Since arsenic trioxide was first approved as the front line therapy for acute promyelocytic leukemia 25 years ago,its anti-cancer properties for various malignancies have been under intense investigation.However,the c...Since arsenic trioxide was first approved as the front line therapy for acute promyelocytic leukemia 25 years ago,its anti-cancer properties for various malignancies have been under intense investigation.However,the clinical successes of arsenic trioxide in treating hematological cancers have not been translated to solid cancers.This is due to arsenic＇s rapid clearance by the body＇s immune system before reaching the tumor site.Several attempts have henceforth been made to increase its bioavailability toward solid cancers without increasing its dosage albeit without much success.This review summarizes the past and current utilization of arsenic trioxide in the medical field with primary focus on the implementation of nanotechnology for arsenic trioxide delivery to solid cancer cells.Different approaches that have been employed to increase arsenic＇s efficacy,specificity and bioavailability to solid cancer cells were evaluated and compared.The potential of combining different approaches or tailoring delivery vehicles to target specific types of solid cancers according to individual cancer characteristics and arsenic chemistry is proposed and discussed.展开更多
BACKGROUND Reactivation of hepatitis B virus(HBV)during anticancer treatment is a critical issue.When treating patients with solid tumors,it is unclear whether specific cancer types or treatments affect HBV reactivati...BACKGROUND Reactivation of hepatitis B virus(HBV)during anticancer treatment is a critical issue.When treating patients with solid tumors,it is unclear whether specific cancer types or treatments affect HBV reactivation in hepatitis B surface antigen(HBsAg)-negative and hepatitis B core antibody(HBcAb)-positive patients,socalled de novo hepatitis B patients.The risk of de novo hepatitis B may vary based on different background factors.AIM To determine the frequency and risk factors for de novo hepatitis B during solid tumor treatment.METHODS This retrospective cohort study comprised 1040 patients without HBsAgs and with HBcAbs and/or hepatitis B surface antibodies(HBsAbs).The patients were treated for solid cancer from 2008 to 2018 at the National Kyushu Cancer Center and underwent HBV DNA measurements.Patient characteristics and disease and treatment information were investigated.HBV DNA measurements were performed using TaqMan polymerase chain reaction(PCR).To identify the risk factors associated with HBV DNA expression,the age,sex,original disease,pathology,treatment method,presence or absence of hepatitis C virus(HCV),and HBsAb and/or HBcAb titers of all subjects were investigated.In patients with HBV DNA,the time of appearance,presence of HBsAgs and HBsAbs at the time of appearance,and course of the subsequent fluctuations in virus levels were also investigated.RESULTS Among the 1040 patients,938 were HBcAb positive,and 102 were HBcAb negative and HBsAb positive.HBV DNA expression was observed before the onset of treatment in nine patients(0.9%)and after treatment in 35 patients(3.7%),all of whom were HBcAb positive.The HBV reactivation group showed significantly higher median HBcAb values[9.00(8.12-9.89)vs 7.22(7.02-7.43),P=0.0001]and significantly lower HBsAb values(14 vs 46,P=0.0342)than the group without reactivation.Notably,the reactivated group showed a significantly higher proportion of cancers in organs related to digestion and absorption(79.0%vs 58.7%,P=0.0051).A high HBcAb titer and cancers in organs involved in digestion and absorption were identified as independent factors for HBV reactivation(multivariate analysis,P=0.0002 and P=0.0095).The group without HBsAbs tended to have a shorter time to reactivation(day 43 vs day 193),and the frequency of reactivation within 6 mo was significantly higher in this group(P=0.0459)than in the other group.CONCLUSION A high HBcAb titer and cancers in organs involved in digestion and absorption are independent factors that contribute to HBV reactivation during solid tumor treatment.展开更多
To the Editor：Irreversible electroporation （IRE） is a CE- and FDA- approved treatment modality for pancreatic and liver tumors that is based on the site-confined destruction of tumor tissue by multiple short, high-...To the Editor：Irreversible electroporation （IRE） is a CE- and FDA- approved treatment modality for pancreatic and liver tumors that is based on the site-confined destruction of tumor tissue by multiple short, high-intensity electrical pulses.展开更多
