Levels In Cancer Patients Research Articles

Machine-learning-based Analysis Identifies miRNA Expression Profile for Diagnosis and Prediction of Colorectal Cancer: A Preliminary Study.

The stage of colorectal cancer (CRC) at the day of diagnosis has the greatest influence on survival rate. Thus, for CRC, which is mainly identified as advanced disease, non-invasive, molecular blood or stool tests could boost the diagnosis and lower mortality. Evaluation of miRNA expression levels in serum of patients diagnosed with CRC is a potential tool in early screening. Screening can be supported by machine learning (ML) as a tool for developing a cancer risk predictive model based on genetic data. miRNA was isolated from the serum of 8 patients diagnosed with CRC and 10 patients from a control group matched for age and sex. The expression of 179 miRNAs was determined using a serum/plasma panel (Exiqon). Determinations were conducted using real-time PCR technique on an Applied Biosystems QuantStudio3 device in 96-well plates. A predictive model was developed through the Azure Machine Learning platform. A wide panel of 29 up-regulated miRNAs in CRC were identified and divided into two subgroups: 1) miRNAs with significantly higher serum level in cancer patients vs. controls (24 miRNAs) and 2) miRNAs detected only in cancer patients and not in controls (5 miRNAs). Re-analysis of published miRNA profiles of CRC tumours or CRC exosomes revealed that only 2 out of 29 miRNAs were up-regulated in all datasets including ours (miR-34a and miR-25-3p). Our research suggests the potential role of overexpressed miRNAs as diagnostic or prognostic biomarkers among CRC patients. Such clustering of miRNAs may be a potential direction for discovering new diagnostic panels of cancer (including CRC), especially using ML. The low correspondence between deregulation of miRNAs in serum and tumour tissue revealed in our study confirms previously published reports.

The allergy mediator histamine confers resistance to immunotherapy in cancer patients via activation of the macrophage histamine receptor H1.

Reinvigoration of antitumor immunity remains an unmet challenge. Our retrospective analyses revealed that cancer patients who took antihistamines during immunotherapy treatment had significantly improved survival. We uncovered that histamine and histamine receptor H1 (HRH1) are frequently increased in the tumor microenvironment and induce Tcell dysfunction. Mechanistically, HRH1-activated macrophages polarize toward an M2-like immunosuppressive phenotype with increased expression of the immune checkpoint VISTA, rendering Tcells dysfunctional. HRH1 knockout or antihistamine treatment reverted macrophage immunosuppression, revitalized Tcell cytotoxic function, and restored immunotherapy response. Allergy, via the histamine-HRH1 axis, facilitated tumor growth and induced immunotherapy resistance in mice and humans. Importantly, cancer patients with low plasma histamine levels had a more than tripled objective response rate to anti-PD-1 treatment compared with patients with high plasma histamine. Altogether, pre-existing allergy or high histamine levels in cancer patients can dampen immunotherapy responses and warrant prospectively exploring antihistamines as adjuvant agents for combinatorial immunotherapy.

The Impact of COVID-19 on Anxiety Levels of Cancer Patients

The Impact of COVID-19 on Anxiety Levels of Cancer Patients

Properties and functions of TP/PD-ECGF — enzyme and angiogenic factor in norm and in neoplastic pathology

Thymidine phosphorylase is a protein which may has a dual action: it is a rate-limiting enzyme in thymidine metabolism and it is similar to the platelet – derived endothelial cell growth factor (PD/ECGF). The enzyme catalyzes the reversible reaction of phosphorolytic cleavage of thymidine to thymine and deoxyribose-1-phosphate. It has been found that TP has higher activity in tumor tissues. Also it is involved in a proliferative process in a wide variety of chronic inflammatory diseases. Increased expression of PD/ECGF in many tumors is associated with aggressive disease and/or poor prognosis. Its known that high TP activity is related to malignant angiogenesis and invasion.
 On the other hand, TP inhibits a hypoxia induced apoptotic pathway and enhances expression of various inflammatory cytokines and interferons. This apparent role of enzyme in tumor progression has prompted investigation a large number of TP inhibitors for applicability in chemotherapy backbone regimens. The enzymatic activity of PD/ECGF is being able to generate 5-fluorouracile from capecitabine and other precursors. Thus TP is identified as a prime target for developing novel anticancer therapies. The serum TP level in cancer patients provides useful prognostic information regarding both responses to chemotherapy and length of survival and should be used in planning appropriate therapy. TP could be suggested that control of individual enzyme activity in blood serum may be used as informative tool for monitoring of patients and treatment optimization.

