Improvement In Cancer Patients Research Articles

Astragalus Injection Enhances the Sensitivity of Clinical Cancer Patients to Chemotherapy: A Systematic meta-Analysis

Background Traditional Chinese Medicine Astragalus was commonly used to assist chemo-drug treatment in clinical cancer patients. However, whether Astragalus injection (AGI) reverses drug resistance remains unclear. Therefore, a meta-analysis is necessary to assess the effect of AGI on resistance reversement in cancer patients. Method The studies presenting tumor response rates in cancer patients receiving chemo-drugs treatment in combination with AGI were systematically searched from six common scientific databases until February 2024. The relative risks (RRs) indicating the tumor response rate, 1-year survival rate, and quality of life improvement in clinical patients among two groups were calculated in metan package. The pooled RRs with 95% confidence intervals (CIs) were used to explore the effect of AGI on enhancing drug sensitivity in terms of tumor response, 1-year survival rate and quality of life improvement in cancer patients. Result Fifty-one studies were included for meta-analysis following a thorough screening process that adhered to the inclusion and exclusion criteria. A total of 4613 patients were enrolled in all included trials. Results obtained indicated that AGI significantly enhanced the sensitivity of cancers to chemo-drugs with pooled RRs (95% CI) of 1.25 (1.18, 1.32), prolonged the 1-year survival rate of patients with pooled RRs (95% CI) of 1.34 (1.14, 1.57), improved the quality of life with pooled RRs (95% CI) of 1.61 (1.34, 1.93). Similarly, Astragalus's main component, astragaloside polysaccharides (APS), also enhances drug sensitivity in clinical cancer patients. Conclusion Our findings demonstrated that AGI had the ability to resensitize cancers to chemo-drugs and improve the quality of life of cancer patients. Therefore, AGI could potentially be used as a drug resistance reversal for resistant cancer treatment.

Stress and cancer: The mechanisms of immune dysregulation and management.

Advances in the understanding of psychoneuroimmunology in the past decade have emphasized the notion that stress and cancer are interlinked closely. Durable chronic stress accelerated tumorigenesis and progression, which is unfavorable for clinical outcomes of cancer patients. Available evidence has provided unprecedented knowledge about the role and mechanisms of chronic stress in carcinogenesis, the most well-known one is dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). With abnormal activation of neuroendocrine system, stress-related hormones contribute to increased oncogenes expression, exacerbated chronic inflammation and impaired immunologic function. In addition, accumulating studies have demonstrated that diverse stress interventions including pharmacological approaches, physical exercises and psychological relaxation have been administered to assist in mental disorders reduction and life quality improvement in cancer patients. In this review, we systematically summarize the connection and mechanisms in the stress-immune-cancer axis identified by animal and clinical studies, as well as conclude the effectiveness and deficiencies of existing stress management strategies.

Prise en charge de la maladie thromboembolique veineuse chez le patient avec cancer

Venous thromboembolic events (VTE) consist of a frequent complication in cancer patients. Their incidence has increased during the last decennial, whatever the cancer site. Taking into account for the life expectancy improvement in cancer patients in general, and in patients with cancer and thrombosis, specifically, two issues should be considered for therapeutic strategy in cancer patients with VTE: first, the initial management of the VTE, second, the long-term treatment (beyond 6 months after the initial event). Literature data and current recommendations on VTE and cancer will be reviewed in this article.1877-1203/© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Aromatherapy with single essential oils can significantly improve the sleep quality of cancer patients: a meta-analysis

