Forum of Clinical Oncology最新文献

{"title":"Metabolomics in oncology – A fascinating travel into the mechanisms of metabolic disturbances during carcinogenesis","authors":"E. Karamitrousis, M. Liontos, N. Tsoukalas","doi":"10.2478/fco-2021-0017","DOIUrl":"https://doi.org/10.2478/fco-2021-0017","url":null,"abstract":"cancerous transformation, among them cellular metabolism. Intrinsic and extrinsic factors, such as environmental and genetic factors, play a key role in the metabolic pathway alterations of cancer cells and contribute to the oncogenic processes altering the cellular phenotype and molecular physiology (1, 2). Metabolomics is the large-scale study of small molecules, known as metabolites. Collectively, these small molecules and their interactions within a biological system are known as the metabolome. Metabolomics are currently used in biomarker identification for the diagnosis and prognosis of cancer and can play a crucial role in the evaluation of therapeutic interventions (3, 4). The most prominent alteration in cancer cell metabolism is the phenomenon called “Warburg effect” or aerobic glycolysis. Cancer cells uptake glucose that in the presence of oxygen is not used through the Krebs cycle, but is instead incompletely oxidized or fermented to lactate. Unlike other oncogenic pathways that can be completely abrogated by using small molecular inhibitors or antibodies, this is not applicable to fundamental metabolic pathways. The latter would have immediate detrimental effects to the whole organism. Targeting through the level of enzymatic activity of nodal enzymes in metabolic pathways could provide therapeutic opportunities. Metabolomics can help us to identify the exact processes which a cancer cell can use a biological molecule (such as glucose) in order to produce energy or all the other essential biological molecules (such as nucleotides, lipids, and amino acids) (6)(7). Metabolomics could have several applications in oncology. Metabolomics can be used for the development of sensitive biomarkers to help in early diagnosis of several tumors. For example, the metabolic profile in urine samples could be used for the early and precise diagnosis of renal carcinoma, which is a tumor that is often diagnosed at advanced stages (8). In ovarian cancer, metabolomics can be used in order to detect the metabolic profile of serum proteins, which is different from the metabolic profile in healthy postmenopausal women (9). Also, prostate cancer cells carry alterations in their metabolites, such as increased amounts of phosphatidylcholine and decreased amounts of branched amino acids (10). Metabolomics can also assist to develop new therapeutic interventions for several tumors. A decade ago it was shown that mutations in the isocitrate dehydrogenase 1 enzyme (IDH1) lead to the intracellular accumulation of the metabolite 2-hydroxyglutarate (2HG) (11). 2HG contributes to the malignant transformation of glial cells. Currently, IDH1/2 inhibitors – namely ivosidenib and enasidenib – have been approved for patients with relapsed or refractory acute myeloid leukemia. Cervical cancer is another area that the use of metabolomics could have therapeutic implications. Through this Forum of Clinical Oncology","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":" ","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49309522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving role of PARP inhibitors in advanced ovarian cancer","authors":"S. Levva, A. Skolariki, E. Sogka, A. Bokas, Avraam Assi, Marianna K. Pispirigou, P. Koliou","doi":"10.2478/fco-2021-0002","DOIUrl":"https://doi.org/10.2478/fco-2021-0002","url":null,"abstract":"Abstract The field of ovarian cancer has been revolutionized with the use of poly (ADP-ribose) polymerase (PARP) inhibitors, which present greater inhibition effect in epithelial subtype due to high rates of homologous recombination deficiency. PARP inhibition exploits this cancer pitfall by disrupting DNA repair, leading to genomic instability and apoptosis. Three PARP inhibitors (olaparib, niraparib, and rucaparib) are now approved for use in women with epithelial ovarian cancer, while others are under development. Among women with BRCA1/2 mutations, maintenance PARP therapy has led to a nearly fourfold prolongation of PFS, while those without BRCA1/2 mutations experience an approximately twofold increase in PFS. Differences in trial design, patient selection and primary analysis population affect the conclusions on PARP inhibitors. Limited OS data have been published and there is also limited experience regarding long-term safety. With regard to toxicity profile, there are no differences in serious adverse events between the experimental and control groups. However, combining adverse event data from maintenance phases, a trend towards more events in the experimental group, compared with controls, has been shown. The mechanisms of PARP-inhibitor resistance include restoration of HR through reversion mutations in HR genes, leading to resumed HR function. Other mechanisms that sustain sufficient DNA repair are discussed as well. PARP inhibitors play a pivotal role in the management of ovarian cancer, affecting the future treatment choices. Defining exactly which patients will benefit from them is a challenge and the need for HRD testing to define ‘BRCA-ness’ will add additional costs to treatment.