scholarly journals 213 Genomic alteration of a metastatic gastric-type cervical adenocarcinoma: hints and personalized treatment options

2021 ◽  
Author(s):  
A Sarivalasis ◽  
B Bisig ◽  
D Hastir ◽  
K Lefort ◽  
A Liapi
Keyword(s):  
Treatment Options ◽  
Cervical Adenocarcinoma ◽  
Personalized Treatment ◽  
Genomic Alteration ◽  
Gastric Type

scholarly journals Personalized treatment options for chronic diseases using precision cohort analytics

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenney Ng ◽  
Uri Kartoun ◽  
Harry Stavropoulos ◽  
John A. Zambrano ◽  
Paul C. Tang
Keyword(s):  
Decision Making ◽  
Chronic Diseases ◽  
Primary Care Physicians ◽  
Treatment Guidelines ◽  
Point Of Care ◽  
Data Extraction ◽  
Treatment Options ◽  
Personalized Treatment ◽  
Medical Decision ◽  
Similarity Model

AbstractTo support point-of-care decision making by presenting outcomes of past treatment choices for cohorts of similar patients based on observational data from electronic health records (EHRs), a machine-learning precision cohort treatment option (PCTO) workflow consisting of (1) data extraction, (2) similarity model training, (3) precision cohort identification, and (4) treatment options analysis was developed. The similarity model is used to dynamically create a cohort of similar patients, to inform clinical decisions about an individual patient. The workflow was implemented using EHR data from a large health care provider for three different highly prevalent chronic diseases: hypertension (HTN), type 2 diabetes mellitus (T2DM), and hyperlipidemia (HL). A retrospective analysis demonstrated that treatment options with better outcomes were available for a majority of cases (75%, 74%, 85% for HTN, T2DM, HL, respectively). The models for HTN and T2DM were deployed in a pilot study with primary care physicians using it during clinic visits. A novel data-analytic workflow was developed to create patient-similarity models that dynamically generate personalized treatment insights at the point-of-care. By leveraging both knowledge-driven treatment guidelines and data-driven EHR data, physicians can incorporate real-world evidence in their medical decision-making process when considering treatment options for individual patients.

Gastric-type cervical adenocarcinoma with squamous differentiation: buried in adenosquamous carcinomas?

2021 ◽  
Author(s):  
Hiroshi Yoshida ◽  
Tomoaki Naka ◽  
Mayumi Kobayashi-Kato ◽  
Nao Kikkawa ◽  
Yasuhito Tanase ◽  
...  
Keyword(s):  
Cervical Adenocarcinoma ◽  
Squamous Differentiation ◽  
Gastric Type

scholarly journals G-quadruplexes: a promising target for cancer therapy

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nils Kosiol ◽  
Stefan Juranek ◽  
Peter Brossart ◽  
Annkristin Heine ◽  
Katrin Paeschke
Keyword(s):  
Breast Cancer ◽  
Structure Formation ◽  
Genome Instability ◽  
Treatment Options ◽  
Personalized Treatment ◽  
Cancer Development ◽  
Intratumor Heterogeneity ◽  
Dna And Rna ◽  
New Strategy ◽  
The Stability

AbstractDNA and RNA can fold into a variety of alternative conformations. In recent years, a particular nucleic acid structure was discussed to play a role in malignant transformation and cancer development. This structure is called a G-quadruplex (G4). G4 structure formation can drive genome instability by creating mutations, deletions and stimulating recombination events. The importance of G4 structures in the characterization of malignant cells was currently demonstrated in breast cancer samples. In this analysis a correlation between G4 structure formation and an increased intratumor heterogeneity was identified. This suggests that G4 structures might allow breast cancer stratification and supports the identification of new personalized treatment options. Because of the stability of G4 structures and their presence within most human oncogenic promoters and at telomeres, G4 structures are currently tested as a therapeutic target to downregulate transcription or to block telomere elongation in cancer cells. To date, different chemical molecules (G4 ligands) have been developed that aim to target G4 structures. In this review we discuss and compare G4 function and relevance for therapeutic approaches and their impact on cancer development for three cancer entities, which differ significantly in their amount and type of mutations: pancreatic cancer, leukemia and malignant melanoma. G4 structures might present a promising new strategy to individually target tumor cells and could support personalized treatment approaches in the future.

