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1.
BMC Cancer ; 24(1): 209, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360633

RESUMO

BACKGROUND: Cancer-associated fibroblasts (CAFs) play an important role in the tumor microenvironment. Despite the well-known in vitro antitumoral effect of vitamin D3 (VD3), its impact on breast CAFs is almost unknown. In this study, we analyzed the ex vivo effects of calcitriol on CAFs isolated from breast cancer tissues. METHODS: CAFs were cultured with 1 and 10 nM calcitriol and their phenotype; gene expression, protein expression, and secretion were assessed. Calcitriol-treated CAFs-conditioned media (CM) were used to analyze the effect of CAFs on the migration and protein expression of MCF-7 and MDA-MB-231 cells. RESULTS: Tumor tissues from VD3-deficient patients exhibited lower levels of ß-catenin and TGFß1, along with higher levels of CYP24A1 compared to VD3-normal patients. In VD3-deficient patients, CAF infiltration was inversely associated with CYP24A1 levels and positively correlated with OPN levels. Calcitriol diminished CAFs' viability, but this effect was weaker in premenopausal and VD3-normal patients. Calcitriol reduced mRNA expression of CCL2, MMP9, TNC, and increased PDPN, SPP1, and TIMP1. It also decreased the secretion of CCL2, TNC, and the activity of MMP-2, while increasing cellular levels of TIMP1 in CAFs from all patient groups. In nonmetastatic and postmenopausal patients, PDPN surface expression increased, and CAFs CM from these groups decreased MCF-7 cell migration after ex vivo calcitriol treatment. In premenopausal and VD3-deficient patients, calcitriol reduced IDO1 expression in CAFs. Calcitriol-treated CAFs CM from these patients decreased OPN expression in MCF-7 and/or MDA-MB-231 cells. However, in premenopausal patients, calcitriol-treated CAFs CM also decreased E-cadherin expression in both cell lines. CONCLUSION: The effects of calcitriol on breast CAFs, both at the gene and protein levels, are complex, reflecting the immunosuppressive or procancer properties of CAFs. The anticancer polarization of CAFs following ex vivo calcitriol treatment may result from decreased CCL2, TNC (gene and protein), MMP9, and MMP-2, while the opposite effect may result from increased PDPN, TIMP1 (gene and protein), and SPP1. Despite these multifaceted effects of calcitriol on molecule expression, CAFs' CMs from nonmetastatic and postmenopausal patients treated ex vivo with calcitriol decreased the migration of MCF-7 cells.


Assuntos
Neoplasias da Mama , Fibroblastos Associados a Câncer , Humanos , Feminino , Fibroblastos Associados a Câncer/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Metaloproteinase 2 da Matriz/metabolismo , Vitamina D3 24-Hidroxilase/genética , Vitamina D3 24-Hidroxilase/metabolismo , Colecalciferol , Calcitriol/farmacologia , Fibroblastos/metabolismo , Movimento Celular/genética , Linhagem Celular Tumoral , Microambiente Tumoral/genética
2.
J Cancer Educ ; 38(5): 1608-1613, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37171530

RESUMO

Cancer is the second most common cause of death in Poland and the number of new cases is expected to increase by 28% over the next 10 years. Despite modifications and expenditure growth in the Polish health care system, oncological treatment outcomes are lower comparing to the other European Union countries. Early preventative interventions are effective in reducing the total number of cancers and improving early detection. OnkoLogika is an educational campaign launched in 2016 by the Comprehensive Cancer Centre, aimed at improving cancer awareness. One hundred and twenty students from 25 high schools of the Lower Silesia region in Poland participated in the OnkoLogika program, which consisted of four-segment workshops containing pre-/post-tests, theoretical and practical parts within the project. The mean number of correct answers from the both tests improved after educational intervention (p < 0.001). Students' knowledge increased, especially in relation to risk factors of breast cancer development (416.31% increase), HPV-related cancers (344.81% increase), risk factors and red flag signs of skin melanoma (120.31% and 99.05% increase respectively). Approx. 86% of participants were satisfied with the OnkoLogika with 14% of respondents being dissatisfied and 94% declared increased awareness about cancer prophylaxis. High schools students indicated insufficient time (250; 16.67%) and lack of details considering presented cancers (80; 5.33%) to be the major weaknesses of the program. Nevertheless, 94% of participants would recommend OnkoLogika to a friend. OnkoLogika promotes healthy lifestyle and helps acquire necessary knowledge about chosen cancers.


