1
|
Zeghondy J, Rassy E, Lapidari P, Eid R, Pistilli B. Telehealth in breast cancer following the coronavirus disease 2019 pandemic. Explor Target Antitumor Ther 2023; 4:1249-1259. [PMID: 38213534 PMCID: PMC10776597 DOI: 10.37349/etat.2023.00195] [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: 02/03/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer (BC) is the second most diagnosed cancer in 2018 with around 2.3 million cases globally in 2020. In March 2020 and after its worldwide spread, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak, a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, a pandemic. During this time, cancer patients were heavily impacted and their treatment plans were changed due to measures to fight the disease and solutions had to be found to maintain their follow-up and management from a distance. Some cancer groups worldwide have recommended then the use of telemedicine for oncology patients to ensure the continuity of medical care during the pandemic. This method was considered effective and clinicians worldwide continued using telehealth even after the cessation of worldwide restrictions. To this end, current up-to-date data on the use of telemedicine in BC patient after the COVID-19 outbreak are summarized in this narrative review.
Collapse
Affiliation(s)
- Jean Zeghondy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Elie Rassy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Pietro Lapidari
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Roland Eid
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| |
Collapse
|
2
|
Zalaquett Z, Catherine Rita Hachem M, Kassis Y, Hachem S, Eid R, Raphael Kourie H, Planchard D. Acquired resistance mechanisms to osimertinib: The constant battle. Cancer Treat Rev 2023; 116:102557. [PMID: 37060646 DOI: 10.1016/j.ctrv.2023.102557] [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: 02/05/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 04/17/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. Detectable driver mutations have now changed the course of lung cancer treatment with the emergence of targeted therapy as a novel strategy that widely improved lung cancer prognosis, especially in metastatic patients. Osimertinib (AZD9291) is an irreversible third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used to treat stage IV EGFR-mutated non-small-cell lung cancer. It was initially designed to target both EGFR-activating mutations and the EGFR T790M mutation as well, which is the most common resistance mechanism to first- and second-generation EGFR-TKIs. Following the FLAURA trial, osimertinib is now widely used in the first-line setting. However, resistance to osimertinib inevitably develops, with numerous mechanisms leading to its resistance, classified into two main categories: EGFR-dependent and EGFR-independent mechanisms. While EGFR-dependent mechanisms consist mainly of the C797S EGFR mutation, EGFR-independent mechanisms include bypass pathways, oncogenic fusions, and phenotypic transformation, among others. This review summarizes the molecular resistance mechanisms to osimertinib, with the aim of identifying novel therapeutic approaches to overcome osimertinib resistance and improve patient outcome.
Collapse
Affiliation(s)
- Ziad Zalaquett
- Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Maria Catherine Rita Hachem
- Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Yara Kassis
- Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Samir Hachem
- Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roland Eid
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - David Planchard
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
3
|
Eid R, Zamparini E, Ouchrif Y, Snanoudj R, Ottolenghi C, Zaidan M. Une cause peu commune d’acidose métabolique à trou anionique plasmatique élevé. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.324] [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: 10/14/2022]
|
4
|
Eid R, Assayag M, Lefevre E, Escaut L, Laifi M, Brodinsartorius A, Zaidan M, Snanoudj R. Invasive bacillary angiomatosis in a kidney transplant recipient: A challenging case on belatacept immunosuppression. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.030] [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: 10/14/2022]
|
5
|
Diakonikolaou S, Styliou T, Christou V, Eid O, Eid R, Karataraki F, Abdelrahman R, Moutiris J. Diabetes mellitus in coronary artery disease. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.178] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Morbidity and mortality are increased in patients with myocardial infarction that also have co-existing diabetes mellitus (DM) making it an important risk factor for coronary artery disease (CAD). Overall, diabetes mellitus worsens the prognosis in CAD patients.
Purpose
This paper was done from a study, that enabled us to measure the prevalence of diabetes mellitus in patients with coronary artery disease, in relevance to other CAD risk factors (age, gender, systolic blood pressure, LDL-C and smoking). These results would give us the ability to compare it with the outcomes of the EUROSPIRE IV study published in 2015 (1).
Methods
Retrospective observational study of consecutive patients from the Registry of Cyprus Heart Survey, examined in the Cardiology Clinic of Nicosia General Hospital, between the years 2011-14. The total number of patients was 371 (11.5% females and 88.4% males). These patients had a history of myocardial infarction and underwent either a PCI or a CABG.
Results
From the total amount of patients, 36.9% had history of diabetes mellitus. The percentage adjusted to gender shows that 44% of females and 35.6% of males included in the study had diabetes. The mean age of people that had diabetes and coronary artery disease was 68.65 (CI: 67.18, 70.12). The prevalence of diabetics with hypertension and coronary artery disease was 75.91% while the average systolic blood pressure (SBP) was 138 mmHg (CI: 135.33, 140.67). The systolic blood pressure was ≥140 mmHg in half of the diabetic individuals. Smoking was also assessed as a risk factor in patients with diabetes and CAD. The prevalence of ex-smokers was 28.46%, of smokers 18.24% and of non-smokers 53.28%. Finally, values of low density lipoprotein cholesterol (LDL-C) were measured in 90.5% of diabetic patients, 88.7% of them had an LDL-C ≥1.8 mmol/L (≥70mg/dL) and 53.22% had an LDL-C ≥2.5 mmol/L (≥100mg/dL). The average LDL-C value was 109.19 mg/dL.
Conclusions
The outcome of the study revealed that a substantial number of patients with CAD suffer from diabetes. Therefore, diabetes was verified as a major risk factor in patients with CAD and the development of acute coronary syndrome. Regarding those patients, other risk factors proved to have a negative impact on their cardiovascular health. Moreover, the risk factors in patients with DM and CAD of this study were compared with the well known study, EUROASPIRE IV (1). The prevalence of diabetes in the present study was 36.9%, compared to 26.8% in EUROASPIRE IV, indicating a higher prevalence in our study. We concluded that marked reduction in the events of myocardial infarction can be seen if we reduce the prevalence of uncontrolled diabetes mellitus occurrences with medication or better control of the risk factors of CAD early in the diagnosis to reduce complications.
Collapse
Affiliation(s)
- S Diakonikolaou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - T Styliou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - V Christou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - O Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - F Karataraki
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Abdelrahman
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - J Moutiris
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| |
Collapse
|
6
|
Christou V, Karataraki F, Diakonikolaou S, Eid O, Eid R, Styliou T, Abdelrahman R, Moutiris J. Assessing the prevalence of hypertension in patients with chronic coronary artery disease in Cyprus. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.174] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Coronary Heart Disease (CHD) is the most common type of heart disease and a major cause of mortality worldwide, since according to CDC and WHO, it accounts for 18.2 million cases and 17.9 million deaths annually, respectively. Hypertension can precipitate the condition significantly, thus controlling it plays an important role in the secondary prevention of the disease.
Aim
The aim of this study is to highlight the significance of hypertension as a risk factor in patients with CAD, as well as, to compare its prevalence to those of the EUROASPIRE IV and the statistics published from the ESC Atlas of Cardiology in 2019.
Methods
A retrospective, observational study was created, from the Registry of Cyprus Heart Survey, where 375 individuals (88% Males, 66 years old on average) were examined in Nicosia General Hospital Cardiology Clinics with CAD, between the years 2011 and 2014. Their past medical history in regards to hypertension was noted and the data was analyzed by using Microsoft Excel software.
