Screening of Myocardial Cardiotoxicity Induced by Anticancer Chemotherapy and the Importance of Global Longitudinal Strain

Introduction: The improvement of survival in patients with cancer and the expansion of therapeutic options have led to the emergence of a new profile of cardiotoxicity, specifically associated with antimitotic agents. Our study aimed to assess the incidence of chemotherapy-induced myocardial toxicity in patients with cancer. Patients and Methods: We conducted a looking-forward longitudinal cohort study including all patients admitted to the Cardiology departments of Aristide le Dantec Hospital and Dalal Jamm National Hospital Centre for apre-chemotherapy check-up. The included patients did not undergo any pre-existing cardiopathy. Results: Over a period of two years ranging from January 2019 to December 2021, a total of 37 patients were included in the study. Notably, there was a female predominance (92%) with an average age of 49.7 years ± 13.69. Breast cancer accounted for 70% of the neoplasms. Laboratory findings revealed moderate anemia in 19 patients (51%). At inclusion, the left ventricle (LV) was of normal size (LV diastole at 44.46 ± 4.97 mm). The systolic function of the left ventricle was normal in all patients, with an average ejection fraction (EF) of 63.1% ± 5.80 and a mean global longitudinal strain (GLS) of −20.4% ± 2.58. The most commonly used agents were anthracyclines. During follow-up, 3 patients (8.1%) developed clinical symptoms of left heart failure, and LV dysfunction on echocardiography was observed in 5 (13.5%) patients, with a significant decrease in EF Conclusion: The incidence of cardiac toxicity is not negligible, hence the importance of early screening. Strain imaging is an essential tool that should be performed as part of the assessment before chemotherapy and re-evaluated during treatment.

Relationship between Circulating Plasma Galectin-3 Levels and T-Cell Activation during Cervical Cancer Chemotherapy

Objective: Despite the existence of several therapeutic strategies, the management of cervical cancer remains challenging. Our region has very little data on the interaction between the immune system and the clinical response to chemotherapy. This work examines plasma levels of galectin-3 (Gal-3) and percentages of activated T cells in patients with cervical cancer treated with chemotherapy and investigates if there is a relationship between the rates of these two elements. Methods: We compared data from 37 patients with cervical cancer undergoing chemotherapy and 42 controls with normal cervical cytology. Plasma Gal-3 concentrations were assessed by ELISA and expression of activation markers by T cells (CD69 and HLA-DR) was assessed by flow cytometry at three different time points during chemotherapy. Results: Our results showed that patients had a significantly higher concentration of Gal-3 compared to controls (4.025 vs. 1.340, p 0.001), similarly, they had a significantly high percentage of activated lymphocytes (2.610 vs. 0.731;p 0.0001). According to the response to treatment, patients with no response to treatment had a lower concentration of circulating Gal-3 but had approximately the same percentage of activated CD4 and CD8 lymphocytes as patients with a partial or total response. In addition, we found a positive correlation between the Gal-3 level and CD4 T cells expressing the activation marker CD69 (p 0.05;rho = 0.44). Conclusion: In conclusion, our results show that there would be a relationship between circulating galectin-3 and the percentage of peripheral CD4+CD69+ cells in cervical cancer.

Peripheral Blood Cytokines Levels in Senegalese Women with Cervical Cancer during Chemotherapy

