Bogusław Maciejewski, Daniel Bula, Justyna Rembak-Szynkiewicz
Aim of the present review of various classic and novel therapeutic strategies in oncology is critical discussion of its efficacy to answer whether once upon a time is it real and possible to win a war against cancer. Although technological progress in radiotherapy (RT) has led to develop many sophisticated 3D, 4D techniques, the use of the RT as a sole modality has become more and more limited to the tumours in early stage of disease, in favour of combined surgery-RT-chemotherapy (CHT) therapies. Nevertheless patients curability has never reached the level higher than 95% (stereotactic hypofractionated RT – limited too small tumours only). The CHT for solid malignant tumours is not effective enough, and therefore it is mainly combined with Surg and RT as a method of the boost. Common use of partial or complete regression (PR, CR) as end-points of its efficacy is irrelevant, since it is quasi-quantified tumour cell clearance but not cell kill effects, and the regrowth delay (time of tumour regrowth to the size, volume at the beginning of therapy) is the only proper end-point. Efficacy of various genetic, molecular, immuno, and antiangiogenic modalities tested in many clinical studies is critically discussed, and it has generally showed some therapeutic benefits, but not very spectacular. It has been well documented that genotypes and phenotypes of the tumours (even within the same location, stage and histology) are individually highly heterogeneous. Therefore, the term “average probability” referred to individual patients becomes meaningless, and moreover, this term has never been replaced by “certainty” yet. Statistics of many studies and trials consist of various pitfalls and biases. Thus, although we and our patients are more often winners on the individual battlefields, the winning once upon a time of whole war against cancer seems to be possible (hope), but not for sure (real).
{"title":"Once upon a time in oncology – will we definitely win a war against cancer? Critical review of the progresses in cancer therapies","authors":"Bogusław Maciejewski, Daniel Bula, Justyna Rembak-Szynkiewicz","doi":"10.5603/njo.96917","DOIUrl":"https://doi.org/10.5603/njo.96917","url":null,"abstract":"Aim of the present review of various classic and novel therapeutic strategies in oncology is critical discussion of its efficacy to answer whether once upon a time is it real and possible to win a war against cancer. Although technological progress in radiotherapy (RT) has led to develop many sophisticated 3D, 4D techniques, the use of the RT as a sole modality has become more and more limited to the tumours in early stage of disease, in favour of combined surgery-RT-chemotherapy (CHT) therapies. Nevertheless patients curability has never reached the level higher than 95% (stereotactic hypofractionated RT – limited too small tumours only). The CHT for solid malignant tumours is not effective enough, and therefore it is mainly combined with Surg and RT as a method of the boost. Common use of partial or complete regression (PR, CR) as end-points of its efficacy is irrelevant, since it is quasi-quantified tumour cell clearance but not cell kill effects, and the regrowth delay (time of tumour regrowth to the size, volume at the beginning of therapy) is the only proper end-point. Efficacy of various genetic, molecular, immuno, and antiangiogenic modalities tested in many clinical studies is critically discussed, and it has generally showed some therapeutic benefits, but not very spectacular. It has been well documented that genotypes and phenotypes of the tumours (even within the same location, stage and histology) are individually highly heterogeneous. Therefore, the term “average probability” referred to individual patients becomes meaningless, and moreover, this term has never been replaced by “certainty” yet. Statistics of many studies and trials consist of various pitfalls and biases. Thus, although we and our patients are more often winners on the individual battlefields, the winning once upon a time of whole war against cancer seems to be possible (hope), but not for sure (real).","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"67 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318198","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}
The Wnt pathway has a pivotal function in tissue development and homeostasis, overseeing cell growth or differentiation. Aberrant Wnt signalling pathways have been associated with the pathogenesis of diverse malignancies, influencing cell proliferation, differentiation, cancer stem cell renewal, tumor microenvironment and thereby significantly impacting tumour development and therapeutic responsiveness. Promisingly, current research underscores the potential therapeutic value of targeting Wnt pathways, particularly the canonical Wnt/β-catenin signalling, in the context of numerous cancer types. Key constituents of the Wnt pathway, such as the Wnt/receptor, β-catenin degradation or transcription complexes, have been focal points for interventions in preclinical studies. To comprehend potential therapeutic strategies, we conduct an analysis of ongoing clinical trials that specifically aim to target components of the Wnt pathways across a diverse spectrum of cancer types. By scrutinizing these trials, including their respective phases, targeted patient populations, and observed outcomes, this review provides a consolidated overview of the current translational landscape of Wnt-targeted therapies, thus offering a roadmap for future research endeavours.