Assuntos
Instituições Acadêmicas , Estudantes , Humanos , Polônia , Escolaridade , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários
3.
Postepy Dermatol Alergol ; 40(3): 416-420, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37545825

RESUMO

Introduction: Follow-up plays a key role in melanoma management, especially in the first years after diagnosis. During this period it is crucial to assess possible recurrence, progression of the disease or treatment complications. An important aspect is also the possibility of formation of new primary foci or other skin cancers. Aim: To assess the coincidence of skin lesions and cancers among the melanoma patients. Material and methods: Patients treated in the Comprehensive Cancer Centre between 2019 and 2022 were retrospectively analysed for occurrence of skin lesions diagnosed during the follow-up, and confirmed by biopsy. The lesions considered included skin cancers, dysplastic nevus and actinic keratosis. Results: In 100 (14%) out of 709 enrolled patients, 184 lesions were diagnosed. In 7 patients it was melanoma, in 49 BCC, and in 16 SCC. Dysplastic nevus and actinic keratosis were excised in 28 and 14 patients, respectively. More than one site of the skin lesion was observed in 39 patients, and more than one type of the lesion in 13 patients. Patients with lesions were on average 8.6 years older (p < 0.001), had less advanced tumours (p = 0.010), and primary melanoma was more often located on the head and neck (p = 0.056). Conclusions: Among melanoma patients, particular attention must be paid to, apart from early detection of melanoma recurrence and progression, the occurrence of new primary foci or independent skin cancers.

4.
BMC Cancer ; 22(1): 939, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36045330

RESUMO

BACKGROUND: This analysis presents the outcomes of the operations of the National Cancer Network (NCN) pilot project in Lower Silesian Voivodeship, Poland, for lung cancer for the period of 2019-2021. The results concerning measures of the quality of medical processes were analysed. METHODS: Twenty-one measures used to gauge the quality of oncological care for lung cancer were assessed. Data collection and processing for the purpose of calculating the measures were carried out as part of the NCN pilot project based on the Regulation of the Ministry of Health enacted on 13 December 2018. The measures were calculated at the Voivodeship Coordination Center, and the data were derived from the centres included in the network in the area of the analysed voivodeship. RESULTS: A total of 3,638 patients diagnosed with lung cancer were enrolled in the NCN pilot program during the analysed period. For 3 measures, out of 21, target values were obtained. For 2 measures, the values differed significantly from the assumed target value. CONCLUSION: In our opinion, the NCN pilot study, as a test of the network's functioning, meets the assumed goal. The NCN assessment is based on, inter alia, analysis of the outcomes of oncological quality of care measures for lung cancer, and facilitates monitoring of the quality of medical services provided and the identification of areas for improvement. In addition, the pilot program, which will last until the end of 2022, will allow for further in-depth analysis regarding the network's limitations before implementing the system on a national scale in Poland. This will be the subject of further investigation.


Assuntos
Neoplasias Pulmonares , Indicadores de Qualidade em Assistência à Saúde , Coleta de Dados , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/terapia , Projetos Piloto , Polônia/epidemiologia
5.
BMC Cancer ; 22(1): 1207, 2022 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-36419046

RESUMO

BACKGROUND: In recent years, benchmarking and assessment methods to improve the quality of care have become increasingly important. Such approaches allow for a uniform assessment, comparisons between centers or over time, and the identification of weaknesses. In this study, the results of a 20-month pilot program to assess, monitor and improve the quality of care in melanoma patients primarily treated surgically are presented. METHODS: The pilot program started in May 2020 at the Lower Silesian Oncology, Pulmonology and Hematology Center (LSOPHC) in Wroclaw, Poland (Lower Silesian Voivodeship, southwestern province of Poland with a population of 2,9 million). The program involved the introduction of a synoptic histopathological protocol, medical coordinators, and a set of measures to assess oncological care. In total, 11 Skin Cancer Unit (SCU) measures were introduced to analyze clinical outcomes, diagnostic quality, and duration. Data from 352 patients covered by the program were analyzed. In addition, the completeness of diagnostics from external sites was compared to our own results. Furthermore, the timeliness of the initial diagnostic tests and in-depth diagnostics were assessed and compared to the timeliness before implementation of the pilot program. RESULTS: The introduced measures assessed the mortality related to oncological treatment, the rate of complications, advanced stages of melanoma, the completeness and duration of diagnostics, the involved nodes after lymphadenectomy, and melanoma screening. During the study period, the timeliness of the initial diagnostics was maintained at 87.8%, and the timeliness of the in-depth diagnostics at 89.5%. Compared to a similar period before the program, these values were 36.1% and 67.5%, respectively. CONCLUSION: The introduced measures seem to be effective and practical tools for benchmarking clinical and diagnostic aspects. They also allowed for a sensitive assessment of individual issues and indicated sensitive points. Furthermore, the actions undertaken in this pilot program allowed for a shortening of the duration of diagnostics.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Polônia/epidemiologia , Projetos Piloto , Melanoma/diagnóstico , Melanoma/epidemiologia , Melanoma/terapia , Oncologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/terapia
6.
Int J Mol Sci ; 23(9)2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35563554

