Study on the Impact of CMV-Encephalopathy on the Survival of Brain Cancer Patients Undergoing Radio(Chemo)therapy of the Brain

2017 ◽  
Vol 99 (2) ◽  
pp. E75-E76
Author(s):  
N.L. Goerig ◽  
B. Frey ◽  
K. Korn ◽  
B. Fleckenstein ◽  
K. Ueberla ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Brain Cancer ◽  
The Impact ◽  
The Brain

Study of the impact of cytomegalovirus-encephalopathy on survival of brain cancer patients undergoing treatment with radio(chemo)therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 2036-2036
Author(s):  
Nicole Lydia Goerig ◽  
Benjamin Frey ◽  
Klaus Korn ◽  
Bernhard Fleckenstein ◽  
Klaus M Ueberla ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Disease Progression ◽  
Cancer Patients ◽  
Brain Cancer ◽  
Antiviral Treatment ◽  
High Grade ◽  
Increased Risk ◽  
One Year ◽  
The Impact ◽  
The Brain

2036 Background: As recently demonstrated (Neurooncology, 2016), neurological decline of patients with brain cancer (high grade glioma, brain metastases) during radio(chemo)therapy (RCT) of the brain is oftentimes caused by CMV-encephalopathy but not disease progression or therapeutic complications. We examined the impact of clinical and serological CMV-status on the survival one year after the onset of radio(chemo)therapy of the brain. Methods: 118 patients requiring whole-brain radiotherapy for brain metastases (n = 55) or local RCT of the brain for high-grade gliomas (n = 63) were observed in the prospective GLIO-CMV-01 study. MRIs and blood samples were obtained before, halfway through, and at the end of radiotherapy. MRIs were screened for disease progression or increased intracranial pressure. Blood was tested for anti-CMV immunoglobulin (Ig)M, anti-CMV IgG, and CMV DNA. Results: 68 of 118 (58%) patients were positive for anti-CMV IgG before radio(chemo)therapy. 28 of those 68 (41%) developed CMV-viremia during or up to 28 days after the end of irradiation. 21 of those 28 (75%) required treatment for symptomatic CMV-associated encephalopathy. One year after the start of RCT, survival was 72% (34/47) (no encephalopathy, anti-CMV-IgG+) or 68% (34/50) (no encephalopathy, anti-CMV-IgG-) versus 38% (8/21) (encephalopathy) (p = 0.0034). Conclusions: Symptomatic CMV-encephalopathy all but doubles the mortality of brain cancer patients within one year of RCT, despite antiviral treatment with ganciclovir. These findings heavily underline the importance to identify patients with increased risk profile for developing CMV-encephalopathy before initiating RCT.

scholarly journals Convection-Enhanced Delivery in silico study for personalized brain cancer treatment

2021 ◽  
Author(s):  
Chryso Lambride ◽  
Vasileios Vavourakis ◽  
Triantafyllos Stylianopoulos
Keyword(s):  
Brain Cancer ◽  
In Silico ◽  
Drug Transport ◽  
Drug Distribution ◽  
Local Drug Delivery ◽  
Patient Specific ◽  
Convection Enhanced Delivery ◽  
Formidable Challenge ◽  
The Impact ◽  
The Brain

Abstract Brain cancer therapy remains a formidable challenge in oncology. Convection-enhanced delivery (CED) is an innovative and promising local drug delivery method for the treatment of brain cancer, overcoming the challenges of the systemic delivery of drugs to the brain. To improve our understanding about CED efficacy and drug transport, we present an in silico methodology for brain cancer CED treatment simulation. To achieve this, a three-dimensional finite element biomechanics formulation is utilized which employs patient-specific brain model representation and is used to predict the drug deposition in CED regimes. The model encompasses nonlinear biomechanics and the transport of drugs in the brain parenchyma. Drug distribution was studied under various patho-physiological conditions of the tumor, in terms of tumor vessel wall pore size and tumor tissue hydraulic conductivity as well as for drugs of various sizes, spanning from small molecules to nanoparticles. Our contribution reports for the first time the impact of the size of the vascular wall pores and that of the therapeutic agent on drug distribution during and after CED. The in silico findings provide useful insights of the spatio-temporal distribution and average drug concentration in the tumor towards an effective treatment of brain cancer.

The Impact of Diagnostic MRI on the Early Detection of Lethal Genes in Human Genome and to Develop Genomic Medicine to Treat Brain Cancers

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Hameed Khan A
Keyword(s):  
Early Detection ◽  
Brain Cancer ◽  
Genomic Medicine ◽  
Three Dimensional ◽  
Good Health ◽  
Rational Approach ◽  
Chemotherapeutic Approach ◽  
The Impact ◽  
The Brain ◽  
Lethal Genes

