Wspolczesna Onkologia-Contemporary Oncology最新文献

Introduction: This study introduces a novel methodology for classifying human papillomavirus (HPV) using colposcopy images, focusing on its potential in diagnosing cervical cancer, the second most prevalent malignancy among women globally. Addressing a crucial gap in the literature, this study highlights the unexplored territory of HPV-based colposcopy image diagnosis for cervical cancer. Emphasising the suitability of colposcopy screening in underdeveloped and low-income regions owing to its small, cost-effective setup that eliminates the need for biopsy specimens, the methodological framework includes robust dataset augmentation and feature extraction using EfficientNetB0 architecture.

Material and methods: The optimal convolutional neural network model was selected through experimentation with 19 architectures, and fine-tuning with the fine κ-nearest neighbour algorithm enhanced the classification precision, enabling detailed distinctions with a single neighbour.

Results: The proposed methodology achieved outstanding results, with a validation accuracy of 99.9% and an area under the curve (AUC) of 99.86%, with robust performance on test data, 91.4% accuracy, and an AUC of 91.76%. These remarkable findings underscore the effectiveness of the integrated approach, which offers a highly accurate and reliable system for HPV classification.Conclusions: This research sets the stage for advancements in medical imaging applications, prompting future refinement and validation in diverse clinical settings.

Introduction: Metastatic breast cancer (MBC) can profoundly impact patients' lives. The health-related quality of life (HRQOL) of MBC metavivors remains a paramount concern. This study exa-mined the multifaceted aspects of HRQOL in MBC metavivors.

Material and methods: Ninety-eight participants with over 4 years of meta-static disease were evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30, QLQ-BR42 and QLQ-BM22 alongside the Assessment of Survivor Concerns (ASC) questionnaire.

Results: HRQOL scores were high (> 80/100 points) in some HRQOL areas, including role, cognitive and social functioning and breast symptoms. Moderate limitations (> 30 points) occurred in global QOL and financial impact (QLQ-C30); sexual functioning, sexual enjoyment, future perspective, breast satisfaction, upset by hair loss, skeletal symptoms, and weight gain (QLQ-BR42); and psychosocial aspects of QLQ-BM22. Worries were moderate in the two ASC factors (6.8 and 5.3) and the global scale (11.7). The multivariate model that best explains high risk of low global QOL included limiting comorbidity, financial impact, cancer worry and role functioning (R ² = 0.692). Patients with only bone metastases showed higher cancer and health worries (ASC scale) than patients with soft tissues and visceral sites.

Conclusions: This study shows that MBC metavivors adapted well to their situation and underscores the persistent HRQOL challenges they face. In-depth analysis of the QLQ-C30 glo-bal score highlights the need to address not only medical aspects but also integrated psychosocial and economi-cal support in MBC metavivor care. HRQOL variations across metastatic sites underscore the need to tailor interventions to address site-specific challenges.

Introduction: The incidence of neuroendocrine tumours (NETs) increased over the last years. Most of them are non-functioning, and the course of the disease is asymptomatic for a long time. This results in late diagnosis at an advanced stage. The aim of our study was the evaluation of selected circulating cytokines of interleukin-6 family - interleukin 6 (IL-6), oncostatin M (OSM), and cardiotrophin-1 (CT1) - in NETs.

Material and methods: The study group comprised 80 patients (56%) in several subgroups, including gastroenteropancreatic (GEPNETs, n = 64, 80%) and bronchopulmonary neuroendocrine tumours (BPNETs, n = 16; 20%). Serum IL-6, OSM, and CT1 concentrations were tested using ELISA.

Results: The median concentration of IL-6 was 41.5 pg/ml in the study group and 32.6 pg/ml in the control group, and the difference was statistically significant (p < 0.001). The concentration of OSM was significantly lower in the study group than in the control group (p < 0.001), at 105.6 pg/ml and 115.5 pg/ml, respectively. There was a significant difference (p < 0.01) in concentration of CT1 in the study group (222.0 pg/ml) and controls (267.2 pg/ml). Our investigation into selected IL-6 family cytokines revealed differential modulation of signal transduction pathways.

Conclusions: These findings suggest that despite utilising a common signalling transducer, individual IL-6 family cytokines exert distinct biological effects on neuroendocrine tumour development. Notably, IL-6 appears to promote tumourigenesis, while OSM and CT1 exhibit inhibitory effects on gastro-entero-pancreatic and bronchial neuroendocrine tumour development. Further studies are necessary to validate the diagnostic utility of IL-6 family cytokines in NETs.

Introduction: The BRAF^V600E mutation is found in 6-11% of metastatic colo-rectal cancer (mCRC) patients. According to international guidelines for BRAF^V600E-mutated mCRC, the triplet chemotherapy FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin, irinotecan) or double chemotherapy with or without bevacizumab, and encorafenib plus cetuximab should be considered in the first- and second-line settings. We aimed to evaluate clinical practices in BRAF^V600E-mutated mCRC patients treated at five Polish oncology centers.