{"title":"Wnt pathways in focus – mapping current clinical trials across cancer spectrum","authors":"Renata Pacholczak-Madej, Paulina Frączek, Klaudia Skrzypek, Mirosława Püsküllüoğlu","doi":"10.5603/njo.97607","DOIUrl":"https://doi.org/10.5603/njo.97607","url":null,"abstract":"The Wnt pathway has a pivotal function in tissue development and homeostasis, overseeing cell growth or differentiation. Aberrant Wnt signalling pathways have been associated with the pathogenesis of diverse malignancies, influencing cell proliferation, differentiation, cancer stem cell renewal, tumor microenvironment and thereby significantly impacting tumour development and therapeutic responsiveness. Promisingly, current research underscores the potential therapeutic value of targeting Wnt pathways, particularly the canonical Wnt/β-catenin signalling, in the context of numerous cancer types. Key constituents of the Wnt pathway, such as the Wnt/receptor, β-catenin degradation or transcription complexes, have been focal points for interventions in preclinical studies. To comprehend potential therapeutic strategies, we conduct an analysis of ongoing clinical trials that specifically aim to target components of the Wnt pathways across a diverse spectrum of cancer types. By scrutinizing these trials, including their respective phases, targeted patient populations, and observed outcomes, this review provides a consolidated overview of the current translational landscape of Wnt-targeted therapies, thus offering a roadmap for future research endeavours.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"62 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318199","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}
Stanisław Ciechanowicz, Piotr Kupidłowski, Mateusz Wichtowski
{"title":"Rare case of recurrent myofibroblastoma in a female patient","authors":"Stanisław Ciechanowicz, Piotr Kupidłowski, Mateusz Wichtowski","doi":"10.5603/njo.95979","DOIUrl":"https://doi.org/10.5603/njo.95979","url":null,"abstract":"","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971954","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}
Ewa Pustelnik, Katarzyna Pikora, Katarzyna Pawelec
Methotrexate is an antifolate widely used in oncology and rheumatology that plays an important role in the treatment of acute lymphoblastic leukemia in children. One of its most common side effects is oral mucositis, which is a general term for ulceration and inflammation of the mucous membrane of the mouth. It can severely affect a patient's quality of life, causes poor nutrition, and may lead to discontinuation of the next course of chemotherapy. Oral mucositis typically develops a few days after chemotherapy infusion. Due to this risk, it appears reasonable to use preventive agents against oral mucositis before the inclusion of methotrexate in therapy. To date, clinical trials have examined the effectiveness of medications such as glutamine, palifermin, chlorhexidine, amifostine, cyclooxygenase-1 inhibitor, leucovorin or other methods including laser therapy and oral cryotherapy. There are also several methods used to control already established inflammation and reduce pain more effectively: laser therapy, platelet-rich plasma and platelet gel, taxifolin, film-forming and coating agents. A crucial role is played by supportive interventions involving analgesic treatment, including topical morphine and benzydamine and a modern approach to pain management – for example, the use of virtual reality.
