Journal of the Egyptian National Cancer Institute最新文献

Gliomas represent predominant and fatal central nervous system (CNS) cancers lacking a gold standard of treatment, which need accurate prognosis, diagnosis, and intervention. Glioma accurate therapy using common traditional approaches such as surgical treatment, radiotherapy, and chemotherapy results insufficient mainly due to side effects, recurrence, and resistance. Scientific and medical challenges can be decreased considering novel therapeutic targets. The multiple and diverse role of microRNAs (miRNAs) in cellular processes has been demonstrated. The appreciation of miRNAs regulatory roles in cancer cell proliferation or growth inhibition opens new perspectives in the development of novel strategies targeting cancers. Six inducers (miRNAs) including miR-363-3P, miR720, miR-484, miR-890, miR-496, and miR-939-5p can develop into glioma cells with the potential of therapeutic targets. Therefore, the tracking of glioma stage and response to anticancer therapy is associated with various miRNAs. The objective of this review is to provide a comprehensive assessment of the role of miRNAs in glioma cancer development.

Background: Solid pseudopapillary tumor (SPT) is a rare tumor of the pancreas with a low degree of malignancy. This tumor is most common in the female field, and in the children's population, this pathology is less common and occurs on average for the ages of 11-14 years old. The differential diagnosis of the tumor is difficult due to the lack of specific symptoms. The most informative methods of examination are computed tomography (CT) and magnetic resonance imaging (MRI). Surgical treatment is currently the most beneficial method of choice for the treatment of SPT.

Case presentation: A 9-year-old girl for the first time experienced multiple episodes of vomiting and abdominal pain against the background of complete well-being. There were performed ultrasound examination, CT, and MRI, the results of which revealed a cystic neoplasm of the head of the pancreas. There was carried out a differential diagnosis with serous cystadenoma, mucosal cystadenoma, and SPT. The child underwent surgical intervention - upper-median laparotomic access and enucleation of the tumor of the hook-shaped process of the pancreas. The postoperative period proceeded smoothly. According to the histological examination, there was identified the solid-pseudopapillary tumor of the pancreas.

Conclusion: The presented clinical case of tumor enucleation of a rare uncinate process tumor in a child is an alternative to radical surgical resections of the pancreas.

Background: Aromatase inhibitors have demonstrated superior outcomes compared to tamoxifen in various studies. However, research in Africa, including Kenya, where breast cancer mortality rates are disproportionately high, is lacking.

Objectives: The study aimed to assess the comparative efficacy of tamoxifen and aromatase inhibitors among hormone receptor-positive breast cancer patients at Kenyatta National Hospital.

Methods: A retrospective cohort study was conducted at the Oncology Department of Kenyatta National Hospital, involving all eligible hormone receptor-positive breast cancer patients treated in the facility between 1st January 2019 to 31st December 2022. The study was hospital-based and used a data abstraction tool to collect data from the patients' medical records. The data obtained was then analyzed using SPSS version 25 and Kaplan-Meier analysis was used to estimate the median survival time. Cox regression analysis was employed to determine whether there was a significant association between the variables. The collected data was presented in the form of frequency tables and graphs.

Results: In our study, aromatase inhibitors consistently demonstrated superior outcomes compared to tamoxifen across various parameters. Specifically, aromatase inhibitors showed a lower incidence of disease progression (24% vs. 29.7%), a higher rate of complete radiological response (24% vs. 13.5%), and a reduced likelihood of developing distant metastasis while on treatment, coupled with a lower mortality rate (40% vs. 48.0%). Additionally, the median survival time for patients receiving aromatase inhibitors was notably longer at 49.0 months compared to 42.0 ± 3.6 months for those on tamoxifen (P = 0.410). Similarly, the aromatase inhibitor group exhibited a more extended median metastasis-free survival time (42.0 months vs. 30.0 ± 1.4 months, P = 0.056) and a more favorable survival time from metastasis to death (8 ± 0.6 months vs. 6 ± 0.8 months in the tamoxifen group, P = 0.142).

Conclusion: These findings collectively suggest a consistent trend towards improved treatment outcomes with aromatase inhibitors compared to tamoxifen. The observed reduction in mortality rates among aromatase inhibitor-treated patients highlights their potential clinical benefit, with superior overall survival and disease progression.

Background: Adequate nutrition can mitigate side-effects and improve recovery for patients with locally advanced head-and-neck squamous cell cancer (LAHNSCC), while malnourishment can increase morbidity and mortality. We aimed to evaluate the baseline nutritional status of patients with LAHNSCC planned for curative chemoradiotherapy (CRT), the evolution of nutritional status during the course of CRT and to assess whether nutrition impacted their clinical outcomes.

