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Calik J, Zawada T, Sauer N, Bove T. High Intensity Focused Ultrasound (20 MHz) and Cryotherapy as Therapeutic Options for Granuloma Annulare and Other Inflammatory Skin Conditions. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01163-7. [PMID: 38703308 DOI: 10.1007/s13555-024-01163-7] [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: 03/05/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION In dermatology, inflammatory skin conditions impose a substantial burden worldwide, with existing therapies showing limited efficacy and side effects. This report aims to compare a novel immunological activation induced by hyperthermic 20 MHz high intensity focused ultrasound (HIFU) with conventional cryotherapy. The bioeffects from the two methods are initially investigated by numerical models, and subsequently compared to clinical observations after treatment of a patient with the inflammatory disease granuloma annulare (GA). METHODS Clinical responses to moderate energy HIFU and cryotherapy were analysed using numerical models. HIFU-induced pressure and heat transfer were calculated, and a three-layer finite element model simulated temperature distribution and necrotic volume in the skin. Model output was compared to 22 lesions treated with HIFU and 10 with cryotherapy in a patient with GA. RESULTS Cryotherapy produced a necrotic volume of 138.5 mm3 at - 92.7 °C. HIFU at 0.3-0.6 J/exposure and focal depths of 0.8 or 1.3 mm generated necrotic volumes up to only 15.99 mm3 at temperatures of 68.3-81.2 °C. HIFU achieved full or partial resolution in all treated areas, confirming its hyperthermic immunological activation effect, while cryotherapy also resolved lesions but led to scarring and dyspigmentation. CONCLUSION Hyperthermic immunological activation of 20 MHz HIFU shows promise for treating inflammatory skin conditions as exemplified by GA. Numerical models demonstrate minimal skin necrosis compared to cryotherapy. Suggested optimal HIFU parameters are 1.3 mm focal depth, 0.4-0.5 J/exposure, 1 mm spacing, and 1 mm margin. Further studies on GA and other inflammatory diseases are recommended.
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Affiliation(s)
- Jacek Calik
- Old Town Clinic, Wszystkich Świętych 2a, 50-127, Wrocław, Poland
- Department of Clinical Oncology, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Tomasz Zawada
- TOOsonix A/S, Agern Allé 1, 2970, Hoersholm, Denmark.
| | - Natalia Sauer
- Old Town Clinic, Wszystkich Świętych 2a, 50-127, Wrocław, Poland
- Faculty of Pharmacy, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Torsten Bove
- TOOsonix A/S, Agern Allé 1, 2970, Hoersholm, Denmark
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Wojciechowska-Puchałka J, Calik J, Krawczyk J, Obrzut J, Tomaszewska E, Muszyński S, Wojtysiak D. The effect of caponization on tibia bone histomorphometric properties of crossbred roosters. Sci Rep 2024; 14:4062. [PMID: 38374163 PMCID: PMC10876549 DOI: 10.1038/s41598-024-54791-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/16/2024] [Indexed: 02/21/2024] Open
Abstract
The negative effect of caponization on the structural, geometric and mechanical parameters of femur and tibia has been shown in a few studies. Nevertheless, its influence on tibia bone microarchitecture is still largely unknown. Therefore, this study aimed to assess the effect of castration on the microstructural parameters of the trabecular and compact bone of tibia bone in crossbred chickens. The experiment involved 96 roosters derived from crossing Yellowleg Partridge hens ([Formula: see text]-33) and Rhode Island Red cockerels (R-11) fattened until the 16th, 20th and 24th week of life. Animals were randomly divided into 2 groups of 48 each. Group I (control) consisted of intact roosters and group II (experimental) consisted of birds subjected to caponization at the 8th week of age. The castration surgery had no influence on some properties within compact bone such as osteon diameter On.Dm, osteon perimeter On.Pm, osteon area On.Ar, osteocyte lacunar number Ot.Lc.N, osteon bone area On.B.Ar, osteon wall thickness On.W.Th as well as thick-mature collagen content in all analyzed age groups of animals. Nevertheless, our results demonstrate that castration caused a decrease of Haversian canal area Hc.Ar, osteocyte lacunar area Ot.Lc.Ar and osteocyte lacunar porosity Ot.Lc.Po among the 16-week-old birds, decrease of Haversian canal perimeter Hc.Pm and increase of fraction of bone area On.B.Ar/On.Ar among 16- and 24-week-old individuals and also an increase of osteocyte lacunar density Ot.Lc.Dn in the osteons of the oldest roosters. Additionally, some microstructural parameters of trabecular bone show the negative effect of caponization. The youngest 16-week-old capons were characterized by thinnin the trabecular in the epiphysis part of tibia. Moreover, in the case of 24-week-old, there is an increase in the trabecular separation Tb.Sp with simultaneous decrease of trabecular number Tb.N compared to roosters, which may suggest the increase of the bone resorption among the oldest individuals. The increased bone turnover in the epiphysis part of the tibia bone also indicates changes in the collagen fibers distribution, where among 20-week-old animals there is a decrease in the content of immature thin collagen fibers with simultaneous increase in the content of mature thick collagen fibers. Furthermore, among the oldest 24-week-old individuals we can observe the increased thick-to-thin collagen ratio, which may be a sign of slowing down in bone formation.
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Affiliation(s)
- J Wojciechowska-Puchałka
- Department of Animal Reproduction, Anatomy and Genomics, University of Agriculture in Kraków, 24/28 Mickiewicza Ave., 30-059, Cracow, Poland.
| | - J Calik
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - J Krawczyk
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - J Obrzut
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - E Tomaszewska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 12 Akademicka St., 20-950, Lublin, Poland
| | - S Muszyński
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 13 Akademicka St, 20-950, Lublin, Poland
| | - D Wojtysiak
- Department of Animal Genetics, Breeding and Ethology, Faculty of Animal Sciences, University of Agriculture in Kraków, 24/28 Mickiewicza Ave., 30-059, Cracow, Poland
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Calik J, Zawada T, Bove T, Dzięgiel P, Pogorzelska-Antkowiak A, Mackiewicz J, Woźniak B, Sauer N. Healing Process after High-Intensity Focused Ultrasound Treatment of Benign Skin Lesions: Dermoscopic Analysis and Treatment Guidelines. J Clin Med 2024; 13:931. [PMID: 38398246 PMCID: PMC10888560 DOI: 10.3390/jcm13040931] [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: 01/04/2024] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Background: High-Intensity Focused Ultrasound (HIFU) has emerged as a precise and non-invasive modality for tissue ablation and healing. This study presents a detailed dermoscopic analysis of skin healing post-High-Intensity Focused Ultrasound (HIFU) treatment, focusing on common benign skin lesions, such as seborrheic keratosis, sebaceous hyperplasia, vascular lesions, and sebaceous nevi. Methods: Prior to HIFU treatment, a comprehensive assessment was conducted, integrating ultrasound scanning and clinical evaluations. The TOOsonix System ONE-M was employed for HIFU treatments, with parameters tailored to each lesion type. Results: A common pattern observed across all lesions includes initial whitening post treatment, followed by scab formation and the development of a pink area with reparative vessels. This study, however, highlights distinct differences in fibrosis patterns and healing timelines across different lesion types. Each lesion type exhibited unique fibrosis patterns post treatment. Flatter variants of seborrheic keratosis healed within a month, displaying hypopigmentation and reparative vessels, alongside a distinct lattice fibrosis pattern in more verrucous forms, which took about two months to heal. Sebaceous hyperplasia, characterized by rapid healing within three weeks, demonstrated fibrosis with pink areas and perpendicular white lines, concluding with a slight depression. Vascular lesions varied in healing time based on depth, with superficial ones showing whitening and crust formation, while deeper lesions had vessel occlusion and size reduction accompanied by concentric fibrotic bands. Sebaceous nevi presented the longest healing duration of three months, characterized by amorphous white-gray structures, scab formation, and the emergence of pink areas with branching vessels, leading to clear skin with reduced white lines. Conclusions: in conclusion, this meticulous clinical evaluation highlights the unique healing characteristics and timelines for each skin lesion type treated with HIFU. These insights are invaluable for optimizing follow-up assessments, identifying potential complications, and refining treatment protocols. By providing detailed insights into the healing timelines and patterns for different types of lesions, patients can be better informed about their post-treatment journey.
