{"title":"ANK Therapeutic Prospects and Usefulness of PD-L1 and NK Activity as Biomarkers for Predicting Treatment Efficacy Revealed from the Treatment Course of Patients with HTLV-1-Associated Bronchioloalveolar Disease.","authors":"Kenjiro Nagai, Syo Nagai, Yuji Okubo, Keisuke Teshigawara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell neoplasm with poor prognosis that can present as HTLV-1-associated bronchioloalveolar disease (HABA). Chemotherapy is recommended for ATL; however, it is not very effective against all types of ATL. Furthermore, there are no effective treatments for smoldering HABA-associated ATL. We present a case in which amplified natural killer cell (ANK) therapy was effective in a woman in her early 80s who was previously diagnosed with ATL-related smoldering HABA and presented with dyspnea and productive cough on exertion. The symptoms were suppressed for approximately 10 months after the first treatment, but then gradually worsened. About a year later, a second treatment was followed by mild side effects. Suppression of ATL cell proliferation by repeated doses of ANK therapy appears to be effective in this patient. The therapeutic effect was high even with long treatment intervals, and the efficacy and safety of repeated treatments have been demonstrated. ANK therapy is expected to be the mainstay of treatment ATL and HABA. ANK therapy has been reported to kill PD-L1 positive tumor cells and some solid tumors with excellent responses have many PD-L1-positive tumor cells. ANK therapy is thought to be effective for ATL because there are many PD-L1-positive tumor cells. Furthermore, administration of activated NK cells may increase tumor-killing activity in those patients with reduced NK activity. While future studies are needed, PD-L1 positive rate and NK activity may be biomarkers for the effectiveness of ANK therapy.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"6 1","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578538/pdf/nihms-1835791.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10814129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Comandini Danila, Catalano Fabio, Romano Erika, Cremante Malvina, Laura Iaia Maria, Elena Rebuzzi Sara
{"title":"Psychological Distress and Suicide Correlated with Long-Life Expectancy in Advanced Cancer Patients","authors":"Comandini Danila, Catalano Fabio, Romano Erika, Cremante Malvina, Laura Iaia Maria, Elena Rebuzzi Sara","doi":"10.46619/cmj.2022.5.s5.1004","DOIUrl":"https://doi.org/10.46619/cmj.2022.5.s5.1004","url":null,"abstract":"OBJECTIVE Advances in systemic therapy together with better diagnostic and surgical techniques have contributing to survival improvement of many tumor types. Patients with cancer have an increased risk of suicide and the psychological impact of cancer is due the diagnosis itself, side effects of the therapy and cancer-related symptoms. METHOD The purpose of this study is to present the clinical case of an advanced gastrointestinal stromal tumor patient who committed suicide after 6 years of treatment. RESULT A 49-years-old male with a history positive only for an anxiety-depressive disorder was diagnosed with a locally advanced gastrointestinal stromal tumor. After 6 months of neoadjuvant imatinib, with stable disease, the patients decided to undergo surgery, with the subsequent resumption of adjuvant imatinib. Once the patient experienced disease progression, he preferred a surgical approach, even though he was aware that surgery was not the standard treatment and that a second-line systemic therapy was recommended. When the start of a second line therapy was the only possible treatment option, the patient has resigned himself to the idea that he would never be able to heal from cancer. After few months of second-line therapy he died of suicideSIGNIFICANCE OF RESULTS This case report shows that suicidality in cancer patients is a continuum spectrum from wanting to live, through the decreasing will to live, the readiness to die and then actively ending one’s life. Multidisciplinary teams should focus their attention not only on the disease itself but also on the cancer-related long-term psychological distress. Therefore, patient palliative care on psychological aspects should be improved strengthening psycho-social interventions during the entire cancer treatment history, not only at the end of life.","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81546956","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}
Hassan Aziz, Zubair Ahmed, Yi Lee, Gavin Drumm, Muhammad Wasif Saif
{"title":"A Comprehensive Review of Management of Colorectal Liver Mets in the Current Era.","authors":"Hassan Aziz, Zubair Ahmed, Yi Lee, Gavin Drumm, Muhammad Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Colorectal carcinoma is the third most common cancer in the US. The liver tends to be the most common site of metastasis. This review provides an in-depth analysis of non-transplant options available in the management of colorectal liver mets.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"5 1","pages":"46-57"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849579/pdf/nihms-1765757.