Supportive and Palliative Care in Cancer Therapies—Path from Tumor-Driven Therapies to Patient-Driven Ones

Cancer patients frequently report a set of symptoms including fatigue, pain, and physiological and social distress. Families and other personal lay relations give proposals to take supportive drugs and supplemental nutrients, without professional knowledge about their actions. Internet search engines and social networks serve up most of the treatment proposals, opening wide possibilities for quackeries and predatory money-making practices. Medical professionals have a responsibility to clear this field and concentrate on patients’ well-being and personal needs. According to our approach, the integration of supportive and palliative care with conventional therapies needs a change of paradigm from tumour-driven to patient-driven treatment actions. Supportive/palliative care includes a broad spectrum of applied methods, including medications, nourishments, electrical effects, and psycho and social supports. Our goal is to discuss the possibilities for combining conventional oncotherapies with additional supportive/palliative care and to give suggestions on a professional basis.

Controlling hypoxia-inducible factor-2α is critical for maintaining bone homeostasis in mice

Pathological bone loss is caused by an imbalance between bone formation and resorption.The bone microenvironments are hypoxic,and hypoxia-inducible factor (HIF) is known to play notable roles in bone remodeling.However,the relevant functions of HIF-2α are not well understood.Here,we have shown that HIF-2α deficiency in mice enhances bone mass through its effects on the differentiation of osteoblasts and osteoclasts.In vitro analyses revealed that HIF-2α inhibits osteoblast differentiation by targeting Twist2 and stimulates RANKL-induced osteoclastogenesis via regulation of Traf6.In addition,HIF-2α appears to contribute to the crosstalk between osteoblasts and osteoclasts by directly targeting RANKL in osteoprogenitor cells.Experiments performed with osteoblast- and osteoclast-specific conditional knockout mice supported a role of HIF-2α in this crosstalk.HIF-2α deficiency alleviated ovariectomy-induced bone loss in mice,and specific inhibition of HIF-2α with ZINC04179524 significantly blocked RANKLmediated osteoclastogenesis.Collectively,our results suggest that HIF-2α functions as a catabolic regulator in bone remodeling,which is critical for the maintenance of bone homeostasis.

Complete remission of advanced hepatocellular carcinoma by sorafenib: A case report

Hepatocellular carcinoma (HCC) is the fifth most common malignant disease worldwide, and curative treatment remains difficult because the majority of cases are diagnosed in the advanced stage. Sorafenib is the only known effective systemic treatment, but patients rarely achieve complete remission (CR). A 66-year-old man with a history of alcoholic liver cirrhosis with a diagnosis of advanced HCC, was initially treated with transarterial chemoembolization on four occasions. However, the disease progressed with portal vein thrombosis. Therefore, sorafenib was started, and 4 mo later, the patient achieved CR. The treatment was continued for 12 mo, and CR was maintained up to 4 mo after sorafenib discontinuation.

Hydrophobic surface induced pro-metastatic cancer cells for in vitro extravasation models

In vitro vascularized cancer models utilizing microfluidics have emerged as a promising tool for mechanism study and drug screening.However,the lack of consideration and preparation methods for cancer cellular sources that are capable of adequately replicating the metastatic features of circulating tumor cells contributed to low relevancy with in vivo experimental results.Here,we show that the properties of cancer cellular sources have a considerable impact on the validity of the in vitro metastasis model.Notably,with a hydrophobic surface,we can create highly metastatic spheroids equipped with aggressive invasion,endothelium adhesion capabilities,and activated metabolic features.Combining these metastatic spheroids with the well-constructed microfluidic-based extravasation model,we validate that these metastatic spheroids exhibited a distinct extravasation response to epidermal growth factor(EGF)and normal human lung fibroblasts compared to the 2D cultured cancer cells,which is consistent with the previously reported results of in vivo experiments.Furthermore,the applicability of the developed model as a therapeutic screening platform for cancer extravasation is validated through profiling and inhibition of cytokines.We believe this model incorporating hydrophobic surface-cultured 3D cancer cells provides reliable experimental data in a clear and concise manner,bridging the gap between the conventional in vitro models and in vivo experiments.