Pub Date : 2024-01-19DOI: 10.4103/ejcrp.ejcrp-d-23-00050
Ming-Huang Chen, Wan-Shan Li, Bin-Chi Liao, Chiao-En Wu, Chien-Feng Li, Chia Hsieh, Feng-Che Kuan, Huey-En Tzeng, Jen-Fan Hang, Nai-Jung Chiang, Tse-Ching Chen, Tom Wei-Wu Chen, J. W. Chang, Yao-Yu Hsieh, Yen-Lin Chen, Yi-Chen Yeh, Yi-Hsin Liang, Yu-Li Su, Chiung-Ru Lai, James Chih-Hsin Yang
The Taiwan Oncology Society (TOS) and the Taiwan Society of Pathology (TSP) have collaborated to present a joint position paper on the molecular tumor boards (MTBs) within the medical institutions of Taiwan. To raise awareness of MTBs among health-care professionals, policymakers, and the public, a total of 20 experts from TOS and TSP formulated a joint consensus statement through a voting process. The joint statement proposes key recommendations: (1) MTB discussions encompass diverse molecular analyses including next-generation sequencing (NGS), RNA sequencing, whole-exon sequencing, and whole-genomic sequencing addressing relevant genomic changes, tumor mutation burden, microsatellite instability, and specific biomarkers for certain cancers. (2) MTB meetings should involve multidisciplinary participants who receive regular updates on NGS-related clinical trials. (3) Prioritize discussing cases with unique clinical needs, gene alterations lacking treatments, untreatable neoplasms, or oncogenes unresponsive to targeted therapies. (4) Base MTB discussions on comprehensive patient data, including genetics, pathology, timing of specimen collection, and NGS outcomes. (5) MTBs offer treatment recommendations: standard therapies, off-label use, clinical trials, genetic counseling, and multidisciplinary reviews. (6) MTB effectiveness can be gauged by member composition, case reviews, treatment suggestions, and patient outcomes. Encourage government incentives for MTB engagement. The primary aim of this initiative is to promote the advancement of precision oncology in Taiwan.
{"title":"Expert Consensus on Molecular Tumor Boards in Taiwan: Joint Position Paper by the Taiwan Oncology Society and the Taiwan Society of Pathology","authors":"Ming-Huang Chen, Wan-Shan Li, Bin-Chi Liao, Chiao-En Wu, Chien-Feng Li, Chia Hsieh, Feng-Che Kuan, Huey-En Tzeng, Jen-Fan Hang, Nai-Jung Chiang, Tse-Ching Chen, Tom Wei-Wu Chen, J. W. Chang, Yao-Yu Hsieh, Yen-Lin Chen, Yi-Chen Yeh, Yi-Hsin Liang, Yu-Li Su, Chiung-Ru Lai, James Chih-Hsin Yang","doi":"10.4103/ejcrp.ejcrp-d-23-00050","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-23-00050","url":null,"abstract":"\u0000 \u0000 \u0000 The Taiwan Oncology Society (TOS) and the Taiwan Society of Pathology (TSP) have collaborated to present a joint position paper on the molecular tumor boards (MTBs) within the medical institutions of Taiwan.\u0000 \u0000 \u0000 \u0000 To raise awareness of MTBs among health-care professionals, policymakers, and the public, a total of 20 experts from TOS and TSP formulated a joint consensus statement through a voting process.\u0000 \u0000 \u0000 \u0000 The joint statement proposes key recommendations: (1) MTB discussions encompass diverse molecular analyses including next-generation sequencing (NGS), RNA sequencing, whole-exon sequencing, and whole-genomic sequencing addressing relevant genomic changes, tumor mutation burden, microsatellite instability, and specific biomarkers for certain cancers. (2) MTB meetings should involve multidisciplinary participants who receive regular updates on NGS-related clinical trials. (3) Prioritize discussing cases with unique clinical needs, gene alterations lacking treatments, untreatable neoplasms, or oncogenes unresponsive to targeted therapies. (4) Base MTB discussions on comprehensive patient data, including genetics, pathology, timing of specimen collection, and NGS outcomes. (5) MTBs offer treatment recommendations: standard therapies, off-label use, clinical trials, genetic counseling, and multidisciplinary reviews. (6) MTB effectiveness can be gauged by member composition, case reviews, treatment suggestions, and patient outcomes. Encourage government incentives for MTB engagement.\u0000 \u0000 \u0000 \u0000 The primary aim of this initiative is to promote the advancement of precision oncology in Taiwan.\u0000","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"100 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-22-00019
Wan-Yu Hung, Chih-Ling Lee, Chin-Yao Lin
Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia are rare in teenagers. We report an incidental finding of DCIS in a 17-year-old girl who presented with a mass in the right breast. The pathology confirmed lower-grade DCIS in a fibroadenoma. She subsequently underwent right-breast conservative surgery (BCS) without radiotherapy or adjuvant hormone therapy. Six months of clinical surveillance was recommended, and she remained disease-free 25 months after BCS. Hormone therapy and radiotherapy are still controversial in juvenile patients with DCIS, and long-term surveillance and evaluation are still indispensable.