Results
The total prevalence of hypertension, based on the past medical history of the patients was 59% (females 61% and males 68%). Out of these, 44% still had abnormally elevated blood pressure on their visit to the Cardiology Clinic (females 36% and males 45%). Additionally, the EUROASPIRE IV study showed a prevalence of hypertension of 42.7% and ESC Atlas 24.8%, with median rates 22.3% for females and 27.0% for males. The total mean systolic blood pressure amongst all patients in our study was 136 mmHg, with no significant differences between males and females (136 mmHg and 137 mmHg respectively), while in ESC Atlas, the median SBP levels were noted to be 123.0mmHg in females and 130.0 in males.
Conclusion
Comparing the results from this group of consecutive patients from the Cyprus Heart Survey to the results of EUROASPIRE IV and ESC, it is made clear that all three studies point to the same conclusion. Firstly, it is important to acknowledge the difference between the two genders, with males recording a higher prevalence of hypertension. Moreover, despite the improvement observed in the management of hypertension that has been noted in our study, the secondary prevention guidelines are still not appropriately met. Managing appropriately hypertension, is of utmost importance in lowering the risk of recurrence of CAD in the context of secondary prevention measures.
Collapse
Affiliation(s)
- V Christou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - F Karataraki
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - S Diakonikolaou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - O Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - T Styliou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Abdelrahman
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - J Moutiris
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| |
Collapse
|
7
|
Eid O, Eid R, Styliou T, Diakonikolaou S, Christou V, Karataraki F, Abdelrahman R, Moutiris J. Prevalence and impact of high BMI in CAD patients. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.179] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
High body mass index (BMI) is a precursor to coronary artery disease (CAD) and an aggravator of the other co-existing CAD risk factors such as diabetes and hypertension. Lifestyle changes (e.g. balanced diet and exercise) in patients with high BMI are usually overlooked, although they contribute positively to prevention and improvement of CAD.
Purpose
The aim of this study is to calculate the prevalence of overweight and obesity in known CAD patients in both genders, in correlation with diabetes, hypertension, exercise and diet in CAD patients and to compare the findings to EUROASPIRE IV conducted in 2015 (1).
Methods
This study retrospectively included 362 patients (88% male; mean age 67 years) with a history of CAD (MI, PCI or CABG) from the registry of Cyprus heart survey in a hospital, in Nicosia from 2011 to 2014. Age, gender, date of myocardial infarction event, date of PCI or CABG surgery as well as CAD risk factors such as BMI, exercise, diet, hypertension and diabetes were noted on their visit to the cardiac clinic.
Results
Our study showed an overall similarity in BMI prevalence across both genders. The prevalence increased from 17.7% in patients with normal BMI (18.5-24.9) to the highest CAD prevalence of 49.2% which was seen in overweight (BMI = 25 –29.9) patients. However, there was a drop in the prevalence of obese (BMI = 30+) patients to 32.9%. This is supported by EUROASPIRE IV (1) which highlighted that CAD prevalence was higher in overweight patients (male = 83%; female = 80%) than obese patients (male = 36%; female = 44%) by nearly 2-fold. Furthermore, within the higher-than-normal BMIs, we recognized more non-diabetic CAD patients (115 overweight; 67 obese) in our study than diabetic CAD patients (62 overweight; 55 obese). On the contrary, hypertensive CAD patients (106 overweight; 80 obese) were more frequent than non-hypertensive CAD patients (71 overweight; 43 obese). Overweight patients split in nearly half when it came to exercise and diet (96 exercise, 82 do not; 90 diet, 88 do not). While in obese patients there was a higher proportion of patients not exercising or following a diet (47 exercise, 72 do not; 32 diet, 87 do not). According to EUROASPIRE IV (1), obesity contributed to higher prevalence of diabetes as patients did not lose weight.
Conclusion
Overweight and obese patients make up a large percentage of CAD patients. High BMI had a negative additive effect with hypertension but not with diabetes on the risk prevention in CAD patients which mismatches with the EUROASPIRE IV (1) findings. Despite BMI being a modifiable risk factor, not adhering to a diet or exercise was noticed in overweight and obese patients, which in return weakens their prevention of CAD.
Collapse
Affiliation(s)
- O Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Eid
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - T Styliou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - S Diakonikolaou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - V Christou
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - F Karataraki
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - R Abdelrahman
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| | - J Moutiris
- Paphos General Hospital, Department of Cardiology, Paphos, Cyprus
| |
Collapse
|
8
|
Haddad SF, Kerbage A, Eid R, Kourie HR. Awareness about the human papillomavirus (HPV) and HPV vaccine among medical students in Lebanon. J Med Virol 2021; 94:2796-2801. [PMID: 34877678 DOI: 10.1002/jmv.27509] [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] [Received: 07/28/2021] [Revised: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 11/08/2022]
Abstract
As a developing country, Lebanon lacks adequate awareness about Human papillomavirus (HPV) among its population, whether working in the medical field or not. Lebanon is traditionally considered conservative with a low incidence of sexually transmitted infections in general, but recently the incidence of HPV infections has significantly increased. The present cross-sectional study aims to evaluate the level of awareness on HPV and the attitude toward HPV vaccine among Lebanese medical students in a self-administered questionnaire-based survey. A total of 1009 answers were collected and analyzed from a population of about 3000 Lebanese medical students. Our study revealed a significant lack of knowledge and awareness on HPV among medical students in Lebanon, with a strikingly low vaccination rate (16.4%) due to many barriers. Education initiatives in medical schools remain crucial to raise awareness on HPV and promote HPV vaccination, especially among medical students, who represent the country's future healthcare providers and policymakers.
Collapse
Affiliation(s)
- Sara F Haddad
- Department of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Anthony Kerbage
- Department of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Division of Hematology and Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig R Kourie
- Division of Hematology and Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
9
|
Zouein J, Haddad FG, Eid R, Kourie HR. The combination of immune checkpoint inhibitors and chemotherapy in advanced non-small-cell lung cancer: the rational choice. Immunotherapy 2021; 14:155-167. [PMID: 34865502 DOI: 10.2217/imt-2021-0014] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Lung cancer is the second most common cancer worldwide and the leading cause of death among cancers. The progressive approvals of immunotherapy as first-line treatment options have helped improve cancer prognosis. However, longer follow-up has confirmed the possibility of acquired resistance to immune checkpoint inhibitors (ICIs) which can lead to late relapses. Chemotherapy can act as a priming therapy to increase a tumor's response to immunotherapy. We aim through this review to explain the mechanism behind ICI resistance and the value of chemotherapy in escaping this resistance. Finally, all US FDA approvals regarding the management of metastatic non-small-cell lung cancer using a combination of ICIs and chemotherapy are summarized.
Collapse
Affiliation(s)
- Joseph Zouein
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Damas Street, P.O Box 17-5208, 1104 2020, Lebanon
| | - Fady G Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Damas Street, P.O Box 17-5208, 1104 2020, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Damas Street, P.O Box 17-5208, 1104 2020, Lebanon
| | - Hampig R Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Damas Street, P.O Box 17-5208, 1104 2020, Lebanon
| |
Collapse
|
10
|
Eid R, Mounzer C, Mendoza M, Middleton J, Barnes B, McGowan E. A079 DETERMINANTS OF ESOPHAGEAL EOSINOPHILIA AND EOSINOPHILIC ESOPHAGITIS IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.418] [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: 11/16/2022]
|
11
|
Abstract
Metastatic colorectal cancer is the second most common cause of cancer death. Standard chemotherapy in combination with targeted therapies represent the backbone for the treatment of advanced disease. However, options are limited for patients progressing on these regimens. Genetic testing can offer patients the opportunity to benefit from novel therapies, namely immune checkpoint inhibitors in microsatellite instability-positive tumors. HER2 overexpression has recently emerged as a potentially targetable tumor marker in colorectal cancer (CRC). Despite the absence of approvals for anti-HER2 therapies in CRC, many agents such as trastuzumab and pertuzumab were tested and demonstrated significant antitumor activity, even in heavily pretreated patients. Early trials are also evaluating lapatinib, T-DM1, tucatinib and other anti-HER2 agents in patients with metastatic CRC, with promising results.