Somatic distress, mental health and psychological resilience among cancer patients during the Covid-19 pandemic

We aimed to investigate the somatic distress and psychological symptoms levels of cancer patients, and analyze the influencing factors on somatic distress during COVID-19 pandemic. This cross-sectional study included 216 eligible cancer patients. The Patient Health Questionnaire-15, Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5, The Depression, Anxiety and Stress Scale-21, the Brief Resilience Scale, the Stressful Life Events List due to Pandemic were administered to the participants. The moderate to severe somatic distress rate was % 38 and probable PTSD rate was 20.4%. Depression, anxiety and stress symptoms were 36.1%, 49.1% and 45.4%, respectively, from mild to extremely severe. There were substantial association between somatic symptoms severity and high PTSD, anxiety, depression, and stress symptoms levels. Low education, high anxiety levels, high experience stressful life events, and low psychological resilience predicted high somatic distress. This study demonstrates the high risk of somatic distress, PTSD, depression, anxiety and stress in patients with cancer during the pandemic. In addition, somatic distress may indicate high levels of psychological symptoms, high experience stressful life events, and low psychological resilience. It underscores the need to assess psychological status during the pandemic, especially those with high level somatic symptoms.

Relationship between LDH and Mg in Monitoring of Hematological and Non-Hematological Malignant Diseases

Relationship between LDH and Mg in Monitoring of Hematological and Non-Hematological Malignant DiseaseAurelian Udristioiu,Titu Maiorescu University of Bucharest, Faculty of Medicine, Department of Molecular BiologyABSTRACTBackgroundMagnesium, which is the second most abundant into-cellular cation after potassium, plays a key role in regulating many cellular functions and enzymes, including ion channels, metabolic cycles, and signaling pathways.Aim of this study was to evaluate the correlation between the serum levels of lactate dehydrogenase (LDH) and magnesium (Mg) in patients diagnosed with hematological and non-hematological malignant diseases.MethodWe analyzed a cohort of patients (n = 75) comprising males (n = 36) and females (n =39) with a mean age of 57 years, who had cancer and were admitted to the oncology department. The biochemical parameters were measured running a Vitros 250 dry chemistry analyzer (Johnson & Johnson, USA) using the slides for multi-layer spectro-photometry measurements.These patients were closely monitored twice a week during treatment with specific cytostatic drugs and once a week during consolidation therapy, using specific tests for different types of cancer. In addition, with the cooperation of physicians and patients, they were performed along with hematological and biochemical tests, CBC with differential count and LDH and serum Mg levels, which can serve as markers for monitoring the progression of malignancies.Among the patients, 5 patients were diagnosed with lung cancer, 11 patients were diagnosed with breast cancer, 14 patients were diagnosed with colorectal cancer, 43 patients were diagnosed with chronic lymphocytic leukemia (CLL), 1 patient was diagnosed with acute promyelocytic leukemia (LAM-3) and 1 patient was diagnosed with chronic monocytic leukemia (CML).The CBC with the differential count, biochemistry samples, body radiography, ultrasound and computed tomography (CT) were used for the patient to establish the type of cancer diseases. An initial panel of monoclonal antibodies was used to determine the immune phenotypes of the subgroups of differentiated T cells and B cells. The diagnosis of LAM-3 was made based on blood smears, the examination of bone marrow (BM) aspirates, the evaluation of promyelocytes, (greater than 30% in BM), and the presence of a specific immune phenotype.ResultsThe results were interpreted for each patient based on medical history, clinical and para-clinical examinations and other signs of malignant diseases. Among the patients in this study, 55 patients (73%) exhibited normal serum levels of Mg (normal range value = 1.60-2.3 mg/dL; mean value = 2.2 mg/dL; SD = 0.2; p = 0.02) following cancer therapy. Six patients (8%) exhibited low levels of Mg (range = 0.60-1.50 mg/dL; mean value = 1.05 mg/dL). However, 12 patients (16%) displayed high levels of serum Mg (range =2.6-3.27 mg/dL; mean value = 2.89 mg/dL). The levels of serum lactic dehydrogenase (LDH) were also evaluated in patients newly diagnosed with cancer and in patients with unfavorable responses to the cancer therapy (range = 240-1330 U/L; mean value = 787 U/L; SD =1.33; p = 0.002; normal values 135-225 U/L), (Table 1).DiscussionsThe serum Mg level is increased via Mg²+ release from malignant tissues in patients with malignant disease prior to treatment with cytostatic drugs. In the different malignant diseases, the serum Mg values were high, normal or low, independent of the serum LDH values. The LDH levels remained elevated after initial cytostatic treatment until cancer remission.The number of chromosome copies in malignant tumors can be correlated with the total serum LDH values. LDH levels in cancer patients are elevated due to high levels of LDH-3 isoenzyme in patients with malignancies and high levels of LDH-4 and LDH-5 isoenzymes, elevated patients with cancer of liver, muscle, lung and tissue tissues. conjunctive. High concentrations of serum LDH damage the cell membrane. Thereafter, malignant cells become invasive and metastasizes.ConclusionsNormal levels of Mg with moderately increased LDH levels were observed in all patients who had cancer that was in the regression phase following good responses to a specific cancer therapy. Low levels of Mg with high levels of serum LDH were observed in all patients with poor prognosis and metastases. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

