Background: The effectiveness of cetuximab (CTX) combined with methotrexate (MTX) has not yet been evaluated in patients with recurrent and/or metastatic head-and-neck squamous cell carcinoma (RM-HNSCC). Materials and Methods: A retrospective analysis of patients with RM-HNSCC who received 50 mg MTX weekly plus a standard dose of CTX for a maximum of 18 weeks, without maintenance CTX. Results: A total of 164 patients were included (cisplatin-sensitive, 88; cisplatin-refractory, 76). Among 58 cisplatin-sensitive patients receiving CTX/MTX as the first-line treatment, the outcomes were 39.7% response rate (RR), 70.7% disease control rate (DCR), 6.0 months of median progression-free survival (PFS), and 9.0 months of overall survival (OS). Among cisplatin-refractory patients, results were 31.6% RR, 51.3% DCR, 4.0 months of PFS, and 6.0 months of OS. Multivariable analyses revealed PFS and OS were not associated with cisplatin-refractory status, age, performance status, or the lines of CTX/MTX treatments. In cisplatin-refractory patients, those with only locoregional-recurrence disease had significantly worse PFS, but this did not affect OS; a similar trend was observed in cisplatin-sensitive patients. Conclusion: A CTX/MTX regimen, without maintenance CTX, is a safe and effective palliative treatment for both patients with cisplatin-sensitive or cisplatin-refractory RM-HNSCC. The low adverse events and easy administration makes this treatment a suitable option in various contexts, particularly for cisplatin-unfit or frail patients with RM-HNSCC.
{"title":"Cetuximab plus methotrexate in recurrent and/or metastatic head-and-neck squamous cell carcinoma","authors":"Hung-Ming Wang, Wen-Chen Tang, Pei-Wei Huang, Chien-Yu Lin, Chia-Hsun Hsieh, Cheng-Lung Hsu, Shiang-Fu Huang, Chun-Ta Liao, Chih-Hua Yeh, Nai-Ming Cheng","doi":"10.4103/ejcrp.ejcrp-d-23-00010","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-23-00010","url":null,"abstract":"Background: The effectiveness of cetuximab (CTX) combined with methotrexate (MTX) has not yet been evaluated in patients with recurrent and/or metastatic head-and-neck squamous cell carcinoma (RM-HNSCC). Materials and Methods: A retrospective analysis of patients with RM-HNSCC who received 50 mg MTX weekly plus a standard dose of CTX for a maximum of 18 weeks, without maintenance CTX. Results: A total of 164 patients were included (cisplatin-sensitive, 88; cisplatin-refractory, 76). Among 58 cisplatin-sensitive patients receiving CTX/MTX as the first-line treatment, the outcomes were 39.7% response rate (RR), 70.7% disease control rate (DCR), 6.0 months of median progression-free survival (PFS), and 9.0 months of overall survival (OS). Among cisplatin-refractory patients, results were 31.6% RR, 51.3% DCR, 4.0 months of PFS, and 6.0 months of OS. Multivariable analyses revealed PFS and OS were not associated with cisplatin-refractory status, age, performance status, or the lines of CTX/MTX treatments. In cisplatin-refractory patients, those with only locoregional-recurrence disease had significantly worse PFS, but this did not affect OS; a similar trend was observed in cisplatin-sensitive patients. Conclusion: A CTX/MTX regimen, without maintenance CTX, is a safe and effective palliative treatment for both patients with cisplatin-sensitive or cisplatin-refractory RM-HNSCC. The low adverse events and easy administration makes this treatment a suitable option in various contexts, particularly for cisplatin-unfit or frail patients with RM-HNSCC.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135602413","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-22-00026
Ching-Tso Chen, Yi-Hsin Liang, C. Hung, K. Yeh