ObjectiveTo investigate the effect of aromatherapy on sleep quality in cancer patients.MethodsPublished literature on the effect of aromatherapy in cancer patients with sleep disorders in the form of randomized controlled trials (RCTs) were systematically retrieved and screened from PubMed, Cochrane Library, Embase, CBM, CNKI, VIP, and Wanfang databases from inception to November 2021. The methodological quality of the included studies was critically and independently evaluated by two reviewers using the Cochrane Risk of Bias Assessment Tool for RCTs. The correlated data were extracted using the pre-designed form, and all analyses were performed using Reviewer Manager version 5.4. Due to the difference in sleep quality instruments, the data extracted in this study were in the form of standard mean difference (SMD).ResultsTen RCTs included 933 patients (experimental group: 474, control group: 459), and the risk of bias in the included studies was moderate. Aromatherapy could significantly improve the sleep quality of cancer patients [SMD = − 0.79, 95% CI (− 0.93, − 0.66), p < 0.01], especially those with breast cancer [SMD = − 0.98, 95% CI (− 1.57, − 0.40), p < 0.01]. Aromatherapy with single essential oil had a better effect on sleep quality [SMD = -0.94, 95%CI (− 1.25, − 0.62), p < 0.01], of which lavender essential oil had the best effect [SMD = -1.06,95%CI (− 1.49, − 0.63), p < 0.01] while compound essential oils had no effect on sleep quality improvement in cancer patients [SMD = -0.21, 95%CI (− 0.57, 0.14), p = 0.23]. Four of the ten RCTs reported the occurrence of adverse events, of which only one RCT indicated that patients had headache and sneezing while the remaining six did not.ConclusionsThis meta-analysis of 10 RCTs reveals that aromatherapy with single essential oil had a substantial effect on the sleep quality of cancer patients and should be recommended as a beneficial complementary therapy to promote sleep quality in cancer patients.

Immune Checkpoints are Important Therapeutic Targets in Cancer Immunotherapy

Immunotherapy has become one of the greatest advances in medical oncology over the last century; however, the optimal application for the treatment of different types of cancer remains an active area of investigation. Modern immunotherapy strategies augment the immune system and ideally, permit durable tumor-specific immune memory to target and kill cancer cells. This era began when first immune checkpoint inhibitor, ipilimumab, was approved. In fact, several monoclonal antibodies that mediate the immune checkpoint receptors have provided the most clinically meaningful improvement for cancer patients to date. Checkpoint blockade as monotherapy has demonstrated some encouraging results, although some combination strategies appear to augment those responses and may be particularly effective when administered earlier in the course of disease. Additionally, we have also discussed previous and ongoing clinical studies testing individual or combination immunotherapy in cancer patients. Overall, the goal of this review is to provide a summary and current status of immune checkpoints and their inhibitors as therapeutic approaches of cancer immunotherapy and highlight promising future directions. Clinical Trials Registration Numbers: NCT00094653, NCT00257205, NCT01866319, NCT02142738, NCT02302807, NCT01903993, NCT02125461, NCT00732082, NCT01968109, NCT02061761, NCT02817633, NCT03489343, NCT04570839, NCT00298181, NCT00298168, NCT00876902, NCT03812328, NCT02812875, NCT04475523, NCT02768558, NCT02617589, NCT02039674, NCT02030834, NCT03545815, NCT03289962.

