Kennedy Yao Yi Ng, Albert Eng Keong Teo, Sze Huey Tan, Jack Jie En Tan, Desiree Shu Hui Tay, Ailica Wan Xin Lee, Andrea Jing Shi Ang, Lawrence Wen Jun Wong, Su Pin Choo, Han Chong Toh, Suat Ying Lee, Joycelyn Jie Xin Lee, David Wai-Meng Tai
{"title":"Impact of Antibiotics and Chronic Medications on Efficacy of Immune Checkpoint Inhibitors in Patients With Hepatocellular Carcinoma.","authors":"Kennedy Yao Yi Ng, Albert Eng Keong Teo, Sze Huey Tan, Jack Jie En Tan, Desiree Shu Hui Tay, Ailica Wan Xin Lee, Andrea Jing Shi Ang, Lawrence Wen Jun Wong, Su Pin Choo, Han Chong Toh, Suat Ying Lee, Joycelyn Jie Xin Lee, David Wai-Meng Tai","doi":"10.1111/ajco.14139","DOIUrl":"https://doi.org/10.1111/ajco.14139","url":null,"abstract":"<p><strong>Background and aims: </strong>The interaction of immune checkpoint inhibitors (ICI) and concomitant medications such as antibiotics, metformin, statins, beta-blockers, proton pump inhibitors (PPIs), nonsteroidal anti-inflammatory drugs (NSAIDs), and low-dose aspirin has been studied in other malignancies. Our study aims to investigate the relationship between these medications and ICI efficacy in patients with advanced hepatocellular carcinoma (aHCC).</p><p><strong>Methods: </strong>A retrospective review of patients who received at least one dose of ICIs between May 2015 and November 2019 was performed. The primary objectives were to compare the overall survival (OS) and progression-free survival (PFS) between patients with and without medication usage. Log rank test was used to assess for differences in survival. Hazard ratios were reported using Cox proportional hazard regression analysis. The data cutoff date was December 31, 2020.</p><p><strong>Results: </strong>A total of 168 patients were included. Median age was 69 years, 85.7% male, 60.7% ECOG 0, 78.0% Child-Pugh A liver cirrhosis, 57.7% hepatitis B etiology, 8.9% hepatitis C, and 33.3% nonviral. One hundred three patients (61.3%) received ICI monotherapy, while 38.7% received ICI in combination. Sixty-two patients (36.9%) had concomitant antibiotic usage, 26.8% metformin, 30.4% statin, 31.0% beta-blockers, 60.1% PPI, 6.5% NSAIDs, and 11.9% aspirin. Patients with aHCC receiving antibiotics did not have a shorter OS (adjusted HR [aHR] 1.40, 95% CI 0.94-2.09, p = 0.096) or shorter PFS (aHR 0.94, 95% CI 0.66-1.34, p = 0.73), as compared to those who did not receive antibiotics. However, patients with aHCC of viral hepatitis etiology receiving ICI treatment and concurrent antibiotics had shorter OS (5.5 vs. 14.2 months, aHR 1.93, 95% CI 1.17-3.17, p = 0.010) and PFS (1.1 vs. 2.6 months, aHR 2.69, 95% CI 1.28-5.65, p = 0.009), as compared to those who did not receive antibiotics.</p><p><strong>Conclusions: </strong>The use of antibiotics may diminish ICI efficacy in patients with aHCC of viral hepatitis etiology, while the use of metformin, statins, beta-blockers, NSAIDs, and aspirin is not associated with significant clinical outcomes.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Warren Bacorro, Clarito Cairo, Kathleen Baldivia, Aida Bautista, Evelyn Dancel, Jocelyn Mariano, Gil Gonzalez, Teresa Sy Ortin, Rodel Canlas
{"title":"The Case for Shared Decision-making in Oncology and Why the Philippine Healthcare System is Primed for It.","authors":"Warren Bacorro, Clarito Cairo, Kathleen Baldivia, Aida Bautista, Evelyn Dancel, Jocelyn Mariano, Gil Gonzalez, Teresa Sy Ortin, Rodel Canlas","doi":"10.1111/ajco.14143","DOIUrl":"https://doi.org/10.1111/ajco.14143","url":null,"abstract":"<p><p>Shared decision-making is ethically imperative, and is a key component in cost-effective, efficient and equitable cancer care. We review the recent advances in resources, training, tool development, and health policy, supporting the implementation of shared decision-making, and how the Philippines is primed for it.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeinab Tamtaji, Elham Sheikhsagha, Mohammad Behnam, Fatemeh Nabavizadeh, Mehdi Shafiee Ardestani, Fatemeh Rahmati-Dehkordi, Michael Aschner, Hamed Mirzaei, Omid R Tamtaji
