scholarly journals Immunotherapy for Esophageal Cancers: What Is Practice Changing in 2021?

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4632
Author(s):  
Hannah Christina Puhr ◽  
Matthias Preusser ◽  
Aysegül Ilhan-Mutlu
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Survival Rates ◽  
The Novel ◽  
Critical View ◽  
Unselected Patient ◽  
The Face

The prognosis of advanced esophageal cancer is dismal, and treatment options are limited. Since the first promising data on second-line treatment with checkpoint inhibitors in esophageal cancer patients were published, immunotherapy was surmised to change the face of modern cancer treatment. Recently, several studies have found this to be true, as the checkpoint inhibitors nivolumab and pembrolizumab have achieved revolutionary response rates in advanced as well as resectable settings in esophageal cancer patients. Although the current results of large clinical trials promise high efficacy with tolerable toxicity, desirable survival rates, and sustained quality of life, some concerns remain. This review aims to summarize the novel clinical data on immunotherapeutic agents for esophageal cancer and provide a critical view of potential restrictions for the implementation of these therapies for unselected patient populations.

scholarly journals Monoclonal Antibody-Based Immunotherapy and Its Role in the Development of Cardiac Toxicity

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 86
Author(s):  
Mohit Kumar ◽  
Chellappagounder Thangavel ◽  
Richard C. Becker ◽  
Sakthivel Sadayappan
Keyword(s):  
Cancer Patients ◽  
Immune Modulation ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Induced Pluripotent Stem Cell ◽  
High Volume ◽  
Oncolytic Viruses ◽  
Model Systems ◽  
Volume Data ◽  
Late Cardiotoxicity

Immunotherapy is one of the most effective therapeutic options for cancer patients. Five specific classes of immunotherapies, which includes cell-based chimeric antigenic receptor T-cells, checkpoint inhibitors, cancer vaccines, antibody-based targeted therapies, and oncolytic viruses. Immunotherapies can improve survival rates among cancer patients. At the same time, however, they can cause inflammation and promote adverse cardiac immune modulation and cardiac failure among some cancer patients as late as five to ten years following immunotherapy. In this review, we discuss cardiotoxicity associated with immunotherapy. We also propose using human-induced pluripotent stem cell-derived cardiomyocytes/ cardiac-stromal progenitor cells and cardiac organoid cultures as innovative experimental model systems to (1) mimic clinical treatment, resulting in reproducible data, and (2) promote the identification of immunotherapy-induced biomarkers of both early and late cardiotoxicity. Finally, we introduce the integration of omics-derived high-volume data and cardiac biology as a pathway toward the discovery of new and efficient non-toxic immunotherapy.

scholarly journals Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes

2021 ◽  
pp. 1-7
Author(s):  
Herwig Strik ◽  
Werner Cassel ◽  
Michael Teepker ◽  
Thomas Schulte ◽  
Jorge Riera-Knorrenschild ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Cancer Patients ◽  
Treatment Options ◽  
Ethics Committee ◽  
Breathing Disorders ◽  
The One ◽  
Diagnosis Therapy ◽  
The University ◽  
Insomnia Symptoms

<b><i>Introduction:</i></b> On the one hand, sleep disorders in cancer patients are reported in 30–50% of cancer patients. On the other hand, specific causes for these sleep disorders are little known. This study was done to evaluate factors which may affect sleep of cancer patients. To our knowledge, this is the first study which includes return to work as one factor of sleep disturbance. <b><i>Methods:</i></b> 107 patients with various types of cancer treated in 2 hospitals were interviewed with a battery of questionnaires after having given informed consent. The questionnaires intended to detect abnormalities of sleep and related pain, breathing disorders, restless legs syndrome, depression, rumination, medication, and psychosocial distress. The study was approved by the ethics committee of the University of Marburg. <b><i>Results:</i></b> The analysis of the 6 sleep-related questionnaires indicated a sleep disorder of any kind in 68% of all patients. Insomnia symptoms were present in 48 patients (44.9%). Pain, depression, anxiety, and worries about the workplace were significantly related to sleep disorders. <b><i>Conclusion:</i></b> Sleep disorders are common in cancer patients. The causes are manifold and should be considered by caregivers during diagnosis, therapy, and aftercare of cancer patients. Tumour patients should actively be asked about sleep disorders. If these are present, they should be addressed, and as they have a large impact on quality of life, treatment options should be offered in cooperation with sleep specialists.