Material and methods: We retrospectively analyzed the data of BRAF^V600E- mutated mCRC patients treated between 2011 and 2023. Before starting the first-line treatment, all patients were tested for BRAF and RAS mutations.

Results: One hundred twenty-six patients (median age: 68 years; 55% female, 45% male) from five oncology centers were included. The majority of patients (69, 55%) had a right-sided primary tumor. The first line of chemotherapy was received by 100 patients (79.4%). The majority received doublet chemotherapy: FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin), FOLFIRI (folinic acid, 5-fluorouracil, irinotecan), XELOX (capecitabine, oxaliplatin), and FOLFIRI with bevacizumab: 30 (30%), 47 (47%), 5 (5%), and 3 (3%). Only three patients received FOLFOXIRI; one patient received bevacizumab. The median duration of first-line treatment was 5.26 months (95% CI: 0.03-18.9). Subsequently, 40%, 16%, 5%, and 1% of patients received second, third, fourth, and fifth-line therapy, retrospectively. During the median follow-up of 38.5 months, 96 (79.3%) patients died. The median overall survival from the time of mCRC diagnosis was 13.7 months (95% CI: 11.3-17.6).

Conclusions: This study highlights the unmet need for effective treatment strategies for patients with BRAF^V600E-mutated mCRC in Poland.

Introduction: The aim of this study was to evaluate overall survival of men who received systemic therapy with docetaxel for metastatic castration- resistant prostate cancer (MCRPC) in rural Nordland County, Norway. Prognostic factors related to treatment and other variables were evaluated.

Material and methods: Overall, 132 pa- tients were included in this retrospective study covering the years 2009-2022. Uni- and multivariate survival analyses were performed.

Results: In this elderly cohort (median age 72 years), weekly low-dose docetaxel was the preferred regimen (44%). Seventy-three percent were treated in the first line. Only 11 patients (8%) were pre-exposed to docetaxel in the hormone-sensitive phase. Median survival was 14.3 months. Prognostic factors for longer survival included higher hemoglobin, lower lactate dehydrogenase, administration of docetaxel as first-line MCRPC treatment, and use of fewer prescription drugs for comorbidity. Pre-exposure to docetaxel did not play a major role, p = 0.76.

Conclusions: In this rural health care setting, survival after docetaxel was shorter than reported by other groups. Blood test results were confirmed as important prognostic factors. In the present era of evolving treatment sequences, we recommend monitoring of real-world treatment results.

Introduction: Autologous hematopoietic stem cell transplantation (auto- HSCT) preceded by high-dose chemotherapy is a mainstay in relapsed/refractory lymphoma. The study aimed to compare the efficacy and adverse event profile between BEAM and Benda-EAM (BeEAM) regimens and to evaluate prognostic factors for survival in lymphoma patients undergoing auto-HSCT.

Material and methods: We present a single-center retrospective analysis of 82 lymphoma patients (median age 52; IQR 38.2-62.2) who received BEAM (47.6%) or BeEAM (52.4%) followed by auto-HSCT between January 2015 and December 2021.

Results: During the post-HSCT period 58% of patients experienced febrile neutropenia (51.3% vs. 64.3% in BEAM and BeEAM, respectively; p = 0.27), 80.5% mucositis (69.2% vs. 90.7%; p = 0.02), 42.5% bacteremia (50% vs. 35.7%; p = 0.26), and 18.8% pneumonia (31.6% vs. 7.1%; p = 0.01). Patients who received bendamustine required more platelet transfusions (p = 0.02). In the multivariate Cox regression model, C-reactive protein level on the first day of hospitalization (hazard ratio - HR = 1.03, 95% CI: 1.01-1.06) and days of agranulocytosis (HR = 1.15, 95% CI: 1.00-1.32) were predictors of poorer overall survival (OS), whereas hemoglobin level at the auto-HSCT was a protective factor in terms of OS (HR = 0.43, 95% CI: 0.23-0.78) and progression-free survival (PFS) (HR = 0.66, 95% CI: 0.45-0.96). The median OS since auto-HSCT was 87 months, while the median PFS was 49 months. No differences in PFS and OS between BEAM and BeEAM regimens were proven.

Conclusions: Conditioning with BEAM and BeEAM regimens is associated with comparable post-transplant outcomes. The toxicity of these regimens is comparable; however, BEAM is associated with a higher risk of pneumonia, while BeEAM is associated with a higher risk of mucositis.

Colorectal cancer is being detected in increasingly younger age groups, and its incidence has been on the rise in recent years. Neuroendocrine tumors have also shown an increase in occurrence despite their rarity. Neuroendocrine tumors most commonly occur in the gastrointestinal tract and lungs. Therefore, new, better, and more effective treatment methods are being sought. Metformin, a drug commonly used in the treatment of type 2 diabetes, has demonstrated its ability to reduce the incidence and increase the efficacy of chemotherapy in colorectal cancer and neuroendocrine tumors. The biguanide works by inhibiting the mammalian target of rapamycin pathway, activating 5'AMP activated protein kinase, and reducing insulin-like growth factor 1. In studies conducted on human cells and xenografts, the drug has shown its positive effects in combating these tumors by reducing proliferation, slowing the growth of cancer cells, and inhibiting metastasis. The main goal of this review is to comprehensively summarize the current state of knowledge regarding metformin in the treatment of colorectal cancer and neuroendocrine tumors.

