Integrative Cancer Therapies最新文献

Research on the relationship between integrative oncology (IO) programs and dispensing of chemotherapy agents and supportive care drugs, and hospitalization rates is limited. The present study examined these outcomes in chemotherapy-treated patients with cancer, comparing patients highly adherent to integrative care (high-AIC) to those with low adherence (low-AIC). Data from patients with cancer treated with taxane and/or platinum-based agents participating in an ongoing prospective, controlled pragmatic trial were examined retrospectively. Patients were referred to an IO consultation and weekly treatments at 3 medical centers in Northern Israel, with high-AIC defined as attending ≥4 sessions at 6 weeks; low-AIC, 0-3 sessions. Cancer-related parameters; dispensing of medication (chemotherapy agents, analgesics, anxiolytics and opioids); rates of hospitalizations and emergency room visits were analyzed using generalized linear regression models. Of 615 patients attending the IO consultation, 367 (59.7%) were high-AIC, with both groups having mostly similar baseline characteristics. Dispensing rates for taxanes (P = .336), platinum agents (P = .403), non-opioid analgesics (P = .201), and anxiolytics (P = .350), and number of emergency room visits were similar in both groups at 12 weeks. However, high-AIC patients had fewer dispensed opioid prescriptions (RR = 0.50, 95% CI = 0.30-0.85, P = .010); lower rates of hospitalization (OR = 0.59, 95% CI = 0.39-0.88, P = .010); and fewer hospitalization days (RR = 0.53, 95% CI = 0.31-0.90, P = .019). In conclusion, dispensing of chemotherapy drugs was similar between groups, though high-AIC patients used less opioids and had fewer hospitalizations at 12 weeks. Further research is needed with randomized and prospective studies exploring the relationship between adherence to IO care; adherence to chemotherapy; quality of life; opioid use; and hospitalization.

Chemoresistance is still an important factor affecting the efficacy of treatment in colorectal cancer (CRC) patients. Hypoxia is related to poor prognosis and treatment resistance in cancer. Relevant studies have shown that a hypoxic microenvironment can promote the polarization of M2 macrophages and thus promote tumor development. Previous research has found that bufalin has a wide range of antitumor effects, but whether bufalin can reverse tumor resistance by improving the hypoxic tumor microenvironment is still unclear. In present research, it was found that high expression of SRC-3 in CRC cells under hypoxic conditions promoted the polarization of M2 and caused chemotherapy resistance, while bufalin, a monomeric drug used in Chinese medicine, reduced the level of SRC-3 and HIF-1α, thereby reversing chemoresistance. In addition, overexpression of SRC-3 reduced the hypoxia-mitigating effect of bufalin on CRC cells to promote the polarization of M2. Bufalin also inhibits the polarization of M2 caused by hypoxic CRC cells. Therefore, bufalin has the potential to become a new adjuvant therapy that can be further explored in future studies on its treatment of CRC.

Screening for pulmonary nodules (PN) using low-dose CT has proven effective in reducing lung cancer (LC) mortality. However, current treatments relying on follow-up and surgical excision fail to fully address clinical needs. Pathological angiogenesis plays a pivotal role in supplying oxygen necessary for the progression of PN to LC. The interplay between hypoxia and angiogenesis establishes a vicious cycle, rendering anti-angiogenesis therapy alone insufficient to prevent PN to LC transformation. In traditional Chinese medicine (TCM), PN is referred to as "Feiji," which is mainly attributed to Qi and blood deficiency, correspondingly, the most commonly prescribed medicines are Astragalus membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao (huang qi) (AR) and Angelica sinensis (Oliv.) Diels (dang gui) (ARS). Modern pharmacological studies have demonstrated that AR and ARS possess immune-enhancing, anti-tumor, anti-inflammatory, and anti-angiogenic properties. However, the precise mechanisms through which AR and ARS exert anti-angiogenic effects to delay PN progression to LC remain inadequately understood. This review explores the critical roles of hypoxia and angiogenesis in the transition from PN to LC. It emphasizes that, compared to therapies targeting angiogenic growth factors alone, AR, ARS, and their compound-based prescriptions offer additional benefits. These include ameliorating hypoxia by restoring blood composition, enhancing vascular structure, accelerating circulation, promoting vascular normalization, and blocking or inhibiting various pro-angiogenic expressions and receptor interactions. Collectively, these actions inhibit angiogenesis and delay the PN-to-LC transformation. Finally, this review summarizes recent advancements in related research, identifies existing limitations and gaps in knowledge, and proposes potential strategies and recommendations to address these challenges.

