The Use of Granulocyte Colony-Stimulating Factor as Primary Prophylaxis in Patients Undergoing Chemotherapy: An Experience of Moroccan Oncologists.

Febrile neutropenia (FN) is a frequent and serious emergency for oncologic patients undergoing chemotherapy. Using granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis of febrile neutropenia is an integral part of the management of cancer patients. Our study aims to identify the challenges that prevent Moroccan oncologists from prescribing G-CSF for primary prevention. Seventy doctors participated in our study, with a participation rate of 35.35%. Twenty-two participants had at least five years of experience in oncology. Most participants were medical oncologists (82.9%), and two-thirds of them practiced in teaching hospitals. Regarding the use of G-CSF in primary prevention, all participants complied with the recommendations for FN risk assessment and the prescription of G-CSF for prophylaxis in patients at high risk of FN (>20%). However, their use in intermediate-risk patients remains limited mainly by the cost of these drugs (45.7% of participants). FN remains a dreadful complication in oncology. Since the introduction of G-CSF into standard oncology practice, particularly in primary prevention, the management of certain patients has improved considerably. Nevertheless, the indications for G-CSF in our context, essentially in intermediate-risk patients, are uncertain.

Eighteen Years of Medical Oncology in Morocco: A Bibliometric Evaluation.

Medical publications constitute an essential tool for sharing scientific advances in the medical field. They are also an educational tool of great significance in initial medical training, and also in further medical education. These publications are necessary to ensure an interface between the researchers and members of the medical scientific community, who are always looking for the correct and optimal treatment for their patients. Several golden rules have been laid out in terms of assessing the improvement in scientific productivity, namely the quality of the subject, the type of publication, the publication review and its impact factor, and the establishment of international collaborations. Bibliometrics is a quantitative and qualitative analysis of scientific publications, which aids in assessing the scientific productivity of a community or a scientific institution. To the best of our knowledge, this is the first bibliometric study to evaluate the scientific productivity in the field of medical oncology in Morocco.

Primary Squamous Cell Carcinoma of the Sigmoid Revealed by Acute Intestinal Occlusion in Moroccan Young Male Patient: A Case Report and Literature Review.

Primary colorectal squamous cell carcinoma (SCC) is an extremely rare subtype of colon cancer, with an incidence of less than 1% of colorectal malignancies. We report a case of a 40-year-old male patient admitted to the emergency department with symptoms of acute intestinal obstruction. Histopathological evaluation of colonoscopic biopsies revealed squamous cell carcinoma. A sigmoidectomy was performed. In order to enrich the medical literature, we add our case to the collection of colorectal squamous cell carcinoma cases by analyzing and summarizing the clinical, pathological, and therapeutic features of this rare entity.

Granulosa tumor: two spontaneous pregnancies after combined medico-surgical treatment: case report and review of the literature.

BACKGROUND: Granulosa tumor is a rare tumor that arises from the mesenchyme and the sexual cord of the ovary. The prognosis is generally excellent, and treatment is mainly based on surgery, followed by chemotherapy depending on the extension of the disease. However, "the obstetrical prognosis" is compromised. CASE PRESENTATION: We report the case of a 32-year-old Caucasian patient who was diagnosed during a primary infertility assessment with an ultrasound image of a 39 mm organic left ovarian cyst confirmed on pelvic magnetic resonance imaging with infiltration of the uterosacral space. Tumor markers, including cancer antigen 125, alpha fetoprotein, and ß-human chorionic gonadotropin, were normal. Histological study of biopsies of the ovarian lesion taken during exploratory laparoscopy confirmed the diagnosis of adult granulosa tumor. After a normal extension assessment including a thoracoabdominopelvic computed tomography scan and a positron emission tomography scan, the patient underwent complete conservative surgery and the disease was classified as stage Ic. Three cycles of adjuvant chemotherapy according to the "BEP" protocol combining bleomycin, etoposide, and cisplatin were performed after oocyte cryopreservation. After a 5-year follow-up period, the patient had no sign of tumor progression and had two spontaneous pregnancies, the first occurring 3 months after the end of chemotherapy and the second 14 months later. CONCLUSION: Granulosa cell tumor remains a rare tumor whose management considerably compromises fertility and reduces the chances of having a spontaneous pregnancy. The particularity of our observation is that the diagnosis of the granulosa tumor was made following a primary infertility assessment and that the patient had two spontaneous pregnancies 3 months after the end of a medico-surgical treatment known to be very gonadotoxic.