A Legal and Institutional Study on the Treatment Improvement in Cancer Patients

2020년 12월 24일 발표된 2017년 국가암등록통계 보건복지부·중앙암등록본부, “암 진단 후 5년 초과 생존자 100만 명 넘었다”, 2019, 12, 24일자 보도자료. 에 따르면 암 유병자 187만 명(전 국민의 3.6%)이며, 암발생률은 인구 10만 명 당 연령표준화발생률(이하 발생률)은 282.8명으로 전년 대비 6.6명(2.3%) 감소하였다. 이러한 암 발생률은 1999년 이후 2011년까지 연평균 3.7%씩 증가하다가, 2011년 이후 매년 약 2.6%씩 감소하고 있다. 우리나라 국민들이 기대수명(83세)까지 생존할 경우 암에 걸릴 확률은 37.4%였으며 남자(80세)는 5명 중 2명(39.8%), 여자(86세)는 3명 중 1명(34.2%)에서 암이 발생할 것으로 추정되고 있다. 국가암정보센터(https://www.cancer.go.kr/)- 암 발생율(검색일자: 2021. 7. 14.) 이러한 추세를 본다면 암은 결코 개인의 문제가 아닌 사회적인 문제로 인식되어야 하며 국가와 지방자치단체의 발 빠른 대처가 필요하다고 할 것이다. 이에 대해 국가에서는 「암관리법」을 규정하여 국가가 암의 예방과 진료 및 연구 등에 관한 정책을 종합적으로 수립ㆍ시행하고 있고 「호스피스ㆍ완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률」에 있어서 호스피스 완화의료 및 임종과정에 있는 환자의 대상자 중 암 환자를 대상으로 함으로서 암 환자의 연명의료결절에 있어서의 권리를 규정하고 있으나 실질적으로 암 환자의 처우를 개선하기 위한 입법적 도입이나 효율성 있는 정책은 한계점이 있다. 향후 암 환자의 증가가 명백히 예상되는 바, 처우를 개선하기 위한 국가 및 지방자치단체의 관리가 더욱 필요하다고 할 수 있다. 따라서 암 환자를 우리 사회에서 더욱 보호해야 될 대상인 사회적 약자로 인식하고, 암 환자의 처우개선을 위한 법적 근거를 바탕으로 국가 및 지방자치단체의 책무를 명시하고 암 환자 처우에 있어서 「암관리법」의 법률 정비를 통해 암 환자의 권리를 명시하여 처우개선에 있어서 근거 법률을 규정하여야 하며 현재 「암환자에 대한 의료비 지원기준 등에 관한 고시」의 암 환자의 재정적 지원에 관한 규정을 법률로서 명시하고 암환자를 사회적 약자로 규정하여 그에 대한 생계지원도 함께 이루어져야 한다. 또한, 암 환자 상담 및 관리를 위한 국가 및 지방자치단체에서 전문인력의 확충을 통해 다양한 복지처우를 제공하여야 하며 암 환자의 심리 치료 지원을 적극적으로 지원함으로서 암 환자의 처우 개선이 증대되며 향후 증가하는 암 환자를 관리함으로서 생존율을 높여 암 환자의 삶의 질 향상을 가져오게 될 것이다.

BET-Inhibitor I-BET762 and PARP-Inhibitor Talazoparib Synergy in Small Cell Lung Cancer Cells.

Small cell lung cancer (SCLC) is an aggressive type of lung cancer with high mortality that is caused by frequent relapses and acquired resistance. Despite that several target-based approaches with potential therapeutic impact on SCLC have been identified, numerous targeted drugs have not been successful in providing improvements in cancer patients when used as single agents. A combination of targeted therapies could be a strategy to induce maximum lethal effects on cancer cells. As a starting point in the development of new drug combination strategies for the treatment of SCLC, we performed a mid-throughput screening assay by treating a panel of SCLC cell lines with BETi or AKi in combination with PARPi or EZH2i. We observed drug synergy between I-BET762 and Talazoparib, BETi and PARPi, respectively, in SCLC cells. Combinatorial efficacy was observed in MYCs-amplified and MYCs-wt SCLC cells over SCLC cells with impaired MYC signaling pathway or non-tumor cells. We indicate that drug synergy between I-BET762 and Talazoparib is associated with the attenuation HR-DSBR process and the downregulation of various players of DNA damage response by BET inhibition, such as CHEK2, PTEN, NBN, and FANCC. Our results provide a rationale for the development of new combinatorial strategies for the treatment of SCLC.

The CINs of Polo-Like Kinase 1 in Cancer.

Simple SummaryMany alterations specific to cancer cells have been investigated as targets for targeted therapies. Chromosomal instability is a characteristic of nearly all cancers that can limit response to targeted therapies by ensuring the tumor population is not genetically homogenous. Polo-like Kinase 1 (PLK1) is often up regulated in cancers and it regulates chromosomal instability extensively. PLK1 has been the subject of much pre-clinical and clinical studies, but thus far, PLK1 inhibitors have not shown significant improvement in cancer patients. We discuss the numerous roles and interactions of PLK1 in regulating chromosomal instability, and how these may provide an avenue for identifying targets for targeted therapies. As selective inhibitors of PLK1 showed limited clinical success, we also highlight how genetic interactions of PLK1 may be exploited to tackle these challenges.Polo-like kinase 1 (PLK1) is overexpressed near ubiquitously across all cancer types and dysregulation of this enzyme is closely tied to increased chromosomal instability and tumor heterogeneity. PLK1 is a mitotic kinase with a critical role in maintaining chromosomal integrity through its function in processes ranging from the mitotic checkpoint, centrosome biogenesis, bipolar spindle formation, chromosome segregation, DNA replication licensing, DNA damage repair, and cytokinesis. The relation between dysregulated PLK1 and chromosomal instability (CIN) makes it an attractive target for cancer therapy. However, clinical trials with PLK1 inhibitors as cancer drugs have generally displayed poor responses or adverse side-effects. This is in part because targeting CIN regulators, including PLK1, can elevate CIN to lethal levels in normal cells, affecting normal physiology. Nevertheless, aiming at related genetic interactions, such as synthetic dosage lethal (SDL) interactions of PLK1 instead of PLK1 itself, can help to avoid the detrimental side effects associated with increased levels of CIN. Since PLK1 overexpression contributes to tumor heterogeneity, targeting SDL interactions may also provide an effective strategy to suppressing this malignant phenotype in a personalized fashion.

