Qianqian Yu1, Zhihuan Li2, Xiaoqi Nie1, Lu Wang1, Chen Gong1, Bo Liu1, Xin Liao3, Ben Zhao1, Qianxia Li1, Mingsheng Zhang1, Hong Qiu1, Xianglin Yuan1*

1Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China.

2Dongguan Enlife Stem Cell Biotechnology Institute, Dongguan 523000, Guangdong, China

3Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China

Irinotecan-based chemotherapy is a fundamental cytotoxic regimen for advanced colorectal cancer. The disposition of irinotecan is known to vary in a fashion partially depending on genetic variations in the drug metabolic pathways. UDP-glucuronosyltransferase (UGT)1A1 is a predominant enzyme that converts the active metabolite of irinotecan to the inactive form via a glucuronidation process. Several UGT1A1 polymorphisms are linked to SN-38 glucuronidation and irinotecan-related adverse events, while the predictive role of UGT1A1 polymorphisms regarding therapeutic outcome is controversial. In this review, we will evaluate the impact of UGT1A1 genotypes on irinotecan-induced toxicity and therapeutic efficacy in colorectal cancer patients receiving irinotecan-based treatment.

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Francesca Dionigi1,2*, Valentina Martinelli3, Eugenia Trotti3, Alberta Ferrari2,5, Carlos Alberto Garcia Etienne2, Angelica Della Valle2, Donatella Grasso6, Elisa Ferraris6, Gianpiero Rizzo6, Angioletta Lasagna6, Vincenza Pratico2, Paolo Pedrazzoli, Pierluigi Politi6, Adele Sgarella2,5

1Dottorato di Ricerca in Medicina Sperimentale, Università degli Studi di Pavia, 27100, Pavia, Italy

2Fondazione IRCCS Policlinico “San Matteo”, Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy

3Dipartimento di Medicina e Sanità Pubblica, Università dell'Insubria, via Ottorino Rossi 9, 21010 Varese, Italy

4Department of Biotechnology and Life Sciences, Università degli Studi dell’Insubria, via Ottorino Rossi 9, 21010, Varese, Italy

5Università degli Studi di Pavia, Pavia, Italy

6Fondazione IRCCS Policlinico “San Matteo”, Unità Operativa Complessa di Oncologia Medica, Pavia, Italy

We present our commentary about the case of a 48-year-old woman diagnosed with early breast cancer, already presented as publication. A candidate for mastectomy, she refused immediate reconstruction. She was referred to a psycho-oncologist for further evaluation and support. Psychological sessions helped reveal a history of intimate partner violence and helped clarify the reason for her refusal to undergo immediate reconstruction and other uncommon behavior about oncological treatment and disease paths. Our experience highlights the importance of a multidisciplinary practice in which collaboration between surgeons, oncologists, and mental health professionals leads to a more in-depth understanding of the apparently paradoxical behaviors of patients, and to better care for their needs.

DOI: 10.29245/2578-2967/2020/2.1181 View / Download Pdf

A. H. M. Zuberi Ashraf1,2, Syeda H. Afroze3, Grace A. Osuji2, Saba Y. Kayani3, Natalie Colon3, Ahmed F. Pantho3, Thomas J. Kuehl3, Kimberly A Pilkinton4, M. Nasir Uddin3,5

1Department of Science & Mathematics, Texas A&M University-Central Texas, Killeen, TX, U.S.A.

2Baylor Scott & White Health, Temple, TX, U.S.A.

3Orion Institute for Translational Medicine, Temple, TX, U.S.A.

4Department of Clinical Sciences, University of Houston College of Medicine, Houston, TX, U.S.A.

5Department of Medical Physiology, Texas A&M University College of Medicine, Temple, TX, U.S.A.

