Antonio Piras, Andrea D'Aviero, Antonella Sanfratello, Luca Boldrini, Gianfranco Pernice, Massimiliano Spada, Gianluca Gaudio, Mirko Pinelli, Giuseppe Salamone, Vittorio Gebbia, Nino Dispensa, Gabriele Tulone, Riccardo Laudicella, Albert Comelli, Domenico Di Raimondo, Antonino Tuttolomondo, Tommaso Angileri, Antonino Daidone
Introduction Penile metastases (PM) are a rare clinical presentation mainly related to advanced stages of disease. Considering the low incidence, an optimal treatment approach has not yet been defined; surgery, chemotherapy, and radiotherapy are different options used in the vast majority with palliative intent. The advances in modern RT can represent an innovative tool in PM management and a curative option. This paper aims to report the case of a PM patient treated with Stereotactic Body Radiotherapy (SBRT) and perform a systematic literature review of current evidence on the RT approach to PM. Case report We reported the case of an 80-year-old patient with PM from primary bladder cancer. Following the surgical approach for the primary tumor, evidence of PM was shown, and the patient was admitted to SBRT treatment on PM after an adjuvant RT course on the pelvis. A 25 Gy in 5 fractions SBRT treatment was performed, and a complete clinical response was shown at the first follow-up. Methods A Pubmed/MEDLINE and Embase systematic review was carried out. The search strategy terms were [('penile metastasis'/exp OR 'penile metastasis' OR (penile AND ('metastasis'/exp OR metastasis))) AND ('radiotherapy'/exp OR radiotherapy)] and only original articles up to the 24.10.2023 were considered. Results A total of 174 studies were obtained using the previously mentioned search strategy, and the analysis was performed on 15 papers obtained following the complete selection process. All reported evidence was focused on the palliative approach of PM showing good results in terms of symptom control. Discussion The potential role of modern RT in the management of PM has yet to be defined. The reported case showed the feasibility and the clinical impact of SBRT in PM treatment.
{"title":"Stereotactic Radiotherapy for penile metastasis: case report and systematic literature review.","authors":"Antonio Piras, Andrea D'Aviero, Antonella Sanfratello, Luca Boldrini, Gianfranco Pernice, Massimiliano Spada, Gianluca Gaudio, Mirko Pinelli, Giuseppe Salamone, Vittorio Gebbia, Nino Dispensa, Gabriele Tulone, Riccardo Laudicella, Albert Comelli, Domenico Di Raimondo, Antonino Tuttolomondo, Tommaso Angileri, Antonino Daidone","doi":"10.1159/000539275","DOIUrl":"https://doi.org/10.1159/000539275","url":null,"abstract":"<p><p>Introduction Penile metastases (PM) are a rare clinical presentation mainly related to advanced stages of disease. Considering the low incidence, an optimal treatment approach has not yet been defined; surgery, chemotherapy, and radiotherapy are different options used in the vast majority with palliative intent. The advances in modern RT can represent an innovative tool in PM management and a curative option. This paper aims to report the case of a PM patient treated with Stereotactic Body Radiotherapy (SBRT) and perform a systematic literature review of current evidence on the RT approach to PM. Case report We reported the case of an 80-year-old patient with PM from primary bladder cancer. Following the surgical approach for the primary tumor, evidence of PM was shown, and the patient was admitted to SBRT treatment on PM after an adjuvant RT course on the pelvis. A 25 Gy in 5 fractions SBRT treatment was performed, and a complete clinical response was shown at the first follow-up. Methods A Pubmed/MEDLINE and Embase systematic review was carried out. The search strategy terms were [('penile metastasis'/exp OR 'penile metastasis' OR (penile AND ('metastasis'/exp OR metastasis))) AND ('radiotherapy'/exp OR radiotherapy)] and only original articles up to the 24.10.2023 were considered. Results A total of 174 studies were obtained using the previously mentioned search strategy, and the analysis was performed on 15 papers obtained following the complete selection process. All reported evidence was focused on the palliative approach of PM showing good results in terms of symptom control. Discussion The potential role of modern RT in the management of PM has yet to be defined. The reported case showed the feasibility and the clinical impact of SBRT in PM treatment.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066135","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}
BACKGROUND The cancers of the digestive tract, including colorectal cancer (CRC), gastric cancer (GC) and Esophageal cancer (ESCA), are part of the most common cancers as well as one of the most important leading causes of cancer death worldwide. SUMMARY Despite the emergence of immune checkpoint inhibitors (e.g., anti-CTLA-4 and anti-PD-1/PD-L1) in the past decade, offering renewed optimism in cancer treatment, only a fraction of patients derive benefit from these therapies. This limited efficacy may stem from tumor heterogeneity and the impact of metabolic reprogramming on both tumor cells and immune cells within the tumor microenvironment (TME). The metabolic reprogramming of glucose, lipids, amino acids, and other nutrients represents a pivotal hallmark of cancer, serving to generate energy, reducing-equivalent and biological macromolecule, thereby fostering tumor proliferation and invasion. Significantly, the metabolic reprogramming of tumor cells can orchestrate changes within the TME, rendering patients unresponsive to immunotherapy. KEY MESSAGES In this review, we predominantly encapsulate recent strides on metabolic reprogramming among digestive tract cancer, especially CRC, in the TME with a focus on how these alterations influence antitumor immunity. Additionally, we deliberate on potential strategies to address these abnormities in metabolic pathways and the viability of combined therapy within the realm of anticancer immunotherapy.
