The Role of Body Mass Index in Triple Negative Breast Cancer.

BACKGROUND: Triple-negative breast cancer (TNBC) has none of the targeted treatment choices due to its distinct biological property, making this subtype a unique disease. In this study, we evaluated the impact of obesity on clinical outcomes of TNBC. METHODS: The data of breast cancer patients admitted to our department were collected. TNBC was defined as lack of estrogen receptor (ER), progesterone receptor (PR) and HER-2. The body mass index (BMI) of 112 TNBC patients was calculated with weight at the time of diagnosis and height. The patients were classified into groups with a BMI of < 25 (normal/underweight), 25-29.9 (overweight) or ≥ 30 (obese). After a mean follow-up of 23.2 ± 15.5 months, there were 12 recurrences (10.71%) and 6 deaths (5.35%). Disease-free survival (DFS) and overall survival (OS) were assessed. RESULTS: The survival analyses of all the patients did not demonstrate any differences in OS or DFS in obese as compared to non-obese patients. However, we showed that obesity was associated with a poorer OS for postmenopausal TNBC patients (p < 0.05). CONCLUSION: Obesity is related to a poorer OS in postmenopausal TNBC patients. Due to the heterogeneous disease profile of TNBC, larger randomized studies will be needed to clarify the exact role of obesity in TNBC.

Second-line capecitabine and oxaliplatin combination for gemcitabine-resistant advanced pancreatic cancer.

BACKGROUND: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. MATERIALS AND METHODS: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin 130 mg/m2 and capecitabine 1000 mg/m2 twice daily with a 3 week interval, until unacceptable toxicity or disease progression. RESULTS: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. CONCLUSIONS: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.

Undifferentiated embryonal sarcoma of the liver in an adult patient: case report.

Undifferentiated embryonal sarcoma of the liver is a rare and aggressive tumor in adults, with an unfavorable prognosis. We present a 33-year-old female patient who was admitted with fatigue, weight loss and right upper abdominal pain. Magnetic resonance imaging of the liver revealed a bulky malignant mass with necrotic and cystic center, which nearly occupied the left lobe and invaded the middle-left hepatic vein and left portal vein. The patient was evaluated as inoperable, and in order to determine the histologic diagnosis, a Tru-cut biopsy was performed. Both histopathologic features and the immunocytochemical stainings revealed the diagnosis of hepatic embryonal sarcoma. Since the patient had no chance of surgery due to the advanced stage of the tumor and progressive hepatic failure, a combination chemotherapy was applied. Unfortunately, the patient did not respond to treatment at all and died in the second post-therapy week. Undifferentiated embryonal sarcoma of the liver is a highly chemo-sensitive tumor. Radical resection may be possible after combination chemotherapy in the childhood period, but since the disease is extremely rare in adults, an optimal treatment approach is still unknown.

Enhancing cytotoxic and apoptotic effect in OVCAR-3 and MDAH-2774 cells with all-trans retinoic acid and zoledronic acid: a paradigm of synergistic molecular targeting treatment for ovarian cancer.

