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Post-mastectomy radiation therapy (PMRT) improves locoregional control and overall survival in patients with breast cancer. With the evolution of systemic therapy, the benefit of PMRT in patients with triple-negative disease requires further evaluation.
BEATRICE is a phase III randomized clinical trial that examined the efficacy of bevacizumab in patients with triple-negative breast cancer (TNBC). The current study is a retrospective analysis of data on patients enrolled and treated with mastectomy and systemic therapy. The primary endpoint was determining the effect of PMRT on locoregional recurrence rates (LRR). Hazard ratios were estimated using Cox regression, and LRR curves were generated by the Kaplan-Meier method.
In total, 940 patients were included in our analysis, of whom 359 (38.2%) received PMRT while 581 (61.8%) did not. At median follow-up of 5 years, no significant difference in LRR was noted between the PMRT and no PMRT groups in node-negative patients (HR = 1.09). Patients with N1 disease had 5-year LRR-free survival of 96% for PMRT versus 91% for no PMRT (HR = 0.46). Most N2 patients received PMRT and had 5-year LRR-free survival of 76%.
PMRT benefit in TNBC patients treated with modern systemic therapy is lower than historical reports. Delivery of PMRT in patients with N1 disease enrolled in the BEATRICE trial was not shown to improve local control. As this might be due to patient selection for PMRT, future randomized controlled trials are required to assess the role of PMRT in this patient population.
PMRT benefit in TNBC patients treated with modern systemic therapy is lower than historical reports. Delivery of PMRT in patients with N1 disease enrolled in the BEATRICE trial was not shown to improve local control. As this might be due to patient selection for PMRT, future randomized controlled trials are required to assess the role of PMRT in this patient population.
Invasive lobular carcinoma (ILC) is thought be a unique entity with higher rates of multifocal/multicentric and bilateral disease. This study aimed to evaluate the true extent of the disease, risk of bilaterality, lymph node involvement, and impact of preoperative imaging to help guide surgical decisionmaking.
A retrospective analysis identified patients treated for ILC between 2004 and 2017. Clinical staging and pathologic results were compared. Follow-up details including local recurrence, contralateral breast cancer (CBC), and survival outcomes were evaluated.
The study identified 692 patients with ILC, including 43 patients (6%) with a diagnosis of CBC and 232 patients (33%) with a diagnosis of multifocal/multicentric disease at presentation. Preoperative magnetic resonance imaging (MRI) led to an identification of additional disease in 20% of the patients. Preoperative MRI resulted in a more accurate prediction of tumor size staging but did not improve the discordance between clinical and pathologic nodal staging. Overall, the rate of imaging occult lymph node disease was 24%. At the 6-year follow-up evaluation, a local recurrence had developed in 2.3%, a CBC in 2.3, and a distant metastasis in 9.4% of the patients. The overall survival rate was 96% at 3 years and 91% at 5 years.
Invasive lobular carcinoma is a distinct subset of cancer that poses a diagnostic staging challenge. The results of this study favor MRI for accurate tumor staging and for improving detection of multicentricity and bilaterality. However, clinicians should be aware of the higher likelihood of occult lymph node involvement with ILC and subsequent early metastasis.
Invasive lobular carcinoma is a distinct subset of cancer that poses a diagnostic staging challenge. The results of this study favor MRI for accurate tumor staging and for improving detection of multicentricity and bilaterality. However, clinicians should be aware of the higher likelihood of occult lymph node involvement with ILC and subsequent early metastasis.Although postmastectomy radiation therapy is known to reduce local recurrence in patients with T1/2N1 breast cancer, some have postulated that not all patients require this treatment. In this era of genomic analyses and personalized therapy, clinicians have debated whether the toxicity of post-mastectomy radiation therapy (PMRT) can be avoided for some subsets of patients. However, the data in this regard remain controversial, particularly as surgeons de-escalate the surgical management of the axilla. Several ongoing clinical trials may provide a glimpse into optimal management in this scenario. However, the "right" answer to this debate currently remains unclear.
Esophageal adenocarcinoma (EAC) has increased in incidence in Western countries, and its poor prognosis necessitates the development of novel therapeutics. We previously reported the potential of conditionally replicative adenoviruses (CRAd) as a novel therapeutic treatment for this disease. To further augment the therapeutic effectiveness of our cyclooxygenase-2 (Cox2) controlled CRAd in EAC, we inserted an interferon alpha (IFN) transgene into the viral genome that is expressed upon viral replication. In this manuscript, we analyze the cytotoxic and oncolytic effects of an IFN-expressing oncolytic adenovirus in EAC and the role of the Cox2 promoter in providing for selective replication in human tissues.
An infectivity-enhanced IFN-expressing CRAd (5/3 Cox2 CRAd ΔE3 ADP IFN) and other control viruses were first tested in vitro with cell lines. For the in vivo study, EAC xenografts in nude mice were treated with a single intratumoral dose of virus. An ex vivo analysis with live tissue slices was conducted using surgically resected EAC patient specimens.
Expression of IFN significantly enhanced the cytotoxic and oncolytic effect of a Cox2-promoter controlled CRAd. This virus showed significant tumor growth suppression in a xenograft model. Furthermore, in human EAC samples, the promoter-controlled virus demonstrated selective replication in cancerous tissues, leaving normal esophageal tissue unaffected.
