Life Expectancy Of Cancer Patients Research Articles

Non-coding RNAs and their potential exploitation in cancer therapy-related cardiotoxicity.

Life expectancy in cancer patients has been extended in recent years, thanks to major breakthroughs in therapeutic developments. However, this also unmasked an increased incidence of cardiovascular diseases in cancer survivors, which is in part attributable to cancer therapy-related cardiovascular toxicity. Non-coding RNAs (ncRNAs) have received much appreciation due to their impact on gene expression. NcRNAs, which include microRNAs, long ncRNAs and circular RNAs, are non-protein-coding transcripts that are involved in the regulation of various biological processes, hence shaping cell identity and behaviour. They have also been implicated in disease development, including cardiovascular diseases, cancer and, more recently, cancer therapy-associated cardiotoxicity. This review outlines key features of cancer therapy-associated cardiotoxicity, what is known about the roles of ncRNAs in these processes and how ncRNAs could be exploited as therapeutic targets for cardioprotection.

Metastasis in the periocular region

Orbital and periocular metastatic tumors used to be considered very rare; however, with the constant updating of drugs and detection methods for cancer treatment, new chemotherapies and radiation treatments are being used. The life expectancy of cancer patients has become longer and periocular metastases are becoming easier to detect. Our knowledge of this rare disease of metastases also needs to be updated. This article reviews the incidence, symptomatic presentation, clinical features, diagnostic approaches and current treatment of metastatic tumors of the orbit and ocular adnexa in these patients.

Comparing Survival Extrapolation within All-Cause and Relative Survival Frameworks by Standard Parametric Models and Flexible Parametric Spline Models Using the Swedish Cancer Registry.

In health technology assessment, restricted mean survival time and life expectancy are commonly evaluated. Parametric models are typically used for extrapolation. Spline models using a relative survival framework have been shown to estimate life expectancy of cancer patients more reliably; however, more research is needed to assess spline models using an all-cause survival framework and standard parametric models using a relative survival framework. To assess survival extrapolation using standard parametric models and spline models within relative survival and all-cause survival frameworks. From the Swedish Cancer Registry, we identified patients diagnosed with 5 types of cancer (colon, breast, melanoma, prostate, and chronic myeloid leukemia) between 1981 and 1990 with follow-up until 2020. Patients were categorized into 15 cancer cohorts by cancer and age group (18-59, 60-69, and 70-99 y). We right-censored the follow-up at 2, 3, 5, and 10 y and fitted the parametric models within an all-cause and a relative survival framework to extrapolate to 10 y and lifetime in comparison with the observed Kaplan-Meier survival estimates. All cohorts were modeled with 6 standard parametric models (exponential, Weibull, Gompertz, log-logistic, log-normal, and generalized gamma) and 3 spline models (on hazard, odds, and normal scales). For predicting 10-y survival, spline models generally performed better than standard parametric models. However, using an all-cause or a relative survival framework did not show any distinct difference. For lifetime survival, extrapolating from a relative survival framework agreed better with the observed survival, particularly using spline models. For extrapolation to 10 y, we recommend spline models. For extrapolation to lifetime, we suggest extrapolating in a relative survival framework, especially using spline models. For survival extrapolation to 10 y, spline models generally performed better than standard parametric models did. However, using an all-cause or a relative survival framework showed no distinct difference under the same parametric model.Survival extrapolation to lifetime within a relative survival framework agreed well with the observed data, especially using spline models.Extrapolating parametric models within an all-cause survival framework may overestimate survival proportions at lifetime; models for the relative survival approach may underestimate instead.

R-ketorolac ameliorates cancer-associated cachexia and prolongs survival of tumour-bearing mice.