The effects of chemotherapy-induced alopecia on cancer patients’ distress

Background: Hair is a human characteristic, which has an important role in presenting the individual gender, race, nation, social interaction as well as mental and physical health status. Chemotherapy-induced alopecia (CIA), which has an incidence of 65%, is known to be one of the most psychological shocks among cancer patients. Chemotherapy-induced Alopecia Distress Scale (CADS) created by a group of Korean scientists is a new tool developed to evaluate alopecia’s effects on patients’ mentality. It is necessary to investigate the effects of alopecia on cancer patients and to understand the demands of patients in coping with CIA. However, to our knowledge, this is a topic that is still lacking objective and scientific evidence in Hue, Vietnam. Therefore, we conducted the study to describe the alopecia characteristics of patients treated with chemotherapy, and to identify the distress level of cancer patients using CADS and the preference of patients to deal with the alopecia. Methods: A cross-sectional study was conducted on 56 cancer patients undergoing chemotherapy at the Oncology department of Hue University of Medicine and Pharmacy Hospital from 01/12/2020 to 25/03/2021. The hair loss grade was assessed by CTCAE and the level of distress was evaluated by CADS. Statistical analysis was performed in Microsoft Excel 2016 and the R 3.6.0 program. Results: The mean age of patients in our study was 56.48 ± 10.244. Of all 56 patients, the majority of participants were female (69.6%), married (82.1%), and had above-average economic status (67.9%). Breast cancer patients accounted for the highest percentage with 39.3%. Most of the patients were in grade III (32.1%) and grade IV (39.3%). Our study revealed that 82.1% of patients having hair loss at grade 2 according to CTCAE 5.0. Evaluating by CADS showed that 87.5% of participants experienced low distress. Hat/ headscarf and wig were the most popular coping strategy against the CIA (66.1% and 35.7%, respectively). Scalp cooling is a new method that can prevent the CIA effectively. A proportion of 41.1% was willing to try the scalp cooling systems. Conclusions: Alopecia grade 2 accounted for the majority of patients in our study (82.1%). This was a symptom that should be concerned, however, our study revealed that the alopecia’s effects were not so serious among patients in the study. Most of the patients did not worry about chemotherapy - induced alopecia (89.3%), and 87.5% of participants experienced low distress, while there was still a proportion of 12.5% with higher distress. To cope against alopecia, many feasible coping strategies have been used by patients, including hat/ headscarf or wig.

P12.02 Systemic Anticancer Therapy Upregulate Plasma Levels of Damage-Associated Molecular Patterns in Patients With Advanced Lung Cancer

Immunogenic cell death (ICD) characterized by the release of damage-associated molecular patterns (DAMPs) from dying cancer cells may contribute to the synergistic antitumor effect of cytotoxic chemotherapy combined with an immune checkpoint inhibitor. The kinetics of circulating DAMP levels in cancer patients have remained largely uncharacterized, however.