RESUMO

The molecular mechanisms of telomerase reverse transcriptase (TERT) upregulation in breast cancer (BC) are complex. We compared genetic variability within TERT and telomere length with the clinical data of patients with BC. Additionally, we assessed the expression of the TERT, MYC, TP53 and SP1 genes in BC patients and in BC organoids (3D cell cultures obtained from breast cancer tissues). We observed the same correlation in the blood of BC patients and in BC organoids between the expression of TERT and TP53. Only in BC patients was a correlation found between the expression of the TERT and MYC genes and between TP53 and MYC. We found associations between TERT genotypes (rs2735940 and rs10069690) and TP53 expression and telomere length. BC patients with the TT genotype rs2735940 have a shorter telomere length, but patients with A allele rs10069690 have a longer telomere length. BC patients with a short allele VNTR-MNS16A showed higher expression of the SP1 and had a longer telomere. Our results bring new insight into the regulation of TERT, MYC, TP53 and SP1 gene expression related to TERT genetic variability and telomere length. Our study also showed for the first time a similar relationship in the expression of the above genes in BC patients and in BC organoids. These findings suggest that TERT genetic variability, expression and telomere length might be useful biomarkers for BC, but their prognostic value may vary depending on the clinical parameters of BC patients and tumor aggressiveness.


Assuntos
Neoplasias da Mama , Telomerase , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Genes myc , Humanos , Polimorfismo de Nucleotídeo Único , Fator de Transcrição Sp1/genética , Telomerase/genética , Telômero/patologia , Proteína Supressora de Tumor p53/genética
7.
Przegl Epidemiol ; 76(1): 37-50, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35860959

RESUMO

INTRODUCTION: The National Cancer Control Programme 2006-2015 (NCCP) was implemented to improve the health situation of Polish women in 2006. Its effectiveness was evaluated by analysing trends of changes in incidence rates of pre-invasive (D05) and invasive (C50) breast cancers in three age cohorts: pre-screening cohort (<50), screening cohort (50-69) and post-screening cohort (>69). MATERIAL AND METHODS: Medical data of 13,089 women with C50 and 738 women with D05 diagnosed in 2005-2014 in the Lower Silesian Voivodeship (LS) were analysed. RESULT: In 2009-2014, incidence rates of C50 (p=0.0224) and D05 (p=0.0003) were found to be higher in the LS than those recorded for Poland. During this period, there were approx. 1,400 cases of C50 and 90-100 cases of D05 per year. After the NCCP had been implemented, there was a gradual increase in the proportion of the female population included in the mammography screening, from 32% in 2007 to 45% in 2014. The age group included in the screening programme experienced a significant increase in the proportion of pre-invasive cancers - from 3% in 2005 to 7-10% in 2010-2013. In that group, cancer was statistically more frequently detected in Tis- or T1- stages (p=0.0002). Beneficial effects of screening were also observed in post-screening women. There was no similar trend in patients aged <50. CONCLUSIONS: This analysis shows positive population effects of mammography screening. The least favourable changes in the detection of early stages of breast cancer were observed in female patients aged less than 50 years. This suggests that some modifications regarding both the age range and the screening interval in the Polish population should be considered.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Mamografia , Programas de Rastreamento , Polônia/epidemiologia
8.
Postepy Dermatol Alergol ; 39(3): 559-564, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35950133