The purpose of this article is to review the role of different epigenetic modifications in ovarian cancer. Epigenetic changes can lead to disease development, malignant transformation, and drug resistance of ovarian cancer. Silencing, methylation, and histone modification of genes contribute to ovarian cancer formation. miRNAs have frequently been found to be dysregulated in ovarian cancer cells. Cancer stem cells possess incredible DNA-repair mechanisms and higher rates of mutation; therefore, making them very invasive and resistant to most chemotherapeutic agents. The pathogenesis of ovarian cancer, types of epigenetic modifications, role of miRNA, and cancer stem cells are discussed, as well as targeting of epigenetic pathways with alternative interventions, and application of combination therapies. Using newly discovered combination therapies, it might be possible to create means to manipulate the detrimental epigenetic pathways which can lead to earlier detection, prevention, and treatment of ovarian cancer.

DOI: 10.29245/2578-2967/2020/2.1179 View / Download Pdf

Ryan Nguyen1, Cody J. Peer1, William D. Figg1*

1Clinical Pharmacology Program, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

Herein, the strengths and weaknesses of a study previously published in Scientific Reports will be discussed. The major aim of this study was to investigate the spatial uptake of enzalutamide by intact prostate tissue using matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI-MSI) and histological staining. Additionally, quantitative analysis of in situ tissue enzalutamide concentration was achieved by conventional liquid chromatography-tandem mass spectrometry (LC-MS/MS). The authors demonstrated that enzalutamide rapidly permeates prostate tissue and accumulates in regions containing high epithelial cell counts. While these findings have potential to inform future pharmacodynamic experimental designs and endpoints, this study is limited in its scope by the current state of MALDI-MSI technology, which is not yet sensitive enough to investigate clinically relevant in situ enzalutamide concentrations.

DOI: 10.29245/2578-2967/2020/2.1183 View / Download Pdf

Juwairiya Arshi1, Feng Yin1*

1Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA

Sarcomatoid transformation in a carcinoma is a rare event but frequently associated with advanced disease stage, aggressive clinical behavior and dismal prognosis. It’s likely a result of stepwise gene mutations in pluripotent stem cell and involves the epithelial to mesenchymal transition (EMT). In this review, we discuss the sarcomatoid transformation in various types of cancers. Sarcomatoid transformation in a carcinoma should always be in the differential when there is a sudden increase in size of the tumor during neoadjuvant therapy. Use of agents that interfere with the tyrosine kinase pathway might be the new potential addition to the chemotherapy regimen in these cases. Precision medicine, a rapidly emerging field, seems to be promising in the management of these cancers.

DOI: 10.29245/2578-2967/2020/2.1178 View / Download Pdf

Saranya NavaneethaKrishnan1, Jesusa L. Rosales1, Ki-Young Lee1*

1Department of Cell Biology & Anatomy, Arnie Charbonneau Cancer and Alberta Children’s Hospital Research Institutes, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

DOI: 10.29245/2578-2967/2020/2.1180 View / Download Pdf

Xianglong Tan1, Mengyang Li2, Zhiming Zhao1*

1The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China

2Department of Hepatopancreatobiliary Surgery, The Fourth Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China

Liver metastases occur during the progression of various malignancies. Similar to colorectal cancer, liver metastases of neuroendocrine cancer, gastrointestinal stromal tumor, and pancreatic cancer also determine patient prognosis to some extent. With the development of surgical techniques, pharmaceutical research, and perioperative treatment, therapeutic strategies for non-colorectal cancer liver metastases have improved greatly during the last two decades, inevitably leading to some controversies. Here, we have reviewed the current treatment options for non-colorectal cancer with the aim of enhancing our understanding of the latest developments in this field.