{"title":"Association between metabolic reprogramming and immune regulation in digestive tract tumors.","authors":"Jiafeng Liu, Tianxiao Wang, Wenxin Zhang, Yuxin Huang, Xinhai Wang, Qunyi Li","doi":"10.1159/000538659","DOIUrl":"https://doi.org/10.1159/000538659","url":null,"abstract":"BACKGROUND\u0000The cancers of the digestive tract, including colorectal cancer (CRC), gastric cancer (GC) and Esophageal cancer (ESCA), are part of the most common cancers as well as one of the most important leading causes of cancer death worldwide.\u0000\u0000\u0000SUMMARY\u0000Despite the emergence of immune checkpoint inhibitors (e.g., anti-CTLA-4 and anti-PD-1/PD-L1) in the past decade, offering renewed optimism in cancer treatment, only a fraction of patients derive benefit from these therapies. This limited efficacy may stem from tumor heterogeneity and the impact of metabolic reprogramming on both tumor cells and immune cells within the tumor microenvironment (TME). The metabolic reprogramming of glucose, lipids, amino acids, and other nutrients represents a pivotal hallmark of cancer, serving to generate energy, reducing-equivalent and biological macromolecule, thereby fostering tumor proliferation and invasion. Significantly, the metabolic reprogramming of tumor cells can orchestrate changes within the TME, rendering patients unresponsive to immunotherapy.\u0000\u0000\u0000KEY MESSAGES\u0000In this review, we predominantly encapsulate recent strides on metabolic reprogramming among digestive tract cancer, especially CRC, in the TME with a focus on how these alterations influence antitumor immunity. Additionally, we deliberate on potential strategies to address these abnormities in metabolic pathways and the viability of combined therapy within the realm of anticancer immunotherapy.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689791","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}
Andrea Valera-Barrero, Jorge Madera-Fernández, Vicente González-Quintanilla, M. J. Sedano-Tous, Francisco Martínez Dubarbie
INTRODUCTION Breast cancer in males is a very rare entity, and survival is mainly influenced by the stage at diagnosis. The lack of early detection tools in men results in a diagnostic delay of about 5-10 years and a higher percentage of metastatic disease at diagnosis. However, the characteristics of head metastases are not well defined. CASE REPORTS We present two cases of male breast cancer with metastases affecting cranial nervous structures and we provide imaging and histologic data. Both were middle-aged patients with ductal-type, HER-2 negative and androgen receptor positive primary tumors. DISCUSSION Although central nervous system involvement is uncommon, this entity should be considered in middle-aged males with focal neurologic symptoms. More cases would be necessary to better understand the biology of this condition in order to establish an adequate diagnosis and treatment.