Cancer-associated cachexia (CAC) is a debilitating syndrome associated with poor quality of life and reduced life expectancy of cancer patients. CAC is characterized by unintended body weight reduction due to muscle and adipose tissue loss. A major hallmark of CAC is systemic inflammation. Several non-steroidal anti-inflammatory drugs (NSAIDs) have been suggested for CAC treatment, yet no single medication has proven reliable. R-ketorolac (RK) is the R-enantiomer of a commonly used NSAID. The effect of RK on CAC has not yet been evaluated. Ten- to 11-week-old mice were inoculated with C26 or CHX207 cancer cells or vehicle control (phosphate-buffered saline [PBS]). After cachexia onset, 2mg/kg RK or PBS was administered daily by oral gavage. Body weight, food intake and tumour size were continuously measured. At study endpoints, blood was drawn, mice were sacrificed and tissues were excised. Immune cell abundance was analysed using a Cytek® Aurora spectral flow cytometer. Cyclooxygenase (COX) activity was determined in lung homogenates using a fluorometric kit. Muscle tissues were analysed for mRNA and protein expression by quantitative real-time PCR and western blotting analysis, respectively. Muscle fibre size was determined on histological slides after haematoxylin/eosin staining. Ten-day survival rate of C26-bearing animals was 10% while RK treatment resulted in a 100% survival rate (P=0.0009). Chemotherapy resulted in a 10% survival rate 14days after treatment initiation, but all mice survived upon co-medication with RK and cyclophosphamide (P=0.0001). Increased survival was associated with a protection from body weight loss in C26 (-0.61±1.82 vs. -4.48±2.0g, P=0.0004) and CHX207 (-0.49±0.33 vs. -2.49±0.93g, P=0.0003) tumour-bearing mice treated with RK, compared with untreated mice. RK ameliorated musculus quadriceps (-1.7±7.1% vs. -27.8±8.3%, P=0.0007) and gonadal white adipose tissue (-18.8±49% vs. -69±15.6%, P=0.094) loss in tumour-bearing mice, compared with untreated mice. Mechanistically, RK reduced circulating interleukin-6 (IL-6) concentrations from 334±151 to 164±123pg/mL (P=0.047) in C26 and from 93±39 to 35±6pg/mL (P=0.0053) in CHX207 tumour-bearing mice. Moreover, RK protected mice from cancer-induced T-lymphopenia (+1.8±42% vs. -49.2±12.1% in treated vs. untreated mice, respectively). RK was ineffective in ameliorating CAC in thymus-deficient nude mice, indicating that the beneficial effect of RK depends on T-cells. RK improved T-lymphopenia and decreased systemic IL-6 concentrations, resulting in alleviation of cachexia and increased survival of cachexigenic tumour-bearing mice, even under chemotherapy and independent of COX inhibition. Considering its potential, we propose that the use of RK should be investigated in patients suffering from CAC.

Associations of sleep pattern with survival and life expectancy of cancer patients

Associations of sleep pattern with survival and life expectancy of cancer patients

The Effect of Educational Religious Intervention on Improving Life Expectancy in Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Clinical Trial

Background and Purpose: The main problem of cancer patients is the feeling of despair and hopelessness. Religious beliefs can boost the morale of cancer patients. This study aimed to determine the effect of religious interventions on life expectancy in cancer patients undergoing chemotherapy. Materials and Methods: The present clinical trial study was conducted on 128 patients with cancer undergoing chemotherapy referred to the oncology unit of a teaching hospital in Khorramabad, Iran. After selecting the sample size, the patients were randomly divided into intervention and control groups. In addition to routine care, religious intervention sessions were performed for the intervention group, and the control group received only routine care. For the intervention group, training sessions focused on trust in God, good morals, patience, gratitude, and remembrance of God. After 3 weeks and 6 sessions (after finishing the sessions), the post-test was done. Data collection tools were the demographic and Miller’s standard life expectancy questionnaires. Analysis of covariance was used to compare life expectancy after the intervention. SPSS software, version 23 was employed for data analysis. A significance level of 0.05 was considered for all tests. Results: There were 64 men and 64 women in both groups. Also, 111 people were married in both groups. The most frequent cancer seen in both intervention and control groups was gastric cancer (n=37). The mean life expectancy scores of the experimental and control groups before the intervention were not statistically significant (P<0.05). There was a statistically significant difference in life expectancy scores before and after the intervention in the experimental group (P<0.05). There was a statistically significant difference in life expectancy scores after the intervention in the experimental and control groups (P=0.000). Conclusion: Religious intervention increases the life expectancy of cancer patients undergoing chemotherapy. Medical staff, especially nurses, can, along with other routine care, guide patients undergoing chemotherapy to spirituality and help them accept the disease and its complications better.

Increase in the Life Expectancy of Patients with Cancer in the United States.

