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Al-Ezzi EM, Zahralliyali A, Hansen AR, Hamilton RJ, Crump M, Kuruvilla J, Wood L, Nappi L, Kollmannsberger CK, North SA, Winquist E, Soulières D, Hotte SJ, Jiang DM. The Use of Salvage Chemotherapy for Patients with Relapsed Testicular Germ Cell Tumor (GCT) in Canada: A National Survey. Curr Oncol 2023; 30:6166-6176. [PMID: 37504318 PMCID: PMC10378146 DOI: 10.3390/curroncol30070458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Although metastatic germ cell tumor (GCT) is highly curable with initial cisplatin-based chemotherapy (CT), 20-30% of patients relapse. Salvage CT options include conventional (CDCT) and high dose chemotherapy (HDCT), however definitive comparative data remain lacking. We aimed to characterize the contemporary practice patterns of salvage CT across Canada. METHODS We conducted a 30-question online survey for Canadian medical and hematological oncologists with experience in treating GCT, assessing treatment availability, patient selection, and management strategies used for relapsed GCT patients. RESULTS There were 30 respondents from 18 cancer centers across eight provinces. The most common CDCT regimens used were TIP (64%) and VIP (25%). HDCT was available in 13 centers (70%). The HDCT regimen used included carboplatin and etoposide for two cycles (76% in 7 centers), three cycles (6% in 2 centers), and the TICE protocol (11%, in 2 centers). "Bridging" CDCT was used by 65% of respondents. Post-HDCT treatments considered include surgical resection for residual disease (87.5%), maintenance etoposide (6.3%), and surveillance only (6.3%). CONCLUSIONS HDCT is the most commonly used GCT salvage strategy in Canada. Significant differences exist in the treatment availability, selection, and delivery of HDCT, highlighting the need for standardization of care for patients with relapsed testicular GCT.
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Affiliation(s)
- Esmail M Al-Ezzi
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Amer Zahralliyali
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Cancer Services, Princess Alexandra Hospital, Metro South Health, Brisbane, QLD 4113, Australia
| | - Robert J Hamilton
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Michael Crump
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - John Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lori Wood
- Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Lucia Nappi
- Department of Medicine, British Columbia Cancer Agency, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Christian K Kollmannsberger
- Department of Medicine, British Columbia Cancer Agency, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Scott A North
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Eric Winquist
- Department of Oncology, London Health Sciences Centre, Western University, London, ON N6A 3K7, Canada
| | - Denis Soulières
- Département Hématologie-Oncologie, Centre Hospitalier de l'Université de Montréal, Montréal, QC H2X 0C1, Canada
| | - Sebastien J Hotte
- Juravinski Cancer Centre, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Di Maria Jiang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada
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Veitch ZW, Fasih S, Griffin AM, Al-Ezzi EM, Gupta AA, Ferguson PC, Wunder JS, Abdul Razak AR. Clinical outcomes of non-osteogenic, non-Ewing soft-tissue sarcoma of bone--experience of the Toronto Sarcoma Program. Cancer Med 2020; 9:9282-9292. [PMID: 33063945 PMCID: PMC7774718 DOI: 10.1002/cam4.3531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 01/10/2023] Open
Abstract
Non‐osteogenic, non‐Ewing soft‐tissue sarcoma (NONE‐STS) of bone is a rare presentation of primary bone cancers. Optimal treatments and outcomes for this heterogenous group are poorly described. We evaluated the factors associated with long‐term outcomes in patients with this disease. Patients with localized NONE‐STS of bone treated at the Toronto Sarcoma Program from 1987 to 2017 were identified. Clinical characteristics, treatment, and survival information were collected. Kaplan‐Meier (log‐rank) survival estimates from the time of definitive surgery, with uni‐/multivariate analyses (Cox) of sarcoma‐specific survival were performed. A total of 106 patients (60.4% male; median age 46 years) with NONE‐STS of bone were identified. Common histologies included undifferentiated pleomorphic sarcoma [UPS]/malignant fibrous histiocytoma [MFH] (UPS/MFH, 41.5%), leiomyosarcoma (LMS, 20.8%), and fibrosarcoma (FS, 11.3%). Tumors were often high grade (59.4%) and involved the extremities (88.7%), with most receiving chemotherapy (67.9%) with cisplatin/doxorubicin‐based regimens (73.6%). In the full cohort, 10‐year DFS (45.7%, [95%CI: 35.7‐55.8%]), OS (53.4%, [95%CI: 41.7‐62.2%]), and SSS (63.9%, [95%CI: 53.9‐72.5%]) were moderate. Histology specific, 10‐year SSS was 70.7% [95%CI: 56.1‐85.5%] for UPS/MFH, 51.8% [95%CI: 29.8‐73.8%] for LMS, and 72.2% [95%CI: 45.1‐99.2%] for FS. Only UPS/MFH (n = 4) showed sarcoma‐related death >10 years. Multivariate analysis identified axial location (HR = 35.5, [95%CI: 3.4‐369.6]), high grade (HR = 16.9, [95%CI: 1.6‐185.1]), and disease relapse (HR = 485.1, [95%CI: 36.3‐6482.6]) as risk factors for death (p < 0.05). Treatment with chemotherapy (HR = 0.1, [95%CI: 0.01‐0.86]) and necrosis ≥85% (HR = 0.2, [95%CI: 0.04‐0.99]) showed improved survival (p < 0.05). NONE‐STS of bone has favorable long‐term survival similar to osteosarcoma. Patients receiving chemotherapy derive benefit in retrospective analyses. UPS/MFH histologies show sarcoma‐related death beyond 10 years. Further data on histologic subgroups are needed.