Collapse
Affiliation(s)
- Lynn Bitar
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Zouein
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig R Kourie
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
12
|
Haddad FG, Kourie HR, Gebara N, Matta C, Eid R, El Karak F, Nasr F, Chahine G, Ghosn M, Kattan J. Cancer Patients in the Era of Coronavirus: What to Fear Most? J Patient Saf 2021; 17:e35-e38. [PMID: 33394882 DOI: 10.1097/pts.0000000000000797] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to a worldwide medical crisis, affecting mostly immunocompromised patients, such as cancer patients. Various cancer societies have issued recommendations regarding patients care, but few studies addressed the perception of cancer patients regarding this pandemic. OBJECTIVE The aim of the study was to assess the perception of cancer patients regarding their health risks during this pandemic and the preventive measures taken. MATERIALS AND METHODS An anonymous survey was conducted among cancer patients presenting for their treatment, during 10 consecutive working days, at the one-day clinic of Hotel-Dieu de France University hospital in Beirut. We evaluated their state of disease, comorbidities, precautions taken, and their concerns regarding the virus spread. RESULTS A total of 216 patients responded with a mean age of 60 years. The majority had a good performance status (performance status = 0-1 in 79.6%), 51.4% had metastatic disease, and chemotherapy was the main therapy used (65.7%). A total of 52.3% of patients considered themselves to be at increased risk of contracting the virus. A total of 55.1% were more worried about the coronavirus rather than their disease. The priority was for the treatment of their cancer in 47.7% of the total patients studied. Of note, only 2.8% of planned one-day clinic reservations were canceled or postponed to avoid COVID-19 exposure. CONCLUSIONS Although cancer is a disease with a high mortality rate, many patients are more concerned about the actual pandemic rather than their disease. Nevertheless, the absenteeism from their treatment sessions during the COVID-19 atmosphere was minimal.
Collapse
Affiliation(s)
| | | | - Nicole Gebara
- Family Medicine, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | | - Roland Eid
- From the Departments of Hematology-Oncology
| | | | - Fadi Nasr
- From the Departments of Hematology-Oncology
| | | | | | | |
Collapse
|
13
|
Elkaddoum R, Gh Haddad F, Eid R, Kourie HR. In reply to: incorporating teleoncology practices in the undergraduate medical curriculum. Future Oncol 2020; 17:11-12. [PMID: 33244996 PMCID: PMC7720648 DOI: 10.2217/fon-2020-0985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ronaldo Elkaddoum
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Fady Gh Haddad
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Roland Eid
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| |
Collapse
|
14
|
Eid R, McGowan E, Al-Hazaymeh A, Sauer B. M007 A CASE OF ESOPHAGEAL EOSINOPHILIA (EE) ASSOCIATED WITH IPILUMUMAB/NIVOLUMAB TREATMENT FOR METASTATIC MELANOMA. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.179] [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: 10/23/2022]
|
15
|
Kourie HR, Eid R, Haddad FG. Agnostic biomarkers in gastrointestinal tumors: microsatellite instability and NTRK. Per Med 2020; 18:5-7. [PMID: 33124525 DOI: 10.2217/pme-2020-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Hampig Raphael Kourie
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
16
|
Eid R, Kourie H, Khaddage A, Moubarak M, Atallah D. Characteristics of ovarian tumors in Lebanon: Twenty years of experience in a Lebanese tertiary center. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.181] [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: 10/23/2022]
|
17
|
Eid R, Kourie H, Khaddage A, Moubarak M, Atallah D. Ovarian metastases from breast cancer: Series over a 20-year period at a Lebanese tertiary care center. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.232] [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: 10/23/2022]
|
18
|
Ghayad T, Mekhael M, Gebara N, Eid R, Kourié HR, Haddad F, Nemr E. [Lebanese physicians' attitude towards prostate cancer screening]. Bull Cancer 2020; 107:1199-1201. [PMID: 32977939 DOI: 10.1016/j.bulcan.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/29/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Toni Ghayad
- Université Saint-Joseph de Beyrouth, faculté de médecine, Beyrouth, Liban
| | - Mario Mekhael
- Université Saint-Joseph de Beyrouth, faculté de médecine, Beyrouth, Liban
| | - Nicole Gebara
- Université Saint-Joseph de Beyrouth, faculté de médecine, département de médecine de famille, Beyrouth, Liban.
| | - Roland Eid
- Université Saint-Joseph de Beyrouth, département d'hématologie et d'oncologie médicale, faculté de médecine, Beyrouth, Liban
| | - Hampig Raphael Kourié
- Université Saint-Joseph de Beyrouth, département d'hématologie et d'oncologie médicale, faculté de médecine, Beyrouth, Liban
| | - Fady Haddad
- Université Saint-Joseph de Beyrouth, département de médecine interne, Beyrouth, Liban
| | - Elie Nemr
- Université Saint-Joseph de Beyrouth, faculté de médecine, département d'urologie, Beyrouth, Liban
| |
Collapse
|
19
|
Affiliation(s)
- Hampig Raphael Kourie
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Roland Eid
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Fady Gh Haddad
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Michel Scheuer
- Ethical Committee of Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| | - Roland Tomb
- Department of Dermatology, Faculty of Medicine, Saint Joseph University of Beirut, Riad El Solh, 11-5076, Lebanon
| |
Collapse
|
20
|
Haddad FG, Abboche E, Mohanna R, Khoury SE, Eid R, Lahoud MJ, Karak FE, Kourie HR. The Opinion of Oncologists on the Practice of Hypnosis among Cancer Patients in Lebanon. Complement Ther Med 2020; 53:102534. [DOI: 10.1016/j.ctim.2020.102534] [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] [Received: 05/15/2020] [Revised: 06/21/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022] Open
|
21
|
Kerbage F, Ducreux M, Eid R, Boige V, Malka D, Gelli M, Perret A, Smolenschi C, Prieux C, Verlingue L, Martin-Romano P, Massard C, Hollebecque A. 1563P Early clinical trials in patients with pancreatic cancer: Assessment of factors limiting eligibility and effectiveness. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2046] [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: 10/23/2022] Open
|
22
|
Eid R, Hage S, Antonios I, Moussa R, Khoury M, Haddad FG, Kourie HR, Kesrouani C, Ghorra C, Abadjian G, Kattan J. Epidemiologic and histologic characteristics of CNS lesions: a 20-year experience of a tertiary center in Lebanon. CNS Oncol 2020; 9:CNS55. [PMID: 32603607 PMCID: PMC7341156 DOI: 10.2217/cns-2020-0001] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Report the epidemiologic and histologic characteristics of CNS lesions in the Lebanese population. Methods: We conducted a retrospective study evaluating 2025 CNS lesions diagnosed between 1998 and 2017 in the pathology laboratory of a Lebanese tertiary center. Results: 52.2% of patients were men with a median age of 50 years. The most frequent symptoms were epilepsy (22.5%), headache (20.6%) and motor impairment (19.9%). 90.7% of tumors were primary. Lung (35.6%) and breast (16.5%) were the most frequent primaries of metastases. 46.2% of primary CNS tumors were glial, predominantly astrocytic (56.4%), and (42.5%) were nonglial, predominantly meningeal tumors (58%). Conclusion: Compared with Western literature, the Lebanese population is characterized by a younger age of onset of brain tumors, a lower rate of meningiomas and a higher rate of gliomas.