RESUMO

Introduction: Patients with cutaneous malignant melanoma (MM), in case of non-resectability of the lesions, have only a limited pool of the available treatment options. In recent years especially electrochemotherapy (ECT) has become an increasingly important therapy in locoregionally advanced MM. Aim: In this study an analysis of the ECT treatment of locoregionally advanced malignant melanoma was presented. Material and methods: Six ECT cycles in 5 patients were performed in the Wroclaw Comprehensive Cancer Centre. Treatment response, long-term observation, technical data downloaded from electroporator and photographs taken before and after the ECT were assessed in the analysis. Results: In total, 200 nodules in 5 patients were treated with ECT in palliative intent. After 5 out of 6 ECT cycles, the particular clinical response has been observed. Four patients with primary unresectable lesions underwent 11 surgeries of the cutaneous metastases. In long-term follow-up in 2 patients, of whom one died 19 months after the ECT, the disease progressed and in another two, no recurrence was observed. Conclusions: ECT is an encouraging therapy for patients in whom the recurrent cutaneous melanoma cannot be treated with other methods, however, access to this method in eastern part of Central Europe is limited. The presented study seems to confirm the usefulness of this palliative approach in a specific group of patients suffering from cutaneous MM.

9.
Postepy Dermatol Alergol ; 39(1): 189-194, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35369642

RESUMO

Introduction: A rapid spread of the emerging COVID-19 pandemic limited the availability of professional medical advice. As a result, a significant increase in the number of undiagnosed and chronically ill patients without medical care was noticed. In reaction to the urgent need, the telemedical consultation, instead of the classical form, may be introduced as a vulnerable tool in preclinical evaluation of patients with potentially malignant skin lesions. Aim: In this study the results of the implementation of telemedical consultation programme with the intention to early detect the skin cancers in patients who, due to the COVID-19 pandemic, could not undergo the standard consultation was presented. Material and methods: The programme of remote dermatological consultation, which was introduced on 1 June 2020, covered all patients who had no possibility or will to visit the standard healthcare units. In case of suspicion of life-threatening skin lesions patients were invited for additional diagnostics or surgery. Obtained data, including demography, age, surgery description and pathomorphological examination were descriptively analysed. Results: In total, 80 consecutive patients were enrolled during the screening programme. In total, 31 lesions in 25 patients were excised. In this group there were 10 serious diagnoses including 5 cases of basal cell carcinoma, melanoma in situ and dysplastic nevi. Moreover, another 10 patients were referred to other specialists or specific recommendations were advised. Conclusions: An alternative track using teledermatology for patients with skin diseases was successfully introduced under the specific conditions of epidemiologic danger. Despite its disadvantages teledermatology enabled the diagnosis and treatment in a significant number of serious cases.

10.
BMC Cancer ; 21(1): 1252, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34800990

RESUMO

BACKGROUND: This study aimed to present the performance of the National Cancer Network's (NCN) pilot program in the Lower Silesian Voivodeship (southwestern province of Poland with a population of 2,9 million in 2019), to analyse measures describing lung cancer patients and to determine whether those measures can be used to improve the treatment outcomes of stage III and IV patients with lung cancer in Poland. METHODS: Three measures of the NCN pilot programme were analysed: "Percentage of patients with genetic and molecular testing for predictive factors", "Assessment of the completeness of a pathological examination", and "Percentage of stage III and IV cancer patients". As many as 2,218 patients with ICD-10-CM Diagnosis Code C34 were included in the NCN pilot program from 1 to 2019 to 31 December 2020, in the Lower Silesian Voivodeship. The scores of each measure were calculated quarterly by the Regional Coordinating Centre, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland. RESULTS: Genetic and molecular testing among stage III and IV patients was performed in only 40% and 60% of patients, respectively. The incompleteness of histopathological examinations did not exceed 0.5%. Stage III and stage IV patients accounted for 37% and 35% of the analysed patients, respectively. CONCLUSIONS: The NCN pilot program measures presented in this study appear to be highly sensitive, simple, and transparent tools to monitor the quality of lung cancer diagnosis and assess clinical staging in patients within a specific region. An increase in the proportion of stage III and IV patients who will undergo genetic and molecular testing in the era of modern drug therapies should result in improved treatment outcomes in this patient group. In the present analysis, the values of the main analysed measure, which evaluates the number of genetic and molecular tests for predictive factors for lung cancer, were subject to significant fluctuations during the pilot project. Both upwards and downwards trends were observed. Further analysis in the future is warranted to eliminate the unfavourable factors influencing the obtained values of the measure.


