scholarly journals Follicular lymphoma: is there an optimal way to define risk?

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 313-319
Author(s):  
Carla Casulo
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Prognostic Markers ◽  
Treatment Strategies ◽  
Genetic Data ◽  
Disease Recurrence ◽  
Comprehensive Understanding ◽  
Rapid Pace ◽  
Patient Prognosis ◽  
Clinical Advances

Abstract Follicular lymphoma (FL) has a long natural history and typically indolent behavior. In the present era, there are a plethora of prognostic factors combining clinical, biological, and genetic data to determine patient prognosis and help develop treatment strategies over the course of a patient's lifetime. The rapid pace of tumor-specific and clinical advances in FL has created a challenge in the prioritization and implementation of these factors into clinical practice. Developing a comprehensive understanding of existing prognostic markers in FL will help select optimal ways of utilization in the clinical setting and investigate opportunities to define and intervene upon risk at FL diagnosis and disease recurrence.

scholarly journals Retrospective analysis of primary neuroendocrine tumors of the ovary: Management and outcomes

2021 ◽  
Author(s):  
li pang ◽  
zhiqiang guo
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumors ◽  
Early Stage ◽  
Treatment Strategies ◽  
Histological Type ◽  
Comprehensive Treatment ◽  
Cancer Specific Survival ◽  
Ajcc Stage ◽  
Low Incidence ◽  
Patient Prognosis

Abstract Background Due to the low incidence of ovarian neuroendocrine tumors (NETs), clinicians may be unaware of appropriate treatments for the disease and factors influencing patient prognosis, which may cause them to miss the window of opportunity for treatment. Moreover, there is currently no recognized first-line treatment strategy, and no studies have reported prognostic statistics derived from large samples. This retrospective study aimed to investigate the clinical behavior of ovarian NETs. Methods The Surveillance, Epidemiology, and End Results database was used to identify women diagnosed with ovarian NETs from 2004 to 2015. Overall survival (OS), cancer-specific survival (CSS), and independent prognostic factors for ovarian NETs were evaluated. The effects of different treatments on prognosis were also compared, as were OS and CSS rates for histological subtypes. Results The 5-year OS rates were 83.3%, 30.0%, 20.3%, and 9.8% for patients in stages I (n = 159), II (n = 23), III (n = 101), and IV (n = 148), respectively. The 5-year CSS rates were 85.6%, 41.7%, 21.2%, and 9.8% for patients in stages I–IV, respectively. Age, American Joint Committee on Cancer (AJCC) stage, lymph node metastasis, treatment, and histological type were related to poor OS and CSS. In the early stage, the 5-year OS and CSS rates were 97.03% and 96.90%, respectively. For patients in the advanced stage receiving comprehensive treatment (surgery + chemotherapy + radiotherapy), 5-year OS and CSS rates were 72.9% and 70.00%, respectively. When comparing low- and high-grade neuroendocrine carcinoma, the 5-year OS rates were 93.96% vs. 7.01%, 5-year CSS rates were 97.44% vs. 7.31%, 10-year OS rates were 93.56% vs. 2.34%, and 10-year CSS rates were 97.44% vs. 4.88%, respectively. Conclusion Age, AJCC stage, treatment, and histological type are independent prognostic factors of ovarian NETs. Prognosis is relatively good for early-stage cases treated with surgery alone, whereas more comprehensive treatment is required to improve prognosis for advanced cases. Future studies should focus on the development of individualized treatment strategies for prolonging survival time in patients with ovarian NETs.

scholarly journals The Jekyll and Hyde of Cellular Senescence in Cancer

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 208
Author(s):  
Dilara Demirci ◽  
Bengisu Dayanc ◽  
Fatma Aybuke Mazi ◽  
Serif Senturk
Keyword(s):  
Cancer Cell ◽  
Cellular Senescence ◽  
Expression Profiles ◽  
Treatment Strategies ◽  
Gene Expression Profiles ◽  
Therapy Resistance ◽  
Disease Recurrence ◽  
Adverse Outcomes ◽  
Cell Senescence ◽  
Great Promise