{"title":"Metastases affecting cranial nervous structures in male breast cancer: Two cases report.","authors":"Andrea Valera-Barrero, Jorge Madera-Fernández, Vicente González-Quintanilla, M. J. Sedano-Tous, Francisco Martínez Dubarbie","doi":"10.1159/000538933","DOIUrl":"https://doi.org/10.1159/000538933","url":null,"abstract":"INTRODUCTION\u0000Breast cancer in males is a very rare entity, and survival is mainly influenced by the stage at diagnosis. The lack of early detection tools in men results in a diagnostic delay of about 5-10 years and a higher percentage of metastatic disease at diagnosis. However, the characteristics of head metastases are not well defined.\u0000\u0000\u0000CASE REPORTS\u0000We present two cases of male breast cancer with metastases affecting cranial nervous structures and we provide imaging and histologic data. Both were middle-aged patients with ductal-type, HER-2 negative and androgen receptor positive primary tumors.\u0000\u0000\u0000DISCUSSION\u0000Although central nervous system involvement is uncommon, this entity should be considered in middle-aged males with focal neurologic symptoms. More cases would be necessary to better understand the biology of this condition in order to establish an adequate diagnosis and treatment.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687999","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":"Society Bulletins","authors":"","doi":"10.1159/000536337","DOIUrl":"https://doi.org/10.1159/000536337","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140695785","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}
M. G. Geukes Foppen, M. Rohaan, J. Borgers, Daisy Philips, F. Vyth-Dreese, Jos H. Beijnen, B. Nuijen, J. H. van den Berg, J. B. Haanen
INTRODUCTION Naked DNA vaccination could be a powerful and safe strategy to mount antigen-specific cellular immunity. We designed a phase I clinical trial to investigate the toxicity of naked DNA vaccines encoding CD8+ T-cell epitope from tumor-associated antigen MART-1 in patients with advanced melanoma. METHODS This dose escalating phase Ia clinical trial investigates the toxicity and immunological response upon naked DNA vaccines encoding a CD8+ T-cell epitope from the tumor-associated antigen MART-1, genetically linked to the gene encoding domain 1 of subunit-tetanus toxin fragment C in patients with advanced melanoma (inoperable stage IIIC-IV, AJCC 7th edition). The vaccine was administrated via intradermal application using a permanent make-up or tattoo device. Safety was monitored according to CTCAE v.3.0 and skin biopsies and blood samples were obtained for immunologic monitoring. RESULTS Nine pretreated, HLA-A*0201-positive patients with advanced melanoma expressing MART-1 and MHC class I, with a good performance status, and adequate organ function, were included. With a median follow-up of 5.9 months, DNA vaccination was safe, without treatment-related deaths. Common treatment-emergent adverse events of any grade were dermatologic reactions at the vaccination site (100%) and pain (56%). One patient experienced grade 4 toxicity, most likely related to tumor progression. One patient (11%) achieved stable disease, lasting 353 days. Immune analysis showed no increase in vaccine-induced T cell response in peripheral blood of five patients, but did show a MART-1 specific CD8+ T cell response at the tattoo administration site. The maximum dose administered was 2 mg due to lack of clinical activity. CONCLUSION We showed that the developed DNA vaccine, applied using a novel intradermal application strategy, can be administered safely. Further research with improved vaccine formats is required to show possible clinical benefit of DNA vaccination.
简介：裸DNA疫苗接种是一种强大而安全的抗原特异性细胞免疫策略。我们设计了一项 I 期临床试验，研究编码肿瘤相关抗原 MART-1 的 CD8+ T 细胞表位的裸 DNA 疫苗对晚期黑色素瘤患者的毒性。方法这项剂量递增的 Ia 期临床试验研究了在晚期黑色素瘤患者（无法手术的 IIIC-IV 期，AJCC 第 7 版）中使用编码肿瘤相关抗原 MART-1 的 CD8+ T 细胞表位的裸 DNA 疫苗的毒性和免疫反应。疫苗通过永久化妆或纹身设备进行皮内注射。根据 CTCAE v.3.0 对安全性进行了监测，并采集了皮肤活检和血液样本进行免疫学监测。中位随访时间为5.9个月，DNA疫苗接种是安全的，没有出现与治疗相关的死亡病例。常见的任何级别的治疗突发不良反应是接种部位的皮肤反应（100%）和疼痛（56%）。一名患者出现了四级毒性，很可能与肿瘤进展有关。一名患者（11%）病情稳定，持续了 353 天。免疫分析表明，5 名患者外周血中疫苗诱导的 T 细胞反应没有增加，但在纹身给药部位出现了 MART-1 特异性 CD8+ T 细胞反应。由于缺乏临床活性，最大给药剂量为 2 毫克。要想证明 DNA 疫苗接种可能带来的临床益处，还需要对改进后的疫苗形式进行进一步研究。