MicroRNA 142-5p promotes tumor growth in oral squamous cell carcinoma via the PI3K/AKT pathway by regulating PTEN

MicroRNAs (miRNAs) play an important role in carcinogenesis and cancer progression. The purpose of this study was to identify miRNAs associated with carcinoma function in OSCC and to investigate the potential role of the specific miRNAs. First, a comprehensive microarray analysis was performed, and miR-142-5p was identified as a candidate miRNA involved in OSCC. miR-142-5p has been reported to show high expression levels in cancer patients and to be involved in tumor growth and metastasis. However, the expression and function of miR-142-5p in oral squamous cell carcinoma (OSCC) are not fully characterized. We evaluated miR-142-5p expression in both OSCC-derived cell lines and primary OSCC tissues and performed functional analysis of miR-142-5p in OSCC-derived cell lines using mimics and inhibitors. miR-142-5p expression was up-regulated in OSCC tissues and OSCC cell lines. Overexpression of miR-142-5p significantly promoted the proliferation and invasion of OSCC cells. Bioinformatics analysis was performed using TargetScan to predict potential target sites that match the seed region of miR-142-5p. Phosphatase and tensin homolog deleted on chromo-some 10 (PTEN) was identified as a potential target and selected for further analysis. PTEN expression levels were down-regulated and AKT expression levels were up-regulated in miR-142-5p-overexpressing cells. We have shown that miR-142-5p targets the PTEN gene and is involved in cancer progression. Our results suggest that miR-142-5p is involved in the progression of OSCC by controlling the phosphatidylinositol 3-kinase (PI3K)/AKT pathway by targeting the PTEN gene. Our findings suggest that miR-142-5p may be a new target for the treatment of OSCC.

Relationship between hope and fatigue levels in cancer patients

Aim: The aim of the present study is; to determine the relationship between fatigue and hope levels in cancer patients. 
 Material and Method: The study was conducted as a descriptive study. Data were collected using Socio-Demographic Data Qestionnaire, Herth Hope Index, Brief Fatigue Inventory (BFI). The questionnaires were filled outthrough face-to-face interviews. 
 Results: 213 cancer patients with 50.23% 21-54 years of age were taken into the study. There was no significant relationship between fatigue status of patients and sociodemographic variables. However, a significant correlation was found between the score of hope and the time after diagnosis(KW =2.608; p=0.053). In our study, the difference between mean score of hope level and gender, age,marital status, educational status and employment was not statistically significant. 
 Conclusions: There was a significant negative correlation between fatigue and hope total scores of the patients. This shows us that the management of fatigue during the illness and treatment positively affects the hope and patients are struggling with their disease. it is suggested that the diagnosis of fatigue and hope levels of the patients from the diagnosis and the planning of the attempts to manage them can be suggested.

1612P The impact of COVID-19 pandemic on distress level in cancer patients, a cross-sectional multicentric study

The pandemic of coronavirus disease 2019 (COVID-19) was declared in March 2020. The first wave of the pandemic was marked by strict epidemiological measures: lockdown, social distancing, and self isolation. Cancer patients receiving systemic oncology treatments were considered a high-risk population regarding COVID19. These new circumstances posed possible obstacles for the treatment continuation, which in turn potentially led to an increase in distress. This study aimed to examine the impact of COVID-19 outbreak on a distress level among cancer patients.

Anemia in cancer patients

Anemia is a common feature in c.40% of patients at the time of cancer diagnosis and in more than half of patients undergoing anticancer therapy. Cancer-related anemia does have an unfavourable impact on the functional capacity of the relevant tissue and organs. Its pathogenesis is complex and often difficult to identify. Symptoms related to cancer and chemotherapy-induced anemia may have a negative impact on the quality of life and may influence treatment efficacy, disease progression and even survival. Moreover, anemia causing tumor hypoxia leads to tumor progression through the increase of local tumor expansion and spreading of metastases. Tumor hypoxia directly or indirectly confers resistance to irradiation, some chemotherapeutic drugs, and photodynamic therapy. Therapeutic alternatives in cancer patients with anemia include the substitution of the lacking agents, red blood cell (RBC) transfusions, iron supplementation, and erythropoiesis-stimulating agents (ESAs). Using ESAs reduces the need for red blood cell transfusions, decreases the risk of post-transfusion adverse reactions, and improves the quality of life for cancer patients with chemotherapy-induced anemia. The immediate administration of RBC transfusions is justified in patients with hemoglobin (Hb) under 7–8 g/dL and/or severe anemia-related symptoms (even at higher Hb levels) and who require immediate Hb and symptom improvement. Therefore, clinical evidence supports the need to closely monitor Hb level in cancer patients. Anemia should be corrected to improve chemo- and radiosensitivity and the quality of life.

