2024-03-29T02:42:36Z
https://resoncol.journals.ekb.eg/?_action=export&rf=summon&issue=18448
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
How Adequate is the Adequate Kidney Function for Clinical Trial Enrollment of Novel Anticancer Drugs?
Nehal
Gamal
Kyrillus
Shohdy
Excessively restrictive eligibility criteria hinder the enrollment of cancer patients to clinical trials. Those patients are supposed to represent the range of characteristics of the overall population with particular cancer. This, in turn, affects the generalizability of results and efficiency of the drug development process in oncology. Recent guidelines from the American Society of Clinical Oncology recommend broadening the eligibility criteria for early and late phase trials. A clearly defined rationale is essential for excluding patients. They selected specific items that commonly lead to the exclusion of patients from clinical trials, namely brain metastases, the minimum age for enrollment, human immunodeficiency virus infection, prior and concurrent malignancies, and organ dysfunction. We reviewed the clinical trials of abemaciclib and tucatinib, two novel anticancer agents, to investigate the eligibility criteria used in their ongoing trials and how the cut-offs for adequate kidney functions were defined. We provided recommendations to allow for enrollment of otherwise eligible patients.
Abemaciclib
Clinical trials
Eligibility criteria
Kidney function
Tucatinib
2020
12
01
31
34
https://resoncol.journals.ekb.eg/article_104142_860510327b2a79921e3af298b4f05ca5.pdf
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis
Wael
Makar
Shaimaa
Lasheen
Background: Breast cancer is a heterogenous group of diseases classified into the biological subtypes luminal A, luminal B, HER2-enriched and triple negative. These subtypes have different treatment response patterns and survival rates. Ki-67 is the most commonly used proliferative marker in breast cancer and is used for the distinction between luminal A and B subtypes.
Methods: A retrospective study that included patients with early breast cancer diagnosed between 2010 and 2016 and treated in a single cancer center.
Results: The medical records of 498 patients were retrospectively reviewed. The median age of patients was 51 years (range: 21 – 81) and the median value of Ki-67 level among them was 20% (interquartile range: 10-30%). Ki-67 was significantly higher in younger (<35 years) and premenopausal patients (p=0.0002 and 0.0055, respectively). Higher Ki-67 level associated significantly with higher T stage, estrogen and progesterone receptors-negativity, HER2-positivity and higher grade (p=0.0256, <0.0001, <0.0001, =0.0001 and =0.0031; respectively). Univariate Cox regression analysis showed that the ≥14% and ≥20% cutoff values of Ki-67 level are associated with poorer disease-free survival (DFS) (HR=1.989 [95%CI: 1.163-3.402, p=0.0121] and HR=1.616 [95%CI: 1.001-2.61, p=0.0496], respectively). On stratifying patients according to the Ki-67 proliferation index into three strata, <14%, ≥14%--<20% and ≥20%; DFS differed significantly between them (p=0.0394). The 5-year DFS rate for the three strata was 82.2%, 64.7% and 64.8%; respectively.
Conclusion: Early breast cancer patients with lower Ki-67 levels have significantly better DFS. A Ki-67 cutoff value of ≥14% appears to correlate better with DFS than the newer cutoff value of ≥20%.
Biological subtypes
Cutoff value
Early breast cancer
Ki-67
prognosis
2020
12
01
35
41
https://resoncol.journals.ekb.eg/article_105973_a6a27eb70bcfe4f4a60f607bafcc215d.pdf
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
Changes in Cancer Treatment Practice During the COVID-19 Pandemic: An Egyptian Multi-Institution Study
Mohamed
Abolkasem
Ahmed
Abdelhafeez
Moustafa
Al-Daly
Mohamed
Alm El-Din
Rasha
Elsaka
Ahmed
Hassan
Abdel-Motaleb
Mohamed
Sherif
Mokhtar
Noha
Ibrahim
Background: In many countries, especially the lower-income ones, the COVID-19 pandemic had a significant negative impact on the services provided to cancer patients. This necessitated setting guidelines for the management of cancer during the pandemic and resulted in changes in its practice. Aim:To explore the change in practice of cancer treatment in cancer centers during the COVID-19 pandemic in Egypt, a lower-income country. Methods: Oncologists from six geographically-distributed Egyptian cancer centers were invited to complete a semi-structured questionnaire evaluating their cancer treatment practice changes. This included systemic anti-cancer treatment, radiotherapy, surgery and supportive and palliative care. Results: Regarding systemic chemotherapy, there was a switch from weekly to 3-4 weekly schedules, from longer to shorter courses and from parenteral to oral administration whenever possible in the majority of centers. Single agents were encouraged and regimens more likely to cause neutropenia were avoided. Hormonal and palliative care treatments were prescribed for longer durations. For many indications, especially the palliative, a switch to hypofractionated radiotherapy regimens was adopted. Excluding emergencies, surgeries were postponed in many centers. The number of elective hospital admissions was minimized and the time interval of follow up visits was prolonged. The majority used phone calls to follow up patients. Conclusion: The COVID-19 pandemic has been associated with many changes in cancer treatment practice in Egyptian cancer care facilities. These changes are likely to minimize the risk of exposure of patients and health care professionals and to utilize the limited resources in a better way.