{"title":"Intradermal naked DNA vaccination by DNA tattooing for mounting tumor-specific immunity in stage IV melanoma patients: a phase I clinical trial.","authors":"M. G. Geukes Foppen, M. Rohaan, J. Borgers, Daisy Philips, F. Vyth-Dreese, Jos H. Beijnen, B. Nuijen, J. H. van den Berg, J. B. Haanen","doi":"10.1159/000537896","DOIUrl":"https://doi.org/10.1159/000537896","url":null,"abstract":"INTRODUCTION\u0000Naked DNA vaccination could be a powerful and safe strategy to mount antigen-specific cellular immunity. We designed a phase I clinical trial to investigate the toxicity of naked DNA vaccines encoding CD8+ T-cell epitope from tumor-associated antigen MART-1 in patients with advanced melanoma.\u0000\u0000\u0000METHODS\u0000This dose escalating phase Ia clinical trial investigates the toxicity and immunological response upon naked DNA vaccines encoding a CD8+ T-cell epitope from the tumor-associated antigen MART-1, genetically linked to the gene encoding domain 1 of subunit-tetanus toxin fragment C in patients with advanced melanoma (inoperable stage IIIC-IV, AJCC 7th edition). The vaccine was administrated via intradermal application using a permanent make-up or tattoo device. Safety was monitored according to CTCAE v.3.0 and skin biopsies and blood samples were obtained for immunologic monitoring.\u0000\u0000\u0000RESULTS\u0000Nine pretreated, HLA-A*0201-positive patients with advanced melanoma expressing MART-1 and MHC class I, with a good performance status, and adequate organ function, were included. With a median follow-up of 5.9 months, DNA vaccination was safe, without treatment-related deaths. Common treatment-emergent adverse events of any grade were dermatologic reactions at the vaccination site (100%) and pain (56%). One patient experienced grade 4 toxicity, most likely related to tumor progression. One patient (11%) achieved stable disease, lasting 353 days. Immune analysis showed no increase in vaccine-induced T cell response in peripheral blood of five patients, but did show a MART-1 specific CD8+ T cell response at the tattoo administration site. The maximum dose administered was 2 mg due to lack of clinical activity.\u0000\u0000\u0000CONCLUSION\u0000We showed that the developed DNA vaccine, applied using a novel intradermal application strategy, can be administered safely. Further research with improved vaccine formats is required to show possible clinical benefit of DNA vaccination.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737494","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}
Gul Sema Yıldıran Keskin, İ. Ertürk, M. Aykan, R. Acar, Aysegul Dumludag, Alper Topal, Caglar Koseoglu, Omer Faruk Kuzu, Ece Ornek, N. Karadurmuş
PURPOSE The optimal management of relapsed/refractory germ cell tumors remains unsettled. In this study, we aimed to evaluate the efficacy of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) as salvage therapy in patients who progressed after at least one line of cisplatin-based chemotherapy. METHODS We retrospectively reported the results of 133 patients who underwent HDCT and ASCT as salvage therapy from 2016 to 2021. Patients received 3 cycles of paclitaxel, ifosfomide and cisplatin (TIP) regimen as induction and 1 cycle of carboplatin 700 mg/m2 on days 1 to 3 plus etoposide 750 mg/m2 on days 1 to 3, followed by ASCT. Demographic and clinicopathological features of patients, the International Germ Cell Cancer Collaborative Group (IGCCCG) risk group at diagnosis, serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) levels before HDCT, treatment related complications and survival outcomes were recorded. RESULTS The median age of the patients was 31 (range 18-62). The median follow-up was 31.1 months (95% CI, 28.9 to 33.3 months). During the median follow-up period, 74 of the 133 patients were still alive, and 63 of these were in complete remission. The median progression-free survival (PFS) was 25.8 months (95% CI, 8.1-43.4 months). The 2-year PFS rate was 50.3% and the 2-year overall survival rate was 60.8%. Variables that remained statistically significant in multivariable analysis and were associated with poor prognosis were mediastinal primary tumor location, presence of brain metastases, and higher AFP and HCG levels at baseline. CONCLUSION One course of HDCT and ASCT after induction with TIP is an effective and feasible treatment option for salvage treatment of relapsed/refractory germ cell tumors, with cure rates of up to 60%.
