RESUMO
Radiation-induced coronary artery disease (RICAD) poses a serious concern for cancer patients post radiotherapy, typically emerging after over a decade. Immune checkpoint inhibitors (ICIs), known for cardiotoxicity, are increasingly recognized for causing cardiovascular complications. Here we report the case of a 63-year-old man with metastatic lung cancer who developed coronary artery disease during his third-line therapy with an ICI (nivolumab) and an antiangiogenic agent (bevacizumab), 3 years post chest radiotherapy. Angiography revealed relatively isolated stenosis in the left main coronary artery ostium, consistent with the radiotherapy site, with no other risk factors, suggesting RICAD. The potential for ICIs to accelerate RICAD development should be considered and necessitates careful surveillance in patients receiving both radiotherapy and ICIs.
Sometimes cancer patients receive a type of treatment called radiotherapy, which uses high-energy beams to target the cancer. This treatment is very helpful, but when applied to the chest, it can cause problems in the blood vessels of the heart many years later, a condition called radiation-induced heart disease. This report is about a 63-year-old man who developed this heart problem much sooner than usual, just 3 years after receiving radiation treatment for lung cancer. Alongside radiotherapy, he also received two advanced kinds of cancer treatments. One helped his immune system to better identify and fight the cancer, and the other worked to stop the cancer from getting the blood supply it needs to grow. Our report suggests that these new treatments may interact with radiotherapy in a way that causes heart problems more quickly. This is especially important to consider in patients without previous heart problems. Our findings remind doctors to closely monitor the heart health of patients receiving these treatments and point to the need for more research into how these treatments may affect the heart when used together.
Assuntos
Doença da Artéria Coronariana , Masculino , Humanos , Pessoa de Meia-Idade , Inibidores de Checkpoint Imunológico/efeitos adversos , Radioimunoterapia , Inibidores da Angiogênese , BevacizumabRESUMO
BACKGROUND: SLC20A1, a prominent biomarker in several cancers, has been understudied in its predictive role in head and neck squamous cell carcinoma (HNSCC). METHODS: The Cancer Genome Atlas (TCGA) database was used to analyze HNSCC prognosis, SLC20A1 overexpression, and clinical characteristics. Quantitative real-time PCR and Western blot analysis confirmed SLC20A1 expression in HNSCC tissues. Cellular behaviors such as invasion, migration and proliferation were assessed using Transwell, wound healing and colony formation assays. Immune system data were obtained from the Tumor Immune Estimation Resource (TIMER) and CIBERSORT databases. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) were used to explore biological parameters and pathways associated with SLC20A1 overexpression in HNSCC. RESULTS: In 499 HNSCC samples, SLC20A1 mRNA and protein expression were significantly higher than in 44 normal counterparts, confirmed by 24 paired samples. Patients were categorized based on SLC20A1 levels, survival status and overall survival. High SLC20A1 expression correlated with advanced T stage, increased risk scores and decreased survival. Stage, age and SLC20A1 expression emerged as independent predictive factors for HNSCC in univariate and multivariate analyses. SLC20A1 overexpression, which is associated with poor prognosis, may influence cell proliferation, migration, invasion, chemotherapy response, and the immune milieu. CONCLUSIONS: SLC20A1 overexpression in HNSCC, characterized by increased cellular invasion, migration and proliferation, is a potential prognostic biomarker and therapeutic response indicator.
Assuntos
Neoplasias de Cabeça e Pescoço , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Prognóstico , Neoplasias de Cabeça e Pescoço/genética , Estudos Prospectivos , Biomarcadores Tumorais/genética , Proteínas Cotransportadoras de Sódio-Fosfato Tipo IIIRESUMO
Granular cell tumor of the breast (GCTB) is a rare tumor, particularly in lactating women. This tumor can clinically and radiologically mimic breast carcinoma, which poses particular problems. The association between GCTB and sex hormones should receive particular attention. The present study reports a case of GCTB in a lactating patient. In this tsudy, the case of a 29-year old female who presented with a mass in the right breast is decribed. Immunohistochemical and cytological analysis revealed a GCT and subsequently wide local excision was performed. At 15 months following surgery, the patient is well and no tumor recurrence has been identified. A comprehensive review of the literature was also performed to assess and compare all cases of GCTB, with particular attention to hyperestrogenic and hyperprolactinemic states. Further studies are required to explore the association between granular cell tumors and hyperestrogenic and hyperprolactinemic states.