Cancer is becoming more of a chronic disease due to improvements in treatment and early detection for multiple cancer sites. To gain insight on increased life expectancy due to these improvements, we quantified trends in the loss in expectation of life (LEL) due to a cancer diagnosis for six cancer sites from 1975 through 2018. We focused on patients diagnosed with female breast cancer, chronic myeloid leukemia (CML), colon and rectum cancer, diffuse large B-cell lymphoma (DLBCL), lung cancer, or melanoma between 1975 and 2018 from nine Surveillance, Epidemiology, and End Results cancer registries. Life expectancies for patients with cancer ages 50+ were modeled using flexible parametric survival models. LEL was calculated as the difference between general population life expectancy and life expectancy for patients with cancer. Over 2 million patients were diagnosed with one of the six cancers between 1975 and 2018. Large increases in life expectancy were observed between 1990 and 2010 for female breast, DLBCL, and CML. Patients with colon and rectum cancer and melanoma had more gradual improvements in life expectancy. Lung cancer LEL only began decreasing after 2005. Increases in life expectancy corresponded with decreases in LEL for patients with cancer. The reported gains in life expectancy largely correspond to progress in the screening, management, and treatment of these six cancers since 1975. LEL provides an important public health perspective on how improvements in treatment and early detection and their impacts on survival translate into changes in cancer patients' life expectancy.

Synthesis of Multifunctional Mn3O4-Ag2S Janus Nanoparticles for Enhanced T1-Magnetic Resonance Imaging and Photo-Induced Tumor Therapy.

The global burden of cancer is increasing rapidly, and nanomedicine offers promising prospects for enhancing the life expectancy of cancer patients. Janus nanoparticles (JNPs) have garnered considerable attention due to their asymmetric geometry, enabling multifunctionality in drug delivery and theranostics. However, achieving precise control over the self-assembly of JNPs in solution at the nanoscale level poses significant challenges. Herein, a low-temperature reversed-phase microemulsion system was used to obtain homogenous Mn3O4-Ag2S JNPs, which showed significant potential in cancer theranostics. Structural characterization revealed that the Ag2S (5-10 nm) part was uniformly deposited on a specific surface of Mn3O4 to form a Mn3O4-Ag2S Janus morphology. Compared to the single-component Mn3O4 and Ag2S particles, the fabricated Mn3O4-Ag2S JNPs exhibited satisfactory biocompatibility and therapeutic performance. Novel diagnostic and therapeutic nanoplatforms can be guided using the magnetic component in JNPs, which is revealed as an excellent T1 contrast enhancement agent in magnetic resonance imaging (MRI) with multiple functions, such as photo-induced regulation of the tumor microenvironment via producing reactive oxygen species and second near-infrared region (NIR-II) photothermal excitation for in vitro tumor-killing effects. The prime antibacterial and promising theranostics results demonstrate the extensive potential of the designed photo-responsive Mn3O4-Ag2S JNPs for biomedical applications.

Therapy-Related Myeloid Neoplasms: Predisposition and Clonal Evolution.

Therapy-related Myeloid Neoplasm (t-MN) represents one of the worst long-term consequences of cytotoxic therapy for primary tumors and autoimmune disease. Poor survival and refractoriness to current treatment strategies characterize affected patients from a clinical point of view. In our aging societies, where newer therapies and ameliorated cancer management protocols are improving the life expectancy of cancer patients, therapy-related Myeloid Neoplasms are an emerging problem. Although several research groups have contributed to characterizing the main risk factors in t-MN development, the multiplicity of primary tumors, in association with the different therapeutic strategies available and the new drugs in development, make interpreting the current data still complex. The main risk factors involved in t-MN pathogenesis can be subgrouped into patient-specific, inherited, and acquired predispositions. Although t-MN can occur at any age, the risk tends to increase with advancing age, and older patients, characterized by a higher number of comorbidities, are more likely to develop the disease. Thanks to the availability of deep sequencing techniques, germline variants have been reported in 15-20% of t-MN patients, highlighting their role in cancer predisposition. It is becoming increasingly evident that t-MN with driver gene mutations may arise in the background of Clonal Hematopoiesis of Indeterminate Potential (CHIP) under the positive selective pressure of chemo and/or radiation therapies. Although CHIP is generally considered benign, it has been associated with an increased risk of t-MN. In this context, the phenomenon of clonal evolution may be described as a dynamic process of expansion of preexisting clones, with or without acquisition of additional genetic alterations, that, by favoring the proliferation of more aggressive and/or resistant clones, may play a crucial role in the progression from preleukemic states to t-MN.