{"title":"High dose chemotherapy and autologous stem cell transplantation for salvage therapy of relapsed /refractory germ cell tumors; a single center experience.","authors":"Gul Sema Yıldıran Keskin, İ. Ertürk, M. Aykan, R. Acar, Aysegul Dumludag, Alper Topal, Caglar Koseoglu, Omer Faruk Kuzu, Ece Ornek, N. Karadurmuş","doi":"10.1159/000538660","DOIUrl":"https://doi.org/10.1159/000538660","url":null,"abstract":"PURPOSE\u0000The optimal management of relapsed/refractory germ cell tumors remains unsettled. In this study, we aimed to evaluate the efficacy of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) as salvage therapy in patients who progressed after at least one line of cisplatin-based chemotherapy.\u0000\u0000\u0000METHODS\u0000We retrospectively reported the results of 133 patients who underwent HDCT and ASCT as salvage therapy from 2016 to 2021. Patients received 3 cycles of paclitaxel, ifosfomide and cisplatin (TIP) regimen as induction and 1 cycle of carboplatin 700 mg/m2 on days 1 to 3 plus etoposide 750 mg/m2 on days 1 to 3, followed by ASCT. Demographic and clinicopathological features of patients, the International Germ Cell Cancer Collaborative Group (IGCCCG) risk group at diagnosis, serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) levels before HDCT, treatment related complications and survival outcomes were recorded.\u0000\u0000\u0000RESULTS\u0000The median age of the patients was 31 (range 18-62). The median follow-up was 31.1 months (95% CI, 28.9 to 33.3 months). During the median follow-up period, 74 of the 133 patients were still alive, and 63 of these were in complete remission. The median progression-free survival (PFS) was 25.8 months (95% CI, 8.1-43.4 months). The 2-year PFS rate was 50.3% and the 2-year overall survival rate was 60.8%. Variables that remained statistically significant in multivariable analysis and were associated with poor prognosis were mediastinal primary tumor location, presence of brain metastases, and higher AFP and HCG levels at baseline.\u0000\u0000\u0000CONCLUSION\u0000One course of HDCT and ASCT after induction with TIP is an effective and feasible treatment option for salvage treatment of relapsed/refractory germ cell tumors, with cure rates of up to 60%.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739970","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":"Thoracic Oncology Highlights from the European Society for Medical Oncology Annual Meeting 2023 with focus on perioperative therapy, radiotherapy and BiTEs.","authors":"Marcel Kemper, Puyan Soltani Germy, Fabian Acker, Jingting Luan, F. Griesinger, Amanda Tufman, Cornelia Kropf-Sanchen, T. Overbeck, Annalen Bleckmann, Miriam Blasi","doi":"10.1159/000538662","DOIUrl":"https://doi.org/10.1159/000538662","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742519","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}
Nargiz Majidova, Murat Sarı, Fatma Akdag Kahvecıglu, Erkan Ozcan, Mutıanur Ozkorkmaz Akdag, Akıf Dogan, Sedat Yıldırım, Sermın Dınc Sonusen, Emıl Yunusov, Alper Yaşar, A. Celebı, Nadiye Sever, Erkam Kocaaslan, Pınar Erel, Yeşim Ağyol, Ali Kaan Guren, R. Arıkan, S. Isik, O. Balvan, Ç. Geredeli, K. Uygun, İ. Hacıbekiroğlu, Osman Kostek, I. V. Bayoglu
INTRODUCTION Nasopharyngeal carcinoma (NPC) accounts for 0.01% of all carcinomas, and 70% of patients have locally advanced disease with a poor prognosis. The mainstay therapy is chemoradiotherapy (CRT), and concurrent administration of platinum-based agents and irradiation provides high local control rates. However, induction (neoadjuvant) chemotherapy (ICT) prior to chemoradiotherapy is recommended for large tumors with a high tumor burden at category 1 level. For induction chemotherapy, platinum-based doublet or triplet combination regimens are recommended. Selected patients with high tumor burden at the time of diagnosis who did not receive induction chemotherapy before chemoradiotherapy were given adjuvant (consolidation) therapy after chemoradiotherapy. This multi-center study aims to share our experience in treatment of NPC and evaluate the factors associated with survival. METHODS The study included patients diagnosed with NPC who were followed and treated between 2008 and 2022. 142 patients from 6 centers were evaluated. The factors associated with disease-free survival (DFS) overall survival (OS) were evaluated. RESULTS The median age of our patients was 51 years (IQR: 16-81 years), and the male:female ratio was 2.5:1. A majority of patients (71%) had stage 3-4 disease. They had locally advanced disease, and 48 patients (34%) received induction chemotherapy. Twenty patients (14%) received adjuvant therapy. The median follow-up was 41 months (range, 2.7 to 175.1 months). The median DFS in NPC was 92.6 months (range, 71.9 to 113.3 months), with the 40th month DFS of 70.9%. The median OS was 113 months (range, 91 to 135 months), with the 40th month OS of 84.7%. Median DFS was 95.3 months (range, 64.2 to 126.4 months) in patients who received induction chemotherapy before CRT, which was longer than in the CRT-only group (p=0.6). DFS at the 40th month was 75.1% in patients treated with induction chemotherapy compared to 65.1% in the CRT-only group. Median OS was 117 months (range, 92 to 142 months) in patients receiving induction chemotherapy, which was longer than in the CRT-only group (p=0.4). OS at the 40th month was 86.7% in patients receiving ICT, but 83.6% in the CRT-only group. CONCLUSIONS Both objective response rate (ORR) and survival were longer in patients who radiologically responded to chemoradiotherapy following induction chemotherapy. Non-response to induction chemotherapy is a negative predictive indicator. The role of induction chemotherapy in locally advanced NPC is increasing.
