Anna V Alyasova, Amir M Ben Ammar, Vladimir T Zarkua, Andrey G Rerberg
{"title":"A case report of successful combined intra-arterial immunotherapy and cytokine genetic therapy treatment in a patient with recurrent glioblastoma.","authors":"Anna V Alyasova, Amir M Ben Ammar, Vladimir T Zarkua, Andrey G Rerberg","doi":"10.21037/cco-24-34","DOIUrl":"10.21037/cco-24-34","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GBM) is the most common primary malignant brain tumor with very poor prognosis due to frequent recurrence and short overall survival (OS) time, which according to different sources, is not longer than 17 months after the diagnosis. Infiltrative growth pattern often leads to tumor propagation into functionally significant brain areas while surgery is cytoreductive and does not necessarily alter the prognosis. Many patients are in the working age, thus finding conservative approaches to the treatment of this type of neoplasms is of utmost importance. The aim of the work is to demonstrate the effectiveness of treatment of GBM using cytokine genetic therapy (CGT) and present an algorithm for patient management.</p><p><strong>Case description: </strong>This paper describes the first case of successful intra-arterial (IA) bevacizumab therapy with following CGT of a 46-year-old patient with recurrent GBM after a combined treatment. Sixteen courses of 15 mg/kg IA bevacizumab with hyperosmolar opening of blood-brain barrier (BBB) resulted in stabilization of the neoplastic process. After that, 9 courses of CGT with recombinant interferon gamma (IFN-γ) and tumor necrosis factor (TNF)-thymosin α1 were performed. Both magnetic resonance imaging (MRI) with contrast and positron emission tomography (PET) confirmed a complete response to the combined treatment. OS time is currently more than 25 months from the diagnosis. The observation continues.</p><p><strong>Conclusions: </strong>This case study expands the range of treatment options for GBM, especially in the context of intolerance and high toxicity of cytostatic drugs, and may lead to improved recurrence-free survival (RFS).</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"75"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281027","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}
Charbel Elias, Amaan Rahman, Jason Mial-Anthony, Godwin Packiaraj, Andrew Crane, Sarmad Alshamery, Armando Ganoza, Vikraman Gunabushanam, Colin Powers, Stalin Dharmayan, Subashini Ayloo, Hao Liu, Christof Kaltenmeier, Eishan Ashwat, Isabel Neckerman, Berkay Demirors, Michele Molinari
{"title":"Advancements in cholangiocarcinoma: evolving strategies for diagnosis, treatment, and palliation over three decades.","authors":"Charbel Elias, Amaan Rahman, Jason Mial-Anthony, Godwin Packiaraj, Andrew Crane, Sarmad Alshamery, Armando Ganoza, Vikraman Gunabushanam, Colin Powers, Stalin Dharmayan, Subashini Ayloo, Hao Liu, Christof Kaltenmeier, Eishan Ashwat, Isabel Neckerman, Berkay Demirors, Michele Molinari","doi":"10.21037/cco-23-144","DOIUrl":"10.21037/cco-23-144","url":null,"abstract":"<p><p>In recent years, significant progress has been made in the diagnosis, treatment, and palliation of cholangiocarcinoma (CC). CC accounts for 15% of all primary liver neoplasms and 3% of all gastrointestinal malignancies. Despite the significant advances in the diagnosis and treatment of CC, this tumor remains a formidable challenge, accounting for 2% of all cancer-related deaths. Chronic inflammation, genetic predisposition, and congenital biliary abnormalities are the primary risk factors for CC. CC is anatomically categorized into intrahepatic CC (ICC), perihilar, and distal types, with the latter two collectively termed extrahepatic CC (ECC). Although the incidence of ICC surpasses that of ECC, both have exhibited an upward trend over the last two decades. The advancements in diagnostic techniques, including high-resolution imaging modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, have improved the early detection and staging of CC. Molecular profiling and biomarker discovery have further enabled personalized treatment approaches. Endoscopic techniques have also evolved, providing minimally invasive options for biopsy and stent placement, which improve both diagnosis and palliative care. Treatment strategies have seen significant evolution, with surgical resection and liver transplantation being the only curative