Improvement in neoantigen prediction via integration of RNA sequencing data for variant calling.

Neoantigen-based immunotherapy has emerged as a promising strategy for improving the life expectancy of cancer patients. This therapeutic approach heavily relies on accurate identification of cancer mutations using DNA sequencing (DNAseq) data. However, current workflows tend to provide a large number of neoantigen candidates, of which only a limited number elicit efficient and immunogenic T-cell responses suitable for downstream clinical evaluation. To overcome this limitation and increase the number of high-quality immunogenic neoantigens, we propose integrating RNA sequencing (RNAseq) data into the mutation identification step in the neoantigen prediction workflow. In this study, we characterize the mutation profiles identified from DNAseq and/or RNAseq data in tumor tissues of 25 patients with colorectal cancer (CRC). Immunogenicity was then validated by ELISpot assay using long synthesis peptides (sLP). We detected only 22.4% of variants shared between the two methods. In contrast, RNAseq-derived variants displayed unique features of affinity and immunogenicity. We further established that neoantigen candidates identified by RNAseq data significantly increased the number of highly immunogenic neoantigens (confirmed by ELISpot) that would otherwise be overlooked if relying solely on DNAseq data. This integrative approach holds great potential for improving the selection of neoantigens for personalized cancer immunotherapy, ultimately leading to enhanced treatment outcomes and improved survival rates for cancer patients.

The Schiff base hydrazine copper(II) complexes induce apoptosis by P53 overexpression and prevent cell migration through protease-independent pathways.

Although chemotherapy has increased the life expectancy of cancer patients, its toxic side effects remain a major challenge. Recently, organometallic compounds, such as Schiff base copper complexes, have become promising candidates for next-generation anticancer drugs owing to their unique anticancer activities. In this study, binuclear copper(II) complex-1 and mononuclear copper(II) complex-2 were examined to analyze their anticancer mechanisms further. For this purpose, a viability test, flow cytometry analysis of apoptosis and the cell cycle, migration assay, and gene expression analysis were performed. According to our results, complex-1 was more cytotoxic than complex-2 at 24/48-h intervals. Our findings also demonstrated that both complexes induced apoptosis at IC50 concentrations and arrested the cell cycle at the G1-S checkpoint. However, complex-1 accelerates cell cycle arrest at the sub-G0/G1 phase more than complex-2 does. Furthermore, gene expression analysis showed that only complex-1 induces the expression of p53. Interestingly, both complexes induced Bcl-2 overexpression. However, they did not affect MMP-13 expression. More interestingly, both complexes inhibited cell migration in different ways, including amoeboid and collective, by recruiting protease-independent pathways. This study confirmed that adding several metal cores and co-ligands increased the activity of the complex. It also appeared that Cu-containing complexes could prevent the migration of cancer cells through protease-independent pathways, which can be used for novel therapeutic purposes.

Treatment of anemic syndrome in patients receiving surgical and chemotherapeutic treatment for breast and colorectal cancer

