Side Effects Of Anticancer Therapy Research Articles

MicroRNA hsa-let-7e-5p in hUC-MSC-EVs alleviates oral mucositis by targeting TAB2.

Oral mucositis (OM) is a severe side effect of anti-cancer therapy, with limited available treatments. Mesenchymal stem cells (MSCs) and their secreted extracellular vesicles (EVs) have demonstrated effective protection against OM. However, the underlying mechanism remains elusive. In the current study, we purified EVs secreted by human umbilical cord MSCs (hUC-MSC-EVs) and investigated their role in lipopolysaccharide (LPS)-induced human oral keratinocytes (HOKs). We observed that treatment with hUC-MSC-EVs significantly reduced the inflammatory response of HOKs to LPS induction. Through small RNA-seq using miRNAs extracted from hUC-MSC-EVs, we identified hsa-let-7e-5p as one of the most highly expressed miRNAs. Bioinformatic analysis data indicated that hsa-let-7e-5p may inhibit the NF-κB signalling pathway by targeting TAB2. Overexpression of the hsa-let-7e-5p inhibitor significantly attenuated the anti-inflammatory effect of hUC-MSC-EVs in LPS-induced HOKs, which could be reversed by the knockdown of TAB2. In addition, we administered hUC-MSC-EVs in a hamster model for OM and observed that these EVs alleviated OM phenotypes. Taken together, our observations suggest that hsa-let-7e-5p in hUC-MSC-EVs could protect the oral mucosa from OM by repressing TAB2 expression.

HIITING CANCER BACK: THE EFFECTS OF ONE MONTH OF HIGH INTENSITY INTERVAL TRAINING ON INFLAMMATION, BODY COMPOSITION, AND CARDIORESPIRATORY FITNESS IN CANCER SURVIVORS

INTRODUCTION/AIMS Chronic inflammation, low fitness, and unfavourable body composition are often side effects of anti-cancer therapies and are associated with an increased risk of cancer recurrence. However, the response of these variables to high intensity interval training (HIIT), and the relationship among these predictors of cancer recurrence, is yet to be explored in cancer survivors. The aim of this study was to investigate the effect of one month of HIIT on inflammation, body composition, and cardiorespiratory fitness and explore the relationships among these variables in breast, prostate, and colorectal cancer survivors. METHODS Survivors (n=131) of breast, prostate, and colorectal cancer (60.1±10.3 years, 26.9±4.9 kg/m2, 67% female) completed one month of HIIT (12 sessions: 4x4min at 85-95% peak heart rate (HRpeak), interspersed with 3-minutes at 50-75% HRpeak). Body composition via dual-energy X-ray absorptiometry, cardiorespiratory fitness via V̇O2peak, and fasted blood were measured at baseline and at one month. Blood was analysed for inflammatory factors (interleukin (IL)-6, IL-10), and tumour necrosis factor alpha (TNF-α)). RESULTS HIIT resulted in significant reductions in IL-6, IL-10, TNF-α (-37-39%, p<0.001) and significant increases in leg lean mass (+400g, p=0.008) and absolute V̇O2peak (+0.2 L/min, p<0.001). Despite this, the only significant association among the changes in these variables was a weak correlation between IL-10 and absolute V̇O2peak (rs=0.256, p=0.013). CONCLUSION One month of HIIT elicited significant improvement in markers of systemic inflammation, body composition, and cardiorespiratory fitness. However, improvements in these variables were not strongly related and occur independent of each other. The findings of this study demonstrate 4x4 HIIT is an effective prescriptive tool to elicit rapid improvements in physiological markers, through apparent independent pathways. Therefore, exercise physiologists working with cancer survivors should consider utilising 4x4 HIIT to their exercise prescriptions as a time efficient means to reduce the risk of cancer recurrence and improve survivorship.

Gut microbiota in cancer: insights on microbial metabolites and therapeutic strategies.