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Affiliation(s)
- Jacek Calik
- Department of Clinical Oncology, Wroclaw Medical University, 50-556 Wrocław, Poland
- Old Town Clinic, 50-136 Wroclaw, Poland;
| | - Tomasz Zawada
- TOOsonix A/S, 2970 Hoersholm, Denmark; (T.Z.); (T.B.)
| | - Torsten Bove
- TOOsonix A/S, 2970 Hoersholm, Denmark; (T.Z.); (T.B.)
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, T. Chalubinskiego 6a, 50-368 Wroclaw, Poland;
- Department of Human Biology, Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | | | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | | | - Natalia Sauer
- Old Town Clinic, 50-136 Wroclaw, Poland;
- Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Calik J, Dzięgiel P, Sauer N. Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study. Front Oncol 2024; 14:1332362. [PMID: 38347840 PMCID: PMC10859400 DOI: 10.3389/fonc.2024.1332362] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024] Open
Abstract
This case study documents an extraordinary disease progression in a 70-year-old patient diagnosed with metastatic melanoma. The patient's condition advanced to an unusual manifestation characterized by generalized melanosis and melanuria, a rare and foreboding complication of metastatic melanoma. The clinical presentation involved rapid-onset skin darkening, primarily affecting the face and torso, along with darkened urine, marking the onset of melanuria. Despite extensive diagnostic evaluations, including abdominal ultrasound, neck ultrasound, thoracic CT scans, and endoscopic examinations, the exact metastatic sites remained elusive, demonstrating the diagnostic challenges associated with this condition. Laboratory tests revealed abnormal hematological and biochemical markers, along with elevated S100 protein levels, indicating disease progression. The patient underwent a surgical skin biopsy that confirmed the diagnosis of metastatic melanoma, leading to a multidisciplinary approach to treatment. Following this, the patient-initiated chemotherapy with dacarbazine (DTIC). Regrettably, this was necessitated by the absence of reimbursement for BRAF and MEK inhibitors as well as immunotherapy, and it subsequently led to rapid disease progression and a decline in the patient's clinical condition. The patient's condition further complicated with erysipelas and increased distress, ultimately leading to their unfortunate demise. This case highlights the aggressive nature of generalized melanosis, characterized by a rapid clinical course, substantial pigmentation, and limited response to conventional chemotherapy. Importantly, the patient had a BRAF mutation, emphasizing the urgency of exploring alternative treatment strategies. Patients with a BRAF mutation are excellent candidates for BRAF and MEK inhibitor treatment, potentially allowing them to extend their lifespan if this therapy were available. The challenges encountered in diagnosing, managing, and treating this aggressive form of metastatic melanoma underline the need for early detection, tailored therapeutic approaches, and ongoing research efforts to improve patient outcomes in such cases.
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Affiliation(s)
- Jacek Calik
- Department of Clinical Oncology, Wroclaw Medical University, Wrocław, Poland
- Old Town Clinic, Wroclaw, Poland
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wrocław, Poland
- Department of Human Biology, Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Natalia Sauer
- Old Town Clinic, Wroclaw, Poland
- Faculty of Pharmacy, Wroclaw Medical University, Wrocław, Poland
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Calik J, Pilarski B, Migdał M, Sauer N. Assessing Excessive Keratinization in Acral Areas through Dermatoscopy with Cross-Polarization and Parallel-Polarization: A Dermatoscopic Keratinization Scale. J Clin Med 2023; 12:7077. [PMID: 38002691 PMCID: PMC10671891 DOI: 10.3390/jcm12227077] [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: 09/18/2023] [Revised: 11/06/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
Excessive epidermal hyperkeratosis in acral areas is a common occurrence in dermatology practice, with a notable prevalence of approximately 65% in the elderly, especially in plantar lesions. Hyperkeratosis, characterized by thickening of the stratum corneum, can have various causes, including chronic physical or chemical factors, genetic predispositions, immunological disorders, and pharmaceutical compounds. This condition can significantly impact mobility, increase the risk of falls, and reduce the overall quality of life, particularly in older individuals. Management often involves creams containing urea to soften hyperkeratotic areas. Currently, subjective visual evaluation is the gold standard for assessing hyperkeratosis severity, lacking precision and consistency. Therefore, our research group proposes a novel 6-point keratinization scale based on dermatoscopy with cross-polarization and parallel-polarization techniques. This scale provides a structured framework for objective assessment, aiding in treatment selection, duration determination, and monitoring disease progression. Its clinical utility extends to various dermatological conditions involving hyperkeratosis, making it a valuable tool in dermatology practice. This standardized approach enhances communication among healthcare professionals, ultimately improving patient care and research comparability in dermatology.
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Affiliation(s)
- Jacek Calik
- Old Town Clinic, 50-043 Wroclaw, Poland;
- Department of Clinical Oncology, Wroclaw Medical University, 50-556 Wrocław, Poland
| | | | | | - Natalia Sauer
- Old Town Clinic, 50-043 Wroclaw, Poland;
- Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wrocław, Poland
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Sauer N, Matkowski I, Bodalska G, Murawski M, Dzięgiel P, Calik J. Prognostic Role of Prolactin-Induced Protein (PIP) in Breast Cancer. Cells 2023; 12:2252. [PMID: 37759471 PMCID: PMC10527336 DOI: 10.3390/cells12182252] [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: 08/13/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Prolactin-inducible protein (PIP), also referred to as gross cystic disease fluid protein 15 (GCDFP-15), has been a trending topic in recent years due to its potential role as a specific marker in breast cancer. PIP binds to aquaporin-5 (AQP5), CD4, actin, fibrinogen, β-tubulin, serum albumin, hydroxyapatite, zinc α2-glycoprotein, and the Fc fragment of IgGs, and the expression of PIP has been demonstrated to be modulated by various cytokines, including IL4/13, IL1, and IL6. PIP gene expression has been extensively studied due to its captivating nature. It is influenced by various factors, with androgens, progesterone, glucocorticosteroids, prolactin, and growth hormone enhancing its expression while estrogens suppress it. The regulatory mechanisms involve important proteins such as STAT5A, STAT5B, Runx2, and androgen receptor, which collaborate to enhance PIP gene transcription and protein production. The expression level of PIP in breast cancer is dependent on the tumor stage and subtype. Higher expression is observed in early-stage tumors of the luminal A subtype, while lower expression is associated with luminal B, basal-like, and triple-negative subtypes, which have a poorer prognosis. PIP expression is also correlated with apocrine differentiation, hormone receptor positivity, and longer metastasis-free survival. PIP plays a role in supporting the immune system's antitumor response during the early stages of breast cancer development. However, as cancer progresses, the protective role of PIP may become less effective or diminished. In this work, we summarized the clinical significance of the PIP molecule in breast cancer and its potential role as a new candidate for cell-based therapies.