{"title":"Methotrexate-associated oral mucositis in children with acute lymphoblastic leukemia","authors":"Ewa Pustelnik, Katarzyna Pikora, Katarzyna Pawelec","doi":"10.5603/njo.96144","DOIUrl":"https://doi.org/10.5603/njo.96144","url":null,"abstract":"Methotrexate is an antifolate widely used in oncology and rheumatology that plays an important role in the treatment of acute lymphoblastic leukemia in children. One of its most common side effects is oral mucositis, which is a general term for ulceration and inflammation of the mucous membrane of the mouth. It can severely affect a patient's quality of life, causes poor nutrition, and may lead to discontinuation of the next course of chemotherapy. Oral mucositis typically develops a few days after chemotherapy infusion. Due to this risk, it appears reasonable to use preventive agents against oral mucositis before the inclusion of methotrexate in therapy. To date, clinical trials have examined the effectiveness of medications such as glutamine, palifermin, chlorhexidine, amifostine, cyclooxygenase-1 inhibitor, leucovorin or other methods including laser therapy and oral cryotherapy. There are also several methods used to control already established inflammation and reduce pain more effectively: laser therapy, platelet-rich plasma and platelet gel, taxifolin, film-forming and coating agents. A crucial role is played by supportive interventions involving analgesic treatment, including topical morphine and benzydamine and a modern approach to pain management – for example, the use of virtual reality.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971955","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}
Breast cancer is considered the most commonly diagnosed tumors. Biomarkers used for the diagnosis and treatment of breast cancer are: tissue biomarkers (PR, ER, HER2, Ki-67) and serum biomarkers (CA15-3, CA125, CA27.29, CEA, cytokeratins). ECD HER2, metalloproteinases and leptin are emerging promising biomarkers for breast cancer. There is a growing need for personalized diagnostics based on tumor genome characterization, relying on liquid biopsy containing components such as CTC and ctDNA, cell-free RNA. Biomarkers can also be used use as a target for anti breast cancer treatment (PGRN and sortilin, AR, PD-1/PD-L1). Another potential fields of application of breast cancer biomarkers is monitoring of treatment side effects, such us inflammatory biomarkers causing cardiotoxicity, thyroiditis biomarkers (TSH, FT4, TPOab TgAb) in IrAE, NF-L and MCP-1 in ICI-associated neurotoxity. It is expected to develop new prognostic and predictive biomarkers that would provide accurate and reliable information for clinical application. Through the recognition of emerging biomarkers, it is possible to identify subgroups of patients who benefit from targeted therapies and managing treatment by monitoring side effects. However, these new biomarkers need to be validated and tested for their suitability before entering clinical use.
{"title":"The importance of selected biomarkers in the clinical practice of breast cancer patients","authors":"Agata Makówka, Beata Kotowicz","doi":"10.5603/njo.95605","DOIUrl":"https://doi.org/10.5603/njo.95605","url":null,"abstract":"Breast cancer is considered the most commonly diagnosed tumors. Biomarkers used for the diagnosis and treatment of breast cancer are: tissue biomarkers (PR, ER, HER2, Ki-67) and serum biomarkers (CA15-3, CA125, CA27.29, CEA, cytokeratins). ECD HER2, metalloproteinases and leptin are emerging promising biomarkers for breast cancer. There is a growing need for personalized diagnostics based on tumor genome characterization, relying on liquid biopsy containing components such as CTC and ctDNA, cell-free RNA. Biomarkers can also be used use as a target for anti breast cancer treatment (PGRN and sortilin, AR, PD-1/PD-L1). Another potential fields of application of breast cancer biomarkers is monitoring of treatment side effects, such us inflammatory biomarkers causing cardiotoxicity, thyroiditis biomarkers (TSH, FT4, TPOab TgAb) in IrAE, NF-L and MCP-1 in ICI-associated neurotoxity. It is expected to develop new prognostic and predictive biomarkers that would provide accurate and reliable information for clinical application. Through the recognition of emerging biomarkers, it is possible to identify subgroups of patients who benefit from targeted therapies and managing treatment by monitoring side effects. However, these new biomarkers need to be validated and tested for their suitability before entering clinical use.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"48 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971953","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}
Karolina Gasz, Agnieszka Żyłka, Joanna Długosińska, Marek Dedecjus
