sanford N, Su J, Huang E, Kazmi SMA. Clinical, pathological, and adjuvant chemotherapy use differences among microsatellite unstable and microsatellite stable colon cancers. JOURNAL OF THE NATIONAL CANCER CENTER 2024; 4:169-175. [PMID: 39282583 PMCID: PMC11390619 DOI: 10.1016/j.jncc.2024.04.003] [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: 01/21/2024] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 09/19/2024] Open
Abstract
Background Colon cancers are categorized into mismatch repair deficient/microsatellite unstable (MSI-H) and mismatch repair proficient/microsatellite stable (MSS) cancers. This study aims to compare the disease characteristics and trends in the utilization of cancer therapies across different age groups and stages in these two groups. Methods MSI-H and MSS colon adenocarcinomas from 2010 to 2016 were identified using the National Cancer Database. We compared patient and disease characteristics between the two groups and evaluated the use of adjuvant chemotherapy across age groups and cancer stages. Within MSI-H and MSS groups, we conducted a landmark analysis after propensity score matching for adjuvant chemotherapy versus no chemotherapy to determine its effect on survival. Results Of the 542,368 patients that met inclusion criteria, 120,751 (22%) had mismatch repair results available-out of these 96,928 (80%) had MSS colon cancers while 23,823 (19.7%) had MSI-H cancers. MSI-H disease had a bimodal age distribution (<40 years = 22%; ≥75 years = 26%) and was frequent among females (22%) and non-Hispanic Whites (20%). Among those < 65 years, 15% of low-risk stage 2 MSI-H patients and 40% of high-risk stage 2 MSI-H patients received adjuvant chemotherapy. More than two-thirds of stage 3 patients <65 years received adjuvant chemotherapy in both groups. After conducting propensity-score matching for age, gender, and co-morbidities, we found that adjuvant chemotherapy use had a trend towards lower overall survival (OS) in low-risk stage 2 MSI-H (HR = 1.8 [95% CI, 0.8-4.02]) and high-risk stage 2 MSI-H (HR = 1.42 [95% CI, 0.96-2.12]) groups. Adjuvant chemotherapy significantly improved OS in stage 3 colon cancer patients irrespective of microsatellite status or risk category of disease. Conclusions MSI-H colon cancer had bimodal age distribution. Among stage 2 MSI-H patients <65 years, a notable proportion received adjuvant chemotherapy. Among MSI-H stage 2 patients, adjuvant chemotherapy use was associated with lower survival while it significantly improved survival for stage 3 patients, irrespective of MSI status.
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Affiliation(s)
- Baqir Hasan Jafry
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Munir Hassan Buhaya
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, USA
| | - Allante Milsap
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Amy Little Jones
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | | | - Nilesh Verma
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Timothy J Brown
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Amy Hughes
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, USA
| | - Rasmi Nair
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, USA
| | - Nina Sanford
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Joseph Su
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, USA
| | - Emina Huang
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, USA
| | - Syed Mohammad Ali Kazmi
- Department of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, USA
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Choi Y, Kim N. Sex Difference of Colon Adenoma Pathway and Colorectal Carcinogenesis. World J Mens Health 2024; 42:256-282. [PMID: 37652658 PMCID: PMC10949019 DOI: 10.5534/wjmh.230085] [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: 04/18/2023] [Accepted: 05/09/2023] [Indexed: 09/02/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common causes of cancer morbidity in both sexes but shows sex differences. First, sex-specific differences in tumor recurrence and survival rates have been reported. For example, the development of CRC is found about 1.5 times higher and 4-8 years earlier in males compared to females, suggesting the protective role of estrogen in the disease. Furthermore, female patients have a higher risk of developing right-sided (proximal) colon cancer than male patients, which is known to have more aggressive clinical character compared to left-sided (distal) colon cancer. That is, left and right CRCs show differences in carcinogenic mechanism, that the chromosomal instability pathway is more common in left colon cancer while the microsatellite instability and serrated pathways are more common in right colon cancer. It is thought that there are sex-based differences on the background of carcinogenesis of CRC. Sex differences of CRC have two aspects, sexual dimorphism (biological differences in hormones and genes) and gender differences (non-biological differences in societal attitudes and behavior). Recently, sex difference of colon adenoma pathway and sexual dimorphism in the biology of gene and protein expression, and in endocrine cellular signaling in the CRC carcinogenesis have been accumulated. In addition, behavioral patterns can lead to differences in exposure to risk factors such as drinking or smoking, diet and physical activity. Therefore, understanding sex/gender-related biological and sociocultural differences in CRC risk will help in providing strategies for screening, treatment and prevention protocols to reduce the mortality and improve the quality of life. In this review, sex/gender differences in colon adenoma pathway and various aspects such as clinicopathological, biological, molecular, and socio-cultural aspects of CRC were described.
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Affiliation(s)
- Yonghoon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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Xiao Z, Li K, Su F, Yang X, Zou H, Qu S. Nomogram model of survival prediction for nasopharyngeal carcinoma with lung metastasis: developed from the SEER database and validated externally. Front Oncol 2024; 14:1351578. [PMID: 38567156 PMCID: PMC10985206 DOI: 10.3389/fonc.2024.1351578] [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: 12/06/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Objective Distant metastasis occurs in some patients at the first diagnosis of nasopharyngeal carcinoma (NPC), the prognosis is poor, and there are significant individual differences. This study established a nomogram model of lung metastasis of NPC as a supplement to TNM staging. Methods The training cohort is used to build the nomogram model, and the validation cohort is used to evaluate the model. The training cohort of 177 patients is from the Surveillance, Epidemiology, and End Results (SEER) database. Factors affecting overall survival (OS) in patients with lung metastasis of NPC analysis by Cox regression analysis and then a nomogram were established. 122 patients from the Affiliated Tumor Hospital of Guangxi Medical University were selected as the external validation cohort. The concordance index (C-index), the area under the curve (AUC), and the calibration curve were used to assess the accuracy of the nomogram and used the decision curve analysis (DCA) curve to measure the clinical benefit capacity of the model. The patients were separated into two groups with different risks, and the "Kaplan-Meier (KM)" survival analysis was used to evaluate the differentiation ability of the model. Results Age, T-stage, radiation, chemotherapy, and brain metastases can affect the OS in NPC with lung metastasis. A nomogram was developed according to the above five factors. The C-index of the training cohort and the validation cohort were 0.726 (95% CI: 0.692-0.760) and 0.762 (95% CI: 0.733-0.791). The AUC of the nomogram was better than that of the TNM staging. In the training cohort, the nomogram predicted OS AUC values of 0.767, 0.746, and 0.750 at 1, 2, and 3 years, TNM stage of 0.574, 0.596, and 0.640. In the validation cohort, nomogram predictions of OS AUC values of 0.817, 0.857, and 0.791 for 1, 2, and 3 years, TNM stage of 0.575, 0.612, and 0.663. DCA curves suggest that nomogram have better clinical net benefits than TNM staging. The KM survival analysis shows that the nomogram has a reasonable risk stratification ability. Conclusion This study successfully established a nomogram model of NPC lung metastasis, which can be used as a supplement to TNM staging and provide reference for clinicians.
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Affiliation(s)
- Zhehao Xiao
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Kaiguo Li
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Fang Su
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Xiaohui Yang
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Hongxing Zou
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Song Qu
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
- Key Laboratory of Early Prevention and Treatment of Regional High Incidence Tumors, Ministry of Education, Guangxi Medical University, Nanning, China
- Nasopharyngeal Carcinoma Clinical Medical Research Center, Guangxi Medical University, Nanning, China
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Tang D, Qiu R, Qiu X, Sun M, Su M, Tao Z, Zhang L, Tao S. Dietary restriction rescues 5-fluorouracil-induced lethal intestinal toxicity in old mice by blocking translocation of opportunistic pathogens. Gut Microbes 2024; 16:2355693. [PMID: 38780487 PMCID: PMC11123560 DOI: 10.1080/19490976.2024.2355693] [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: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Chemotherapy remains a major treatment for malignant tumors, yet the application of standard dose intensity chemotherapy is limited due to the side effects of cytotoxic drugs, especially in old populations. The underlying mechanisms of cytotoxicity and strategies to increase the safety and tolerance of chemotherapy remain to be explored. Using 5-fluorouracil (5-FU), a cornerstone chemotherapeutic drug, we demonstrate that the main cause of death in ad libitum (AL) fed mice after 5-FU chemotherapy was infection caused by translocation of intestinal opportunistic pathogens. We show that these opportunistic pathogens greatly increase in the intestine after chemotherapy, which was closely related to loss of intestinal lysozyme. Of note, two weeks of dietary restriction (DR) prior to chemotherapy significantly protected the loss of lysozyme and increased the content of the beneficial Lactobacillus genera, resulting in a substantial inhibition of intestinal opportunistic pathogens and their translocation. The rescue effect of DR could be mimicked by Lysozyme or Lactobacillus gavage. Our study provides the first evidence that DR achieved a comprehensive protection of the intestinal physical, biological and chemical barriers, which significantly improved the overall survival of 5-FU-treated mice. Importantly, the above findings were more prominent in old mice. Furthermore, we show that patients over 65 years old have enriched opportunistic pathogens in their gut microbiota, especially after 5-FU based chemotherapy. Our study reveals important mechanisms for the poor chemotherapy tolerance of the elderly population, which can be significantly improved by short-term DR. This study generates new insights into methods for improving the chemotherapeutic prognosis by increasing the chemotherapy tolerance and safety of patients with malignant tumors.
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Affiliation(s)
- Duozhuang Tang
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Rongrong Qiu
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xingxing Qiu
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Man Sun
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Mingyue Su
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhendong Tao
- Department of Medical Laboratory Medicine, Jiangxi Province Hospital of Integrated Chinese & Western Medicine, Nanchang, Jiangxi, China
| | - Liu Zhang
- Intensive Care Unit, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Si Tao
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Sebastian D, Joseph J, Mathews E. The prevalence and correlates of comorbidities among patients with cancer attending a tertiary care cancer center in South India: An analytical cross-sectional study. CANCER RESEARCH, STATISTICS, AND TREATMENT 2023; 6:526-533. [PMID: 38826774 PMCID: PMC7616054 DOI: 10.4103/crst.crst_93_23] [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] [Indexed: 06/04/2024] Open
Abstract
Background Comorbidities in patients with cancer can affect treatment, and should, therefore, be prioritized and managed. Objectives Our primary aim was to assess the prevalence of comorbidities among patients with cancer. The secondary objective was to identify the association of comorbidities with various sociodemographic and clinical variables. Materials and Methods This was a cross-sectional study conducted between December 2019 and March 2020 among patients with cancer, seeking treatment at Malabar Cancer Center, in Kannur District of northern Kerala in South India. Semi-structured interviews were conducted, and comorbidities were assessed using the Charlson Comorbidity Index. The anthropometric measurements were recorded using a standardized instrument and protocol. Results We enrolled 242 patients in this study. There were 148 (61.2%) female patients; 106 (43.8%) were aged between 41 and 50 years. Cancers of the head-and-neck and breast accounted for the majority of cases (23.1% each, n = 56), followed by the digestive system (18.6%, n = 45) and female reproductive system (11.2%, n = 27). The most common primary cancers in the head-and-neck, digestive, and female reproductive systems were oral, colorectal, and cervical, respectively. The prevalence of comorbidities among patients with cancer was 70.2% (n = 170). Common comorbidities were hypertension (n = 82 ; 33.9%), arthritis (n = 57; 23.6%), and diabetes (n = 53; 21.6%). After controlling for potential confounders, the factors noted to be independently associated with the presence of comorbidities were advanced age, family history of comorbidity, normal weight or underweight, and cancer treatment for more than 6 months' duration. Conclusions The high prevalence of comorbidities among patients with cancer suggests the need for an integrated system of care and management as the comorbidities affect the overall management of cancer treatment and care.