An IFN-expressing CRAd driven by the Cox2 promoter has strong oncolytic effects as well as cancer-specific replication. Our novel vector possesses critical characteristics that make it a potential candidate for clinical translation to treat EAC.
An IFN-expressing CRAd driven by the Cox2 promoter has strong oncolytic effects as well as cancer-specific replication. Our novel vector possesses critical characteristics that make it a potential candidate for clinical translation to treat EAC.
The purpose of this study was to compare the histopathologic findings of pre- and post-active decompression of odontogenic keratocyst and to establish if such findings were consistent.
A retrospective case series from a group of patients diagnosed with odontogenic keratocyst who underwent active decompression and distraction sugosteogenesis followed by final enucleation was designed and implemented. The dependent variable was changed in histologic diagnosis, as evaluated by an oral and maxillofacial pathologist. Other variables included age, gender, anatomic location of the lesion, and time elapsed from initial biopsy to final enucleation.
Six patients diagnosed with odontogenic keratocyst who underwent active decompression followed by enucleation and curettage were studied. The mean age was 45.6years (range, 16 to 74) 83.33% were males, 16.66 females. Lesions were located in the mandible in 83.33% of cases and in the maxilla in 16.66% of cases. Post-active decompression histologic examination at the time of definitive enucleation was consistent with the initial diagnosis in 83.33% of cases.
The histopathological diagnosis at the time of definitive treatment by enucleation and curettage is consistent with the pre-active decompression diagnosis.
The histopathological diagnosis at the time of definitive treatment by enucleation and curettage is consistent with the pre-active decompression diagnosis.
The objective of this study was to assess the impact of orthognathic surgery for dental facial deformities on oral health-related quality of life (OHRQoL) in the immediate postoperative period up to at least 1year after surgery.
This prospective study evaluated data from 85 patients. OHRQoL was assessed using the Dutch version of the Oral Health Impact Profile questionnaire (OHIP-14NL) preoperatively (T
), each day for 7days postoperatively (T
-T
) and 4weeks (T
), 6months (T
), and at least 1year (T
) after surgery. The total OHIP score was calculated for each patient, with higher OHIP scores indicating a worse impact on oral health. Patients also completed an extra questionnaire about self-care, discomfort, and experienced pain (rated on a 10-point scale) in the postoperative period (T
-T
).
The mean OHIP score increased sharply at T
compared to T
but decreased significantly in the first postoperative week. The mean OHIP score at T
was still higher than before surgery. However, at T
and T
, the mean OHIP score was significantly lower than at T
(P < .05). No significant difference in OHIP score was found between gender, age, type of surgery, and indication for surgery. Pain significantly decreased from T
to T
. The OHIP and pain scores significantly positively correlated at every time point except T
.
The findings indicate that OHRQoL is reduced from baseline in the immediate postoperative period but improves over time. By 1year, OHRQoL improves significantly after orthognathic surgery in patients with dentofacial deformities.
The findings indicate that OHRQoL is reduced from baseline in the immediate postoperative period but improves over time. By 1 year, OHRQoL improves significantly after orthognathic surgery in patients with dentofacial deformities.Biosynthesis of silver nanoparticles (AgNPs) from marine actinobacteria offers a promising avenue for exploring bacterial extracts as reducing and stabilizing agents. We report extracellular extracts of Rhodococcus rhodochrous (MOSEL-ME29) and Streptomyces sp. (MOSEL-ME28), identified by 16S rRNA gene sequencing for synthesis of AgNPs. Ultrafine silver nanoparticles were biosynthesized using the extracts of R. rhodochrous and Streptomyces sp. and their possible therapeutic applications were studied. The physicochemical properties of nanoparticles were established by HR-SEM/TEM, SAED, UV-Vis, EDS, XRD, and FTIR. UV-Vis spectra displayed characteristic absorption at 430 nm and 412 nm for AgNPs from Streptomyces sp. (S-AgNPs) and Rhodococcus sp. (R-AgNPs), respectively. HR-SEM/TEM, XRD, EDS analysis confirmed the spherical shape, crystalline nature, and elemental formation of silver. Crystallite or grain size was deduced as 5.52 nm for R-AgNPs and 35 nm for S-AgNPs. Zeta-potential indicated electrostatic negativntial to be used in diverse biological applications and that the marine actinobacteria are an excellent resource for fabrication of AgNPs.A novel protease-producing actinobacterium, designated strain NEAU-A11T, was isolated from soil collected from Aohan banner, Chifeng, Inner Mongolia Autonomous Region, China, and characterised using a polyphasic approach. Ki16425 datasheet The hydrolytic enzymes, such as proteases, played critical roles in destruction of fungi by degrading the protein linkages to disrupt integrity in the cell wall. This suggested that the isolate could be a good biocontrol candidate against pathogens to control fungal diseases. On the basis of 16S rRNA gene sequence analysis, strain NEAU-A11T was indicated to belong to the genus Actinoplanes and was most closely related to Actinoplanes rectilineatus JCM 3194 T (98.9%). Cell walls contained meso-diaminopimelic acid as the diagnostic diamino acid and the whole-cell sugars were arabinose, xylose and glucose. The phospholipid profile contained diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylinositol and two phosphatidylinositol mannosides. The predominant menaquinones were MK-9(H4), MK-9(H6) and MK-9(H8).
Homepage: https://www.selleckchem.com/products/Ki16425.html
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