In recent years, the role of gut microbiota in cancer treatment has attracted substantial attention. It is now well established that gut microbiota and its metabolites significantly contribute to the incidence, treatment, and prognosis of various cancers. This review provides a comprehensive review on the pivotal role of gut microbiota and their metabolites in cancer initiation and progression. Furthermore, it evaluates the impact of gut microbiota on the efficacy and associated side effects of anticancer therapies, including radiotherapy, chemotherapy, and immunotherapy, thus emphasizing the clinical importance of gut microbiota reconstitution in cancer treatment.

Recent Advances in the Development of Drug Delivery Applications of Magnetic Nanomaterials.

With the predicted rise in the incidence of cancer, there is an ever-growing need for new cancer treatment strategies. Recently, magnetic nanoparticles have stood out as promising nanostructures for imaging and drug delivery systems as they possess unique properties. Moreover, magnetic nanomaterials functionalized with other compounds can lead to multicomponent nanoparticles with innovative structures and synergetic performance. The incorporation of chemotherapeutic drugs or RNA in magnetic drug delivery systems represents a promising alternative that can increase efficiency and reduce the side effects of anticancer therapy. This review presents a critical overview of the recent literature concerning the advancements in the field of magnetic nanoparticles used in drug delivery, with a focus on their classification, characteristics, synthesis and functionalization methods, limitations, and examples of magnetic drug delivery systems incorporating chemotherapeutics or RNA.

Comparative Transcriptome of Dorsal Root Ganglia Reveals Distinct Etiologies of Paclitaxel- and Oxaliplatin-induced Peripheral Neuropathy in Rats.

Chemotherapy-induced peripheral neuropathy is one of the most common side effects of anticancer therapy. It is anticipated that chemotherapies with different mechanisms of action may affect somatosensory neurons differently. This study aimed to explore similar and differential etiologies of oxaliplatin- and paclitaxel-induced neuropathy by comparing the transcriptomes of dorsal root ganglia (DRGs). We retrieved our previously published transcriptome data of DRGs extracted from vehicle-, oxaliplatin- and paclitaxel-treated rats (GSE160543), to analyze in parallel the differentially expressed genes (DEGs) and Gene ontology (GO) terms enrichment. We found that both oxaliplatin and paclitaxel treatments consistently produced mechanical allodynia, thermal hyperalgesia, and cold hyperalgesia in rats. Compared to vehicle, 320 and 150 DEGs were identified after oxaliplatin and paclitaxel treatment, respectively. Only 17 DEGs were commonly dysregulated by the two reagents. Activating transcription factor 3 (Atf3), a marker of nerve injury, was elevated only after paclitaxel treatment. GO analysis suggested that paclitaxel treatment was associated with neuronal changes characterized by numerous terms that are related to synaptic transmission, while oxaliplatin was more likely to affect dividing cells (e.g., the glia) and neuroinflammation. Notably, 29 biological processes GO terms were commonly enriched in response to both drugs. However, 28 out of 29 terms were oppositely modulated. This study suggests that distinct mechanisms underly paclitaxel- and oxaliplatin-induced neuropathy. Paclitaxel might directly affect somatosensory neurons while oxaliplatin primarily targets dividing cells and immune cells.

Cancer, cancer treatment and aneurysmatic ascending aorta growth within a retrospective single center study.

Background: Multi-morbidity poses a substantial challenge for health care in an aging population. Recent studies did not provide evidence for general side effects of anti-cancer therapy regarding the growth rate of coincident abdominal aortic aneurysms, although it was suggested that specific therapeutic substances might accelerate growth. Aneurysm pathology, however, differs with respect to localization. Hence, we present the first ever analysis on the association of cancer and cancer therapy with growth alteration of aneurysms of the ascending aorta (AscAA). Patients and methods: A retrospective single-center identification of AscAA+cancer patients was performed in the institutional picture archiving and communication system (PACS). Included were all patients with ≥2 CT angiograms over ≥6 months and additional malignancy. Clinical data and aneurysm diameters were retrieved and analyzed for an association of cancer (stratified by tumor entity) or cancer therapy (stratified by several classes of chemotherapeutic agents and radiation therapy) with annual growth rate, respectively. Statistics included t-test, Wilcoxon test, and a linear regression model accounting for initial AscAA diameter and type of treatment. Results: From 2003 to 2021, 151 patients (median age 70 years; 85% male) with AscAA and coincident 163 malignancies were identified. Prostate (37%) and hematologic cancer (17%) were most frequent. One-hundred-eleven patients (74%) received chemotherapy and 75 patients (50%) had radiation. After exclusion of six patients with an initial AscAA diameter >55 mm, the average annual AscAA growth rate was 0.18±0.64 mm/year, with only 12 patients experiencing a growth rate >1mm/year. Neither tumor entity nor radiation or chemotherapy - alone or in combination - were significantly associated with an alteration of the annual AscAA growth rate. Likewise, a subanalysis for singular chemotherapeutic agents did not reveal a specific association with AscAA growth alteration. Conclusions: Growth rates of AscAA are low in this cohort with coincident malignancy. Cancer and/or chemotherapy or radiation are not associated with an alteration of the annual growth rate. Additional control examinations seem unnecessary.