Immunotherapy-related adverse events (irAEs) such as hepatitis or cholestasis have been well recognized. In contrast, acholia was not previously reported as an irAE with a lack of standard treatment. We presented a case of a 68-year-old man with metastatic colon cancer that progressed after several chemotherapy sessions with targeted agents. He received nivolumab plus regorafenib (REGONIVO) as salvage treatment. However, he reported clay-colored stools and jaundice after 3 months of REGONIVO treatment. Computed tomography (CT) revealed no significant biliary tract dilation. Laboratory tests ruled out viral hepatitis or autoimmune hepatitis. Endoscopic retrograde cholangiopancreatography showed multiple filling defects of blood clot formation, and endoscopic retrograde biliary drainage was ineffective. An irAE presenting as acholia and hyperbilirubinemia was diagnosed. Subsequently, the patient was initially administered a corticosteroid only, with an equivalent dose of prednisone (1 mg/kg/day); however, this treatment had only limited effect. After the addition of multiple immunosuppressants, including mycophenolate mofetil and tacrolimus, the severity of hyperbilirubinemia declined and acholia was resolved. This case demonstrated that irAEs can present as acholia and hyperbilirubinemia without significant biliary obstruction. Although the mechanism of such an unusual irAE remains unclear, it seems to be refractory to corticosteroid treatment alone. A more aggressive strategy, such as multiple immunosuppressants, may be advisable.
{"title":"Multiple immunosuppressants for immune-related acholia in a patient with metastatic colorectal cancer","authors":"Ching-Tso Chen, Yi-Hsin Liang, C. Hung, K. Yeh","doi":"10.4103/ejcrp.ejcrp-d-22-00026","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-22-00026","url":null,"abstract":"Immunotherapy-related adverse events (irAEs) such as hepatitis or cholestasis have been well recognized. In contrast, acholia was not previously reported as an irAE with a lack of standard treatment. We presented a case of a 68-year-old man with metastatic colon cancer that progressed after several chemotherapy sessions with targeted agents. He received nivolumab plus regorafenib (REGONIVO) as salvage treatment. However, he reported clay-colored stools and jaundice after 3 months of REGONIVO treatment. Computed tomography (CT) revealed no significant biliary tract dilation. Laboratory tests ruled out viral hepatitis or autoimmune hepatitis. Endoscopic retrograde cholangiopancreatography showed multiple filling defects of blood clot formation, and endoscopic retrograde biliary drainage was ineffective. An irAE presenting as acholia and hyperbilirubinemia was diagnosed. Subsequently, the patient was initially administered a corticosteroid only, with an equivalent dose of prednisone (1 mg/kg/day); however, this treatment had only limited effect. After the addition of multiple immunosuppressants, including mycophenolate mofetil and tacrolimus, the severity of hyperbilirubinemia declined and acholia was resolved. This case demonstrated that irAEs can present as acholia and hyperbilirubinemia without significant biliary obstruction. Although the mechanism of such an unusual irAE remains unclear, it seems to be refractory to corticosteroid treatment alone. A more aggressive strategy, such as multiple immunosuppressants, may be advisable.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"38 - 43"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42243174","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-22-00023
Yi-Hsuan Huang, N. Chow, Yu-Ting Yu, W. Su
Fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) is a rare but aggressive subtype of renal cancer associated with germline or somatic mutations of the FH gene. The histology demonstrates a broad range of morphologic patterns with loss of FH immunostaining. There is no standard therapy approved for FH-deficient RCC, and treatment is often extrapolated from other subtypes of RCC. With a better understanding of the molecular mechanism and pathogenesis, more studies including this population are ongoing. We reported a 33-year-old man with no relevant family history diagnosed with locally advanced FH-deficient RCC and who later developed distant metastasis. He received erlotinib-bevacizumab combination therapy and achieved a partial response. We also performed a literature review of FH-deficient RCC.