A 63-year-old man diagnosed with pT3N1b medullary thyroid carcinoma (MTC) was referred for further management three months after total thyroidectomy with left lateral lymphadenectomy. On admission the levels of carcinoembryonic antigen (CEA) and calcitonin (CT) were slightly elevated (CT – 51.1 pg/ml; CEA – 5.13 ng/ml). The patient underwent radiotherapy three months after surgical treatment. A follow-up CT of the thorax performed after succeeding three months, revealed numerous pulmonary nodules (fig. 1) and the mediastinal lymphadenopathy (fig. 2) suspected of metastases. CT levels remained elevated (43 pg/ml) with decrease of CEA level equally (3.61 ng/ml) and the patient did not exhibit any respiratory symptoms. The histopathological examination of retrieved lymph nodes did not show any abnormalities. Since the possibility of metastases could not be ruled out, the patient underwent an anterior thoracotomy. The removed lung masses unveiled black-grey nodules which turned out to be pneumoconiosis. The patient history revealed exposure to dust and fumes. This is the first described case of pneumoconiosis mimicking MTC metastases. What draws attention is the short period of time from the radical surgery to the occurrence of initially absent multiple pulmonary lesions with a relatively insignificant growth of calcitonin. This pattern is characteristic for singular nodular MTC metastases rather than multiple micronodular metastases in solid organs [1]. It is worth to emphasize that in such cases we
{"title":"Pneumoconiosis mimicking lung metastases of medullary thyroid carcinoma","authors":"Karolina Gasz, Agnieszka Żyłka, Joanna Długosińska, Marek Dedecjus","doi":"10.5603/njo.96322","DOIUrl":"https://doi.org/10.5603/njo.96322","url":null,"abstract":"A 63-year-old man diagnosed with pT3N1b medullary thyroid carcinoma (MTC) was referred for further management three months after total thyroidectomy with left lateral lymphadenectomy. On admission the levels of carcinoembryonic antigen (CEA) and calcitonin (CT) were slightly elevated (CT – 51.1 pg/ml; CEA – 5.13 ng/ml). The patient underwent radiotherapy three months after surgical treatment. A follow-up CT of the thorax performed after succeeding three months, revealed numerous pulmonary nodules (fig. 1) and the mediastinal lymphadenopathy (fig. 2) suspected of metastases. CT levels remained elevated (43 pg/ml) with decrease of CEA level equally (3.61 ng/ml) and the patient did not exhibit any respiratory symptoms. The histopathological examination of retrieved lymph nodes did not show any abnormalities. Since the possibility of metastases could not be ruled out, the patient underwent an anterior thoracotomy. The removed lung masses unveiled black-grey nodules which turned out to be pneumoconiosis. The patient history revealed exposure to dust and fumes. This is the first described case of pneumoconiosis mimicking MTC metastases. What draws attention is the short period of time from the radical surgery to the occurrence of initially absent multiple pulmonary lesions with a relatively insignificant growth of calcitonin. This pattern is characteristic for singular nodular MTC metastases rather than multiple micronodular metastases in solid organs [1]. It is worth to emphasize that in such cases we","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"29 24","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971956","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}
Bogusław Maciejewski, Dorota Gabryś, Justyna Rembak-Szynkiewicz, Aleksandra Napieralska, Małgorzta Stąpór-Fudzińska
In the era of distinct technological innovations in radiotherapy, clinically important question arises has the increase of the RT effectiveness been achieved due to these innovations, at least in case of the head and neck (H&N) cancers. To answer to this question 133 studies published in the literature, including 21 058 patients with H&N cancer treated in the period a 1970-2010 years were selected to the present survey. Three end-points, e.g. 5-year local tumour control (LTC), disease-free survival (DFS) and overall survival (OS) and its averages have been evaluated in the consecutive decades of time. For cancer in the early stage, both LTC and DFS were constantly high (80–90%) through the analyzed decades. For locally advanced cancer, average rates of the LTC and an DFS were also constant, but much lower (40-45%) than expected. The OS has an increasing tendency from 45–50% in 1980 to more than 70% in 2010. It may suggest that during the 5-year follow-up some rate (~20%) of advanced tumours gradually progressed from local to chronic disease. Various technical and clinical problems influencing the results of the present review are discussed in details. Some uncertainties and doubts regarding the RT trials may suggest that “ evidence based ” recommendations are not a good ambassador enough, and in the era of combined treatment modalities it may seem reasonably to replace it by “ individually personalized combined therapy ” . However, nowadays the only plausible solution to improve H&N curability is to intensify all efforts to detect H&N cancer in a very early stage of disease and to increase various activities to convince people to participate in regular prophylactic examinations.