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Affiliation(s)
- Natalia Sauer
- Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland
- Old Town Clinic, 50-127 Wroclaw, Poland
| | - Igor Matkowski
- Jan Mikulicz-Radecki University Teaching Hospital, Borowska 213, 50-556 Wroclaw, Poland;
| | - Grażyna Bodalska
- Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Marek Murawski
- 1st Department and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, T. Chalubinskiego 6a, 50-368 Wroclaw, Poland;
- Department of Human Biology, Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Jacek Calik
- Old Town Clinic, 50-127 Wroclaw, Poland
- Department of Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Wojciechowska-Puchałka J, Calik J, Krawczyk J, Obrzut J, Tomaszewska E, Muszyński S, Wojtysiak D. The effect of caponization on bone homeostasis of crossbred roosters. I. Analysis of tibia bone mineralization, densitometric, osteometric, geometric and biomechanical properties. Sci Rep 2023; 13:14512. [PMID: 37667027 PMCID: PMC10477200 DOI: 10.1038/s41598-023-41806-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
The presented study focuses on assessing the effect of caponization on the densitometric, osteometric, geometric and biomechanical parameters of tibial bones in crossbred chickens. The study was carried out on 96 hybrids between Yellowleg Partridge hens (Ż-33) and Rhode Island Red cockerels (R-11) aged 16 weeks, 20 weeks and 24 weeks. Birds were randomly assigned to 2 groups-the control group (n = 48; which consisted of intact roosters) and the experimental group (n = 48, which consisted of individuals subjected to caponization at the age of 8 weeks). The caponization had no effect on the densitometric, osteometric and geometric parameters (except the horizontal internal diameter of 16-week-old individuals) of tibia bone, as well as the content of calcium (Ca), phosphorus (P) and the Ca/P ratio in the bone mineral fraction in all analyzed age groups of animals. However, it contributes to a lower percentage of ash in the bones of capons at 20 and 24 weeks of age compared to cockerels. On the contrary, some mechanical and material parameters show the negative effect of caponization. Ultimate load and bending moment decreased in capons in all of the analyzed age groups of animals and yield load, stiffness and ultimate stress also decreased but only in the group of 20-week-old and 24-week-old individuals. This can contribute to the weakening of the capon bones, and in the perspective of prolonged maintenance to their deformation and even fracture.
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Affiliation(s)
- J Wojciechowska-Puchałka
- Department of Animal Reproduction, Anatomy and Genomics, University of Agriculture in Kraków, 24/28 Mickiewicza Ave., 30-059, Cracow, Poland.
| | - J Calik
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - J Krawczyk
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - J Obrzut
- Department of Poultry Breeding, National Research Institute of Animal Production, 32-083, Balice, Poland
| | - E Tomaszewska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 12 Akademicka St., 20-950, Lublin, Poland
| | - S Muszyński
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 13 Akademicka St., 20-950, Lublin, Poland
| | - D Wojtysiak
- Department of Animal Genetics, Breeding and Ethology, Faculty of Animal Sciences, University of Agriculture in Kraków, 24/28 Mickiewicza Ave., 30-059, Cracow, Poland
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Calik J, Obrzut J. Physicochemical characteristics of meat from capons derived from the crossing of conserved breed hens and meat roosters. Poult Sci 2023; 102:102500. [PMID: 36764135 PMCID: PMC9929852 DOI: 10.1016/j.psj.2023.102500] [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: 08/11/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
The study aimed to determine the effect of castration on physicochemical properties of meat from capons derived from the crossing of Rhode Island Red (R-11) hens and meat roosters. Subjects were 100 crossbred cockerels, which were randomly assigned to 2 groups of 50 each. Group I (control) consisted of intact cockerels and birds from group II were subjected to castration. The castration was performed at 7 wk of age under local anesthesia by a veterinarian. All birds were fed ad libitum with the same feed mixtures and placed on litter under optimal environmental conditions at a stocking density of 5 birds/m2. At the end of fattening (20 wk of age), 10 birds whose body weight was similar to group average, were selected from each group for slaughter. After slaughter, the birds were analyzed for dressing percentage and physicochemical parameters of breast and leg muscles, which were subjected to sensory evaluation. The results demonstrated that compared to intact cockerels, capons were characterized by significantly higher body weight, dressing percentage and carcass muscle content. Both the breast and leg muscles of the capons showed better physicochemical parameters and higher sensory score. It is therefore concluded that the birds derived from the crossing of Rhode Island Red (R-11) hens and meat roosters are good material for capon production, their meat is a product of distinctly higher quality.
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Wozniak B, Bove T, Zawada T, Calik J. Treatment of Cutaneous Neurofibromas in Patients with Neurofibromatosis Type 1. Case Rep Dermatol 2023; 15:194-201. [PMID: 37899948 PMCID: PMC10601743 DOI: 10.1159/000534270] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Neurofibromatosis type 1 is a genetic disorder impacting approximately 2.5 million people worldwide, often leading to development of numerous benign yet disfiguring cutaneous neurofibromas (cNF). Removal of cNF is limited to excision or laser ablation with common post-operation complications and scarring. The current case explores a new approach to removal or reduction of cNF by a minimally invasive and pain-reduced treatment modality. A 40-year-old female patient with numerous cNF across her body underwent a single treatment using a 20 MHz dermatologically focused ultrasound device on seven selected cNF on the upper back. Each cNF was treated in a single session of 20-60 s without anesthesia due to manageable pain. Only one minimal adverse reaction in the form of dyspigmentation in a single treated tumor was noted from treatment or during the healing of a thin scab that formed on each cNF a few days after treatment. At the 12-month follow-up, four out of seven treated cNF showed full remission, two showed partial or significant reduction in tumor volume, while two did not respond to treatment. The reason for the variability is not fully understood, but speculations include difference in tissue content, e.g., due to tumor age. The method is concluded to be a promising candidate for a new safe and minimally invasive treatment that can potentially be used for single-session removal/reduction of a large number of cNF. Further research should focus on refining treatment parameters and strategies to enhance response predictability.