scholarly journals Discriminative sparse coding in the analysis of electrocardiogram during ventricular arrhythmias

2021 ◽  
Author(s):  
Iman Kalaji
Keyword(s):  
Ventricular Fibrillation ◽  
Sparse Coding ◽  
Ventricular Arrhythmias ◽  
Treatment Options ◽  
Survival Rates ◽  
Learning Approach ◽  
Time Frequency ◽  
Frequency Domains ◽  
Optimized Treatment

Abnormalities in the rhythmic electromechanical contractions of the heart results in cardiac arrhythmias. When these abnormalities rise from the ventricles of the heart, they are classified as ventricular arrhythmias. The two major types of ventricular arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation (VF). Ventricular fibrillation is the most dangerous among the two arrhythmias, that usually leads to sudden cardiac death if not treated immediately. Annually about 40,000 sudden cardiac deaths are reported in Canada. Due to high mortality rate and serious impact on quality of life, researchers have been focusing on characterizing ventricular arrhythmias that may lead to delivering optimized treatment options in improving the survival rates. In this thesis two major types of ventricular arrhythmias were analyzed and quantified by performing discriminative sparse coding analysis called label consistent K-SVD using time frequency dictionaries that are well localized in time and frequency domains. The analyzed signals were 670 ECG ventricular arrhythmia segments from 33 patients extracted from the Malignant Ventricular Ectopy and Creighton University Tachy-Arrhythmia databases. Using the LCKSVD dictionary learning approach, an overall maximum classification accuracy of 73.3% was achieved with a hybrid optimized wavelet dictionary. Based on the comparative analysis, the trained (learned) dictionaries yielded better performance than the untrained dictionaries. The results indicate that discriminative sparse coding approach has greater potential in extracting signal adaptive and morphologically discriminative time-frequency structures in studying ventricular arrhythmias.

scholarly journals Discriminative sparse coding in the analysis of electrocardiogram during ventricular arrhythmias

2021 ◽  
Author(s):  
Iman Kalaji
Keyword(s):  
Ventricular Fibrillation ◽  
Sparse Coding ◽  
Ventricular Arrhythmias ◽  
Treatment Options ◽  
Survival Rates ◽  
Learning Approach ◽  
Time Frequency ◽  
Frequency Domains ◽  
Optimized Treatment

Abnormalities in the rhythmic electromechanical contractions of the heart results in cardiac arrhythmias. When these abnormalities rise from the ventricles of the heart, they are classified as ventricular arrhythmias. The two major types of ventricular arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation (VF). Ventricular fibrillation is the most dangerous among the two arrhythmias, that usually leads to sudden cardiac death if not treated immediately. Annually about 40,000 sudden cardiac deaths are reported in Canada. Due to high mortality rate and serious impact on quality of life, researchers have been focusing on characterizing ventricular arrhythmias that may lead to delivering optimized treatment options in improving the survival rates. In this thesis two major types of ventricular arrhythmias were analyzed and quantified by performing discriminative sparse coding analysis called label consistent K-SVD using time frequency dictionaries that are well localized in time and frequency domains. The analyzed signals were 670 ECG ventricular arrhythmia segments from 33 patients extracted from the Malignant Ventricular Ectopy and Creighton University Tachy-Arrhythmia databases. Using the LCKSVD dictionary learning approach, an overall maximum classification accuracy of 73.3% was achieved with a hybrid optimized wavelet dictionary. Based on the comparative analysis, the trained (learned) dictionaries yielded better performance than the untrained dictionaries. The results indicate that discriminative sparse coding approach has greater potential in extracting signal adaptive and morphologically discriminative time-frequency structures in studying ventricular arrhythmias.