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Affiliation(s)
- Divya Sebastian
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod
| | | | - Elezebeth Mathews
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod
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10
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Knowles R, Kemp E, Miller M, Koczwara B. "There could be something going wrong and I wouldn't even know": a qualitative study of perceptions of people with cancer about cardiovascular disease (CVD) risk and its management. J Cancer Surviv 2023:10.1007/s11764-023-01468-0. [PMID: 37775614 DOI: 10.1007/s11764-023-01468-0] [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: 05/24/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Despite being at higher risk, many people with cancer do not receive adequate cardiovascular disease (CVD) risk assessment or management. The purpose of this research was to examine people with cancer's perceptions, experiences and needs regarding CVD risk factor awareness, assessment and management. METHODS We conducted 15 individual interviews to examine people with cancer's perspectives regarding CVD care in cancer. Reflexive thematic analysis was utilised to collect and organise data into themes and to synthesise findings. RESULTS Fifteen people (6 males) diagnosed with diverse cancer types participated. Majority participants were not or only somewhat aware of CVD risk in cancer, but all expressed it was an important issue. A diverse range of priorities and needs for CVD care was discussed, including some participants' prioritisation of dealing with cancer and preferred amount, type and manner of information provision and support. Websites and brochures were identified as potential solutions for optimising CVD care. CONCLUSIONS Codesign methodology should be used to engage patients in the development of flexible, tailored resources to increase awareness of CVD risk and strategies for its management. IMPLICATIONS FOR CANCER SURVIVORS Perceptions of people with cancer regarding CVD care can inform new interventions that reduce the impact of CVD in cancer.
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Affiliation(s)
- Reegan Knowles
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
| | - Emma Kemp
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Michelle Miller
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
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11
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De Nunzio V, Donghia R, Pesole PL, Coletta S, Calò N, Notarnicola M. Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer. J Clin Med 2023; 12:5986. [PMID: 37762927 PMCID: PMC10532301 DOI: 10.3390/jcm12185986] [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: 07/10/2023] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The tumor location in colorectal cancer (right- or left-sided colon cancer) is a key factor in determining disease progression. Right- and left-sided colon tumors are different in their clinical and molecular characteristics. Dysregulation of serum levels of proinflammatory cytokines, such as Transforming Growth Factor β (TGF-β) and Tumor Necrosis Factor-α (TNF-α), and Peroxisome Proliferator Activated Receptor-γ (PPAR-γ), known to be a growth-limiting and differentiation-promoting factor, as well as changes in miRNAs expression, are the major signaling pathways involved in the pathogenesis of this neoplasia. In the serum from 60 colorectal cancer (CRC) patients, we compared the differences in the expression of the levels of TGF-β, TNF-α, and PPAR-γ and in the expression of the main human miRNAs between right and left CRC. A significant over-expression in the TGF-β and TNF-α levels was observed in the serum from right-sided colon cancer patients. For the PPAR-γ, the patients with CRC located on the right-side showed lower levels than those detected in the serum from left-sided CRC subjects. Furthermore, significant differences also existed in the expression of specific circulating miRNAs between right- and left-sided CRC. In particular, the right upregulated miRNAs were all involved in the cell growth and proliferation related pathways. These findings confirm that the analysis of circulating levels of TGF-β, TNF-α, and PPAR-γ, as well as the study of the specific miRNAs in the serum, are able to identify specific characteristics of CRC patients, useful for choosing a personalized treatment protocol.
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Affiliation(s)
| | | | | | | | | | - Maria Notarnicola
- National Institute of Gastroenterology-IRCCS “Saverio de Bellis”, Castellana Grotte, 70013 Bari, Italy; (V.D.N.); (R.D.); (P.L.P.); (S.C.); (N.C.)
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12
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Harper EI, Weeraratna AT. A Wrinkle in TIME: How Changes in the Aging ECM Drive the Remodeling of the Tumor Immune Microenvironment. Cancer Discov 2023; 13:1973-1981. [PMID: 37671471 PMCID: PMC10654931 DOI: 10.1158/2159-8290.cd-23-0505] [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: 04/29/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 09/07/2023]
Abstract
SUMMARY Cancer is an age-related disease, with the majority of patients receiving their diagnosis after the age of 60 and most mortality from cancer occurring after this age. The tumor microenvironment changes drastically with age, which in turn affects cancer progression and treatment efficacy. Age-related changes to individual components of the microenvironment have received well-deserved attention over the past few decades, but the effects of aging at the interface of two or more microenvironmental components have been vastly understudied. In this perspective, we discuss the relationship between the aging extracellular matrix and the aging immune system, how they affect the tumor microenvironment, and how these multidisciplinary studies may open avenues for new therapeutics. Cancer is a disease of aging. With a rapidly aging population, we need to better understand the age-related changes that drive tumor progression, ranging from secreted changes to biophysical and immune changes.
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Affiliation(s)
- Elizabeth I. Harper
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
| | - Ashani T. Weeraratna
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 1650 Orleans Street, Room 485, Baltimore, MD 21205
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13
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Galve-Calvo E, Alonso-Babarro A, Martínez-García M, Pi-Figueras M, Villalba G, Alonso S, Contreras J. Narrative Review of Multidisciplinary Management of Central Nervous Involvement in Patients with HER2-Positive Metastatic Breast Cancer: Focus on Elderly Patients. Adv Ther 2023; 40:3304-3331. [PMID: 37291377 DOI: 10.1007/s12325-023-02538-6] [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] [Accepted: 04/28/2023] [Indexed: 06/10/2023]
Abstract
The tumor biology of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) promotes the development of central nervous system (CNS) metastases, with 25% of patients with HER2-positive BC developing CNS metastases. Furthermore, the incidence of HER2-positive BC brain metastases has increased in the last decades, likely because of the improved survival with targeted therapies and better detection methods. Brain metastases are detrimental to quality of life and survival and represent a challenging clinical problem, particularly in elderly women, who comprise a substantial proportion of patients diagnosed with BC and often have comorbidities or an age-related decline in organ function. Treatment options for patients with BC brain metastases include surgical resection, whole-brain radiation therapy, stereotactic radiosurgery, chemotherapy, and targeted agents. Ideally, local and systemic treatment decisions should be made by a multidisciplinary team, with input from several specialties, based on an individualized prognostic classification. In elderly patients with BC, additional age-associated conditions, such as geriatric syndromes or comorbidities, and the physiologic changes associated with aging, may impact their ability to tolerate cancer therapy and should be considered in the treatment decision-making process. This review describes the treatment options for elderly patients with HER2-positive BC and brain metastases, focusing on the importance of multidisciplinary management, the different points of view from the distinct disciplines, and the role of oncogeriatric and palliative care in this vulnerable patient group.
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Affiliation(s)
- Elena Galve-Calvo
- Medical Oncology Service, Hospital Universitario Basurto (OSI Bilbao-Basurto), Avda. Montevideo 18, 48013, Bilbao, Bisczy, Spain.
| | | | | | | | | | | | - Jorge Contreras
- Radiation Oncology Department, Hospital Carlos Haya, Málaga, Spain
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14
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Joo HJ, Lee HS, Jang BI, Kim DB, Kim JH, Park JJ, Kim HG, Baek IH, Lee J, Kim B. Sex-specific differences in colorectal cancer: A multicenter retrospective cohort study. Cancer Rep (Hoboken) 2023; 6:e1845. [PMID: 37348877 PMCID: PMC10432433 DOI: 10.1002/cnr2.1845] [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: 10/30/2022] [Revised: 05/11/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Due to sex-specific differences in the incidence and clinical and histopathological characteristics of colorectal cancer (CRC), understanding the impact of sex on CRC may suggest sex-targeted strategies for screening, treatment, and prevention, leading to improved prognosis of CRC. However, there have been few studies investigating the sex-specific differences in CRC in the Republic of Korea. We aimed to assess sex differences in CRC in the Republic of Korea. METHODS This was a retrospective, multicenter, cohort study of patients diagnosed with CRC between January 2012 and December 2013 at nine hospitals. Patients who had an uncertain CRC stage, were diagnosed with other cancers within 5 years, had carcinoma in situ, non-epithelial cancer, or primary cancer other than CRC, were excluded. Factors associated with overall survival or progression-free survival were investigated using Cox regression analysis. Cumulative probability of metachronous lesions was compared using the Kaplan-Meier estimator survival analysis and we compared the survival curves of each group using a log-rank test. Outcomes were compared using the chi-square, Fisher's exact, or Student's t-test, as appropriate. RESULTS Three thousand one hundred and forteen patients (1999 men, 1315 women) were included. There was no significant difference in the age at onset between men and women. The proportion of patients diagnosed through regular health check-ups, and asymptomatic at time of diagnosis, was higher in men (48.9% men vs. 42.0% women, p < .001). Rectal cancers were more common in men (38.8% men vs. 31.8% women, p < .001). Right colon cancers were more common in women (31.4% women vs. 22.7% men, p < .001). KRAS mutations were found in 109/317 (34.4%) women and 112/480 (23.3%) men. Overall CRC survival and progression-free survival were similar in both sexes. CONCLUSION Sex differences in CRC may be due to the biological and social-behavioral differences between the sexes. They should be considered during screening, diagnosis, and treatment of CRC for better outcomes.
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Affiliation(s)
- Hyun Jin Joo
- Division of Gastroenterology, Department of Internal MedicineChung‐Ang University Medical CenterSeoulRepublic of Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National UniversityKyungpook National University HospitalDaeguRepublic of Korea
| | - Byung Ik Jang
- Department of Internal MedicineYeungnam University College of MedicineDaeguRepublic of Korea
| | - Dae Bum Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of MedicineThe Catholic University of KoreaSuwonRepublic of Korea
| | - Jae Hyun Kim
- Department of Internal MedicineKosin University College of MedicineBusanRepublic of Korea
| | - Jae Jun Park
- Department of Internal Medicine and Institute of GastroenterologyYonsei University College of MedicineSeoulRepublic of Korea
| | - Hyun Gun Kim
- Institute for Digestive ResearchSoonchunhyang University College of MedicineSeoulRepublic of Korea
| | - Il Hyun Baek
- Department of Gastroenterology, International St. Mary's HospitalCatholic Kwandong UniversityIncheonRepublic of Korea
| | - Jun Lee
- Department of Internal MedicineChosun UniversityGwangjuRepublic of Korea
| | - Bun Kim
- Center for Colorectal Cancer and Department of Internal Medicine, Research Institute and HospitalNational Cancer CenterGoyangRepublic of Korea
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15
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Chen Y, Zheng Y, Wu Y, Dai J, Zhu X, Wu T, Tang W, Yang S, Zhang J, Zhou S, Wu M, Zhang C, Wang S. Local excision as a viable alternative to hysterectomy for early-stage cervical cancer in women of reproductive age: a population-based cohort study. Int J Surg 2023; 109:1688-1698. [PMID: 37074037 PMCID: PMC10389310 DOI: 10.1097/js9.0000000000000417] [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: 12/14/2022] [Accepted: 04/12/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Local excision as the main alternative for fertility-sparing surgery (FSS) has been widely used in patients with early-stage cervical cancer to achieve fertility preservation, but its safety and practicability are still questioned. Therefore, The authors evaluated the current application of local excision in early-stage cervical cancer with this population-based study and compared its efficacy with hysterectomy. MATERIALS AND METHODS Women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I cervical cancer at childbearing age (18-49 years) recorded in the Surveillance, Epidemiology and End Results (SEER) database from 2000 to 2017 were included. Overall survival (OS) and disease-specific survival (DSS) rates were compared between local excision and hysterectomy. RESULTS A total of 18 519 patients of reproductive age with cervical cancer were included, and 2268 deaths were observed. 17.0% of patients underwent FSS via local excision, and 70.1% underwent hysterectomy. Among patients younger than 39 years, OS and DSS of local excision were comparable to those of hysterectomy, whereas, in patients older than 40 years, OS and DSS of local excision were significantly worse than those of hysterectomy. In addition, OS and DSS of local excision were similar to hysterectomy in patients with stage IA cervical cancer, but OS and DSS were inferior to hysterectomy in patients with stage IB cervical cancer who underwent local excision. CONCLUSION For patients without fertility requirements, hysterectomy remains the best therapeutic option. However, for patients under 40 years of age diagnosed with stage IA cervical cancer, FSS via local excision is a viable option that can achieve a well-balanced outcome between tumour control and fertility preservation.