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"82 - 104"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44156267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance Between ER, PR, HER2 neu Receptors Before and After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer","authors":"Heba F. Taha, O. Elfarargy, R. Salem, Doaa Mandour, A. Salem, Mohamed Riad","doi":"10.2478/fco-2019-0021","DOIUrl":"https://doi.org/10.2478/fco-2019-0021","url":null,"abstract":"Abstract Background Introducing neoadjuvant chemotherapy (NCT) in a breast cancer patient may be associated with changes in estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth hormone receptor 2 (HER2) status. Patients and methods In our prospective cohort study, we evaluated the impact of change in estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth hormone receptor 2 (HER2) on the prognosis of breast cancer patients treated with neoadjuvant chemotherapy (NCT). We investigated 110 patients with locally advanced breast cancer for ER, PR and HER2 status of their lesions before and after NCT. Results For hormone receptor status (HR) (which include ER, PR) of the residual tumor of the patients after receiving NCT, 12 (10.9%) of them changed from HR (+) to HR (−) and 15 (13.6%) changed from HR (−) to HR (+). For HER2 status after NCT, 8 (7.3%) patients changed from HER2 (+) to HER2 (−) and 9 (8.2%) patients changed from HER2 (−) to HER2 (+). Triple negative (TN) tumor phenotype changes occurred in 17 (15.5%) patients. Patients for whom the HR status changed from positive to negative had poor prognosis for both disease-free survival (DFS) and overall survival (OS) in univariate survival analysis. Conclusions Changes in ER, PR, HER2 status and tumor phenotype in breast cancer patients after NCT had a negative prognostic impact and were associated with a poor prognosis.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"3 - 11"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45103638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of cytokines in breast cancer: Correlation with positive hormonal status and obesity","authors":"N. Ibrahim, S. Talima, David F. Kaldas, Hebatallah A. Kassem, N. Kassem","doi":"10.2478/fco-2021-0001","DOIUrl":"https://doi.org/10.2478/fco-2021-0001","url":null,"abstract":"Abstract Background The relation of interleukin 6 (IL6) and molecular subtypes as well as body mass index is not well settled. Little is known about interferon gamma (IFγ) and prognosis of breast cancer. Patients and methods Serum level of IL6 and IFγ was assessed by enzyme-linked immunosorbent assay (ELISA) and correlated with the TNM staging, molecular subtypes, and body mass index. Results Among 78 patients, the median age was 54 years. The majority of the cases were T2 (62.8%), N1 (38.5%), and M0 (89.74%) with stage II being the most common (47.4%). Most females were estrogen receptor (97.9%) and progesterone receptor positive (96.9%) with high Ki67 ≥ 20 (61.5%). Her2 neu positive presented 16.7%. Luminal A and luminal B presented 29.5% and 53.8%, respectively. Obese patients presented by far the majority (82.1%). The median level of IL6 and IFγ was 56.20 ± 28.715 and 76.37 ± 41.54, respectively. IL6 was significantly correlated with tumor size (P = 0.001), nodal involvement (P = >0.0001), the presence of metastasis (P = 0.008), and the stage (P = >0.0001). High level of IL6 was associated with positive estrogen receptor, Her2 neu positive, luminal A, and being obese (P = 0.09, 0.07, 0.06, and 0.05, respectively). High IFγ was only associated with lower nodal burden being significantly higher in N1 than in N3 (118.15 ± 31.07 vs 76.37 ± 44.46, P = 0.01) and early stage (P = 0.02). Conclusions IL6 level was correlated to the initial staging, hormonal status, being Her2 positive, and obesity. The IFγ level was inversely correlated IL6 regarding the nodal status (P = 0.05).","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"67 - 73"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42445501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic malignancy in the backdrop of chronic pancreatitis: How much to push the boundaries to achieve R0 resection","authors":"Kunal