scholarly journals The Current Status of Integrative Oncology in Korea

2021 ◽  
Vol 20 ◽  
pp. 153473542110638
Author(s):  
Eun-Bin Kwag ◽  
Soo-Dam Kim ◽  
Ji Hye Park ◽  
So-Jung Park ◽  
Mi-Kyung Jeong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Causes Of Death ◽  
Survival Rates ◽  
Current Status ◽  
Integrative Oncology ◽  
Recurrence Rates ◽  
Current State ◽  
Look Ahead

Cancer is one of the leading causes of death worldwide, and Korea is no exception. Humanity has been fighting cancer for many years, and as a result, we now have effective treatments such as chemotherapy, radiation, and surgery. However, there are other issues that we are only now beginning to address, such as cancer patients’ quality of life. Moreover, numerous studies show that addressing these issues holistically is critical for overall cancer treatment and survival rates. This paper describes how Korea is attempting to reduce cancer incidence and recurrence rates while also managing the quality of life of cancer patients. Integrative Oncology is the field that addresses these broad issues, and understanding the current state of integrative oncology in Korea is critical. The goal of this paper is to provide an overview of the current state of integrative oncology in Korea as well as to look ahead to future developments.

QUALITY OF LIFE IN ESOPHAGEAL CANCER PATIENTS

2008 ◽  
pp. 663-674
Author(s):  
Mark I. van Berge Henegouwen ◽  
Mirjam Locadia ◽  
Mirjam A.G. Sprangers ◽  
Jan J.B. van Lanschot
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Cancer Patients

scholarly journals Current Treatments of Metastatic Colorectal Cancer with Immune Checkpoint Inhibitors—2020 Update

2020 ◽  
Vol 9 (11) ◽  
pp. 3520
Author(s):  
Gerhard Jung ◽  
Daniel Benítez-Ribas ◽  
Ariadna Sánchez ◽  
Francesc Balaguer
Keyword(s):  
Colorectal Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Clinical Trial Design ◽  
Predictive Biomarkers ◽  
Host Immune System ◽  
Systemic Treatments

During the last 20 years, chemotherapy has improved survival rates of colorectal cancer (CRC). However, the majority of metastatic cases do not respond to or progress after first line conventional chemotherapy and contribute to the fatalities of patients with CRC. Insights into the immune contexture of the tumor microenvironment (TME) have enabled the development of new systemic treatments that boost the host immune system against the tumor—the immune checkpoint inhibitors (ICI). These promising drugs have already shown astonishing efficacies in other cancer types and have raised new hope for the treatment of metastatic CRC (mCRC). In this review, we will summarize the results of the clinical trials that led to their accelerated approval by the U.S. Food and Drug Administration (FDA) in 2017, as well as all relevant recent studies conducted since then—some of which are not published yet. We will focus on therapeutic efficacy, but also discuss the available data for drug safety and security, changes in quality of life indicators and predictive biomarkers for treatment response. The burgeoning evidence for a potential use of ICIs in other settings than mCRC will also be mentioned. For each trial, we have made a preliminary assessment of the quality of clinical trial design and of the “European Society of Medical Oncology (ESMO) magnitude of clinical benefit” (ESMO-MCBS) in order to provide the first evidence-based recommendation to the reader.

Is there a role for neoadjuvant radiation dose escalation in esophageal cancer? A meta-analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 102-102
Author(s):  
Laila Lobo ◽  
Danny Yakoub ◽  
Caroline Ripat ◽  
Rishika Sharma ◽  
Raphael Yechieli
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Radiation Dose ◽  
Esophageal Carcinoma ◽  
Meta Analysis ◽  
Survival Rates ◽  
Fistula Formation ◽  
Significant Difference ◽  
Patient Reported