Cellular senescence is a state of stable cell cycle arrest that can be triggered in response to various insults and is characterized by distinct morphological hallmarks, gene expression profiles, and the senescence-associated secretory phenotype (SASP). Importantly, cellular senescence is a key component of normal physiology with tumor suppressive functions. In the last few decades, novel cancer treatment strategies exploiting pro-senescence therapies have attracted considerable interest. Recent insight, however, suggests that therapy-induced senescence (TIS) elicits cell-autonomous and non-cell-autonomous implications that potentially entail detrimental consequences, reflecting the Jekyll and Hyde nature of cancer cell senescence. In essence, the undesirable manifestations that generally culminate in inflammation, cancer stemness, senescence reversal, therapy resistance, and disease recurrence are dictated by the persistent accumulation of senescent cells and the SASP. Thus, mitigating these pro-tumorigenic effects by eliminating these cells or inhibiting their SASP production holds great promise for developing innovative therapeutic strategies. In this review, we describe the fundamental aspects and dynamics of cancer cell senescence and summarize the comprehensive research on the adverse outcomes of TIS. Furthermore, we underline the rationale and motivation of emerging senotherapeutic modalities surrounding the removal of senescent cells and the SASP to help maximize the overall efficacy of cancer therapies.

scholarly journals Sarcomas of the head and neck. Prognostic factors and treatment strategies

Cancer ◽  
1992 ◽  
Vol 70 (1) ◽  
pp. 169-177 ◽  
Author(s):  
Luir M. Tran ◽  
Rufus Mark ◽  
Robert Meier ◽  
Thomas C. Calcaterra ◽  
Robert G. Parker
Keyword(s):  
Prognostic Factors ◽  
Head And Neck ◽  
Treatment Strategies

scholarly journals NOVEL DRUGS IN FOLLICULAR LYMPHOMA

2016 ◽  
Vol 8 ◽  
pp. 2016061 ◽  
Author(s):  
Giuseppe Rossi ◽  
Antonella Anastasia
Keyword(s):  
Follicular Lymphoma ◽  
Treatment Strategies ◽  
Cell Receptor ◽  
Phase Iii ◽  
Non Hodgkin Lymphoma ◽  
Free Treatment ◽  
Phase Iii Trials ◽  
New Treatment ◽  
Anti Cd20 ◽  
Key Steps

Follicular lymphoma(FL) is the most common indolent non-Hodgkin lymphoma and constitutes 15% to 30% of lymphoma diagnoses. The natural history of the disease is characterized by recurrent relapses and progressively shorter remissions with a median survival of 10yrs. The impossibility of a chieving a definite cure, have prompted investigations into the possible role of more effective and less toxic strategies with innovative therapeutic agents.  Recently Casulo et al demonstrated that approximately 20% of patients with FL actually relapse within 2 years after achieving remission with R-CHOP and have a poor prognosis. It is conceivable that this particularly chemoresistant population would benefit from specifically targeting the biologic and genetic factors that likely contribute to their poor prognosis.Evolving strategies for difficult to treat FL patients have recently considered  immunomodulatory agents, new monoclonal antibodies as well as drugs targeting selective intracellular pathways. The importance of targeting the microenvironment together with the malignant FL cell has been particularly underscored. We review the most promising approaches, such as the combination of anti-CD20 antibodies with immunomodulatory drugs (Lenalidomide), with mAbs directed against other surface antigens such as CD22 and CD23 (epratuzumab, lumiliximab), with immunomodulatory antibodies such as PD-1, or with inhibitors of key steps in the B-cell receptor pathway signaling such as PI3K inibithors(idelalisib, duvelisib). Another highly attractive approach is the application of the bi-specific T-cell engaging (BiTE) antibody blinatumomab which targets both CD19 and CD3 antigens. Moreover, we highlight the potential of these therapies,  taking into account their toxicity. Of course we must wait for Phase III trials results to confirm the benefit of these new treatment strategies toward a new era of chemotherapy-free treatment for follicular lymphoma.

scholarly journals Roles of tumor-associated macrophages in tumor progression: implications on therapeutic strategies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Shangli Zhu ◽  
Ming Yi ◽  
Yuze Wu ◽  
Bing Dong ◽  
Kongming Wu
Keyword(s):  
Tumor Progression ◽  
Tumor Development ◽  
Treatment Strategies ◽  
Therapeutic Strategies ◽  
Tumor Associated Macrophages ◽  
Promising Target ◽  
Multiple Processes ◽  
Enhance Tumor Cell ◽  
Patient Prognosis ◽  
Anti Tumor Activity

