Synergistic effect between doxorubicin and a low dose of all-trans-retinoic acid in MCF-7 breast cancer cell line

The effect of doxorubicin (DOX) used in combination with a low dose (10(-7) M) of all-trans-retinoic acid (tRA) was tested on MCF-7 breast carcinoma cell line. Both drugs are able to inhibit cell proliferation in these cells in a dose-dependent way. The combined treatment with DOX and tRA was more effective in inhibiting cell growth than each of the two compounds alone. This was evidenced in the following experimental conditions: pre-treatments with tRA, for 72 h or 18 h, before DOX incubation; post-treatment with tRA for 18 h after DOX incubation. A consistent synergism was reached by 72 h pre-treatment with tRA and also with brief pre- and post-treatments, but only if tRA was also present during DOX incubation (co-treatments). The mechanisms involved in this interaction between chemotherapeutics and differentiating agents are as yet unclear and should be evaluated further.

Multiparametric MR imaging of the prostate at 1.5-T without endorectal coil using an 8 channel pelvic phased array: Is it still a viable option?

INTRODUCTION

The purpose of our work was to evaluate the feasibility of prostate multiparametric MR imaging at 1.5-T without endorectal coil using an 8 channel pelvic phased array coil.

MATERIAL AND METHODS

A total of 154 patients who underwent mp-MRI were retrospectively included. Patients received a standardized mp-MRI, compliant with 2012 European Society of Uro-Radiology guidelines, with 1·5 T magnetic field strength and an 8 channel pelvic phased-array coil. Two blinded readers graded the image quality of mp-MRI on a three-point scale and they scored the prostate lesions according to PI-RADS v2. All PI-RADS of 4 or 5 underwent biopsy. A third radiologist and a pathologist verified the correspondence between the MRI images and the results of the biopsy.

RESULTS

64 (41.6%) patients showed a Pi-rads of 4 or 5. At biopsy, 79.7% showed a Gleason score ≥7, 12.5% showed a Gleason score of 6 and 7.8% showed a negative biopsy. In the group of Pi-rads ≤ 3, 12 patients underwent a biopsy with the following results: negative biopsy in 33.3%, atypical Small Acinar Proliferation in 16.7%, prostatic intraepithelial neoplasia in 25% and indolent PCa 25%. Mp-MRI in the identification of clinically significant cancer provided a low percentage of false positive (7.8%) while in 79.7% of cases it was capable to detect clinically significant prostate cancer. In 92.2% of patients mp-MRI identified a prostate cancer with a Gleason score ≥6. The inter-reader agreement was excellent in defining both the quality of the examination and the PI-RADS category (k = 0.83 and k = 0.70, respectively).

CONCLUSIONS

mp-MRI at 1.5-T without endorectal coil using an 8 channel phased array is an appropriate tool for early detection of clinically significant prostate cancer.

IMPLICATIONS FOR PRACTICE

8 channel pelvic phased array is still an appropriate tool for early detection of clinically significant prostate cancer and for obtaining a reduction in overdiagnosis of indolent PCa.

[Locally recurrent rectal cancer. Our experience]

The aim of this study was to describe the personal experience in the treatment of 31 patients (19 males, 12 females) with local recurrence following surgery for rectal adenocarcinoma. The exeresis of recurrence was possible in 17 patients (6 Miles, 9 Hartmann, 1 re-resection, 1 transanal resection); of these, only 6 patients reported an improvement of the quality of life. Patients surgically treated and patients with recurrence inoperable and submitted to palliative treatment (colostomy, pain control, radio- and/or chemotherapy) showed similar survival rates.

Associations of retinoids, tamoxifen and alpha-interferon 2a in human breast cancer

We evaluated in vitro the potentiating and/or synergistic antitumor effects among retinoids (all-trans-retinoic acid, tRA, and 13-cis-retinoic acid, 13cRA), alpha-interferon 2a (alpha-IFN 2a) and tamoxifen (TAM) on both estrogen receptor positive (ER(+)) and negative (ER(-)) human breast cancer cell lines. In our experimental model, the three studied agents showed antiproliferative activity in ER(+) cell lines MCF-7 and ZR-75.1, while alpha-IFN 2a was the most effective drug in the ER(-) cell line MDA-MB-231. Retinoids and TAM exerted a strong apoptotic effect in MCF-7 cells, while such an effect was obtained in MDA-MB-231 cells by alpha-IFN 2a. The tested combinations displayed different effects in the different evaluated cell lines: i) in MCF-7 cells tRA + TAM showed additive activity, both tRA + alpha-IFN 2a and TAM + alpha-IFN 2a association displayed a synergistic effect, and a further potentiation of the antiproliferative action was detected with the triple combination; ii) in ZR-75.1 cell line an additive activity was showed by tRA + TAM and TAM + alpha-IFN 2a, while tRA + alpha-IFN 2a produced synergistic action; iii) in MDA-MB-231 cell line only alpha-IFN 2a displayed a strong antiproliferative effect, and no significant potentiation was exerted by any drug association. The feasibility and activity of such combinations have been tested in two pilot clinical trials on patients with metastatic breast cancer: both the tested associations were tolerable, with good treatment compliance and low toxicity. The different antiproliferative and apoptotic effects observed in vitro on apparently similar breast cancer cell lines prompted us to a further investigation of the mutual biological modulations of these drug combinations, in view of a better selection of patients who might potentially benefit from these treatments.

Current Impact of Transrectal Ultrasonography in Prostate Cancer Diagnosis

Aims

We evaluate the diagnostic accuracy of transrectal prostate ultrasonography (TRUS) in prostate cancer (PCa) diagnosis in a group of patients who underwent prostate biopsy in 2008.

Material and Methods

100 patients (mean age 65 years) underwent transrectal prostate biopsy at our center. Indications to biopsy were: suspected malignancy at rectal examination or increase of total PSA and/or PSA velocity and/or PSA density and/or low percentage of free PSA. 10–12 biopsies and additional ones in case of suspected ecographic images in every patient were carried out. We classified the ecographic aspects as: highly suggestive for heteroplasia (focal or widespread hypoechoic area in the peripheral zone), weakly suggestive (small hypoechoic focal alterations), and isohecoic areas.

Results

At ultrasound examination, highly suggestive images were found in 20 patients, weakly suggestive images in 39 patients, and isoechoic images in 41 patients. PCa was diagnosed in 45 patients. 40% of cancers (18 pts) appeared as highly suggestive hypoechoic images, 31% (14 pts) as weakly suggestive, and 29% (13 pts) as isoechoic. 32% was the positive predictive value of isoechoic areas biopsies, 90% of highly suggestive hypoechoic images, and 36% of weakly suggestive images. In the last ones, the diagnosis was often coincidental, i.e. in the opposite lobe, or in a different sextant of the same lobe (serendipity). Detection rate was 60% for prostate volumes ≤50 cc and 24% for volumes >50 cc.

Discussion

The result analysis allowed us to formulate the following considerations: - 60% of currently diagnosed PCa are not detectable by ultrasonography, or there are aspecific ecographic findings - 40% of cancers are detectable by ultrasonography with specific ecographic findings - The clinical value of the hypoechoic focal alterations is similar to isoechoic ones - Detection rate is positively influenced by prostate volume.

Conclusions

The study of hypoechoic and isoechoic bioptised areas shows a significant difference in TRUS accuracy in prostate cancer diagnosis. In this set of patients, prostate volume and transrectal ultrasonographic findings proved to be the most informative variables about PCa risk at the moment of first biopsy at any age.