DOI: 10.29245/2578-2967/2020/2.1177 View / Download Pdf

Sruti Chandra1, Hoang Michael Nguyen1, Kylar Wiltz1, Nicholas Hall1, Shanzay Chaudhry1, George Olverson1, Tarun Mandal2, Srikanta Dash3, Anup Kundu1*

1Department of Biology, Xavier University of Louisiana, New Orleans, Louisiana

2Center for Nanomedicine and Drug Delivery, Xavier University College of Pharmacy, New Orleans, Louisiana

3Department of Pathology and Laboratory Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana

OBJECTIVE: The MDR of metastatic breast cancer cells is accompanied by the overexpression of P-gp transporter. This study has been focused to determine whether silencing the expression of P-gp by aptamer-labeled siRNA nanoparticles could enhance the delivery of doxorubicin into breast cancer cells in culture.

METHODOLOGY: The nanoparticle F-31 was prepared using DOTAP, cholesterol, and PLGA, and then incorporating Mal-PEG to facilitate aptamer-binding. The nanoparticles were surface-functionalized with aptamer A6, which targets Her-2 receptors overexpressed on the surface of breast cancer cells.

RESULTS: This study has shown that the uptake of Dox by Dox-resistant 4T1-R is significantly less than Dox-sensitive 4T1-S which is partly attributed to the higher expression of drug-efflux pump P-gp on the surface of the resistant cells. The targeted knockdown of P-gp has been enhanced when the particles carrying P-gp siRNA was labeled with aptamer. Concurrently, the uptake of Dox into the Dox-resistant 4T1-R breast cancer cells has increased significantly when the P-gp was silenced by P-gp siRNA-encapsulated aptamer-labeled nanoparticles.

CONCLUSIONS: This preliminary study concludes that downregulating P-gp expression by targeted delivery of P-gp siRNA using aptamer-labeled lipid-based hybrid nanoparticles could effectively increase the intracellular trafficking of doxorubicin in Dox-resistant mouse breast cancer cells.

DOI: 10.29245/2578-2967/2020/1.1176 View / Download Pdf

Dexter P. Mendoza1, Subba R. Digumarthy1*

1Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, USA

DOI: 10.29245/2578-2967/2019/4.1174 View / Download Pdf

Alberto Romão Sineque1,2*, Filomena Rosa Dos Anjos3, Custódia Lina Macuamule4

1Department of Biological Science, Faculty of Science, Eduardo Mondlane University, Mozambique

2DREAM Laboratory, Comunidade de Sant’Egídio, Maputo, Mozambique

3Department of Animal Nutrition, Faculty of Veterinary, Eduardo Mondlane University, Mozambique

4Department of ParaClinicas, Faculty of Veterinary, Eduardo Mondlane University, Mozambique

Aflatoxins have gained increased recognition worldwide as several researches reveal the negative impacts on health, food security and trade. Major staple foods in Mozambique are prone to aflatoxin contamination, posing health risks to consumers, including the development of liver cancer and the progression of some infectious diseases. Aflatoxin contamination is mainly reported in peanuts, maize and their products. Nevertheless, some studies had reported the presence of aflatoxins and its metabolites in some foodstuffs of animal origin. Surprisingly, some of the contaminated foods had levels greater than the Codex permissible limits adopted by the Mozambican Government Authorities. Lack of awareness of occurrence and risks of mycotoxins, legislation enforcement, poor agricultural practices and undiversified diets predispose populations to dietary aflatoxin exposure. Regular surveys on aflatoxin contamination of food and exposure assessment through the measurement of aflatoxin biomarkers in human biological samples are not yet being performed. Regardless of these findings, the more important task is to monitor and control humans from being exposed to aflaoxins. Dietary assessment, clinical measurements and the enforcement of law should be immediately implemented as preventive strategies. With the current research on aflatoxin in Mozambique, both national and global networking for research collaboration is needed to expand the knowledge and disseminate the information to the global scientific community.