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Affiliation(s)
- Bartosz Wozniak
- Department of Dermatology and Venereology, Regional Specialist Hospital, Wroclaw, Poland
- Old Town Clinic, Wroclaw, Poland
| | | | | | - Jacek Calik
- Old Town Clinic, Wroclaw, Poland
- Department of Oncology, Academic Hospital Wroclaw, Wroclaw, Poland
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Calik J, Zawada T, Bove T. Treatment of Condylomata Acuminata Using a New Non-Vapor-Generating Focused Ultrasound Method following Imiquimod 5% Cream. Case Rep Dermatol 2022; 14:275-282. [PMID: 36824153 PMCID: PMC9941760 DOI: 10.1159/000525896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/20/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022] Open
Abstract
Condylomata acuminata is the most common sexually transmitted disease in the world. Physical treatments include excision, cryotherapy, electrocautery and ablative CO2, and Nd:YAG laser ablation, while topical treatments include imiquimod immunotherapy and antimitotic podophyllotoxin or sinecatechins. Efficacies of all methods are low, and recurrences are very common. A new combined method is presented as a single case in a 25-year-old male patient diagnosed with numerous condylomas on the penis, scrotum, and lower abdomen. The treatment consisted of a 7-week topical monotherapy using 5% imiquimod cream followed by local treatment with 20 MHz high-intensity focused ultrasound on remaining recalcitrant lesions. Results showed resolution of approximately 70% of the condylomas after imiquimod treatment, and full resolution of all recalcitrant condylomas treated subsequently with high-intensity focused ultrasound. The method is concluded to be safe and effective and, furthermore, presents a new physical method that does not generate airborne infectious human papillomavirus particles that pose a health risk for the medical team performing therapy. Further studies in larger populations are recommended to confirm the combined efficacy of the proposed method.
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Affiliation(s)
| | | | - Torsten Bove
- bTOOsonix A/S, Hoersholm, Denmark,*Torsten Bove,
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Cybulska-Stopa B, Czarnecka AM, Ostaszewski K, Piejko K, Zietek M, Dziura R, Rutkowska E, Galus Ł, Calik J, Sałek-Zań A, Zemelka T, Kamycka A, Bal W, Kubiatowski T, Rogala P, Switaj T, Kaminska-Winciorek G, Suwiński R, Mackiewicz J, Rutkowski P. Is the BRAF mutation still an unfavorable risk factor in patients with metastatic melanoma in the era of modern therapies? J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21544 Background: BRAF-mutated (MUT) melanoma is characterized by specific clinical features including more aggressive biological behavior than BRAF wild-type (WT) melanoma. BRAF mutations are historically known as negative prognostic factor for to shorter overall survival (OS) in patients with stage IV disease with melanoma. Methods: Consecutive patients with unresectable or metastatic melanoma started treatment with BRAF inhibitors (BRAFi), BRAFi and MEK inhibitors (MEKi) or IT (anti-PD-1 antibody) between 1/Jan/2013 and 31/Dec/2020. Clinical factors including age, gender, primary location of melanoma, ECOG performance status, baseline LDH level, and location of metastases, response to treatment were analyzed. Survival analyses were performed using the Kaplan-Meier method, Log-rank and chi-square tests were used for comparison between groups. Data cut-off was 31/Dec/2021. Results: In total 1456 patients were enrolled. BRAF mutation was found in 723 (49.7%) patients and 733 (50.3%) patients were BRAF WT. All BRAF WT patients received first-line IT, while BRAF MUT patient received first-line treatment with BRAFi (n = 134/723, 18%), BRAFi and MEKi (n = 426, 58%) or anty-PD-1 (n = 173, 24%). BRAF MUT patients were significantly younger (median 60 vs 69; p < 0.0001), had worse ECOG (p = 0.0008), elevated LDH (p < 0.0001), had higher number of metastatic sites (p < 0.0001) and brain metastases (p < 0.0001). The estimated median OS (mOS) in BRAF WT group was 17.3 month while in BRAF MUT - 14.8 months (p = 0.33; HR = 0.94, Cl 95% 0.8-1.1). mOS in BRAF MUT group treated with BRAFi was - 10.0, while with BRAFi and MEKi combination - 14.9. BRAF WT and BRAF MUT groups treated with IT did not differ significantly in baseline characteristics. BRAF MUT group treated with IT achieved mOS of 26.2 months, while in BRAF WT 17.3 months. Conclusions: The analysis showed no differences in the median OS between BRAF MUT and BRAF WT patients with unresectable or metastatic melanoma treated with novel therapies (BRAFi-MEKi combination or IT), despite unfavorable prognostic factors in the BRAF MUT group. Moreover mOS was significantly prolonged in the BRAF MUT patients treated with IT.
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Affiliation(s)
- Bozena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | | | - Krzysztof Ostaszewski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Marcin Zietek
- Department of Oncology, Wroclaw Medical University; Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland
| | - Robert Dziura
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Ewa Rutkowska
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Łukasz Galus
- MARIA SKLODOWSKA CURIE GREATER POLAND CANCER CTR., Poznan, Poland
| | - Jacek Calik
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | | | | | | | | | - Pawel Rogala
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Tomasz Switaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Grazyna Kaminska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Skin Cancer and Melanoma Team, Maria Sklodowska- Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jacek Mackiewicz
- Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Rogala P, Czarnecka AM, Cybulska-Stopa B, Ostaszewski K, Piejko K, Ziętek M, Dziura R, Rutkowska E, Galus Ł, Kempa-Kamińska N, Calik J, Sałek-Zań A, Zemełka T, Bal W, Kamycka A, Świtaj T, Kamińska-Winciorek G, Suwiński R, Mackiewicz J, Rutkowski P. Long-Term Outcomes of Targeted Therapy after First-Line Immunotherapy in BRAF-Mutated Advanced Cutaneous Melanoma Patients—Real-World Evidence. J Clin Med 2022; 11:jcm11082239. [PMID: 35456332 PMCID: PMC9032972 DOI: 10.3390/jcm11082239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Currently, limited data on targeted therapy and immunotherapy sequencing in patients with BRAF-mutant melanoma is available. Targeted therapy and immunotherapy are expected to be comparable in terms of overall survival (OS) when used as second-line therapies; therefore, understanding the characteristics of patients who completed sequential treatment is needed. Methods: The primary objective of this study was to analyze the efficacy of BRAFi/MEKi activity as second-line therapy in patients with advanced melanoma. We also aimed to describe the clinical characteristics of patients with advanced melanoma who were treated sequentially with immunotherapy and targeted therapy. We enrolled 97 patients treated between 1st December 2015 and 31st December 2020 with first-line immunotherapy with programmed cell death 1 (PD-1) checkpoint inhibitors; and for the second-line treatment with at least one cycle of BRAFi/MEKi therapy with follow-up through 31 January 2022. Results: Median OS since first-line treatment initiation was 19.9 months and 12.8 months since initiation of BRAFi/MEKi treatment. All BRAFi/MRKi combinations were similarly effective. Median progression free survival (PFS) was 7.5 months since initiation of any BRAFi/MEKi treatment. Conclusions: BRAFi/MEKi therapy is effective in the second-line in advanced and metastatic melanoma patients. For the first time, the efficacy of all BRAFi/MEKi combinations as second-line therapy is shown.