Effect Of Spiritual Emotional Freedom Technique (SEFT) On The Decrease In Anxiety Levels In Cancer Patients


 According to WHO 2013 data, every year the number of cancer patients in the world increases, the incidence of cancer is increasing from 12.7 million cases in 2008 to 14.1 million cases of 2012. The diagnosis of cancer is daunting for the patient and can affect the patient's psychological conditions especially anxiety. This anxiety is common because of the financial problems, diseases of symptoms, concerns about healing, concerns that can not run function as humans maximally, and may affect the prognosis of disease that should be good, but becomes otherwise. The harassment of nonfarmochalate anxiety is by distraction and relaxation one of them is a Left. This study aims to determine the effect of theft of left therapy on the decline of anxiety in cancer patients. Research methods using experimental pre-design by using the type of One Group Pre-test post-test design, with purposive sample technique and using the t-paired test of Wilcoxon test alternative. The results of the research obtained that the level of anxiety of respondents before the soft therapy is the average anxiety is as much as 11 people (73.3%). While the rate of anxiety of respondents after the seft therapy is the average of lightweight anxiety as many as 14 people (93.3%). From the results of the Wilcoxon test is obtained there is the effect of giving the seft to the decrease in anxiety level in cancer patients with value ρ value = 0,002 (ρ <0.05). The conclusion of this research is there is an enhanced influence between the spiritual therapy of the Emotional Freedom Technique (Seft) to the decline in anxiety level in cancer patients at Griya Al-Afiat clinics.

YKL-40 protein expression in human tumor samples and human tumor cell line xenografts: implications for its use in tumor models

BackgroundYKL-40, also known as non-enzymatic chitinase-3 like-protein-1 (CHI3L1), is a glycoprotein expressed and secreted mainly by inflammatory cells and tumor cells. Accordingly, several studies demonstrated elevated YKL-40 serum levels in cancer patients and found YKL-40 to be correlated with a poor prognosis and disease severity in some tumor entities. YKL-40 was suggested to be involved in angiogenesis and extracellular matrix remodeling. As yet, however, its precise biological function remains elusive.MethodsAs YKL-40 protein expression has only been investigated in few malignancies, we employed immunohistochemical detection in a large multi-tumor tissue microarray consisting of 2,310 samples from 72 different tumor entities. In addition, YKL-40 protein expression was determined in primary mouse xenograft tumors derived from human cancer cell lines.ResultsYKL-40 could be detected in almost all cancer entities and was differently expressed depending on tumor stage and subtype (e.g., thyroid cancer, colorectal cancer, gastric cancer and ovarian cancer). While YKL-40 was absent in in vitro grown human cancer cell lines, YKL-40 expression was upregulated in xenograft tumor tissues in vivo.ConclusionsThese data provide new insights into YKL-40 expression at the protein level in various tumor entities and its regulation in tumor models. Our data suggest that upregulation of YKL-40 expression is a common feature in vivo and is finely regulated by tumor cell-microenvironment interactions.

Predictors of financial toxicity and its associations with health-related quality of life and treatment non-adherence in Turkish cancer patients.

This study aims to determine the financial toxicity (FT) level in cancer patients, identify the risk factors associated with this level, and reveal the effect of this level on patient outcomes (health-related quality of life (HRQoL) and treatment non-adherence). The data of 316 cancer patients, who were receiving inpatient treatment in an oncology hospital affiliated to a public university in Ankara, Turkey, were ≥ 18years old, and were receiving chemotherapy for at least 3months, were evaluated. The data were collected through a face-to-face interview. FT was measured with the COmprehensive Score for financial Toxicity (COST) Measure (v2), HRQoL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G) Scale (v4), and treatment adherence was measured using a questionnaire created by conducting a literature review. Patients were found to experience FT above the moderate level (mean ± SD, 21.85 ± 12.02; median value, 24.0). Younger age, being married, low education level, low monthly household income, and receiving social/economic support for treatment were revealed to be the determinants of high FT. Moreover, as the FT score decreased (as the FT level felt increased), the HRQoL was observed to decrease, and treatment non-adherence increased. The results indicate that FT problem is also valid for cancer patients in Turkey despite the system of general health insurance. The FT was found to result from socio-economic characteristics rather than the disease and treatment-related characteristics. The significant associations revealed between FT and patient outcomes emphasize the importance of reducing the FT in cancer patients.

Effects of palliative radiotherapy and bisphosphonate usage on bone turnover marker levels in cancer patients with osteolytic bone metastases.