Acquired hemophilia A(AHA) is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ(FⅧ) activity related to the appearance of inhibitors against FⅧ. Common etiological fac...Acquired hemophilia A(AHA) is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ(FⅧ) activity related to the appearance of inhibitors against FⅧ. Common etiological factors include autoimmune diseases, malignancy, and pregnancy. We report two cases of AHA in solid cancer. The first case is a 63-year-old man who developed peritoneal and intestinal bleeding after gastrectomy for gastric cancer. He was diagnosed with AHA, and was treated with prednisone, followed by cyclophosphamide. In the second case, a 68-year-old man developed a subcutaneous hemorrhage. He was diagnosed with AHA in hepatocellular carcinoma on CT imaging, and treated with rituximab alone. Hemostasis was achieved for both patients without bypassing agents as the amount of inhibitors was reduced and eradicated. However, both patients died within 1 year due to cancer progression. Successful treatment for AHA in solid cancer can be difficult because treatment of the underlying malignancy is also required.展开更多
Background: Neutropenic sepsis is a frequent complication of cytotoxic chemotherapy delivered for cancer patients. Its management is well determined by clinical guidelines. Non-neutropenic sepsis is another potential ...Background: Neutropenic sepsis is a frequent complication of cytotoxic chemotherapy delivered for cancer patients. Its management is well determined by clinical guidelines. Non-neutropenic sepsis is another potential complication in cancer patients. Its management is less established in the medical literature. Materials and Methods: Three cases are presented to illustrate favourable evolution of non-neutropenic biliary-, uro- and bronchogenic-sepsis in cancer patients with poor prognosis. Results: All three patients had a survival over six months after the management of the septic complication. Two of them received subsequent systemic anticancer treatment. Conclusions: Survival benefit offered by the management of cancer-related non-neutropenic sepsis may be comparable to the benefit obtained by systemic anticancer treatments. Cost-effectiveness of sepsis management may be better than that of anticancer treatments.展开更多
Elastography is one of technologies assisting diagnosis ofsolid pancreatic lesions(SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of "harder the ...Elastography is one of technologies assisting diagnosis ofsolid pancreatic lesions(SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of "harder the lesions, higher chance for malignancy". Two elastography techniques; strain and shear wave elastography, are available. For endoscopic ultrasound(EUS), only the former is existing. To interpret results of EUS elastography for SPL, 3 methods are used:(1) pattern recognition;(2) strain ratio; and (3) strain histogram. Based on results of existing studies, these 3 techniques provide high sensitivity but low to moderate specificity and accuracy rate. This review will summarize all available information in order to update current situation of using elastography for an evaluation of SPLs to readers.展开更多
Precision medicine aims to identify the right drug, for the right patient, at the right dose, at the right time, which is particularly important in cancer therapy. Problems such as the variability of treatment respons...Precision medicine aims to identify the right drug, for the right patient, at the right dose, at the right time, which is particularly important in cancer therapy. Problems such as the variability of treatment response and resistance to medication have been longstanding challenges in oncology, especially for development of new medications. Solid tumors, unlike hematologic malignancies or brain tumors, are remarkably diverse in their cellular origins and developmental timing. The ability of next-generation sequencing(NGS) to analyze the comprehensive landscape of genetic alterations brings promises to diseases that have a highly complex and heterogeneous genetic composition such as cancer. Here we provide an overview of how NGS is able to facilitate precision medicine and change the paradigm of cancer therapy, especially for solid tumors, through technical advancements, molecular diagnosis, response monitoring and clinical trials.展开更多