options. The refinement of surgical techniques and perioperative care has increased the success rates of these procedures. Additionally, neoadjuvant and adjuvant therapies, including chemoradiation, have shown promise in improving surgical outcomes and overall survival rates. Multidisciplinary teams (MDTs) play a crucial role in managing CC, ensuring that patients receive comprehensive care that includes surgical, medical, and supportive treatments. This team approach has led to the development of more effective treatment protocols and improved patient outcomes. Palliative care has also advanced, with new chemotherapeutic agents and targeted therapies providing better management of symptoms and prolongation of life. Innovations in interventional radiology, such as radiofrequency ablation and transcatheter arterial chemoembolization (TACE), offer additional palliative options that can significantly enhance quality of life. This review article outlines the progress made in diagnosing and treating individuals with CC over the last 30 years, highlighting the critical role of technological advancements and multidisciplinary care in improving patient outcomes.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"70"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399555","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}
Valeria Internò, Assunta Melaccio, Pasquale Vitale, Roberta Spedaliere, Massimo Buonfantino, Raffaella Messina, Anna Laura Lippolis, Francesco Signorelli, Raffaele Addeo, Francesco Giuliani
{"title":"Therapeutic inhibition of isocitrate dehydrogenase mutations in glioma and cholangiocarcinoma: new insights and promises-a narrative review.","authors":"Valeria Internò, Assunta Melaccio, Pasquale Vitale, Roberta Spedaliere, Massimo Buonfantino, Raffaella Messina, Anna Laura Lippolis, Francesco Signorelli, Raffaele Addeo, Francesco Giuliani","doi":"10.21037/cco-24-17","DOIUrl":"10.21037/cco-24-17","url":null,"abstract":"<p><strong>Background and objective: </strong>The identification of mutation hot spots in the isocitrate dehydrogenase (IDH) genes is one of the most important cancer genome-wide sequencing discoveries with relevant impact in the treatment of some orphan tumors. These genes were mostly found mutated in lower-grade gliomas (LGGs), acute myeloid leukaemia (AML), myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) and in cholangiocarcinoma. This aberrant genomic condition represents a therapeutic target of great interest in cancer research, especially in AML, given the limitations of currently approved therapies in this field. In this review, we investigate the role of IDH mutation and the mutant IDH (mIDH)-targeted therapies for cholangiocarcinoma and glioma.</p><p><strong>Methods: </strong>Here, we provide an overview of the IDH mutation role and discuss its role in tumorigenesis and progression of some solid cancers, in which the therapeutic strategy can be completely changed thanks to these brand-new therapeutic options.</p><p><strong>Key content and findings: </strong>The encouraging early clinical data demonstrated to be a proof of concept for investigational mIDH1/2 inhibitors in tumors with a paucity of therapeutic possibilities.</p><p><strong>Conclusions: </strong>Moreover, we list the most important randomised clinical trials still active with their preliminary results.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"69"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281031","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":"Primary angiosarcoma of the breast: a literature review.","authors":"Yidan Zhu, Shogo Nakamoto, Takahiro Tsukioki, Yuko Takahashi, Yoko Iwatani, Tsuguo Iwatani, Xinfeng Zhang, Maki Tanioka, Tadahiko Shien","doi":"10.21037/cco-24-16","DOIUrl":"10.21037/cco-24-16","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary angiosarcoma of the breast (PBA) is an extremely rare and heterogeneous disease. PBA is difficult to diagnose and has a poor prognosis. In order to better understand the disease and provide evidence-based treatment for PBA patients, a review of the published literature in the English language was conducted.</p><p><strong>Methods: </strong>A literature review in agreement with the PRISMA protocol was conducted. Medline and Cochrane databases were searched for English articles on PBA patients in September 2023 with a predetermined strategy. The articles were categorized and assessed based on hierarchical levels of scientific evidence.