Collapse
Affiliation(s)
- Roland Eid
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Stephanie Hage
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ingrid Antonios
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Rita Moussa
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Makram Khoury
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Ghassan Haddad
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Carole Kesrouani
- Department of Pathology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Claude Ghorra
- Department of Pathology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Gerard Abadjian
- Department of Pathology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
23
|
Elkaddoum R, Haddad FG, Eid R, Kourie HR. Telemedicine for cancer patients during COVID-19 pandemic: between threats and opportunities. Future Oncol 2020; 16:1225-1227. [PMID: 32356460 PMCID: PMC7202358 DOI: 10.2217/fon-2020-0324] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 01/13/2023] Open
Affiliation(s)
- Ronaldo Elkaddoum
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Gh Haddad
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roland Eid
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| |
Collapse
|
24
|
Affiliation(s)
- Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Dolla Karam Sarkis
- Microbiology Department, Faculty of Pharmacy, Saint Joseph University of Beirut
| |
Collapse
|
25
|
Ghosn M, Eid R, Hamada E, Abdel Azim H, Zekri J, Al-Mansour M, Jaloudi M, Nasr F, Errihani H, Bounedjar A, Mezlini A, Boussen H, Kattan J, El Karak F, Farhat F. OSSMAR: An Observational Study to Describe the Use of Sunitinib in Real-Life Practice for the Treatment of Metastatic Renal Cell Carcinoma. J Glob Oncol 2020; 5:1-10. [PMID: 31657977 PMCID: PMC6825247 DOI: 10.1200/jgo.18.00238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Sunitinib offers improved efficacy for patients with metastatic renal cell carcinoma (mRCC). To provide better disease management in the Middle East, we studied its use in mRCC in real-life practice in this region. MATERIAL AND METHODS Patients diagnosed with mRCC and started on sunitinib between 2006 and 2016 from 10 centers in Africa and the Middle East region were studied in this regional, multicenter, observational, retrospective trial to obtain routine clinical practice data on the usage patterns and outcomes of sunitinib in mRCC in real-life practice. RESULTS A total of 289 patients were enrolled. Median age at diagnosis was 58.7 years. The patient characteristics were as follows: 73.6% of patients were males; 85.8% had clear-cell renal cell carcinoma (RCC); 97.5% had unilateral RCC; 66.3% had metastatic disease at initial diagnosis; 56.3% received previous treatment for RCC, among which 98.7% had undergone surgery; and 15.2% and 31.4% were classified in the favorable and poor-risk groups (expanded Memorial Sloan Kettering Cancer Center criteria), respectively. On treatment initiation, the mean total sunitinib dose was 48.1 mg, and 87.6% of patients were started on a sunitinib dose of 50 mg. The mean duration of sunitinib treatment was 9.6 months. Overall response rate was 20.8%, with a median duration of 8.2 months. Median time to progression was 5.7 months. Median follow-up time was 7.8 months. By months 12 and 24, 34.3% and 11.4% of patients, respectively, were still alive. Seventy-six patients (60.9%) experienced 314 adverse events. Twenty-three patients (8.0%) experienced 28 serious adverse events. Overall, 83 patients (28.7%) discontinued their sunitinib treatment. CONCLUSION The results are indicative of the general treatment outcomes of patients with mRCC in the Middle East using sunitinib in routine clinical practice. Reported adverse events are similar to those described in the literature but at lower frequencies.
Collapse
Affiliation(s)
- Marwan Ghosn
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | | | | | - Jamal Zekri
- King Faisal Specialist Hospital and Research Centre and Al-Faisal University, Al-Ahsa, Saudi Arabia
| | - Mubarak Al-Mansour
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,Princess Noorah Oncology Center, Jeddah, Saudi Arabia
| | | | - Fadi Nasr
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | | | | | | | | | - Joseph Kattan
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | - Fadi El Karak
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | - Fadi Farhat
- Hotel Dieu de France University Hospital and Saint Joseph University, Beirut, Lebanon
| | | |
Collapse
|
26
|
Abstract
The evolution of precision medicine in the field of oncology has led to a radical change in the course of malignancies. PARP inhibitors are drugs that block the activity of the PARP enzyme responsible for base excision repair and have shown significant positive response when used for tumors lacking homologous recombination, namely high efficacy among BRCA-mutated tumors. Since 2014, when olaparib received an accelerated US FDA approval in ovarian cancer, we witnessed many other FDA approvals for olaparib, rucaparib, niraparib and talazoparib. Additionally, many Phase I, II and III trials were published presenting revolutionizing results. Other ongoing trials combined PARP inhibitors with checkpoint inhibitors. We aimed in this review to state the FDA approvals for PARP inhibitors in breast, ovarian, fallopian tube and primary peritoneal cancers, report the major published trials in high impact medical journals, and mention the ongoing trials combining these drugs with checkpoint inhibitors.
Collapse
Affiliation(s)
- Gaëlle Haddad
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marie Christelle Saadé
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
- Unité de Génétique Médicale, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
27
|
Costa J, Haddad FG, Costa G, Harb A, Eid R, Kourie HR, Helou JE. Seizures in cancer patients: a vast spectrum of etiologies. Future Neurology 2019. [DOI: 10.2217/fnl-2019-0015] [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: 11/21/2022]
Abstract
Aim: This study aims to recognize the distribution of different seizures etiologies in cancer patients, the most common primary tumors responsible for brain metastases, the most epileptogenic primary tumors and the therapeutic modalities. Methods: A retrospective study was conducted at Hotel-Dieu de France Hospital targeting patients admitted to hematology–oncology department between 2005 and 2016 who presented a seizure. Results: Of the 153 included patients, mean age was 57 years (standard deviation = 16 years) and a male predominance (66%). The majority of seizures were due to a primary tumor (49%) or brain metastases (32%). Other reversible (metabolic and drug) or nonreversible causes (carcinomatous meningitis, radiation and cardiovascular complications) formed the remaining causes. Regarding antiepileptic treatments, sodium valproate was mostly used, followed by levetiracetam and phenytoin. Conclusion: Numerous reversible causes are involved in the onset of epileptic seizures, including metabolic disorders, antibiotics and chemotherapies.
Collapse
Affiliation(s)
- Jad Costa
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Georges Costa
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ahmad Harb
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Jeanine El Helou
- Neurology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
28
|
Moujaess E, Haddad FG, Eid R, Kourie HR. The emerging use of immune checkpoint blockade in the adjuvant setting for solid tumors: a review. Immunotherapy 2019; 11:1409-1422. [PMID: 31621445 DOI: 10.2217/imt-2019-0087] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The use of immune checkpoint inhibitors has been approved in the advanced and metastatic setting for many types of solid tumors. Nonetheless, their role in the adjuvant setting is limited to the treatment of surgically resected melanoma. Ipilimumab was the first immune checkpoint inhibitor approved for this indication, followed by nivolumab and pembrolizumab. Many ongoing trials are evaluating these molecules in the postoperative setting, alone or in combination with other therapies. Preliminary results are promising regarding the treatment of other cutaneous tumors, lung cancers, head and neck squamous cell carcinomas, bladder cancer and renal cell carcinomas. Some data assessing their use for the adjuvant treatment of esophageal, colorectal, ovarian cancer and other solid tumors are similarly emerging.