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Affiliation(s)
- Zachary W Veitch
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
| | - Samir Fasih
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
| | - Anthony M Griffin
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,The Hospital for Sick Children, Toronto, Canada
| | - Esmail M Al-Ezzi
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Peter C Ferguson
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada.,University of Toronto Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Canada.,Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Jay S Wunder
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada.,University of Toronto Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Canada.,Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Albiruni R Abdul Razak
- Toronto Sarcoma Program at Mount Sinai Hospital, Toronto, Canada.,Princess Margaret Cancer Centre, Toronto, Canada
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Nour Eldin EEM, Nour Eldein MM, El-Readi MZ, Mirza AA, Fatani SH, Al-Amodi HS, Althubiti MA, Al-Ezzi EM, Eid SY, Kamel HFM. Evaluation of the Diagnostic and Predicative Values of 8-Iso-Prostaglandin F2α as a Biomarker of Breast Cancer. Oncol Res Treat 2020; 43:506-517. [PMID: 32721979 DOI: 10.1159/000509671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/24/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Breast cancer (BC) is a commonly reported cancer that is widely prevalent among women. Its early detection improves patient survival and results in better outcomes. For diagnosis and follow-up care, tumor markers are one of the feasible investigations to be ordered. 8-Iso-prostaglandin F2α (8-iso-PGF2α) serves as a serum marker reflecting oxidative stress and subsequent damaging of DNA. In the present study, we aimed to evaluate both diagnostic and predictive values of 8-iso-PGF2α in BC patients. MATERIALS AND METHODS Serum levels of 8-iso-PGF2α were assessed for 66 women with benign breast tumors and 65 women who had malignant BC. To compare the patients who had breast tumors with healthy individuals, 63 women free of breast diseases were selected as controls. RESULTS The serum level of 8-iso-PGF2α in the BC patients (57.92 pg/mL) was significantly higher compared to those with benign tumors (18.89 pg/mL) (p < 0.001). In addition, individuals with no breast diseases had less 8-iso-PGF2α (4.02 pg/mL) compared to those who had developed a tumor (p < 0.001). Serum 8-iso-PGF2α was found to be positively correlated with both carcinoembryonic antigen (r = 0.74, p < 0.001) and cancer antigen 15-3 (r = 0.80, p < 0.001). Furthermore, serum 8-iso-PGF2α showed high diagnostic performance in BC (AUC = 0.999, sensitivity = 100%, specificity = 99.2% at a cutoff value of 36.18 pg/mL). CONCLUSIONS Our study found that the high level of serum 8-iso-PGF2α helps to provide a non-invasive indicator to detect BC. Future work with a larger sample size and various phases of BC can confirm the current results which provide insights into the early detection of cancer.
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Affiliation(s)
| | - Mohamed Mahmoud Nour Eldein
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.,Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Zaki El-Readi
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Biochemistry, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt
| | - Ahmad A Mirza
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia, .,Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Sameer Hasan Fatani
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hiba Saeed Al-Amodi
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Esmail M Al-Ezzi
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Safaa Yehia Eid
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hala Fawzy Mohammed Kamel
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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