</p><p><strong>Key content and findings: </strong>A total of 255 articles were identified, among these 137 publications which included 1,888 patients met the criteria for inclusion in the final analysis. No prospective, randomized trials exclusive to PBA have been recognized. This article provides an overview of the most current and comprehensive evidence concerning the epidemiology, etiology, genomic features, clinical presentations, diagnosis, treatment, and prognosis of PBA.</p><p><strong>Conclusions: </strong>Despite the fact that current evidence is largely derived from retrospective studies, database analyses, and case reports, we utilized this information to tackle important clinical questions concerning optimal patient management practices for PBA. Complete surgical excision continues to be the mainstay treatment for PBA. However, the effectiveness of adjuvant therapies is still unclear. This narrative review highlights the urgent need for more rigorously designed research to enhance the management and treatment strategies for PBA.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"68"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281030","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}
Maurizio Zizzo, Andrea Morini, Magda Zanelli, Chiara Grasselli, Francesca Sanguedolce, Andrea Palicelli, Giuseppe Broggi, Nektarios I Koufopoulos, Lucia Mangone, Melissa Nardecchia, Angelo Cormio, Rosario Caltabiano, Giulia Besutti, Stefano Ascani, Massimiliano Fabozzi
{"title":"Short-term outcomes in obese and non-obese patients undergoing transperitoneal laparoscopic adrenalectomy for benign or malignant adrenal diseases: an updated systematic review and meta-analysis.","authors":"Maurizio Zizzo, Andrea Morini, Magda Zanelli, Chiara Grasselli, Francesca Sanguedolce, Andrea Palicelli, Giuseppe Broggi, Nektarios I Koufopoulos, Lucia Mangone, Melissa Nardecchia, Angelo Cormio, Rosario Caltabiano, Giulia Besutti, Stefano Ascani, Massimiliano Fabozzi","doi":"10.21037/cco-24-55","DOIUrl":"10.21037/cco-24-55","url":null,"abstract":"<p><strong>Background: </strong>Transperitoneal laparoscopic adrenalectomy (TLA) is the most frequently chosen approach in adrenal surgery. At present, impact of obesity on patient outcomes following adrenal surgery is frequently under discussion. We intended to offer updated evidence thanks to a comparison between intraoperative and perioperative outcomes in non-obese and obese patients, who underwent TLA for benign or malignant adrenal diseases.</p><p><strong>Methods: </strong>Our systematic review made use of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Articles of interest turned out from a search with PubMed/MEDLINE, Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials-CENTRAL), Web of Science (Science and Social Science Citation Index), and Scopus databases. We evaluated two groups of outcomes: intraoperative (operative time, intraoperative complications rate, estimated blood loss (EBL), transfusion rate, conversion to open surgery rate) and postoperative (overall postoperative complications rate, major postoperative complications rate, length of hospital stay). RevMan (Computer program) Version 5.4 was used to perform the meta-analysis. The heterogeneity of the included studies in the meta-analysis was assessed by using the I2 statist.</p><p><strong>Results: </strong>The 8 included comparative studies (1,646 patients: 995 non-obese versus 651 obese) had a time frame of approximately 30 years (1994-2020) and an observational nature. Meta-analysis showed no differences in terms of operative time, intraoperative complications rate, EBL, transfusion rate, conversion to open surgery rate, overall postoperative complications rate, major (Clavien-Dindo ≥ III) postoperative complications rate, length of hospital stay between non-obese and obese populations.</p><p><strong>Conclusions: </strong>We can say that obesity does not impact TLA safety and effectiveness. Due to biases among meta-analyzed studies (small overall sample size and small number of events analyzed, in particular), careful interpretation is needed to interpret our results. Additional randomized, possibly multi-center trials may contribute to confirm our results.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 5","pages":"67"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575281","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}