Collapse
Affiliation(s)
- Elissar Moujaess
- Hematology and Oncology department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology and Oncology department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology and Oncology department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology and Oncology department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
29
|
El Karak F, Gh Haddad F, Eid R, Al Ghor M, El Rassy E, Ahmadieh N, Choullamy T, Halim NA, Tfayli A, Farhat F, Kattan J, Nasr F, Ghosn M, Assi HI. Lung cancer and immunotherapy: a real-life experience from second line and beyond. Future Oncol 2019; 15:3025-3032. [DOI: 10.2217/fon-2019-0144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: This study assessed the efficacy of anti-PD-1/PD-L1 agents in real life when used in second line or beyond. Materials & methods: Patients with advanced non-small-cell lung cancer progressing after standard chemotherapy and receiving immunotherapy in the second line or beyond were included. Results: One hundred and ten patients were included with PD-L1 expression above 50%, between 1–49 and <1% in 38.6, 27.3 and 34.1% of patients, respectively. Checkpoint inhibitors were used as second, third and fourth line in 74.7, 21.8 and 3.5%, respectively. Partial response was observed in 25.6% of patients. Median progression-free survival was 4 months and median overall survival was 8.1 months. Conclusion: Immunotherapies are emerging as important tools in the oncologic field with good responses in real-life practice.
Collapse
Affiliation(s)
- Fady El Karak
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Maya Al Ghor
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Elie El Rassy
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nizar Ahmadieh
- Department of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Theresia Choullamy
- Department of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nour A Halim
- Department of Internal Medicine, Hematology & Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Arafat Tfayli
- Department of Internal Medicine, Hematology & Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Farhat
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Nasr
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology–Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hazem I Assi
- Department of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
30
|
Ali R, Hammad A, El-Nahrery E, Hamdy N, Elhawary AK, Eid R. Serum RANKL, osteoprotegerin (OPG) and RANKL/OPG ratio in children with systemic lupus erythematosus. Lupus 2019; 28:1233-1242. [DOI: 10.1177/0961203319867129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Systemic lupus erythematosus (SLE) patients have lower bone mineral density (BMD) compared with healthy individuals because of general, genetic, disease and medication-related factors. The disturbance of the receptor activator of nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG) ratio has been reported to be associated with low BMD in many disorders in adults and children alike. Objectives The objectives of this study were (i) to assess serum OPG, RANKL and RANKL/OPG ratio levels in SLE children and controls, (ii) to determine whether the cumulative glucocorticoid (CGCS) dose had any effect on the concentration of serum RANKL, OPG and RANKL/OPG ratio, and (iii) to determine the relation of these parameters to BMD. Methods We evaluated 50 SLE children and 50 age- and sex-matched healthy controls. RANKL and OPG were assessed in serum and compared between patients and controls. For SLE patients, a univariate followed by multivariable analysis were carried out to detect the possible predictors of the changes in RANKL, OPG and RANKL/OPG ratio levels. Lumbar BMD for all patients was assessed by dual-energy X-ray absorptiometry (DXA) scan and then correlated to different probable correlated factors. Results RANKL, OPG and RANKL/OPG ratio were significantly higher in SLE patients ( p ≤ 0.001). Univariate analysis showed significant correlations of RANKL with CGCS ( p ≤ 0.001) and with DXA scan z-score ( p = 0.007): OPG was significantly correlated to Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score ( p = 0.001) and anti-double-stranded DNA ( p = 0.001), whereas RANKL/OPG was significantly correlated to duration of illness and DXA z-score ( p = 0.002). The multivariable analysis showed that DXA z-score was an independent predictor of RANKL and RANKL/OPG ratio ( p = 0.019 and 0.008, respectively), whereas SLEDAI score was an independent predictor of OPG levels. BMD was negatively correlated to disease duration ( p = 0.008) and CGCS dose ( p = 0.015), but no significant correlation has been found between BMD and cumulative SLEDAI score ( p = 0.29). Conclusions Serum RANKL/OPG ratio is elevated in Egyptian children with SLE and is considered a risk factor for reduced bone mass in these children. Other risk factors for low BMD include high CGCS dose and disease duration, supporting that osteoporosis in SLE is multifactorial.
Collapse
Affiliation(s)
- R Ali
- Clinical Laboratory Sciences Department, Faculty of Applied Medical Sciences, Taibah University, AL-Madinah Al-Mounawara, Saudi Arabia
- Genetics Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - A Hammad
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - E El-Nahrery
- Biochemistry, Chemistry Department, Faculty of Science, Suez University, Suez, Egypt
| | - N Hamdy
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - A K Elhawary
- Pediatric Endocrinology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - R Eid
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| |
Collapse
|
31
|
Mehanna J, Haddad FG, Eid R, Lambertini M, Kourie HR. Triple-negative breast cancer: current perspective on the evolving therapeutic landscape. Int J Womens Health 2019; 11:431-437. [PMID: 31447592 PMCID: PMC6682754 DOI: 10.2147/ijwh.s178349] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [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: 03/30/2019] [Accepted: 07/09/2019] [Indexed: 12/19/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is known to have a poor prognosis and limited treatment options, namely chemotherapy. Different molecular studies have recently classified TNBC into different subtypes opening the door to potential new-targeted treatment options. In this review, we discuss the current standard of care in the treatment of TNBC in the neoadjuvant, adjuvant and metastatic settings. In addition, we summarize the ongoing phase III clinical trials evaluating different associations between the 3 pillars of anticancer treatment: chemotherapy, targeted therapy and immunotherapy.
Collapse
Affiliation(s)
- Joe Mehanna
- Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Gh Haddad
- Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roland Eid
- Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Matteo Lambertini
- Department of Medical Oncology, U.O.C. Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Hampig Raphael Kourie
- Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| |
Collapse
|
32
|
Nasr F, Al Ghoche A, Eid R, Nasr L, Diab S, Hallit S, Riachi M. Negativation of PD-L1 Postoperatively in Initially Inoperable Stage III Non-Small Cell Lung Cancer Treated with Pembrolizumab: Two Case Reports. Case Rep Oncol 2019; 12:421-425. [PMID: 31244645 PMCID: PMC6587214 DOI: 10.1159/000500671] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/19/2022] Open
Abstract
Stage III non-small cell lung cancer is a border line stage between localized and metastatic disease. PDL-1 is gaining an important role in the therapeutic arsenal of lung cancer, the most frequent cancer worldwide. We report for the first time a negativation of PDL-1 status in 2 cases of stage IIIA NSCLC with conversion to operable disease after using immunotherapy. The first patient was a 59-year old female diagnosed incidentally to have stage IIIA inoperable NSCLC that was treated with combination chemo-immunotherapy, and converted to operable disease with a negative PD-L1 in the postoperative setting. The second case is that of a 56-year old male that also had an inoperable stage IIIA NSCLC treated with chemotherapy first line followed by pembrolizumab at progression, then operated after surgical conversion, with negative PD-L1 postoperatively. In front of these findings, further work should be done to elucidate if the reverse of the PDL-1 status and the conversion to operability were due to the use of immunotherapy or to an incidental finding. If confirmed, it may have a therapeutic impact.