Assuntos
Testes Genéticos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias , Distribuição por Idade , Idoso , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Pessoa de Meia-Idade , Projetos Piloto , Polônia , Avaliação de Programas e Projetos de Saúde , Garantia da Qualidade dos Cuidados de Saúde
11.
Arch Gynecol Obstet ; 301(2): 591-602, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31853712

RESUMO

PURPOSE: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients' age. METHODS: We analysed 101,714 CC women diagnosed in 2000-2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. RESULTS: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. CONCLUSION: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.


Assuntos
Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , União Europeia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias do Colo do Útero/mortalidade
12.
Rep Pract Oncol Radiother ; 24(4): 325-330, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31193916

RESUMO

AIM: The aim of the analysis was to compare doses obtained for temporal lobes in patients being irradiated for meningiomas of the brain using the conformal technique and volumetric modulated arc therapy (VMAT). We try to answer the question whether the application of VMAT would lead to higher doses within temporal lobes. BACKGROUND: In recent years a significant increase in the detection of meningiomas and effectiveness of treatment has been observed. Hence quality of life should be considered as an important aspect after a treatment course. MATERIALS AND METHODS: Treatment plans of 27 patients were evaluated retrospectively. Radiotherapy procedures were carried out from 2007 until 2016 at the Department of Radiation Oncology in Wroclaw, Poland. For individual patients, alternative treatment plans were generated in relation to the ones originally used, wherein from dynamic techniques, volumetric modulated arc therapy was selected for analysis. Evaluated dosimetric parameters for temporal lobes were: mean dose, V10 Gy, V20 Gy, V45 Gy. RESULTS: Statistically significant differences were observed for V45 Gy for both temporal lobes (p = 0.023) and for V45 Gy for the right (p = 0.001) and the left temporal lobe (p = 0.016) considered for VMAT. The mean values of the V45 Gy for both temporal lobes, for the right temporal lobe and for the left temporal lobe were lower for VMAT than for 3D, respectively: 7.54% and 7.90%, 6.82% and 9.47%, 5.67% and 7.14%.Analysis of the remaining results found no statistical differences. CONCLUSION: Application of VMAT in patients treated for meningioma of the brain is not related to higher doses of radiation in the temporal lobe area, compared with the conformal technique.

13.
World J Surg Oncol ; 14: 72, 2016 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-26956623

RESUMO

BACKGROUND: The aim of this study was to assess the usefulness of the breast segmentectomy with rotation mammoplasty (BSRMP) in conserving therapy for an extensive ductal carcinoma in situ (DCIS) with or without an invasive component. METHODS: Thirty-six women with DCIS visible as large area of microcalcifications distributed out of the retroareolar area regardless of the quadrant were studied prospectively. All the patients underwent BSRMP and axillary procedure (31 sentinel node biopsy, 5 axillary dissection) followed by radiotherapy. In each case, follow-up was carried out carefully and special effort was made to identify postoperative complications. Cosmetic result was judged 6 months after radiotherapy by the patient herself and two surgeons being rated as poor, mediocre, medium, good or excellent. RESULTS: Operation was completed without any difficulties in all the cases. Appropriate BSRMP was easily done after the skin marking. Regardless of the type of axillary approach, it was conveniently performed. Wound was healed by primary adhesion; skin or breast tissue necrosis did not develop. Neither haematoma nor surgical site infection was observed. In none of the patient, centralisation of the nipple-areola complex (NAC) was needed. Three patients (8.3%) with close margins (1 mm or less) successfully underwent subsequent re-excision. The scar did not result in any impairment of arm movement. Cosmetic outcome was evaluated by the women as excellent and good in 55 (87%) and 8 (13%) cases, respectively, while by the surgeons as excellent, good and medium in 52 (82%), 8 (13%), and 3 cases (5%), respectively. CONCLUSIONS: BSRMP is a simple and safe technique achieving good cosmetic results without NAC centralisation and giving the wide and easy access to axilla for both sentinel node biopsy and lymphadenectomy. It can be helpful in cases of extensive, radially spreading tumours (in particular DCIS or invasive cancers with intraductal component), eccentric lesions, or superficially located cancers when the neighbouring skin is excised. However, due to its limitations (long incision, difficult subsequent mastectomy, possibility of scar placement in the visible area of decollete), a careful patients' selection should be done. Further studies are needed to assess long-term cosmetic outcomes including delayed post-radiotherapy effects.