Marcelo Antonini, André Mattar, Fernanda Grace Bauk Richter, Gabriel Duque Pannain, Marina Diogenes Teixeira, Andressa Gonçalves Amorim, Denise Joffily Pereira da Costa Pinheiro, Leonardo Ribeiro Soares, Francisco Pimentel Cavalcante, Marcellus do Nascimento Moreira Ramos, Marcelo Madeira, Felipe Zerwes, Odair Ferraro, Reginaldo Guedes Coelho Lopes, Luiz Henrique Gebrim
{"title":"Real-world evidence of survival outcomes in breast cancer subtypes after neoadjuvant chemotherapy in a Brazilian reference center.","authors":"Marcelo Antonini, André Mattar, Fernanda Grace Bauk Richter, Gabriel Duque Pannain, Marina Diogenes Teixeira, Andressa Gonçalves Amorim, Denise Joffily Pereira da Costa Pinheiro, Leonardo Ribeiro Soares, Francisco Pimentel Cavalcante, Marcellus do Nascimento Moreira Ramos, Marcelo Madeira, Felipe Zerwes, Odair Ferraro, Reginaldo Guedes Coelho Lopes, Luiz Henrique Gebrim","doi":"10.21037/cco-24-54","DOIUrl":"10.21037/cco-24-54","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NAC), traditionally used for locally advanced disease, is now applied for operable disease, particularly to treat aggressive breast cancer (BC). This study aimed to characterize the pathological complete response (pCR) and its relationship with overall survival (OS) and disease-free survival (DFS) among BC patients receiving NAC in a Brazilian public reference center, as well as the association between pCR and BC subtypes.</p><p><strong>Methods: </strong>A retrospective cohort study used a comprehensive BC database from a Brazilian women's health reference center, including patients diagnosed between 2011 and 2020 who underwent NAC. We collected demographic, cancer-specific, and treatment-related data, analyzing OS and DFS based on pCR status using the semiparametric Kaplan-Meier method, with the date of BC diagnosis as the starting point.</p><p><strong>Results: </strong>The study included 1,601 patients, with an average age of 49 years and a majority presenting stage IIIa disease (35%). Most had invasive nonspecial type (NST) BC (94%), and a significant portion (86.7%) exhibited a Ki-67 index <14. The overall pCR rate was 22.7%, with higher frequencies observed in the triple negative and luminal B subtypes. Patients who achieved pCR had significantly higher survival rates (89% alive vs. 61%, P<0.001) and better DFS (90% vs. 66%, P<0.001), except in the luminal A subtype, where pCR did not correlate with improved OS or DFS.</p><p><strong>Conclusions: </strong>These updated real-world data (RWD) from BC patients who underwent NAC in Brazil revealed a pCR rate of 22.7% in all cancer subtypes and stages. pCR was not associated with better outcomes in patients with luminal A, contrasting with other subtypes.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"65"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399559","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}
Garima Gupta, Reema Patel, Mehmet Akce, Aman Chauhan
{"title":"Triplet regimen with camrelizumab plus apatinib in combination with hepatic artery infusion chemotherapy (HAIC): a new treatment paradigm for select patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma?","authors":"Garima Gupta, Reema Patel, Mehmet Akce, Aman Chauhan","doi":"10.21037/cco-24-22","DOIUrl":"https://doi.org/10.21037/cco-24-22","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 5","pages":"80"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575303","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":"Triple combination of hepatic arterial infusion chemotherapy, immune checkpoint inhibitors, and tyrosine kinase inhibitors for treatment of advanced hepatocellular carcinoma: more robust evidence is still needed.","authors":"Mohammad Saeid Rezaee-Zavareh, Ju Dong Yang","doi":"10.21037/cco-23-155","DOIUrl":"https://doi.org/10.21037/cco-23-155","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 5","pages":"77"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575286","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":"The TRIPLET study: more is better?","authors":"Salim I Khakoo","doi":"10.21037/cco-23-158","DOIUrl":"https://doi.org/10.21037/cco-23-158","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 5","pages":"78"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575282","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}