Cardiac Biomarkers for the Detection and Management of Cancer Therapy-Related Cardiovascular Toxicity.

Cardiotoxicity is one of the major side effects of anti-cancer therapy affecting the overall prognosis of patients and possibly leading to the discontinuation of chemotherapy. Traditional cardiovascular tests such as electrocardiography and transthoracic echocardiography have limited sensitivity and specificity for the early detection of myocardial injury. Cardiovascular imaging generally detects cancer therapy-related cardiac dysfunction (CTRCD) at advanced stages, whereas biomarkers are inexpensive, easily detected, reproducible, and capable of detecting even minimal cardiomyocyte damage or mild hemodynamic fluctuations. The presence of circulating cardiac biomarkers has been investigated as early indicators of cardiotoxicity and predictors of subsequent CTRCD. Currently, the most frequently used cardiac biomarkers are cardiac troponin (cTn) and natriuretic peptides (NPs). This review presents the evidence gathered so far regarding the usefulness and limitations of cardiac biomarkers in the field of cardio-oncology.

Targeting of Heparanase in the Murine Model Protects against Radiation-Induced Nephropathy

<h3>Purpose/Objective(s)</h3> Adverse effects are common in virtually all types of treatment modalities in cancer including that of radiation therapy. Several agents are clinically used to aid in the reduction of side effects of anti-cancer therapy, however these agents <i>per se</i> are typically not endowed with tumor-suppressing properties. Herein we report that the extracellular matrix (ECM)-degrading enzyme heparanase (a valid target for anti-cancer drug development) is also a promising candidate for interventions aimed at preventing development of radiation nephropathy - a significant side effect of radiation therapy in the treatment of abdominal/pelvic malignancies. Heparanase is the sole mammalian endoglucuronidase that cleaves heparan sulfate in the ECM. The enzymatic action of heparanase has not only been found to promote tumor development and progression at various anatomic sites but is upregulated in essentially all tumor types found in the abdominal/pelvic cavity, whose radiation treatment may result in the development of radiation nephropathy. <h3>Materials/Methods</h3> Eleven-week-old female C3H/HeNHsd mice were administered 10 Gy of radiation using brachytherapy to induce radiation nephropathy. Subcutaneous injections of Roneparstat, a specific heparanase inhibitor, were administered to the mice and urine samples were collected over 24h. Urinary albumin was measured using an ELISA kit. Prior to and following irradiation, heparanase and early growth response (Egr1) transcription factor mRNA levels were determined by qRT-PCR in both HK-2 human proximal tubule epithelial cells and HEK-293 human embryonic kidney cells. <h3>Results</h3> In this study, we evaluated the potential of targeting heparanase to diminish radiation therapy-induced kidney damage. We demonstrated that clinically relevant doses of ionizing radiation upregulate heparanase expression in renal cells (most likely through a transcription factor Egr 1 –dependent mechanism). Moreover, utilizing a murine model of abdominal radiation therapy, we found that the specific heparanase inhibitor, Roneparstat, abolished radiation-induced albuminurea –the hallmark of radiation nephropathy. <h3>Conclusion</h3> Given the well-documented anti-cancer effects of heparanase inhibition, our present findings attest this enzyme as a unique target in the landscape of cancer therapy due to its dual action. Indeed, targeting of heparanase exerts not only direct anti-tumor effects but also protects from kidney damage induced by radiation - the backbone of cancer therapy across a broad range of abdominal/pelvic malignancies.