Assuntos
Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Intraductal não Infiltrante/cirurgia , Mamoplastia/métodos , Mastectomia Segmentar/métodos , Complicações Pós-Operatórias , Adulto , Idoso , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Rotação
14.
Rep Pract Oncol Radiother ; 19(6): 353-60, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25337407

RESUMO

This survey is performed to update knowledge about methods and trends in lung cancer radiotherapy. A significant development has been noticed in radiotherapeutic techniques, but also in the identification of clinical prognostic factors. The improvement in the therapeutic line includes: application of the four-dimensional computer tomography (4DCT), taking advantage of positron emission tomography (PET-CT), designing of new computational algorithms, allowing more precise irradiation planning, development of treatment precision verification systems and introducing IMRT techniques in chest radiotherapy. The treatment outcomes have improved with high dose radiotherapy, but other fractionation alternations have been investigated as well.

15.
Biomed Pharmacother ; 174: 116532, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38574625

RESUMO

Chimeric antigen receptor T (CAR-T) cell therapy, a groundbreaking immunotherapy. However, it faces formidable challenges in treating solid tumors, grappling with issues like poor trafficking, limited penetration, and insufficient persistence within the tumor microenvironment (TME). CAR-T cells are engineered to express receptors that target specific cancer antigens, enhancing their ability to recognize and eliminate cancer cells. This review paper explores the intricate interplay between CAR-T therapy and radiotherapy (RT), investigating their synergistic potential. Radiotherapy, a standard cancer treatment, involves using high doses of radiation to target and damage cancer cells, disrupting their ability to grow and divide. We highlight that RT modulates the TME, augments antigen presentation, and promotes immune cell infiltration, bolstering CAR-T cell-mediated tumor eradication. Molecular insights shed light on RT-induced alterations in tumor stroma, T cell recruitment promotion, and induction of immunogenic cell death. Noteworthy, strategies, such as combining hypofractionated radiotherapy with myeloid-derived suppressor cell blockade, underscore innovative approaches to enhance CAR-T cell therapy in solid tumors. Bridging indications for RT and CAR-T cells in hematological malignancies are discussed, emphasizing scenarios where RT strategically enhances CAR-T cell efficacy. The paper critically evaluates the RT as a bridge compared to traditional chemotherapy, highlighting timing and dosage considerations crucial for optimizing CAR-T therapy outcomes. In summary, the paper provides valuable insights into the intricate molecular mechanisms activated by RT and innovative strategies to improve CAR-T cell therapy, fostering a deeper understanding of their combined potential in cancer treatment.


Assuntos
Imunoterapia Adotiva , Neoplasias , Microambiente Tumoral , Humanos , Neoplasias/radioterapia , Neoplasias/imunologia , Neoplasias/patologia , Imunoterapia Adotiva/métodos , Animais , Receptores de Antígenos Quiméricos/imunologia , Receptores de Antígenos Quiméricos/metabolismo , Terapia Combinada/métodos , Radioterapia/métodos
16.
Am J Cancer Res ; 14(6): 3036-3058, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39005669

RESUMO

Cancer is the leading cause of death worldwide. The World Health Organization (WHO) estimates that 10 million fatalities occurred in 2023. Breast cancer (BC) ranked first among malignancies with 2.26 million cases, lung cancer (LC) second with 2.21 million cases, and colon and rectum cancers (CC, CRC) third with 1.93 million cases. These results highlight the importance of investigating novel cancer prognoses and anti-cancer markers. In this study, we investigated the potential effects of alpha-2 macroglobulin and its receptor, LRP1, on the outcomes of breast, lung, and colorectal malignancies. Immunohistochemical staining was used to analyze the expression patterns of A2M and LRP1 in 545 cases of invasive ductal breast carcinoma (IDC) and 51 cases of mastopathies/fibrocystic breast disease (FBD); 256 cases of non-small cell lung carcinomas (NSCLCs) and 45 cases of non-malignant lung tissue (NMLT); and 108 cases of CRC and 25 cases of non-malignant colorectal tissue (NMCT). A2M and LRP1 expression levels were also investigated in breast (MCF-7, BT-474, SK-BR-3, T47D, MDA-MB-231, and MDA-MB-231/BO2), lung (NCI-H1703, NCI-H522, and A549), and colon (LS 180, Caco-2, HT-29, and LoVo) cancer cell lines. Based on our findings, A2M and LRP1 exhibited various expression patterns in the examined malignancies, which were related to one another. Additionally, the stroma of lung and colorectal cancer has increased levels of A2M/LRP1 areas, which explains the significance of the stroma in the development and maintenance of tumor homeostasis. A2M expression was shown to be downregulated in all types of malignancies under study and was positively linked with an increase in cell line aggressiveness. Although more invasive cells had higher levels of A2M expression, an IHC analysis showed the opposite results. This might be because exogenous alpha-2-macroglobulin is present, which has an inhibitory effect on several cancerous enzymes and receptor-dependent signaling pathways. Additionally, siRNA-induced suppression of the transcripts for A2M and LRPP1 revealed their connection, which provides fresh information on the function of the LRP1 receptor in A2M recurrence in cancer. Further studies on different forms of cancer may corroborate the fact that both A2M and LRP1 have high potential as innovative therapeutic agents.