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Affiliation(s)
- Paweł Rogala
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-546-24-55
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Krzysztof Ostaszewski
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Marcin Ziętek
- Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland;
- Department of Oncology, Wroclaw Medical University, 50-376 Wroclaw, Poland
| | - Robert Dziura
- Department of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, Poland; (R.D.); (E.R.)
| | - Ewa Rutkowska
- Department of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, Poland; (R.D.); (E.R.)
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland; (Ł.G.); (J.M.)
| | - Natasza Kempa-Kamińska
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland; (N.K.-K.); (J.C.)
| | - Jacek Calik
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, Poland; (N.K.-K.); (J.C.)
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Tomasz Zemełka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Kraków, Poland; (B.C.-S.); (K.P.); (A.S.-Z.); (T.Z.)
| | - Wiesław Bal
- Department of Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | | | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
| | - Grażyna Kamińska-Winciorek
- The Skin Cancer and Melanoma Team, Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, Poland; (Ł.G.); (J.M.)
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melansoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.R.); (K.O.); (T.Ś.); (P.R.)
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Calik J, Migdal M, Zawada T, Bove T. Treatment of Seborrheic Keratosis by High Frequency Focused Ultrasound - An Early Experience with 11 Consecutive Cases. Clin Cosmet Investig Dermatol 2022; 15:145-156. [PMID: 35125879 PMCID: PMC8808045 DOI: 10.2147/ccid.s348106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/15/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE High intensity focused ultrasound operating at 20 MHz has been demonstrated as a safe and efficient treatment modality for a range of dermatological indications. The method is potentially also applicable to removal of seborrheic keratosis. PATIENTS AND METHODS A total of 54 seborrheic keratoses in 11 volunteer subjects (8 women and 3 men, average age 51.5 ± 13.2 years) were treated in a single session with a medical 20 MHz high intensity focused ultrasound device developed for dermatological conditions. Handpieces with nominal focal depths of 0.8 mm below the skin surface were used to administer acoustic energy of 0.99-1.2 J/dose. An integrated dermoscope in the handpiece was used to monitor the treatment in real-time. Treatment efficacy and side-effects were assessed directly after treatment and at follow-up 4-15 weeks after treatment. RESULTS The treatment showed positive results in 96.3% of the cases. About 68.5% of the cases were classified as complete response and 27.8% of the cases as partial response. Two cases (3.7%) did not respond to treatment and were classified as stable condition. No subjects experienced worsening of their condition, and no treatment received the classification of progressive condition. Side effects were primarily redness in the treatment area due to superficial telangiectasia, mild scarring, and persisting and slow-healing lichen planus-like keratosis. No adverse events were observed. CONCLUSION HIFU is concluded to be a safe and efficient skin treatment for seborrheic keratoses. It has advantages over conventional treatments that can lead to pain during treatment and scarring after healing.
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Calik J, Zawada T, Bove T. Treatment of superficial benign vascular tumors by high intensity focused ultrasound: Observations in two illustrative cases. J Cosmet Dermatol 2021; 21:3371-3379. [PMID: 34921489 PMCID: PMC9544960 DOI: 10.1111/jocd.14682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/19/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
Background Existing therapeutic methods for reduction or removal of superficial vascular malformations and tumors have high risks of scarring and other complications that result in aesthetic appearance less favorable than the baseline. Patients are often cautioned against intervention, which can lead to psychosocial problems and low self‐esteem. Improved treatment modalities are therefore relevant from both medical and aesthetic perspectives. Methods Two volunteer subjects were treated with a medical 20 MHz high intensity focused ultrasound device developed for dermatological conditions. One patient was given three treatments to remove a superficial congenital hemangioma on the left middle cheek. The other patient was given a single treatment to remove seven cherry angiomas on the thighs. Handpieces with nominal focal depths of 0.8 – 1.8 mm below the skin surface were used to administer acoustic energy of 1.1 – 1.2 J/dose. An integrated dermoscope in the handpiece was used to monitor the treatment in real‐time. Results During treatment, blood in the capillary network of the lesions was coagulated immediately, and capillary walls were collapsed due to the thermal and mechanical effects of the high intensity focused ultrasound. During the healing phase, the areas regenerated a normal skin structure with very limited scar or dyspigmentation. At follow‐up, a clear aesthetic improvement was observed over the baseline for all treated targets with the exception of two cherry angiomas, where focal depth and/or dose coverage had not been optimal. Conclusion High intensity focused ultrasound is concluded to be a safe and efficient skin treatment for benign superficial vascular malformations and tumors.
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Cybulska-Stopa B, Ziętek M, Czarnecka AM, Piejko K, Dziura R, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Seredyńska J, Gądek K, Zemełka T, Teterycz P, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Development of immunity-related adverse events correlates with baseline clinical factors, survival and response to anti-PD-1 treatment in patients with inoperable or metastatic melanoma. J DERMATOL TREAT 2021; 33:2168-2174. [PMID: 34057374 DOI: 10.1080/09546634.2021.1937477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The relationship between immune related adverse events (irAEs) and efficacy is not definitively proven, and data on the relationship between irAE and treatment efficacy are contradictory. MATERIAL AND METHODS Five hundred ninety-three consecutive patients with unresectable or metastatic melanoma treated in the first line with anti-PD-1 (nivolumab or pembrolizumab) between January 2016 and December 2019 were enrolled in the study. RESULTS Statistically significant differences were demonstrated between the group of patients without and with irAE in median OS and PFS (p < .0001 both) and also in OS between the group of patients without irAE and patients with irAE within 3, 6, and 9 months from the start of anti-PD-1 therapy (p = .0121, p = .0014, p < .0001; respectively) and PFS (p = .0369, p = .0052, p = .0001; respectively). A statistically significant relationship was demonstrated between the occurrence of irAE and the location of the primary tumor (skin vs. mucosa vs. unknown; p = .0183), brain metastasis (present vs. absent; p = .0032), other locations (present vs. absent, p = .0032), LDH (normal vs. elevated; p = .0046) and stage according to TNM (p = .0093). CONCLUSION The occurrence of irAE was associated with longer OS, PFS, and more frequent response to treatment. IrAE occurred statistically significantly more often in patients with mucosa primary tumor, with normal LDH levels, without brain metastases, stages III, M1a, and M1b.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Marcin Ziętek
- Department of Oncology, Wrocław Medical University, Wrocław, Poland.,Department of Surgical Oncology, Wrocław Comprehensive Cancer Center, Wrocław, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Robert Dziura
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, Poznan, Poland.,Chemotherapy Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Stanisław Kieszko
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin, Poland
| | | | - Jacek Calik
- Department of Clinical Oncology, Wrocław Comprehensive Cancer Center, Wroclaw, Poland
| | - Joanna Seredyńska
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Kamila Gądek
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Tomasz Zemełka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Tomasz Kubiatowski
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin, Poland