Joshi, Sisir Bodepudi, S. Ganapathi, C. Murugesan, J. Balu, S. Subramanian","doi":"10.2478/fco-2019-0011","DOIUrl":"https://doi.org/10.2478/fco-2019-0011","url":null,"abstract":"Abstract Tumors of the body and tail of the pancreas are often more aggressive than tumors of the head and would have often undergone metastatic spread to other organs at the time of diagnosis. Most patients with carcinoma of the body and tail of the pancreas present at a late stage. Surgery is only indicated in those patients in whom there is no evidence of metastatic spread. Surgery is often not possible in cancers of the body and tail of the pancreas if the tumor invades celiac artery. Controversy exists regarding the margin status impact of microscopic resection margin involvement (R1) after pancreaticoduodenectomy (PD) for PDAC. There are reports indicating the rate of R1 resections increases significantly after PD if pathological examination is standardized. In this report, we present the case of a 56-year-old female who had undergone lateral pancreaticojejunostomy for chronic pancreatitis 8 years ago, but has now developed malignancy of the body and tail of the pancreas involving multiple organs. This patient underwent en bloc resection involving: 1. distal pancreatectomy with jejunal loop (lateral pancreaticojejunostomy) resection; 2. splenectomy; 3. left nephrectomy; 4. total gastrectomy; and 5. segmental colectomy with reconstruction by esophagojejunostomy, jejunojejunostomy, and colocolic anastomosis. The infrequent occurrence of tumor in the distal gland and advanced tumor stage at the time of diagnosis have both combined to produce therapeutic nihilism/dilemma in the minds of many surgeons. This report highlights the decision on how much to the push limits for multi-organ resection (en bloc resection with distal pancreatectomy, gastrectomy, splenectomy, colectomy, nephrectomy) with the intent of achieving R0 status in spite of the complexity of surgery in selected patients.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"47 - 51"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47752848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Triple Negative Breast Cancer: The New Era of Thinking","authors":"Amrallah A. Mohammed, Mohamed A Elbassuiony, Hanaa Rashied","doi":"10.2478/fco-2018-0007","DOIUrl":"https://doi.org/10.2478/fco-2018-0007","url":null,"abstract":"Abstract The heterogeneity of triple negative breast cancer (TNBC) is reflected in a bizarre response to therapy. Although it is chemotherapy sensitive, the failure is the usual pathway either in local or distance status. With progression in Gene Expression Profile (GEP) and other molecular techniques, TNBC is divided into sub-types with unique pathways. In the current review, we are trying to highlight based on the molecular classification of TNBC and the management based on every type.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"31 - 38"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44233691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive role of breast cancer on dyslipidemia and hypertension metabolic risk according to treatment exposure and menopausal status","authors":"Safaa A. Al-Zeidaneen, M. N. Ahmad, A. Al-Ebous, Rawan MohD Al Saudi","doi":"10.2478/fco-2019-0018","DOIUrl":"https://doi.org/10.2478/fco-2019-0018","url":null,"abstract":"Abstract Background Breast cancer (BC) is the principal cause of cancer related deaths among women worldwide. The available evidence suggests that cardio-metabolic risk factors such as dyslipidemia and hypertension may contribute differently to breast cancer severity and pathogenesis. The aim of this study is to evaluate the interactive role of BC on dyslipidemia and HTN risk according to the type of treatment exposure and menopausal status. Patients and methods Observational experimental design implemented; permit to include 134 newly-diagnosed patients who were naïve to any type of treatment interventions and 262 recently-diagnosed patients during their first three months of treatments’ exposure including chemotherapy treatments. Patients with breast cancer were evaluated for dyslipidemia and hypertension biomarkers. Results About 5.0% of breast cancer patients had dyslipidemia. The prevalence of increased triglycerides and total cholesterol were more frequent (p < 0.05) in recently-diagnosed group than in newly-diagnosed patients. While 23% of patients had overt hypertension, with higher (p < 0.05) prevalence in chemo group (28%), triglycerides was higher (p < 0.05) in postmenopausal than premenopausal BC patients (221.0 ± 5.9 vs. 195 ± 4.7 mg/dl). Similarly, the prevalence of abnormal systolic blood pressure (9% vs. 5%) and diastolic blood pressure (11% vs. 7%) was higher (p < 0.05) in postmenopausal patients. Conclusions Dyslipidemia and hypertension biomarkers were prevalent among breast cancer patients and the risk increased in postmenopausal women and after treatments’ exposure specially chemotherapy. This conclusion requires a closer attention by healthcare professionals in order to improve the outcomes after diagnosis and to enhance treatment exposure regarding postmenopausal women.