17.
Sci Rep ; 14(1): 22126, 2024 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-39333342

RESUMO

Vitamin D3 (VD) is known for its immunomodulatory and anticancer effects. This study aimed to characterize tumor-associated macrophages (TAMs) in breast cancer (BC) and assess the influence of VD and its active metabolite, calcitriol, on their polarization. TAMs were isolated from BC patients and characterized. Monocytes were differentiated into macrophage classes (M0, M1, M2a, M2c) and treated ex vivo with calcitriol. The expression of VD-related proteins in tumor tissue was correlated with TAMs and monocyte-derived macrophages (MDMs) characteristics. TAM expression of CD200R, CD204, CD80, HLA-DR, and CD44 was negatively correlated with CYP27B1 in selected patient groups. Patients with high CYP27B1 tumor expression showed significantly lower CD200R, CD204, and CD44 expression. In patients with normal VD levels and premenopausal, CD80 expression in M2a and M2c MDMs (control, untreated ex vivo with calcitriol) was negatively correlated with plasma VD. Calcitriol reduced HLA-DR during MDM differentiation in all patients; CD80 decrease significantly except in patients with normal VD levels or metastasis. Calcitriol also decreased CD163 expression. The decrease in both M1 and M2 macrophage markers by calcitriol or their negative correlation with CYP27B1 indicate the modulatory, but rather anticancer activity of VD. The intensity of these effects was the strongest in postmenopausal patients and those without metastases.


Assuntos
Neoplasias da Mama , Colecalciferol , Humanos , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/tratamento farmacológico , Feminino , Colecalciferol/farmacologia , Pessoa de Meia-Idade , 25-Hidroxivitamina D3 1-alfa-Hidroxilase/metabolismo , 25-Hidroxivitamina D3 1-alfa-Hidroxilase/genética , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos Associados a Tumor/metabolismo , Macrófagos Associados a Tumor/efeitos dos fármacos , Macrófagos Associados a Tumor/imunologia , Calcitriol/farmacologia , Adulto , Idoso , Diferenciação Celular/efeitos dos fármacos , Antígenos CD/metabolismo , Biomarcadores Tumorais/metabolismo
18.
J Appl Genet ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722458

RESUMO

Neoadjuvant chemotherapy is the foundation treatment for triple-negative breast cancer (TNBC) and frequently results in pathological complete response (pCR). However, there are large differences in clinical response and survival after neoadjuvant chemotherapy of TNBC patients. The aim was to identify genes whose expression significantly associates with the efficacy of neoadjuvant chemotherapy in patients with TNBC. Transcriptomes of 46 formalin-fixed paraffin-embedded (FFPE) tumor samples from TNBC patients were analyzed by RNA-seq by comparing 26 TNBCs with pCR versus 20 TNBCs with pathological partial remission (pPR). Subsequently, we narrowed down the list of genes to those that strongly correlated with drug sensitivity of 63 breast cancer cell lines based on Dependency Map Consortium data re-analysis. Furthermore, the list of genes was limited to those presenting specific expression in breast tumor cells as revealed in three large published single-cell RNA-seq breast cancer datasets. Finally, we analyzed which of the selected genes were significantly associated with overall survival (OS) in TNBC TCGA dataset. A total of 105 genes were significantly differentially expressed in comparison between pPR versus pCR. As revealed by PLSR analysis in breast cancer cell lines, out of 105 deregulated genes, 42 were associated with sensitivity to docetaxel, doxorubicin, paclitaxel, and/or cyclophosphamide. We found that 24 out of 42 sensitivity-associated genes displayed intermediate or strong expression in breast malignant cells using single-cell RNAseq re-analysis. Finally, 10 out of 24 genes were significantly associated with overall survival in TNBC TCGA dataset. Our RNA-seq-based findings suggest that there might be transcriptomic signature consisted of 24 genes specifically expressed in tumor malignant cells for predicting neoadjuvant response in FFPE samples from TNBC patients prior to treatment initiation. Additionally, nine out of 24 genes were potential survival predictors in TNBC. This group of 24 genes should be further investigated for its potential to be translated into a predictive test(s).