Introduction: Fibroblast growth factor receptor 2 (FGFR2) activation is associated with endocrine therapy resistance in luminal breast cancer (BC) in vitro, but clinical evidence remains inconsistent. Given the role of FGFRs in mediating tumour microenvironment (TME) interactions, the prognostic value of FGFR2 may depend on the stromal component. This study aimed to validate the association between FGFR-related profile of the stroma and FGFR2 prognostic value in oestrogen receptor-positive invasive ductal carcinoma (IDC).

Material and methods: An in silico gene expression analysis identified 12 stromal factors (FAP, CXCL12, PDGFRA, COL1A1, HSPG2, CCL2, MMP14, S100A4, MMP9, PDGFA, MCAM, IL6) forming an "FGFR-related profile of the stroma". A cohort of 257 ER+ IDC patients from The Cancer Genome Atlas (TCGA) was analysed. Tumours were clustered using k-means based on stromal gene expression, and Cox proportional hazards regression models were used to assess the association between FGFR2 and overall survival (OS).

Results: Two clusters of ER+ IDC tumours were identified based on the stromal gene expression profile. While both clusters had similar tumour stages and hormone receptor statuses, multivariable analysis adjusted for clinical factors revealed a significant association between FGFR2 expression and cluster assignment. In Cluster I (high expression of stromal genes), high FGFR2 was linked to poor prognosis, whereas in Cluster II (low expression), high FGFR2 indicated favourable prognosis. FGFR1, FGFR3, and FGFR4 showed no significant prognostic value.

Conclusions: Stromal profiles modulate the prognostic significance of FGFR2 in luminal breast carcinoma, highlighting the importance of TME profiling for biomarker assessment and explaining inconsistencies in FGFR2 studies.

Introduction: Lung cancer is one of the most prevalent cancers worldwide. Dickkopf-1 (DKK-1) and -2 (DKK-2) are important proteins for the regulated Wnt signalling pathway. Alternations in the Wnt pathway are associated with tumour progression. The aim of the study was to analyse the concentration of DKK-1 and DKK-2 in tumour and matched non-tumour (NT) samples of 65 patients with non-small cell lung cancer (NSCLC), including 3 subtypes: adenocarcinoma (AC), squamous cell carcinoma (SCC), and large cell carcinoma (LCC).

Material and methods: The protein concentration was measured by enzyme-linked immunosorbent assay (ELISA) in homogenates.

Results: The difference between the level of DKK-1 in tumour and NT specimens was not significant for the whole NSCLC group and SCC and LCC subtype, while in AC samples they were significantly higher (p = 0.028). The highest concentration of DKK-1 was found in the advanced NSCLC samples, with the T4 parameter as well as stage III. Significantly decreased DKK-2 concentrations were detected in all NSCLC subtypes (p < 0.05). Moreover, the DKK-2 level was higher in non-smokers than in smokers. The results indicate that concentrations of DKKs were different in relation to subtypes as well as clinical and socio-demographic parameters. The concentration of DKKs could be associated with the progression of NSCLC.

Conclusions: We suggest that DKK-1 could play an oncogenic role in AC, while DKK-2 could be a tumour suppressor in all NSCLC subtypes. Dickkopf-1 and DKK-2 proteins could have differential roles in the Wnt signalling pathway, which is important in many cellular processes, such as proliferation and apoptosis.

Glioblastoma is the most aggressive form of primary brain tumour in adults. This tumour employs numerous transcription factors to advance and sustain its progression. Current evidence suggest that early growth response 1 (EGR1) plays a dual role as both an oncogene and a tumour suppressor in glioblastoma. Early growth response 1 expression is prevalent in glioblastoma, affecting over 80% of cases. Early growth response 1 regulatory roles extend to angiogenesis, cell adhesion, and resistance to chemotherapy, notably influencing pathways like hypoxia-inducible factor 1α and vascular endothelial growth factor A. Early growth response 1 can also induce cell adhesion, migration, chemoresistance against temozolomide, stemness, and self-renewal in glioblastoma cells. Despite its oncogenic functions, EGR1 can also suppress tumours by upregulating non-steroidal anti-inflammatory drug-activated gene 1 and phosphatase and tensin homolog deleted on chromosome ten, and inhibiting invasion and metastasis. Additionally, EGR1 may have hypothetical implications in the viral hit-and-run theory, particularly regarding cytomegalovirus infection. The key findings of this review are the context- dependent nature of EGR1's actions and its potential as a prognostic marker in glioblastoma. Further research is needed to understand EGR1's role fully and exploit its potential in clinics.