Notes

Crisis CT incorrect diagnosis throughout severe aortic malady.
Hypoxia is a characteristic of many solid tumours and results in an increase in expression of HIF-1α. Many studies have investigated the prognostic value of HIF-1α expression in breast cancer (BC), however, the prognostic value remains unclear. Therefore, a systematic review and meta-analysis was undertaken to determine the prognostic value of HIF-1α in BC patients.

The electronic databases PubMed and Web of science were systematically searched to identify relevant papers. The clinical outcomes included disease-free survival (DFS), recurrence-free survival (RFS) and overall survival (OS) in BC patients. Review Manager version 5.4 was employed to analysis data from 30 eligible studies (containing 6201patients).

High expression of HIF-1α was associated with poorer DFS and OS. There was an effect of survival analysis, study region, antibodies used, scoring and threshold methods on HIF-1α expression.

HIF-1α overexpression was significantly associated with poorer DFS and OS in breast cancer patients.
HIF-1α overexpression was significantly associated with poorer DFS and OS in breast cancer patients.Epidermal Growth Factor Receptor (EGFR) mutations are the most common targetable oncogenic driver mutation in metastatic non-small lung cancer (NSCLC). There have been significant advances in the management of metastatic EGFR-mutant NSCLC from the advent of first and second generation EGFR inhibitors to, more recently, the third-generation inhibitor osimertinib. Osimeritinib is now established as first-line therapy on the basis of improved outcomes compared to first and second generation agents. However, despite excellent initial response rates, responses may not be durable due to the development of acquired resistance. Understanding these mechanisms of resistance is critical to the development of rational drug and drug combinations capable of circumventing them. We discuss the major mechanisms of resistance to first, second and third generation EGFR TKIs. The potential of drug combinations utilising chemotherapy, immunotherapy and anti-angiogenic drugs are explored. We examine strategies to aid drug development, including circulating tumour DNA and novel trial designs.
The immune response has been recognized as a major tumor-eradication component of radiotherapy.

This review studies, under a clinical perspective, two contrasting effects of radiotherapy, namely immunosuppression and radiovaccination.

We critically reviewed the available clinical and experimental experience on radiotherapy-induced lymphopenia.

Radiation-induced tumor damage promotes radio-vaccination, enhances cytotoxic immune responses, and potentiates immunotherapy. Nevertheless, radiotherapy induces systemic and intratumoral lymphopenia. The above effects are directly related to radiotherapy fractionation and field size/location, and tumor characteristics.

Hypofractionated stereotactic and accelerated irradiation better promotes radio-vaccination and produces less severe lymphopenia. Adopting cytoprotective policies and combining lympho-stimulatory agents or agents blocking regulatory lymphocyte activity are awaited to unmask the radio-vaccination effect, enhancing the efficacy immuno-radiotherapy.

Radiation-induced lymphopenia and immunosuppression are important issues that should be considered in the design of immuno-radiotherapy clinical trials.
Radiation-induced lymphopenia and immunosuppression are important issues that should be considered in the design of immuno-radiotherapy clinical trials.A number of epidemiological studies have suggested a positive association between periodontal diseases and oro-digestive cancers, including liver cancer. The purpose of the present systematic review was to analyze the current evidence regarding the potential association between periodontitis and/or tooth loss and the risk of liver cancer. A comprehensive search of PubMed, Scopus and Web of Science databases was conducted in August 2019. The inclusion criteria comprised all observational studies that assessed the relationship between periodontitis or tooth loss and liver cancer. Case reports, animal studies, experimental studies, and reviews were excluded. Due to great heterogeneity among the included studies, no meta-analysis was conducted. Six studies (five prospective cohorts and one case-control) comprising 619,834 subjects (including 916 liver cancer cases) were included. The studies were conducted in the United States, Europe, and Asia. Three large-scale cohort studies reported a positive association between periodontitis or tooth loss and the risk of liver cancer. One case-control study found some association between liver cancer and loss of 12-23 teeth, but such association was not replicated in patients with greater number of tooth loss. Contrarily, two studies failed to report any association between periodontitis and/or tooth loss and the risk of liver cancer. The available evidence suggests a possible link between tooth loss/periodontitis and the risk of liver cancer. However, the evidence is not conclusive enough, a fact that drives to conduct more, well-designed, prospective cohort studies to further explore the potential association between periodontitis and the risk of liver cancer.Cholangiocarcinoma and biliary tract cancers are rare but aggressive tumors that are characterized by an heterogenous molecular and genetic footprint. Genetic aberrations such as FGFR2 fusion and ErBb2 amplification are common in those cancers. Recent studies aimed at exploring the efficacy and benefit of targeted therapy in the treatment of advanced cholangiocarcinoma. Many promising drugs exist and warrant additional investigations. This review will summarize available results and highlight therapeutic strategies incorporated in clinical trials.
Several randomized trials of neoadjuvant chemo-immunotherapy in early triple negative breast cancer (TNBC) have been recently reported, showing conflicting results.

We systematically searched PubMed, Cochrane CENTRAL, Embase and key oncological meetings for trials of neoadjuvant chemo-immunotherapy in TNBC. The primary endpoint was pCR, with sub-analyses based on PD-L1 expression and risk of relapse.

Five randomized trials enrolling 1496 TNBC patients were included. We observed a statistically significant association between PD1/PD-L1 blockade addition and pCR (SOR = 1.72, 95 %CI 1.22-2.42). The benefit was significant in the PD-L1 positive subgroup (SOR = 1.65; 95 %CI 1.06-2.57). selleck compound pCR was also significantly increased in the high-risk subgroup (SOR = 2.39; 95 %CI 1.09-5.22), when restricting to patients receiving an anthracycline-based NACT. We found no significant association between immunotherapy addition and toxicity, and no evidence of publication bias.

The addition of PD1/PD-L1 blockade to NACT significantly improves pCR rates in TNBC patients, particularly in patients at high-risk of relapse.
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