Objectives In this study, we aimed to investigate the bone turnover marker levels according to bisphosphonate usage and radiotherapy (RT) in cancer patients with metastases in osteolytic pattern.Patients and methods A total of 52 patients (13 males, 39 females; median age: 52 years; range, 37 to 78 years) treated with RT for osteolytic bone metastases between April 2005 and April 2006 were retrospectively analyzed. Bone-specific alkaline phosphatase (BAP), amino-terminal cross-linked telopeptide of type I collagen (NTX-I), amino-terminal propeptide of type I procollagen (PINP), osteocalcin (OC), deoxypyridinoline (DPD), pyridinoline (PYD), alkaline phosphatase (ALP), creatinine, calcium (Ca), phosphate (P), magnesium (Mg), and 24-h urine Ca levels were measured in blood and urine before the initiation of RT, six weeks and six months after RT.Results A decrease in BAP, PINP, and creatinine levels was observed after RT (Week 6 p=0.006, Month 6 p=0.008). Sixteen patients who already used bisphosphonate before RT were excluded from statistical calculation. The remaining 36 patients who were treated with bisphosphonate after the first blood test were evaluated separately. In this group of patients, BAP, PINP, NTX, creatinine, and Ca levels significantly increased at six weeks after RT. The PINP and creatinine values significantly decreased at six months after RT. The variation between two different RT arms was assessed with repeated measures variance analysis. There was a statistically significant difference for NTX, OC, and creatinine levels between the first and second measurements.Conclusion Radiotherapy is an effective method in the treatment of osteolytic bone metastases. Bone turnover markers can provide an objective evaluation on RT response and parallel to imaging modalities criteria for evaluation. Bisphosphonates may alter the levels of these indicators. However, in this study, there were no statistically significant differences between the levels of markers for two different RT schedules.

The relation between ACKR4 and CCR7 genes expression and breast cancer metastasis

AimsBreast cancer is the most severe malignant tumor in women. Chemokines and their receptors appear to be implicated in tumorigenesis and metastatic pattern. Also the scavenger atypical chemokine receptors are emerging as crucial regulators for the availability of chemokines. Therefore the aim of the present study is to evaluate the expression of CCR7, ACKR4 and their ligand; CCL21 in human breast cancer. Main methodsIn this study, RT-PCR was done to detect the expression of CCR7 and ACKR4 in 50 non-metastatic and 30 metastatic breast cancer tissue. Also CCL21 level in the serum of study group was detected by ELISA. The expression of all markers is compared to 80 control healthy individual. Key findingsOur results revealed the increase in expression of CCR7 and CCL21 level in metastatic group compared to non-metastatic and control groups while ACKR4 expression is significantly increased in breast tissues of non-metastatic patients compared to both control and metastatic groups. Also there was significant positive correlation between CCR7 expression and CCL21 level in cancer patients and significant negative correlation between ACKR4 and both CCR-7 and CCL21 in both non-metastatic and metastatic cancer groups. SignificanceThus, it might be elucidating that ACKR4 and CCR7 could be a novel target for tumor therapy as targeting the chemokine-receptors axis might represent a powerful tool to prevent infiltration and metastasis and consequently improve cancer prognosis and treatment.

Increased plasma levels of damage-associated molecular patterns during systemic anticancer therapy in patients with advanced lung cancer.

BackgroundImmunogenic cell death (ICD) characterized by the release of damage-associated molecular patterns (DAMPs) from dying cancer cells may contribute to the synergistic antitumor effect of cytotoxic chemotherapy combined with an immune checkpoint inhibitor. The kinetics of circulating DAMP levels in cancer patients have remained largely uncharacterized, however.MethodsWe evaluated the possible effects of various systemic anticancer therapy modalities on the kinetics of plasma DAMP concentrations in a prospective observational study of patients with advanced lung cancer. The plasma concentrations of high-mobility group box 1 (HMGB1), calreticulin (CRT), heat shock protein 70 (HSP70), annexin A1, and histone H3 were thus determined in 121 such patients at four time points during the first cycle of treatment.ResultsThe mean of the maximum fold change in HMGB1, HSP70, or annexin A1 concentration observed during treatment was significantly greater than the corresponding baseline value (P<0.005). The maximum fold changes in HMGB1 and CRT concentrations tended to be associated with clinical response as evaluated by RECIST criteria, although the changes in the levels of these two DAMPs were not correlated, suggestive of differential induction mechanisms. Among the various treatment modalities administered, platinum-based combination or single-agent chemotherapy tended to elicit robust increases in the concentrations of HMGB1 and CRT.ConclusionsSerial monitoring of plasma revealed that systemic anticancer therapy increased the circulating levels of HMGB1 and CRT and that these changes tended to be associated with clinical response, suggesting that agents capable of releasing these DAMPs into plasma might induce ICD in advanced lung cancer patients.

