Serum MiRNA as Predictive and Prognosis Biomarker in Advanced Stage Non-small Cell Lung Cancer in Indonesia

Background and objective Lung cancer is the most common cause of death in men in the world and in Indonesia where nonsmall cell carcinoma lung cancer(NSCLC) constitutes 85% of all lung cancer cases. The high mortality rate is due to a poor prognosis and is often diagnosed as having advanced stages. If it is known at the initial stage, the prognosis of lung cancer will be better. Prognosis can be predicted with a marker of prognostic biology, one of which is micro RNA(mi RNA). This study aims to prove that serum mi RNA can be predictive biological marker and prognosis in NSCLC patients in Indonesia.Methods This study was cohort retrospective among 52 subjects in "Dharmais" Hospital National Cancer Center. Sample was obtained from patients’ serum. Mi R-34, mi R-148, mi R-155 and mi R-222 serum are measured through Real-Time PCR(q PCR). Data were analyzed and interpreted with descriptive analysis, bivariate analysis(Mann Whitney-U for two type of variables or Kruskal-Wallis for more than two type of variables. Kaplan-Meier analysis was used to know association between characteristic which are sociodemographic, performance status, clinico-pathology, and survival rate in mi RNA expression. Results From this study, mi RNA expression: mi R-34(46.15%), mi R-148(23.08%), mi R-155(40.38%) and mi R-222(32.69%). Performance status score was statistically significant correlation with mi R-148(P=0.049) and mi R-222(P=0.018). High mi R-34 is associated with multiple M1 b metastatic type(P=0.020), cancer cell type(adenocarcinoma, P=0.009) and adenocarcinoma epidermal growth factor receptor(EGFR) mutation(negative, P=0.031). There was a significant correlation between the high mi R-222 as a poor prognosis in advanced stage NSCLC with M1 b metastasis(Median Survival/MS: 27 d, P=0.049) and positive EGFR mutations(MS: 74 d, P=0.049) and correlation of mi R-155 with adenocarcinoma(MS: 69 d, P=0.034) and positive EGFR gene mutations(MS: 58 d, P=0.023).Conclusion High mi R-34 expression in advanced stage NSCLC is the predictive factor for multiple metastatic, adenocarcinoma cell type and adenocarcinoma negative EGFR mutation. High expression of mi R-155 and mi R-222 are poor prognoses, especially high mi R-222 found in metastasis M1 b and positive EGFR mutation and mi R-155 found in adenocarcinoma and positive EGFR gene mutations. Further studies regarding correlation between mi RNA and survival rate are needed.

Effect Observation of Clinical Treatment with Oxaliplatin and Tiggio for Biliary Tract Tumors on Advanced Stage

Objective:To investigate the effect of oxaliplatin combined with tiggio in the treatment of advanced biliary tract tumors.Methods:The research period was from November 2019 to November 2020.80 patients with advanced biliary tumor disease were enrolled.They were divided into groups according to the order of admission,with 40 cases in each group.The control group received oxaliplatin combined with gemcitabine,and the experimental group received oxaliplatin combined with tiggio.Incidence of adverse reactions,time to disease progression,survival time and clinical efficacy were checked and assessed.Results:Compared with the incidence of adverse reaction of the experimental group,which was 5.00%(2/40),the incidence of adverse reaction of the control group was 25.00%(10/40).The chi-square value=6.2745,p-value=0.0122.The time to progression and survival time of patients in the experimental group were shorter than those of the control group,with significant differences between the groups(p<0.05);the clinical efficacy of the experimental group and the control group were 97.50%(39/40)and 77.50%(31/40)respectively,the comparative chi-square value=7.3143,p-value=0.0068.Conclusion:The combined treatment of oxaliplatin and Tiggio in the treatment of advanced biliary tract tumors has higher safety and reduces the incidence of adverse reactions.

Pang Fuwan Uses Yao Medicine to Observe the Therapeutic Effects on the Physical and Mental Symptoms of Patients with Advanced Non-Small Cell Lung Cancer