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Affiliation(s)
- Ying Chen
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Yongqiang Zheng
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Centre, Sun Yat-sen University, Guangzhou
| | - Yaling Wu
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Jun Dai
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Xiaoran Zhu
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Tong Wu
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Weicheng Tang
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Shuhao Yang
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Jinjin Zhang
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Su Zhou
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Meng Wu
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Chun Zhang
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shixuan Wang
- Department of Obstetrics and Gynaecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan
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16
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Ning J, Ge T, Zhu S, Han Y, Ruan S, Ma Y, Liu R. The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis. Front Oncol 2022; 12:958187. [PMID: 36249007 PMCID: PMC9565197 DOI: 10.3389/fonc.2022.958187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundSurgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC could benefit from surgery.MethodsWe collected the data of patients with SCLC between 2000 and 2015 from the Surveillance, Epidemiology, and End Results Program database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included, and we converted the staging information into those of the eighth edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no-surgery groups.ResultsBefore PSM, the distribution proportions of clinical characteristics in 1,229 patients were unbalanced. The Kaplan–Meier curves of overall survival (OS) and cancer-specific survival (CSS) showed that the patients in the surgery group were better than those in the non-surgery group (all P < 0.001). After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P > 0.05). The OS and CSS of patients in the surgery group were still better than that of patients in the no-surgery group (all P < 0.001), and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups (almost P < 0.001). The multivariate Cox analysis further confirmed this result (OS: HR, 0.33; 95% CI, 0.27–0.39; P < 0.001; CSS: HR, 0.29; 95% CI, 0.23–0.36; P < 0.001). The result of subgroup analysis based on age, T stage, and adjuvant therapy showed that surgery was related to better OS and CSS compared with non-surgery group (almost P < 0.001) and that lobectomy exhibited the longer survival than sublobectomy. Age, sex, and race were the independent prognostic factors for OS in patients undergoing surgery, whereas only the factor of age affects the CSS in patients with surgery.ConclusionsOlder patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment, and lobectomy provides better prognosis than sublobectomy.
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Affiliation(s)
- Jing Ning
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Tao Ge
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shuncang Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingli Han
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Suhong Ruan
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Yuchen Ma
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
- *Correspondence: Yuchen Ma, ; Rentao Liu,
| | - Rentao Liu
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
- *Correspondence: Yuchen Ma, ; Rentao Liu,
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Ganduri V, Rajasekaran K, Duraiyarasan S, Adefuye MA, Manjunatha N. Colorectal Carcinoma, Cyclooxygenases, and COX Inhibitors. Cureus 2022; 14:e28579. [PMID: 36185863 PMCID: PMC9521169 DOI: 10.7759/cureus.28579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 12/24/2022] Open
Abstract
Colorectal carcinoma (CRC) is the most common of gastrointestinal cancers, the majority presenting with sporadic occurrence compared to the less frequently inherited syndromes. The increasing incidence, decreasing gender and age disparities, and the prevalent risk factors are concerning. The malignancy arising from benign precursor polyps transforms slowly over time. The adenoma variant polyps reported a marked upregulation of cyclooxygenases (COX), significantly COX-2 isoform, influenced by various determinants such as genetics, pathology, histology, and site of the carcinoma. These COX enzymes are responsible for prostaglandin synthesis and the consequent cascade of cell inflammation and proliferation. Therefore, COX inhibition by non-steroidal anti-inflammatory drugs (NSAIDs) targeted against both the isoforms COX-1 and COX-2 have been studied for decades in anticipation of preventing the occurrence of colorectal carcinoma in high-risk populations. This article has collated and highlighted the overexpression of COX enzymes by the adenomatous polyps and provides corroborating evidence from multiple studies in favor of COX inhibition by NSAIDs. Aspirin and Sulindac were two drugs to be initially proven to halt the progression and cause regression of the polyps. Celecoxib, a selective COX-2 inhibitor besides NSAIDs, was also used in experimental studies.
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Hamid M, Hannan M, Myo Oo N, Lynch P, Walsh DJ, Matthews T, Madden S, O’Connor M, Calvert P, Horgan AM. Chemotherapy Toxicity in Older Adults Optimized by Geriatric Assessment and Intervention: A Non-Comparative Analysis. Curr Oncol 2022; 29:6167-6176. [PMID: 36135053 PMCID: PMC9498117 DOI: 10.3390/curroncol29090484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
The Comprehensive Geriatric Assessment (CGA) is recommended to guide treatment choices in older patients with cancer. Patients ≥ 70 years referred to our oncology service with a new cancer diagnosis are screened using the G-8. Patients with a score of ≤14 are eligible to attend the Geriatric Oncology and Liaison (GOAL) Clinic in our institution, with referral based on physician discretion. Referred patients undergo multidimensional assessments at baseline. CGA domains assessed include mobility, nutritional, cognitive, and psychological status. Chemotherapy toxicity risk is estimated using the Cancer Aging and Research Group (CARG) calculator. We undertook a retrospective analysis of patients attending the GOAL clinic over a 30-month period to April 2021. The objective was to determine rates of treatment dose modifications, delays, discontinuation, and unscheduled hospitalizations as surrogates for cytotoxic therapy toxicity in these patients. These data were collected retrospectively. Ninety-four patients received chemotherapy; the median age was 76 (70-87) and 45 were female (48%). Seventy-five (80%) had an ECOG PS of 0-1. Seventy-two (77%) had gastrointestinal cancer, and most had stage III (47%) or IV (40%) disease. Chemotherapy with curative intent was received by 51% (n = 48) and 51% received monotherapy. From the CGA, the median Timed Up and Go was 11 s (7.79-31.6), and 90% reported no falls in the prior 6 months. The median BMI was 26.93 (15.43-39.25), with 70% at risk or frankly malnourished by the Mini Nutritional Assessment. Twenty-seven (29%) patients had impaired cognitive function. Forty-three (46%) had a high risk of toxicity based on the baseline CARG toxicity calculator. Twenty-six (28%) required dose reduction, 55% (n = 52) required a dose delay, and 36% (n = 34) had a hospitalization due to toxicity. Thirty-nine patients (42%) discontinued treatment due to toxicity. Despite intensive assessment, clinical optimization and personalized treatment decisions, older adults with cancer remain at high risk of chemotherapy toxicity.
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Affiliation(s)
- Munzir Hamid
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Michelle Hannan
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Nay Myo Oo
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Paula Lynch
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Darren J. Walsh
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Tara Matthews
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Stephen Madden
- Data Science Centre, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Miriam O’Connor
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Paula Calvert
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
| | - Anne M. Horgan
- Oncology Department, University Hospital Waterford, X91 ER8E Waterford, Ireland
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Huang HC, Shiu BH, Su SC, Huang CC, Ting WC, Chang LC, Yang SF, Chou YE. The Impact of Matrix Metalloproteinase-11 Polymorphisms on Colorectal Cancer Progression and Clinicopathological Characteristics. Diagnostics (Basel) 2022; 12:diagnostics12071685. [PMID: 35885589 PMCID: PMC9317823 DOI: 10.3390/diagnostics12071685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/08/2022] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cause of cancer mortality worldwide and the most prevalent cancer in Taiwan. The matrix metalloproteinase (MMP)-11 is a proteolytic enzyme of the MMP family which is involved in extracellular matrix degradation and tissue remodeling. In this study, we focused on the associations of MMP-11 single-nucleotide polymorphisms (SNPs) with CRC susceptibility and clinicopathological characteristics. The MMP-11 SNPs rs131451, rs738791, rs2267029, rs738792, and rs28382575 in 479 controls and 479 patients with CRC were analyzed with real-time polymerase chain reaction. We found that the MMP-11 SNP rs738792 “TC + CC” genotype was significantly associated with perineural invasion in colon cancer patients after controlling for clinical parameters [OR (95% CI) = 1.783 (1.074–2.960); p = 0.025]. The MMP-11 rs131451 “TC + CC” genotypic variants were correlated with greater tumor T status [OR (95% CI):1.254 (1.025–1.534); p = 0.028] and perineural invasion [OR (95% CI):1.773 (1.027–3.062); p = 0.040) in male CRC patients. Furthermore, analyses of The Cancer Genome Atlas (TCGA) revealed that MMP-11 levels were upregulated in colorectal carcinoma tissue compared with normal tissues and were correlated with advanced stage, larger tumor sizes, and lymph node metastasis. Moreover, the data from the Genotype-Tissue Expression (GTEx) database exhibited that the MMP-11 rs738792 “CC” and “CT” genotypic variants have higher MMP-11 expression than the “TT” genotype. In conclusion, our results have demonstrated that the MMP-11 SNPs rs738792 and rs131451 may have potential to provide biomarkers to evaluate CRC disease progression, and the MMP-11 rs131451 polymorphism may shed light on sex discrepancy in CRC development and prognosis.
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Affiliation(s)
- Hsien-Cheng Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (H.-C.H.); (B.-H.S.)
- Department of Emergency Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
| | - Bei-Hao Shiu
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (H.-C.H.); (B.-H.S.)
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-C.H.); (W.-C.T.)
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Shih-Chi Su
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Chi-Chou Huang
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-C.H.); (W.-C.T.)
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Wen-Chien Ting
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan; (C.-C.H.); (W.-C.T.)
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Lun-Ching Chang
- Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (H.-C.H.); (B.-H.S.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: (S.-F.Y.); (Y.-E.C.)
| | - Ying-Erh Chou
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: (S.-F.Y.); (Y.-E.C.)
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20
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Chen X, Wu H, Huang S. Excessive Sodium Intake Leads to Cardiovascular Disease by Promoting Sex-Specific Dysfunction of Murine Heart. Front Nutr 2022; 9:830738. [PMID: 35845798 PMCID: PMC9285006 DOI: 10.3389/fnut.2022.830738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Globally, a high-salt diet (HSD) has become a threat to human health as it can lead to a high risk of cardiac damage. Although some studies investigating HSD have been carried out, the majority has been conducted in males, and there are few female-specific studies, thereby ignoring any effects of sex-specific damage on the heart. In this study, we determined how HSD induces different pathways of cardiovascular diseases through sex-specific effects on cardiac damage in mice. Methods An HSD murine model of male and female C57BL/6J mice was fed with sodium-rich chow (4% NaCl). After 8 weeks, cardiac tissues were collected, and the whole gene transcriptome of the hearts of male and female mice was characterized and analyzed using high-throughput RNA sequencing. Immunohistochemistry staining was used to further assess the harmful effects of HSD on protein expression of genes associated with immunity, fibrosis, and apoptosis in male and female mice. Results HSD drastically altered the cardiac transcriptome compared to that of the normal heart in both male and female mice and had a sex-specific effect on the cardiac composition in the transcriptome. HSD produced various differentially expressed genes and affected different KEGG pathways of the transcriptome in male and female mice. Furthermore, we found that HSD induced different pathways of cardiovascular disease in the male mice and female mice. The pathway of hypertrophic cardiomyopathy is significantly enriched in HSD-treated male mice, while the pathway of dilated cardiomyopathy is significantly enriched in HSD-treated female mice. Finally, metabolism, immunity, fibrosis, and apoptosis in the mouse heart showed sex-specific changes predicting cardiac damage. Conclusion Our results demonstrate that HSD adversely impacts cardiac structure and function by affecting the metabolism, immunity, fibrosis, and apoptosis in the murine heart and induces the mouse to suffer from sex-specific cardiovascular disease. This study provides a new perspective and basis for the differences in the pharmacology and interventional treatment of sex-specific cardiovascular diseases induced by HSD in men and women.
