Vol 5 (2023)

Published: 2024-02-20

Abstract views: 407   PDF downloads: 126  

Page 187-192

Breast carcinoma in the Democratic Republic of the Congo: Characterization of hormone receptors

blankpage Guy Ilunga Nday, Manix Banza Ilunga, Anasthasie Umpungu Ngalula, Olivier Mukuku, Jules Thaba Ngwe

Purpose: Breast cancer is a heterogeneous disease, and understanding its characteristics is crucial for effective treatment. Therefore, this study aims to investigate breast carcinomas as a function of hormone receptors (estrogen and progesterone) in the Democratic Republic of the Congo (DRC), which can contribute to better management of breast cancer cases in the country.
Methods: We conducted an analytical cross-sectional study from 2014 to 2016 in the cities of Kinshasa and Lubumbashi. Using non-random sampling, we collected 86 cases of breast carcinoma.
Results: The study found that out of the 86 cases of breast carcinoma, 33 patients (38.3%) had both types of hormone receptors (ER+/PgR+), while 37 patients (43.0%) had negative results for both receptor types (ER-/PgR-). Additionally, 15 patients (17.4%) had only estrogen receptors. The study did not find any significant association between the presence of estrogen receptors and patient age, T stage, histological type, and Ki67 proliferation index. However, the study did observe that estrogen receptors were significantly more present in grade I and II tumors (74.4%) than in grade III tumors (40.4%) (Odds ratio=4.3 [1.7-10.8]; p=0.003).
Conclusion: The findings of this study demonstrate a high prevalence of hormone receptors in breast cancer cases in the DRC. Additionally, the study revealed a significant association between the presence of estrogen receptors and tumor grade, underlining the relevance of these markers in the characterization and treatment of the disease.

Abstract views: 771   PDF downloads: 179  

Page 168-180

Risk of severe immune-related adverse events in cancer patients with pre-existing autoimmunity receiving immune checkpoint inhibitor therapy

blankpage Dayna Jill Isaacs, Nikhita Kathuria-Prakash, Robin Hilder, Melissa G. Lechner, Alexandra Drakaki

Purpose: To evaluate the frequency and severity of irAEs in patients with pre-existing autoimmunity, including irAE-related morbidity and mortality, irAE-related management and resolution, and outcome of ICI rechallenge, to better understand the treatment options for this vulnerablepatient population.
Methods: We designed a retrospective, single-center, case-control study at a large, academic medical center to evaluate the incidence and severity of irAEs in patients with pre-existing autoimmunity compared to controls. Controls were matched 2:1 for age, sex, cancer histology, and ICI class. Patients were identified with ICD 9 and 10 codes followed by manual chart extraction. Cases were defined as patients with pre-existing, systemic autoimmunity. The primary outcome was severe irAE (Grade 3 or higher by Common Terminology Criteria for Adverse Events) within 6 months of ICI therapy. Secondary outcomes included response to ICIs, resolution of the irAE, ICI rechallenge success, and survival. Statistical analyses were performed by Chi-square, Fishers exact, Mann-Whitney, and Log-rank tests.
Results: Of 3,130 patients treated with ICIs from 2015-2021, 28 cases with pre-existing autoimmune disease were identified and were matched with 56 controls. Pre-existing autoimmune conditions included antiphospholipid syndrome, inflammatory polyarthritis, juvenile rheumatoid arthritis, multiple sclerosis, psoriatic arthritis, rheumatoid arthritis, and type I diabetes. Multiple cancer histologies, including genitourinary, gynecologic, head & neck, hepatobiliary, lung, melanoma, and pancreatic, were represented. Six of 28 cases (21.4%) experienced severe irAEs compared to 9/56 (16.1%) controls; the odds of developing a severe irAE were not significantly different (OR 0.43, 95% CI 0.083-2.33, = 0.627, ns). Moreover, there were no significant differences in overall survival or tumor response between the two groups. The majority of irAEs resolved without long-term sequelae (66.7% of cases, 55.6% of controls). The majority of patients who were rechallenged with ICIs were successful in continuing therapy (66.7% of cases, 100% of controls).
Conclusion: Our study suggests that patients with pre-existing autoimmune disease can be treated with ICI cancer therapies and experience rates of severe irAEs and overall survival that are similar to those of the general population. These data can aid oncologists in discussing risks and benefits of ICIs when treating patients with pre-existing autoimmunity and solid tumors.

Abstract views: 856   PDF downloads: 526  

Pages 156-159

Abstract views: 751   PDF downloads: 407  

Page 153-155

Abstract views: 457   PDF downloads: 140  

Page 181-186

Perspectives on chemotherapy-induced toxicities in pancreatic cancer

blankpage Henu Kumar Verma, Tarun Sahu, LVKS Bhaskar

Despite breakthroughs in screening, identification, and therapy, pancreatic cancer (PC) remains a serious issue in cancer-related mortality. This comprehensive review investigates the long-term and latent effects of chemotherapy in PC, focusing on commonly used medicines such as gemcitabine, docetaxel, irinotecan, nab-paclitaxel, and others. Gemcitabine, a common PC medication, causes a variety of adverse effects, including myelosuppression and weariness. Combination therapy, such as docetaxel and irinotecan, enhance toxicity, resulting in problems such as neutropenia and gastrointestinal difficulties. Significantly, chemotherapy-related complications, such as thrombosis and cardiac difficulties connected to paclitaxel, present serious concerns. Erlotinib, gefitinib, vatalanib, and sunitinib studies show significant side effects. Despite ongoing challenges, determining the causes of the low objective response rate in gemcitabine-refractory patients remains challenging. The study emphasizes the importance of future advances in cancer etiology, arguing for large, straightforward studies examining combination chemotherapies to improve tolerance and minimize chemotherapy-induced sequelae. This overview serves as a thorough guide for physicians, researchers, and policymakers as they navigate the complex terrain of PC chemotherapy, providing significant insights to improve patient care.