A retrospective study of hepatic arterial infusion (HAI) FUDR/Dex and mitomycin C (MMC) for chemotherapy refractory unresectable intrahepatic cholangiocarcinomas (ICC).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 432-432
Author(s):  
Gustavo Dos Santos Fernandes ◽  
Nancy E. Kemeny ◽  
Haley Hauser ◽  
James J. Harding ◽  
Thomas Boerner ◽  
...  
Keyword(s):  
Treatment Options ◽  
Hepatic Arterial Infusion ◽  
Progression Free Survival ◽  
Response Assessment ◽  
Cancer Center ◽  
Genomic Alteration ◽  
Free Survival ◽  
Heavily Pretreated ◽  
Localized Disease ◽  
Next Generation Sequencing Ngs

432 Background: ICC are aggressive tumors with approximately 6,000 cases a year in US. The 5-year survival rate is less than 30% even for localized disease. There is only one approved line of systemic (SYS) treatment and further treatment options are necessary. HAI chemotherapy is an option to treat liver predominant cancers. Methods: After obtaining IRB approval, we retrospectively reviewed patients (pts) with ICC chemo refractory unresectable liver limited (LL) or liver dominant (LD) disease who received intrahepatic chemotherapy with HAI MMC. Baseline characteristics, previous lines of therapy, toxicity profile, combinations and radiographic responses were reviewed. Tumor genomic analyses were performed on samples using an on-site next generation sequencing (NGS) assay. Results: Between January 2011 and October 2018, 19 patients ICC with LL or LD disease were treated with HAI FUDR/Dex/MMC at Memorial Sloan Kettering Cancer Center. Disease was confined to the liver in 58% of the pts. All pts had previous chemotherapy (1-4 lines) and 14 (74%) previously had HAI FUDR/Dex. Of the 19 pts, 56% had HAI with FUDR/Dex and MMC, 43% had FUDR/Dex, MCC and SYS and 5% had HAI MMC and SYS. Seventeen patients were evaluable for response, two are being treated and will have response assessment for the meeting. Response was noted in 4 (23.5%), stable disease in 6 (35.5%) and progressive disease in 7 (41%) pts. Median overall survival from treatment was 6.1months (0.36-26). Median progression free survival was 3.65 months (0.36-9.53). Four patients had dose reductions. Common toxicity attributed to MMC was grade (G) one fatigue (32%), thrombocytopenia G1(16%) and G2 (5%). Of the 12 tumors analyzed to date the most 92% of tumors harbored at least one (0-10) genomic alteration. Common genomic alterations were ARID1 (25%), RASA1 (25%), IDH1(16.6%), NTRK (16.6%), TERT (16.6%), NRAS (16.6%), CDKN2 (16. 6%). FGFR2-FOXP1 and GTL2MEt fusions were found in one patient each. Conclusions: HAI FUDR/Dex/MMC containing regimens are active in pts with heavily pretreated refractory unresectable ICC. This strategy should be further investigated. Translational data will be presented.

Delivery of a Personalized Treatment Approach to Women with Epilepsy

2017 ◽  
Vol 37 (06) ◽  
pp. 611-623 ◽  
Author(s):  
Page Pennell ◽  
P. Voinescu
Keyword(s):  
Antiepileptic Drugs ◽  
Seizure Frequency ◽  
Intrauterine Device ◽  
Treatment Options ◽  
Drug Clearance ◽  
Personalized Treatment ◽  
Relative Risks ◽  
Dose Monitoring ◽  
Good Treatment Option ◽  
Antiepileptic Medications

AbstractPersonalized treatment for women with epilepsy is essential, and requires thorough weighing of the risks and benefits of the initial diagnostic and therapeutic options chosen, with readjustments of the antiepileptic regimen throughout the patient's life.Approximately one-third of women with epilepsy have a catamenial pattern, and the most common pattern is an increase in seizure frequency in the perimenstrual phase. These women are also more likely to experience a decrease in seizure frequency during pregnancy and menopause. A good treatment option for catamenial epilepsy is still lacking.For contraception, an intrauterine device is currently the preferred choice. Prior to conception, it is advisable to review the known impact of different antiepileptic drugs on the developing fetus and to optimize the patient's treatment regimen. Pregnancy registries and observational studies have provided key data and continue to refine our understanding of the risks to the structural and cognitive development of the fetus of specific antiepileptic drugs, including polytherapies and newer medications. Different studies consistently report that valproic acid has notably high relative risks for congenital malformations, lower IQ, and features of autism. During pregnancy, there is growing evidence that therapeutic dose monitoring is beneficial for seizure control. Counseling about seizure safety and minimizing provoking factors during the peripartum period is important for the patient with epilepsy.Clinical studies continue to investigate the complex relationship between cycling sex steroid hormones, epilepsy, and antiepileptic medications, with hopes to better explain drug clearance changes during pregnancy, changes in seizure frequency, and neuroendocrine abnormalities. Thorough understanding of these key factors and a continuous review of literature for updated data on different treatment options will enable optimal treatment recommendations that will improve the health of women with epilepsy and their children.

scholarly journals New Therapies and Biomarkers: Are We Ready for Personalized Treatment in Small Cell Lung Cancer?