Development of an EORTC Item Bank for Computer-Adaptive Testing of Nausea and Vomiting

ObjectivesNausea and vomiting (NV) remain common cancer symptoms and frequent side effects of anticancer therapies despite available antiemetics. They can lead to treatment disruption and discontinuation. NV is an important patient reported outcome in oncology. This study aimed to build an item bank for computer-adaptive testing (CAT) based on NV questions in the European Organisation for Research for Treatment of Cancer, Quality of Life for Cancer Patients (EORTC QLQ-C30) questionnaire and complete the first three phases of development as described in the EORTC Quality of Life Group guidelines. Data SourcesThe development followed a standard procedure. The three phases include conceptualization and literature search (phase 1); item classification, selection, formulation and rating, and expert evaluations (phase 2); and patient pretesting (phase 3). The literature search resulted in a preliminary list of 115 items. Following classification, formulation, and rating, 21 candidate items adhered to the QLQ-C30 format. Evaluation by experts (n = 11) from five countries and patients (n = 31) pretesting in Denmark, Poland, and the UK lead to a final list of 20 items. ConclusionThe selection, development, and refining of NV items have been described. The nature of this testing ensures an initial CAT item bank that after field testing (phase 4) and psychometric analysis is expected to provide a precise and efficient NV measurement while still being comparable to the original QLQ-C30 scale. Implications for Nursing PracticeAccess to reliable tools that facilitate NV comprehensive assessment is an important issue for nurses caring for patients with cancer. This CAT item bank is meant to support clinical decisions when all phases of testing are completed.

Fatigue among Cancer Patients Receiving Radiation Therapy in a Selected Hospital, Mangalore

Abstract Introduction Cancer is a group of diseases characterized by the uncontrolled proliferation of aberrant cells. Radiation therapy is one of the cancer treatments options. It uses high-energy waves to attack tumor cells, as well as adjacent cells. The majority of cancer patients report feeling tired at the start of treatment or after a few weeks of radiation therapy. It is one of the most disabling and ongoing side effects of anticancer therapy among cancer patients. As a result, cancer-related fatigue can be a troubling symptom for most people getting anticancer treatment which is commonly underdiagnosed by the health care team. This research study aids us in assessing fatigue in cancer patients who receive radiation therapy as a treatment. Materials and Methods A quantitative descriptive research design was used in this study to collect data from 138 cancer patients who were undergoing radiation therapy both inpatient and outpatient departments of the selected Medical College Hospital in Mangaluru. The samples for this study were chosen using a purposive sampling technique. Data were collected by administering baseline proforma and Fatigue Assessment Scale. Results Majority of the patients were experiencing substantial fatigue, that is, 105 (76.08%) of patients were experiencing fatigue, 8 (5.79%) were experiencing extreme fatigue. and only 25 (18.11%) were experiencing no fatigue. Mean percentage shows that the majority, that is, 57%, of the patients with cancer experience physical fatigue and 50.25% experience mental fatigue. There is no significant association found between fatigue and selected demographic variables except for marital status (p = 0.015). Hence H0 is accepted at 0.05 level of significance, except for one selected variable. Conclusion The present study concluded that fatigue is one of the common symptoms and adverse effects experienced among cancer patients who receive radiation therapy. Health care professionals should consider the impact of fatigue on the individual and effective fatigue management to be provided to improve the quality of life

Hydrogen sulfide suppress the pathological alterations of endocrine glands induced by Gamma irradiation and cyclophosphamide

Hydrogen sulfide (H2S) is a gaseous mediator and is usually recommended to have antioxidant, anti-inflammatory, anticancer and antiapoptotic consequences. In the endocrine system, H2S can act at the thyroid, adrenal gland, and gonad through the hypothalamus-pituitary axis, in addition to at the pancreas there by collaborating withinside the law of many hormones of the body, and the hypothalamus pituitary axis can, in turn, adjust the manufacturing of (H2S). Chemotherapy (Cyclophosphamide) can cause damage of thyroid, pituitary, pancreatic and adrenal glands. Radiation-induced thyroid, hypothalamus, and anterior pituitary gland disorders. Radiation-induced injury of the endocrine pancreas is known to increase the risk of diabetes mellitus. Testis tissue, radiosensitive organ, has a variety of cells that differ in their degree of sensitivity. In this manner, cancer patient needs for protective agent against different side effects of anticancer therapy especially in case of combination between chemo and radio therapies.

