Current Cancer Reports

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

2024-03-26T16:52:58+08:00

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.

Perspectives on chemotherapy-induced toxicities in pancreatic cancer

2024-02-21T09:11:55+08:00

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.

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

2024-02-20T11:06:12+08:00

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, p = 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.

Safety and feasibility of preoperative simultaneous portal vein embolization and biliary drainage in hilar cholangiocarcinoma prior to hepatectomy

2024-02-20T11:06:13+08:00

Purpose: Evaluate safety and feasibility of simultaneous biliary drainage (BD) and portal vein embolization (PVE) prior to hepatectomy in hilar cholangiocarcinoma (HCCA) patients.
Methods: From January 2010 to June 2022, patients with potentially surgically resectable HCCA who underwent preoperative PVE and BD were analyzed. Type of initial BD, time interval between BD and PVE, changes in future liver remnant (FLR), time interval between BD, PVE and resection, and complications were recorded. Patients were divided into 3 groups based on the BD-PVE interval: Group A: simultaneous BD and PVE or within 7 days (d), n = 6; Group B: d ≥ 7 to ≤ 30, n = 7; Group C: d > 30, n = 14). Primary endpoints were post-PVE complications, FLR change, and resection rate. Secondary endpoints were Clavien-Dindo ≥ 3, Grade B/C Post Hepatectomy Liver Failure (PHLF) and 90 days mortality rate.
Results: A total of 27 patients (mean age = 64.4 +/- 11.2 years) underwent both BD and PVE prior to hepatectomy. Mean degree of hypertrophy at 4-6 weeks post-PVE was 10.4 +/- 3.7% with no significant difference between the 3 groups (p > 0.05). Resection was 67% in Group A, and 57% and 36% in groups B and C respectively (p < 0.05). Time to surgery was 38.5 +/- 12 days in Group A, and 60 and 147 days in groups B and C respectively (p = 0.002). No major post PVE SIR complication was reported in group A. Overall rate of Grade III/IV Clavien-Dindo complication was 61.5% with no difference among the three groups (50%, 75%, and 60%; groups A, B and C, respectively). Overall PHLF Grade B/C was reported in 46.2% of patients. No patients in Group A demonstrated Grade B/C PHLF.
Conclusion: Simultaneous BD and PVE is safe and reduces the time to surgery, which may help contribute to a higher rate of surgical resection.

Tumor microenvironment

2024-02-20T11:06:15+08:00

Retrospection and prospect of Current Cancer Reports (CCR)

2024-02-20T11:06:15+08:00

Black-White disparities in fatigue and comorbidity among breast cancer survivors

2023-03-07T14:17:01+08:00

Epidemiological and histopathological features of ocular tumors in Bukavu, Democratic Republic of the Congo

2022-08-25T16:23:17+08:00

Purpose: To describe epidemiological and histopathological features of ocular tumors observed in two ophthalmology departments in Bukavu in the Democratic Republic of the Congo.
Methods: A cross-sectional descriptive study and a simple proportion analysis were performed to describe the epidemiological and histopathological characteristics of 103 consecutive anatomical pieces taken after tumor removal from two ophthalmology services in Bukavu city from January 2018 to December 2020.
Results: Children accounted for 40% of patients and ocular tumors were unilateral in 84.5% of cases. The most common locations were the retina (34.8%), conjunctiva (33.7%) and eyelids (22.8%). Benign tumors predominated (51.4%), followed by malignant tumors (37.9%), and undetermined tumors (15.5%). The main histological forms found were retinoblastoma (34.8%), conjunctival nevus (20.6%), and palpebral granuloma (16.3%).
Conclusion: Ocular tumors are common in Bukavu. Histopathological examination remains essential to guide management to reduce the risk of recurrence and related complications.

Women’s breast cancer risk factors in Kinshasa, Democratic Republic of the Congo

2022-06-15T09:58:25+08:00

Purpose: Breast cancer (BC) is the most common malignancy and the leading cause of cancer-related deaths among women worldwide. Risk factors for this disease are numerous and their prevalence varies according to racial and ethnic groups and geographical regions. Therefore, we sought to identify BC risk factors in the Congolese population.
Methods: A case-control study was conducted at the Nganda Hospital Center in Kinshasa, Democratic Republic of the Congo. One hundred and sixty patients with breast cancer (cases) were compared to 320 women who did not have BC (controls). STATA version 16 was used to analyze data with statistical significance considered at p < 0.05.
Results: There is a strong association between BC in Congolese women and early menarche age (adjusted odds ratio [aOR] = 2.3; 95% CI: 1.2-4.3), family history of BC (aOR = 2.5; 95% CI: 1.2-5.5), overweight (aOR = 1.8; 95% CI: 1.1-2.7), and obesity (aOR = 7.3; 95% CI: 4.0-13.4).
Conclusion: Our results indicate the presence of certain conventional risk factors. Thus, these results will be of great value in establishing adequate evidence-based awareness and preventive measures among the Congolese population.

A case of life threatening acute Nivolumab induced autoimmune haemolytic anaemia

2022-05-10T17:08:22+08:00

Autoimmune haemolytic anemia is a rare but potentially catastrophic adverse event of im-mune checkpoint inhibitor therapy. We present the case of a gentleman who presented with non-specific symptoms while undergoing adjuvant Nivolumab therapy after potential-ly curative surgery for gastroesophageal cancer. The patient’s haemoglobin deteriorated to 4.7 g/dl with no evidence of bleeding and serologic tests indicative of hemolysis. He re-ceived emergent massive RCC transfusion receiving 9 units of bloods in 1 night, and was commenced on high dose methylprednisolone. During subsequent weeks of inpatient care, the patient continued to received multiple daily red cell transfusions and had a total of 53 RCC transfusions during admission, along with high doses of steroids,4 doses of weekly Rituximab as well as 2 doses of IVIG.While he was discharged on day 38 of admission, he required a slow taper of steroids over 6 months. Immune related hemolytic anemias are a rare corollary of immune check point inhibitors. The cases of immune related AIHA docu-mented in the literature were treated with steroids, Rituximab and IVIG, which are also rec-ommended by guidelines for the treatment of immune related haemolytic anemias.