{"title":"A juvenile female with ductal carcinoma In situ arising from a fibroadenoma","authors":"Wan-Yu Hung, Chih-Ling Lee, Chin-Yao Lin","doi":"10.4103/ejcrp.eJCRP-D-22-00019","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00019","url":null,"abstract":"Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia are rare in teenagers. We report an incidental finding of DCIS in a 17-year-old girl who presented with a mass in the right breast. The pathology confirmed lower-grade DCIS in a fibroadenoma. She subsequently underwent right-breast conservative surgery (BCS) without radiotherapy or adjuvant hormone therapy. Six months of clinical surveillance was recommended, and she remained disease-free 25 months after BCS. Hormone therapy and radiotherapy are still controversial in juvenile patients with DCIS, and long-term surveillance and evaluation are still indispensable.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"82 - 84"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44420420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-22-00018
Ming-Jing Lee, H. Kao
The treatment options for patients with head-and-neck squamous cell carcinoma (HNSCC) are limited when the disease progresses after taking platinum, a PD-1 inhibitor, and cetuximab. To develop new agents for managing such pretreated malignancies, therapies targeting carcinogenic pathways could be possible in HNSCC patients. Several pathways have been identified in HNSCC, including the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. The PI3K/AKT/mTOR pathway is frequently dysregulated in various cancers due to activating mutations or amplification of PIK3CA. The inhibition of this pathway has been proven to improve clinical outcomes in some malignancies with PIK3CA mutations. We report a heavily pretreated HNSCC patient with a good treatment response to alpelisib, a PI3K inhibitor. Furthermore, we discuss the possible limitations of alpelisib monotherapy and possible solutions to overcome these limitations.
{"title":"Promising response with PI3K inhibitor for a patient with heavily pretreated PIK3CA mutation head-and-neck cancer","authors":"Ming-Jing Lee, H. Kao","doi":"10.4103/ejcrp.eJCRP-D-22-00018","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00018","url":null,"abstract":"The treatment options for patients with head-and-neck squamous cell carcinoma (HNSCC) are limited when the disease progresses after taking platinum, a PD-1 inhibitor, and cetuximab. To develop new agents for managing such pretreated malignancies, therapies targeting carcinogenic pathways could be possible in HNSCC patients. Several pathways have been identified in HNSCC, including the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. The PI3K/AKT/mTOR pathway is frequently dysregulated in various cancers due to activating mutations or amplification of PIK3CA. The inhibition of this pathway has been proven to improve clinical outcomes in some malignancies with PIK3CA mutations. We report a heavily pretreated HNSCC patient with a good treatment response to alpelisib, a PI3K inhibitor. Furthermore, we discuss the possible limitations of alpelisib monotherapy and possible solutions to overcome these limitations.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"75 - 77"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45105772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-22-00030
M. Chen, Chia Hsieh, Ching-Yao Yang, H. Tsai, Li‐Tzong Chen
Objective: The current study aimed to investigate the issues in contemporary management strategies that focus on small pancreatic neuroendocrine tumors (PNETs). Data Sources and Study Selection: We searched various scientific databases using specific keywords. Results: Surveillance-only strategies were considered for selected patients. The exact cut-off value of small neuroendocrine tumors for surveillance-only strategies needs to be verified with additional high-level evidence. Conclusion: There is no consensus on the size and treatment strategy for small PNETs currently. Patients with small nonfunctioning PNETs require individualized recommendations for surgery versus active surveillance based on tumor size, radiographic characteristics, and patient characteristics, such as age and comorbidities and also patient references.