ZINC SUPPLEMENTATION IN THE MANAGEMENT OF ORAL MUCOSITIS IN HEAD AND NECK CANCER PATIENTS: NARRATIVE LITERATURE REVIEW

<h3>Objectives</h3> The aim of this study was to perform a narrative review about the influence of zinc supplementation in treatment and/or prevention of oral mucositis (OM), the most common side effect of anticancer therapies in patients with head and neck cancer (HNC). <h3>Study Design</h3> A survey of studies related to the definition, treatment, and prevention of OM with nutrients, particularly zinc, was carried out between January 2018 and July 2019 using the PubMed, Cochrane Library, and Scielo databases. Inclusion criteria were human clinical trials and systematic and narrative reviews on nutritional supplements to treat and prevent OM in HNC. Exclusion criteria were animal studies and no association between nutrients and/or supplements to the treatment and/or prevention of OM. Sixty-one scientific papers published between 2004 and 2019 were selected. <h3>Results</h3> Zinc supplementation had positive effects on reducing manifestation and severity of OM due to its antioxidant and immunomodulatory properties. In general, the zinc supplement was well tolerated and did not show significant side effects. However, the ideal dose and possible side effects of its use have not yet been defined. <h3>Conclusions</h3> This study suggests the effectiveness of zinc in preventing and treating OM. Further studies are needed to establish drug administration protocol and to evaluate the effects of its use.

Efficacy of remotely monitored cardiac rehabilitation in patients after cancer treatment: A pilot study

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): This research was funded by the Ministry of Health, Czech Republic; conceptual development of research organization (FNBr, 65269705). Background Cardiovascular diseases are usually a partial cause of mortality in patients after cancer treatment. The increased cardiovascular risk in cancer patients is obtained from the cumulation of risk factors and the side effects of anticancer therapy. A multimodal model of cardiac rehabilitation (CR) can improve cardiorespiratory fitness (CRF), cardiovascular risk, and prognosis in this population. Despite the benefits of CR, patient participation in CR programs is very low. One of the main reasons for the low utilization and completion is the geographical distance from a specialized CR center. The remotely monitored CR method can solve a fundamental barrier that prevents CR programs' extensive and effective use. Purpose To examine the feasibility of remotely monitored CR as an alternative approach in hemato-oncological patients after cancer treatment. We assumed that the 12 weeks of remotely monitored CR would be feasible and improve the CRF. Methods From March to September 2021, a 12-week study of remotely monitored CR was performed in hemato-oncology patients after cancer treatment. The intervention was based on the principles of phase II CR and consisted of standardized exercise-based in a home-based model with regular telemonitoring and remote supervision. After a cardiovascular assessment, echocardiogram, troponin, brain natriuretic peptides, cardiopulmonary exercise test-CRF were examined, patients were instructed to perform prescribed exercise 3 times per week, for 30 - 50 minutes, at the target heart rate (HR) zone (70 - 90% HRmax) determined by baseline cardiopulmonary exercise testing. Patients were instructed to record their exercise training intensity using a HR monitor and the Borg scale (level 12 - 14 out of 20). Results Eight hemato-oncological patients (50% males; mean age 59.4 ± 12.0 years) enrolled in a remotely monitored CR program. All patients were post-cancer treatment, including cancer systemic chemotherapy-based treatment with recommended supportive care. The analysis showed a statistically significant increase in CRF by 13.7% (∆ 20.5 watts, p &amp;lt; 0.05, Abstract Figure). Overall training adherence was high (33.25 / 36 sessions). No exercise-related adverse events were recorded. Conclusions The pilot study results support the feasibility assumption of remotely monitored CR in hemato-oncological patients after cancer treatment. CR could lead to significant improvements in CRF. The study results can be useful for sample size estimation of future controlled studies to explore more significant evidence in this area.