Taking a Full Snapshot of Cancer Biology: Deciphering the Tumor Microenvironment for Effective Cancer Therapy in the Oncology Clinic.

A bottleneck that is hindering therapeutics innovation in cancers is the current lack of integration of what we have learned in tumor biology as well as the tumor microenvironment (TME). This is because tumors are complex tissues composed of cancer cells, stromal cells, and the extracellular matrix (ECM). Although genetic alterations might cause the initial uncontrolled growth, resistance to apoptosis in cancer cells and stromal cells play additional key roles within the TME and thus influence tumor initiation, progression, therapy resistance, and metastasis. Therapies targeting cancer cells are usually insufficient when the stromal component of the TME causes therapy resistance. For innovation in cancer treatment and to take a full snapshot of cancer biology, anticancer drug design must, therefore, target both cancer cells and the stromal component. This expert review critically examines the TME components such as cancer-associated fibroblasts and ECM that can be reprogrammed to create a tumor-suppressive environment, thereby aiding in tumor treatment. Better cancer experimental models that mimic the TME such as tumor spheroids, microfluidics, three dimensional (3D) bioprinted models, and organoids will allow deeper investigations of the TME complexity and can lead to the translation of basic tumor biology to effective cancer treatments. Ultimately, innovative cancer treatments and, by extension, improvement in cancer patients' outcomes will emerge from combinatorial drug development strategies targeting both cancer cells and stromal components of the TME. Combinatorial treatment strategies can take the form of chemotherapy and radiotherapy (targeting tumor cells and stromal components) and immunotherapy that is able to regulate immune responses against tumor cells. This expert review thus addresses a previously neglected knowledge gap in cancer drug design and development by broadening the focus in cancer biology to TME so as to empower disruptive health care innovations in the oncology clinic.

Improving the breast cancer patient pathway using a consultant breast radiographer

Background: Adjuvant breast, nodal and chest wall radiotherapy comprises a significant workload of all radiotherapy centres. Improvement in cancer patients’ experience and reductions in waiting times are both factors at the forefront of NHS England’s drive to achieving world-class cancer treatment.1 Allied health professionals are increasingly being developed into specialty consultant roles to meet these targets.2 This skill mix is essential given the national consultant oncology work force challenge.3, 4

The day after: correlates of patient-reported outcomes with actigraphy-assessed sleep in cancer patients at home (inCASA project).

Subjective sleep assessment in cancer patients poorly correlates with actigraphy parameters that usually encompass multiple nights. We aimed to determine the objective actigraphy measures that best correlated with subjective sleep ratings on a night-by-night basis in cancer patients. Thirty-one cancer patients daily self-rated sleep disturbances using the single dedicated item of the MD Anderson Symptom Inventory (0-10 scale) with 18 other items, and continuously wore a wrist actigraph for 30 days. Objective sleep parameters were computed from the actigraphy nighttime series, and correlated with subjective sleep disturbances reported on the following day, using repeated measures correlations. Multilevel Poisson regression analysis was performed to identify the objective and subjective parameters that affected subjective sleep rating. Poor subjective sleep score was correlated with poor sleep efficiency (rrm = -0.13, p = 0.002) and large number of wake episodes (rrm = 0.12, p = 0.005) on the rated night. Multilevel analysis demonstrated that the expected sleep disturbance score was affected by the joint contribution of the wake episodes (exp(β) = 1.01, 95% confidence interval = 1.00 to 1.02, p = 0.016), fatigue (exp(β) = 1.35, 95% confidence interval = 1.15 to 1.55, p < 0.001) and drowsiness (exp(β) = 1.70, 95% confidence interval = 1.19 to 2.62, p = 0.018), self-rated the following evening, and sleep disturbance experienced one night before (exp(β) = 1.77, 95% confidence interval = 1.41 to 2.22, p < 0.001). The night-by-night approach within a multidimensional home tele-monitoring framework mainly identified the objective number of wake episodes computed from actigraphy records as the main determinant of the severity of sleep complaint in cancer patients on chemotherapy. This quantitative information remotely obtained in real time from cancer patients provides a novel framework for streamlining and evaluating interventions toward sleep improvement in cancer patients.