Objective: Investigate the efficacy and safety of Yao Medicine in the treatment of advanced non-small-cell lung carcinoma, and explore the best therapeutic measure for clinical benefit. Methods: From July 2020 to July 2022, 84 patients with advanced non-small-cell lung carcinoma were selected and randomly divided into the Observation Group and control group, and the control group was treated with routine Western medicine, with 42 cases in each group. The activity of daily living (ADL) was assessed before and after treatment, meanwhile, the self-rating depression scale (SDS) and self-rating anxiety SAS (SAS) were used to assess the improvement of a bad mood, and quality of life SF-36 was used to assess the quality of life, to judge the efficacy and safety. Results: The effective rate of observation group was 91.67%. The effective rate of the control group was 76.19%. The effective rate of the observation group was significantly higher than that of the control group (P 0.05). There were no significant differences in the scores of SDS, SAS and quality of life between the two groups before treatment (P > 0.05), and after treatment, the scores of SDS, SAS and quality of life in the two groups were compared with those in the control group (P > 0.05), the scores of VAS, SDS and SAS decreased significantly, while ESCV, angle of straight leg elevation, ADL, physiological score, emotional score, social score and health status score increased significantly, the difference was statistically significant (P 0.05). Conclusion: Yao Medicine can improve the psychosomatic symptoms of patients with advanced non-small-cell lung carcinoma better, with better efficacy and higher safety.

Clinical Characteristics of Prostate Cancer in Advanced Stage and Its Treatment by Chinese and Western Medicine

Prostate cancer is a common malignant tumor in male seniors,with the higher rates in the Europe and America.There has been obvious increase in the incidence of prostate cancer in China recently.It has been reported that the incidence of prostate cancer was only

Re-evaluating the role of pelvic radiation in the age of modern precision medicine and systemic therapy

The efficacy of pelvic radiation in the management of locally advanced stage rectal cancer has come under scrutiny in the context of modern precision medicine and systemic therapy as evidenced by recent clinical trials such as FOWARC(J Clin Oncol 2019;37:3223-3233),NCT04165772(N Engl J Med 2022;386:2363-2376),and PROSPECT(N Engl J Med 2023;389:322-334).In this review,we comprehensively assess these pivotal trials and offer additional insights into the evolving role of pelvic radiation in contemporary oncology.

Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma

BACKGROUND Hilar cholangiocarcinoma(HC)is a good adaptation certificate of hepatic arterectomy,and hepatic arterectomy is conductive to the radical resection of cholangiocarcinoma,which simplifies the operation and helps with a combined resection of the peripheral portal tissue.With continuous development of surgical techniques,especially microsurgical technique,vascular invasion is no longer a contraindication to surgery in the past 10 years.However,hepatic artery reconstruction after hepatic arterectomy has been performed to treat liver tumor in many centers with better results,but it is rarely applied in advanced HC.AIM To determine the prognosis of patients with advanced HC after hepatic artery resection and reconstruction.METHODS A total of 98 patients with HC who underwent radical operation in our hospital were selected for this retrospective analysis.According to whether the patients underwent hepatic artery resection and reconstruction or not,they were divided into reconstruction(n=40)and control(n=58)groups.The traumatic indices,surgical resection margin,liver function tests before and after the operation,and surgical complications were compared between the two groups.RESULTS Operation time,blood loss,hospital stay,and gastrointestinal function recovery time were higher in the reconstruction group than in the control group(P<0.05);The R0 resection rates were 90.00%and 72.41%in the reconstruction and control groups,respectively(P<0.05).Serum alanine aminotransferase was lower in the reconstruction group on day one and three postoperatively,whereas serum aspartate aminotransferase was lower on the third day(P<0.05).Preoperatively,the Karnofsky performance status scores were similar between the groups(P>0.05),but was higher in the reconstruction group(P<0.05)two weeks postoperatively.There was no difference in the complication rate between the two groups(27.50%vs 32.67%,P>0.05).Two-year survival rate(42.50%vs 39.66%)and two-year survival time(22.0 mo vs 23.0 mo)were similar between the groups(P>0.05).CONCLUSION Radical surgery combined with reconstruction after hepatic artery resection improves R0 resection rate and reduces postoperative liver injury in advanced HC.However,the operation is difficult and the effect on survival time is not clear.

Sequential chemotherapy and icotinib as first-line treatment for advanced epidermal growth factor receptor-mutated non-small cell lung cancer

BACKGROUND Icotinib could have potential effect and tolerability when used sequentially with chemotherapy for advanced epidermal growth factor receptor(EGFR)-mutated non-small cell lung cancer(NSCLC).AIM To evaluate the efficacy and safety of chemotherapy followed by icotinib maintenance therapy as first-line treatment for advanced EGFR-mutated NSCLC.METHODS This multicenter,open-label,pilot randomized controlled trial enrolled 68 EGFRmutated stage IIIB/IV NSCLC patients randomized 2:3 to the icotinib alone and chemotherapy+icotinib groups.RESULTS The median progression-free survival in the icotinib alone and chemotherapy+icotinib groups was 8.0 mo(95%CI:3.84-11.63)and 13.4 mo(95%CI:10.18-16.33),respectively(P=0.0249).No significant differences were found in the curative effect when considering different cycles of chemotherapy or chemotherapy regimen(all P>0.05).CONCLUSION A sequential combination of chemotherapy and EGFR-tyrosine kinase inhibitor is feasible for stage IV EGFR-mutated NSCLC patients.