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences, Poznan, Poland.,Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Cybulska-Stopa B, Zietek M, Czarnecka AM, Piejko K, Dziura R, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Gajewska-Wicher K, Gądek K, Sałek-Zań A, Seredyńska J, Drosik-Kwaśniewska A, Kaminska-Winciorek G, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Comparison of the efficacy and toxicity of anti-PD-1 monoclonal antibodies (nivolumab versus pembrolizumab) in treatment of patients with metastatic melanoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21514 Background: Anti-programmed cell death-1 antibodies (anti-PD-1) have become a standard treatment option for melanoma patients. Currently, two anti-PD-1 antibodies are registered in the treatment of melanoma patients: nivolumab and pembrolizumab. Nivolumab is a human monoclonal antibody, while pembrolizumab is a humanized antibody. Unfortunately, there are very few clinical data comparing the efficacy and toxicity of nivolumab and pembrolizumab in routine practice. Methods: Consecutive patients treated in the first line with anti-PD-1 (nivolumab or pembrolizumab) for unresectable or metastatic melanoma in comprehensive cancer centers between 03/2016 and 09/2020 were enrolled in the analysis. Baseline factors (age, gender, primary location of melanoma, BRAF mutation status, ECOG performance status, baseline LDH level, and location of metastases) were evaluated to identify predictors of overall survival (OS). Data on response to treatment and the occurrence of irAEs were collected prospectively during anti-PD-1 treatment. OS were assessed using Kaplan–Meier and Cox models. The Chi-Square statistic was used for testing relationships between categorical variables. Median follow up for nivolumab and pembrolizumab group was 12.6 (range 0.2-52.1) and 10.7 (range 0.03-53.5) months, respectively. Results: Overall, 736 patients were included in the present analysis (443 nivolumab, 293 pembrolizumab). There were no statistically significant differences in baseline factors (age, gender, primary location of melanoma, BRAF mutation status, ECOG performance status, baseline LDH level (normal vs elevated), brain metastasis and TNM stage) between the groups. Median OS for patients treated with nivolumab and pembrolizumab was 22 and was 17.3 months, respectively. There was no statistically significant difference in OS between the nivolumab and pembrolizumab groups (p = 0.12, HR = 1.2, Cl 95% 0.9-1.4). At multivariate analysis normal LDH levels, no brain metastases, and ECOG 0 or 1 were positive prognostic factors for OS both in nivolumab and pembrolizumab groups. In the nivolumab and pembrolizumab groups, 6% and 5% CR (complete response), 33% and 31% PR (partial response), 25% and 24% SD (stable disease), respectively, were observed. There was no statistical difference between the groups in the response to treatment (p = 0.65). There was no statistical difference between the groups in occurrence of the irAEs (p = 0.97) as well as in the type of irAEs. Conclusions: Our analysis in melanoma patients treated in routine practice with nivolumab or pembrolizumab confirmed no statistical differences in OS and treatment responses between these two anti-PD-1 antibodies. There were also no differences in toxicity between the two drugs. The choice of treatment should be based on the preferences of the patient and the physician.
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Affiliation(s)
- Bozena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Marcin Zietek
- Department of Oncology, Wroclaw Medical University; Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland
| | - Anna Malgorzata Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Robert Dziura
- Clinical Oncology Department, Holy Cross Cancer Center, Kielce, Poland
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences, Chemotherapy Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Stanisław Kieszko
- Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin, Poland
| | | | - Jacek Calik
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland
| | - Katarzyna Gajewska-Wicher
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Kamila Gądek
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Joanna Seredyńska
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Anna Drosik-Kwaśniewska
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Grazyna Kaminska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Skin Cancer and Melanoma Team, Maria Sklodowska- Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | | | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jacek Mackiewicz
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Cybulska-Stopa B, Ziętek M, Kamińska-Winciorek G, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Zemełka T, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Anti-programmed cell death-1 therapy in octogenarian and nonagenarian advanced/metastatic melanoma patients. Melanoma Res 2021; 31:49-57. [PMID: 33165240 DOI: 10.1097/cmr.0000000000000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Immunotherapy with anti-programmed cell death-1 (PD-1) agents is an effective treatment for metastatic melanoma. Octogenarians and nonagenarians represent a significant cohort of melanoma patients. This multicenter retrospective analysis enrolled 499 patients treated with nivolumab or pembrolizumab. Seventy-three patients were aged 80-100, 218 patients were aged 65-79, and 208 patients were <65 years old. Baseline parameters were comparable. The median overall survival (OS) was 14.7, 18.7, 25.9, and the median progression-free survival (PFS) was 8.7, 7.7, and 6.2 months in the age groups of 80-100, 65-79, and <65 years, respectively. The median melanoma-specific survival (MSS) was 22.5, 27.8, and 31.6 months in the age groups of 80-100, 65-79, and <65 years, respectively. There was no statistically significant difference in OS (P = 0.2897), PFS (P = 0.7155), and MSS (P = 0.9235) between the group of 80-100 years old vs. 65-79 and vs. <65 years old patients. Overall response rate and disease control rate was similar in all groups (P = 0.06974 and P = 0.89435, respectively). Overall, the immune-related adverse event (irAE) rate was comparable in the three age groups (41, 34, and 37.5% in the groups of patients aged 80-100, 65-79, and <65 years, respectively). Also, the rates of G3 and G4 irAEs were comparable (4, 6, and 7% in the groups of patients, respectively). The efficacy and toxicity of anti-PD-1 therapy in octogenarians and nonagenarians with metastatic melanoma are similar as in patients aged <65 years and 65-79 years. The patients' age should not be considered as an exclusion criterion for anti-PD-1 treatment.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Marcin Ziętek
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center
- Department of Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Łukasz Galus
- Department of Medical and Experimental Oncology, University of Medical Sciences
- Chemotherapy Department, Greater Poland Cancer Centre, Poznan
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Stanisław Kieszko
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin
| | | | - Jacek Calik
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center
| | - Tomasz Zemełka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch
| | - Tomasz Kubiatowski
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin
| | - Rafał Suwiński
- II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch
| | - Jacek Mackiewicz
- Department of Medical and Experimental Oncology, University of Medical Sciences
- Department of Clinical Oncology, Lower Silesian Oncology Center, Wroclaw
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology
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Cybulska-Stopa B, Pacholczak-Madej R, Kamińska-Winciorek G, Ziętek M, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Rolski J, Sałek-Zań A, Gajewska-Wicher K, Drosik-Kwaśniewska A, Rogala P, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. First-line treatment of advanced/metastatic melanoma with anti-PD-1 antibodies: multicenter experience in Poland. Immunotherapy 2020; 13:297-307. [PMID: 33353420 DOI: 10.2217/imt-2020-0217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: To evaluate treatment results in advanced/metastatic melanoma patients treated with anti-PD-1 immunotherapy in routine practice in oncology centers in Poland. Methods: Multicenter retrospective analysis included 499 patients with unresectable/metastatic (stage IIIC-IV) melanoma treated with anti-PD-1 in first-line therapy. Results: Estimated median overall survival (OS) and progression-free survival (PFS) were 19.9 and 7.9 months, respectively. Multivariate analysis confirmed that ECOG 0, no brain metastases, normal lactate dehydrogenase level and occurrence of immune-related adverse events (irAEs) were statistically significantly associated with improved OS and PFS. Any irAE occurred in 24% of patients. Grade 3 or Grade 4 irAEs occurred in 6% of patients. Conclusion: Analysis revealed a slightly worse OS in real-world treatment in comparison to clinical trials (KEYNOTE-006 and CheckMate 066). Polish population treatment results are similar to other studies of real-world data. PFS and ORR are similar in our research and clinical trials.