The incidence of lung cancer in the Gejiu area of Yunnan Province ranks the first inthe world. The radon level (indoor, soil) was measured in the Gejiu area by the SSNTDmethod from 1990 to 1996. The result indicates a...The incidence of lung cancer in the Gejiu area of Yunnan Province ranks the first inthe world. The radon level (indoor, soil) was measured in the Gejiu area by the SSNTDmethod from 1990 to 1996. The result indicates an extensive high-level of indoor radon in thatarea though U and Th are lower in local limestones. The indoor radon level of houses located inthe geologic fault zone is 6 times high that 2 km far from the fau1t zone. The reason probably isthat the radon level of soil in the fault is 6-8 times high that 1 km far from the faults. Ourdata indicate that a lower range of rad0n levels, 0 - 100 Bq’ m- 3, exists in healthy families.However, a higher radon level, over 800 Bq’ m- 3, is often f0und corresponding to that of can-cer patients’ homes (the house-owners are suffering from either lung cancer or leukaemia or liv-er cancer). Obviously, an increase in lung cancer incidence follows an increase in indoor radonlevel. The risk of cancer induced by indoor radon is no longer an inference, but a fact.展开更多
Objective： Response Evaluation Criteria in Solid Tumors （RECIST） guideline version 1.0 （RECIST 1.0） was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized mea...Objective： Response Evaluation Criteria in Solid Tumors （RECIST） guideline version 1.0 （RECIST 1.0） was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure. With a number of issues being raised on RECIST 1.0, however, a revised RECIST guideline version 1.1 （RECIST 1.1） was proposed by the RECIST Working Group in 2009. This study was conducted to compare CT tumor response based on RECIST 1.1 vs. RECIST 1.0 in patients with advanced gastric cancer （AGC）. Methods： We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010. These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using the κ statistic. Results： The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0 （P〈0.0001）. However, there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0 0（κ=0.844）. The overall response rates （ORRs） according to RECIST 1.0 and RECIST 1.1 were 32.7% （20/61） and 34.5% （20/58）, respectively. One patient with partial response （PR） based on RECIST 1.0 was reclassified as stable disease （SD） by RECIST 1.1. Of two patients with SD by RECIST 1.0, one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1. Conclusions： RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.展开更多
目的:探讨乳腺实性乳头状癌(solid papillary carcinoma of the breast,SPC)的灰阶超声、彩色多普勒超声及超声弹性成像表现,并探讨SPC的超声表现与其病理学检查结果的相关性。方法:分析71例经术后病理学检查证实的SPC患者的临床资料,...目的:探讨乳腺实性乳头状癌(solid papillary carcinoma of the breast,SPC)的灰阶超声、彩色多普勒超声及超声弹性成像表现,并探讨SPC的超声表现与其病理学检查结果的相关性。方法:分析71例经术后病理学检查证实的SPC患者的临床资料,共包括75个SPC病灶的灰阶超声、彩色多普勒超声表现和35个SPC病灶的超声弹性成像表现。比较不同病理学亚型SPC的超声表现及与病理学检查结果的相关性。结果:SPC的超声表现大多为单发的低回声实性肿块,呈水平生长,形态不规则,边缘不光整,后方回声增强或不变,可伴有导管扩张及钙化,Adler血流分级Ⅱ~Ⅲ级,阻力指数(resistance index,RI)为0.62~0.84。几乎不伴有腋窝淋巴结转移。75个SPC病灶病理学分子分型均为Luminal A型。Ki-67增殖指数在42个原位SPC病灶中均<20%,在15个浸润性SPC中为20%~60%,两者差异有统计学意义(P=0.000)。结论:SPC超声表现具有一定特征性,结合灰阶、彩色多普勒超声及超声弹性成像可提高其诊断准确度,但超声无法鉴别原位SPC及浸润性SPC,Ki-67增殖指数与SPC是否浸润有关。展开更多
文摘Since arsenic trioxide was first approved as the front line therapy for acute promyelocytic leukemia 25 years ago,its anti-cancer properties for various malignancies have been under intense investigation.However,the clinical successes of arsenic trioxide in treating hematological cancers have not been translated to solid cancers.This is due to arsenic＇s rapid clearance by the body＇s immune system before reaching the tumor site.Several attempts have henceforth been made to increase its bioavailability toward solid cancers without increasing its dosage albeit without much success.This review summarizes the past and current utilization of arsenic trioxide in the medical field with primary focus on the implementation of nanotechnology for arsenic trioxide delivery to solid cancer cells.Different approaches that have been employed to increase arsenic＇s efficacy,specificity and bioavailability to solid cancer cells were evaluated and compared.The potential of combining different approaches or tailoring delivery vehicles to target specific types of solid cancers according to individual cancer characteristics and arsenic chemistry is proposed and discussed.