{"title":"Small pancreas neuroendocrine tumors: How small is small?","authors":"M. Chen, Chia Hsieh, Ching-Yao Yang, H. Tsai, Li‐Tzong Chen","doi":"10.4103/ejcrp.eJCRP-D-22-00030","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00030","url":null,"abstract":"Objective: The current study aimed to investigate the issues in contemporary management strategies that focus on small pancreatic neuroendocrine tumors (PNETs). Data Sources and Study Selection: We searched various scientific databases using specific keywords. Results: Surveillance-only strategies were considered for selected patients. The exact cut-off value of small neuroendocrine tumors for surveillance-only strategies needs to be verified with additional high-level evidence. Conclusion: There is no consensus on the size and treatment strategy for small PNETs currently. Patients with small nonfunctioning PNETs require individualized recommendations for surgery versus active surveillance based on tumor size, radiographic characteristics, and patient characteristics, such as age and comorbidities and also patient references.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"50 - 56"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70714663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-22-00033
Li‐Chun Lu, G. Feng, Chih-Hung Hsu
Objective: Immunotherapy with immune checkpoint inhibitors (ICIs) has become a standard of care for many malignancies. The tumor microenvironment (TME) varies across different organs and affects tumor initiation, progression, and treatment outcomes. Organ-specific differential responses to ICIs have been observed in various cancers. The underlying mechanisms warrant further investigation. Data Sources and Study Selection: We enrolled relevant clinical and preclinical studies conducted by our groups and others. Current evidence and data were reviewed and future implication was discussed. Results: In patients with advanced hepatocellular carcinoma or esophageal cancer, non-small cell lung cancer, or melanoma with liver metastases, the efficacy of ICI-based therapy was generally lower in the liver than in other organs. The mouse liver cancer study showed that myeloid-derived suppressor cells (MDSCs) might play a role in immunosuppressive TME in the liver as compared to subcutaneous tissues; targeting MDSCs enhanced anti-tumor efficacy in the liver. The metastatic colon cancer models showed that monotherapy with anti-programmed death ligand-1 (PD-L1) antibody was less effective in suppressing tumor growth in the liver than in subcutaneous tissues. Mechanistically, modulation of hepatic innate immune cells was associated with the improved response of anti-PD-L1 antibody in the liver. Conclusion: The relatively unfavorable tumor response to immunotherapy in the liver of various cancers may be attributable to the immunosuppressive hepatic TME. Future comprehensive immune profiling is required to identify key factors and mechanisms in specific organs to overcome immunosuppressive TME, particularly in the liver.
{"title":"Unfavorable tumor responses to immunotherapy in the liver: Lessons learned from clinical and preclinical studies","authors":"Li‐Chun Lu, G. Feng, Chih-Hung Hsu","doi":"10.4103/ejcrp.eJCRP-D-22-00033","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00033","url":null,"abstract":"Objective: Immunotherapy with immune checkpoint inhibitors (ICIs) has become a standard of care for many malignancies. The tumor microenvironment (TME) varies across different organs and affects tumor initiation, progression, and treatment outcomes. Organ-specific differential responses to ICIs have been observed in various cancers. The underlying mechanisms warrant further investigation. Data Sources and Study Selection: We enrolled relevant clinical and preclinical studies conducted by our groups and others. Current evidence and data were reviewed and future implication was discussed. Results: In patients with advanced hepatocellular carcinoma or esophageal cancer, non-small cell lung cancer, or melanoma with liver metastases, the efficacy of ICI-based therapy was generally lower in the liver than in other organs. The mouse liver cancer study showed that myeloid-derived suppressor cells (MDSCs) might play a role in immunosuppressive TME in the liver as compared to subcutaneous tissues; targeting MDSCs enhanced anti-tumor efficacy in the liver. The metastatic colon cancer models showed that monotherapy with anti-programmed death ligand-1 (PD-L1) antibody was less effective in suppressing tumor growth in the liver than in subcutaneous tissues. Mechanistically, modulation of hepatic innate immune cells was associated with the improved response of anti-PD-L1 antibody in the liver. Conclusion: The relatively unfavorable tumor response to immunotherapy in the liver of various cancers may be attributable to the immunosuppressive hepatic TME. Future comprehensive immune profiling is required to identify key factors and mechanisms in specific organs to overcome immunosuppressive TME, particularly in the liver.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"45 - 49"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44668814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Extramedullary myeloma disease represents an infrequent but aggressive variant of multiple myeloma (MM), and it is associated with a poor prognosis. An optimal treatment strategy for this clinical subset has not yet been clarified. In this report, we demonstrate a patient with MM with the uncommon manifestation of plasmacytomas with a very high burden in the bilateral adrenal glands at diagnosis, which were treated successfully with daratumumab-based second-line therapy.