Methods: This was a pre-planned secondary analysis of a Phase III randomized controlled trial conducted between 2013 and 2017 in 300 patients with LAHNSCC who were randomly assigned to receive either cisplatin 30 mg/m² once-a-week or 100 mg/m² once-in-3-weeks concurrently with radiation. This analysis included 112 patients for whom nutritional parameters were recorded. Patient Generated Subjective Global Assessment (PG-SGA) forms were used to evaluate malnutrition severity at different treatment stages. Scores on the PG-SGA ranged from 0 to 35, with higher scores denoting greater malnutrition. Scores were grouped, with 0-3 indicating normal to mild malnutrition, and ≥ 4 denoting moderate to severe malnutrition. Baseline scores were compared with subsequent scores and survival outcomes were analyzed.

Results: At baseline assessment, 42.8% of patients had normal to mild malnutrition, while 57.1% had moderate to severe malnutrition. There were higher baseline malnutrition rates in women, users of smokeless tobacco, and patients with buccal mucosa tumors. By day 21 of treatment, 44 (56.4%) patients had moderate to severe malnutrition, while 34 (43.6%) had normal nutrition or mild malnutrition. Among those with moderate to severe malnutrition at baseline, 13 (29.5%) patients had an improvement in their nutritional status, while 14 (41.2%) patients with normal to mild nutrition at baseline had deterioration in their nutritional status during the course of CRT. Baseline nutritional status did not significantly impact progression-free, locoregional relapse-free or overall survivals.

Conclusions: Pre-treatment nutrition is crucial for managing weight and reducing treatment complications in patients with LAHNSCC. Over 40% of patients with normal baseline nutrition have deterioration of their nutritional status during CRT. We were unable to find any correlation between nutrition and clinical outcomes in patients with LAHNSCC receiving curative CRT. Larger studies are needed to explore the impact of nutrition on treatment outcomes, emphasizing regular dietary assessments and interventions to improve patient compliance.

Trial registration: Clinical Trial Registry of India, under the registration number CTRI/2012/10/003062.

Introduction: Breast cancer is considered to be the most common cancer that affects women worldwide, where it accounts for approximately 38.8% of all cancer cases among females. Luminal subtypes are the most prevalent in Egypt. Small noncoding RNAs also called microRNAs (miRNAs) influence gene expression posttranscriptionally. Since they regulate the epithelial-mesenchymal transition process, which is vital for tumor invasion and metastasis, microRNAs play a critical role in the progression of cancer.

Methods: This study has investigated the expression profiles of four microRNAs (miR-101-3p, miR-106a-5p, miR-106b-5p, and miR-130b-5p) and their impacts on genes associated with epithelial-mesenchymal transition (EMT) in luminal breast cancer. Tissue samples from 43 luminal breast cancer patients and 18 controls have been studied via real-time PCR (RT-qPCR). The association between the expression levels was evaluated using the Pearson correlation test. The correlation between the measured variables and numerous clinicopathological characteristics was assessed using the linear regression test.

Results: The results demonstrated that miR-101-3p, miR-106a-5p, and miR-106b-5p were significantly dysregulated, highlighting their possible role as oncogenes or tumor suppressors in the development of breast cancer. EMT markers, especially Twist, SNAI1, and E-cadherin, show significant alterations, indicating the activation of EMT pathways in luminal breast cancer. Correlation analysis showed interactions between miRNAs and EMT-related genes, showing a negative correlation between miR-101-3p and SNAI1, as well as a positive correlation between Twist and miR-106a-5p. Moreover, logistic regression analysis associated expression levels of those miRNAs with clinicopathological characteristics, such as body weight, age, and tumor laterality.

Conclusion: These findings highlight the leading role of miR-101-3p and miR-106b-5p in the progression of luminal breast cancer via interacting with the EMT process and their potential as diagnostic, prognostic, and therapeutic targets.

Background: Hepatocellular carcinoma (HCC) is a major global health concern due to its high prevalence and mortality rate. Although emodin, a natural anthraquinone derivative, has demonstrated in vitro anticancer activity against HCC cells, its specific molecular targets in HCC remain unclear.

Method: This study used an integrated approach combining in silico network pharmacology, molecular docking, molecular dynamics simulations (MDS), and in vitro cytotoxicity assays to evaluate three emodin derivatives: emodin, 3-acetyl emodin (ACE), and 1,3,8-triacetyl emodin (TAEM). Target predictions were performed using the SwissTargetPrediction database, and HCC-related genes were retrieved from cBioPortal. Functional annotations (Gene Ontology and Reactome) identified EGFR and KIT as key targets. Docking simulations were conducted to assess binding affinities, followed by 100 ns MDS to evaluate stability. Cytotoxic effects on HepG2 cells were also assessed.

Result: TAEM showed the strongest binding affinity to both EGFR and KIT and demonstrated the highest cytotoxicity against HepG2 cells (IC50 = 0.021 mM). MDS results indicated that the KIT-TAEM complex was the most stable among all tested combinations, supported by RMSD, RMSF, Rg, protein-ligand distance, and MM-GBSA binding energy analyses.