Background: Adherence in rehabilitation services includes attending appointments, regularly performing prescribed exercises, and correct exercise execution. The Exercise Adherence Rating Scale (EARS) has been adapted into several languages, but there is lack of a standardized tool for various Indian languages and cultural contexts, particularly for use with cancer survivors. With the anticipated 57.7% rise in cancer cases by 2040, this study aims to address this gap.

Aims and objectives: To cross-culturally adapt EARS to Kannada (EARS-Kn) and evaluate its validity and reliability amongst HNC survivors enrolled in the Multimodal Oncology Rehabilitation Exercise-MORE^© Program.

Methodology: Following Beaton guidelines, the EARS tool was adapted to Kannada. 34 HNC survivors engaged in the MORE^© program. Internal consistency (Cronbach's ⍺) and construct validity (Exploratory Factor Analysis, EFA) were assessed. The Receiver Operating Curve (ROC) determined cut-off scores, sensitivity and specificity of the EARS-Kn.

Results: The EARS-Kn demonstrated a Cronbach's-⍺ value of .93. The EFA revealed a one-factor solution with eigenvalues exceeding one and 70.1% loading. The area under the curve (AUC) was 0.908. A cut-off score of 17 was established, with 95.83% sensitivity and 80% specificity.

Conclusion: The EARS-Kn version showed strong validity and reliability among Kannada-speaking HNC survivors, indicating its potential to enhance the understanding of exercise adherence among them. Future studies could explore the EARS-Kn version among diverse populations prescribed various rehabilitation regimes. Studies could also further investigate psychometric properties of the EARS in different Indian languages among cancer survivors, which would help improve survivorship outcomes.

BackgroundOsteosarcoma (OS) is an aggressive bone tumour which affects mostly young children. Despite advances in chemotherapy regimens there is still high fatality and cure rates remain low. Annona muricata Graviola (GR) is a tropical fruit bearing tree whose leaves, stems and fruits have indigenous medicinal properties. Studies have shown that GR has anti-tumour effects on breast, liver and prostate tumours.ObjectivesThe aim of this study was to investigate the effect of GR on bone cancer cell lines of the OS lineage.MethodsTwo human OS cell lines; HOS and MG63 were cultured with GR (300 mg/mL) for 24 h at 37°C. After which supernatants and cell pellets were collected and analyzed for apoptosis by microscopy and flow cytometry, using annexin staining. Culture supernatants were analyzed for IL-6 and transforming growth beta (TGFβ) using ELISAs. Label free proteomics was used to evaluate changes in protein expression. We also investigated the effect of combining blocking antibodies to p53 and BCL-2 with GR treatment on the cell lines. The effect on TGFβ expression was then measured using flow cytometry.ResultsTreatment of HOS and MG63 cells with GR increased the expression of annexin compared to untreated cells. GR treatment also caused a dysregulation in the secretion of the cytokines IL-6 and TGFβ. Proteomics showed that GR induced apoptosis in OS cells through multiple pathways triggering an alteration in the expression of key proteins involved in cellular respiration, cell cycle, motility, DNA synthesis and cell death. Further, GR was shown to downregulate TGFβ through BCL-2 and p53 mediated pathways.ConclusionThe data suggest GR has anti-tumour effects on OS cell lines therefore the efficacy of GR should be tested clinically in OS patients.