{"title":"Bilateral bulky adrenal plasmacytomas with very good response to daratumumab-based therapy","authors":"Fang Wang, Han-Kuang Hsieh, Tso-fu Wang, Yi-Feng Wu","doi":"10.4103/ejcrp.eJCRP-D-22-00027","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00027","url":null,"abstract":"Extramedullary myeloma disease represents an infrequent but aggressive variant of multiple myeloma (MM), and it is associated with a poor prognosis. An optimal treatment strategy for this clinical subset has not yet been clarified. In this report, we demonstrate a patient with MM with the uncommon manifestation of plasmacytomas with a very high burden in the bilateral adrenal glands at diagnosis, which were treated successfully with daratumumab-based second-line therapy.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"78 - 81"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48235423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.ejcrp-d-22-00036
Makoto Kadokura, Keisuke Tanaka, F. Amemiya, S. Takano, M. Fukasawa, N. Enomoto
Background: The usefulness of various prognostic factors for pancreatic cancer has been reported, but limited studies have focused on these changes during chemotherapy. The purpose of the present study was to investigate the prognostic factors and to evaluate the significance of these changes during chemotherapy in patients with advanced pancreatic cancer (APC). Materials and Methods: We retrospectively analyzed 213 patients with APC who underwent chemotherapy between January 2006 and December 2018 at Kofu Municipal Hospital and University of Yamanashi Hospital. Univariate and multivariate cox regression models were applied to investigate independent prognostic factors. Results: Multivariate analysis revealed that Eastern Cooperative Oncology Group Performance Status 2 (hazard ratio [HR] 4.07, P < 0.01), neutrophil-to-lymphocyte ratio (NLR) ≥3.9 (HR 1.97, P < 0.001), modified Glasgow prognostic score 1–2 (HR 2.77, P < 0.001), carcinoembryonic antigen ≥5.0 (HR 1.44, P = 0.026), carbohydrate antigen 19-9 ≥37 (HR 1.83, P = 0.004), ΔNLR >0 (HR 2.01, P < 0.001), ΔCEA (subtracting the baseline from the start of second cycles of chemotherapy) >0 (HR 1.64, P = 0.002), and ΔCA19-9>0 (HR 1.77, P = 0.002) were independent negative prognostic factors. Conclusion: Baseline and change in tumor markers and NLR are useful in predicting overall survival in APC patients undergoing chemotherapy.
背景:各种胰腺癌预后因素的有用性已被报道，但有限的研究集中在化疗期间的这些变化。本研究的目的是探讨晚期胰腺癌(APC)患者化疗期间这些变化的预后因素和意义。材料与方法:我们回顾性分析了2006年1月至2018年12月期间在神府市立医院和山梨县大学医院接受化疗的213例APC患者。采用单因素和多因素cox回归模型研究独立预后因素。结果:多变量分析显示,东部合作肿瘤组性能状态2(危险比[HR] 4.07, P < 0.01), neutrophil-to-lymphocyte比率(NLR)≥3.9 (HR 1.97, P < 0.001),修改格拉斯哥预后评分1 - 2 (HR 2.77, P < 0.001),癌胚抗原≥5.0 (HR 1.44, P = 0.026),碳水化合物抗原胜负≥37 (HR 1.83, P = 0.004),ΔNLR > 0 (HR 2.01, P < 0.001),ΔCEA(减去基线从一开始的第二个周期的化疗)> 0 (HR 1.64, P = 0.002),ΔCA19-9>0 (HR 1.77, P = 0.002)是独立的不良预后因素。结论:基线及肿瘤标志物和NLR的变化可用于预测APC化疗患者的总生存期。
{"title":"Significance of baseline and changes of tumor markers and neutrophil-to-lymphocyte ratio in predicting overall survival for patients with advanced pancreatic adenocarcinoma: A retrospective analysis","authors":"Makoto Kadokura, Keisuke Tanaka, F. Amemiya, S. Takano, M. Fukasawa, N. Enomoto","doi":"10.4103/ejcrp.ejcrp-d-22-00036","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-22-00036","url":null,"abstract":"Background: The usefulness of various prognostic factors for pancreatic cancer has been reported, but limited studies have focused on these changes during chemotherapy. The purpose of the present study was to investigate the prognostic factors and to evaluate the significance of these changes during chemotherapy in patients with advanced pancreatic cancer (APC). Materials and Methods: We retrospectively analyzed 213 patients with APC who underwent chemotherapy between January 2006 and December 2018 at Kofu Municipal Hospital and University of Yamanashi Hospital. Univariate and multivariate cox regression models were applied to investigate independent prognostic factors. Results: Multivariate analysis revealed that Eastern Cooperative Oncology Group Performance Status 2 (hazard ratio [HR] 4.07, P < 0.01), neutrophil-to-lymphocyte ratio (NLR) ≥3.9 (HR 1.97, P < 0.001), modified Glasgow prognostic score 1–2 (HR 2.77, P < 0.001), carcinoembryonic antigen ≥5.0 (HR 1.44, P = 0.026), carbohydrate antigen 19-9 ≥37 (HR 1.83, P = 0.004), ΔNLR >0 (HR 2.01, P < 0.001), ΔCEA (subtracting the baseline from the start of second cycles of chemotherapy) >0 (HR 1.64, P = 0.002), and ΔCA19-9>0 (HR 1.77, P = 0.002) were independent negative prognostic factors. Conclusion: Baseline and change in tumor markers and NLR are useful in predicting overall survival in APC patients undergoing chemotherapy.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45428306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-22-00031