Early detection of the onset of diseases are essential if we want to maintain good health. MRI technique provides a three-dimensional image of a microscopic lesion in an organ. Human body is made of 220 different tissues which interact to make an organ and several organs interact to make a human. As a part of medical record, taking MRI of each organ every year and comparing them with each other will identify the appearance of microscopic changes. For example, if you are diagnosed with Brain cancer today, you did not get the cancer yesterday. Abnormal changes are the result of accumulation of harmful mutations over the years predicting the onset of diseases. Once the brain tumor is confirmed, the patient dies within fourteen months. To save the life of the patient, the following three strategies are available and they are Surgery, Radiation and Chemotherapy. This article describes the Chemotherapeutic approach to treat cancers in general and brain cancer, Glioblastoma, in particular. Using rational approach, we designed AZQ (US Patent 4,146,622 & 4,233,215) to treat Glioblastomas. MRI Would identify appearance of microscopic lesions of Glioblastoma and help us start treatment with AZQ long before the disease is confirmed. Using similar rational approach of early diagnosis with MRI, we could design drugs to treat other diseases including cancers.

scholarly journals Recent Advances in Liquid Biopsy of Brain Cancers

2021 ◽  
Vol 12 ◽  
Author(s):  
Yunyun An ◽  
Fei Fan ◽  
Xiaobing Jiang ◽  
Kun Sun
Keyword(s):  
Cerebrospinal Fluid ◽  
Early Diagnosis ◽  
Cancer Patients ◽  
Brain Cancer ◽  
Liquid Biopsy ◽  
Causes Of Death ◽  
Survival Rates ◽  
Relapse Prediction ◽  
Clinical Benefits ◽  
The Brain

Brain cancers are among the top causes of death worldwide. Although, the survival rates vary widely depending on the type of the tumor, early diagnosis could generally benefit in better prognosis outcomes of the brain cancer patients. Conventionally, neuroimaging and biopsy are the most widely used approaches in diagnosis, subtyping, and prognosis monitoring of brain cancers, while emerging liquid biopsy assays using peripheral blood or cerebrospinal fluid have demonstrated many favorable characteristics in this task, especially due to their minimally invasive and easiness in sampling nature. Here, we review the recent studies in the liquid biopsy of brain cancers. We discuss the methodologies and performances of various assays on diagnosis, tumor subtyping, relapse prediction as well as prognosis monitoring in brain cancers, which approaches have made a big step toward clinical benefits of brain cancer patients.

Depression, Inflammation, and Cancer

2021 ◽  
pp. 644-653
Author(s):  
Daniel C. McFarland ◽  
Leah E. Walsh ◽  
Andrew H. Miller
Keyword(s):  
Cancer Patients ◽  
Inflammatory Markers ◽  
Increased Risk ◽  
Brain Changes ◽  
The Many ◽  
Many Sources ◽  
The Impact ◽  
The Relationship ◽  
The Brain

Depression in cancer is common, often unrecognized and untreated, and has a significant impact on quality of life and morbidity and mortality. Increasing understanding of the impact of the immune system and inflammation on the brain has revealed that cancer patients are at an especially increased risk for inflammation-induced depression by virtue of the many sources of inflammation to which they are exposed. Treatments including surgery, radiation, chemotherapy, and immunotherapy as well as cancer itself are associated with increased inflammation that can drive brain changes and depression. This chapter will review the relationship between depression and inflammation in cancer patients with special attention paid to the data that support increased inflammatory markers in cancer patients with depression, the neurobiological mechanisms by which inflammation can impact neurotransmitters and neurocircuits in the brain, and the data addressing interventions that reduce inflammation and depression in cancer patients. Finally, the chapter addresses future directions regarding the translational implications of this work.

scholarly journals Liver Immune Microenvironment and Metastasis from Colorectal Cancer-Pathogenesis and Therapeutic Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2418
Author(s):  
Xuezhen Zeng ◽  
Simon E. Ward ◽  
Jingying Zhou ◽  
Alfred S. L. Cheng
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Cancer Patients ◽  
High Recurrence Rate ◽  
Immune Microenvironment ◽  
Liver Sinusoidal Endothelial Cells ◽  
Premetastatic Niche ◽  
Cancer Pathogenesis ◽  
Colorectal Cancer Patients ◽  
The Impact

A drastic difference exists between the 5-year survival rates of colorectal cancer patients with localized cancer and distal organ metastasis. The liver is the most favorable organ for cancer metastases from the colorectum. Beyond the liver-colon anatomic relationship, emerging evidence highlights the impact of liver immune microenvironment on colorectal liver metastasis. Prior to cancer cell dissemination, hepatocytes secrete multiple factors to recruit or activate immune cells and stromal cells in the liver to form a favorable premetastatic niche. The liver-resident cells including Kupffer cells, hepatic stellate cells, and liver-sinusoidal endothelial cells are co-opted by the recruited cells, such as myeloid-derived suppressor cells and tumor-associated macrophages, to establish an immunosuppressive liver microenvironment suitable for tumor cell colonization and outgrowth. Current treatments including radical surgery, systemic therapy, and localized therapy have only achieved good clinical outcomes in a minority of colorectal cancer patients with liver metastasis, which is further hampered by high recurrence rate. Better understanding of the mechanisms governing the metastasis-prone liver immune microenvironment should open new immuno-oncology avenues for liver metastasis intervention.

scholarly journals The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Patient Experience ◽  
Emotional Support ◽  
Social Care ◽  
Legal Issues ◽  
Care Services ◽  
Health And Social Care ◽  
Ethical And Legal Issues ◽  
The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

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