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Affiliation(s)
- Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Renata Pacholczak-Madej
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland.,Department of Anatomy, Jagiellonian University, Medical College, 31-543 Krakow, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation & Hematology-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Marcin Ziętek
- Department of Oncological Surgery - Skin Cancer Unit, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland.,Department of Oncological Surgery, Wroclaw Medical University, 53-413 Wroclaw, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Karolina Piejko
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Łukasz Galus
- Department of Medical & Experimental Oncology, Poznan University of Medical Sciences, 60-786 Poznan, Poland.,Chemotherapy Department, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Barbara Ziółkowska
- II Clinic of Radiotherapy & Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Stanisław Kieszko
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, 20-090 Lublin, Poland
| | | | - Jacek Calik
- Department of Clinical Oncology, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland
| | - Janusz Rolski
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Agata Sałek-Zań
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Katarzyna Gajewska-Wicher
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Anna Drosik-Kwaśniewska
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, 31-115 Krakow, Poland
| | - Paweł Rogala
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Tomasz Kubiatowski
- Department of Clinical Oncology, Saint Jan of Dukla Oncology Centre of the Lublin Region, 20-090 Lublin, Poland
| | - Rafał Suwiński
- II Clinic of Radiotherapy & Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Jacek Mackiewicz
- Department of Medical & Experimental Oncology, Poznan University of Medical Sciences, 60-786 Poznan, Poland.,Department of Diagnostics & Cancer Immunology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma & Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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Lewko L, Krawczyk J, Calik J. Effect of genotype and some shell quality traits on lysozyme content and activity in the albumen of eggs from hens under the biodiversity conservation program. Poult Sci 2020; 100:100863. [PMID: 33516470 PMCID: PMC7936162 DOI: 10.1016/j.psj.2020.11.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of the study was to determine shell quality of eggs laid by some strains of native breed hens of different ages, with special consideration of their effect on lysozyme concentration and enzymatic activity. Evaluation was made of the eggshells from 6 breeds/strains of laying hens covered by the gene pool protection program in Poland: Greenleg Partridge (Z-11), Yellowleg Partridge (Ż-33), Rhode Island Red (R-11), Rhode Island White (A-33), Sussex (S-66), and Leghorn (H-22). Significant (P ≤ 0.01) differences were established for all the shell quality characteristics between hen strains. As the birds aged, shell weight and porosity increased, and shell compression strength decreased in all the experimental groups. Lysozyme content was lowest in white-shelled eggs (H-22) and highest in cream-colored and light brown eggs (Z-11, Ż-33, and R-11). Furthermore, age of hens had a greater effect on lysozyme concentration and activity in the eggs than on shell quality traits. Regardless of the layer genotype, eggs from older hens showed higher lysozyme concentration and enzymatic activity.
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Affiliation(s)
- L Lewko
- National Research Institute of Animal Production, Experimental Station Kołuda Wielka, Waterfowl Genetic Resources Station in Dworzyska, 62-035 Kórnik, Poland.
| | - J Krawczyk
- National Research Institute of Animal Production, Department of Poultry Breeding, 32-083 Balice, Poland
| | - J Calik
- National Research Institute of Animal Production, Department of Poultry Breeding, 32-083 Balice, Poland
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20
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Pogorzelska-Antkowiak A, Calik J. Mimics of melanoma in reflectance confocal microscopy. Int J Dermatol 2020; 60:540-546. [PMID: 33166094 DOI: 10.1111/ijd.15306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/06/2020] [Accepted: 10/16/2020] [Indexed: 01/25/2023]
Abstract
The diagnosis of melanoma is challenging for both dermatologists and oncologists. Incidence of melanoma increases at a rate of 3-7% per year. Usage of modern tools such as dermoscopy and in vivo reflectance confocal microscopy improve early diagnosis and can save a life. There are a few melanoma simulators which can cause confusion and mislead in the differential diagnosis. This study aims to present skin lesions which can be similar to melanoma in confocal microscopy and to emphasize the importance of a detailed differential diagnosis. We describe five melanocytic lesions similar to melanoma and misleading confocal features. Although in vivo reflectance confocal microscopy is very useful in differentiating melanocytic lesions, histopathology evaluation in cases of melanoma mimics is definitive.
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Affiliation(s)
| | - Jacek Calik
- Lower Silesian Oncology Center Wroclaw Department of Chemotherapy, Wroclaw, Poland
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21
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Sputa‐Grzegrzolka P, Wozniak Z, Akutko K, Pytrus T, Baran W, Calik J, Glatzel‐Plucinska N, Domagala Z, Podhorska‐Okolow M, Stawarski A, Dziegiel P. Laugier‐Hunziker syndrome: a case report of the pediatric patient and review of the literature. Int J Dermatol 2020; 59:1513-1519. [DOI: 10.1111/ijd.15262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/12/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Affiliation(s)
| | | | - Katarzyna Akutko
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Tomasz Pytrus
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Wojciech Baran
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Poland
| | - Jacek Calik
- Department of ChemotherapyLower Silesian Oncology Center Wroclaw Poland
| | - Natalia Glatzel‐Plucinska
- Division of Histology and Embryology Department of Human Morphology and Embryology Wroclaw Medical University Poland
| | - Zygmunt Domagala
- Division of Anatomy Department of Human Morphology and Embryology Wroclaw Medical University Poland
| | | | - Andrzej Stawarski
- 2nd Department and Clinic of Pediatrics, Gastroenterology and Nutrition Wroclaw Medical University Poland
| | - Piotr Dziegiel
- Division of Histology and Embryology Department of Human Morphology and Embryology Wroclaw Medical University Poland
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22
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Cybulska-Stopa B, Ziętek M, Kamińska-Winciorek G, Czarnecka AM, Piejko K, Galus Ł, Ziółkowska B, Kieszko S, Kempa-Kamińska N, Calik J, Kubiatowski T, Suwiński R, Mackiewicz J, Rutkowski P. Porównanie pośrednie wyników leczenia chorych na zaawansowane/przerzutowe czerniaki za pomocą niwolumabu lub pembrolizumabu – analiza wieloośrodkowa. Oncol Clin Pract 2020. [DOI: 10.5603/ocp.2020.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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23
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Cybulska-Stopa B, Lugowska I, Zietek M, Dawidowska A, Czarnecka AM, Piejko K, Galus L, Ziolkowska B, Kieszko S, Kosela-Paterczyk H, Switaj T, Kozak K, Rogala P, Kempa-Kaminska N, Calik J, Teterycz P, Staroslawska E, Suwinski R, Mackiewicz J, Rutkowski P. Correlation of immunity-related adverse events with survival and response to anti-PD-1 treatment in patients with metastatic melanoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15164 Background: Immunotherapy has become a standard treatment option for metastatic melanoma patients, and the use of anti-programmed cell death-1 monoclonal antibodies (anti-PD-1) has significantly improved the outcomes of this group of patients. Immune related adverse events (irAEs) during anti-PD-1 treatment may present a significant problem. However, irAEs' relationship with overall survival although suggested in single studies was not confirmed in real world data. Methods: Consecutive patients starting treatment between March 2016 and April 2019 with fist line anti-PD-1 (nivolumab or pembrolizumab) for unresectable or metastatic melanoma in 6 comprehensive cancer centers in Poland were enrolled in the study. Baseline patients characteristics and irAEs development during treatment were evaluated to identify predictors of progression-free (PFS) and overall (OS) survival in Cox model. PFS and OS were assessed using Kaplan–Meier method. Results: Overall, 410 patients were included in the present analysis and 107 patients experienced irAEs. Response rate (RR) and disease control rate (DCR) were 36% (148 pts) and 65% (267 pts) respectively. Median PFS and OS were 7.6 (2.8–21.6) and 21.6 (6.7–38.2) months, respectively. In univariate analysis normal LDH level, no brain metastases, ECOG 0 or 1, ≤ 2 number of metastases locations were positive prognostic factors for both OS and PFS. At the same time irAEs occurrence was correlated with longer PFS, OS, RR and DCR (all p < 0.001); moreover high LDH level correlated with irAEs (p = 0.027) development. There was no correlation between irAEs and the number of cycles of anti-PD-1 patients received. Conclusions: Our study showed an association between irAEs and longer survival on anti-PD1 therapy in patients with advanced or metastatic melanoma. An association with irAEs and response to therapy has also been demonstrated.