Impact of Glucocorticoid Use in Oncology in the Immunotherapy Era.

Thanks to their anti-inflammatory, anti-oedema, and anti-allergy properties, glucocorticoids are among the most widely prescribed drugs in patients with cancer. The indications for glucocorticoid use are very wide and varied in the context of cancer and include the symptomatic management of cancer-related symptoms (compression, pain, oedema, altered general state) but also prevention or treatment of common side effects of anti-cancer therapies (nausea, allergies, etc.) or immune-related adverse events (irAE). In this review, we first give an overview of the different clinical situations where glucocorticoids are used in oncology. Next, we describe the current state of knowledge regarding the effects of these molecules on immune response, in particular anti-tumour response, and we summarize available data evaluating how these effects may interfere with the efficacy of immunotherapy using immune checkpoint inhibitors.

Diferenciální diagnostika zvětšení hypofýzy

Enlargement of the pituitary gland is heterogenous in the etiology. Common causes of pituitary enlargement are physiological hypertrophy during pregnancy, primary and secondary tumors, autoimmune hypophysitis including side effects of anticancer therapy with check-point inhibitors. Terms like hypertrophy, hyperplasia, sellar expansion and hypophysitis are commonly used to describe enlargement of the pituitary gland on MR scan regardless its etiology. The most common pathology causing pituitary gland enlargement is pituitary adenoma. Magnetic resonance imaging can differentiate pituitary tumors from diffuse enlargement due to hypophysitis in most but not all cases. Changes on imaging during time or response to pharmacotherapy might help determine the final diagnosis in uncertain cases. We present a case report of a young woman with sellar expansion due to prolonged untreated peripheral hypothyroidism mimicking pituitary adenoma. Interdisciplinary cooperation of endocrinologist, radiologist and neurosurgeon is crucial in determining the diagnosis.

Probiotics for the Management of Oral Mucositis: An Interpretive Review of Current Evidence.

Mucositis is one of the major side effects of anti-cancer therapies. Mucositis may lead to other abnormalities such as depression, infection, and pain, especially in young patients. Although there is no specific treatment for mucositis, several pharmacological and non-pharmacological options are available to prevent its complications. Probiotics have been recently considered as a preferable protocol to lessen the complications of chemotherapy, including mucositis. Probiotics could affect mucositis by anti-inflammatory and anti-bacterial mechanisms as well as augmenting the overall immune system function. These effects may be mediated through anti microbiota activities, regulating cytokine productions, phagocytosis, stimulating IgA releasement, protection of the epithelial shield, and regulation of immune responses. We have reviewed available literature pertaining to the effects of probiotics on oral mucositis in animal and human studies. While animal studies have reported protective effects of probiotics on oral mucositis, the evidence from human studies is not convincing.

In vivo Study of Proliferative Effect and Growth Promoting Effect of Ultra Diluted Phytolacca decandra in Chick Embryo by Using Cam Assay

Homoeopathy and complementary integrative medicine treatments aimed at decreasing the side effects of anti-cancer therapy and cancer symptoms, as well as providing nutritional and lifestyle advice to help patients with breast cancer and enhance their quality of life. Angiogenesis can be used to investigate phase-specific processes in both physiological and pathological situations. Phytolacca decandra has a specific effect on breast cancer ulceration and scar tissue. The current study deals with the angiogenesis activity by using CAM Assay. Phytolacca decandra was taken in account and it increases angiogenesis in a CAM assay, indicating that it is not hazardous to normal cells. It also improves blood supply, which aids in proliferation, and has no side effects on normal cells.