Collapse
Affiliation(s)
- Fadi Nasr
- Hematology-Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon.,Hematology-Oncology Department, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Ahmad Al Ghoche
- Hematology-Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Lewis Nasr
- Hematology-Oncology Department, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Saada Diab
- Hematology-Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Moussa Riachi
- Pulmonary Department, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
33
|
Hajjar AH, Eid R, Haddad FG, Kourie HR. FOLFIRINOX: a new standard of care in the adjuvant setting of resectable pancreatic adenocarcinomas. Future Oncol 2019; 15:1947-1950. [DOI: 10.2217/fon-2019-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Abdel Hadi Hajjar
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology & Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
34
|
Elkaddoum R, Eid R, Haddad F, Germanos M, Mehawej C, Kourie HR, Kattan JG. The results of 3000 Fit: A prospective study led at Saint Joseph University of Beirut. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e15141] [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
e15141 Background: In terms of frequency, colorectal cancer (CRC) is the 3rd cancer in Lebanon with 1093 incidences registered in 2015. To this date not a single screening campaign has been organized in the country. Fecal immunochemical test (FIT) is an advised screening technique. We found it useful to organize a screening campaign using FIT to determine the prevalence of CRC in a population of 3000 healthy Lebanese allowing the extraction of useful data. Methods: 3000 tubes were distributed to Lebanese adults (45-80 years old) at average risk of developing CRC, followed by explanations. FIT analysis was done at the medical genetics unit (UGM) of Saint-Joseph University and patients with positive FIT were asked to undergo further investigations. Results: Out of the 3000 distributed tests, 705 were returned (23.5%) with 459 fully analyzable. The age median was 56 (45-80). Sex ratio F/M 2.3. Out of the 459 patients, 278 (60.5%) showed 0ng/ml, 137 (29.8%) showed 1-79ng/ml, 3 (0.6%) showed 80-99ng/ml (intermediate risk values), 33 (7.1%) showed 100-800ng/ml considered as a positive value and finally 8 (1.7%) showed over range values. Among the 44 positive patients we contacted 41. Out of the 8 (18%) colonoscopies results received: 5 showed hemorrhoids leading to false positive, 1 ulcerative ileitis, 1 tubular adenomas and 1 carcinoma. Conclusions: While it was hard for us to quantify people for whom a free FIT was proposed, the low restitution rate among those who took the test shows the necessity of national screening and sensitization campaigns.
Collapse
Affiliation(s)
| | - Roland Eid
- Saint Joseph University, Beirut, Lebanon
| | - Fady Haddad
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Myrna Germanos
- Hematology Laboratory, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Cybel Mehawej
- Medical Genetics Unit, Faculty of medicine, Saint Joseph University, Beirut, Lebanon, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon, Beirut, Lebanon
| | | |
Collapse
|
35
|
Al Ajami J, Jalkh N, Moubarak G, Eid R, Haddad F, Kattan JG, Ghosn M, Atallah DM, Chouery Khoury E, Kourie HR. Results of NGS panel of hereditary breast and ovarian cancer in Lebanese women. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13045] [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
e13045 Background: Hereditary breast (BC) and ovarian cancer (OC) genetic alterations are considered the most prevalent among familial cancer. To date, four studies have exposed the mutations related to hereditary BC predisposition in the Lebanese population , with percentage of BRCA-related pathogenic mutations ranging between 5 % and 15 %. Methods: Between 2017 and 2019, 117 patients with high risk hereditary breast and ovarian cancer were referred to undergo the testing at the Unité de Génétique médicale (UGM) of Saint-Joseph University of Beirut, Lebanon. The sequencing was accomplished by using the 21-panel Next-Generation Sequencing (NGS) method for all of our patients, to which we also added the MLPA technique followed by the Sanger sequencing for validation whenever a genetic alteration was found. Results: From 117 Lebanese women with high-risk hereditary breast and ovarian cancer predisposition, 19 pathogenic mutations were identified in this study: 11 BRCA1, 1 BRCA2, 2 PALB2, 1 ATM, 1 CDH1, 1 MSH6, 1 RAD51C, and 1 BRIP1. Among those, 13 patients had BC, one had OC and five were healthy individuals. Five similar mutations were found within the BRCA1 gene, the p.C44F mutation, accounting for 45.4 %, thus suggesting a founder effect. Average age at diagnosis in the BC patients carrying a mutation was 41 years and 38.5% had a triple negative BC. Conclusions: The overall pathogenic mutation rate was equal to 16.2% while the BRCA deleterious mutation rate was 10.3% lower to those reported in the literature. The p.C44F mutation appeared five times suggesting a founder effect. [Table: see text]
Collapse
Affiliation(s)
| | | | | | - Roland Eid
- Saint Joseph University, Beirut, Lebanon
| | - Fady Haddad
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | | - Marwan Ghosn
- Hotel-Dieu de France University Hospital, Beirut, Lebanon
| | | | | | | |
Collapse
|
36
|
Eid R, Hage S, Antonios I, Moussa R, Khoury M, Haddad F, Kourie HR, Kesrouani C, Ghorra C, Abadjian G, Kattan JG. Epidemiologic and histologic characteristics of central nervous system lesions: A 20-year experience of a single institution in Lebanon. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13544] [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
e13544 Background: Lesions of the central nervous system (CNS) are a heterogeneous group of tumoral and non-tumoral lesions, benign or malignant, primary or metastatic. The overall incidence rate of all brain tumors is estimated to be 10.82 per 100 000 person-years. There is no data in Lebanon characterizing the CNS lesions. The aim of our study is to report the epidemiologic and histologic characteristics of these lesions in a Lebanese tertiary center. Methods: This is a retrospective study evaluating the characteristics of the CNS lesions diagnosed in 20 years (from January 1998 to June 2017) in the pathology laboratory of Hôtel Dieu de France, Saint Joseph University hospital of Beirut, Lebanon. The data were extracted from the computerized records of the laboratory. Different variables were evaluated, from the samples types and epidemiologic characteristics, to the revealing symptoms and the histologic subtypes. Statistical analysis was performed using SPSS 24.0. Results: 2025 tumoral lesions over 20 years were interpreted. 25.4% of the samples were obtained by biopsy, 65% by surgical resection, 3.7% were cerebral spinal fluid and 5.9% were undetermined. 52.2% of the patients were men and 47.8% were women with a median age of 50 years, from 0 to 89 years. The most frequent revealing symptoms were epilepsy (22.5%), headache (20.6%) and motor impairment (19.9%). 90.7% of the CNS tumors were primary and 9.3% were metastatic. Lung (35.6%) and breast (16.5 %) were the two most frequent primaries of the metastatic lesions. 46.2% of primary CNS tumors were glial, 42.5% non-glial, 3.5% mixed neuroglial and 6.4% mesenchymal. The two most frequent glial tumors were astrocytic (56.4%) and oligodendroglial (17.9%) tumors, while the most frequent non-glial tumors were meningeal tumors (58%) and cranial nerve and paraspinal tumors (16.3%). Conclusions: The histological and epidemiological characteristics of brain tumors in Lebanon are consistent in many features with what is known in the literature, but the Lebanese population differs by a younger age of onset, a lower rate of meningiomas, and a higher rate of gliomas.
Collapse
Affiliation(s)
- Roland Eid
- Saint Joseph University, Beirut, Lebanon
| | | | | | - Rita Moussa
- Universite Saint-Joseph de Beyrouth, Beirut, Lebanon
| | - Makram Khoury
- Universite Saint-Joseph de Beyrouth, Beirut, Lebanon
| | - Fady Haddad
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | | | | - Claude Ghorra
- Universite Saint-Joseph de Beyrouth, Beirut, Lebanon
| | | | | |
Collapse
|
37
|
Abstract
Testicular germ cell tumors are chemosensitive with very high cure-rates even in the metastatic setting. However, patients with platinum-refractory and relapsing tumors after autologous stem cell transplant have very poor outcomes despite salvage treatments, and with no effective alternative therapies. Immunotherapy, notably with PD-1 inhibitors, has proven to be very effective in treating various solid tumors. This review summarizes the experience with anti-PD-1 agents (pembrolizumab, nivolumab) in the treatment of testicular germ cell tumor relapsing after multiple lines of treatment, and exposes future trials evaluating newer checkpoint inhibitors in this setting.