Chang-Ting Lin, Chenhsuan Wu, Hsuan-Ying Huang, Chien-ting Liu
An inflammatory myofibroblastic tumor (IMT) is an uncommon sarcoma subtype with histopathological features, including inflammatory infiltrates. Anaplastic lymphoma kinase (ALK) gene rearrangement has been reported in half of the patients with IMTs; therefore, crizotinib, an ALK inhibitor, may achieve a response rate of 50% in these patients. We present a case with an initial diagnosis of uterine sarcoma and multiple lung metastases. After the failure of doxorubicin-based chemotherapy, revised pathology from a palliative hysterectomy revealed an IMT with ALK gene rearrangement. Treatment with alectinib achieved an excellent tumor response. The accurate differential diagnosis of uncommon sarcoma subtypes is crucial because a specific targeted therapy may considerably alter treatment outcomes.
{"title":"Pneumothorax during alectinib treatment for a uterine inflammatory myofibroblastic tumor with lung metastasis","authors":"Chang-Ting Lin, Chenhsuan Wu, Hsuan-Ying Huang, Chien-ting Liu","doi":"10.4103/ejcrp.eJCRP-D-22-00031","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-22-00031","url":null,"abstract":"An inflammatory myofibroblastic tumor (IMT) is an uncommon sarcoma subtype with histopathological features, including inflammatory infiltrates. Anaplastic lymphoma kinase (ALK) gene rearrangement has been reported in half of the patients with IMTs; therefore, crizotinib, an ALK inhibitor, may achieve a response rate of 50% in these patients. We present a case with an initial diagnosis of uterine sarcoma and multiple lung metastases. After the failure of doxorubicin-based chemotherapy, revised pathology from a palliative hysterectomy revealed an IMT with ALK gene rearrangement. Treatment with alectinib achieved an excellent tumor response. The accurate differential diagnosis of uncommon sarcoma subtypes is crucial because a specific targeted therapy may considerably alter treatment outcomes.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"71 - 74"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47729287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ejcrp.eJCRP-D-23-00003
Yuan-Ting C. Lo, H. Ku, Cheng-Shyong Chang, Hui-Ju Ch’ang, Chih-Ming Ho, T. Liu, Shih-Min Lin
Background: Whether or not patients with stage I epithelial ovarian cancer (EOC) benefit from postoperative chemotherapy in the Asian population remains unclear. This retrospective cohort study was aimed at investigating the use of adjuvant chemotherapy in clinical practice to treat patients with early-stage EOC considering clinical factors. Materials and Methods: A total of 414 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IA–IC and grade 1 EOC were enrolled from the Taiwan Cancer Registry. We used multivariable Cox proportional-hazards models to control for clinical factors. The overall survival (OS) and disease-free survival (DFS) were estimated with the Kaplan–Meier method. Results: DFS did not improve significantly for patients with FIGO stage IA/IB EOC receiving adjuvant chemotherapy, with a 10-year DFS rate of 98% and 88% for those with and without adjuvant chemotherapy, respectively (hazard ratio [HR] = 0.41, 95% confidence interval [CI]: 0.05–3.36). OS did not improve significantly for patients with FIGO stage IA/IB EOC with adjuvant chemotherapy (HR = 0.86, 95% CI: 0.18–4.22) or stage IC (HR = 0.50, 95% CI: 0.10–2.45). OS did not differ significantly for patients with optimal (10-year OS: 92% with chemotherapy and 86% without chemotherapy in the log-rank test, P = 0.629) or nonoptimal staging (10-year OS: 73% with chemotherapy and 90% without chemotherapy in the log-rank test, P = 0.959). Conclusion: Adjuvant chemotherapy did not improve the prognosis of patients with low to intermediate-risk EOC and optimal/nonoptimal surgery. This result should be considered in clinical practice.
