Relapse of Rectal Cancer in an Anal Fistula: A Rare Case

xlomafota13 shared this article with you from Inoreader Relapse of Rectal Cancer in an Anal Fistula: A Rare Case Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2937-2940. doi: 10.21873/invivo.12585. ABSTRACT BACKGROUND: Colorectal cancer is the second most common cause of cancer-related death worldwide. It is well-known that metasta sis to the liver and lung and local recurrences can occur. Additionally, colorectal cancer occasionally metastasizes to other sites. Only a few reports of such metastases have been published and no definitive therapeutic strategies have been proposed for them. CASE REPORT: The case of a 77-year-old man who was diagnosed with rectal cancer is presented. Eighteen months after curative laparoscopic low anterior resection and D3 lymph node resection, an anal fistula metastasis was diagnosed by computed tomography and biopsy. After administering radiotherapy, percutaneous excision of the lesion. was performed. At 21 months from the surgery, the patient is healthy and no recurrence has been found. CONCLUSION: Metachronous metastas is of a colorectal cancer to an anal fistula is rare. Careful investigation and optimal treatment can result in a disease-free status. PMID:34410990 | DOI:10.21873/invivo.12585 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emotional Problems Prior to Adjuvant Radiation Therapy for Breast Cancer

xlomafota13 shared this article with you from Inoreader Emotional Problems Prior to Adjuvant Radiation Therapy for Breast Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2763-2770. doi: 10.21873/invivo.12561. ABSTRACT BACKGROUND/AIM: Being scheduled for radiotherapy can cause emotional distress. This study aimed to identify risk factors in 338 patients assigned to radiotherapy for breast cancer. PATIENTS AND METHODS: Nineteen potential risk factors including the COVID-19 pandemic were investigated for associations with the six emotional problems included in the National Comprehensive Cancer Network Distress Thermometer. RESULTS: Worry and fears were significantly associated with age ≤60 years; sadness with age and Karnofsky performance score (KPS) <90; depression with KPS and Charlson Comorbidity Index ≥3; loss of interest with KPS. Trends were found for associations between sadness and additional breast cancer/DCIS, Charlson Index and chemotherapy; between depression and additional breast cancer/DCIS, treatment volume and nodal stage N1-3; between nervous ness and additional breast cancer/DCIS, mastectomy and triple-negativity; between loss of interest and Charlson Index, family history of breast cancer/DCIS, invasive cancer, chemotherapy, and treatment volume. The COVID-19 pandemic did not increase emotional problems. CONCLUSION: Several risk factors for emotional problems were identified. Patients with such factors should receive psychological support well before radiotherapy. PMID:34410966 | DOI:10.21873/invivo.12561 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acquired EGFR C797G Mutation Detected by Liquid Biopsy as Resistance Mechanism After Treatment With Osimertinib: A Case Report

xlomafota13 shared this article with you from Inoreader Acquired EGFR C797G Mutation Detected by Liquid Biopsy as Resistance Mechanism After Treatment With Osimertinib: A Case Report Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2941-2945. doi: 10.21873/invivo.12586. ABSTRACT BACKGROUND: Osimertinib is a third-generation EGFR-tyrosine kinase inhibitor approved for the treatment of T790M-positive non-small-cell lung cancer. More recently, osimertinib demonstrated improved disease control compared to other EGFR-TKIs. Multiple mechanisms of resistance have been described in T790M-positive patients who experienced treatment failure with osimertinib. CASE REPORT: We report the case of a 78-year-old non-smoker woman with stage IV EGFR L858R-positive lung adenocarcinoma presented with T790M mutation after five years of treatment with gefitinib. The patient was started on osimertinib, but after two and a half years of treatment experienced disease progression. The analyses of circulating tumor DNA using next-generation sequencing showed, together with the pre-existing T790M and exon 21 L858R, the presence of the EGFR C797G resistance mutation. CONCLUSION: Our case report revealed a rare EGFR-dependent acquired resistance mutation to osimertinib in circulating tumor DNA. Liquid biopsy appears to be a promising resource to understand the biology of osimertinib resistance by clonal evolution monitoring and the identification of novel resistance mechanisms. PMID:34410991 | DOI:10.21873/invivo.12586 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Glasgow Prognostic Score 2 as a Prognostic Marker in Patients With Metastatic Urothelial Carcinoma