{"title":"Fumarate hydratase-deficient renal cell carcinoma: A case report and literature review","authors":"Yi-Hsuan Huang, N. Chow, Yu-Ting Yu, W. Su","doi":"10.4103/ejcrp.ejcrp-d-22-00023","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-22-00023","url":null,"abstract":"Fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) is a rare but aggressive subtype of renal cancer associated with germline or somatic mutations of the FH gene. The histology demonstrates a broad range of morphologic patterns with loss of FH immunostaining. There is no standard therapy approved for FH-deficient RCC, and treatment is often extrapolated from other subtypes of RCC. With a better understanding of the molecular mechanism and pathogenesis, more studies including this population are ongoing. We reported a 33-year-old man with no relevant family history diagnosed with locally advanced FH-deficient RCC and who later developed distant metastasis. He received erlotinib-bevacizumab combination therapy and achieved a partial response. We also performed a literature review of FH-deficient RCC.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"10 1","pages":"28 - 30"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45773484","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-23-00005
Chien-Tzu Huang, Jeng-Shiun Du
Immune checkpoint inhibitors have emerged as an effective standard of care for deficient mismatch repair (dMMR)/high microsatellite instability (MSI-H) metastatic colorectal cancer (CRC). However, the role of immunotherapy in the neoadjuvant setting remains uncertain. We report a patient with advanced colon cancer who received curative surgery after successful treatment with pembrolizumab monotherapy. She remains in complete remission after 16 months following the first diagnosis without any immune-related adverse events. In conclusion, single-agent pembrolizumab has strong potential in neoadjuvant therapy for patients with dMMR/MSI-H advanced CRC.
{"title":"Successful neoadjuvant therapy with pembrolizumab monotherapy for advanced ascending colon cancer","authors":"Chien-Tzu Huang, Jeng-Shiun Du","doi":"10.4103/ejcrp.ejcrp-d-23-00005","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-23-00005","url":null,"abstract":"Immune checkpoint inhibitors have emerged as an effective standard of care for deficient mismatch repair (dMMR)/high microsatellite instability (MSI-H) metastatic colorectal cancer (CRC). However, the role of immunotherapy in the neoadjuvant setting remains uncertain. We report a patient with advanced colon cancer who received curative surgery after successful treatment with pembrolizumab monotherapy. She remains in complete remission after 16 months following the first diagnosis without any immune-related adverse events. In conclusion, single-agent pembrolizumab has strong potential in neoadjuvant therapy for patients with dMMR/MSI-H advanced CRC.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135602404","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-23-00006
Da-Liang Ou, Cheng-Zhe Jian, Guan-Sian Low, Li Lin
Objective: Immune checkpoint inhibitors, particularly anti-programmed cell death protein 1 (PDCD1/PD-1), anti-CD274 molecule (CD274/PD-L1), or anti-cytotoxic T-lymphocyte-associated protein 4 inhibitors, have shown notable anticancer efficacy in 10%–40% of cancer patients and >10 different cancer types. However, they have also reached an impasse. Therefore, targeting tumor-associated myeloid immune cells has become another viable approach. The CD47 molecule (CD47) is a “do not eat me” signal to phagocytes widely expressed in various tumor cells as a potential immune surveillance evasion mechanism. CD47 receptor signal-regulating protein alpha (SIRPα) is expressed in myeloid immune cells and inhibiting the CD47-SIRPα signaling pathway leads to tumor cell phagocytosis. Data Sources: We organized and presented the preclinical research of anti-CD47 in the past 40 years, and we also reviewed the results of anti-CD47-based clinical trials from 2018 to 2022. Study Selection: All studies we cited focus on using anti-CD47 blocking agents for targeting CD47/SIRPα. Results: In preclinical studies, anti-CD47 showed effectiveness in inducing macrophage phagocytosis of both solid tumors and blood cancers. However, clinically, anti-CD47 can only produce effective therapeutic effects when combined with other drugs, especially in treating blood cancers. Anti-CD47 may depend on directly regulating macrophage phagocytosis, tumor antigen capture by dendritic cells, and open adaptive immunity through cross-priming. Conclusion: Ongoing studies are investigating anti-CD47 in combination with chemotherapy, radiotherapy, targeted therapy, and immunomodulatory agents. Their results are eagerly awaited and will help clinical practice.