{"title":"Has innovations in radiotherapy for head and neck cancer improved patients curability?","authors":"Bogusław Maciejewski, Dorota Gabryś, Justyna Rembak-Szynkiewicz, Aleksandra Napieralska, Małgorzta Stąpór-Fudzińska","doi":"10.5603/njo.95700","DOIUrl":"https://doi.org/10.5603/njo.95700","url":null,"abstract":"In the era of distinct technological innovations in radiotherapy, clinically important question arises has the increase of the RT effectiveness been achieved due to these innovations, at least in case of the head and neck (H&N) cancers. To answer to this question 133 studies published in the literature, including 21 058 patients with H&N cancer treated in the period a 1970-2010 years were selected to the present survey. Three end-points, e.g. 5-year local tumour control (LTC), disease-free survival (DFS) and overall survival (OS) and its averages have been evaluated in the consecutive decades of time. For cancer in the early stage, both LTC and DFS were constantly high (80–90%) through the analyzed decades. For locally advanced cancer, average rates of the LTC and an DFS were also constant, but much lower (40-45%) than expected. The OS has an increasing tendency from 45–50% in 1980 to more than 70% in 2010. It may suggest that during the 5-year follow-up some rate (~20%) of advanced tumours gradually progressed from local to chronic disease. Various technical and clinical problems influencing the results of the present review are discussed in details. Some uncertainties and doubts regarding the RT trials may suggest that “ evidence based ” recommendations are not a good ambassador enough, and in the era of combined treatment modalities it may seem reasonably to replace it by “ individually personalized combined therapy ” . However, nowadays the only plausible solution to improve H&N curability is to intensify all efforts to detect H&N cancer in a very early stage of disease and to increase various activities to convince people to participate in regular prophylactic examinations.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"5 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971959","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}
Irmina M. Michałek, Florentino Luciano Caetano dos Santos, Urszula Wojciechowska, Joanna Didkowska
Introduction. This study aimed to explore socioeconomic factors influencing suicide rate in Polish cancer patients. Material and methods. Data on cancer cases and socioeconomic covariates were obtained from the Polish National Cancer Registry and Statistics Poland. Suicide rates were calculated for each year. Multivariable linear regression analyses explored associations between unemployment, income, university education, access to physicians overall and to psychiatry hospitals, and suicide incidence. Results. The study included 1.43 million cancer patients diagnosed between 2009 and 2019. Among them, 830 suicides were identified, with higher rates among men. Income per capita and higher education degrees were significant predictors of suicide among male cancer patients (p = 0.05 and 0.01, respectively). However, no significant associations were found for female cancer patients. The regression models explained 13% of the variation in male suicide incidence. Conclusions. Lower income and higher education increase suicide risk in male cancer patients, highlighting the need for targeted interventions.
{"title":"Socioeconomic factors and suicide risk in Polish cancer patients – a population-based cohort study exploring associations and implications","authors":"Irmina M. Michałek, Florentino Luciano Caetano dos Santos, Urszula Wojciechowska, Joanna Didkowska","doi":"10.5603/njo.96512","DOIUrl":"https://doi.org/10.5603/njo.96512","url":null,"abstract":"Introduction. This study aimed to explore socioeconomic factors influencing suicide rate in Polish cancer patients. Material and methods. Data on cancer cases and socioeconomic covariates were obtained from the Polish National Cancer Registry and Statistics Poland. Suicide rates were calculated for each year. Multivariable linear regression analyses explored associations between unemployment, income, university education, access to physicians overall and to psychiatry hospitals, and suicide incidence. Results. The study included 1.43 million cancer patients diagnosed between 2009 and 2019. Among them, 830 suicides were identified, with higher rates among men. Income per capita and higher education degrees were significant predictors of suicide among male cancer patients (p = 0.05 and 0.01, respectively). However, no significant associations were found for female cancer patients. The regression models explained 13% of the variation in male suicide incidence. Conclusions. Lower income and higher education increase suicide risk in male cancer patients, highlighting the need for targeted interventions.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971958","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}
Grzegorz J. Stępień, Thomas Wow, Agnieszka Kołacińska-Wow
Introduction. BRCA1 / 2 mutation carriers are at a higher risk of developing breast cancer. There are several established risk-reducing therapies. Our study aimed to characterize the BRCA1/2 mutation carriers, and to evaluate the implemented treatment methods. Material and methods. Retrospective analysis of clinical records of 96 female patients hospitalized from October 2019 to December 2022 in the Breast Cancer Unit in Lodz, Poland. Results. Out of 85 BRCA1 and 11 BRCA2 mutation carriers, 96.88% received nipple-sparing or skin-sparing, unilateral or bilateral risk-reducing mastectomies. Out of all the patients, 36 developed 38 breast cancers. One patient was diagnosed with breast cancer 2 years after bilateral risk-reducing mastectomy. The most common breast cancer subtype was triple-negative breast cancer (73.68%). The patients could receive surgery, chemotherapy, endocrine therapy, and radiotherapy. 18 patients had neoadjuvant chemotherapy, in 6 of these patients a complete pathological response (ypT0N0) was achieved. Conclusions. Oncoplastic bilateral risk-reducing mastectomies are effective and safe procedures.