Проспективная комплексная оценка химиоиндуцированной периферической нейропатии у пациенток с раком молочной железы

Introduction. Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-dependent side effect of anticancer therapy that affects the patient’s quality of life. Currently, the problem of effective and reliable diagnostics for CIPN remains unresolved. Therefore, it is critically important to develop recommendations for a comprehensive assessment of peripheral neuropathy based on simple tests for vibration, tactile, pain sensitivity together with questionnaires. Aim. A prospective comprehensive assessment of the incidence and severity of CIPN using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) and the Patient Neurotoxicity Questionnaire (PNQ) in patients with breast cancer treated with taxanes. Materials and methods. Symptoms of CIPN were prospectively assessed in 60 patients using the PNQ, the NCI-CTCAE and the Eastern Cooperative Oncology Group (ECOG) Performance Status scores at baseline, 1 week after and 13 weeks after the start of chemotherapy. Results. The CIPN scores according to the PNQ were widely distributed among patients compared to the NCI-CTCAE scores for both sensory and motor neuropathy. There was a marked increase in symptoms of motor neuropathy in patients who were identified only on the basis of PNQ data. The PNQ was used to formally assess the impact of neuropathy on the patient’s activities of daily living. Conclusion. A comprehensive methodology based on a neurological examination together with the NCI-CTCAE and the PNQ will allow a more detailed assessment of the severity of СIPN, and in the future will provide an opportunity to develop a more effective patient management plan. The PNQ has shown itself to be a more sensitive tool compared to the NCI-STCAE, especially in assessing sensory neuropathy. Thus, it is reasonable to include patient-reported data in the evaluation of СIPN in order to provide a more accurate identification of the frequency and severity of neuropathy.

Disorders of Divalent Ions (Magnesium, Calcium, and Phosphorous) in Patients With Cancer.

Disorders of the divalent ions (magnesium, calcium, and phosphorous) are frequently encountered in patients with cancer. Of these, hypomagnesemia, hypocalcemia, hypercalcemia, and hypophosphatemia are seen most commonly. These electrolyte disturbances may be related to the underlying malignancy or due to side effects of anticancer therapy. When caused by a paraneoplastic process, these abnormalities may portend a poor prognosis. Importantly, the development of severe electrolyte derangements may be associated with symptoms that negatively impact quality of life, preclude the administration of critical chemotherapeutic agents, or lead to life-threatening complications that require hospitalization and emergent treatment. In accordance, prompt recognition and treatment of these disorders is key to improving outcomes in patients living with cancer. This review will discuss selected derangements of the divalent ions seen in this population, with a focus on paraneoplastic and therapy-associated etiologies.

THE RELATIONSHIP BETWEEN METABOLIC DISORDERS AND TUMOR PROGRESSION: REVIEW OF PRESENT DATA AND NEW THERAPEUTIC TARGETS

Background. Type 2 diabetes mellitus, obstructive sleep apnea, osteoarthritis and certain types of cancer are known to correlate with obesity. The mechanisms underlying the link between metabolic disorders and cancer remain obscure, yet assuming a potentially important role of reduced insulin sensitivity, altered glucose metabolism in tumor cells (the so-called Warburg effect), changes in the spectrum of secreted adipokines or interaction with their cognitive receptors as well as changes in steroid sex hormone production.Material and methods. A search for articles published in peer-reviewed journals indexed in pubmed, Wos, scopus and Rsci was carried out. More than 150 articles devoted to the study of the relationship between metabolic disorders and tumor progression were analyzed, of which 69 were included in this review.Results. The main strategy of anticancer therapy is to suppress the proliferation of tumor cells and metastasis. However, one should take into consideration a significant role of additional factors that can enhance side effects of anticancer therapy, ensure the resistance of tumor cells to chemotherapy or change cancer cell metabolic profile. New data recently emerging in the literature indicate an important function of proteins such as t-cadherin and urokinase receptor (upar) and their possible involvement in the regulation of tumor cell metabolism, in particular, sensitivity to insulin and adipose tissue hormones. The review encompasses recent data on the involvement of t-cadherin and upar in the regulation of metabolism and proposes a model explaining the relationship between these proteins and metabolic disorders associated with the processes of carcinogenesis and chemoresistance of cancer cells.Conclusion. Understanding of the factors and mechanisms that support obesity and metabolic disorders is relevant both for the development of cancer preventive measures and optimization of therapeutic strategies for combating cancer.