Cervical cancer is the leading cause of cancer deaths of women in developing world. Several studies demonstrated evidences of inflammatory cytokines implication in cancer progression including in initiation, promotion and invasion by affecting the immune surveillance. Our aim was to measure blood circulating pro- and anti-inflammatory cytokines levels, their profiles according to treatment issue and relation with prognostic factors in cervical cancer during chemotherapy. Blood samples were collected from a cohort of 35 cervical cancer women and 42 women healthy controls (HC) with no history of malignancy. For each CP, three samples were taken at three-week intervals. The first one (S1) was taken before initiation of the chemotherapy protocol. S2 and S3 were samples collected respectively at day 21 and day 42. Cytokines levels were evaluated by ELISA. Mean age of patients was 54.1 year (35 - 77 yo). In groups, no relation was observed between age and cytokines levels. Before chemotherapy, high levels of IL-6, IL-4 and IFN-γ were observed in CP compared to HC (p 0.001) and at the same period, IL-10 and TNF-α levels were significantly low in CP (p 0.05) and negatively correlated (r = —0.79;p = 0.017). In this CP group, IL-4 levels were positively correlated between S1 and S2 (r = 0.72;p = 0.002) and between S1 and S3 (r = 0.74;p = 0.019). Similar correlations were observed for TNF-α levels: S1/S2 (r = 0.54;p = 0.027), S2/S3 (r = 0.82;p = 0.009) and S1/S3 (r = 0.66;p = 0.036) with a significant increase of TNF-α in blood during treatment. Depending on chemotherapy’s efficacy, CP patients were separated into 1) non responders (NR), 2) partial responders (PR) and 3) good responders (GR). Compared to PR and GR groups, NR patients showed: a) higher serum levels of IL-6, IL-10 and IFN-γ during the follow-up and b) lower serum levels of IL-4 and TNF-α. In addition, serum levels of IL-4 were significantly higher in GR patients however TNF-α was the predominant cytokines in PR group. Our results highlight the variation of circulating cytokines such as IL-6, IL-10 and IFN-γ during cervical cancer chemotherapy. In addition, this study suggested that IL-4 and TNF-α might represent potential biomarkers candidate in cervical cancer. Applications in cancer management need further investigations particularly about the relevant prognostic indicator following chemotherapy and validation studies must provide more assurance for translation into clinical practice.

Gastric Adenocarcinoma at the Joliot Curie Institute in Dakar: Epidemiological, Diagnostic and Therapeutic Aspects about 54 Cases

Objectives: To study the epidemiological, diagnostic, therapeutic and prognostic aspects of gastric adenocarcinoma at the Joliot Curie Institute in Dakar. Materials and Methods: We conducted a retrospective study over a seven-year period from January 2010 to December 2017 at the Joliot Curie Institute in Dakar. All cases of gastric adenocarcinoma proven by fibroscopy followed by histology or proven on the histological analysis of a surgical specimen were taken into account. The parameters studied were age, risk factors, stages of the disease, treatment and prognosis. Results: There were 54 cases of gastric adenocarcinoma over a period of 7 years. The average age was 54.74 years with extremes of 25 and 84 years. A male predominance was noted (35/54). The main risk factors found were alcohol (5/54), tobacco (13/54), Helicobacter pilori (4/54), gastric ulcer (12/54). Epigastralgia was the most frequent clinical manifestation. FOGD was carried out in 77.8% of patients. Histology was obtained before surgery in 40 patients (74.1% of cases) and on the operating room in 14 patients (25.9%). Patients were classified as stage II in 2/54 cases, stage III in 5/54 cases and stage IV in 47/54 cases. Gastro-entero-anastomosis was the main surgical procedure performed. External radiotherapy was performed in 1/54 patients. Chemotherapy was done in 52/54 patients, 96.3% of the cases. It was palliative in 66.7% of cases, neoadjuvant in 1.9% of cases, adjuvant in 24.1% of cases, perioperative in 3.7% of cases. Mortality was 79.6%. Patient survival times were relatively short: in less than 6 months 24/54 cases, 13/54 cases between 6 - 12 months, 5/54 cases between 13 - 24 months and 6/54 cases beyond 24 months. 6/54 patients were lost from view. Conclusion: Gastric adenocarcinoma is diagnosed lately in our conditions. It is responsible for a high mortality rate. Palliative treatment is often the only option because of the delay in diagnosis.