Conclusion: These findings highlight TAEM as a promising therapeutic candidate for HCC. The study demonstrates the value of integrating computational predictions with experimental validation in early-stage drug discovery.

Introduction and background: Non-small cell lung cancer (NSCLC) is the third most common type of cancer in Palestine and has the highest mortality rate. Treatment approaches for NSCLC depend on many factors including stage, histology, molecular profile, and patient performance status.

Objectives: This study explored the patient characteristics, molecular profiles, metastatic sites, prognosis, and treatment modalities.

Methods: This observational retrospective cohort study was conducted at multiple Palestinian hospitals. This study included patients diagnosed with metastatic NSCLC between 2016 and 2022. Patients with small-cell lung cancer (SCLC), newly diagnosed lung cancer, or incomplete information were excluded from the study. Patient data were obtained from the date of lung cancer diagnosis until death or loss to follow-up. Data were analyzed using IBM SPSS, and overall survival was calculated using the Kaplan-Meier estimate.

Results: The study included 102 patients, 80.4% were male, 40.2% were current smokers, 42.2% were ex-smokers, and 17.6% were nonsmokers. (86.35%) of the patients were diagnosed with adenocarcinoma, and (77.5%) were diagnosed with stage IV NSCLC. Tumor recurrence was observed in 47.1% of patients after surgery. A total of 56.9% had PDL-1 expression ≥ 10%, and 45.1% had EGFR mutations. Fourteen (13.7%) received mono-chemotherapy with an estimated OS of (1219.200) days, 34 (33.3%) received mono-immunotherapy with an estimated OS of (720.152) days, and 54 (52.9%) received a combination of chemotherapy and immunotherapy with an OS of 2006.777 days. PFS (> 1 year) was higher in patients receiving combination therapy (58.3%). Myelosuppression, renal damage, and liver damage are some of the major side effects experienced by patients receiving either type of treatment.

Conclusion: The findings of this study provide vital information on tumor molecular mutation patterns and PDL expression for the adoption of appropriate measures in prevention and treatment strategies for NSCLC in Palestine. The majority of patients diagnosed with NSCLC were males with a history of smoking and were diagnosed at an advanced stage, which requires increased education, wariness of lung cancer, and smoking cessation programs at the national level.

Background: The literature on nutrition support therapy prescribing practices by physicians and the roles of nutrition support pharmacists in palliative and hospice care cancer patients is limited.

Methods: The study aimed to analyze the prescribing practices of physicians and the roles of clinical pharmacists at a tertiary cancer center. A retrospective analysis of 12527 electronic records of hospice and palliative care cancer patients. All nutrition support therapy prescriptions by physicians and clinical pharmacists' interventions were recorded. Analysis was conducted utilizing the Jamovi statistical package 2022.

Results: The study population comprised inpatients and homecare patients. The most frequently prescribed nutrition support therapy was vitamins and minerals supplements, followed by enteral nutrition and parenteral nutrition. The total number of nutrition support pharmacist interventions was 660 (5.2%). The acceptance rate of interventions by physicians was 90%. Initiating mineral use was the most frequent intervention, followed by discontinuation of mineral use.

Conclusion: Vitamins and mineral supplements are the most prescribed type of nutrition support therapy. The interventions of clinical pharmacists were highly accepted by physicians. Initiating mineral use is the most frequent intervention. Further research is needed to explore the impact of nutrition support therapy on patient outcomes and barriers to its implementation.

Background: Immunocompromised individuals, such as those affected by and treated for hematological malignancies, face a higher risk of prolonged SARS-CoV-2 infection. Increased disease risk is further compounded by limited treatment options. Currently, approved antiviral monotherapies against COVID-19 include remdesivir (Veklury) and nirmatrelvir/ritonavir (Paxlovid) which have stringent recommended prescribing windows within 7 and 5 days of symptom onset, respectively. Furthermore, these two antiviral therapies are approved for treatment lengths of 3 (remdesivir) and 5 days (Paxlovid).

Case presentation: Herein, we describe the successful treatment of prolonged COVID-19 in a patient with a history of diffuse large B-cell lymphoma with an extended combination therapy; remdesivir and nirmatrelvir/ritonavir. The patient presented with symptomatic COVID-19 that was unsuccessfully treated with a 10-day course of remdesivir. After 2 months of symptomatic infection, the patient was treated with remdesivir in combination with nirmatrelvir/ritonavir for 10 days, which quickly resolved the cough and cleared viral load.

Conclusion: Our case highlights the efficacy of administrating a combination treatment of remdesivir and nirmatrelvir/ritonavir outside recommended guidelines for the treatment of persistent COVID-19 infection in an immunocompromised individual. High-quality studies evaluating the usefulness of this combinatory therapy as a longer-course treatment in patients with neoplasms is warranted.