DOI: 10.29245/2578-2967/2019/4.1139 View / Download Pdf

Erin Schwab1, Justin A. Chen1, Jasmine C. Huynh1, Jingran Ji1, Mili Arora1, May Cho1, Edward J. Kim1*

1Department of Internal Medicine, University of California Davis, USA

Based on the well-established importance of dysregulated apoptosis as a hallmark of cancer, there has been robust interest in development of targeted drugs to promote cancer cell apoptosis. A promising target for promoting apoptosis is the Bcl-2 family of proteins. Bcl-2 family proteins are crucial in maintaining balance between cell survival and death through regulation of apoptotic signaling pathways via pro-survival and pro-apoptotic family members. To date, there has been limited efficacy with Bcl-2 inhibition alone in clinical development with benefit restricted to hematologic malignancies. However, combination approaches to inhibition of Bcl-2 and other oncogenic signaling pathways have provided evidence for potential anti-tumor synergy. We review herein the current evidence for targeting Bcl-2 family proteins as a cancer therapeutic strategy across both hematologic and solid organ malignancies.

DOI: 10.29245/2578-2967/2019/4.1172 View / Download Pdf

Qin Ye1, Jiayang Liu2, Ke Xie1*

1Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, P.R. China

2State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, 610041, P.R. China

The B7 family of proteins is commonly divided into three classes according to their structure and the type of receptor they bind to. The B7 proteins exhibit both positive and negative functions with regard to the immune response and are known to be co-inhibitory or co-stimulatory ligands that regulate antitumor immune responses. They are also involved in the regulation of cancer progression via non-immunological functions such as accelerating metabolism, promoting proliferation, and facilitating chemoresistance. Given the dynamic interaction between cancer cells and B7 family proteins, each member has been considered as a novel biomarker or therapeutic target that may well improve the effectiveness of cancer diagnosis and treatment. In this review, we summarize the characteristics of B7 proteins and their immunological and non-immunological roles in cancer progression.

DOI: 10.29245/2578-2967/2019/4.1171 View / Download Pdf

Sonia Bouri1, John P Martin1

1Charing cross hospital, Imperial College London

Iron deficiency anaemia (IDA) is a common condition. The finding of IDA should be given urgent attention as 8-15% of patients will be diagnosed with a gastrointestinal cancer and patients requiring urgent investigation should be identified. IDA is defined as a haemoglobin below the normal range with iron studies that indicate the presence of iron deficiency. This article will discuss the causes of IDA, interpretation of iron studies, and initial investigations for IDA. In the presence of infection or inflammation, the ferritin can be up to 100µg/l even in the presence of IDA and these patients should be considered as having IDA if the other iron studies are supportive. Patients of all ages with IDA should have urinalysis and a Coeliac screen. Patients above 60 years and symptomatic patients of any age should be offered a colonoscopy and gastroscopy within 2 weeks. Men and women younger than 60 years, who are asymptomatic can have routine colonoscopy and gastroscopy. Pre-menopausal women should undergo the relevant endoscopy if they have symptoms or a family history of cancer. If initial bi-directional endoscopies do not show cancer, cancer should be considered in patients who do not respond to iron supplementation, which can indicate ongoing blood loss from the small bowel, or from extra-gastrointestinal sources.

DOI: 10.29245/2578-2967/2019/3.1167 View / Download Pdf

Karen A Fitzner1*, Milda Plioplys2

1FH Consultants, 554 Hillcrest Dr, Sawyer, MI, USA

2Clinical & Human Research Protections, City of Hope, Duarte, CA, USA

A chapter, Impact of cost on the safety of cancer pharmaceuticals, by Fitzner and Oteng Mensah in a recent book, Cancer Policy: Pharmaceutical Safety1, aims to inform readers about the economics associated with the interplay between safety, costs of cancer treatment, and outcomes of cancer care. That chapter includes a general discussion of safety-related costs, cancer care expenditures, and processes that aim to ensure drug safety. It also identifies the negative effects of the high cost of care on patients with cancer and their families. The authors’ focus on safety and cost of cancer pharmaceuticals, while appropriate for the book in which it appears, is limited. Pharmaceutical costs and their impact are only part of the safety story. A more holistic approach to thinking about patient safety can be constructive.