{"title":"Anti-CD47 antibodies: A potential new cancer immunotherapy","authors":"Da-Liang Ou, Cheng-Zhe Jian, Guan-Sian Low, Li Lin","doi":"10.4103/ejcrp.ejcrp-d-23-00006","DOIUrl":"https://doi.org/10.4103/ejcrp.ejcrp-d-23-00006","url":null,"abstract":"Objective: Immune checkpoint inhibitors, particularly anti-programmed cell death protein 1 (PDCD1/PD-1), anti-CD274 molecule (CD274/PD-L1), or anti-cytotoxic T-lymphocyte-associated protein 4 inhibitors, have shown notable anticancer efficacy in 10%–40% of cancer patients and >10 different cancer types. However, they have also reached an impasse. Therefore, targeting tumor-associated myeloid immune cells has become another viable approach. The CD47 molecule (CD47) is a “do not eat me” signal to phagocytes widely expressed in various tumor cells as a potential immune surveillance evasion mechanism. CD47 receptor signal-regulating protein alpha (SIRPα) is expressed in myeloid immune cells and inhibiting the CD47-SIRPα signaling pathway leads to tumor cell phagocytosis. Data Sources: We organized and presented the preclinical research of anti-CD47 in the past 40 years, and we also reviewed the results of anti-CD47-based clinical trials from 2018 to 2022. Study Selection: All studies we cited focus on using anti-CD47 blocking agents for targeting CD47/SIRPα. Results: In preclinical studies, anti-CD47 showed effectiveness in inducing macrophage phagocytosis of both solid tumors and blood cancers. However, clinically, anti-CD47 can only produce effective therapeutic effects when combined with other drugs, especially in treating blood cancers. Anti-CD47 may depend on directly regulating macrophage phagocytosis, tumor antigen capture by dendritic cells, and open adaptive immunity through cross-priming. Conclusion: Ongoing studies are investigating anti-CD47 in combination with chemotherapy, radiotherapy, targeted therapy, and immunomodulatory agents. Their results are eagerly awaited and will help clinical practice.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135602417","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 : 2022-10-01DOI: 10.4103/2311-3006.362637
Yun-Tzu Lin, Hung‐Chang Wu
Sorafenib was approved for the treatment of hepatocellular carcinoma more than 10 years ago; however, the efficacy is limited. The IMbrave150 trial demonstrated better overall survival and progression-free survival with atezolizumab plus bevacizumab combination therapy compared to sorafenib, and so it has become the choice of first-line treatment. However, the optimal choice of subsequent therapy after atezolizumab plus bevacizumab is unknown. We present a case with advanced hepatocellular carcinoma who achieved a complete response for more than 2 years under sorafenib treatment after progression with atezolizumab and bevacizumab combination therapy.
