Volume Articles

Commentary On SwissMTB: Establishing Comprehensive Molecular Cancer Diagnostics In Swiss Clinics

Franziska Singer^1,2, Daniel J. Stekhoven^1,2*

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

²SIB Swiss Institute of Bioinformatics, 4058 Basel, Switzerland

Commentary: Comprehensive Treatment with Chinese Medicine in Patients with Advanced Non-Small Cell Lung Cancer

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

Stage III Non-Small Cell Lung Cancer in Older Patients: Are We Ready for This Population?

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.

Physical Activity and Sociodemographic Variables Related to Global Health, Quality of Life, and Psychological Factors in Breast Cancer Survivors

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.

Hypoxia-Induced Autophagy Degrades Stromal Lumican into Tumor Microenvironment of Pancreatic Ductal Adenocarcinoma: A Mini-Review

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.

Mini-Review: GARP, a Putative Potential Molecule in Tumor Immunosuppressive Environment

Miao Guo¹, Wei Wu⁵, Wei Liu^{2, 3}*, Fu Ren^{2, 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.

Do Breast Cancer Survivorship Care Plans Improve Health Outcomes?

Steven S. Coughlin^1,2*, 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.