DOI: 10.29245/2578-2967/2019/2.1168 View / Download Pdf

Sunjida Ahmed1, Christopher Schwartz1, M. Zahidunnabi Dewan1, Ruliang Xu1*

1Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA

The transforming growth factor β (TGF-β) superfamily includes a group of structurally related cytokines that regulate a wide variety of biological processes. The diversity of its action depends on the dynamic tissue microenvironment, and interplays among the factors involving in the signaling pathway. Although its expression is tightly regulated in normal tissue, overexpression of TGF-β has been identified in multiple tumor types, including pancreatic adenocarcinoma. In pancreatic tumorigenesis, TGF-β acts initially as a tumor suppressor through phosphorylation and activation of SMAD4/DPC4 gene. Mutation of SMAD4/DPC4 gene results in carcinogenesis and tumor progression in many cancers like lung, colon, and pancreatic cancer. SMAD4 mutation is now recognized in >50% of pancreatic ductal carcinomas. This review is to evaluate the diagnostic and prognostic value targeting the TGF-β/SMAD4 pathway in pancreatic ductal adenocarcinoma.

DOI: 10.29245/2578-2967/2019/2.1141 View / Download Pdf

Steven S. Coughlin1,2*, Lee Caplan3, Jessica Lynn Stewart4, Lufei Young5

1Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA

2Research Service, Charlie Norwood Veterans Administration Medical Center, Augusta, GA

3Morehouse College of Medicine, Department of Community Health and Preventive Medicine, Atlanta, GA

4College of Allied Health Sciences, Augusta University, Augusta, GA

5College of Nursing, Augusta University, Augusta, GA

Although they have been widely studied, important questions remain about the impact of breast cancer survivorship care plans on improving health outcomes. The goal of this article was to review published studies on the impact of cancer survivorship care plans on health outcomes and health care delivery among breast cancer survivors. A total of 111 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, 7 studies met the eligibility criteria. All of the studies had a randomized controlled design. Early trials of the efficacy of breast cancer survivorship care plans generally showed little or no improvement in health outcomes. The positive findings of recent studies suggest that survivorship care interventions that empower and activate patients to self-manage their follow-up care and improve patient-provider communication may be especially promising.

DOI: 10.29245/2578-2967/2019/1.1166 View / Download Pdf

Miao Guo1, Wei Wu5, Wei Liu2, 3*, Fu Ren2, 3, 4#

1Department of Clinical Laboratory, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, Liaoning, China

2Institute of Biological Anthropology, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou 121001, Liaoning, China

3Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou 121001, Liaoning, China

4Department of Anatomy, College of Basic Medical Sciences of Jinzhou Medical University, Jinzhou 121001, Liaoning, China

5School of Humanities and Management, Jinzhou Medical University, Jinzhou, Liaoning, China 121001

Glycoprotein A Repetitions Predominant (GARP), also known as leucine-rich repeats containing 32 (LRRC32), is a transmembrane protein that presents latent TGF-β1 on the surface of regulatory T cells (Tregs) and modulates its activation in tumor immunosuppressive environment. Tregs are immunosuppressive immune cells that play an important role in tumor development and progression. Inhibition of Treg function is considered to be an effective strategy for antitumor therapy. In addition to its expression in Tregs, GARP has been recently found to be highly expressed in a few types of human solid tumor tissues, yet the role of its expression in tumor tissues or cells remains unknown. Most previous studies on GARP have focused on GARP function in Tregs and the role of GARP in latent TGF-β1 activation. The present review provides an up to date overview of GARP expression and its potential role in tumor cells and tissues.