{"title":"The efficacy of sorafenib after progression on atezolizumab and bevacizumab combination therapy in a patient with advanced hepatocellular carcinoma","authors":"Yun-Tzu Lin, Hung‐Chang Wu","doi":"10.4103/2311-3006.362637","DOIUrl":"https://doi.org/10.4103/2311-3006.362637","url":null,"abstract":"Sorafenib was approved for the treatment of hepatocellular carcinoma more than 10 years ago; however, the efficacy is limited. The IMbrave150 trial demonstrated better overall survival and progression-free survival with atezolizumab plus bevacizumab combination therapy compared to sorafenib, and so it has become the choice of first-line treatment. However, the optimal choice of subsequent therapy after atezolizumab plus bevacizumab is unknown. We present a case with advanced hepatocellular carcinoma who achieved a complete response for more than 2 years under sorafenib treatment after progression with atezolizumab and bevacizumab combination therapy.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"9 1","pages":"149 - 152"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42224007","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}
H. Sepai, Pratyusha Mukherjee, A. Bandyopadhyay, Bidisha Ghosh
Background: The cornerstone of management of phyllodes tumor is surgery. No standard of care exists regarding adjuvant therapy; however, local recurrence is a predominant pattern of failure. The aims of this study were to evaluate the clinical characteristics and treatment patterns of phyllodes tumor and to compare local recurrence and disease-free survival rates of patients with borderline and malignant phyllodes tumor treated with or without adjuvant radiotherapy. Materials and Methods: We analyzed the demographic data, treatment details, and recurrence patterns of all patients with nonmetastatic phyllodes tumors of the breast (n = 34) treated with a multimodality approach who presented to our institute from January 2015 to December 2020. Results: The median age at presentation was 41.2 years, and the median tumor size was 12.5 cm. All patients underwent definitive surgical procedures in the form of wide local excision or mastectomy. No recurrence was noted in the patients with a benign histology. After a median follow-up period of 38 months, the local recurrence rate was 27% for the patients with borderline and malignant histology treated with adjuvant radiotherapy (n = 11) versus 47% for those (n = 17) who did not receive adjuvant radiotherapy. The 3-year local recurrence-free survival rate was 72% in the adjuvant radiotherapy group, versus 51% in the surgery only group. Conclusion: The results of the current study confirm the excellent prognosis of patients with benign phyllodes tumor undergoing surgery alone. Local recurrence was the predominant mode of failure in the patients with borderline and malignant histology. Locoregional control was improved with the addition of postoperative radiotherapy in the patients with borderline and malignant histology irrespective of margin status.
{"title":"A retrospective review of phyllodes tumor of breast treated with multimodality approach: Experience of a tertiary care institution in Eastern India","authors":"H. Sepai, Pratyusha Mukherjee, A. Bandyopadhyay, Bidisha Ghosh","doi":"10.4103/jcrp.jcrp_6_22","DOIUrl":"https://doi.org/10.4103/jcrp.jcrp_6_22","url":null,"abstract":"Background: The cornerstone of management of phyllodes tumor is surgery. No standard of care exists regarding adjuvant therapy; however, local recurrence is a predominant pattern of failure. The aims of this study were to evaluate the clinical characteristics and treatment patterns of phyllodes tumor and to compare local recurrence and disease-free survival rates of patients with borderline and malignant phyllodes tumor treated with or without adjuvant radiotherapy. Materials and Methods: We analyzed the demographic data, treatment details, and recurrence patterns of all patients with nonmetastatic phyllodes tumors of the breast (n = 34) treated with a multimodality approach who presented to our institute from January 2015 to December 2020. Results: The median age at presentation was 41.2 years, and the median tumor size was 12.5 cm. All patients underwent definitive surgical procedures in the form of wide local excision or mastectomy. No recurrence was noted in the patients with a benign histology. After a median follow-up period of 38 months, the local recurrence rate was 27% for the patients with borderline and malignant histology treated with adjuvant radiotherapy (n = 11) versus 47% for those (n = 17) who did not receive adjuvant radiotherapy. The 3-year local recurrence-free survival rate was 72% in the adjuvant radiotherapy group, versus 51% in the surgery only group. Conclusion: The results of the current study confirm the excellent prognosis of patients with benign phyllodes tumor undergoing surgery alone. Local recurrence was the predominant mode of failure in the patients with borderline and malignant histology. Locoregional control was improved with the addition of postoperative radiotherapy in the patients with borderline and malignant histology irrespective of margin status.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"9 1","pages":"140 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47287547","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 : 2022-10-01DOI: 10.4103/2311-3006.362638
Yi-Wei Chen, P. Mu, Ting-yu Huang, Ko‐Han Lin, Po-Shen Pan, Jen-Kun Chen, Hong-ming Liu, Meng-Hao Wu, F. Chou