HER2-Positive Metastatic Breast Cancer: Available Treatments and Current Developments.

For several years, the overexpression of the HER2 receptor in breast cancer has been correlated with a poor prognosis and an increased risk of developing brain metastases. Currently, the combination of anti-HER2 double blockade and taxane and trastuzumab emtansine (T-DM1) are considered the standard treatments for metastatic breast cancer overexpressing these receptors in the first and second line. Very recently, the development of a new antidrug conjugate, trastuzumab-deruxtecan, has improved the overall survival of patients, even in second-line treatment. However, trastuzumab-deruxtecan has become a new standard. Despite the benefits of these antidrug conjugates, this benefit in patients with brain metastases remains unclear. Tucatinib is a new tyrosine kinase inhibitor that has given hope for the treatment of these patients. The objective of this article was to review data on the established drugs and novel agents for HER2-positive MBC and to discuss how to incorporate anti-HER2 therapies in first and later-line settings.

Unusual penile localization of melanoma.

Penile's melanoma is a rare situation, often associated with late diagnosis and high morbidity and mortality. We report the case of a 70-year-old man. He represented progressive skin lesions of the penile gland. A surgical biopsy with histopathological and immunohistochemical studies established the diagnosis of malignant melanoma of the penis in the metastatic stage. This case was managed by palliative immunotherapy and is currently under treatment by Pembrolizumab. Malignant melanoma of the penis represents an exceptional situation, in which only rapid diagnosis at an early stage allows treatment with optimal therapeutic results.

Hepatic Metastasis Revealing a Melanoma of the Penis: Case Report.

Melanoma of the penis is a rare tumor with a poor prognosis. We report the case of a 73-year-old patient with no significant medical history, admitted for deterioration of the general condition and bilateral inguinal lymph nodes. An abdominal ultrasound and thoraco-abdomino-pelvic CT (computed tomography) scan revealed metastatic liver nodules, the tumoral nature of which was confirmed by an anatomopathological examination. Further clinical examination revealed papular and ulcerated lesions of the penis located at the urethral meatus and glans penis. These lesions were biopsied and histologically assessed as melanoma. The contribution of imaging in penile tumors is generally not useful for diagnosis as clinical examination is key. However, it has its place in the assessment of locoregional and distant extension. In our case, it was the distant lesions that helped orient the diagnosis. The patient underwent immunotherapical treatment and is still alive 19 months after the diagnosis.

Factors influencing Quality of life in Moroccan patients with cancer: A monocentric Prospective study.

BACKGROUND: Cancer as a chronic and serious disease affects the quality of life (QoL) of patients, which has increasingly become a major challenge at the heart of cancer management. The purpose of our study was to define the most involved factors in the degradation of QoL in cancer patients. MATERIALS AND METHODS: We conducted a prospective, mono-centric, qualitative and descriptive study carried out within the medical oncology department of the Ibn Sina Military Hospital spread over six months between January and June 2019. RESULTS: Of the 100 patients included, 58% were male with a median age of 54.42 years. 90% were married, 39% were illiterate and 43% were retired while 99% of patients had social coverage. Breast cancer was the most common in 29%. More than 54% of the patients included had localized cancer while 38% were metastatic. The Pain was estimated to be greater than or equal to six on the Visual Analog Scale (VAS) in 23%. In 78% of the cases, chemotherapy was indicated in these patients and treatment with psychotropic drugs was initiated only in 2% of the patients. The analytical study showed that most of the patients had a slightly degraded QoL 63% with a large participation of the psychic dimension, followed by the physical and spiritual dimension while the socioeconomic dimension came last. It was established a clear correlation between the QoL and certain socio-demographic factors (sex, marital status, level of education), and significant correlation with some factors related to the disease (a type of cancer, stage, and treatment received). CONCLUSION: We tried to assess the impact of cancer and to identify factors affecting the QoL of patients to guide the establishment of the support structure and accompanying devices.

Managing cancer care during the COVID-19 pandemic: brief report from a North African single center.

The potential threat of COVID-19 pandemic on the continuity of care for cancer patients is thought to be significant. Oncologists are weighing up the balance of risks and benefits carefully when planning daily cancer care and making treatment decisions in the face of rapid change during this public health crisis. This report describes management strategies and care models that have been adopted by a single Medical Oncology department in a North Africa, Morocco.