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Affiliation(s)
- Xiuli Chen
- Obstetrical Department, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Haiying Wu
- Obstetrical Department, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Shenzhen Huang
| | - Shenzhen Huang
- Henan Eye Institute, Henan Eye Hospital and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
- Haiying Wu
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21
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Carvalho AED, Souza RAGD, Galvão ND, Melanda FN, Caló RDS, Souza BDSND, Lima FCDSD, Aguilar LB. Colorectal cancer mortality trend in Mato Grosso, Brazil, 2000 to 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220007. [PMID: 35766764 DOI: 10.1590/1980-549720220007.supl.1] [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: 08/17/2021] [Accepted: 02/07/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE To analyze the time series of colorectal cancer (CRC) mortality, according to sex and age group, in Mato Grosso, Brazil, from 2000 to 2019. METHODS Ecological time series study, with standardized mortality rates from CRC (C18 to C21) among residents of Mato Grosso. Information on deaths was provided by the Mato Grosso State Health Department, comprising the Mortality Information System and demographic information obtained from the Brazilian Institute of Geography and Statistics. The joinpoint regression analysis was used in the analysis of temporal trend. RESULTS A total of 2,406 deaths from CRC were identified in Mato Grosso between 2000 and 2019. The highest rates were found among the age group from 60 to 79 years. There was an increasing trend in mortality rates among men due to CRC for almost all age groups, with the exception of those aged 40 to 49 years and 80 years and older. For women, there was a significant increase in the age groups from 50 to 59 years and 80 years and older. CONCLUSION The results showed an increase in mortality rates from CRC in the state of Mato Grosso, from 2000 to 2019, in certain age groups for both sexes, but especially for men. Knowledge about the evolution of mortality can provide data on the epidemiological situation of cancer at the local level and, thus, contribute to the development of actions to control and prevent this disease.
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Affiliation(s)
- Alessandra Emídio de Carvalho
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
- Hospital Universitário Júlio Müller - Cuiabá (MT), Brazil
| | - Rita Adriana Gomes de Souza
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Institute for Collective Health - Cuiabá (MT), Brazil
- Mato Grosso State Health Department - Cuiabá (MT), Brazil
| | - Francine Nesello Melanda
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Romero Dos Santos Caló
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Bárbara da Silva Nalin de Souza
- Universidade Federal de Mato Grosso, Institute for Collective Health, Postgraduate Program in Collective Health - Cuiabá (MT), Brazil
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22
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Examples of Inverse Comorbidity between Cancer and Neurodegenerative Diseases: A Possible Role for Noncoding RNA. Cells 2022; 11:cells11121930. [PMID: 35741059 PMCID: PMC9221903 DOI: 10.3390/cells11121930] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/25/2022] [Accepted: 06/13/2022] [Indexed: 02/06/2023] Open
Abstract
Cancer is one of the most common causes of death; in parallel, the incidence and prevalence of central nervous system diseases are equally high. Among neurodegenerative diseases, Alzheimer’s dementia is the most common, while Parkinson’s disease (PD) is the second most frequent neurodegenerative disease. There is a significant amount of evidence on the complex biological connection between cancer and neurodegeneration. Noncoding RNAs (ncRNAs) are defined as transcribed nucleotides that perform a variety of regulatory functions. The mechanisms by which ncRNAs exert their functions are numerous and involve every aspect of cellular life. The same ncRNA can act in multiple ways, leading to different outcomes; in fact, a single ncRNA can participate in the pathogenesis of more than one disease—even if these seem very different, as cancer and neurodegenerative disorders are. The ncRNA activates specific pathways leading to one or the other clinical phenotype, sometimes with obvious mechanisms of inverse comorbidity. We aimed to collect from the existing literature examples of inverse comorbidity in which ncRNAs seem to play a key role. We also investigated the example of mir-519a-3p, and one of its target genes Poly (ADP-ribose) polymerase 1, for the inverse comorbidity mechanism between some cancers and PD. We believe it is very important to study the inverse comorbidity relationship between cancer and neurodegenerative diseases because it will help us to better assess these two major areas of human disease.
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23
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Lazow MA, Salloum R, Pressey JG. Comorbidity Burden in a Cohort of Adolescent and Young Adult Patients Diagnosed with Central Nervous System Tumors and Sarcomas. J Adolesc Young Adult Oncol 2022; 12:215-223. [PMID: 35675692 DOI: 10.1089/jayao.2022.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) oncology patients experience unique biological, behavioral, and socioeconomic challenges, for which provision of care must be tailored. AYAs with central nervous system (CNS) tumors and sarcomas represent a vulnerable population with worse outcomes and potential for serious sequelae from intense multimodal therapy. Comorbidity burden impacts treatment tolerance, adherence, and efficacy, yet has been understudied among these high-risk AYA patients. Methods: Utilizing a validated AYA oncology comorbidity index, we (1) measured comorbid conditions present at diagnosis in AYA-aged patients with CNS tumors and sarcomas and (2) compared baseline comorbidity burden across ascending AYA age groups (15-19, 20-29, and 30-39 years) and with pediatric patients (10-14 years). Results: The cohort included 131 AYAs and 50 pediatric patients. Mean comorbidity score significantly differed between pediatric (0.8) and AYA (1.7) patients, and across ascending age subgroups (0.8 [10-14] < 1.2 [15-19] < 1.7 [20-29] < 2.5 [30-39]). AYAs were significantly more likely than pediatric patients to have ≥2 or ≥3 comorbidities (47% vs. 18%, 24% vs. 6%), with increasing prevalence across ascending age subgroups. Frequency of overweight/obese status, smoking/substance use, obstetric/gynecologic conditions, and cardiovascular comorbidities increased with age. In multivariate analyses adjusting for sex, tumor type, and race, age remained a significant predictor of comorbidity score. Conclusions: AYAs with CNS tumors or sarcomas have a high burden of baseline comorbidities, which increase with age at diagnosis, conferring susceptibility to treatment-related toxicity and mortality. Improving the prognosis for AYAs requires appropriate identification of pre-existing comorbidities and tailoring therapeutic and supportive care accordingly.
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Affiliation(s)
- Margot A Lazow
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Ralph Salloum
- Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joseph G Pressey
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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24
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Gaiger A, Lubowitzki S, Krammer K, Zeilinger EL, Acel A, Cenic O, Schrott A, Unseld M, Rassoulian AP, Skrabs C, Valent P, Gisslinger H, Marosi C, Preusser M, Prager G, Kornek G, Pirker R, Steger GG, Bartsch R, Raderer M, Simonitsch-Klupp I, Thalhammer R, Zielinski C, Jäger U. The cancer survival index-A prognostic score integrating psychosocial and biological factors in patients diagnosed with cancer or haematologic malignancies. Cancer Med 2022; 11:3387-3396. [PMID: 35315594 PMCID: PMC9487871 DOI: 10.1002/cam4.4697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
Objective We aimed to investigate whether (1) psychological and social indicators influence survival in patients diagnosed with cancer or haematologic malignancies when important biological aspects are controlled for, (2) psychological, social and biological indicators can be utilised to design one collated index for survival, usable in clinical practice to identify patients at risk of shorter survival and to improve personalised healthcare provision. Methods In this cross‐sectional study, 2263 patients with cancer or haematologic malignancies participated. We analysed 15 biological, psychological and social indicators as risk factors for survival with a Cox proportional hazards model. Indicators significantly associated with survival were combined to compute models for the identification of patient groups with different risks of death. The training sample contained 1122 patients. Validation samples included the remaining 1141 patients, the total sample, as well as groups with different cancer entities. Results Five indicators were found to significantly impact survival: Cancer site (HR: 3.56), metastatic disease (HR: 1.88), symptoms of depression (HR: 1.34), female sex (HR: 0.73) and anaemia (HR: 0.48). Combining these indicators to a model, we developed the Cancer Survival Index, identifying three distinct groups of patients with estimated survival times of 47.2 months, 141 months and 198.2 months (p < 0.001). Post hoc analysis of the influence of depression on survival showed a mediating effect of the following four factors, related to both depression and survival: previous psychiatric conditions, employment status, metastatic disease and haemoglobin levels. Conclusions Psychosocial and biological factors impact survival in various malignancies and can be utilised jointly to compute an index for estimating the survival of each patient individually—the Cancer Survival Index.
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Affiliation(s)
- Alexander Gaiger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Simone Lubowitzki
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Katharina Krammer
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Elisabeth L Zeilinger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Andras Acel
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Olivera Cenic
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | | | - Matthias Unseld
- Department of Medicine I, Division of Palliative Medicine, Medical University of Vienna, Vienna, Austria
| | - Anahita Paula Rassoulian
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Cathrin Skrabs
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Heinz Gisslinger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Gerald Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Gabriela Kornek
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Robert Pirker
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Günther G Steger
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Rupert Bartsch
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | | | - Renate Thalhammer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph Zielinski
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Centre, Medical University Vienna - General Hospital, Vienna, Austria
| | - Ulrich Jäger
- Department of Medicine I, Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria
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25
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Colorectal cancer chemotherapy: can sex-specific disparities impact on drug toxicities? Eur J Clin Pharmacol 2022; 78:1029-1038. [PMID: 35192004 PMCID: PMC9107437 DOI: 10.1007/s00228-022-03298-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 02/01/2022] [Indexed: 01/13/2023]
Abstract
Purpose Given the biological differences between females and males, sex-specific evaluations should be carried out to obtain better cancer prevention, diagnosis, and treatment strategies. To this purpose, our aim was to evaluate sex differences for toxicity in a cohort of colorectal cancer (CRC) patients undergoing chemotherapy. Methods We performed a retrospective study in 329 CRC patients. Differences between males and females were tested performing the Mann-Whitney U test or the Fisher exact test. Multivariate logistic regression models were computed to evaluate the association between sex and risk of chemotherapy agent-related toxicity. Results According association sex toxicity, significant differences were observed in the median number of episodes of nausea (p = 0.044), vomit (p = 0.007), heartburn (p = 0.022), thrombocytopenia (p = 0.005), mucositis (p = 0.024). Moreover, statistically significant differences between males and females were observed in the distribution of the highest toxicity grades of nausea (p = 0.024), heartburn (p = 0.016), and thrombocytopenia (p = 0.034). Females have an increased risk of vomit (p = 0.002), alopecia (p = 0.035), heartburn (p = 0.005), mucositis (p = 0.003), and lower risk for thrombocytopenia (p = 0.005). Conclusion According to the association of sex chemotherapy agent-related toxicities, females resulted on average at a significant increased risk of more common adverse events (constipation, dysgeusia, alopecia, heartburn, vomit, asthenia, nausea, pain events, and mucositis). Sex-tailored CRC chemotherapy treatment is necessary to obtain efficacy avoiding toxicity, based on patients’ biological and genetic characteristics, a vision that would change CRC setting, a stable disease but still orphan of a real tailored approach. Supplementary information The online version contains supplementary material available at 10.1007/s00228-022-03298-y.