Objective: Glioblastoma (WHO classification Grade IV) is a highly malignant brain tumor with a high propensity for recurrence even after standard treatments. Patient death is inevitable, as the available methods are largely ineffective for remediation and treatment once recurrence has occurred. This review presents recent advancements in boron neutron capture therapy (BNCT) that have allowed for its clinical use in treating glioblastoma. Data Sources: We retrospectively reviewed the results of clinical trials and articles published in the past 30 years worldwide. Study Selection: All included studies addressed the use of BNCT to treat high-grade gliomas, including glioblastoma. Results: The development of boron-containing agents exhibiting specificity and improvements in technologies that generate neutron sources have led to the clinical use of BNCT for treating tumors. BNCT involves the delivery of a boron-10-containing drug specifically to tumor cells, followed by irradiation with low-energy thermal neutrons to generate two biologically active particles (helium [α particle] and lithium nuclei). Although these particles are highly effective at destroying cells, their field of destruction is limited to the tumor cells. Therefore, BNCT serves as an excellent mode of targeted particle therapy for tumors, particularly those that are infiltrative. The published articles reviewed here demonstrate the gradual refinement of the BNCT technique and prolonged survival for glioma patients compared to conventional treatments. Conclusion: With continued improvements, BNCT may become the first-choice treatment for malignant infiltrative glioblastoma in the near future.
{"title":"Latest advances in boron neutron capture therapy for intracranial glioblastoma","authors":"Yi-Wei Chen, P. Mu, Ting-yu Huang, Ko‐Han Lin, Po-Shen Pan, Jen-Kun Chen, Hong-ming Liu, Meng-Hao Wu, F. Chou","doi":"10.4103/2311-3006.362638","DOIUrl":"https://doi.org/10.4103/2311-3006.362638","url":null,"abstract":"Objective: Glioblastoma (WHO classification Grade IV) is a highly malignant brain tumor with a high propensity for recurrence even after standard treatments. Patient death is inevitable, as the available methods are largely ineffective for remediation and treatment once recurrence has occurred. This review presents recent advancements in boron neutron capture therapy (BNCT) that have allowed for its clinical use in treating glioblastoma. Data Sources: We retrospectively reviewed the results of clinical trials and articles published in the past 30 years worldwide. Study Selection: All included studies addressed the use of BNCT to treat high-grade gliomas, including glioblastoma. Results: The development of boron-containing agents exhibiting specificity and improvements in technologies that generate neutron sources have led to the clinical use of BNCT for treating tumors. BNCT involves the delivery of a boron-10-containing drug specifically to tumor cells, followed by irradiation with low-energy thermal neutrons to generate two biologically active particles (helium [α particle] and lithium nuclei). Although these particles are highly effective at destroying cells, their field of destruction is limited to the tumor cells. Therefore, BNCT serves as an excellent mode of targeted particle therapy for tumors, particularly those that are infiltrative. The published articles reviewed here demonstrate the gradual refinement of the BNCT technique and prolonged survival for glioma patients compared to conventional treatments. Conclusion: With continued improvements, BNCT may become the first-choice treatment for malignant infiltrative glioblastoma in the near future.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"9 1","pages":"129 - 134"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41317515","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 : 2022-10-01DOI: 10.4103/2311-3006.362640
H. Peng, Y. Soong, Chiao-En Wu, Cheng‐Tao Lin
This is a case of cervical cancer stage IIB according to the International Federation of Obstetrics and Gynecology Staging who initially presented with abnormal vaginal bloody discharge noted in August 2018. A cervical biopsy showed poorly differentiated squamous cell carcinoma, and pelvic magnetic resonance imaging revealed a 4.3-cm cervical mass involving the anterior lip, upper third of the vagina, and right parametrium without nodal or distant lesions. Although she underwent concurrent chemoradiotherapy, a residual cervical tumor was noted in April 2019. She then underwent salvage radical hysterectomy, bilateral pelvic lymph node dissection, and hyperthermic intraperitoneal chemotherapy with cisplatin in May 2019, followed by immunotherapy (picibanil-based intraperitoneal imiquimod), immune checkpoint inhibitors (pembrolizumab, atezolizumab, ipilimumab, and nivolumab), and concurrent chemoradiotherapy until March 2020. The immune risk profile showed T cell proliferation and alteration of Th1/Th2 activation after immunotherapy and immune checkpoint inhibitor therapy. There was significant increase in natural killer (NK) T cells (3.9-fold) and CD4+CD25 (4.25-fold). CD3, CD4, CD8, CD19, CD8+CD28−, and CD4/CD8 cells were increased, while CD2+CD279+ and NK cells were decreased. She received eight cycles of adjuvant chemotherapy (cisplatin, paclitaxel) and bevacizumab in June 2020 for local tumor recurrence in the pelvis which was found in April 2020. Unfortunately, she died in November 2020 due to septic shock.