基金Supported by Eisai Corporation,No.HHCS20181030011。
文摘BACKGROUND Reactivation of hepatitis B virus(HBV)during anticancer treatment is a critical issue.When treating patients with solid tumors,it is unclear whether specific cancer types or treatments affect HBV reactivation in hepatitis B surface antigen(HBsAg)-negative and hepatitis B core antibody(HBcAb)-positive patients,socalled de novo hepatitis B patients.The risk of de novo hepatitis B may vary based on different background factors.AIM To determine the frequency and risk factors for de novo hepatitis B during solid tumor treatment.METHODS This retrospective cohort study comprised 1040 patients without HBsAgs and with HBcAbs and/or hepatitis B surface antibodies(HBsAbs).The patients were treated for solid cancer from 2008 to 2018 at the National Kyushu Cancer Center and underwent HBV DNA measurements.Patient characteristics and disease and treatment information were investigated.HBV DNA measurements were performed using TaqMan polymerase chain reaction(PCR).To identify the risk factors associated with HBV DNA expression,the age,sex,original disease,pathology,treatment method,presence or absence of hepatitis C virus(HCV),and HBsAb and/or HBcAb titers of all subjects were investigated.In patients with HBV DNA,the time of appearance,presence of HBsAgs and HBsAbs at the time of appearance,and course of the subsequent fluctuations in virus levels were also investigated.RESULTS Among the 1040 patients,938 were HBcAb positive,and 102 were HBcAb negative and HBsAb positive.HBV DNA expression was observed before the onset of treatment in nine patients(0.9%)and after treatment in 35 patients(3.7%),all of whom were HBcAb positive.The HBV reactivation group showed significantly higher median HBcAb values[9.00(8.12-9.89)vs 7.22(7.02-7.43),P=0.0001]and significantly lower HBsAb values(14 vs 46,P=0.0342)than the group without reactivation.Notably,the reactivated group showed a significantly higher proportion of cancers in organs related to digestion and absorption(79.0%vs 58.7%,P=0.0051).A high HBcAb titer and cancers in organs involved in digestion and absorption were identified as independent factors for HBV reactivation(multivariate analysis,P=0.0002 and P=0.0095).The group without HBsAbs tended to have a shorter time to reactivation(day 43 vs day 193),and the frequency of reactivation within 6 mo was significantly higher in this group(P=0.0459)than in the other group.CONCLUSION A high HBcAb titer and cancers in organs involved in digestion and absorption are independent factors that contribute to HBV reactivation during solid tumor treatment.
文摘To the Editor：Irreversible electroporation （IRE） is a CE- and FDA- approved treatment modality for pancreatic and liver tumors that is based on the site-confined destruction of tumor tissue by multiple short, high-intensity electrical pulses.
文摘Acquired hemophilia A(AHA) is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ(FⅧ) activity related to the appearance of inhibitors against FⅧ. Common etiological factors include autoimmune diseases, malignancy, and pregnancy. We report two cases of AHA in solid cancer. The first case is a 63-year-old man who developed peritoneal and intestinal bleeding after gastrectomy for gastric cancer. He was diagnosed with AHA, and was treated with prednisone, followed by cyclophosphamide. In the second case, a 68-year-old man developed a subcutaneous hemorrhage. He was diagnosed with AHA in hepatocellular carcinoma on CT imaging, and treated with rituximab alone. Hemostasis was achieved for both patients without bypassing agents as the amount of inhibitors was reduced and eradicated. However, both patients died within 1 year due to cancer progression. Successful treatment for AHA in solid cancer can be difficult because treatment of the underlying malignancy is also required.
文摘Background: Neutropenic sepsis is a frequent complication of cytotoxic chemotherapy delivered for cancer patients. Its management is well determined by clinical guidelines. Non-neutropenic sepsis is another potential complication in cancer patients. Its management is less established in the medical literature. Materials and Methods: Three cases are presented to illustrate favourable evolution of non-neutropenic biliary-, uro- and bronchogenic-sepsis in cancer patients with poor prognosis. Results: All three patients had a survival over six months after the management of the septic complication. Two of them received subsequent systemic anticancer treatment. Conclusions: Survival benefit offered by the management of cancer-related non-neutropenic sepsis may be comparable to the benefit obtained by systemic anticancer treatments. Cost-effectiveness of sepsis management may be better than that of anticancer treatments.