{"title":"Adjuvant chemotherapy in patients with low-risk epithelial ovarian cancer: A Taiwanese cohort study","authors":"Yuan-Ting C. Lo, H. Ku, Cheng-Shyong Chang, Hui-Ju Ch’ang, Chih-Ming Ho, T. Liu, Shih-Min Lin","doi":"10.4103/ejcrp.eJCRP-D-23-00003","DOIUrl":"https://doi.org/10.4103/ejcrp.eJCRP-D-23-00003","url":null,"abstract":"Background: Whether or not patients with stage I epithelial ovarian cancer (EOC) benefit from postoperative chemotherapy in the Asian population remains unclear. This retrospective cohort study was aimed at investigating the use of adjuvant chemotherapy in clinical practice to treat patients with early-stage EOC considering clinical factors. Materials and Methods: A total of 414 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IA–IC and grade 1 EOC were enrolled from the Taiwan Cancer Registry. We used multivariable Cox proportional-hazards models to control for clinical factors. The overall survival (OS) and disease-free survival (DFS) were estimated with the Kaplan–Meier method. Results: DFS did not improve significantly for patients with FIGO stage IA/IB EOC receiving adjuvant chemotherapy, with a 10-year DFS rate of 98% and 88% for those with and without adjuvant chemotherapy, respectively (hazard ratio [HR] = 0.41, 95% confidence interval [CI]: 0.05–3.36). OS did not improve significantly for patients with FIGO stage IA/IB EOC with adjuvant chemotherapy (HR = 0.86, 95% CI: 0.18–4.22) or stage IC (HR = 0.50, 95% CI: 0.10–2.45). OS did not differ significantly for patients with optimal (10-year OS: 92% with chemotherapy and 86% without chemotherapy in the log-rank test, P = 0.629) or nonoptimal staging (10-year OS: 73% with chemotherapy and 90% without chemotherapy in the log-rank test, P = 0.959). Conclusion: Adjuvant chemotherapy did not improve the prognosis of patients with low to intermediate-risk EOC and optimal/nonoptimal surgery. This result should be considered in clinical practice.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"63 - 70"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49235238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ejcrp.ejcrp-d-22-00021
P. Chen, Wan-Ting Li, Chih-Hung Hsu, T. Chen
Ewing's sarcoma (ES) is the second most common primary bone malignancy of childhood, whereas extraosseous ES (EES) is more common in older patients. EES of the small intestine is an extremely rare disease. We present a case of ES of the small intestine with liver metastasis mimicking a gastrointestinal stromal tumor. The diagnosis of ES requires a combination of histological, immunohistochemical, and molecular techniques. Further studies to investigate whether multimodality treatments can improve the survival of metastatic EES are needed.
{"title":"Ewing's sarcoma of the small intestine with liver metastasis mimicking gastrointestinal stromal tumor","authors":"P. Chen, Wan-Ting Li, Chih-Hung Hsu, T. Chen","doi":"10.4103/ejcrp.ejcrp-d-22-00021","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-22-00021","url":null,"abstract":"Ewing's sarcoma (ES) is the second most common primary bone malignancy of childhood, whereas extraosseous ES (EES) is more common in older patients. EES of the small intestine is an extremely rare disease. We present a case of ES of the small intestine with liver metastasis mimicking a gastrointestinal stromal tumor. The diagnosis of ES requires a combination of histological, immunohistochemical, and molecular techniques. Further studies to investigate whether multimodality treatments can improve the survival of metastatic EES are needed.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"24 - 27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46621419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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