102 Background: In treating esophageal cancer chemo-radiation is used in the definitive as well as neo-adjuvant setting. Optimal dosage of radiation for best outcome has been debated. The aim of this study is to evaluate clinical outcomes of lower radiation dosage compared to higher. Methods: Online search for studies comparing radiation dose from 1990 to present was performed. Primary outcome was overall-survival rates for up to 5 years. Secondary outcomes included post-treatment complications and treatment response. A cut point of 51 Gy and less was considered as lower dose and greater than 51 Gy was considered higher dose. Quality of included studies was evaluated by STROBE criteria. Relative Risk (RR) and 95% Confidence Intervals (CI) were calculated from pooled data. Results: The search strategy yielded 142 studies, 12 met our selection criteria and included 1876 patients receiving radiation for resectable esophageal carcinoma. Of these patients, 1057 received lower and 819 were treated with greater than 51 Gy. Median age was 63 and 64 years for lower and higher radiation dose respectively. Meta-analysis showed no statistically significant difference in survival and toxicities between the two groups. 1 year overall survival (RR = 0.97, 95% CI 0.84-1.13, p = 0.69), 2 year overall survival (RR = 1.29, 95% CI 0.76-2.19, p = 0.34), 3 year overall survival (RR = 1.18, 95% CI 0.83-1.68, p = 0.37), 4 year overall survival (RR = 1.37, 95% CI 0.64-2.94, p = 0.41), 5 year overall survival (RR = 1.11, 95% CI 0.72-1.69, p = 0.64), Esophagitis (RR = 0.76, 95% CI 0.39-1.50, p = 0.43), Dermatitis (RR = 0.98, 95% CI 0.12-7.94, p = 0.99), Fistula formation (RR = 0.72, 95% CI 0.32-1.60, p = 0.42), Hematologic complications (RR = 1.10, 95% CI 0.20-6.02, p = 0.91), Stricture formation (RR = 1.39, 95% CI 0.54-3.58, p = 0.5). Conclusions: Lower radiation dose appears to be as effective as higher dose in esophageal carcinoma with similar toxicity profile and survival rates. Larger prospective randomized trials, focusing on patient-reported quality-of-life are required to consolidate these results.

Identifying potential barriers to sperm cryopreservation among Pakistani male cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18223-e18223 ◽  
Author(s):  
Nida Latif ◽  
Natasha Ali
Keyword(s):  
Cancer Patients ◽  
Health Care Providers ◽  
Treatment Options ◽  
Female Gender ◽  
Care Providers ◽  
Sperm Cryopreservation ◽  
Structured Interviews ◽  
Potential Barriers ◽  
American Society

e18223 Background: Cancer survivor rates have increased over the past few decades leading to a growing interest in research related to quality of life. The American society of clinical oncology’s updated guidelines of 2013 recommend that health care providers discuss the possibility of infertility with patients and present fertility preservation options to those who express interest. We attempted to explore the unique barriers that might prevent adult male cancer patients from accessing sperm cryopreservation in Pakistan Methods: We conducted semi-structured interviews of male cancer patients aged 18-45 years, diagnosed with cancer of any stage or type. The interviews were audio-recorded in Urdu and translated to English, following which they were transcribed ad verbatim. The topics included quality of information received regarding the risk of infertility following chemotherapy, future reproductive choices and barriers to sperm cryopreservation Results: Out of the 25 patients interviewed, there were n = 10 cases of Leukemia, n = 3 of Lymphoma, n = 2 cases each of colorectal carcinoma and Multiple Myeloma, n = 1 case each of Neuroblastoma and Osteosarcoma, and solitary cases involving the lung, breast, thymus, brain, jaw and testis. Only n = 4 patients knew about the potential for infertility due to cancer chemotherapy, all of whom were also aware of the option of sperm cryopreservation. Two patients had their sperm preserved prior to the initiation of chemotherapy. Perceived treatment related expenses appeared to be the biggest barrier to sperm cryopreservation for n = 9 patients (36%). This was followed by lack of information which was cited by n = 8 patients (32%) and religious reasons (n = 2 patients, 8.3%). Other barriers were identified as family wishes, female gender of the doctor and patient’s preferences. Four patients stated there are no barriers. Conclusions: There is a significant lack of awareness among male cancer patients regarding threat to fertility following cancer treatment. It is imperative that physicians inform them of this and discuss treatment options, along with addressing potential barriers.

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