{"title":"Clinicopathologic Features And Efficacy Of Induction Chemotherapy In Nasopharyngeal Carcinoma: Real-World Experience.","authors":"Nargiz Majidova, Murat Sarı, Fatma Akdag Kahvecıglu, Erkan Ozcan, Mutıanur Ozkorkmaz Akdag, Akıf Dogan, Sedat Yıldırım, Sermın Dınc Sonusen, Emıl Yunusov, Alper Yaşar, A. Celebı, Nadiye Sever, Erkam Kocaaslan, Pınar Erel, Yeşim Ağyol, Ali Kaan Guren, R. Arıkan, S. Isik, O. Balvan, Ç. Geredeli, K. Uygun, İ. Hacıbekiroğlu, Osman Kostek, I. V. Bayoglu","doi":"10.1159/000537988","DOIUrl":"https://doi.org/10.1159/000537988","url":null,"abstract":"INTRODUCTION\u0000Nasopharyngeal carcinoma (NPC) accounts for 0.01% of all carcinomas, and 70% of patients have locally advanced disease with a poor prognosis. The mainstay therapy is chemoradiotherapy (CRT), and concurrent administration of platinum-based agents and irradiation provides high local control rates. However, induction (neoadjuvant) chemotherapy (ICT) prior to chemoradiotherapy is recommended for large tumors with a high tumor burden at category 1 level. For induction chemotherapy, platinum-based doublet or triplet combination regimens are recommended. Selected patients with high tumor burden at the time of diagnosis who did not receive induction chemotherapy before chemoradiotherapy were given adjuvant (consolidation) therapy after chemoradiotherapy. This multi-center study aims to share our experience in treatment of NPC and evaluate the factors associated with survival.\u0000\u0000\u0000METHODS\u0000The study included patients diagnosed with NPC who were followed and treated between 2008 and 2022. 142 patients from 6 centers were evaluated. The factors associated with disease-free survival (DFS) overall survival (OS) were evaluated.\u0000\u0000\u0000RESULTS\u0000The median age of our patients was 51 years (IQR: 16-81 years), and the male:female ratio was 2.5:1. A majority of patients (71%) had stage 3-4 disease. They had locally advanced disease, and 48 patients (34%) received induction chemotherapy. Twenty patients (14%) received adjuvant therapy. The median follow-up was 41 months (range, 2.7 to 175.1 months). The median DFS in NPC was 92.6 months (range, 71.9 to 113.3 months), with the 40th month DFS of 70.9%. The median OS was 113 months (range, 91 to 135 months), with the 40th month OS of 84.7%. Median DFS was 95.3 months (range, 64.2 to 126.4 months) in patients who received induction chemotherapy before CRT, which was longer than in the CRT-only group (p=0.6). DFS at the 40th month was 75.1% in patients treated with induction chemotherapy compared to 65.1% in the CRT-only group. Median OS was 117 months (range, 92 to 142 months) in patients receiving induction chemotherapy, which was longer than in the CRT-only group (p=0.4). OS at the 40th month was 86.7% in patients receiving ICT, but 83.6% in the CRT-only group.\u0000\u0000\u0000CONCLUSIONS\u0000Both objective response rate (ORR) and survival were longer in patients who radiologically responded to chemoradiotherapy following induction chemotherapy. Non-response to induction chemotherapy is a negative predictive indicator. The role of induction chemotherapy in locally advanced NPC is increasing.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751381","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}
K. Heinrich, Volker Heinemann, S. Stintzing, Lothar Müller, T. Ettrich, P. Buechner-Steudel, Michael Geissler, Jörg Trojan, N. Moosmann, Gunnar Folprecht, Johannes Schmidt, S. Kanzler, Frank Kullmann, Jean-Charles Moulin, Jens Werner, Martin K Angele, Victoria Probst, S. Held, C. Schulz, Myrto Boukovala
INTRODUCTION S-1 has been shown to be an effective adjuvant treatment option for East Asian patients who underwent gastrectomy for stage II/III gastric cancer. We conducted a phase I/II study to evaluate the feasibility, tolerability and efficacy of administering S-1 in the adjuvant setting after R0-resection of adenocarcinoma of the stomach and esophagogastric junction (EGJ) in Caucasian patients. METHODS In this single-cohort, open-label, phase I/II trial, we enrolled patients with locally advanced adenocarcinoma of the stomach or EGJ having undergone R0-resection with or without neoadjuvant treatment. One treatment cycle consisted of oral S-1 (30mg/m² bid) for 14 days. Cycles were repeated every 3 weeks for 18 cycles (54 weeks). Primary endpoint was feasibility and tolerability. Safety was evaluated according