Interventional oncologic procedures for pain palliation

Cancer patients quite commonly will report different types of pain associated with the disease substrate. Systemic analgesia and radiotherapy provide only partial pain relief in the majority of these patients. Interventional Oncology techniques for pain management and mobility improvement in cancer patients include percutaneous techniques such as neurolysis, ablation and augmentation (both in the spine and peripheral skeleton) as well as trans-arterial embolization. Percutaneous neurolysis acts indirectly providing regional anesthesia whilst the rest of the aforementioned techniques act directly upon the tumor either by inhibiting local growth or by providing stability and skeletal augmentation. Whenever possible, techniques such as ablation and trans-arterial embolization apart from pure palliation may add to the principle of local tumor control. The aim of this review is to provide details concerning the Interventional Oncology techniques used for cancer pain management and to address the necessity for a tailored-based approach applying different techniques or combinations of them in different cases and locations.

RELAX: An immersion virtual reality relaxation intervention for quality of life improvement in cancer patients.

152 Background: Interventions that reduce symptom distress and enhance positive feelings are crucial for improving quality of life and, conceivably, overall survival of cancer patients. One remedy is the immersive virtual reality relaxation (VR-R) environment/s to inspire an emotion-focused coping mechanism in cancer patients. Herein, we report on our experience with the use of this VR-R intervention in normal volunteers and cancer patient volunteers. Methods: Fifty cancer patient volunteers underwent VR-R training and used the VR-R environment/s for 5 - 30 minutes. VR-R is a software-based simulation, which allows an individual to be placed inside an experience, hearing and interacting with stimuli that correspond with visual images of an artificial world. The VR equipment consists of the Oculus Rift Head Mounted Display (HMD) that enables play of an interactive scenario or game that patients can experience from a first-person perspective (i.e., upon entering the interactive scenario, participants are transported into a virtual, 3D world). After the immersion VR-R intervention, patients reported on their experience during the VR-R intervention by answering a QoL questionnaire created by IFGCURE/Cancer Center of Southern California/Sarcoma Oncology Center. Results: Eight of 50 (16%) patients experienced mild motion sickness as the only adverse event associated with its use. Table 1 shows the emotions that patients reportedly experienced during VR-R intervention. Conclusions: Taken together, the data support the premise that VR-R intervention is safe and may be efficacious in improving symptom distress and quality of life of cancer patients. A phase 1/2 study is planned to evaluate the safety and efficacy of the VR-R intervention in improving quality of life in a larger number of cancer patients. [Table: see text]

Consolidation and prediction of long-term treatment effect of group and online mindfulness-based cognitive therapy for distressed cancer patients

Background: Group face-to-face and individual internet-based mindfulness-based cognitive therapy (MBCT and eMBCT) have been demonstrated to reduce psychological distress for distressed cancer patients in a randomized controlled trial (RCT). This study focused on the long-term effects of this RCT during the nine-month follow-up period, and on possible predictors, moderators and working mechanisms.Methods: Distressed cancer patients (n = 245) were randomized to MBCT or eMBCT. Data were collected at baseline, post-treatment, three- and nine-month follow-up. Data were analyzed with linear mixed effect models and (hierarchical) linear regressions.Results: Analyses revealed long-term reductions in psychological distress and rumination, and long-term increases in positive mental health and mental health-related quality of life (QoL) in both interventions over the course of the nine-month follow-up. Interestingly, patients reported less psychological distress in the follow-up period after eMBCT in comparison to MBCT. Less psychological distress, rumination and neuroticism, and more extraversion and agreeableness at baseline predicted less psychological distress at the nine-month follow-up after both interventions. Less mindful and conscientious patients at baseline benefited more from eMBCT than from MBCT. Regarding working mechanisms, changes in mindfulness skills, fear of cancer recurrence and rumination during both interventions predicted less psychological distress at follow-up.Conclusions: Our findings suggest most improvements in cancer patients’ increase over time after both interventions. Furthermore, patients seemed to benefit more from eMBCT than MBCT based on psychological distress levels, especially those patients with low levels of mindfulness skills and conscientiousness.