Profile of Plasma Galectin-3 Concentrations, Inflammatory Cytokines Levels and Lymphocytes Status in Breast Cancer under Chemotherapy

We investigated relationship between galectin-3 (Gal-3) levels and T lymphocytes apoptosis and the activation rates in breast cancer during chemotherapy. We used plasma samples from 112 women classified into two groups: 70 women with breast cancer (BC) and submitted to neoadjuvant chemotherapy (3 cycles) and 42 healthy women used as controls. In the group of BC, blood samples were taken before each cycle of chemotherapy and Gal-3 levels was evaluated by ELISA sandwich. Flow cytometry was used to study T cells apoptosis and activation. Before treatment, median value of Gal-3 was 6.31 ng/ml (range 1.07 - 50.74) in BC and 0.84 ng/ml (range 0.00 - 4.82) in HC. Gal-3 levels were highest in plasmas from BC (p p p = 0.010). In addition, we found a dynamic relationship between gal-3 levels, tumor size and T lymphocytes apoptosis rates during treatment depending to the cure efficiency. We suggest gal-3 plasma concentrations could be used as predictive biomarker for chemotherapy efficiency in breast cancer patients.

Epidemiological, Diagnosis, Therapeutic and Evolving Profile of Triple Negative Breast Cancer in Senegal

Objective: Describe the epidemiological, diagnostic, therapeutic and evolutionary profile of triple negative breast cancer at the Dakar Cancer Institute in Senegal. Patients and Methods: This was a retrospective study between January 1, 2011 and December 31, 2014. All patients with a triple negative molecular profile were included. The data were collected from the medical records of the patients. The data were entered and analyzed with SPSS edition 16 software under Windows 7. Results: Two hundred and twenty-five patients were selected. The mean age was 47.9 ± 12.5 years with extremes of 25 and 90 years. The main reason for consultation was dominated by the finding of a breast lump. The mean clinical tumor size was 8, 54 cm with a large majority of T3-T4 tumors 26% and 63% respectively, lymph node involvement in one hundred and seventy-two cases (76.4%);twenty eight patients (12.4%) were metastatic from the outset. Non-specific invasive carcinoma was the most common histologic type (78.2%), and more than half of the patients (53.3%) had an aggressive tumor (Scarff-Bloom-Richardson grading III). Neoadjuvant chemotherapy was performed in 65.78% of cases. We noted 27.7% total response and 41.7% partial response in patients who have received this neoadjuvant chemotherapy. The surgery was radical in 77% of cases, conservative in 14% and cleanliness surgery for palliative purposes in 9% of cases. Adjuvant radiotherapy is performed in 58.6% of operated patients. The mean time to follow-up was 20.63 months with extremes of 1 and 53 months. Overall survival was 69.8% at one year, 41.6% at two years and 25.6% at three years. Conclusion: The descriptive analysis of these results confirms the high frequency of triple-negative breast cancer in Senegal and its poor prognosis.

Predictive Significance of IL-17A Serum Levels during Chemotherapy in Senegalese Women with Cervical Cancer

Background and Objectives: Cervical cancer is a leading cause of cancer death in female populations. It is a virally induced carcinoma resulting from sexually transmitted high risk Human Papillomavirus infections (e.g. HPV-16, HPV-18). Previous studies have shown associations between IL-17A levels in cancer micro-environments and metastasis of tumor cells. In Africa, chemotherapy (CT) is the standard first-line treatment for cervical cancer and the prognosis remains poor for metastatic and recurrent cases. The impact of CT as a treatment option is still unclear. We investigated the prognostic relevance of IL-17A profiles in Cervical cancer patients (CP) patients treated with cisplatin in combination with 5-fluouracil (5FU) for three cycles. Methods: The study included 57 CP and 59 women with no history of malignancy as healthy controls (HC). IL-17A plasma levels were evaluated by ELISA. For each CP, three blood samples were collected at three-week intervals before initiation of the chemotherapy protocol. Results: Before chemotherapy CP showed higher serum levels of IL-17A compared to HCs (p = 0.035). No relation was detected between age and IL-17A levels. We observed a significant increase in serum IL-17A during treatment of the CP group (p Conclusion: Our results suggest that high serum levels of IL-17A are associated with poor responses to classical chemotherapy. However, considering these results to design CC biomarkers, we need further investigations particularly about the relevant prognostic indicator following chemotherapy.