DOI: 10.29245/2578-2967/2019/1.1164 View / Download Pdf

Bhaswati Sarcar1, Xinqun Li2, Jason B. Fleming1*

1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, FL, USA

2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, TX, USA

The extracellular matrix (ECM) in the tumor microenvironment (TME) has gained considerable interest in recent years as a crucial component in fundamental cellular processes and provides novel therapeutic targets. Lumican is a class II small leucine-rich proteoglycan with a key role in ECM organization and modulation of biological functions dependent on tumor type, abundance, and stage of disease. The presence of stromal lumican in the ECM surrounding pancreatic ductal adenocarcinoma (PDAC) inhibits cancer cell replication and is associated with improved patient outcomes after multimodal therapies. In this mini-review, we re-present our novel findings describing how hypoxia (1% O2) within the TME influences stromal lumican expression and secretion. We observed that hypoxia specifically inhibited lumican expression and secretion post-transcriptionally only from pancreatic stellate cells. Hypoxia-induced increased lactate production did not influence lumican expression. Notably, autophagy was induced by hypoxia in ex vivo cultures of patient-derived primary PDAC xenograft and pancreatic stellate cells; however, the cancer cells remain unaffected. Moreover, hypoxia-inducible factor (HIF)-1α expression or inhibition of AMP-regulated protein kinase (AMPK) activation within hypoxic stellate cells restored lumican expression levels. Interestingly, AMPK inhibition attenuated hypoxia-reduced phosphorylation of the mTOR/p70S6K/4EBP signaling pathway. The aim of this mini-review is to summarize our recent publication that hypoxia reduces stromal lumican in PDAC through autophagy-mediated degradation and reduction in protein synthesis within pancreatic cancer stellate cells. This may provide another plausible mechanism by which hypoxia-induced stromal autophagy leads to cancer growth.

DOI: 10.29245/2578-2967/2019/1.1165 View / Download Pdf

Laurent Schwartz

Assistance Publique des Hôpitaux de Paris, Avenue Victoria 75003 Paris, France

A first patient with metastatic adenocarcinoma of the pancreas has decided, on his own, to refuse chemotherapy but to treat himself with lipoïc acid, hydroxycitrate combined with oral ingestion of chlorine dioxide. His blood tests and radiological examinations have almost normalized and the disease is stable at 18 months. Another patient with hormone resistant metastatic prostate cancer has experienced a sharp drop in PSA level as well as improved medical condition. From extensive literature review, the mechanism of action of chlorine dioxide is unknown. It is our hypothesis (albeit unproven) that chlorine dioxide results in tumor cell acidification of the alkaline pH of cancer cells.

DOI: 10.29245/2578-2967/2018/1.1107 View / Download Pdf

Efrossini D. Patsou1, George T. Alexias1, Fotios G. Anagnostopoulos1, Michalis V. Karamouzis2*

1Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece

2Medical School, National and Kapodistrian University of Athens, Athens, Greece

Breast cancer is the most common cancer affecting women worldwide. Women have many disturbing feelings and psychological side effects during diagnosis, treatment and survivorship which include depression, anxiety, low self-esteem and poor quality of life. The aim of the study was to examine the associations between physical activity, global health, quality of life, depressive symptoms, self-esteem, and anxiety in breast cancer survivors after finishing cancer treatment and through survivorship. Demographic variables such as marital status, education, and income, as well as cancer stage and level of physical activity were tested as predictors of depressive mood, anxiety, self-esteem and quality of life in 171 Greek breast cancer survivors.

We are presenting a commentary on the paper in order to highlight the most important conclusions of the study and suggest areas for further investigation.