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Nagashima F, Furuse J. Treatments for elderly cancer patients and reforms to social security systems in Japan. Int J Clin Oncol 2022; 27:310-315. [PMID: 35098370 PMCID: PMC8801270 DOI: 10.1007/s10147-021-02099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/28/2021] [Indexed: 11/05/2022]
Abstract
In Japan, the population aged 65 years and above accounts for 29% of the total population. Furthermore, the number of cancer patients among the elderly is increasing. Geriatric oncology is a discipline that deals with appropriate care for elderly cancer patients based on their characteristics. The International Society of Geriatric Oncology considers education, treatment, research, and partnership building areas of significance and priority for policy goals. In Japan, the Third Term of the Basic Plan to Promote Cancer Control is an initiative to improve the infrastructure and health services involved in cancer care. Content related to "cancer in the elderly" was added to establish guidelines for treating cancer in the elderly. Thus far, "Clinical Practice Guidelines of Cancer Drug Therapies for the Elderly" have been published. With the increasing age of the population, social security expenditures will increase substantially after the fiscal year 2022. Reforms to social security systems, such as pensions, medical care, and nursing care, are underway. It is important to enhance cooperation between oncology and geriatrics and to support cooperative systems among families and medical professionals to promote geriatric oncology. Since the working-age population and the total population have begun to decline, Japan is facing many challenges. As a leader of a super-aging society, Japan has the potential to share its experience on a global scale and address potential long-term outcomes.
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Affiliation(s)
- Fumio Nagashima
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Junji Furuse
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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Shohat S, Vol E, Shifman S. Gene essentiality in cancer cell lines is modified by the sex chromosomes. Genome Res 2022; 32:1993-2002. [PMID: 36418059 PMCID: PMC9808629 DOI: 10.1101/gr.276488.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
Human sex differences arise from gonadal hormones and sex chromosomes. Studying the direct effects of sex chromosomes in humans is still challenging. Here we studied how the sex chromosomes can modulate gene expression and the outcome of mutations across the genome by exploiting the tendency of cancer cell lines to lose or gain sex chromosomes. We inferred the dosage of the sex chromosomes in 355 female and 408 male cancer cell lines and used it to dissect the contributions of the Y and X Chromosomes to sex-biased gene expression. Furthermore, based on genome-wide CRISPR screens, we identified genes whose essentiality is different between male and female cells depending on the sex chromosomes. The most significant genes were X-linked genes compensated by Y-linked paralogs. Our sex-based analysis identifies genes that, when mutated, can affect male and female cells differently and reinforces the roles of the X and Y Chromosomes in sex-specific cell function.
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28
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Epstein RS, Weerasinghe RK, Parrish AS, Krenitsky J, Sanborn RE, Salimi T. Real-world burden of chemotherapy-induced myelosuppression in patients with small cell lung cancer: a retrospective analysis of electronic medical data from community cancer care providers. J Med Econ 2022; 25:108-118. [PMID: 34927520 DOI: 10.1080/13696998.2021.2020570] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Chemotherapy-induced myelosuppression, which commonly exhibits as neutropenia, anemia, or thrombocytopenia, represents a substantial burden for patients with cancer that affects health-related quality of life and increases healthcare resource utilization (HCRU). We evaluated the burden of myelosuppression among chemotherapy-treated patients with small cell lung cancer (SCLC) using real-world data from community cancer care providers in the Western United States. MATERIALS AND METHODS This was a retrospective, observational analysis of electronic medical records (EMRs) from Providence St. Joseph Health hospital-associated oncology clinics between January 2016 and December 2019. Patient demographics were assessed from the date of first SCLC diagnosis in adult patients with chemotherapy-induced grade ≥3 myelosuppression in first-line (1L) or second-line-and-beyond (2L+) treatment settings. Myelosuppressive adverse events (AEs), treatment patterns, and HCRU were assessed from the date of chemotherapy initiation (index date) until 12 months, date of the last visit, date of death, or study end, whichever occurred earliest. RESULTS Of 347 eligible patients with SCLC who had received chemotherapy (mean age 66; 49% female), all had received at least 1L treatment, and 103 (29.7%) had a 2L + treatment recorded within the EMR during the study period. Of 338 evaluable patients with longitudinal laboratory data, 206 (60.9%) experienced grade ≥3 myelosuppressive AEs, most commonly neutropenia, anemia, and thrombocytopenia (44.9, 41.1, and 25.4 per 100 patients, respectively). Rates of granulocyte colony-stimulating factor use and red blood cell transfusions were 47.0 and 41.7 per 100 patients, respectively. There was a trend toward increasing the use of supportive care interventions and visits to inpatient and outpatient facilities in patients with myelosuppressive AEs in more than one cell lineage. CONCLUSIONS Chemotherapy-induced myelosuppression places a substantial real-world burden on patients with SCLC in the community cancer care setting. Innovations to protect bone marrow from chemotherapy-induced damage have the potential to reduce this burden.
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Affiliation(s)
| | | | | | | | - Rachel E Sanborn
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, USA
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Carvalho AED, Souza RAGD, Galvão ND, Melanda FN, Caló RDS, Souza BDSND, Lima FCDSD, Aguilar LB. Tendência da mortalidade por câncer colorretal em Mato Grosso, Brasil, de 2000 a 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220007.supl.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência temporal da mortalidade por câncer colorretal (CCR) segundo sexo e faixa etária, em Mato Grosso, Brasil, de 2000 a 2019. Métodos: Estudo ecológico de série temporal das taxas ajustadas de mortalidade pelo CCR (C18 a C21) de residentes de Mato Grosso. As informações sobre os óbitos foram fornecidas pela Secretaria de Estado de Saúde de Mato Grosso e compõem o Sistema de Informações sobre Mortalidade, e as informações demográficas foram obtidas do Instituto Brasileiro de Geografia e Estatística. Para a tendência temporal, foi empregada a análise de regressão por joinpoint. Resultados: Foram identificados 2.406 óbitos por CCR em Mato Grosso no período de 2000 a 2019. As maiores taxas foram encontradas entre as faixas etárias de 60 e 79 anos. Para os homens, evidenciou-se tendência crescente das taxas de mortalidade por CCR para quase todas as faixas etárias, com exceção das de 40 a 49 anos e de 80 anos ou mais. Para as mulheres, houve aumento significativo nas faixas etárias de 50 a 59 anos e de 80 anos ou mais. Conclusão: Os resultados do estudo mostraram aumento das taxas de mortalidade por CCR no estado do Mato Grosso, no período de 2000 a 2019, em determinadas faixas etárias de ambos os sexos, mas sobretudo para os homens. O conhecimento sobre a evolução da mortalidade pode oferecer dados da situação epidemiológica do câncer em nível local e, assim, contribuir para a elaboração de ações de controle e prevenção desse agravo.
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Affiliation(s)
| | | | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Brazil; Mato Grosso State Health Department, Brazil
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Cui CL, Dornisch AM, Umlauf AE, Cuomo RE, Murphy JD, Lopez NE. International Socioeconomic Predictors of Colon and Rectal Cancer Mortality: Is Colorectal Cancer a First World Problem? JCO Glob Oncol 2021; 7:1659-1667. [PMID: 34910590 PMCID: PMC8691512 DOI: 10.1200/go.21.00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Colorectal cancer (CRC) is a leading cause of international morbidity and is the second highest cause of cancer-related mortality in the world. The purpose of this study was to investigate the relationship between international health care spending on CRC mortality over time. METHODS This is a retrospective study using a publicly available data from the WHO Global Health Observatory database. General estimating equations were used to analyze the relationship between total health care expenditure per capita (THEpc) and CRC mortality at the country level. The primary predictors of interest were quartiles of THEpc. Other exposure variables included gross domestic product per capita (GDPpc), smoking (% of adult population smoking), physician density (per 10,000), and time. RESULTS Mortality decreased significantly from 2000 to 2016 (coefficient [95% CI], −2.2 [−3.3 to −1.1]; P < .001). THEpc, GDPpc, time, and percentage of adult population smoking were significant predictors of CRC mortality. Patients in the top two quartiles of THEpc had 3% higher rates of CRC mortality compared with countries in Q1 THEpc (Q3: 3.4 [1.9-4.8], P < .001; Q4: 3.2 [1.4-5.0], P = .001). Similar trends were seen in GDPpc (Q4: 3.2 [1.4-5.0], P = .001; Q3: 3.4 [1.9-4.8], P < .001; Q2: 1.7 [0.7-2.6], P < .001; Q1: reference). CONCLUSION Overall, mortality decreased significantly over the study period. Countries with higher health expenditures and higher gross domestic products experienced higher rates of CRC mortality. Further research will be necessary to determine the cause for this, but we postulate that it may be a result of more robust diagnostic and follow-up methods in countries with more resources. Colorectal Cancer mortality decreased between 2000-2016 but only among developed nations.![]()
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Affiliation(s)
| | - Anna M Dornisch
- University of California, San Diego School of Medicine, La Jolla, CA
| | - Anya E Umlauf
- Department of Psychiatry, University of California, San Diego, San Diego, CA
| | - Raphael E Cuomo
- Department of Anesthesiology, University of California, San Diego, La Jolla, CA
| | - James D Murphy
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA
| | - Nicole E Lopez
- Division of Colon and Rectal Surgery, Department of Surgery, University of California, San Diego, La Jolla, CA
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Abstract
Significant sex differences exist across cellular, tissue organization, and body system scales to serve the distinct sex-specific functions required for reproduction. They are present in all animals that reproduce sexually and have widespread impacts on normal development, aging, and disease. Observed from the moment of fertilization, sex differences are patterned by sexual differentiation, a lifelong process that involves mechanisms related to sex chromosome complement and the epigenetic and acute activational effects of sex hormones. In this mini-review, we examine evidence for sex differences in cellular responses to DNA damage, their underlying mechanisms, and how they might relate to sex differences in cancer incidence and response to DNA-damaging treatments.
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Affiliation(s)
- Lauren Broestl
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO, USA
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Mahmoudian M, Razmara E, Mahmud Hussen B, Simiyari M, Lotfizadeh N, Motaghed H, Khazraei Monfared A, Montazeri M, Babashah S. Identification of a six-microRNA signature as a potential diagnostic biomarker in breast cancer tissues. J Clin Lab Anal 2021; 35:e24010. [PMID: 34528314 PMCID: PMC8605139 DOI: 10.1002/jcla.24010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is by far the most common malignancy among women. Epigenetic modulators, microRNAs in particular, may set stages for BC development and its progression. Herein, we aimed to assess the diagnostic potentiality of a signature of six miRNAs (i.e., hsa-miR-25-3p, -29a-5p, -105-3p, -181b1-5p, -335-5p, and -339-5p) in BC and adjacent non-tumor tissues. METHODS A pair of 50 tumor and adjacent non-tumor samples were taken from BC patients. The expression of each candidate miRNA was measured using quantitative reverse transcription PCR. To investigate the possible roles of each miRNA and their impressions on BC prognosis, in silico tools were used. Receiver operating characteristic (ROC) curves were performed to determine the diagnostic accuracy of each miRNA and the possible association of their expression with clinicopathological characteristics was analyzed. RESULTS Our findings showed the upregulation of hsa-miR-25-3p, -29a-5p, -105-3p, and -181b1-5p, and the downregulation of hsa-miR-335-5p and -339-5p in BC tumor compared to corresponding adjacent tissues. Except for hsa-miR-339-5p, the up-/down-regulation of the candidate miRNAs was associated with TNM stages. Except for hsa-miR-105-3p, each candidate miRNA was correlated with HER-2 status. ROC curve analysis showed that the signature of six-miRNA is a potential biomarker distinguishing between tumor and non-tumor breast tissue samples. CONCLUSION We showed that the dysregulation of a novel signature of six-miRNA can be used as a potential biomarker for BC diagnosis.