Introduction. Anemia syndrome is a common disease that reduces the quality and life expectancy of cancer patients. Prevention, timely diagnosis and effective treatment of anemia are statistically significantly associated with a favorable clinical outcome of the treatment of patients, and also contributes to better tolerability of anticancer therapy.Aim. Evaluation of the effectiveness of oral iron preparations and parenteral use of erythropoietin-alpha in patients with breast cancer and colorectal cancer, iron deficiency anemia or severe iron deficiency, immediate and long-term results of treatment, as well as the quality of life of patients with breast cancer and colorectal cancer.Materials and methods. A retrospective analysis of the material from the Blokhin National Medical Research Center of Oncology, involved 133 patients (validation group 68 people, control group – 65 people), patients with breast cancer or colorectal cancer, suffering from anemia. Depending on the form of anemia, patients were prescribed therapy – oral iron preparations with epoetin alfa in combination or in monotherapy. The effectiveness of therapy was assessed by the rate of blood hemoglobin. Analysis and statistical processing of results using IBM SPSS Statistics 26.0. Survival analysis was carried out using the KaplanMeier method. Descriptive statistics methods are used to analyze socio-demographic and traditional patients.Results. With a median follow-up of 61.2 months, the exclusion groups did not have significant differences in overall survival (p > 0.05). However, the group of patients with IDA who received therapy to correct the anemic syndrome and the group with FDA without adequate therapy had a greater significance in terms of 5-year OS (93.5 and 69.6%, respectively; p = 0.02). There were also no significant values for the 5-year DFS indicator (p > 0.05). However, the groups of patients with IDA who received and did not receive therapy to correct anemia probably made a big difference in terms of 5-year DFS (90.3 and 63.9%, respectively; p = 0.025). The group of patients with IDA treated with anemia to correct anemic syndrome clearly differed from the group of patients with FAD without therapy to correct anemia in terms of 5-year OS (90.3 and 43.6%, respectively; p < 0.001).Conclusions. Carrying out antianemic therapy can significantly increase the 5-year relapse-free survival in patients with iron deficiency anemia (90.3 and 63.9%, with and without therapy, respectively; p = 0.025).

Effect of Nursing Interventions Based on Partnership Care Model on Life Expectancy in Cancer Patients in Shahrekord Teaching Hospitals

Background: Useful communication between patients and nurses and improvement of the quality of care occur following partnership care, resulting in an improvement in the general condition of patients. Objectives: Regarding the cancer patients’ need for education and the important role of nurses in education and care, the present study aimed to investigate the effect of nursing interventions based on the partnership care model on the life expectancy of cancer patients in teaching hospitals of Shahrekord. Methods: The present quasi-experimental study was conducted on 60 cancer patients in Shahrekord educational hospitals in 2021. The subjects of this study were first selected according to inclusion criteria and then randomly divided into the intervention and control groups by random allocation software. The educational intervention based on the partnership care model was carried out in four individual stages, including the creation of motivation, preparation, involvement, and evaluation. The researcher used demographic information questionnaires and Schneider’s Life Expectancy Questionnaire as data collection instruments. Using SPSS 24 software and independent t-test, chi-square test, and analysis of variance, the mean scores before, 48 hours after intervention, and two months after intervention were compared. Results: There was no significant difference between the two groups in terms of mean life expectancy scores before the intervention (P > 0.82), but the scores immediately and two months after the intervention showed a statistically significant difference between the control and intervention groups (P < 0.001). Conclusions: Implementing the educational intervention based on the partnership care model can increase the life expectancy of cancer patients. Due to this program’s effectiveness, low cost, and safety, hospital managers are recommended to use this program to promote health and enhance the patient’s knowledge.

Onconephrology: Acute kidney injury in cancer patients

Acute kidney injury (AKI) is a common complication of cancer, occurring in up to 50% of neoplastic patients during the natural course of their disease. Furthermore, it has a significant impact on key outcomes, such as overall prognosis, length of hospitalization, and costs. AKI in cancer patients has various causes, including patient-related, tumor-related, or treatment-related factors.
 Patient-related risk factors for AKI are similar to those in the general population. Tumor-related risk factors can involve compression, obstruction, direct kidney infiltration by the tumor, as well as precipitation, aggregation, crystallization, or misfolding of paraproteins in conditions like multiple myeloma. Treatment-related risk factors are the most commonly observed in clinical practice and can present as features of tumor lysis syndrome or, for example, immune checkpoint inhibitor-related AKI.
 In the absence of validated biomarkers for AKI, a multidisciplinary clinical approach involving oncologists, intensivists, nephrologists, or onconephrologists is essential. This approach incorporates thorough assessment, the use of appropriate preventive measures, and early intervention to reduce the incidence of AKI in cancer patients. Understanding the essence of preventive measures, timely initiation of treatment, and knowing when to terminate treatment will reduce the frequency of this life-threatening condition and improve the effectiveness of cancer treatment and the quality of life and life expectancy of cancer patients.
 This work aims to improve physicians' awareness of the latest data on the prevention, diagnosis, and treatment of AKI specifically related to oncopathology, tumor lysis syndrome, and acute kidney injury induced by cancer immunotherapy drugs.