Efficacy and safety of XEN 45 gel stent alone or in combination with phacoemulsification in advanced open angle glaucoma patients: 1-year retrospective study

AIM:To assess the effectiveness of the XEN 45 gel stent,either alone or combined with cataract surgery,in advanced stage open angle glaucoma(OAG)patients.METHODS:Retrospective and single-center study conducted on consecutive OAG patients who underwent a XEN 45 gel stent implantation surgery,between July 2017 and September 2018.The primary efficacy end-point was the mean intraocular pressure(IOP)reduction at the end of the follow-up period.Success was defined as an IOP reduction of at least 20%and an IOP value≤18 mm Hg without(complete)or with(qualified)hypotensive medication.RESULTS:Seventy-four patients(80 eyes)were included in the study.In the overall study sample,XEN implant significantly reduced IOP from 21.0(19.8 to 22.1)mm Hg at baseline to 9.3(8.2 to 10.4),10.7(9.6 to 11.9),13.4(12.2 to 14.7),14.5(13.6 to 15.4),14.7(13.8 to 15.6),and 14.7(13.9 to 15.4)mm Hg at 1 d,1 wk,1,3,6,and 12 mo of follow-up,respectively(P<0.0001 each).In the overall study population,at the end of the study the mean IOP reduction was 27.4%(23.3%to 31.5%).Adjusted IOP reduction was similar in XEN and XEN+phacoemulsification groups[30.0(23.4 to 36.4)mm Hg vs 24.8(18.4 to 31.2)mm Hg,respectively,P=0.2939].At the last follow-up visit,52(65.0%)eyes were considered success,29(36.3%)eyes as complete success and 23(28.7%)as qualified success.Mean number of hypotensive medications was significantly reduced from 2.8(2.7 to 3.0)at baseline to 1.1(0.8 to 1.3),P<0.0001.Kaplan-Meier survival analysis did not find any difference in the success rate between XEN and XEN+PHACO,mean hazard ratio 0.56,95%CI 0.26 to 1.23;P=0.1469.Needling was performed in 7(8.8%)eyes at months 1(n=3);3(n=2);4(n=1)and 11(n=1).Eleven(13.8%)eyes presented adverse events.CONCLUSION:XEN implant,either alone or in combination with phacoemulsification,significantly reduced the IOP and the number of hypotensive medications in patients with OAG in advanced stage.

Extranodal Locatio of Lymphoma: Presentation and Evolutionary in Senegalese Patients

Introduction: The frequency of extranodal involvement in lymphoma is not rare, but variously described by authors in Africa. The objective of our work is to describe the profile of patients followed for lymphoma with extranodal locations. Methods: We conducted a descriptive, retrospective and analytic study at the clinical hematology department of Dalal Jamm Hospital, from September 2016 to June 2022. We included patients with a diagnosis of lymphoma immunohistochemistry, with extranodal involvement. The epidemiological, diagnostic, prognostic and survival aspects were studied. Results: Fifty-two (52) patients with extranodal localizations of their lymphoma were included. The mean age was 44.2 ± 17.6 years and the sex ratio was 1.2. The average time to diagnostic was 9.4 ± 3.6 months. We found a performance status ≥ 2 in 65.4% and at least one B symptom in 71.2% of cases. The extranodal manifestations were digestive (19%), cutaneous (17.5%), pleuropulmonary (17.5%), bone marrow (4.8%), thyroid (1.6%), parotid gland (1.6%) and breast (1.6%). Patients presented with Hodgkin’s lymphoma (HL) in 19.2% of cases and non-Hodgkin’s lymphoma (NHL) in 80.8% of cases. At the end of the extension checkup reviews, 61.5% were at an advanced stage and prognostic indices were unfavorable in 32% of patients. Conventional chemotherapy was conducted in 63.5% of patients of which 24 had NHL and 9 had HL. Immuno-chemoterapy was used in 26.9% of patients (13 cases of NHL, 1 case of HL). During the follow-up, we noted only 29.7% of complete remission. The median overall survival was 25.1 months [23.5 - 34.1 months] in HL group and 20.5 months [18.7 - 72.2 months] in NHL patients (p = 0.14). Conclusion: Our study shows that extranodal involvements of lymphomas are various, encountered more during NHL. In our practice, diagnosis is generally made at an advanced stage, with poor response to treatment.