xlomafota13 shared this article with you from Inoreader Modified Glasgow Prognostic Score 2 as a Prognostic Marker in Patients With Metastatic Urothelial Carcinoma Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2793-2800. doi: 10.21873/invivo.12565. ABSTRACT BACKGROUND/AIM: Predicting the prognosis of metastatic urothelial carcinoma (mUC) patients is needed for clinical decisions. We examined the value of a modified Glasgow prognostic score (mGPS) as a predictive marker for mUC patients. PATIENTS AND METHODS: In a multicenter study, 68 mUC patients received short hydration gemcitabine/cisplatin (shGC) and 74 received pembrolizumab (PEM). Patients were allocated according to mGPS. Progression-free (PFS) and cancer-specific (CSS) survival were examined. RESULTS: Higher mGPS reflected poorer PFS and CSS in shGC (p=0.03, p<0.0001, respectively) and PEM (p=0.02, p<0.001, respectively) patients. PFS for the high mGPS group was longer than that of the low mGPS group in the two cohorts (p <0.0001 for both), with similar CSS results (p<0.0001 and p<0.001, respectively). Multivariate analyses revea led high mGPS was a risk factor for poor CSS in both cohorts (HR=3.55, p<0.001, and HR=2.21, p<0.01, respectively). CONCLUSION: In the mUC patients receiving shGC or PEM, mGPS was a predictive prognostic marker. PMID:34410970 | DOI:10.21873/invivo.12565 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nine Cases of SARS-CoV-2-PCR-positive Samples Showed No Increase of Antibodies Against SARS-CoV-2

xlomafota13 shared this article with you from Inoreader Nine Cases of SARS-CoV-2-PCR-positive Samples Showed No Increase of Antibodies Against SARS-CoV-2 Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2947-2949. doi: 10.21873/invivo.12587. ABSTRACT BACKGROUND/AIM: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been affecting Hokkaido, Japan since late February 2020 until present. The aim of this study was to report the relationship between anti-SARS-CoV-2 antibody-positive and SARS-CoV-2 PCR-positive cases by analyzing anti-SARS-CoV-2 antibodies (IgG and total-Ig). PATIENTS AND METHODS: Serum samples were collected from care workers and nurses in two nursing homes and two hospitals which underwent virus outbreak. All people were confirmed to be SARS-CoV-2-positive by RT-qPCR and their sera was analyzed for anti-SARS-CoV-2 antibodies (IgG and total-Ig). RESULTS: Although 34 out of 43 samples (79.1%) showed enough amount of anti-SARS-CoV-2 antibodies, 9 RT-qPCR -positive samples (20.9%) showed absence of anti-SARS-CoV-2 antibodies in their sera. CONCLUSION: The results th at 20.9% of RT-qPCR-positive samples with SARS-CoV-2 showed absence of anti-SARS-CoV-2 antibodies provides a possibility that the innate immune reaction could eliminate the virus without activating adaptive immune reaction. PMID:34410992 | DOI:10.21873/invivo.12587 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Administration of Nivolumab in Metastatic Renal Cell Cancer Following Treatment With mTOR Inhibitors

xlomafota13 shared this article with you from Inoreader Administration of Nivolumab in Metastatic Renal Cell Cancer Following Treatment With mTOR Inhibitors Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2981-2990. doi: 10.21873/invivo.12593. ABSTRACT BACKGROUND/AIM: Immunotherapy with checkpoint inhibitors is currently considered a cornerstone of metastatic renal clear cell cancer (mRCC) therapy. Despite the general improvement in the survival of patients with mRCC, there are some clinical situations that have not been specifically evaluated in clinical trials, such as the use of everolimus before nivolumab. PATIENTS AND METHODS: We performed a retrospective analysis evaluating the efficacy of nivolumab in the real-world setting, including a subset of patients with previous mTOR inhibitor therapy. RESULTS: From a total of 56 patients, 25 were pre-treated with everolimus before receiving nivolumab. The overall progression-free survival (PFS), overall survival (OS), and objective response rate were 10.3, 21.3 months, and 34%, respectively. There were no statistically significant differences in pat ients who were or were not pre-treated with everolimus. CONCLUSION: mRCC patients should be treated with checkpoint inhibitors and prior use of mTOR inhibitors should not be a definitive exclusion criterium. PMID:34410998 | DOI:10.21873/invivo.12593 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'Catastrophic' Thrombosis in a Young Patient With Acute Myeloid Leukemia Presenting Early in the COVID-19 Pandemic - A Case Report