文摘Elastography is one of technologies assisting diagnosis ofsolid pancreatic lesions(SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of "harder the lesions, higher chance for malignancy". Two elastography techniques; strain and shear wave elastography, are available. For endoscopic ultrasound(EUS), only the former is existing. To interpret results of EUS elastography for SPL, 3 methods are used:(1) pattern recognition;(2) strain ratio; and (3) strain histogram. Based on results of existing studies, these 3 techniques provide high sensitivity but low to moderate specificity and accuracy rate. This review will summarize all available information in order to update current situation of using elastography for an evaluation of SPLs to readers.
文摘Precision medicine aims to identify the right drug, for the right patient, at the right dose, at the right time, which is particularly important in cancer therapy. Problems such as the variability of treatment response and resistance to medication have been longstanding challenges in oncology, especially for development of new medications. Solid tumors, unlike hematologic malignancies or brain tumors, are remarkably diverse in their cellular origins and developmental timing. The ability of next-generation sequencing(NGS) to analyze the comprehensive landscape of genetic alterations brings promises to diseases that have a highly complex and heterogeneous genetic composition such as cancer. Here we provide an overview of how NGS is able to facilitate precision medicine and change the paradigm of cancer therapy, especially for solid tumors, through technical advancements, molecular diagnosis, response monitoring and clinical trials.
文摘The incidence of lung cancer in the Gejiu area of Yunnan Province ranks the first inthe world. The radon level (indoor, soil) was measured in the Gejiu area by the SSNTDmethod from 1990 to 1996. The result indicates an extensive high-level of indoor radon in thatarea though U and Th are lower in local limestones. The indoor radon level of houses located inthe geologic fault zone is 6 times high that 2 km far from the fau1t zone. The reason probably isthat the radon level of soil in the fault is 6-8 times high that 1 km far from the faults. Ourdata indicate that a lower range of rad0n levels, 0 - 100 Bq’ m- 3, exists in healthy families.However, a higher radon level, over 800 Bq’ m- 3, is often f0und corresponding to that of can-cer patients’ homes (the house-owners are suffering from either lung cancer or leukaemia or liv-er cancer). Obviously, an increase in lung cancer incidence follows an increase in indoor radonlevel. The risk of cancer induced by indoor radon is no longer an inference, but a fact.
文摘Objective： Response Evaluation Criteria in Solid Tumors （RECIST） guideline version 1.0 （RECIST 1.0） was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure. With a number of issues being raised on RECIST 1.0, however, a revised RECIST guideline version 1.1 （RECIST 1.1） was proposed by the RECIST Working Group in 2009. This study was conducted to compare CT tumor response based on RECIST 1.1 vs. RECIST 1.0 in patients with advanced gastric cancer （AGC）. Methods： We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010. These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using the κ statistic. Results： The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0 （P〈0.0001）. However, there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0 0（κ=0.844）. The overall response rates （ORRs） according to RECIST 1.0 and RECIST 1.1 were 32.7% （20/61） and 34.5% （20/58）, respectively. One patient with partial response （PR） based on RECIST 1.0 was reclassified as stable disease （SD） by RECIST 1.1. Of two patients with SD by RECIST 1.0, one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1. Conclusions： RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.
文摘目的:探讨乳腺实性乳头状癌(solid papillary carcinoma of the breast,SPC)的灰阶超声、彩色多普勒超声及超声弹性成像表现,并探讨SPC的超声表现与其病理学检查结果的相关性。方法:分析71例经术后病理学检查证实的SPC患者的临床资料,共包括75个SPC病灶的灰阶超声、彩色多普勒超声表现和35个SPC病灶的超声弹性成像表现。比较不同病理学亚型SPC的超声表现及与病理学检查结果的相关性。结果:SPC的超声表现大多为单发的低回声实性肿块,呈水平生长,形态不规则,边缘不光整,后方回声增强或不变,可伴有导管扩张及钙化,Adler血流分级Ⅱ~Ⅲ级,阻力指数(resistance index,RI)为0.62~0.84。几乎不伴有腋窝淋巴结转移。75个SPC病灶病理学分子分型均为Luminal A型。Ki-67增殖指数在42个原位SPC病灶中均<20%,在15个浸润性SPC中为20%~60%,两者差异有统计学意义(P=0.000)。结论:SPC超声表现具有一定特征性,结合灰阶、彩色多普勒超声及超声弹性成像可提高其诊断准确度,但超声无法鉴别原位SPC及浸润性SPC,Ki-67增殖指数与SPC是否浸润有关。