根据国际妇产科分期联合会（International Federation of Obstetrics and Gynecology Staging）的数据，这是一例宫颈癌症IIB期病例，最初于2018年8月出现异常阴道出血。宫颈活检显示低分化鳞状细胞癌，盆腔磁共振成像显示4.3厘米的宫颈肿块，涉及前唇、阴道上三分之一和右侧子宫旁，没有淋巴结或远处病变。尽管她同时接受了放化疗，但在2019年4月发现了残留的宫颈肿瘤。随后，她于2019年5月接受了挽救性根治性子宫切除术、双侧盆腔淋巴结清扫术和顺铂腹腔内高温化疗，随后进行了免疫疗法（基于匹西班尼的腹腔内咪喹莫特）、免疫检查点抑制剂（pembrolizumab、atezolizumab、ipilimumab和nivolumab），并同时进行放化疗，直至2020年3月。免疫风险谱显示，免疫疗法和免疫检查点抑制剂治疗后，T细胞增殖和Th1/Th2激活的改变。自然杀伤（NK）T细胞（3.9倍）和CD4+CD25（4.25倍）显著增加。CD3、CD4、CD8、CD19、CD8+CD28−和CD4/CD8细胞增加，CD2+CD279+和NK细胞减少。2020年6月，她接受了八个周期的辅助化疗（顺铂、紫杉醇）和贝伐单抗，治疗2020年4月发现的骨盆局部肿瘤复发。不幸的是，她于2020年11月死于感染性休克。
{"title":"Combined immune checkpoint inhibitors, immunotherapy with picibanil-based intraperitoneal imiquimod, and chemotherapy in cases of advanced cervical cancer and failure of concurrent chemoradiation therapy: A new clinical paradigm","authors":"H. Peng, Y. Soong, Chiao-En Wu, Cheng‐Tao Lin","doi":"10.4103/2311-3006.362640","DOIUrl":"https://doi.org/10.4103/2311-3006.362640","url":null,"abstract":"This is a case of cervical cancer stage IIB according to the International Federation of Obstetrics and Gynecology Staging who initially presented with abnormal vaginal bloody discharge noted in August 2018. A cervical biopsy showed poorly differentiated squamous cell carcinoma, and pelvic magnetic resonance imaging revealed a 4.3-cm cervical mass involving the anterior lip, upper third of the vagina, and right parametrium without nodal or distant lesions. Although she underwent concurrent chemoradiotherapy, a residual cervical tumor was noted in April 2019. She then underwent salvage radical hysterectomy, bilateral pelvic lymph node dissection, and hyperthermic intraperitoneal chemotherapy with cisplatin in May 2019, followed by immunotherapy (picibanil-based intraperitoneal imiquimod), immune checkpoint inhibitors (pembrolizumab, atezolizumab, ipilimumab, and nivolumab), and concurrent chemoradiotherapy until March 2020. The immune risk profile showed T cell proliferation and alteration of Th1/Th2 activation after immunotherapy and immune checkpoint inhibitor therapy. There was significant increase in natural killer (NK) T cells (3.9-fold) and CD4+CD25 (4.25-fold). CD3, CD4, CD8, CD19, CD8+CD28−, and CD4/CD8 cells were increased, while CD2+CD279+ and NK cells were decreased. She received eight cycles of adjuvant chemotherapy (cisplatin, paclitaxel) and bevacizumab in June 2020 for local tumor recurrence in the pelvis which was found in April 2020. Unfortunately, she died in November 2020 due to septic shock.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"9 1","pages":"165 - 167"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49124279","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 : 2022-10-01DOI: 10.4103/2311-3006.362635
A. George, T. Ponni
Background: Head-and-neck cancer (HNC) constitutes one-third of all cancers in developing countries, and the majority present in locally advanced stages. Poor nutritional status is invariably present which compromises treatment compliance, quality of life and survival outcome, posing a major treatment challenge. The aim of this study was to assess the role of pretreatment biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) in predicting treatment tolerance. Materials and Methods: This prospective observational study included 82 patients