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39795803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Synchronous Duodenal and Jejunal Gastrointestinal Stromal Tumors","authors":"A. Petroianu, K. Sabino, Michelle A. Couto","doi":"10.46619/cmj.2022.5-1060","DOIUrl":"https://doi.org/10.46619/cmj.2022.5-1060","url":null,"abstract":"BACKGROUND Gastrointestinal stromal tumor (GIST) constitutes up to 1% of all malignant neoplasms of the gastrointestinal tract, with the stomach and small intestine being the most frequently affected organs. The purpose of this report is to present the first published case of synchronous duodenal and jejunal GISTs. CASE REPORT A 57-years old male patient with type II diabetes complained of asthenia and vertigo, resulting from anemia. On upper digestive endoscopy, a friable lesion was found in the second portion of the duodenum. The biopsy diagnosed GIST and its removal was indicated. During the surgical procedure, a second tumor was found in the jejunum, which was also removed. Anatomopathological examination of this second lesion also revealed GIST with the same cytological features. Digestive reconstruction was performed in Roux-en-Y of the jejunum sectioned distally to the tumor with the open part of the duodenum. The patient evolved without complications, was discharged on the third postoperative day and has been followed up for eleven years without any other treatment and without neoplastic recurrence. Food transit occurs almost exclusively through the duodenum. CONCLUSION This is the first report of two synchronous GISTs of duodenum and jejunum. After removal of both tumors, the Roux-en-Y reconstruction adequately closed the opened duodenum, but food transit persisted physiological through the duodenum.","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88803127","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}
Jeffrey Chi, Su Yun Chung, Shreya Prasad, M Wasif Saif
{"title":"The Role of Olaparib in Metastatic Pancreatic Cancer.","authors":"Jeffrey Chi, Su Yun Chung, Shreya Prasad, M Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 3","pages":"89-91"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208637/pdf/nihms-1707594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39251209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Song, Alexander Yu, Diana Munoz, Song Han, Manjunath Nimmakayalu, Peter C Hu, Jianli Dong
{"title":"Impact of Using Median vs. Mean in Calculating ERBB2 FISH Results in Breast Cancer.","authors":"Jie Song, Alexander Yu, Diana Munoz, Song Han, Manjunath Nimmakayalu, Peter C Hu, Jianli Dong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Erb-b2 receptor tyrosine kinase 2 (ERBB2) testing is used to measure the status of ERBB2 gene expression and DNA amplification. Test results have been reported with a discrepancy as high as 20%. The purpose of this study was to improve ERBB2 fluorescence in situ hybridization (FISH) sensitivity by evaluating results generated by median as well as mean calculations.</p><p><strong>Methods: </strong>We retrospectively identified breast cancer cases at our institution in which ERBB2 FISH testing was performed in-house from June 2018 to May 2020. FISH results were classified using the 2018 American Society of Clinical Oncology/College of American Pathologists guidelines: groups 1 and 5 are FISH positive and negative, respectively, and groups 2-4 are equivocal requiring additional work-up. FISH counting sheets were collected and regrouped by median ERBB2 copy number counts and median ERBB2/CEP17 ratio and compared with the mean ERBB2 and mean ERBB2/CEP17 ratio. Intra-tumor genetic heterogeneity and CEP17 copy number gain (CEP17 ≥3) were assessed to see if they affect the discrepancy between median and mean groups.</p><p><strong>Results: </strong>Seventy-two breast cancer cases were collected and evaluated. Eleven cases (11 of 72 [15%]) had discrepant grouping by mean and median calculations. A significant number of discrepancies were found for CEP17 copy number gain (p = 0.027) but not for ERBB2 (p = 0.411), the ERBB2/CEP17 ratio (p = 0.445), FISH results (p = 0.194), or genetic heterogeneity (p = 0.465). Among the four cases regrouped to median group 1, 2 were from mean group 3 and underwent anti-ERBB2 targeted therapy and 2 were from mean groups 4 and 5 may have benefitted from targeted therapy with more than 30% amplified cells. The median may be better to reflect the monosomy subclone within tumor tissues for the case 387 moved from mean group 5 to median group 2. The 6 cases moved from mean group 5 to median group 4 with CEP17 copy number gain may have had a poor prognosis based on other study result.</p><p><strong>Conclusion: </strong>Including the median calculation may increase ERBB2 sensitivity and identification of CEP17 copy number gain. Further clinical studies are necessary to examine the outcome of including median in calculating ERBB2/CEP17 values.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 3","pages":"87-96"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171267/pdf/nihms-1695277.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39067631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Duilio Divisi, Andrea De Vico, Gino Zaccagna, Azzurra Irelli, Federica Aielli, Katia Cannita, Francesco Martella
{"title":"NSCLC Immunotherapy and Related Rare Toxicities: A Monocentric Real-Life Experience.","authors":"Duilio Divisi, Andrea De Vico, Gino Zaccagna, Azzurra Irelli, Federica Aielli, Katia Cannita, Francesco Martella","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In the last years immunotherapy has revolutionized the treatment of non-small cell lung cancer (NSCLC) not supported by a driver mutation. Immunotherapy related adverse events (irAEs) have a unique toxicity profiles distinct from the toxicities of classical chemotherapy treatment relating to their mechanism of action. We analyzed some serious and uncommon life-threatening irAEs, needing a change in the therapeutic strategy.</p><p><strong>Method: </strong>Between October 2018 and October 2020, 63 NSCLC patients underwent immunotherapy. Thirty-eight patients underwent first-line Pembrolizumab, 200 mg every 21 days (Group A). Twenty patients were treated in second line with Pembrolizumab 200 mg every 21 days or Nivolumab 240 mg every 14 days or Atezolizumab 800 mg every 14 days (Group B). Five stage III patients treated after radio chemotherapy with Durvalumab 1500 mg every 14 days (Group C).