19.
Sci Rep ; 14(1): 3778, 2024 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-38355711

RESUMO

Our research found that vitamin D3 (VD3) treatment increased lung metastasis in mice with 4T1 murine breast cancer (BC). This study aims to investigate the impact of VD3 on the activation of tumor-associated macrophages (TAMs) in BC. Mice bearing 4T1, E0771, 67NR BC cells, and healthy mice, were fed diets with varying VD3 contents (100-deficient, 1000-normal, and 5000 IU/kg-elevated). Some mice in the 1000 and 100 IU/kg groups received calcitriol. We studied bone metastasis and characterized TAMs and bone marrow-derived macrophages (BMDMs). 4T1 cells had higher bone metastasis potential in the 5000 IU/kg and calcitriol groups. In the same mice, an elevated tumor osteopontin level and M2 polarization of TAMs (MHCIIlow CD44high phenotype) were observed. Gene expression analysis confirmed M2 polarization of 4T1 (but not 67NR) TAMs and BMDMs, particularly in the 100 IU + cal group (increased Mrc1, Il23, and Il6). This polarization was likely due to COX-2/PGE2 induction in 4T1 calcitriol-treated cells, leading to increased proinflammatory cytokines like IL-6 and IL-23. Future studies will explore COX-2/PGE2 as a primary mediator of calcitriol-stimulated inflammation in the BC microenvironment, especially relevant for BC patients with VD3 deficiency and supplementation.


Assuntos
Neoplasias da Mama , Glândulas Mamárias Humanas , Humanos , Animais , Camundongos , Feminino , Citocinas/metabolismo , Calcitriol/farmacologia , Macrófagos Associados a Tumor/metabolismo , Ciclo-Oxigenase 2/genética , Glândulas Mamárias Humanas/metabolismo , Linhagem Celular Tumoral , Neoplasias da Mama/patologia , Microambiente Tumoral
20.
Ginekol Pol ; 84(7): 590-5, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24032269

RESUMO

INTRODUCTION: Due to frequent diagnosis of ovarian cancer at an advanced clinical stage, in most cases surgical debulking is followed by chemotherapy. The principal cause of therapeutic failure involves incomplete surgery and resistance of neoplastic cells to chemotherapy. A search continues for substances which would overcome resistance to treatment and, as a result, would increase efficacy of the applied treatment. Quercetin represents one of more interesting compounds, which at present in subjected to several tests. MATERIAL AND METHODS: Studies were performed on in vitro sensitivity of human ovarian cancer cell lines, SKOV-3, EFO27, OVCAR-3 and A278OP to low doses of quercetin and on the effect exerted by quercetin on sensitivity of the cell lines to cisplatin and pactitaxel. RESULTS: The experiments proved that the studied cells of ovarian cancer manifest a similar sensitivity to quercetin. Following incubation of the cells with two distinct concentrations of quercetin and the studied cytostatic agents all the cells lines were found to significantly increase their sensitivity to pactitaxel in cases of two cell lines, OVCAR-2 and A278OP, they also significantly increased their sensitivity to cisplatin. DISCUSSION: Our results demonstrated suitability of low quercetin doses (achievable using oral administration) as a substance which increases sensitivity of ovarian cancer cells to cisplatin and paclitaxel. The value of quercetin include its wide accessibility efficacy and a broad range of activity but also its low toxicity as compared to other examined compounds. CONCLUSIONS: Used in low doses, quercetin increases chemosensitivity of ovarian cancer cells examined compounds.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Antioxidantes/farmacologia , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Neoplasias Ovarianas/tratamento farmacológico , Quercetina/farmacologia , Apoptose/efeitos dos fármacos , Sobrevivência Celular , Cisplatino/farmacologia , Feminino , Humanos , Paclitaxel/farmacologia , Células Tumorais Cultivadas
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