receiving definitive and adjuvant radiotherapy for HNC. Utilizing baseline blood investigations, the NLR, PLR, and PNI (10 × albumin + 0.005× lymphocyte count) were calculated for each patient. The cutoff values of NLR, PLR, and PNI were based on the median values. Treatment tolerance in terms of weight loss of more than 10% during treatment, the need for feeding procedure, treatment breaks, and not completing planned treatment as per the schedule were assessed. Associations of NLR, PLR, and PNI with the treatment tolerance factors were assessed using the Chi-square test and Fisher's exact test, and a P < 0.05 was considered statistically significant. Results: Low PNI significantly correlated with feeding procedure requirement and treatment breaks, thus compromising treatment completion. NLR and PLR did not show statistically significant correlations. Conclusion: Low PNI is a reliable predictive factor of poor treatment tolerance. It is an accessible screening tool to identify patients at risk of poor treatment tolerance in whom early interventions can be made to aid in uneventful treatment completion.
{"title":"Prognostic nutritional index - A predictive tool for treatment tolerance in head and neck radiotherapy","authors":"A. George, T. Ponni","doi":"10.4103/2311-3006.362635","DOIUrl":"https://doi.org/10.4103/2311-3006.362635","url":null,"abstract":"Background: Head-and-neck cancer (HNC) constitutes one-third of all cancers in developing countries, and the majority present in locally advanced stages. Poor nutritional status is invariably present which compromises treatment compliance, quality of life and survival outcome, posing a major treatment challenge. The aim of this study was to assess the role of pretreatment biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) in predicting treatment tolerance. Materials and Methods: This prospective observational study included 82 patients receiving definitive and adjuvant radiotherapy for HNC. Utilizing baseline blood investigations, the NLR, PLR, and PNI (10 × albumin + 0.005× lymphocyte count) were calculated for each patient. The cutoff values of NLR, PLR, and PNI were based on the median values. Treatment tolerance in terms of weight loss of more than 10% during treatment, the need for feeding procedure, treatment breaks, and not completing planned treatment as per the schedule were assessed. Associations of NLR, PLR, and PNI with the treatment tolerance factors were assessed using the Chi-square test and Fisher's exact test, and a P < 0.05 was considered statistically significant. Results: Low PNI significantly correlated with feeding procedure requirement and treatment breaks, thus compromising treatment completion. NLR and PLR did not show statistically significant correlations. Conclusion: Low PNI is a reliable predictive factor of poor treatment tolerance. It is an accessible screening tool to identify patients at risk of poor treatment tolerance in whom early interventions can be made to aid in uneventful treatment completion.","PeriodicalId":31219,"journal":{"name":"Journal of Cancer Research and Practice","volume":"9 1","pages":"135 - 139"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46953707","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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