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Affiliation(s)
- Mojdeh Mahmoudian
- Department of GeneticsFaculty of SciencesScience and Research BranchIslamic Azad UniversityTehranIran
| | - Ehsan Razmara
- Department of Medical GeneticsFaculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Bashdar Mahmud Hussen
- Department of PharmacognosyCollege of PharmacyHawler Medical UniversityKurdistan RegionIraq
| | - Mandana Simiyari
- Department of Veterinary MedicineFaculty of Veterinary MedicineTabriz BranchIslamic Azad UniversityTabrizIran
| | - Nazanin Lotfizadeh
- Department of BiologyFaculty of Advanced Science and TechnologyTehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Hoda Motaghed
- Department of BiologyFaculty of Advanced Science and TechnologyTehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Arefeh Khazraei Monfared
- Department of BiologyFaculty of Biological SciencesIslamic Azad University‐Tehran North BranchTehranIran
| | - Maryam Montazeri
- Department of Medical BiotechnologyFaculty of Advanced Science and TechnologyTehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Sadegh Babashah
- Department of Molecular GeneticsFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
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Sex-Based Differences in the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1329:499-533. [PMID: 34664253 DOI: 10.1007/978-3-030-73119-9_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Cancers are heterogeneous multifactorial diseases consisting of a major public health issue worldwide. Sex disparities are evidenced in cancer incidence, mortality, expression of prognosis factor, response to treatment, and survival. For both sexes, an interplay of intrinsic and environmental factors influences cancer cells and tumor microenvironment (TME) components. The TME cumulates both supportive and communicative functions, contributing to cancer development, progression, and metastasis dissemination. The frontline topics of this chapter are focused on the contribution of sex, via steroid hormones, such as estrogens and androgens, on the following components of the TME: cancer-associated fibroblasts (CAFs), extracellular matrix (ECM), blood and lymphatic endothelial cells, and immunity/inflammatory system.
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Dotan E, Walter LC, Browner IS, Clifton K, Cohen HJ, Extermann M, Gross C, Gupta S, Hollis G, Hubbard J, Jagsi R, Keating NL, Kessler E, Koll T, Korc-Grodzicki B, McKoy JM, Misra S, Moon D, O'Connor T, Owusu C, Rosko A, Russell M, Sedrak M, Siddiqui F, Stella A, Stirewalt DL, Subbiah IM, Tew WP, Williams GR, Hollinger L, George GV, Sundar H. NCCN Guidelines® Insights: Older Adult Oncology, Version 1.2021. J Natl Compr Canc Netw 2021; 19:1006-1019. [PMID: 34551388 DOI: 10.6004/jnccn.2021.0043] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The NCCN Guidelines for Older Adult Oncology address specific issues related to the management of cancer in older adults, including screening and comprehensive geriatric assessment (CGA), assessing the risks and benefits of treatment, preventing or decreasing complications from therapy, and managing patients deemed to be at high risk for treatment-related toxicity. CGA is a multidisciplinary, in-depth evaluation that assesses the objective health of the older adult while evaluating multiple domains, which may affect cancer prognosis and treatment choices. These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines providing specific practical framework for the use of CGA when evaluating older adults with cancer.
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Affiliation(s)
| | | | - Ilene S Browner
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | - Katherine Clifton
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Cary Gross
- Yale Cancer Center/Smilow Cancer Hospital
| | - Sumati Gupta
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | | | | | | | | | - June M McKoy
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | - Dominic Moon
- UT Southwestern Simmons Comprehensive Cancer Center
| | | | - Cynthia Owusu
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Ashley Rosko
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | - Amy Stella
- University of Wisconsin Carbone Cancer Center
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Lee SF, Evens AM, Ng AK, Luque-Fernandez MA. Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study. Sci Rep 2021; 11:17950. [PMID: 34504223 PMCID: PMC8429768 DOI: 10.1038/s41598-021-97455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4017 patients with DLBCL, 2363 (58.8%) patients received both chemotherapy and rituximab and 740 (18.4%) patients received chemotherapy alone, while 1612 (40.1%) and 914 (22.8%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio [OR] 0.44; 95% CI 0.34-0.57) and rituximab (OR 0.41; 95% CI 0.32-0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95% CI 1.67-3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients' SES.
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Affiliation(s)
- Shing Fung Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong, China
| | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Andrea K Ng
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Miguel-Angel Luque-Fernandez
- Department of Non-Communicable Disease Epidemiology, Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Non-Communicable Disease and Cancer Epidemiology, Instituto de Investigacion Biosanitaria de Granada (Ibs.GRANADA), University of Granada, Granada, Spain.
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Pavlović N, Heindryckx F. Exploring the Role of Endoplasmic Reticulum Stress in Hepatocellular Carcinoma through mining of the Human Protein Atlas. BIOLOGY 2021; 10:biology10070640. [PMID: 34356495 PMCID: PMC8301178 DOI: 10.3390/biology10070640] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 12/22/2022]
Abstract
Simple Summary Hepatocellular carcinoma is a highly deadly primary liver cancer. It is usually diagnosed at a late stage, when therapeutic options are scarce, and the lack of predictive biomarkers poses a challenge for early detection. A known hallmark of hepatocellular carcinoma is the accumulation of misfolded proteins in the endoplasmic reticulum (ER), known as ER-stress. Growing experimental evidence suggests that ER-stress is involved in liver cancer initiation and progression. However, it remains unclear if ER-stress markers can be used as therapeutic targets or biomarkers for patients with liver cancer. In this study, we evaluated the prognostic value of proteins involved in managing ER-stress in liver cancer by mining a publicly available patient-derived database, the Human Protein Atlas. We thereby identified 44 ER-stress-associated proteins as prognostic markers in liver cancer. Furthermore, we discussed the expression of these markers in relation to disease stage, age, sex, ethnicity, and tissue localization. Abstract Endoplasmic reticulum (ER) stress and actors of unfolded protein response (UPR) have emerged as key hallmarks of hepatocarcinogenesis. Numerous reports have shown that the main actors in the UPR pathways are upregulated in HCC and contribute to the different facets of tumor initiation and disease progression. Furthermore, ER-stress inducers and inhibitors have shown success in preclinical HCC models. Despite the mounting evidence of the UPR’s involvement in HCC pathogenesis, it remains unclear how ER-stress components can be used safely and effectively as therapeutic targets or predictive biomarkers for HCC patients. In an effort to add a clinical context to these findings and explore the translational potential of ER-stress in HCC, we performed a systematic overview of UPR-associated proteins as predictive biomarkers in HCC by mining the Human Protein Atlas database. Aside from evaluating the prognostic value of these markers in HCC, we discussed their expression in relation to patient age, sex, ethnicity, disease stage, and tissue localization. We thereby identified 44 UPR-associated proteins as unfavorable prognostic markers in HCC. The expression of these markers was found to be higher in tumors compared to the stroma of the hepatic HCC patient tissues.
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Sharifi S, Caracciolo G, Pozzi D, Digiacomo L, Swann J, Daldrup-Link HE, Mahmoudi M. The role of sex as a biological variable in the efficacy and toxicity of therapeutic nanomedicine. Adv Drug Deliv Rev 2021; 174:337-347. [PMID: 33957181 DOI: 10.1016/j.addr.2021.04.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 02/08/2023]
Abstract
Males and females have physiological, hormonal, and genetic differences that can cause different responses to medicinal treatments. The role of sex in the pharmacokinetics and pharmacodynamics of drugs is well established in the literature. However, researchers have yet to robustly and consistently consider the impact of sex differences on the pharmacokinetics and pharmacodynamics of nanomedicine formulations when designing nanomedicine therapeutics and/or constructing clinical trials. In this review, we highlight the physiological and anatomical differences between sexes and discuss how these differences can influence the therapeutic efficacy, side effects, and drug delivery safety of nanomedicine products. A deep understanding of the effects of sex on nano-based drug delivery agents will robustly improve the risk assessment process, resulting in safer formulations, successful clinical translation, and improved therapeutic efficacies for both sexes.
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Ursem C, Diaz-Ramirez LG, Boscardin J, Lee S. Changes in functional status associated with radiation for prostate cancer in older veterans. J Geriatr Oncol 2021; 12:808-812. [PMID: 33388282 PMCID: PMC8184565 DOI: 10.1016/j.jgo.2020.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although older men value maintaining independence and avoiding functional decline, little is known about their functional trajectories with receipt of prostate radiation. METHODS We performed a retrospective cohort study including veterans age 65+ with localized prostate cancer who resided in a VA nursing facility while receiving prostate radiation from 2005 to 2015. We evaluated the change in Minimum Data Set (MDS) activities of daily living (ADL) score during 6 months from the start of treatment. Because prior studies have shown Charlson Comorbidity Index (CCI) to be a strong predictor of treatment-related toxicity, analysis included interaction with CCI. RESULTS We identified 487 patients with median age 73 (range 65-94). For the average patient in our cohort, the predicted MDS-ADL score worsened from 2.9 (95% CI 2.4-3.6) at the start of radiation to 3.8 (95% CI 3.1-4.8) at 3 months and then 4.5 (95% CI 3.5-5.7) at month 6. Patients with greater comorbidity (CCI ≥ 4) had worse functional outcomes in months 0-3 compared to patients with less comorbidity (CCI 0-3). MDS-ADL score worsened by 1.9 in the CCI ≥4 patients compared to 0.3 in the CCI 0-3 group During months 3-6, patients in both Charlson groups experienced similar worsening of MDS-ADL score. CONCLUSIONS In a vulnerable population of older patients with localized prostate cancer, radiation was associated with a decline in functional independence. Patients with higher comorbidity experienced more severe functional decline within the first 3 months of radiation therapy. In all comorbidity levels, functional status had not returned to baseline by 6 months.
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Affiliation(s)
- Carling Ursem
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, San Francisco VA Medical Center, United States of America.
| | - L Grisell Diaz-Ramirez
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, United States of America
| | - John Boscardin
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, United States of America
| | - Sei Lee
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, United States of America
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Tranvåg EJ, Strand R, Ottersen T, Norheim OF. Precision medicine and the principle of equal treatment: a conjoint analysis. BMC Med Ethics 2021; 22:55. [PMID: 33971875 PMCID: PMC8108369 DOI: 10.1186/s12910-021-00625-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed. METHODS We distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a forced-choice conjoint analysis pairs of hypothetical patients were presented, and we calculated the average marginal component effect of seven individual patient characteristics, to estimate how each of them influence doctors' priority-setting decisions. RESULTS A positive biomarker status increased the probability of being allocated the new drug, while older age, severe comorbidity and reduced physical function reduced the probability. Importantly, sex, education level and smoking status had no significant influence on the decision. CONCLUSION Biomarker status is perceived as relevant for priority setting decisions, alongside more well-known patient characteristics like age, physical function and comorbidity. Based on our results, we discuss a framework that can help clarify whether biomarker status should be seen as an ethically acceptable factor for providing unequal treatment to patients with the same disease.
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Affiliation(s)
- Eirik Joakim Tranvåg
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020, Bergen, Norway.