AbstractMacrophages are heterogeneous cells that present as different functional phenotypes due to their plasticity. They can be classified into two categories, namely M1- and M2-like macrophages, which are involved in processes as diverse as anti-tumor activity and immunosuppressive tumor promotion. Tumor-associated macrophages (TAMs) are defined as being of an M2-type and are considered as the active component in tumor microenvironment. TAMs are involved in multiple processes of tumor progression through the expression of cytokines, chemokines, growth factors, protein hydrolases and more, which lead to enhance tumor cell proliferation, angiogenesis, and immunosuppression, which in turn supports invasion and metastasis. It is assumed that the abundance of TAMs in major solid tumors is correlated to a negative patient prognosis. Because of the currently available data of the TAMs’ role in tumor development, these cells have emerged as a promising target for novel cancer treatment strategies. In this paper, we will briefly describe the origins and types of TAMs and will try to comprehensively show how TAMs contribute to tumorigenesis and disease progression. Finally, we will present the main TAM-based therapeutic strategies currently available.

scholarly journals Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

2021 ◽  
Author(s):  
Ádám Jóna ◽  
Anna Kenyeres ◽  
Sándor Barna ◽  
Árpád Illés ◽  
Zsófia Simon
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Follicular Lymphoma ◽  
Risk Group ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
High Risk Group ◽  
Pet Ct ◽  
Significant Difference ◽  
Biological Prognostic Factors

Abstract Introduction: Follicular lymphoma (FL) is an indolent yet heterogeneous B-cell lymphoproliferative disorder. Most people respond to treatment well. However, a particular group of patients has a poor prognosis, and these patients are difficult to define.Patients and methods: We retrospectively analyzed FL patients treated at the University of Debrecen in the past 20 years. We investigated prognostic factors that may influence the survival of FL patients.Results: We found a standardized uptake value (SUV)max cut-off value of 9.85 at the staging PET/CT to significantly separate FL patients’ progression-free survival (PFS) (p=0.0003, HR: 0.2560, 95%CI: 0.1232-0.5318). Lymphocyte/ monocyte (Ly/Mo) ratio of 3.45 drawn at diagnosis also significantly predicted PFS (p=0.0324, HR: 1.806, 95% CI: 1.051-3.104). Combining patients’ with staging SUVmax >9.85 and Ly/Mo < 3.45 a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1033, 95%CI: 0.03719-0.2868). Similarly, a significant difference was shown with a SUVmax cut-off of 3.15 at the interim PET/CT (p<0.0001, HR: 0.1535, 95%CI: 0.06329-0.3720). Combining patients with staging SUVmax >9.85 and interim SUVmax >3.15, a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1037, 95%CI: 0.03811-0.2824). The PFS difference is translated into overall survival advantage (p=0.0506, HR: 0.1187, 95%CI: 0.01401-1.005).Discussion: Biological prognostic factors, such as the Ly/ Mo ratio, may improve the prognostic assessment of staging PET/CT. Nevertheless, PFS difference is translated into OS when using a combination of staging and interim SUVmax. We consider investigating additional biological prognostic factors while currently highlighting PET/CT's role in FL.

scholarly journals Preclinical Evaluation of the HDAC Inhibitor Chidamide in Transformed Follicular Lymphoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengya Zhong ◽  
Jinshui Tan ◽  
Guangchao Pan ◽  
Yuelong Jiang ◽  
Hui Zhou ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Follicular Lymphoma ◽  
Single Agent ◽  
Hdac Inhibitors ◽  
Treatment Strategies ◽  
Annexin V ◽  
Gene Encoding ◽  
New Treatment ◽  
Transformed Follicular Lymphoma

The key factors leading to transformed follicular lymphoma (t-FL) include the aberrations of epigenetic modifiers as early and driving events, especially mutations in the gene encoding for histone acetyltransferase. Therefore, reversal of this phenomenon by histone deacetylase (HDAC) inhibitors is essential for the development of new treatment strategies in t-FL. Several t-FL cell lines were treated with various doses of chidamide and subjected to cell proliferation, apoptosis and cell cycle analyses with CCK-8 assay, Annexin V/PI assay and flow cytometry, respectively. Chidamide dose-dependently inhibited cell proliferation, caused G0/G1 cycle arrest and triggered apoptosis in t-FL cells. In addition, the effects of chidamide on tumor growth were evaluated in vivo in xenograft models. RNA-seq analysis revealed gene expression alterations involving the PI3K-AKT signaling pathway might account for the mechanism underlying the antitumor activity of chidamide as a single agent in t-FL. These findings provide a basis for further clinical exploration of chidamide as a promising treatment for FL.

scholarly journals The chemotherapy and radiation in low-grade myofibroblastic sarcoma: is there a role?