Collapse
Affiliation(s)
- Albert Semaan
- Urology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Elie Nemr
- Urology Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| |
Collapse
|
38
|
Mehanna J, Haddad FGH, Eid R, Lambertini M, Kourié HR. What is the role of HER2-specific antibody immunity in patients with HER2-positive early breast cancer receiving chemotherapy plus trastuzumab? Transl Cancer Res 2018. [DOI: 10.21037/tcr.2018.09.07] [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: 11/06/2022]
|
39
|
Souaid T, Hindy JR, Eid R, Kourie HR, Kattan J. Bladder cancer knowledge in the Lebanese population: When ignorance could be harmful. Bull Cancer 2018; 105:857-861. [DOI: 10.1016/j.bulcan.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/26/2018] [Accepted: 08/02/2018] [Indexed: 01/03/2023]
|
40
|
Affiliation(s)
- Fady Gh Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Elie Barouky
- General Surgery Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
41
|
Kourie HR, Bakouny Z, Haddad FG, Eid R, Kattan J. Adjuvant tyrosine kinase inhibitors for renal cell carcinoma? No, thank you (at least for the present) reply. Future Oncol 2018; 14:2225-2227. [PMID: 30064260 DOI: 10.2217/fon-2018-0436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Hampig R Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Ziad Bakouny
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
42
|
Kourie HR, Bakouny Z, Eid R, Haddad FG, Kattan J. The merit of tyrosine kinase inhibitors in the adjuvant setting of high-risk renal cell carcinoma: a meta-analysis. Future Oncol 2018; 14:829-835. [PMID: 29589470 DOI: 10.2217/fon-2017-0333] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM As no meta-analyses have evaluated tyrosine kinase inhibitors in the adjuvant setting of high-risk renal cell carcinoma (RCC), the aim was to evaluate the benefit of sunitinib and pazopanib in the adjuvant setting. METHODS This meta-analysis included all Phase III randomized controlled trials evaluating adjuvant sunitinib and pazopanib in high-risk RCC. Primary outcome was the comparison of disease-free survival (DFS) between tyrosine kinase inhibitors and placebo. RESULTS There was a tendency for significant overall effect of both sunitinib and pazopanib on DFS (hazard ratio: 0.85; 95% confidence interval: 0.72-1.01; p = 0.06). There was no significant difference between the effect of sunitinib and pazopanib on DFS (p = 0.51; I2 = 0%). CONCLUSION Pazopanib and sunitinib could prolong DFS in the adjuvant treatment of high-risk RCC and seem equally effective in this setting.
Collapse
Affiliation(s)
- Hampig Raphael Kourie
- Laboratory of Medical Genetics, Faculty of Medicine, Campus of Innovation & Sport, University of Saint-Joseph, Damascus street, PO Box 17-5208 Mar Mikhael, Beirut, Lebanon
| | - Ziad Bakouny
- Laboratory of Medical Genetics, Faculty of Medicine, Campus of Innovation & Sport, University of Saint-Joseph, Damascus street, PO Box 17-5208 Mar Mikhael, Beirut, Lebanon
| | - Roland Eid
- Laboratory of Medical Genetics, Faculty of Medicine, Campus of Innovation & Sport, University of Saint-Joseph, Damascus street, PO Box 17-5208 Mar Mikhael, Beirut, Lebanon
| | - Fady Gh Haddad
- Laboratory of Medical Genetics, Faculty of Medicine, Campus of Innovation & Sport, University of Saint-Joseph, Damascus street, PO Box 17-5208 Mar Mikhael, Beirut, Lebanon
| | - Joseph Kattan
- Laboratory of Medical Genetics, Faculty of Medicine, Campus of Innovation & Sport, University of Saint-Joseph, Damascus street, PO Box 17-5208 Mar Mikhael, Beirut, Lebanon.,Hematology-Oncology Department, Hotel-Dieu de France Hospital, University of Saint-Joseph, Beirut, Lebanon
| |
Collapse
|
43
|
Affiliation(s)
- Roland Eid
- Faculty of Medicine, Hematology-Oncology Department, Saint-Joseph University, Beirut, Lebanon
| | - Elie Nemr
- Faculty of Medicine, Urology Department, Saint-Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Faculty of Medicine, Hematology-Oncology Department, Saint-Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Faculty of Medicine, Hematology-Oncology Department, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Faculty of Medicine, Hematology-Oncology Department, Saint-Joseph University, Beirut, Lebanon
| |
Collapse
|
44
|
Kourie HR, Eid R, Kesserouany C, Abadjian G, Kattan J. [Introduction to multidisciplinarity in neuro-oncology in Lebanon: First Annual Day of Neuro-Oncology]. Bull Cancer 2018; 105:327-328. [PMID: 29455871 DOI: 10.1016/j.bulcan.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/17/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Hampig Raphaël Kourie
- Université Saint-Joseph de Beyrouth, faculté de médecine, unité de génétique médicale, Liban; Université Saint-Joseph de Beyrouth, faculté de médecine, département d'hématologie-oncologie, Liban.
| | - Roland Eid
- Université Saint-Joseph de Beyrouth, faculté de médecine, département d'hématologie-oncologie, Liban
| | - Carole Kesserouany
- Université Saint-Joseph de Beyrouth, faculté de médecine, unité de génétique médicale, Liban; Université Saint-Joseph de Beyrouth, faculté de Médecine, département de pathologie, Liban
| | - Gérard Abadjian
- Université Saint-Joseph de Beyrouth, faculté de Médecine, département de pathologie, Liban
| | - Joseph Kattan
- Université Saint-Joseph de Beyrouth, faculté de médecine, département d'hématologie-oncologie, Liban
| |
Collapse
|
45
|
Saleh K, Eid R, Haddad FGH, Khalife-Saleh N, Kourie HR. New developments in the management of head and neck cancer - impact of pembrolizumab. Ther Clin Risk Manag 2018; 14:295-303. [PMID: 29497306 PMCID: PMC5822846 DOI: 10.2147/tcrm.s125059] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC), a heterogeneous group of upper aerodigestive tract malignancies, is the seventh most common cancer worldwide. Tobacco use and alcohol consumption were the most identified risk factors of HNSCC. However, human papilloma virus, a sexually transmitted infection, has been determined as another primary cause of HNSCC. Early-stage disease is treated with surgery or radiotherapy. Recurrent or metastatic HNSCC is associated with poor prognosis with a median overall survival of 10 months. The EXTREME protocol is commonly used in first-line setting. Recently, pembrolizumab, an anti-programmed death-1 agent, has been approved by the US Food and Drug Administration for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck with disease progression on or after a platinum-based therapy. It demonstrated a durable objective response rate with a good safety profile and quality of life. Many ongoing trials are evaluating the use of pembrolizumab for the treatment of HNSCC in various indications such as adjuvant and neoadjuvant setting, maintenance and recurrent disease, alone or in combination with chemotherapy, radiation and targeted therapy. Finding those biomarkers predictive of response to immune checkpoints inhibitors has been a major concern. However, markers have been identified, such as PD-L1 expression, human papilloma virus infection, interferon-γ signature score, microsatellite instability and neoantigen production.