BACKGROUND: Ovarian cancer is the most fatal gynecologic malignancies in the world. Although, platinum based treatments are widely used, the disease becomes treatment refractory within two years, and novel treatment options should be searched. All- trans retinoic acid (ATRA) induces growth arrest, differentiation and cell death in some types of cancer cells and its combination with various anticancer agents results in enhanced cytotoxicity. Zoledronic acid is a common bisphosphonate known for its anticancer effects beyond its current use in the treatment of cancer-induced bone disease. We aimed to investigate the possible additive/synergistic effect of both agents in OVCAR-3 and MDAH-2774 ovarian cancer cell lines, since both agents show superiority to conventional cytotoxics in terms of adverse events. METHODS: XTT cell proliferation assay was used for showing cytotoxicity. For verifying apoptosis, both DNA Fragmentation by ELISA assay and caspase 3/7 activity measurement were used. OligoGeArray which consists of 112 apoptosis related genes was used to elucidate the genetic changes within cancer cells. To validate our oligoarray results, quantitative real-time PCR was performed on four selected genes that were maximally effected by the combination treatment: lymphotoxin beta receptor (LTBR), myeloid cell leukemia-1 (MCL-1), tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A), TNFRSF1A-associated death domain protein (TRADD). RESULTS: We demonstrated that a novel combination of ATRA and zoledronic acid is a strong inducer of apoptotic related cell death in both ovarian cancer cells. While the combination therapy significantly induced proapoptotic genes such as tumor necrosis factor receptor superfamily (TNFRSF), TRADD and caspase 4, some of the antiapoptotic genes such as members of MCL-1, LTBR, BAG3 and Bcl-2 family members were inhibited. CONCLUSIONS: These are the preliminary molecular results of a novel combination treatment of ATRA and zoledronic acid, with fewer side effects as compared to conventional cytotoxic agents. With additional experimental analysis, it may serve as a good option for the treatment of refractory and elderly ovarian cancer patients, for whom there exists very limited choice of treatment.

An Analysis of the Use of Complementary and Alternative Therapies in Patients with Breast Cancer.

BACKGROUND: The aim of the present study was to investigate the use of complementary and alternative medicine (CAM) and the factors that influence their use in patients with breast cancer. PATIENTS AND METHODS: This descriptive and cross-sectional study was carried out with 135 breast cancer patients on chemotherapy. RESULTS: 30.4% of patients admitted using one or more CAM methods. The most common method was herbal therapy (97.6%). There were statistically significant differences among CAM users and non-users in terms of time elapsed since initial diagnosis, current stage of the disease, and current type of therapy. As the time since the initial diagnosis increased, so did the percentage of CAM users. Those patients with advanced stage cancer or relapsed disease who were receiving palliative therapy used CAM methods more than those receiving adjuvant therapy. As far as quality of life was concerned, symptoms such as nausea and vomiting, dyspnea, and diarrhea were more common among CAM users. CONCLUSION: It is important and necessary that health professionals working in oncology clinics are made aware of the common use of CAM methods so that they can provide the necessary communication between patients and other health professionals on these treatment modalities.

HINTERGRUND: Ziel dieser Studie war es, die Anwendung komplementär- und alternativmedizinischer (CAM) Methoden sowie Faktoren, die deren Einsatz bei Brustkrebspatienten beeinflussen, zu untersuchen. PATIENTEN UND METHODEN: Die vorliegende beschreibende Querschnittsstudie wurde mit 135 chemotherapeutisch behandelten Brustkrebspatientinnen durchgeführt. ERGEBNISSE: 30.4% der Patientinnen gaben an, eine oder mehrere CAM-Methoden anzuwenden. Am häufigsten wurden kräutermedizinische Methoden eingesetzt (97.6%). Zwischen Benutzern und Nicht-Benutzern von CAM betanden statistisch signifikante Unterschiede bezüglich der Zeit seit Erstdiagnose, dem aktuellen Krankheitsstadium und der derzeitig angewendeten Therapieform. Mit wachsender Zeitspanne seit Erstdiagnose nahm auch der Anteil an CAM-Benutzern zu. Palliativ behandelte Patientinnen im fortgeschrittenen oder rezidivierten Stadium wendeten CAM häufiger an als adjuvant behandelte Patientinnen. In Bezug auf die Lebensqualität waren Symptome wie Übelkeit und Erbrechen, Dyspnoe und Durchfall unter CAM-Benutzern weiter verbreitet. SCHLUSSFOLGERUNG: Es ist wichtig und notwendig, dass sich in der Onkologie tätige Mediziner der Existenz von CAM-Methoden bewusst werden, so dass sie die nötige Kommunikation zwischen Patienten und Angehörigen anderer Gesundheitsberufe hinsichtlich dieser Behandlungsmodalitäten bereitstellen können.