2020 ◽  
Author(s):  
Yao Xu ◽  
Guijun Xu ◽  
Xin Wang ◽  
Min Mao ◽  
Haixiao Wu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Treatment ◽  
Head And Neck ◽  
Radiation Treatment ◽  
Treatment Strategies ◽  
Neck Region ◽  
Low Grade ◽  
Myofibroblastic Sarcoma ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Regression

Abstract Background: Low-grade myofibroblastic sarcoma (LGMS) is a rare entity with a predilection in the head and neck. There are still no optimal treatment strategies for LGMS. We aimed to investigate the role of chemotherapy and radiation treatment for LGMS. Survival estimate was performed and prognostic factors were identified.Methods: Based on the Surveillance, Epidemiology, and End Result (SEER) database, LGMS patients diagnosed between 2001 and 2015 were involved in our study. Kaplan-Meier curves and log-rank tests were used to estimate overall survival. Cox proportional hazard regression model was performed to identify prognostic factors.Results: A total of 96 eligible patients with LGMS were included, among which 86 (89.6%) received surgical treatment. Twenty-eight (29.2%) patients received radiation treatment while chemotherapy was offered to 20 (10.4%) patients. The median age was 55.0 years old with 22 cases occurred in head and neck region. The mean OS was 125.2 (95%CI 106.3-144.2) months while 1-, 3-, 5- and 10-year OS rates were 88%, 77%, 70% and 59%, respectively. Age older than 60 years, positive nodal status and no surgical treatment were independent prognostic factors for patients with LGMS. Chemotherapy and radiation were not independent prognostic factors for LGMS.Conclusions: Several prognostic factors for LGMS were revealed in this study. Surgical resection is the main therapy while chemotherapy and radiation showed limited effects on survival improvement. Thus, chemotherapy and/or radiation should not be routinely performed in LGMS.

Colorectal Carcinoma: Selected Issues in Pathologic Examination and Staging and Determination of Prognostic Factors

2008 ◽  
Vol 132 (10) ◽  
pp. 1600-1607 ◽  
Author(s):  
Mary Kay Washington
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Colorectal Carcinoma ◽  
Clinical Care ◽  
Treatment Strategies ◽  
Staging System ◽  
Tumor Stage ◽  
The United States ◽  
Lymphatic Invasion ◽  
Pathologic Staging

Abstract Context.—Colorectal carcinoma is one of the most common types of cancer in Western countries and is consistently ranked among the top 3 causes of cancer-related deaths, with approximately 150 000 new cases in the United States and 55 000 deaths in 2006. The pathologist's assessment of tumor stage and stage-independent morphologic features, such as vascular/lymphatic invasion, influences treatment strategies for the individual patient, such as the decision to offer adjuvant therapy after surgery. However, although the pathologist influences clinical care in colorectal cancer, certain aspects of staging and evaluation of prognostic factors remain challenging and confusing. Objectives.—To present the currently used colorectal cancer staging system; to address challenging areas in pathologic staging, including T category considerations and recommendations for the minimum number of lymph nodes sampled; and to discuss assessment of selected stage-independent prognostic factors, such as vascular/ lymphatic invasion. Data Sources.—This review is based on the current staging manual from the American Joint Committee on Cancer, the College of American Pathologists Protocol for Examination of Specimens From Patients With Primary Carcinomas of the Colon and Rectum, and selected articles pertaining to colorectal carcinoma staging and prognostic factors accessible through Ovid Medline (National Library of Medicine, Bethesda, Md). Conclusions.—Proper assessment of pathologic staging for colorectal cancer and of morphologic prognostic factors requires a thorough understanding of staging guidelines and careful specimen dissection and sampling.

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