</p><p><strong>Results: </strong>We experienced: a) 2 bowel perforations (3.2%), necessitating Hartmann's resection. Only one of the two patients restored immunotherapy; b) 1 chronic renal insufficiency (1.6%, creatinine up to 8 mg/dL) and 2 severe hypertransaminasemias (3.2%, up to 65 U/L), requiring the immediate and definitive interruption of ICIs; c) 2 pericardial effusions (3.2%), of which one needed subxiphoid pericardiocentesis for cardiac tamponade. Patient restored immunotherapy after resolution of the acute event.</p><p><strong>Conclusions: </strong>Immunotherapy include monoclonal antibodies reducing the suppression of effector T cells and improving the tumor-specific immune responses. Most common irAEs are evident in mild and reversible form, but sometimes life-threatening irEAs show up. Therefore, further clinical trials needed to increase knowledge of drugs and prevent unexpected irAEs.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 3","pages":"115-119"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570570/pdf/nihms-1748692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Wasif Saif, Shrikar Rajagopal, Jennifer Caplain, Martin D Goodman, Daniel Popowich, Bruce A Orkin, Philip N Tsichlis, Robert Martell
{"title":"The First Study Evaluating the Safety of Pre-Surgery Administration of Metformin in Patients with Colorectal and other Gastrointestinal Cancers and Effect on Cancer Stem Cells.","authors":"Muhammad Wasif Saif, Shrikar Rajagopal, Jennifer Caplain, Martin D Goodman, Daniel Popowich, Bruce A Orkin, Philip N Tsichlis, Robert Martell","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The cancer stem cell (CSC) hypothesis of tumor genesis suggests that unlike most cancer cells within tumor CSC resist chemotherapy and can regenerate various cell types in tumor thereby causing relapse. Hence drugs that selectively target CSC may offer great promise for cancer therapy especially when combined with chemotherapy. Current treatment options for colorectal cancer (CRC) and other gastrointestinal (GI) tumors rely on combination of surgical resection, cytotoxic and targeted drugs. Recent findings showed that metformin, an ant diabetic drug was associated with a significantly lower risk of CRC (0.63 [0.47 - 0.84]; <i>P</i> = 0.002) in patients with type 2 diabetes. We therefore hypothesize that administration of metformin will reduce CSC.</p><p><strong>Methods: </strong>Patients with CRC and other GI cancers undergoing resection were enrolled. Metformin was administered at 500 mg orally twice daily for up to 14 days and terminated 24 hours, prior to planned surgery. Both tumor and normal tissue was procured. Adverse events (AEs) were graded according to NCI CTCAE Version 3.0. Primary objective was to establish the safety of administering metformin prior to resection. Secondary objective was to evaluate the effects of metformin on the expression of CSC markers by measuring relative mRNA levels of CD133, OCT4 and NANOG by RT-PCR and immunohistochemistry.</p><p><strong>Results: </strong>A total of 10 patients (4 Male; 6 Female) received metformin. Grade 3 AEs included anemia, hypoalbuminemia, alanine aminotransferase elevation, abdominal pain and nausea but none of these were related to metformin. No hypoglycemia and lactic acidosis were observed. No unexpected post-operative complications were witnessed. Comparison of markers of CCSC results showed that expression of CD133, OCT4 and NANOG expression were decreased following metformin.</p><p><strong>Conclusions: </strong>Our pilot study showed feasibility of metformin before surgery in GI cancers and indicated impact on CSC. This preliminary data warrants further investigation in a larger randomized placebo-control study to assess these markers and their correlation with survival.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 Suppl 4","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336105/pdf/nihms-1685653.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39292077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amandeep Godara, Anupama Kumar, Kenneth B Miller, Muhammad Wasif Saif
{"title":"Myelodysplastic Syndrome in Patients with Gastro-Pancreatic Malignancies: A Case Series and Review of Literature.","authors":"Amandeep Godara, Anupama Kumar, Kenneth B Miller, Muhammad Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients who develop one primary neoplasm are at increased risk for second cancers. Chemotherapeutic agents can result in DNA damage leading to clonal hematopoiesis, thereby causing myelodysplastic syndrome (MDS). Alkylating agents and topoisomerase inhibitors are most frequently implicated in therapy-related MDS. We report four patients with gastropancreatic malignancies (two with pancreatic adenocarcinoma and two with gastric adenocarcinoma) who developed MDS during or after the treatment of their primary gastrointestinal (GI) malignancies. Two of these patients were diagnosed with MDS during maintenance therapy with ramucirumab. To our knowledge, development of MDS in association with ramucirumab has not been previously reported in the literature. Our findings also suggest that with continued improvement in survival of patients with GI and pancreatic malignancies, more cases of treatment-related MDS might be identified.</p>","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 2","pages":"52-59"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367144/pdf/nihms-1606315.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38170362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Potential Impact of Delay in Cancer Screening due to COVID-19.","authors":"Matthew I Ehrlich, Muhammad Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72513,"journal":{"name":"Cancer medicine journal","volume":"4 2","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324031/pdf/nihms-1601033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38104363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}