cancer treatment
COVID-19
Egypt
Lower-income
pandemic
Practice change
2020
12
01
42
47
https://resoncol.journals.ekb.eg/article_106046_c9535d5d1ef1f75f5a78f0309f081eae.pdf
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
A Potential Invasion-Promoting Role for Ezrin in Endometrial Carcinoma
Ahmed
Ahmed
Ghada
Yousef
Mohamed
Abdel-Raheem
Eman
Muhammad
Background:Ezrin is a cell membrane-cytoskeleton linker that is essential to maintain the normal cell shape and the integrity of cell-cell adhesion. Overexpression of ezrin is correlated with poor prognosis in several malignancies. Aim: To evaluate the expression of ezrin in hyperplastic and neoplastic endometrial tissues and to correlate its expression with the clinical and pathological parameters of endometrial carcinoma. Methods: Tissue sections of 66 specimens including 37 endometrial carcinoma, 16 atypical endometrial hyperplasia and 13 benign endometrial hyperplasia were evaluated for ezrin expression by immunohistochemistry. Results: Ezrin expression was detected in all endometrial carcinoma specimens and in 90% of hyperplasia. There was redistribution of ezrin from membranous expression in endometrial hyperplasia to diffuse cytoplasmic expression in endometrial carcinoma (p < 0.0001). Expression of ezrin was significantly higher in atypical compared to benign hyperplasia (p < 0.001) and it was relatively higher in endometrial carcinoma compared to atypical endometrial hyperplasia (p=0.086). Among the carcinoma specimens, expression of ezrin was significantly associated with invasion of myometrium (p=0.001), higher FIGO stage (p=0.008) and the presence of vascular tumor emboli (p=0.001). Muscle-invasive tumor cells expressed significantly higher levels of ezrin compared to non-invasive cells of the same tumor tissue (p < 0.0001). Tumor size, tumor grade and villoglandular morphology did not correlate significantly with ezrin expression. Conclusion: Ezrin was overexpressed in endometrial carcinoma and its expression was associated with the invasive potential of tumor cells.
carcinoma
Cytoplasmic Expression
Endometrium
ezrin
Hyperplasia
invasion
2020
12
01
48
55
https://resoncol.journals.ekb.eg/article_109948_4d21ed2e95982d6d478a6825e482e762.pdf
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
TFAP2E and MLH1 Genes Methylation Pattern and Microsatellite Instability as Predictors of Rectal Cancer Response to Neoadjuvant Chemoradiotherapy
Mohammed
Rizk
Alaa
Kandil
Suzan
Helal
Waleed
Elshazly
Doreen
Younan
Eman
Elkemary
Background: Neoadjuvant chemoradiotherapy (nCRT) prior to surgery in rectal cancer has several adverse effects. Predictive biomarkers for response to nCRT are needed to save patients unnecessary toxicities and to take a timely tailored treatment decision. Epigenetic modifications like DNA methylation patterns have been suspected to be potential predictive biomarkers.
Aim: To determine the role of TFAP2E and MLH1 genes’ methylation status and microsatellite instability (MSI) in predicting response to 5-fluorouracil – based nCRT in rectal cancer.
Methods: DNA was extracted from 80 patients with newly diagnosed stage II / III rectal cancer. The methylation status of TFAP2E and MLH1 genes was determined by pyrosequencing and MSI was determined using 5 microsatellite loci by conventional polymerase chain reaction and capillary electrophoresis.
Results: The cut-off values for TFAP2E & MLH1 genes’ methylation level were 40% and 15% by receiver operating characteristic curve analysis. Hypermethylated TFAP2E and MLH1 gene promotors and MSI were predominant among non-responders (p <0.001, <0.001 and =0.022; respectively). Other factors associated with significantly higher pathological response to nCRT were well/moderately differentiated adenocarcinoma, pretreatment carcinoembryonic antigen level ≤5 ng/ml and rectal tumor ≤5 cm from the anal verge.
Conclusion: Hypermethylated TFAP2E and MLH1 gene promotors and MSI in rectal cancer tissue were associated with poor response to 5-fluorouracil – based nCRT. They might be of value in predicting the response of rectal cancer to nCRT and in tailoring its treatment.
Epigenetics
MLH1 gene
Microsatellite instability
Neoadjuvant chemoradiotherapy
Rectal Cancer
TFAP2E gene
2020
12
01
56
65
https://resoncol.journals.ekb.eg/article_122437_28aa364b124b252c2f4e96287339fab3.pdf
Research in Oncology
Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.
2357-0687
2357-0687
2020
16
2
Corrigendum: El-beshbeshi et al. Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma. Res Oncol. 2020; 16(1): 22-30.
Wafaa
El-beshbeshi
Amir
Zaid
Osama
Eldamshety
Islam
Metwally
Entsar
Eladl
Engy
Aboelnaga
This corrigendum corrects the name of the 5th author of this article which was misspelled in the original version as “Entesar Aladl”. The correct spelling is “Entsar Eladl”. The corrected version of the article replaces the primarily published one.
Corrigendum
Res Oncol
2020
12
01
66
66
https://resoncol.journals.ekb.eg/article_103050_89ebd562d223e42b2ff7a9efbd29ffc4.pdf