to the common toxicity criteria adverse events 4.0 criteria. Secondary endpoints were one-year relapse-free survival rate, relapse-free survival (RFS) and overall survival (OS). RESULTS Between 10/2015 and 02/2018, 32 patients were enrolled in 12 German centres and 30 started adjuvant study treatment. Seventeen patients completed all 18 cycles. Two patients terminated study treatment due to adverse events (AEs), 7 due to patient's or investigator's decision and 4 due to recurrence or distant metastasis during adjuvant therapy. Dose levels were reduced to 25 mg/m² in 9 patients, and to 20 mg/m² in 1 patient. Of patients completing all 18 cycles, 5 did so with reduced dosage of S-1. Documented grade ≥ 3 AEs were neutropenia, diarrhoea, vomiting, polyneuropathy, palmar-plantar erythrodysaesthesia and rash. Serious AEs were observed in 7 patients. Median RFS was 32.2 months. One-year relapse-free survival rate was 77%. Data on OS were still premature at the end of the study. CONCLUSION Adjuvant treatment with S-1 for one year is a feasible and safe treatment option for Caucasian patients diagnosed with gastric adenocarcinoma or cancer of the EGJ cancer after R0-resection.
{"title":"Adjuvant treatment with S-1 in patients after R0-resection of adenocarcinoma of the stomach and esophagogastric junction - A multicenter phase I/II feasibility study (GMBH-STO-0114).","authors":"K. Heinrich, Volker Heinemann, S. Stintzing, Lothar Müller, T. Ettrich, P. Buechner-Steudel, Michael Geissler, Jörg Trojan, N. Moosmann, Gunnar Folprecht, Johannes Schmidt, S. Kanzler, Frank Kullmann, Jean-Charles Moulin, Jens Werner, Martin K Angele, Victoria Probst, S. Held, C. Schulz, Myrto Boukovala","doi":"10.1159/000538143","DOIUrl":"https://doi.org/10.1159/000538143","url":null,"abstract":"INTRODUCTION\u0000S-1 has been shown to be an effective adjuvant treatment option for East Asian patients who underwent gastrectomy for stage II/III gastric cancer. We conducted a phase I/II study to evaluate the feasibility, tolerability and efficacy of administering S-1 in the adjuvant setting after R0-resection of adenocarcinoma of the stomach and esophagogastric junction (EGJ) in Caucasian patients.\u0000\u0000\u0000METHODS\u0000In this single-cohort, open-label, phase I/II trial, we enrolled patients with locally advanced adenocarcinoma of the stomach or EGJ having undergone R0-resection with or without neoadjuvant treatment. One treatment cycle consisted of oral S-1 (30mg/m² bid) for 14 days. Cycles were repeated every 3 weeks for 18 cycles (54 weeks). Primary endpoint was feasibility and tolerability. Safety was evaluated according to the common toxicity criteria adverse events 4.0 criteria. Secondary endpoints were one-year relapse-free survival rate, relapse-free survival (RFS) and overall survival (OS).\u0000\u0000\u0000RESULTS\u0000Between 10/2015 and 02/2018, 32 patients were enrolled in 12 German centres and 30 started adjuvant study treatment. Seventeen patients completed all 18 cycles. Two patients terminated study treatment due to adverse events (AEs), 7 due to patient's or investigator's decision and 4 due to recurrence or distant metastasis during adjuvant therapy. Dose levels were reduced to 25 mg/m² in 9 patients, and to 20 mg/m² in 1 patient. Of patients completing all 18 cycles, 5 did so with reduced dosage of S-1. Documented grade ≥ 3 AEs were neutropenia, diarrhoea, vomiting, polyneuropathy, palmar-plantar erythrodysaesthesia and rash. Serious AEs were observed in 7 patients. Median RFS was 32.2 months. One-year relapse-free survival rate was 77%. Data on OS were still premature at the end of the study.\u0000\u0000\u0000CONCLUSION\u0000Adjuvant treatment with S-1 for one year is a feasible and safe treatment option for Caucasian patients diagnosed with gastric adenocarcinoma or cancer of the EGJ cancer after R0-resection.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755863","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}
Pub Date : 2024-01-01Epub Date: 2024-05-07DOI: 10.1159/000539143
Katell Le Dû, Anne-Lise Septans, Julien Dômont, Olivier Dupuis, Eric Emmanuel, Anne Peribois, Sophie Gaillard, Caroline Allix-Béguec
Introduction: The incidence of anaemia and its consequences are often underestimated during cancer management. We propose to evaluate the situation before and after the recommendations were updated in order to assess their impact on the day-to-day practice.