Collapse
Affiliation(s)
- Khalil Saleh
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady GH Haddad
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nadine Khalife-Saleh
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | |
Collapse
|
46
|
Hobeika C, Rached G, Eid R, Haddad F, Chucri S, Kourie HR, Kattan J. ALK-rearranged adenocarcinoma transformed to small-cell lung cancer: a new entity with specific prognosis and treatment? Per Med 2018; 15:111-115. [PMID: 29714122 DOI: 10.2217/pme-2017-0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Driving molecular mutations such as rearrangement of ALK and EGFR mutation is present in 5-10% of non-small-cell lung cancer. Tyrosine kinase inhibitors have shown good efficacy and thus become the standard of care. However, tumors have developed several resistance mechanisms against tyrosine kinase inhibitors, including transformation to small-cell lung carcinoma (SCLC). Transformation to SCLC after administration of anti-EGFR in EGFR-mutated adenocarcinoma has been well documented. Similarly, it appears that the same transformation happens in ALK-rearranged adenocarcinoma after the use of anti-ALK. In fact, to date eight cases have been reported in the literature. We aimed in this paper to focus on the characteristics, prognosis and treatment of these transformed SCLC.
Collapse
Affiliation(s)
- Charbel Hobeika
- Genetic Medical Unit, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Gaëlle Rached
- Genetic Medical Unit, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Roland Eid
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Haddad
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Salim Chucri
- Division of Pulmonary Diseases, Geneva University Hospitals, Switzerland
| | - Hampig R Kourie
- Genetic Medical Unit, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.,Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
47
|
Affiliation(s)
- Roland Eid
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Fady Gh Haddad
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
48
|
Abstract
Background Increased expression of interferon-inducible genes is implicated in the pathogenesis of systemic lupus erythematosus (SLE). Interferon regulatory factor 5 (IRF5) is one of the transcription factors regulating interferon and was proved to be implicated in the pathogenesis of SLE in different populations. Objectives The objective of this study was to investigate the correlation between polymorphisms of the IRF5 gene and SLE susceptibility in a cohort of Egyptian children and to investigate their association with clinico-pathological features, especially lupus nephritis. Subjects and methods Typing of interferon regulatory factor 5 rs10954213, rs2004640 and rs2280714 polymorphisms were done using polymerase chain reaction-restriction fragment length polymorphism for 100 children with SLE and 100 matched healthy controls. Results Children with SLE had more frequent T allele and TT genotype of rs2004640 ( Pc = 0.003 and 0.024, respectively) compared to controls. Patients with nephritis had more frequent T allele of rs2004640 compared to controls ( Pc = 0.003). However the allele and genotype frequencies of the three studied polymorphisms did not show any difference in patients with nephritis in comparison to those without nephritis. Haplotype GTA of rs10954213, rs2004640 and rs2280714, respectively, was more frequent in lupus patients in comparison to controls ( p = 0.01) while the haplotype GGG was more frequent in controls than lupus patients ( p = 0.011). Conclusion The rs2004640 T allele and TT genotype and GTA haplotype of rs rs10954213, rs2004640, and rs2280714, respectively, can be considered as risk factors for the development of SLE. The presence of the rs2004640 T allele increases the risk of nephritis development in Egyptian children with SLE.
Collapse
Affiliation(s)
- A Hammad
- Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Egypt
| | - Y M Mossad
- Clinical Immunology Unit, Clinical Pathology Department & Mansoura Research Centre for Cord Stem Cells (MARC_CSC), Mansoura University, Egypt
| | - N Nasef
- Department of Pediatrics, Faculty of Medicine, Mansoura University, Egypt
| | - R Eid
- Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Egypt
| |
Collapse
|
49
|
Assi T, El Rassy E, Abi-Tayeh G, Sader-Ghorra C, Abadjian G, Eid R, Moussa T, Farhat F, Kattan J. Chemotherapy-induced differentiation to cure botryoid rhabdomyosarcoma: a case report and review of the literature. EUR J GYNAECOL ONCOL 2017; 38:323-325. [PMID: 29953806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rhabdomyosarcoma (RMS) occurs rarely in adults and constitutes 2-6% of all uterine neoplasms. The authors report the case of a 26-year-old woman diagnosed with botryoid RMS that presented discordant progression results on follow up imaging and cytodifferentiation on pathologic control. This case showed that radiological evaluation could be misleading as the tumor demonstrated chemotherapy-induced differentiation without volume reduction. This case illustrates the limitations of using the imaging anatomical dimensions of sarcomas for treatment planning and highlights the potential role of functional imaging to assess the response to treatment.
Collapse
|
50
|
Lutfallah AA, Kourie HR, Eid R, Farhat F, Ghosn M, Kattan J. Watch and Wait in Lebanese Chronic Lymphocytic Leukemia Patients: How Relevant is it? Asian Pac J Cancer Prev 2016; 17:215-7. [PMID: 26838212 DOI: 10.7314/apjcp.2016.17.1.215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) is the most frequent form of leukemia in Europe and North America, and it mainly affects older individuals. Many approaches are implemented in the management of CLL from a watch and wait (WandW) strategy to chemotherapeutic regimens. We here reviewed our clinical practice for the relevance of the W and W strategy in Lebanese CLL patients. MATERIALS AND METHODS A total of 95 patients with CLL diagnosed in four institutions in Lebanon, between 1992 and 2013, were selected and their files were reviewed. Characteristics of these patients were noted including age, sex, RAI and Binet scores, CBC values, presence of hepatomegaly or splenomegaly, performance of bone marrow biopsy or peripheral blood flux cytometry for diagnosis, adoption of W and W strategy, different chemotherapeutic regimens and the indications for treatment. RESULTS Some 38 patients (40%) diagnosed with CLL were women and 57 (60%) were men with a mean age of 65.1 years [36-89]. Of the total, 50.5%, 17.2%, 14%, 7.5% and 10.8% had an RAI score at diagnosis of 0, 1, 2, 3 and 4, respectively, while 65.6%, 17.2% and 17.2% had Binet scores of I, II and III. The mean lymphocyte count at diagnosis was 39885/mm3 [1596-290000], the mean hemoglobin level was 12.7 g/dl [6.2-17] and the mean platelet count was 191255/mm3 [14000-458000]. While 26.3% of patients with CLL had splenomegaly, only 7.4% had hepatomegaly. Some 33.7% had undergone a bone marrow biopsy, 66.3% flow cytometry of circulating blood and 5.3% a lymph node biopsy. Overall, the W and W was adopted in 62.4% (58) of patients with a mean duration of 37.7 months [3-216]. The W and W was used in 82.6%, 73.3%, 46.2%, 14.3% and 0% of patients having RAI scores of 0, 1, 2, 3 and 4, respectively, and, it was used in 80%, 46.7% and 6.25% with Binet scores of I, II and III. The most frequent indication for treatment was anemia and thrombocytopenia, accounting for 32.7% of cases. The most frequently used chemotherapeutical regimens were chlorambucil until the end of the last century and flufarabine-cyclophosphamide-rituximab during the last decade. CONCLUSIONS This retrospective review of CLL clinical practice showed an important implementation of the W and W strategy with a long duration, especially in early stage cases with low RAI or Binet scores.
Collapse
Affiliation(s)
- Antoine Abi Lutfallah
- Hematology-Oncology Department, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon E-mail :
| | | | | | | | | | | |
Collapse
|