- Centre for Cancer Biomarkers, Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway.
| | - Roger Strand
- Centre for Cancer Biomarkers, Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway
- Centre for the Study of the Sciences and the Humanities, University of Bergen, 5020, Bergen, Norway
| | - Trygve Ottersen
- Oslo Group On Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, University of Oslo, 0450, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, 0473, Oslo, Norway
| | - Ole Frithjof Norheim
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020, Bergen, Norway
- Centre for Cancer Biomarkers, Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway
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Nazarian A, Kulminski AM. Genome-Wide Analysis of Sex Disparities in the Genetic Architecture of Lung and Colorectal Cancers. Genes (Basel) 2021; 12:genes12050686. [PMID: 34062886 PMCID: PMC8147355 DOI: 10.3390/genes12050686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Almost all complex disorders have manifested epidemiological and clinical sex disparities which might partially arise from sex-specific genetic mechanisms. Addressing such differences can be important from a precision medicine perspective which aims to make medical interventions more personalized and effective. We investigated sex-specific genetic associations with colorectal (CRCa) and lung (LCa) cancers using genome-wide single-nucleotide polymorphisms (SNPs) data from three independent datasets. The genome-wide association analyses revealed that 33 SNPs were associated with CRCa/LCa at P < 5.0 × 10−6 neither males or females. Of these, 26 SNPs had sex-specific effects as their effect sizes were statistically different between the two sexes at a Bonferroni-adjusted significance level of 0.0015. None had proxy SNPs within their ±1 Mb regions and the closest genes to 32 SNPs were not previously associated with the corresponding cancers. The pathway enrichment analyses demonstrated the associations of 35 pathways with CRCa or LCa which were mostly implicated in immune system responses, cell cycle, and chromosome stability. The significant pathways were mostly enriched in either males or females. Our findings provided novel insights into the potential sex-specific genetic heterogeneity of CRCa and LCa at SNP and pathway levels.
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Helissey C, Geiss R, Baldini C, Noret A, Frelaut M, Rodrigues M, Bringuier M. [Why and how to assess older people with cancer?]. Bull Cancer 2021; 108:513-520. [PMID: 33836861 DOI: 10.1016/j.bulcan.2021.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 11/15/2022]
Abstract
The older population accounts for almost 60% of new cancers. Their management is a public health problem and is complex. It raises different questions: Is the patient's prognosis linked to cancer or another pathology? The heterogeneity of this population emphasises the importance of the overall condition assessment, in particular to avoid over-treatment (or under-treatment), and to be able to identify frail or vulnerable elderly patients who are at risk of having more treatment toxicities. Through this article, we will recall the importance of geriatric in-depth evaluation (EGA) by detailing the different factors that impact the therapeutic decision, tolerance to treatments… This EGA is however time-consuming and not all patients can be evaluated. In order to identify the subjects covered by this EGA, screening scales have been developed. Finally, we will develop the place of research in oncogeriatric management.
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Affiliation(s)
- Carole Helissey
- Hôpital militaire Begin, unité de recherche clinique, Saint-69 avenue de Paris, 94160 Saint-Mandé, France.
| | - Romain Geiss
- Hôpital européen Georges-Pompidou, unité d'oncogériatrie, service de gériatrie, 20, rue Leblanc, Paris, France
| | - Capucine Baldini
- Saclay University of Paris, Drug Development Department (DITEP), Gustave Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Aurélien Noret
- Institut Curie, université PSL, département d'Oncologie médicale, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - Maxime Frelaut
- Saclay University of Paris, Drug Development Department (DITEP), Gustave Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Manuel Rodrigues
- Institut Curie, université PSL, département d'Oncologie médicale, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - Michael Bringuier
- Institut Curie, université PSL, département interdisciplinaire de soins de support pour le patient en oncologie (DISSPO) et département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France
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Oytun MG, Bulut G, Gökmen E, Doğu BB, Karabulut B. Older adults with colon cancer are not different from younger ones, but treated differently: Retrospective analysis from single centre. J Oncol Pharm Pract 2021; 28:569-576. [PMID: 33752476 DOI: 10.1177/10781552211002912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Decision- making of the treatment of colon cancer for the older patients becomes more complicated in consequence of comorbidities and geriatric syndromes, most importantly frailty. In the present study, we aimed to investigate whether there is a difference between tumour characteristics, treatment choices, and outcomes between the younger and older adults. METHOD The patients who were diagnosed with colorectal carcinoma in our centre between 2010 and 2015 included. Clinicopathological features of tumour, treatment choices and survivals of the patients were recorded. Patients were separated into two groups according to their chronological age. RESULTS The present study included 465 patients, there were 173 patients aged 65 years and older. Clinicopathological features were similar in both groups. Adjuvant chemotherapy was given in similar rates. Whereas combination chemotherapies were preferred in younger patients as first-line therapy, single agents were given to the older group(p-value < 0.001). No significant differences were observed between combination therapy and monotherapy as progression-free and overall survival in older adults(p value > 0.05). It was observed that 53.2% of the older patients was not treated with any biological treatment (p-value < 0.001). DISCUSSION Geriatric people are underrepresented in clinical trials,because of the presence of the limitations in the older patients. The results of our study revealed older patients with colon cancer patients underwent surgery less than the younger ones, they recieved monotherapy more frequently as first-line chemotherapy, and less frequently targeted therapy. Their mortality was higher. It was shown that decision-making of colon cancer therapy is influenced by age according to our results.
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Affiliation(s)
- Merve Güner Oytun
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Gülcan Bulut
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Turkey
| | - Erhan Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Turkey
| | - Burcu B Doğu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bülent Karabulut
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Turkey
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Heinrich K, Modest DP, Ricard I, Fischer von Weikersthal L, Decker T, Kaiser F, Graeven U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Giessen-Jung C, Stahler A, Michl M, Held S, Jung A, Kirchner T, Stintzing S, Heinemann V. Gender-dependent survival benefit from first-line irinotecan in metastatic colorectal cancer. Subgroup analysis of a phase III trial (XELAVIRI-study, AIO-KRK-0110). Eur J Cancer 2021; 147:128-139. [PMID: 33647548 DOI: 10.1016/j.ejca.2021.01.025] [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: 11/09/2020] [Revised: 01/09/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND XELAVIRI compared sequential (Arm A) versus initial (Arm B) irinotecan in combination with fluoropyrimidine plus bevacizumab in patients with metastatic colorectal cancer, trial identification: NCT01249638. In the full analysis set of the study, non-inferiority of time to failure of strategy (TFS) was not shown. The present analysis was performed to evaluate the effect of gender on treatment outcome and tolerability. METHODS The study end-points overall response rate (ORR), progression-free survival (PFS), TFS and overall survival (OS) were evaluated in female versus male patients and in molecular subgroups (i.e. RAS mutational status). Interaction of treatment and gender was tested by likelihood ratio tests. RESULTS In total, 281 male and 140 female patients (n = 421) were evaluated. Among the male patients, the ORR was 33.6% without and 58.3% with initial irinotecan (P < 0.001). PFS (hazard ratio [HR] 0.54; 95% confidence interval [CI] 0.42-0.69; P < 0.001) and OS (HR 0.63; 95% CI 0.47-0.85; P = 0.002) were also significantly better with initial irinotecan. Among the female patients, the ORR was 42.7% in Arm A and 43.1% in Arm B, PFS was similar (HR 1.09; 95% CI 0.76-1.55; P = 0.649) without and with initial irinotecan. A strong trend for inferior outcome with regard to OS with initial irinotecan was observed (HR 1.46; 95% CI 0.95-2.24; P = 0.081) and the trend reached significance in the multivariate analysis (HR 1.78; 95% CI 1.08-2.95; P = 0.02). Formal interaction of treatment and gender was observed for ORR (P = 0.018), PFS (P = 0.002) and OS (P = 0.001). Treatment-related adverse events were not significantly different between male and female patients. CONCLUSIONS The present analysis suggests that gender interacts with efficacy of initial irinotecan when used in combination with fluoropyrimidines and bevacizumab. Although male patients derived a significant and clinically meaningful benefit from initial combination chemotherapy, this was not observed in female patients.
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Affiliation(s)
- Kathrin Heinrich
- Department of Medicine III, University Hospital, LMU Munich, München, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany.
| | - Dominik P Modest
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Medical Department, Division of Oncology and Hematology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Ingrid Ricard
- Comprehensive Cancer Center, University Hospital, LMU Munich, München, Germany
| | | | | | | | - Ullrich Graeven
- Kliniken Maria Hilf GmbH, Krankenhaus St. Franziskus, Mönchengladbach, Germany
| | | | - Michael Schenk
- Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
| | | | - Bettina Peuser
- Onkologische Praxis Am Diakonissenhaus, Leipzig, Germany
| | | | - Clemens Giessen-Jung
- Department of Medicine III, University Hospital, LMU Munich, München, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Arndt Stahler
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Medical Department, Division of Oncology and Hematology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Marlies Michl
- Department of Medicine III, University Hospital, LMU Munich, München, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | | | - Andreas Jung
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Institut für Pathologie, Ludwig-Maximilians-Universität, München, Germany
| | - Thomas Kirchner
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Institut für Pathologie, Ludwig-Maximilians-Universität, München, Germany
| | - Sebastian Stintzing
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Medical Department, Division of Oncology and Hematology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Volker Heinemann
- Department of Medicine III, University Hospital, LMU Munich, München, Germany; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany; Comprehensive Cancer Center, University Hospital, LMU Munich, München, Germany
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44
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Hases L, Ibrahim A, Chen X, Liu Y, Hartman J, Williams C. The Importance of Sex in the Discovery of Colorectal Cancer Prognostic Biomarkers. Int J Mol Sci 2021; 22:ijms22031354. [PMID: 33572952 PMCID: PMC7866425 DOI: 10.3390/ijms22031354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/26/2022] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer deaths. Advances within bioinformatics, such as machine learning, can improve biomarker discovery and ultimately improve CRC survival rates. There are clear sex differences in CRC characteristics, but the impact of sex has not been considered with regards to CRC biomarkers. Our aim here was to investigate sex differences in the transcriptome of a normal colon and CRC, and between paired normal and tumor tissue. Next, we attempted to identify CRC diagnostic and prognostic biomarkers and investigate if they are sex-specific. We collected paired normal and tumor tissue, performed RNA-seq, and applied feature selection in combination with machine learning to identify the top CRC diagnostic biomarkers. We used The Cancer Genome Atlas (TCGA) data to identify sex-specific CRC diagnostic biomarkers and performed an overall survival analysis to identify sex-specific prognostic biomarkers. We found transcriptomic sex differences in both the normal colon tissue and in CRC. Forty-four of the top-ranked biomarkers were sex-specific and 20 biomarkers showed a sex-specific prognostic value. Our data show the importance of sex in the discovery of CRC biomarkers. We propose 20 sex-specific CRC prognostic biomarkers, including ESM1, GUCA2A, and VWA2 for males and CLDN1 and FUT1 for females.
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Affiliation(s)
- Linnea Hases
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21 Solna, Sweden; (L.H.); (A.I.); (Y.L.)
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden
| | - Ahmed Ibrahim
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21 Solna, Sweden; (L.H.); (A.I.); (Y.L.)
| | - Xinsong Chen
- Department of Oncology and Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden; (X.C.); (J.H.)
| | - Yanghong Liu
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21 Solna, Sweden; (L.H.); (A.I.); (Y.L.)
| | - Johan Hartman
- Department of Oncology and Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden; (X.C.); (J.H.)
- Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Cecilia Williams
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21 Solna, Sweden; (L.H.); (A.I.); (Y.L.)
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden
- Correspondence:
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45
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Pérez-Díez I, Hidalgo MR, Malmierca-Merlo P, Andreu Z, Romera-Giner S, Farràs R, de la Iglesia-Vayá M, Provencio M, Romero A, García-García F. Functional Signatures in Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis of Sex-Based Differences in Transcriptomic Studies. Cancers (Basel) 2021; 13:cancers13010143. [PMID: 33526761 PMCID: PMC7796260 DOI: 10.3390/cancers13010143] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/11/2022] Open
Abstract
While studies have established the existence of differences in the epidemiological and clinical patterns of lung adenocarcinoma between male and female patients, we know relatively little regarding the molecular mechanisms underlying such sex-based differences. In this study, we explore said differences through a meta-analysis of transcriptomic data. We performed a meta-analysis of the functional profiling of nine public datasets that included 1366 samples from Gene Expression Omnibus and The Cancer Genome Atlas databases. Meta-analysis results from data merged, normalized, and corrected for batch effect show an enrichment for Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways related to the immune response, nucleic acid metabolism, and purinergic signaling. We discovered the overrepresentation of terms associated with the immune response, particularly with the acute inflammatory response, and purinergic signaling in female lung adenocarcinoma patients, which could influence reported clinical differences. Further evaluations of the identified differential biological processes and pathways could lead to the discovery of new biomarkers and therapeutic targets. Our findings also emphasize the relevance of sex-specific analyses in biomedicine, which represents a crucial aspect influencing biological variability in disease.
