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Tan RJD, Mercado GJV, Cabrera PE, Astudillo PPP, Domingo RED, Poblete JMS, Cabebe CGM, Te AVR, Gonzales MAS, Sy JG, Aclan BAA, So JT, Regala FG, Comia KAK, Castro JM, Galang MAS, Cabanlas ADC, Aguilar BJE, Evangelista GS, Maniwan JM, Martin AP, Martinez CY, Lim JAH, Bascuna RI, Ng RM, Agsaoay KB, Acluba-Arao KZA, Apostol ERV, Prieto BM. Philippine retinoblastoma initiative multi-eye center study 2010-2020. Int J Ophthalmol 2024; 17:144-156. [PMID: 38239949 PMCID: PMC10754670 DOI: 10.18240/ijo.2024.01.20] [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: 07/01/2023] [Accepted: 10/19/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To provide a comprehensive and more representative national data on the disease, especially on treatment options and outcomes, and to determine access of retinoblastoma patients from Luzon, Visayas and Mindanao to eye care, and determine if access is associated with delay in consultation, staging and outcomes. METHODS Cohort study of retinoblastoma patients seen in eleven institutions located in the three major areas of the Philippines namely Luzon, Vizayas and Mindanao from 2010-2020. RESULTS Totally 636 patients, involving 821 eyes, were included. Majority (57%) were from Luzon and were seen in institutions in Luzon (72%). Annually, 58±10 new cases were seen with 71% having unilateral disease. Median delay of consultation remained long at 9 (3, 17)mo, longest in patients with unilateral disease (P<0.02) and those from the Visayas (P<0.003). Based on the International Retinoblastoma Staging System, only 35% of patients had Stage 1 while 47% already had extraocular disease. Enucleation was the most common treatment received by 484 patients while intravenous chemotherapy was received by 469. There were 250 (39%) patients alive, 195 (31%) dead, 85 (13%) abandoned, 17 (3%) refused and 89 (14%) with no data. CONCLUSION This study presents the largest cohort of retinoblastoma patients in the Philippines in terms of patients' and participating institutions' number and geographical location and type of institution (private and public). It also presents more comprehensive data on the treatments used and outcomes (survival, globe salvage, and vision retention rates). Delay in consultation was still long among patients leading to advanced disease stage and lower survival rate. Despite increasing capacity to diagnose and manage retinoblastoma in the country, the delay of consultation remains long primarily due to accessibility issues to eye care institutions especially in the Visayas and financial concerns. The delay was still significant that overall survival rate remain low.
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Affiliation(s)
- Roland Joseph D. Tan
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Baguio General Hospital and Medical Center, Baguio City 2600, Philippines
| | - Gary John V. Mercado
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines
| | - Patricia E. Cabrera
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Paulita Pamela P. Astudillo
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Jose B. Lingad Memorial Regional Hospital, Pampanga 2000, Philippines
| | | | - Josept Mari S. Poblete
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
| | | | - Adriel Vincent R. Te
- Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines
| | | | - Jocelyn G. Sy
- Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines
| | | | - Jayson T. So
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
| | - Fatima G. Regala
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
| | | | - Josemaria M. Castro
- Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines
| | | | | | - Benedicto Juan E. Aguilar
- Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines
| | - Gabrielle S. Evangelista
- Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines
| | - Jo Michael Maniwan
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Andrei P. Martin
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Calvin Y. Martinez
- Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines
| | - John Alfred H. Lim
- Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines
| | | | - Rachel M. Ng
- Legazpi Eye Center, Legazpi City 4500, Philippines
| | - Kevin B. Agsaoay
- Department of Ophthalmology, Cagayan Valley Medical Center, Tuguegarao City 3500, Philippines
| | | | | | - Beatriz M. Prieto
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
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Hayashi T, Kishimoto N, Abiko K, Konishi I. Treatment With Antitumor Agents Recommended by Cancer Genome Panel for Uterine Leiomyosarcoma. J Clin Med Res 2023; 15:461-468. [PMID: 38189037 PMCID: PMC10769602 DOI: 10.14740/jocmr5052] [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: 10/18/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
To date, cancer genomic medicine, using cancer gene panel covered by health insurance from June 2019, has been performed for advanced malignant tumors under public medical insurance. In gynecology, the first-line treatment for uterine leiomyosarcomas, which is a mesenchymal uterine tumor, is surgery. In uterine leiomyosarcoma cases, recurrence is observed within 2 years postoperatively; however, to date, clinical trials have not shown efficacy with existing antitumor agents. We noted efficacy in two cases with advanced/recurrent uterine leiomyosarcoma using an antitumor agent selected on the basis of cancer gene panel testing results. Following uterine leiomyosarcoma diagnosis, they underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy as standard surgical treatment. After the surgical treatment, the imaging test revealed recurrent tumors; subsequently, they were treated with doxorubicin alone or doxorubicin combined with Gemzar. However, cancer genome gene panel test was performed because the malignant tumor worsened. Based on the cancer genome gene panel test results, the two cases with advanced uterine leiomyosarcoma were associated with increased tumor mutational burden (TMB) or pathogenic variants (PVs) of AKT serine/threonine kinase 1 (AKT1). Therefore, treatment with pembrolizumab, which is a drug covered by insurance for patients with TMB-high, or treatment with kinase inhibitors for patients with PVs in AKT, was considered. Cancer genomic medicine using cancer gene panel provides a new treatment strategy for intractable malignant tumors. This study aimed to discuss the usefulness of cancer genomic medicine by cancer gene panel testing using the cases of advanced and recurrence uterine leiomyosarcoma and the latest findings.
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Affiliation(s)
- Takuma Hayashi
- Cancer Medicine, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
- First-Track Medical R&D, The Japan Agency for Medical Research and Development (AMED), Tokyo 100-0004, Japan
| | - Naoya Kishimoto
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Kaoru Abiko
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Ikuo Konishi
- First-Track Medical R&D, The Japan Agency for Medical Research and Development (AMED), Tokyo 100-0004, Japan
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
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