Debulking surgery and hyperthermic intrathoracic chemotherapy(HITHOC)for lung cancer

One hundred years ago, the first patients with lung cancer have been reported （1）. Since then long term survival in patients with lung cancer remains disappointing, and this is not only due to the delayed diagnosis but also to the dismal survival of the 70%-75% inoperable patients.

Phase Ⅱ study of R-CVP followed by rituximab maintenance therapy for patients with advanced marginal zone lymphoma:consortium for improving survival of lymphoma(CISL)study

Background:The response rate and survival improvement for rituximab,a CD20-targeting monoclonal antibody,have been demonstrated in marginal zone lymphoma(MZL)as monotherapy and in combination with chemotherapeutic regimens,yet relapses still occur despite treatment completion.Thus,extending the period of remission in MZL patients remains an essential goal.This multicenter,single-arm,open-label phase II study evaluated the survival efficacy of 2 years of rituximab-maintenance therapy in patients with stage III-IV CD20-positive MZL who had responded to first-line R-CVP(rituximab,cyclophosphamide,vincristine,and prednisolone).The objective of this study was to determine whether rituximab maintenance following R-CVP warrants further investigation.Methods:Prior to rituximab-maintenance therapy,patients received 6-8 cycles of first-line R-CVP therapy for stage III-IV MZL.Rituximab(375 mg/m^(2)),cyclophosphamide(750 mg/m^(2)),and vincristine(1.4 mg/m^(2);maximum 2 mg)were administered via an intravenous infusion on day 1 of each 3-week cycle,while oral prednisolone(100 mg)was given on days 1-5 of each 3-week cycle.The patients who achieved complete response(CR),partial response(PR),or stable disease(SD)to R-CVP treatment,were prescribed rituximab-maintenance therapy which was administered intravenously at a dose of 375 mg/m^(2) every 8 weeks for up to 12 cycles.The primary endpoint was progression-free survival(PFS).Secondary endpoints were overall survival(OS)and treatment safety.Results:47 patients were enrolled,of whom,45(96%)received rituximab-maintenance treatment.Fifteen(33%)patients had nodal MZL.Following R-CVP first-line therapy,20(44%),22(49%),and 3(7%)patients achieved CR,PR,and SD,respectively.After a median follow-up of 38.2 months,their observed 3-year PFS rate was 81%.During the rituximab-maintenance,6 PR and 1 SD patients achieved CR following the administration of R-CVP.Elevated LDH and the presence of B symptoms were found to be significant prognostic factors for PFS(P=0.003)and demonstrated a 3-year OS rate of 90%.Rituximab-maintenance therapy was well tolerated,and the common treatment-emergent adverse events were sensory neuropathy(18%),myalgia(13%),fatigue(9%),and neutropenia(9%).Conclusion: Rituximab-maintenance therapy following first-line R-CVP demonstrated good PFS in patients with stage III-IV MZL, in addition to a favorable toxicity profile.

Treatment strategies in cervical cancer:treatment of advanced disease

Cervical cancer is the fourth most common cancer in women worldwide,with a global incidence of 604,127 and an annual death rate of 341,831 in 2020.Patients with recurrent,persistent,or metastatic disease not amenable to curative therapy represent a patient population with a dismal prognosis.Until recently,the standard of care for these patients was based on platinum doublet chemotherapy with or without bevacizumab.However,significant advances in the treatment landscape of this disease have recently been achieved with the incorporation,among others,of immunotherapy in the therapeutic armamentarium.This review summarizes the main treatment approaches developed throughout the past decades,with particular emphasis on immunotherapy and novel targeted therapies.

Clinical Study on Effect of Kang'aibao Oral Liquid(抗癌宝口服液) in Treating 103 Patients of Malignant Tumor

Objective: To observe the clinical efficacy of Kang'aibao oral liquid (KABL), a Chinese herbal preparation in treating malignant tumor of middle or advanced stage. Methods: A comparative study was done by observing the effect of 103 patients treated with KABL, and another 90 patients treated with chemotherapy at the same time were taken as the control group.Results: The immunologic function, short term effective rate (complete relieved rate and partial relieved rate), survival quality, 1 , 2 and 3 year survival rate, median survival time, and carcinoembryonic antigen (CEA) declining rate of the KABL group were significantly higher than those of the control group. Conclusion: KABL has the effects of inhibiting tumor growth, prolonging survival time and improving survival quality of tumor patients.