DOI: 10.29245/2578-2967/2019/1.1161 View / Download Pdf

Shinji Atagi

Kinki-chuo Chest Medical Center, Osaka, Japan

As of now, concurrent chemoradiotherapy is the treatment of choice for locally advanced stage III non-small cell lung cancer (NSCLC). Older adults continue to be underrepresented in clinical trials, and studies designed specifically for this age group are rare. Prospective elderly-specific trials for locally advanced stage III NSCLC provide little evidence. Older patients are more susceptible to adverse events. A key question is whether elderly patients can receive the same treatments and derive the same benefit as their younger counterparts. The JCOG0301 demonstrated the clinically significant benefits of concurrent daily low-dose carboplatin and thoracic radiotherapies in elderly patients in comparison with those of radiotherapy alone. Recently, durvalumab therapy improved the progression-free survival of patients with unresectable stage III NSCLC whose disease had not progressed after concurrent chemoradiotherapy. Therefore, immune checkpoint inhibitors will also play an increasing role for elderly patients with stage III NSCLC. There are great differences between elderly individuals. Geriatric assessment is recommended to be incorporated in clinical trials. Furthermore, pragmatic clinical trials are required to establish clinical evidence for older patients with a broad range of conditions.

DOI: 10.29245/2578-2967/2019/1.1148 View / Download Pdf

James E. Trosko

Department of Pediatrics/Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

While the concept of “precision medicine” is not new, sophisticated technologies have led to a view that the data generated will provide individuals, physicians and public policy-makers with the information required to predict, intervene and protect against many diseases. However, without understanding of the underlying molecular mechanisms, such as the mutagenicity, cytotoxicity or epigenetic alterations, induced by agents to which a human has been exposed, and with pathogenic events, such as birth defects, cardiovascular disease, cancer, immune responses, and reproductive or neurological diseases, there will be no “precision”. The aim of this “Commentary” is that, while mutations and cell death contribute to human diseases, including cancers, the toxicity of chemicals is primarily due to epigenetic effects on human organ-specific adult stem cells. From the perspective of biological evolution, the transition from single- to multi-cellular organisms, along with the generation of new genes and cellular processes, led to the evolution of Homo sapiens and “cultural evolution”. This transition has created a “collision” of the slow biological evolution of genes that are important for survival in various environments, with extremely fast cultural evolution. This has occurred when cultural evolution has provided new means of migration for both people and foods, as well as new methods of agriculture and food production/distribution/processing. The population explosion, ecological alterations, global climate changes, and worldwide economic disparities all have a bearing on how the increases in median life span and the incidence of chronic metabolic diseases are managed in the face of globally limited healthcare resources.

DOI: 10.29245/2578-2967/2018/6.1152 View / Download Pdf

Yingtian Wang, Ying Zhang, Jie Liu, Huiting Fan, Xueqian Wang, Hong-sheng Lin*

Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

DOI: 10.29245/2578-2967/2019/1.1138 View / Download Pdf

Franziska Singer1,2, Daniel J. Stekhoven1,2*

1NEXUS Personalized Health Technologies, ETH Zurich, Otto-Stern-Weg 7, 8093, Zurich, Switzerland

2SIB Swiss Institute of Bioinformatics, 4058 Basel, Switzerland

DOI: 10.29245/2578-2967/2019/1.1163 View / Download Pdf

Igor M. A. Melo, Eliane A. Ribeiro, Renata A. Canevari*

Laboratório de Biologia Molecular do Câncer, Instituto de Pesquisa & Desenvolvimento (IP&D), Universidade do Vale do Paraíba (UNIVAP), São José dos Campos, São Paulo, Brasil

Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide and several studies have proven the close relationship between HPV and the development of cervical cancer. Several tests are currently performed for early and reliable diagnosis, in which the cervical cytology evaluation by the Papanicolaou method is highlighted. However, errors in the collection and misinterpretation of cell differentiation degree in smear by the pathologist result in incorrect or inaccurate results. Considering these points, it is of utmost importance to develop new technologies that perform accurate and reliable diagnosis and that present financial advantages and accessibility. Currently, molecular biology assays are excellent detectors of viral DNA, but it presents disadvantages, such as the need for high financial resources to gain access. Therefore, this review has the objective of highlighting the main diagnostic techniques that are already being used, such as specific kits for the detection of high-risk HPVs, or methodologies that are still in the study phase, but which already present good results, such as the application of physical FTIR spectroscopy principles and ultrasensitive biosensors.

DOI: 10.29245/2578-2967/2018/6.1132 View / Download Pdf