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Affiliation(s)
- Bozena Cybulska-Stopa
- Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
| | - Iwona Lugowska
- Early Phase Clinial Trials Unit, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Anna Dawidowska
- Early Phase Clinial Trials Unit, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Malgorzata Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Karolina Piejko
- Clinical Oncology Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Cracov, Poland
| | - Lukasz Galus
- Chemotherapy Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Barbara Ziolkowska
- Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Stanislaw Kieszko
- Saint Jan of Dukla Oncology Centre of the Lublin Region, Lublin, Poland
| | - Hanna Kosela-Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Tomasz Switaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Katarzyna Kozak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Pawel Rogala
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Jacek Calik
- Lower Silesian Oncology Center, Wroclaw, Poland
| | - Pawel Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Rafal Suwinski
- Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Jacek Mackiewicz
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre,, Poznan, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie Institute Oncology Center, Warsaw, Poland
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Calik J, Pula B, Piotrowska A, Wojnar A, Witkiewicz W, Grzegrzolka J, Podhorska-Okolow M, Dziegiel P. Prognostic Significance of NOGO-A/B and NOGO-B Receptor Expression in Malignant Melanoma - A Preliminary Study. Anticancer Res 2016; 36:3401-3407. [PMID: 27354599] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/08/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Neurite outgrowth inhibitor type B (NOGO-B) and its receptor (NGBR) were shown to regulate various crucial cellular processes and may be therefore potential factors influencing carcinogenesis. MATERIALS AND METHODS Expression of NOGO-A, NOGO-A/B and NGBR was studied in benign melanocytic lesions and primary tumors and metastases of malignant melanoma (MM). RESULTS Cytoplasmic expression of the studied antigens was detected in melanocytes and MM cells. NOGO-A/B expression was significantly lower in metastatatic MM cases compared to primary MM tumors (p<0.01) and bening melanocytic lesions (p<0.001). In primary MM tumors, NOGO-A expression intensity positively correlated with NOGO-A/B (r=0.32, p<0.05) and NGBR expression (r=0.53, p<0.0001). NOGO-B and NGBR immunoreactivity correlated negatively with depth of primary MM infiltration (both p<0.01). Moreover, low NOGO-A/B expression was a factor of poor prognosis of primary MM. CONCLUSION NOGO-A/B may be a negative prognostic factor of MM.
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Affiliation(s)
- Jacek Calik
- Department of Chemotherapy, Lower Silesian Oncology Center, Wroclaw, Poland
| | - Bartosz Pula
- Department of Histology and Embryology, Medical University, Wroclaw, Poland Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland
| | - Aleksandra Piotrowska
- Department of Histology and Embryology, Medical University, Wroclaw, Poland Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland
| | - Andrzej Wojnar
- Department of Pathology, Lower Silesian Oncology Center, Wroclaw, Poland
| | - Wojciech Witkiewicz
- Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland
| | | | - Marzena Podhorska-Okolow
- Department of Histology and Embryology, Medical University, Wroclaw, Poland Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland
| | - Piotr Dziegiel
- Department of Histology and Embryology, Medical University, Wroclaw, Poland Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland Department of Physiotherapy, University School of Physical Education, Wroclaw, Poland
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Kaminska-Winciorek G, Calik J, Wydmanski J, Schwartz R, Czajkowski R. Primary melanoma in rare locations: Clinical and dermatoscopic features. Indian J Dermatol Venereol Leprol 2014; 80:369-71. [DOI: 10.4103/0378-6323.136976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pula B, Jethon A, Piotrowska A, Gomulkiewicz A, Owczarek T, Calik J, Wojnar A, Witkiewicz W, Rys J, Ugorski M, Dziegiel P, Podhorska-Okolow M. Podoplanin expression by cancer-associated fibroblasts predicts poor outcome in invasive ductal breast carcinoma. Histopathology 2012; 59:1249-60. [PMID: 22175904 DOI: 10.1111/j.1365-2559.2011.04060.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIMS It has recently been shown that podoplanin, a mucin-type glycoprotein, is expressed by cancer cells and cancer-associated fibroblasts (CAFs), and promotes cancer cell migration and invasiveness. The biological role of podoplanin expression in tumour stroma of invasive ductal carcinoma of the breast (IDC) has not been determined. METHODS AND RESULTS Podoplanin expression was analysed in 117 cases of IDC and 27 cases of fibrocystic change, as well as in breast cancer cell lines, with the use of immunohistochemistry and real-time polymerase chain reaction. In 82.1% of analysed tumours, podoplanin was found only in CAFs. Only two of 117 IDC cases (1.7%) were characterized by expression of this glycoprotein in cancer cells. None of the fibrocystic changes or stroma surrounding normal ducts showed podoplanin expression. Podoplanin-positive CAFs correlated with tumour size (P = 0.0125), grade of malignancy (P = 0.0058), lymph node metastasis (P = 0.0149), lymphovascular invasion (LVI) (P = 0.0486) and Ki67 expression in cancer cells (P = 0.0128). High-level podoplanin expression (>50% of positive stroma) in the tumour stroma was significantly associated with a negative oestrogen status (P = 0.0201). Univariate, but not multivariate, analysis showed that podoplanin expression by CAFs was associated with poor patient outcome (P = 0.0202). CONCLUSIONS Our results suggest that podoplanin expression by CAFs could be an unfavourable prognostic marker for IDC.
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Affiliation(s)
- Bartosz Pula
- Department of Histology and Embryology, Medical University, Poznan, Poland
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