Onconephrology: The time has come

Why did this time come and how this direction (subspecialty) onconephrology formed?
 The effect of actual renal cancer (RC) or malignant lesions of extrarenal localization on the condition of the kidney is realized in different ways. Renal cancer can occur in a healthy kidney or a patient with CKD of any stage, moreover, the higher the stage, the higher the risk of renal cell carcinoma (RCC) [1]. It can cause kidney damage due to the formation of almost the entire spectrum of glomerulopathies or A-amyloidosis [2]. 25-30% of patients with RCC before surgery have CKD of various stages [3].
 In addition, almost any extrarenal localization of a malignant process can directly or indirectly cause damage to healthy kidneys or worsen the course of pre-existing CKD, and an increase in its stage limits the options for choosing a treatment option [4].
 Antitumor therapy, as it has significant nephrotoxic potential, can be another source of various glomerulopathies, acute tubulointerstitial nephritis, acute kidney injury, and increased rate of progression of CKD [5].
 In general, it became clear that RC and malignant processes of extrarenal localization can cause a wide range of negative kidney consequences; under both scenarios, treatment results, quality, and life expectancy of cancer patients deteriorate significantly.
 The issue of starting or stopping the use of dialysis renal replacement therapy methods, kidney transplantation in patients who have survived cancer, and the risks of developing cancer in patients after kidney transplantation and its treatment is difficult to resolve.
 This is far from the complete list of reasons that encouraged the American Society of Nephrology to hold the first onconephrology forum in 2011, including the first demonstration of the need for the formation of a new component of nephrology, onconephrology.
 In 2014, the International Community on Cancer and Kidneys (C-KIN) was established, and in 2015, the European Organization for Research and Treatment of Cancer (EORTC) was founded. In 2017, C-KIN launched the Journal of Onconephrology (JON).
 In 2019, for the first time in Ukraine, at the national oncourology conference, the report "Onconephrology: the time has come" was published, which caused a lively discussion.
 Since that time, at all nephrology events of the Ukrainian National Academy of Sciences and the National Academy of Medical Sciences, the onconephrology topics were discussed.
 In 2022, the "Onconephrology" module was included in the specialization program in nephrology, which is carried out at the State "Institute of Nephrology of NAMA of Ukraine" (order of the Ministry of Education and Culture No. 159-d of 06.09.2021).
 Therefore, solving the majority of the components of the problem of the combination of oncopathology and kidney damage requires either the participation of a multidisciplinary team (oncologist, nephrologist, intensivist, urologist, hematologist, etc.), or a specialist who possesses the listed knowledge and skills in the necessary volumes, i.e. onconephrologist.

Right ventricular dysfunction in cancer patients; Is it real or dilemma? A narrative review

Cardiotoxicity is one of the challenges of treating a cancer patient. With the advancement of treatment methods and the production of new drugs, the life expectancy of cancer patients improved significantly.

Age, sex, primary tumor type and site are associated with mortality after pathological fractures: an observational study of 1453 patients from the Swedish Fracture Register

BackgroundPathological fractures are challenging in orthopedic surgery and oncology, with implications for the patient’s quality of life, mobility and mortality. The efficacy of oncological treatment on life expectancy for cancer patients has improved, but the metastatic pattern for bone metastases and survival is diverse for different tumor types. This study aimed to evaluate survival in relation to age, sex, primary tumor and site of the pathological fractures.MethodsAll pathological fractures due to cancer between 1 September 2014 and 31 December 2021 were included in this observational study from the Swedish Fracture Register (SFR). Data on age, sex, tumor type, fracture site and mortality were collected.ResultsA total of 1453 patients with pathological fractures were included (48% women, median age 73, range 18–100 years). Unknown primary tumors were the most common primary site (n = 308). The lower extremities were the most common site of pathological fractures. Lung cancer had the shortest median survival of 78 days (range 54–102), and multiple myeloma had the longest median survival of 432 days (range 232–629). The site at the lower extremity had the shortest (187 days, range 162–212), and the spine had the longest survival (386 days, range 211–561). Age, sex, primary type and site of the pathological fractures were all associated with mortality.InterpretationAge, sex, primary tumor type and site of pathological fractures were associated with survival. Survival time is short and correlated with primary tumor type, with lung cancer as the strongest negative predictor of survival.