ガンに対する低分子化フコイダンを中心とした統合医療の臨床改善報告 ～第5 報

ガンに対する低分子化フコイダンを中心とした統合医療の臨床改善報告 ～第5 報

Augmented Anticancer Efficacy by si-RNA Complexed Drug-Loaded Mesoporous Silica Nanoparticles in Lung Cancer Therapy

Lung cancer remains the major cause of death throughout the world. However, with the cutting-edge therapeutic approaches the patient’s survivability remains poor. Nanoparticle-mediated targeted gene therapy has surfaced globally for the therapeutic improvement in cancer patients. Recently, mesoporous silica nanoparticles (MSNs) have attracted much attention for the intracellular delivery of siRNA. Further codelivery strategy has been proposed to minimize the amount of each drug and to achieve the synergistic effect for cancer therapies. In the present investigation we explored the efficacy of codelivery of anticancer drugs along with survivin siRNA in the MSNs for a comparative therapeutic efficacy in lung cancer. Our results revealed such combinational approach has provoked enhanced therapeutic efficacy by synergistic drug activity while restraining the action of survivin protein. Thus, we anticipate this emerging approach may be quite beneficial for lung cancer therapy in future.

Clinical Improvement in Cancer Patients through Integrative Medicine Approach Mainly with Low-Molecular Fucoidan ~ The Six Report

Clinical Improvement in Cancer Patients through Integrative Medicine Approach Mainly with Low-Molecular Fucoidan ~ The Six Report

Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels.

BackgroundPain management has been considered as significant contributor to broad quality-of-life improvement for cancer patients. Modulating serum cholesterol levels affects analgesia abilities of opioids, important pain killer for cancer patients, in mice system. Thus the correlation between opioids usages and cholesterol levels were investigated in human patients with lung cancer.MethodsMedical records of 282 patients were selected with following criteria, 1) signed inform consent, 2) full medical records on total serum cholesterol levels and opioid administration, 3) opioid-naïve, 4) not received/receiving cancer-related or cholesterol lowering treatment, 5) pain level at level 5–8. The patients were divided into different groups basing on their gender and cholesterol levels. Since different opioids, morphine, oxycodone, and fentanyl, were all administrated at fixed low dose initially and increased gradually only if pain was not controlled, the percentages of patients in each group who did not respond to the initial doses of opioids and required higher doses for pain management were determined and compared.ResultsPatients with relative low cholesterol levels have larger percentage (11 out of 28 in female and 31 out of 71 in male) to not respond to the initial dose of opioids than those with high cholesterol levels (0 out of 258 in female and 8 out of 74 in male). Similar differences were obtained when patients with different opioids were analyzed separately. After converting the doses of different opioids to equivalent doses of oxycodone, significant correlation between opioid usages and cholesterol levels was also observed.ConclusionsTherefore, more attention should be taken to those cancer patients with low cholesterol levels because they may require higher doses of opioids as pain killer.Electronic supplementary materialThe online version of this article (doi:10.1186/s12944-016-0212-9) contains supplementary material, which is available to authorized users.

Clinical Improvement in Cancer Patients through Integrative Medicine, Mainly with Low-Molecular Weight Fucoidan

Clinical Improvement in Cancer Patients through Integrative Medicine, Mainly with Low-Molecular Weight Fucoidan

Clinical Improvement in Cancer Patients through Integrative Medicine Supplemented Mainly with Low-Molecular Fucoidan

Clinical Improvement in Cancer Patients through Integrative Medicine Supplemented Mainly with Low-Molecular Fucoidan