{"title":"Berberine and Lung Cancer: From Pure Form to Its Nanoformulations.","authors":"Zeinab Tamtaji, Elham Sheikhsagha, Mohammad Behnam, Fatemeh Nabavizadeh, Mehdi Shafiee Ardestani, Fatemeh Rahmati-Dehkordi, Michael Aschner, Hamed Mirzaei, Omid R Tamtaji","doi":"10.1111/ajco.14134","DOIUrl":"https://doi.org/10.1111/ajco.14134","url":null,"abstract":"<p><p>Lung cancer is the most fatal cancer worldwide. The etiology of lung cancer has yet to be fully characterized. Smoking and air pollution are several risk factors for lung cancer. Berberine, an isoquinoline alkaloid, is an antihyperglycemic, antidepressant, antioxidative, anti-inflammatory, and anticancer compound. Evidence substantiates that berberine has antitumor effects, exerting its effects by targeting a variety of cellular and molecular processes, such as apoptosis, autophagy, cell cycle arrest, migration, and metastasis. Although the beneficial effects of berberine have been reported, some limitations including low bioavailability and absorption as well as poor aqueous solubility have hindered its clinical application. Nanotechnology and nanodelivery bioformulation approaches may bypass these limitations. In addition, the combination of berberine with other therapies has been shown to result in greater treatment efficacy for lung cancer. Herein, we summarize cellular and molecular pathways that are affected by berberine, its clinical efficacy upon various combinations, and the potential for nanotechnology in lung cancer therapy.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Real-World Outcomes of Patients Treated With Gemcitabine Using Standardized Dose and Rate and Docetaxel for Advanced Soft Tissue Sarcoma in an Australian Sarcoma Center.","authors":"Isabella Wilson, Madeleine Strach, Vivek Bhadri, Michelle Harrison, Whiter Tang, Peter Grimison","doi":"10.1111/ajco.14138","DOIUrl":"https://doi.org/10.1111/ajco.14138","url":null,"abstract":"<p><strong>Background: </strong>Gemcitabine and docetaxel (GD) is a common chemotherapy regimen for metastatic soft tissue sarcoma (STS). The GeDDiS trial compared GD with doxorubicin in the first-line setting, using gemcitabine 675 mg/m<sup>2</sup> over a prolonged rate of 90 min-reporting a 20% response rate and 5.4-month median progression-free survival (PFS). We aimed to examine the real-world efficacy and toxicity of GD in our center, using a standardized dose of gemcitabine 900 mg/m<sup>2</sup> over 30 min on Days 1 and 8 and intravenous docetaxel 75 mg/m<sup>2</sup> over 60 min on Day 8 every 21 days.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of patients with unresectable or metastatic STS receiving GD between July 2018 and October 2022. Data collected included patient and tumor characteristics, dose intensity, toxicity, response, PFS, and overall survival (OS).</p><p><strong>Results: </strong>Thirty-eight patients were included. Median follow-up was 19 months (range 3-30). Line of treatment (n) was first line (10), second line (13), ≥ third line (15). The median number of cycles was 6. Response rate was 42%, including 5% with a complete response. At the time of data collection, 33 patients had disease progression and 24 patients had died. PFS (median, 6-month rate) was 4.5 months and 44%. OS (median, 12-month rate) was 15 months and 65%. Grade 3/4 toxicity included anemia (21%), neutropenia (5%), thrombocytopenia (5%), and febrile neutropenia (3%).</p><p><strong>Conclusion: </strong>These data demonstrate the activity of gemcitabine using a standardized dose and rate with docetaxel comparable to other published data and favorable toxicity in a real-life patient population despite altered gemcitabine dosing and a heavily pretreated patient population.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susannah Jacob, Gabriel Gabriel, Mei Ling Yap, Shalini Vinod, Kalinda Griffiths, David Sheehan, Susan Anderson, Geoff Delaney
