Journal of cancer science and clinical therapeutics最新文献

Adenocarcinoma of the esophagus and esophagogastric junction is a highly aggressive malignancy with a significant mortality risk and poor overall prognosis. The annual incidence of esophageal adenocarcinoma has risen substantially in recent decades and is now recognized as the most common form of esophageal cancer. Early detection of esophageal adenocarcinoma remains challenging due to the frequency of asymptomatic disease progression and ongoing limitations of current screening guidelines. Barrett's esophagus is the established precursor lesion for esophageal adenocarcinoma. Despite the high mortality rate of esophageal adenocarcinoma, neoplastic progression of Barrett's esophagus is poorly understood. While the presence of dysplasia can help identify the relatively small subset of patients with Barrett's esophagus at a higher risk of progression, it is far from a perfect predictor. More research is needed to understand the underlying mechanisms precipitating malignant transformation. Optimal management of esophageal adenocarcinoma requires a coordinated, multidisciplinary approach to tailor risk-stratified screening algorithms and ensure timely intervention. Advancements in treatment protocols, molecularly targeted therapies, and palliative care have improved perioperative outcomes and quality of life. Even still, long-term survival is poor, and recurrence is frequent. Ongoing translational research is essential for reducing disease burden, improving treatment durability, and extending progression-free survival for patients with esophageal adenocarcinoma. This comprehensive review will detail the established guidelines, recent updates, and deficits surrounding the history, diagnosis, staging, treatment, and prognosis of esophageal adenocarcinoma.

CAR-T therapy (Chimeric antigen receptor T-cell therapy) is a novel and transformative approach to fighting cancer, modulating the immune system involving adoptive cell therapy. In this article, a comprehensive information is provided on the effectiveness of CAR-T therapy in various types of cancers some of which have shown to be particularly challenging cancers to fully eliminate. The clinical effectiveness of CAR-T therapy compared to other traditional methods of cancer treatments such as surgical, radiotherapy, high dose rate (HDR)-brachytherapy, and immunotherapy favors CAR-T cell treatment strategy. The article presents the concept of CAR-T, discuss the structure and function of this novel therapeutic and its efficacy in liquid cancers, and development of therapies in solid cancers. Partial and complete response rates in relation to the CAR-T methodologies on various cancers are critically reviewed with discussion on the durability and overall long-term effects and limitations. Potential role of CAR-T therapies in various cancer treatments is reviewed in conjunction with other therapies and the efficacies and status on the progress of those therapies. Despite the impressive efficacy of CAR-T therapy, it is associated with potentially serious side effects, particularly cardiovascular toxicities that require proper cardiovascular screening prior, during, and after CAR-T therapy. These highlight the standardized modes of monitoring, prevention, and management of the toxicities. The cytokine release storm (CRS) in the pathogenesis of CAR-T toxicities may manifest in different ways emphasizing heterogeneous clinical presentation of CAR-T adverse events, highlighting the need for vigilant monitoring and individualized management strategies. Nonetheless, additional information on the serious adverse effects and long-term effects warrants further investigation.

Predictive genetic testing is a medical test that can effectively reduce morbidity and mortality caused by genetic diseases. This specific test predicts the risk of disease and provides prognostic information in asymptomatic persons, leading to the adoption of prevention strategies and individualized treatment in high-risk persons. Although the cause of some cancers is not known correctly, numerous studies establish that some specific gene mutations make people susceptible to specific cancer. Therefore, genetic screening of people, especially individuals with a family history of cancer, can be essential in reducing disease mortality and improving survival. Although genetic screening, in some cases, is associated with challenges, overall, it can be recognized as an important way to prevent and control hereditary diseases and save many lives. This article provides a critical review of the published reports and discusses the value of preventive genetic testing in preventing and controlling cancers and the role of hereditary mutations associated with cancer development.

Cervical cancer ranks 4th as the most prevalent cancer among women worldwide. In Kenya, it is the 2nd most frequently diagnosed cancer and the leading cause of cancer-related deaths among women. Globally, more than 50% of Cervical Cancer diagnoses are made late, with this proportion rising to over 80% in developing countries. This study aimed to determine the individual-level factors contributing to delayed cervical cancer diagnosis. A cross-sectional hospital-based study was adopted to collect data on; Socio-demographics, affordability and use of health insurance, Cervical cancer and Human Papillomavirus (HPV) screening awareness, Prior HPV screening, Diagnosis circumstances, Time taken to seek medical attention, Fears and social support experiences, from 139 cervical cancer patients systematically sampled at the Kenyatta National Hospital, using a semi-structured questionnaire. Additionally, 8 Key Informants were purposively selected, to provide in-depth information. Associations between stage at diagnosis and individual-level factors were tested using logistic regression at 95% Confidence Interval. The mean age was 51 years and all participants were African and Christians. Majority (63.31%) were married and educated up to primary level, and more than half (61.15%) were unemployed. The prevalence of delayed diagnosis was 86(61.9%). The Risk Factors for delayed diagnosis were; Older age; 50-59 (p-value=0.049) & 60-69 years (0.013), Lack of HPV screening awareness (P-value=0.017), and Seeking medical attention only due to a symptomatic trigger (P-value=0.030). In corroboration, qualitative information reported that, inability to afford diagnosis costs, lack of awareness and poor medical care seeking habits, contribute to delayed diagnosis. The study identified gaps in awareness of Cervical Cancer and HPV screening among women and affordability of diagnosis costs. More community-level awareness should be created and, increase of centers and resources for diagnosis and free screening. Women should also be encouraged to pay for the National Health Insurance Fund (NHIF), so as to lessen their financial burden of diagnosis.

We recently reported a computational method (IDACombo) designed to predict the efficacy of cancer drug combinations using monotherapy response data and the assumptions of independent drug action. Given the strong agreement between IDACombo predictions and measured drug combination efficacy in vitro and in clinical trials, we believe IDACombo can be of immediate use to researchers who are working to develop novel drug combinations. While we previously released our method as an R package, we have now created an R Shiny application to allow researchers without programming experience to easily utilize this method. The app provides a graphical interface which enables users to easily generate efficacy predictions with IDACombo using provided data from several high-throughput cell line screens or using custom, user-provided data.

Glioblastoma (GBM) is one of the most aggressive forms of brain cancer that presents with a median survival rate of 14-30 months and along with a discouraging five-year survival rate of 4-5%. Standard treatment of newly diagnosed GBM, also known as the Stupp protocol, includes a maximally safe surgical resection followed by radiation and chemotherapy. Despite these treatment regimens, recurrence is almost inevitable, emphasizing the need for new therapies to combat the aggressive nature of GBMs. Tumor Treating Fields (TTFs) are a relatively new application to the treatment of GBMs, and results have been promising with both progression-free survival and overall survival when TTFs have been used in combination with temozolomide. This article critically reviews the biophysical and biological mechanisms of TTFs, their clinical efficacy, and discusses the results in clinical trials, including EF-11 and EF-14. Both trials have demonstrated that TTFs can enhance progression free survival and overall survival without compromising quality of life or causing severe adverse effects. Despite the high cost associated with TTFs and the need for further analysis to determine the most effective ways to integrate TTFs into GBM treatments, TTFs represent a significant advancement in GBM therapy and offer hope for improved patient prognosis.