xlomafota13 shared this article with you from Inoreader 'Catastrophic' Thrombosis in a Young Patient With Acute Myeloid Leukemia Presenting Early in the COVID-19 Pandemic - A Case Report Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2951-2955. doi: 10.21873/invivo.12588. ABSTRACT BACKGROUND/AIM: We present the case of a 19-year-old male patient diagnosed concomitantly with extensive thromboses (including two intra-cardiac masses and Budd-Chiari syndrome), as well as acute myeloid leukemia. This necessitated prompt deployment of a monitoring and treatment strategy which included twice-daily blood count assessment, multiple platelet transfusions and anti-coagulation therapy with dose-adjustment per blood count during both induction and consolidation chemotherapy. Multiple factors are believed to contribute to the development of thrombosis in acute leukemia such as diffuse intravascular coagulation, cytokine release and chemotherapy. CASE REPORT: Our patient presented early on in the COVID-19 pandemic, delaying his seeking out medical treatment and we suspect this to have contributed to his 'catastrophic' thrombotic presentation. Wel l-structured guidelines to help clinicians manage these patients are lacking, and most data are from retrospective analyses or case reports. Our patient continued full-dose anticoagulant therapy until successfully undergoing allogeneic stem cell transplant. The thrombi eventually diminished in size, and the patient was not diagnosed with any further thrombotic events. CONCLUSION: Our case highlights the feasibility of intensive monitoring and provision of platelet transfusion as necessary in order to safely administer low molecular weight heparin from the outset of chemotherapy. PMID:34410993 | DOI:10.21873/invivo.1 2588 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cytotoxic Activity of Isoniazid Derivative in Human Breast Cancer Cells

xlomafota13 shared this article with you from Inoreader Cytotoxic Activity of Isoniazid Derivative in Human Breast Cancer Cells Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2675-2685. doi: 10.21873/invivo.12551. ABSTRACT BACKGROUND/AIM: Isoniazid is an antibiotic used for the treatment of tuberculosis. Previously, we found that the isoniazid derivative (E)-N'-(2,3,4-trihydroxybenzylidene) isonicotinohydrazide (ITHB4) could be developed as novel antimycobacterial agent by lead optimization. We further explored the ability of this compound compared to zerumbone in inhibiting the growth of MCF-7 breast cancer cells. MATERIALS AND METHODS: Cytotoxicity was measured by the MTT assay and further confirmed via apoptosis, ROS, cell cycle, DNA fragmentation and cytokine assays. RESULTS: ITHB4 demonstrated a lower IC50 compared to zerumbone in inhibiting the proliferation of MCF-7 cells. ITHB4 showed no toxicity against normal breast and human immune cells. Apoptosis assay revealed that ITHB4, at a concentration equal to the IC50, induces apoptosis of MC F-7 cells and cell cycle arrest at the sub-G1 and G2/M phases. ITHB4 triggered accumulation of intracellular ROS and nuclear DNA fragmentation. Secretion of pro-inflammatory cytokines induced inflammation and potentially immunogenic cell death. CONCLUSION: ITHB4 has almost similar chemotherapeutic properties as zerumbone in inhibiting MCF-7 growth, and hence provide the basis for further experiments in animal models. PMID:34410956 | DOI:10.21873/invivo.12551 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual Presentation of a Post-procedural Breast Hematoma: A Case Report