2021 ◽  
pp. 1-10
Author(s):  
Bingnan Zhang ◽  
Samuel R. Birer ◽  
Mikhail Dvorkin ◽  
Jolly Shruti ◽  
Lauren Byers
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Options ◽  
Current Treatment ◽  
Small Cell ◽  
Personalized Treatment ◽  
Small Cell Lung ◽  
Treatment Standards ◽  
Treatment Paradigm

Small cell lung cancer (SCLC) is an aggressive form of lung cancer with a 5-year survival rate of less than 7%. In contrast to non–small cell lung cancer, SCLC has long been treated as a homogeneous disease without personalized treatment options. In recent years, the incorporation of immunotherapy into the treatment paradigm has brought moderate benefit to patients with SCLC; however, more effective therapies are urgently needed. In this article, we describe the current treatment standards and emerging therapeutic approaches for the treatment of SCLC. We also discuss promising biomarkers in SCLC and the recently discovered four subtypes of SCLC, each with its unique therapeutic vulnerability. Lastly, we discuss the advances in radiation therapy for the treatment of SCLC.

scholarly journals A Retrospective Study on Incidence, Diagnosis, and Clinical Outcome of Gastric-type Endocervical Adenocarcinoma in a Single Institution

2021 ◽  
Author(s):  
Anna Radomska ◽  
Daniel Lee ◽  
Heather Neufeld ◽  
Nancy Korte ◽  
Emina Torlakovic ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Kinase Inhibitor ◽  
P53 Protein ◽  
Progesterone Receptors ◽  
Cervical Adenocarcinoma ◽  
Single Institution ◽  
Mutant Type ◽  
Usual Type ◽  
Endocervical Adenocarcinoma ◽  
Gastric Type

Abstract Background: Gastric-type endocervical adenocarcinoma is rare but the most common subtype of cervical adenocarcinoma not associated with human papillomavirus. It is more aggressive with a shorter five-year survival rate compared to human papillomavirus-associated usual type endocervical adenocarcinoma. The objectives of our study were to determine the incidence and clinical-pathological characteristics of Gastric-type endocervical adenocarcinoma in a single institution. Methods: Twenty four cases of invasive cervical adenocarcinoma were identified between January 2000 and December 2015, from the Saskatoon Health Region pathology database using International Endocervical Adenocarcinoma Criteria and Classification to retrospectively classify endocervical adenocarcinoma. Immunohistochemistry was performed with antibodies for Gastric mucin-6 (MUC-6), p16INK4a, cyclin-dependent kinase inhibitor 2A (p16), p53 protein (p53), estrogen and progesterone receptors. Clinical and pathological data was retrieved from pathology reports and charts. Statistical analysis was performed using Mann-Whitney U test and Chi-Square test.Results: Using the International Endocervical Adenocarcinoma Criteria and Classification criteria, 19 cases (79.2%) were classified as human papillomavirus-associated usual type endocervical adenocarcinoma, and five cases (20.8%) as Gastric-type endocervical adenocarcinoma. In our study 40% of Gastric-type endocervical adenocarcinoma cases presented at stage III compared to none of the usual type endocervical carcinoma cases. All the Gastric-type endocervical adenocarcinoma cases were positive for MUC-6, and negative for p16. 60% Gastric-type endocervical adenocarcinoma cases demonstrated mutant type p53 staining. In contrast, 84.2% of human papillomavirus-associated usual type endocervical adenocarcinoma cases showed block like nuclear and cytoplasmic positivity with p16 antibodies. The Gastric-type endocervical adenocarcinoma group had significantly shorter median survival time than human papillomavirus-associated usual type endocervical adenocarcinoma group, Gastric-type endocervical adenocarcinoma is 22 months compared to human papillomavirus-associated usual type endocervical adenocarcinoma at 118 months (p = 0.043). Conclusions: In this study, Gastric-type endocervical adenocarcinoma accounted for 20.8% of all cervical adenocarcinoma with higher stage at presentation and shorter overall survival. Histomorphology and immunohistochemistry for MUC-6 and p16 could differentiate between Gastric-type endocervical adenocarcinoma and human papillomavirus-associated usual type endocervical adenocarcinoma.

scholarly journals Abstract 2930: Characterization based on therapeutic target biomarkers of patients-driven xenografts model of gastric-type cervical adenocarcinoma

2021 ◽  
Author(s):  
Yuki Kojima ◽  
Hiroshi Yoshida ◽  
Toshihiro Okuya ◽  
Hitomi S. Okuma ◽  
Tadaaki Nishikawa ◽  
...  
Keyword(s):  
Therapeutic Target ◽  
Cervical Adenocarcinoma ◽  
Gastric Type
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