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Affiliation(s)
- Irene Pérez-Díez
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
- Biomedical Imaging Unit FISABIO-CIPF, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, 46012 Valencia, Spain;
| | - Marta R. Hidalgo
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
| | - Pablo Malmierca-Merlo
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
- Atos Research Innovation (ARI), 28037 Madrid, Spain
| | - Zoraida Andreu
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
| | - Sergio Romera-Giner
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
- Atos Research Innovation (ARI), 28037 Madrid, Spain
| | - Rosa Farràs
- Department of Oncogenic Signalling, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain;
| | - María de la Iglesia-Vayá
- Biomedical Imaging Unit FISABIO-CIPF, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, 46012 Valencia, Spain;
| | - Mariano Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain; (M.P.); (A.R.)
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain; (M.P.); (A.R.)
| | - Francisco García-García
- Bioinformatics and Biostatistics Unit, Principe Felipe Research Center (CIPF), 46012 Valencia, Spain; (I.P.-D.); (M.R.H.); (P.M.-M.); (Z.A.); (S.R.-G.)
- Spanish National Bioinformatics Institute, ELIXIR-Spain (INB, ELIXIR-ES), C/Eduardo Primo Yúfera, 3, 46012 Valencia, Spain
- Correspondence:
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46
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Wang Y, Zeng Z, Tang M, Zhang M, Bai Y, Cui H, Xu Y, Guo X, Ma W, Xu G, Qi L, Wang J, Chen S, Gu D, Mao M, Wang X, Zhang C. Sex Disparities in the Clinical Characteristics, Synchronous Distant Metastasis Occurrence and Prognosis: A Pan-cancer Analysis. J Cancer 2021; 12:498-507. [PMID: 33391446 PMCID: PMC7739003 DOI: 10.7150/jca.50536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/25/2020] [Indexed: 12/24/2022] Open
Abstract
Background: This study aims to assess the sex disparities in clinical characteristics and synchronous distant metastasis occurrence at diagnosis, as well as the subsequent prognosis in non-sex-specific cancers. Methods: The study included details from patients diagnosed with non-sex-specific cancers, during the period from 2010 to 2016, in the Surveillance, Epidemiology, and End Results (SEER) program. The distant metastasis prevalence and subsequent survival time were summarized in the total population and the population with specific cancers of different systems. The multivariable logistic and the Cox proportional hazards regressions were applied to evaluate the sex effect on distant metastasis occurrence and prognosis. The results were combined using meta-analysis. Results: Across all non-sex-specific cancers, the pooled prevalence of distant metastasis was 15.2% (95% CI: 14.7-15.7%) and 7.1% (95% CI: 6.8-7.3%) for males and females, respectively. The pooled median survival time was 8.40 months (95% CI: 7.99-8.81) for male patients and 9.40 months (95% CI: 8.84-10.02) for female patients. After combining all non-sex-specific cancers, male patients displayed a higher distant metastasis occurrence than females (pooled OR=1.06, 95% CI: 1.04-1.08; P<0.01), as well as worse overall survival after distant metastasis (pooled HR=1.08, 95% CI: 1.05-1.10; P<0.01). The sex differences were more significant in patients younger than 65 years (P<0.01). Additionally, the sex influence on prognosis was most predominant amongst patients from Asian or Pacific Islander ethnic groups. Conclusion: Male gender appears to be an independent risk factor associated with the occurrence and prognosis of synchronous distant metastasis. Therefore, sex-specific preventions and treatments should become the focus of future research.
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Affiliation(s)
- Yutong Wang
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Ziqian Zeng
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China.,Department of Epidemiology, Chengdu Medical College, Chengdu, 610599, Sichuan province, China
| | - Mingshuang Tang
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Min Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400038, China
| | - Ye Bai
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400038, China
| | - Huijie Cui
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Yao Xu
- Department of Bone and Soft Tissue Tumours, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Xu Guo
- Department of Bone and Soft Tissue Tumours, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Department of Orthopedics, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China
| | - Wenjuan Ma
- Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Guijun Xu
- Department of Bone and Soft Tissue Tumours, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Department of Orthopedics, Tianjin Hospital, Tianjin 300060, China
| | - Lisha Qi
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jingyi Wang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Siyu Chen
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Dongqing Gu
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Min Mao
- Department of Pathology and Southwest Cancer Center, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Xin Wang
- Department of Health Management Center (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Chao Zhang
- Department of Bone and Soft Tissue Tumours, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
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47
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Kim SY, Song HK, Lee SK, Kim SG, Woo HG, Yang J, Noh HJ, Kim YS, Moon A. Sex-Biased Molecular Signature for Overall Survival of Liver Cancer Patients. Biomol Ther (Seoul) 2020; 28:491-502. [PMID: 33077700 PMCID: PMC7585639 DOI: 10.4062/biomolther.2020.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 12/31/2022] Open
Abstract
Sex/gender disparity has been shown in the incidence and prognosis of many types of diseases, probably due to differences in genes, physiological conditions such as hormones, and lifestyle between the sexes. The mortality and survival rates of many cancers, especially liver cancer, differ between men and women. Due to the pronounced sex/gender disparity, considering sex/gender may be necessary for the diagnosis and treatment of liver cancer. By analyzing research articles through a PubMed literature search, the present review identified 12 genes which showed practical relevance to cancer and sex disparities. Among the 12 sex-specific genes, 7 genes (BAP1, CTNNB1, FOXA1, GSTO1, GSTP1, IL6, and SRPK1) showed sex-biased function in liver cancer. Here we summarized previous findings of cancer molecular signature including our own analysis, and showed that sex-biased molecular signature CTNNB1High, IL6High, RHOAHigh and GLIPR1Low may serve as a female-specific index for prediction and evaluation of OS in liver cancer patients. This review suggests a potential implication of sex-biased molecular signature in liver cancer, providing a useful information on diagnosis and prediction of disease progression based on gender.
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Affiliation(s)
- Sun Young Kim
- Department of Chemistry, College of Natural Sciences, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Hye Kyung Song
- Department of Chemistry, College of Natural Sciences, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Suk Kyeong Lee
- Department of Medical Life Sciences, Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06649, Republic of Korea
| | - Sang Geon Kim
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University_Seoul, Goyang 10326, Republic of Korea
| | - Hyun Goo Woo
- Department of Physiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea.,Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea
| | - Jieun Yang
- Department of Physiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea.,Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea
| | - Hyun-Jin Noh
- Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea.,Department of Biochemistry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - You-Sun Kim
- Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea.,Department of Biochemistry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Aree Moon
- Duksung Innovative Drug Center, College of Pharmacy, Duksung Women's University, Seoul 01369, Republic of Korea
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Advanced head and neck cancer in older adults: Results of a short course accelerated radiotherapy trial. J Geriatr Oncol 2020; 12:441-445. [PMID: 33097457 DOI: 10.1016/j.jgo.2020.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/01/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To assess the feasibility and safety of a repeated SHort course Accelerated RadiatiON therapy (SHARON) regimen in the palliative setting of Head and Neck (H&N) cancer in older adults. MATERIAL AND METHODS Patients with histological confirmed H&N cancers, age ≥ 80 years, expected survival >3 months, and Eastern Cooperative Oncology Group (ECOG) performance status of ≤3 were enrolled. Patients were treated in cohorts of six patients: a total dose of 20 Gy was delivered in 2 consecutive days with a twice-daily fractionation (5 Gy per fraction) and at least 8-h interval. If no Grade 3 toxicity was registered, a second enrollment started with another cohort of six patients to whom were administered two cycles (total dose of 40 Gy). The primary endpoint was to evaluate the feasibility of the two cycles of treatment. Secondary endpoints were evaluation of symptoms control rate, symptoms-free survival (SFS), and Quality of Life (QoL) scores. RESULTS Seventeen consecutive patients (median age: 85 years) were treated. Nine patients were treated with one cycle and 8 patients with two cycles. No G3 toxicity was reported in either cohort. With a median follow-up time of 4 months, 3-month SFS in the first and second cohorts was 83.3%, and 87.5%, respectively. The overall palliative response rate was 88%. Among 13 patients reporting pain, 8 (61.5%) showed an improvement or resolution of their pain. CONCLUSION Repeated short course accelerated radiotherapy in a palliative setting of H&N cancers is safe and well-tolerated in older adults.
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van Hagen LJ, Muntinga M, Appelman Y, Verdonk P. Sex- and gender-sensitive public health research: an analysis of research proposals in a research institute in the Netherlands. Women Health 2020; 61:109-119. [PMID: 33073744 DOI: 10.1080/03630242.2020.1834056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Taking sex and gender into account in public health research is essential to optimize methodological procedures, bridge the gender gap in public health knowledge, and advance gender equality. The aim of this study was to evaluate the current status of sex and gender considerations in public health research proposals in a Dutch research institute. We screened a random sample of 38 proposals submitted for review to the institute's science committee between 2011 and 2016. Using the Canadian Institutes of Health Research' Gender and Health Institute criteria for gender-sensitive research and qualitative content analysis, we assessed if, and how sex and gender were considered throughout the proposals (background, research aim, design, data collection, and analysis). Our results show that in general, both sex and gender were poorly considered. Gender was insufficiently taken into account throughout most proposals. When sex was mentioned in a proposal, its consideration was often inconsistent and fragmented. Finally, we identified common methodological pitfalls. We recommend that public health curricula and funding bodies increase their focus on implementing sex and gender in public health research, for instance through quality criteria, training programs for researchers and reviewers, and capacity building initiatives.
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Affiliation(s)
- Lisanne Jeannine van Hagen
- Amsterdam UMC-VUmc, Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maaike Muntinga
- Amsterdam UMC-VUmc, Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-VUmc, Amsterdam, The Netherlands
| | - Petra Verdonk
- Amsterdam UMC-VUmc, Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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50
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Kamel MG, El-Qushayri AE, Sayed AK, Huy NT. Using the primary site as a prognostic tool for nodal mantle cell lymphoma: a SEER-based study. J Comp Eff Res 2020; 9:861-876. [PMID: 32885984 DOI: 10.2217/cer-2020-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Nodal mantle cell lymphoma (NMCL) has a worse survival than extra-nodal mantle cell lymphoma. Materials & methods: A cohort study was conducted to evaluate the primary site role as a mortality predictor using data from 1983 to 2011 from the Surveillance, Epidemiology, and End Results (SEER) database. Results: Most patients had NMCL in multiple regions (71.9%). There was a significantly increased incidence of NMCL cases over years with 83.2% of them occurred between 1998 and 2011. The mean survival was 52.9 months with overall survival/cancer-specific survival rate of 29.2/42.9%, respectively. Lymph nodes of intrathoracic and multiple regions had a worse overall survival while the head, face and neck, intra-abdominal, pelvic, inguinal region and leg as well as multiple regions had worse cancer-specific survival. Conclusion: NMCL primary site can serve as a prognostic factor. We encourage adding it to MCL International Prognostic Index.
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Affiliation(s)
| | | | | | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City 70000, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City 70000, Vietnam
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