xlomafota13 shared this article with you from Inoreader Unusual Presentation of a Post-procedural Breast Hematoma: A Case Report Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2957-2961. doi: 10.21873/invivo.12589. ABSTRACT BACKGROUND/AIM: Hematoma is the most frequent complication after Vacuum-Assisted Breast Biopsy (VABB) in 13% of cases. A direct communication channel with patients eases the diagnosis of VABB complications and ensures treatment at an early stage, as outpatients, in most cases. In 2020, due to the COVID-19 pandemic, we observed a reduction of self-reported postoperative complication leading to delay in the identification of harmful complications, therefore leading to need for more invasive treatment. CASE REPORT: A 50-year-old patient was admitted to the Emergency Department for dry cough, fever, chest discomfort, dyspnea, and slight confusion four days after VABB. Due to the reported symptoms, the patient was sent to our COVID-19 Emergency Department. The COVID-19 swab was negative. Ultrasound revealed a large hematoma at the biopsy site, with active blee ding. Open evacuation with accurate hemostasis was planned with rapid and complete resolution of the clinical symptoms. After surgery, the patient reported that she intentionally avoided admittance in the hospital due to the risk of COVID-19 infection. The patient was discharged in the first postoperative day and maintained in quarantine for 14 days. CONCLUSION: In the COVID-19 era due to the risk of hospital cross-infections, reduction of patient-doctor communication could lead to misdiagnosis, delay in recognition of procedural complications thus leading to requirement for invasive treatment, hospitalization, while also further multiplying the risk of COVID-19 infection. PMID:34410994 | DOI:10.21873/invivo.12589 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Direct Oral Anticoagulants for the Treatment of Venous Thromboembolism in Patients With Active Cancer

xlomafota13 shared this article with you from Inoreader Direct Oral Anticoagulants for the Treatment of Venous Thromboembolism in Patients With Active Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2747-2753. doi: 10.21873/invivo.12559. ABSTRACT BACKGROUND/AIM: Although direct oral anti - coagulants (DOACs) are as safe and effective as conventional anticoagulants for treating venous thromboembolism (VTE), we have insufficient evidence justifying their use in patients with active cancer. We investigated the safety and effectiveness of DOACs in patients with active cancer. PATIENTS AND METHODS: To investigate the safety and efficacy of DOACs, we retrospectively extracted 312 consecutive patients with active cancer who were prescribed edoxaban, rivaroxaban or apixaban for VTE. RESULTS: The most common primary cancer sites were the lung, stomach, colon/rectum, hematology, ovary, and pancreas. Fifty patients (16%) discontinued DOACs due to clinically relevant bleeding; major bleeding events occurred in 18 patients (5.4%). Thrombosis reduced or resolved in 144 of 167 evaluable patients (86%). In particular, pulmonary embolism was reduced or resolved in 46 of 50 patients (92%). CONCLUSION: Our findings revealed that DOACs for cancer-associated VTE are as safe and effective as conventional anticoagulation therapy. PMID:34410964 | DOI:10.21873/invivo.12559 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Independent Validation Study of Candidate microRNAs as Predictive Biomarkers for Bevacizumab-based Therapy in Patients With Metastatic Colorectal Cancer

xlomafota13 shared this article with you from Inoreader An Independent Validation Study of Candidate microRNAs as Predictive Biomarkers for Bevacizumab-based Therapy in Patients With Metastatic Colorectal Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Sep-Oct;35(5):2809-2814. doi: 10.21873/invivo.12567. ABSTRACT BACKGROUND/AIM: The monoclonal antibody bevacizumab is a standard drug used in combination with oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) based chemotherapy in the first or second-line treatment of metastatic colorectal cancer (mCRC). Our previous study identified and subsequently validated 4 microRNAs in a small group of patients as predictors of the therapeutic response to bevacizumab combined with chemotherapy. The aim of this follow-up study is to confirm the predictive ability of these tissue miRNAs in a larger independent cohort of mCRC patients. PATIENTS AND METHODS: The retrospective study included 92 patients with generalized-radically inoperable tumors treated with the combined therapy of bevacizumab/FOLFOX in a standard regimen. RESULTS: Expression levels of candidate miRNA biomarkers (miR-92b-3p, miR-3156-5p, miR-10a-5p and miR-125a-5 p) were determined in tumor tissue specimens and statistically evaluated. MiR-92b-3p and miR-125a-5p were confirmed to be associated with radiological response according to RECIST criteria (p=0.005 and 0.05, respectively) and to be up-regulated in responders to bevacizumab/FOLFOX therapy. Higher levels of miR-92b-3p were also significantly associated with extended progression-free survival (p=0.024). CONCLUSION: We have successfully confirmed miR-92b-3p to be up-regulated in tumor tissue of mCRC patients with good response to bevacizumab/FOLFOX therapy. PMID:34410972 | DOI:10.21873/invivo.12567 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.