{"title":"Comparison of Epidemiology, Demography, Treatment (Surgery and Radiotherapy), and Survival Between Aboriginal and Torres Strait Islander and Non-Indigenous Women With Cervical Cancer in NSW, Australia in 2009-2018.","authors":"Susannah Jacob, Gabriel Gabriel, Mei Ling Yap, Shalini Vinod, Kalinda Griffiths, David Sheehan, Susan Anderson, Geoff Delaney","doi":"10.1111/ajco.14140","DOIUrl":"https://doi.org/10.1111/ajco.14140","url":null,"abstract":"<p><strong>Background: </strong>Health outcomes for Aboriginal and Torres Strait Islander people in Australia are significantly worse than in the non-Indigenous population.</p><p><strong>Aim: </strong>To evaluate demographic factors and treatment (surgery and radiotherapy) rates for cervical cancer and to compare these between the Aboriginal and non-Aboriginal populations to identify any differences in outcomes or modifiable treatment differences between the populations.</p><p><strong>Methods: </strong>Retrospective cohort analysis of all patients in the state of New South Wales, Australia, diagnosed with cervical cancer between 2009 and 2018 using linked registry, treatment, and death data.</p><p><strong>Results: </strong>The crude incidence rate for cervical cancer in Aboriginal women in NSW (17.29/100,000) was more than double the rate among non-Aboriginal women (6.77/100,000). Aboriginal women were diagnosed with cervical cancer, including metastatic disease, at a younger age. There was no significant difference in presentation stage, surgery or radiotherapy treatment rates, or overall survival at 5 years between the two populations.</p><p><strong>Conclusion: </strong>Although access to cancer care looks similar as an aggregate in Aboriginal versus non-Aboriginal populations, there were disparities with reduced access to care (patients who did not receive either radiotherapy or surgery) among Aboriginal patients who were socioeconomically disadvantaged or residing in remote areas. The lower age of cancer diagnosis among Aboriginal women may have effects on survivorship, including negative effects on fertility, loss of income, and other personal, social, and economic consequences. Efforts to improve access to care, including screening, diagnosis, and treatment, should be targeted toward younger Aboriginal women and those who are socioeconomically disadvantaged or those residing in remote areas.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaidyn Muhandiramge, Oliver J. Nilsen, Umbreen Hafeez
{"title":"Cancer Clinical Trial Participation Amongst Culturally and Linguistically Diverse Patients in Australia","authors":"Jaidyn Muhandiramge, Oliver J. Nilsen, Umbreen Hafeez","doi":"10.1111/ajco.14133","DOIUrl":"10.1111/ajco.14133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Clinical trials play a large role in oncological. Many barriers to participation in cancer clinical trials exist, including a patient's status as “culturally and linguistically diverse (CALD)”. Globally, it is thought that CALD patients experience lower rates of trial participation, although very few studies quantify rates of cancer clinical trial participation in this group. Our study therefore aims to characterize CALD participation in cancer clinical trials in an Australian setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of data from the Cancer Clinical Trials Centre at Austin Health, a large tertiary metropolitan cancer center in Melbourne, Australia. Participation in cancer clinical trials between groups was compared using simple descriptive analysis, Chi-squared analysis, and logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2568 patients (mean age 57.9 years, 37% female) offered entry into a cancer clinical trial between 2018 and 2023, 26% were from a CALD background (<i>n</i> = 678), and 9% had a preferred language other than English (<i>n</i> = 219). A greater proportion of non-CALD patients participated in a cancer clinical trial compared with CALD patients (37% versus 33% respectively, <i>p</i> = 0.04). In logistic regression models, Arabic (OR, 0.46; 95% CI, 0.21–0.93 [univariate]) and Greek (OR, 0.54; 95% CI, 0.31–0.91 [multivariate]) language groups, along with overall CALD status (OR, 0.81; 95% CI, 0.67–0.99 [univariate]) were associated with lower cancer clinical trial participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found that CALD patients, those born in non-English speaking countries, and specific language groups, were associated with lower cancer clinical trial participation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"21 1","pages":"58-64"},"PeriodicalIF":1.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}