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"12 1","pages":"39 - 46"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45181735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5th Hellenic Congress of Oncology","authors":"","doi":"10.2478/fco-2019-0035","DOIUrl":"https://doi.org/10.2478/fco-2019-0035","url":null,"abstract":"","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47944757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted therapy in advanced desmoid tumors: Current perspectives","authors":"Amrallah A. Mohammed, Hani El-Tanni, H. M. El-Khatib","doi":"10.2478/fco-2019-0023","DOIUrl":"https://doi.org/10.2478/fco-2019-0023","url":null,"abstract":"Abstract Background Desmoid tumors/aggressive fibromatosis (DTs/AF) are cytological bland fibrous neoplasms originating from the musculoaponeurotic structures throughout the body. The exact cause still remains unknown, however, they may present sporadically or as a manifestation of a hereditary syndrome called familial adenomatous polyposis (FAP). Although they lack the capacity to establish metastases, DTs/AF may be devastated and occasionally fatal. As a result of the heterogeneity of DTs/AF, treatment needs to be individualized to improve local tumor control and maintain patients’ quality of life. Therefore, after a multidisciplinary approach, all treatment options should be discussed with patients. Where systemic chemotherapy has been shown to be unsuccessful with marked side effects in case of advanced DTs/AF, new therapeutic options are needed. Methods A Medline search was conducted and published articles in different studies from 2000 to the present were reviewed. Conclusion More research is needed to illustrate both the prognostic and predictive factors of the targeted therapy and the value of their combinations with or without other treatment modalities to get the best result for the treatment of advanced DTs/AF.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"11 1","pages":"9 - 16"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46544314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acinar cell carcinoma in childhood: A case report of a very rare tumor","authors":"A. Pourtsidis, S. Papachristidou, O. Achilleos, D. Mirza, M. Servitzoglou, D. Doganis, K. Kapetaniou, M. Nikita, E. Magkou, Nikolaos Ptochis, Anastasia Papazoglou, Antonia Moutafi, Georgios Pantalos, A. Michail, M. Baka","doi":"10.2478/fco-2019-0017","DOIUrl":"https://doi.org/10.2478/fco-2019-0017","url":null,"abstract":"Abstract Introduction Pancreatic tumors are reported rarely in childhood and represent an extremely rare entity in Pediatric Oncology. One of the least common types of pediatric pancreatic tumor is acinar cell carcinoma (ACC). We aim to present a rare case of ACC and the difficulties we faced during diagnosis and treatment. Patient and Methods An 8-year old girl presented with jaundice. Workup revealed a tumor originating from the head of the pancreas with multiple metastatic lesions in her liver. Evaluation of tumor markers revealed elevated levels of AFP. Pathology report was indicative of acinar cell carcinoma of the pancreas. Results After consulting the EXPeRT group (European Cooperative Study Group for Pediatric Rare Tumors), chemotherapy was initiated. Partial response was observed after the first 4 courses with decrease of AFP levels. While planning her surgery, AFP elevated and a second-line course of chemotherapy was administered. Our patient underwent Whipple’s Duodenopancreatectomy with partial metastasectomy. Although the postoperative period was uneventful, AFP continued to rise even after postoperative chemotherapy was administered. There were signs of metastatic disease progression. Our patient received a third-line regimen with no improvement. She received local radiotherapy and a next-line chemotherapy course. Local relapse and metastatic disease progression placed our patient in palliative care. She passed away nine months after the initial diagnosis. Conclusions Acinar cell carcinoma of the pancreas is a rare type of pediatric cancer with very challenging diagnosis and treatment. Cooperation at the European level and multicenter management of those rare cases is vital for the optimum outcome.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"11 1","pages":"3 - 8"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43610497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}