Predictive Biomarkers for Immune-Related Endocrinopathies following Immune Checkpoint Inhibitors Treatment.

In recent years, in the context of the increase in the life expectancy of cancer patients, special attention has been given to immunotherapy and, indeed, to immune checkpoint inhibitors. The use of immune checkpoint inhibitors has increased rapidly, and approximately 40% of cancer patients are eligible for this treatment. Although their impact is valuable on cancer treatment, immune checkpoint inhibitors come with side effects, known as immune-related adverse effects. These can affect many systems, including cutaneous, musculoskeletal, cardiovascular, gastrointestinal, endocrine, neural, and pulmonary systems. In this review, we focus on immune-related endocrinopathies that affect around 10% of all treated patients. Endocrine dysfunctions can manifest as hypophysitis, thyroid dysfunction, hypoparathyroidism, insulin-deficient diabetes mellitus, and primary adrenal insufficiency. Currently, there are multiple ongoing clinical trials that aim to identify possible predictive biomarkers for immune-related adverse effects. The design of those clinical trials relies on collecting a variety of biological specimens (tissue biopsy, blood, plasma, saliva, and stool) at baseline and regular intervals during treatment. In this review, we present the predictive biomarkers (such as antibodies, hormones, cytokines, human leukocyte antigens, and eosinophils) that could potentially be utilized in clinical practice in order to predict adverse effects and manage them appropriately.

Mechanisms of Metastasis: Analysis on Abdominal Organs and the Effect of Treatment Options

Metastasis is the leading cause of cancer related deaths and commonly associated with Stage IV cancer. This paper will answer the question of: “How do the different circumstances of metastatic origin, growth, and spread affect the function of abdominal organs and life expectancy in cancer patients as well as how varied treatment options affect tumor spread?” in the style of an empirical review. It details numerous studies on metastasis formation, growth, and its effects in the three abdominal organs of the colon/ rectum, pancreas, and the stomach. Additionally, it delves into the treatment options for metastasis and how they help or worsen the situation. Overall, the key factors in tumor spread is the tumor microenvironment which highlights the interactions between healthy and malignant cells. Tumors secrete various growth factors, the most important being VEGF which is helpful in the processes of acquiring nutrients and oxygen for it to grow and develop. Prior niches are formed which guide the tumors on where to spread depending on the cancer type. In abdominal organs specifically, the most common sites of metastasis are the liver, lung, and peritoneum, which indicates proximal metastasis of cancers which originate in that region. Lastly, treatment methods aimed at eliminating the chance of cancer metastasis can lead to a stimulation of metastasis, having the opposite of its intended effect. Ultimately, cancer research is a field which is actively being experienced and studied to make developments and further existing knowledge.

A Novel Prognostication System for Spinal Metastasis Patients Based on Network Science and Correlation Analysis

AimsDuring the progress of oncological diseases, there is an increased probability that spinal metastases may develop, requiring personalised treatment options. Risk calculator systems aim to provide assistance in the therapeutic decision-making process by estimating survival chances. The predictive ability of such calculators can be improved, thereby optimising the choice of personalised therapy. The aim of this research was to create a new risk assessment system and show a method with which other centres can develop their own local score. Materials and methodsWe created a database by retrospectively processing 454 patients. The prognostic factors were selected via a network science-based correlation analysis that maximises Uno's C-index, keeping only a small number of predictors. To validate the new system, we calculated the D-statistic, the Integrated Discrimination Index, made a five-fold cross-validation and also calculated the integrated time-dependent Brier score. ResultsAs a result of multivariate Cox analysis, we found five independent prognostic factors suitable for the design of the risk calculator. This new system has a better predictive ability compared with six other well-known systems with an average C-index of 0.706 at 10 years (95% confidence interval 0.679–0.733). ConclusionsAn accurate estimation of the life expectancy of cancer patients is essential for the implementation of personalised medicine. The training performance of our system is encouraging, indicating the benefit of a network science-based visualisation step. We believe that in order to further improve the prediction ability, it is necessary to systematise previously ‘unknown’ factors (e.g. radiological morphology).