Current Evidence of the Role of the Myokine Irisin in Cancer.

Simple SummaryRegular exercise/physical activity is beneficial for the health of an individual and lowers the risk of getting different diseases, including cancer. How exactly exercise results in these health benefits is not known. Recent studies suggest that the molecule irisin released by muscles into the blood stream after exercise may be responsible for these effects. This review summarizes all the available in vitro/cell culture, animal and human studies that have investigated the relationship between cancer and irisin with the aim to shed light and understand the possible role of irisin in cancer. The majority of the in vitro studies indicate anticancer properties of irisin, but more animal and human studies are required to better understand the exact role of irisin in cancer.Cancer is a disease associated with extreme human suffering, a huge economic cost to health systems, and is the second leading cause of death worldwide. Regular physical activity is associated with many health benefits, including reduced cancer risk. In the past two decades, exercising/contracting skeletal muscles have been found to secrete a wide range of biologically active proteins, named myokines. Myokines are delivered, via the circulation, to different cells/tissues, bind to their specific receptors and initiate signaling cascades mediating the health benefits of exercise. The present review summarizes the existing evidence of the role of the myokine irisin in cancer. In vitro studies have shown that the treatment of various cancer cells with irisin resulted in the inhibition of cell proliferation, survival, migration/ invasion and induced apoptosis by affecting key proliferative and antiapoptotic signaling pathways. However, the effects of irisin in humans remains unclear. Although the majority of the existing studies have found reduced serum irisin levels in cancer patients, a few studies have shown the opposite. Similarly, the majority of studies have found increased levels of irisin in cancer tissues, with a few studies showing the opposite trend. Clearly, further investigations are required to determine the exact role of irisin in cancer.

Priority levels in cancer patients admitted to medical intensive care at a safety net hospital.

e18599 Background: Admissions of cancer patients to intensive care units (ICU) are increasing with improved mortality. While ICU care can be lifesaving, its higher cost does not always result in reduced mortality. Moreover, timely goals of care (GOC) discussions correlate with less ICU use in those with certain cancers. We investigate if hospital mortality and disposition outcomes for cancer patients correlate to triage by ICU providers. Methods: This subgroup analysis of a prospective cohort of 808 patients admitted to the ICU from 1 July 2015- 15 June 2016 at an academic safety net hospital included 106 patients diagnosed with cancer. Medical records were reviewed by ICU physicians, who assigned priority ranks using Society of Critical Care Medicine guidelines: 1: critically ill, needing treatment/monitoring not provided outside of ICU, 2: not critically ill, but requiring close monitoring/potentially immediate intervention, 3: critically ill patients with reduced likelihood of recovery, 4: not appropriate for ICU, equivalent outcomes achieved with non-ICU care. We did a chart review for factors like prior therapy and documentation of GOC discussions. Statistical tests were conducted to examine if priority levels correlate with disposition, mortality, and length of stay (LOS). Results: χ2-tests revealed priority rank correlated with disposition after hospitalization (p&lt;.05) with group 3 having the highest proportion of deaths and lowest proportion of discharges home. It revealed that mortality rate differed by group (p&lt;.05) with logistic regression showing that priority 3 predicted increased mortality (p&lt;.05). ANCOVA indicated ICU LOS differed by priority group (p&lt;.05), with priority 3 averaging the longest LOS. While priority 3 had the most in-hospital GOC discussions, relatively few were documented pre-hospitalization. Conclusions: Overall, our patients were accurately triaged, with worse mortality and discharge outcomes among priority 3 and a dearth of pre-hospitalization GOC documentation for all groups. Our data show the importance of triaging patients and having early, frequent GOC discussions to minimize ICU admission given increasing demand and costs. GOC discussions are associated with less aggressive medical care near death and better patient quality of life. Thus, holding these talks with our sickest patients prior to potential ICU admission is an area to improve cost-effective high quality care.[Table: see text]