Methods: In this single-centre retrospective study, eligible patients were treated for cancer and warranted overnight hospitalization over two periods (n = 206 in 2011, n = 143 in 2018). The diagnosis of anaemia was defined by a haemoglobin level below 12 and 13 g/dL for women and men, respectively.
Results: The prevalence of anaemia was 26% in 2011 and 16% in 2018 (p < 0.001). Biological assessment had changed between the two periods, with more tests of iron metabolism and measurements of inflammatory parameters. Patients hospitalized in 2018 had more advanced cancer and more severe anaemia (8.2 g/dL [±1.07] in 2011 vs. 7.9 g/dL [±1.18] in 2018). Rate of transfusion therapy did not change, but patients with mild and moderate anaemia were transfused less in 2018 (57% in 2011 vs. 44% in 2018). Intravenous iron and erythropoiesis-stimulating agent were used more frequently in 2018 (1 and 5 and 13 and 23% in 2011 and 2018, respectively), mainly for mild anaemia and life-threatening anaemia, respectively. Overall survival was poor in both cohorts at 24 months (15.4% in 2011 and 6.5% in 2018, p = 0.048).
Conclusion: Practices have changed in the diagnosis of anaemia and prescriptions for erythropoiesis-stimulating agents and intravenous iron have increased. Efforts must continue to explore the causes of anaemia, optimize patients' quality of life, and reduce transfusions.
{"title":"Anaemia in Hospitalized Cancer Patients: A Retrospective Study of Two Cohorts before and after the Guideline Update.","authors":"Katell Le Dû, Anne-Lise Septans, Julien Dômont, Olivier Dupuis, Eric Emmanuel, Anne Peribois, Sophie Gaillard, Caroline Allix-Béguec","doi":"10.1159/000539143","DOIUrl":"10.1159/000539143","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of anaemia and its consequences are often underestimated during cancer management. We propose to evaluate the situation before and after the recommendations were updated in order to assess their impact on the day-to-day practice.</p><p><strong>Methods: </strong>In this single-centre retrospective study, eligible patients were treated for cancer and warranted overnight hospitalization over two periods (n = 206 in 2011, n = 143 in 2018). The diagnosis of anaemia was defined by a haemoglobin level below 12 and 13 g/dL for women and men, respectively.</p><p><strong>Results: </strong>The prevalence of anaemia was 26% in 2011 and 16% in 2018 (p < 0.001). Biological assessment had changed between the two periods, with more tests of iron metabolism and measurements of inflammatory parameters. Patients hospitalized in 2018 had more advanced cancer and more severe anaemia (8.2 g/dL [±1.07] in 2011 vs. 7.9 g/dL [±1.18] in 2018). Rate of transfusion therapy did not change, but patients with mild and moderate anaemia were transfused less in 2018 (57% in 2011 vs. 44% in 2018). Intravenous iron and erythropoiesis-stimulating agent were used more frequently in 2018 (1 and 5 and 13 and 23% in 2011 and 2018, respectively), mainly for mild anaemia and life-threatening anaemia, respectively. Overall survival was poor in both cohorts at 24 months (15.4% in 2011 and 6.5% in 2018, p = 0.048).</p><p><strong>Conclusion: </strong>Practices have changed in the diagnosis of anaemia and prescriptions for erythropoiesis-stimulating agents and intravenous iron have increased. Efforts must continue to explore the causes of anaemia, optimize patients' quality of life, and reduce transfusions.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876976","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号