{"title":"Retrospective analysis of the treatment of BRCA1 and BRCA2 mutation carriers – the experience of a single-center tertiary institution","authors":"Grzegorz J. Stępień, Thomas Wow, Agnieszka Kołacińska-Wow","doi":"10.5603/njo.96294","DOIUrl":"https://doi.org/10.5603/njo.96294","url":null,"abstract":"Introduction. BRCA1 / 2 mutation carriers are at a higher risk of developing breast cancer. There are several established risk-reducing therapies. Our study aimed to characterize the BRCA1/2 mutation carriers, and to evaluate the implemented treatment methods. Material and methods. Retrospective analysis of clinical records of 96 female patients hospitalized from October 2019 to December 2022 in the Breast Cancer Unit in Lodz, Poland. Results. Out of 85 BRCA1 and 11 BRCA2 mutation carriers, 96.88% received nipple-sparing or skin-sparing, unilateral or bilateral risk-reducing mastectomies. Out of all the patients, 36 developed 38 breast cancers. One patient was diagnosed with breast cancer 2 years after bilateral risk-reducing mastectomy. The most common breast cancer subtype was triple-negative breast cancer (73.68%). The patients could receive surgery, chemotherapy, endocrine therapy, and radiotherapy. 18 patients had neoadjuvant chemotherapy, in 6 of these patients a complete pathological response (ypT0N0) was achieved. Conclusions. Oncoplastic bilateral risk-reducing mastectomies are effective and safe procedures.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"18 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971952","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}
Cancer-related anemia (CRA) continues to be a critical concern despite advancements in oncology treatments. The prevalence of anemia varies from 30% to 90%, impacting the quality of life and prognosis of cancer patients. While CRA is often attributed to antineoplastic therapies, it can also result from the disease itself. Inflammation and the iron regulatory hormone hepcidin play significant roles in CRA pathogenesis. Treatment-induced anemia caused by chemotherapy, tyrosine kinase inhibitors (TKIs) and immunotherapy, pose additional challenges. Intravenous (IV) iron has emerged as an effective treatment option for CRA, overcoming limitations associated with oral iron supplementation. Combining IV iron and ESAs enhances treatment outcomes. Future directions involve exploring ESA safety and their immunomodulatory effects. Transfusions provide quick relief but might impact prognosis and immune response. Other considerations include incorporating physical activity and exploring hepcidin-directed therapy. In conclusion, CRA management necessitates a multifaceted approach to address deficiencies, optimize therapies and improve patient outcomes.
{"title":"Anemia in cancer patients: addressing a neglected issue - diagnostics and therapeutic algorithm","authors":"Konrad Tałasiewicz, Aleksandra Kapała","doi":"10.5603/njo.96928","DOIUrl":"https://doi.org/10.5603/njo.96928","url":null,"abstract":"Cancer-related anemia (CRA) continues to be a critical concern despite advancements in oncology treatments. The prevalence of anemia varies from 30% to 90%, impacting the quality of life and prognosis of cancer patients. While CRA is often attributed to antineoplastic therapies, it can also result from the disease itself. Inflammation and the iron regulatory hormone hepcidin play significant roles in CRA pathogenesis. Treatment-induced anemia caused by chemotherapy, tyrosine kinase inhibitors (TKIs) and immunotherapy, pose additional challenges. Intravenous (IV) iron has emerged as an effective treatment option for CRA, overcoming limitations associated with oral iron supplementation. Combining IV iron and ESAs enhances treatment outcomes. Future directions involve exploring ESA safety and their immunomodulatory effects. Transfusions provide quick relief but might impact prognosis and immune response. Other considerations include incorporating physical activity and exploring hepcidin-directed therapy. In conclusion, CRA management necessitates a multifaceted approach to address deficiencies, optimize therapies and improve patient outcomes.","PeriodicalId":39938,"journal":{"name":"Nowotwory","volume":"46 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134971957","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：