Endoscopic stenting for stenosing cancer and digestive canal structures

Background. The purpose of the work was to evaluate the effectiveness of the endoscopic stenting method in stenosing cancer and strictures of the digestive tract. Materials and methods. Since January 2015, endoscopic stenting has been performed in 12 patients using self-expanding nitinol stents with/without polymer coating manufactured by Boston Scientific, Ltd (USA) and uncoated nitinol stents manufactured by Garson (Korea). The study included 8 men (66.7 %) and 4 women (33.3 %) aged 51–80 years, (63.0 ± 4.2) years on average. Stenosing esophageal cancer was diagnosed in 5 patients, stenosing cancer of the gastric outlet — in 3, stenosing duodenal cancer — in one, esophageal stricture — in 3 people. In all patients, the indication for stenting was impaired patency of the digestive tract due to the underlying di-sease. Results. Nutrition was restored in all patients. In the group of stenosing esophageal cancer, the 30-day mortality rate was 20 %, the median survival rate was 9 months. Recurrence of dysphagia was diagnosed in one person, recanalization of the stent lumen was performed. In the group with stenosing cancer of the gastric outlet and duodenum, the 30-day mortality rate was 33.3 %, the median survival rate was 11 months. Impaired gastric emptying was detected in one patient, repeated stent-to-stent stenting was performed. In the group with esophageal stricture, one individual had stent migration, so the stent was repositioned. Conclusions. Endoscopic stenting with self-expanding nitinol stents in incu­rable patients with malignant stenoses of the esophagus, stomach, duodenum and in those with benign esophageal strictures is the surgery of choice, a safe and effective method that allows you to restore and continue natural nutrition and thereby improve the quality of life in incurable cases. Complications arising in the late period after stenting were found in 25 % of patients, and were corrected endoscopically.

New Immunotherapeutic Approaches for Glioblastoma

Glioblastoma (GBM) is the most common primary malignant brain tumor with a high mortality rate. The current treatment consists of surgical resection, radiation, and chemotherapy; however, the median survival rate is only 12–18 months despite these alternatives, highlighting the urgent need to find new strategies. The heterogeneity of GBM makes this tumor difficult to treat, and the immunotherapies result in an attractive approach to modulate the antitumoral immune responses favoring the tumor eradication. The immunotherapies for GMB including monoclonal antibodies, checkpoint inhibitors, vaccines, and oncolytic viruses, among others, have shown favorable results alone or as a multimodal treatment. In this review, we summarize and discuss promising immunotherapies for GBM currently under preclinical investigation as well as in clinical trials.

Primary Squamous Cell Carcinoma of Thyroid – A Rare Case Report

Primary squamous cell carcinoma (SCC) of thyroid is extremely rare & represents less than 1 % of all primary thyroid malignancies. Their diagnosis and management pose a challenge and their prognosis is very poor with a median survival rate of less than 6 months due to their aggressive local manifestations & distant metastasis. One should exclude the possibilities / presence of other primary focuses of squamous cell carcinoma, which could metastasize to thyroid.

Immunotherapy for Glioblastoma: Current Progress and Challenge

Glioblastoma is a highly lethal brain cancer with a median survival rate of less than 15 months when treated with the current standard of care, which consists of surgery, radiotherapy and chemotherapy. With the recent success of immunotherapy in other aggressive cancers such as advanced melanoma and advanced non-small cell lung cancer, glioblastoma has been brought to the forefront of immunotherapy research. Resistance to therapy has been a major challenge across a multitude of experimental candidates and no immunotherapies have been approved for glioblastoma to-date. Intra- and inter-tumoral heterogeneity, an inherently immunosuppressive environment and tumor plasticity remain barriers to be overcome. Moreover, the unique tissue-specific interactions between the central nervous system and the peripheral immune system present an additional challenge for immune-based therapies. Nevertheless, there is sufficient evidence that these challenges may be overcome, and immunotherapy continues to be actively pursued in glioblastoma. Herein, we review the primary ongoing immunotherapy candidates for glioblastoma with a focus on immune checkpoint inhibitors, myeloid-targeted therapies, vaccines and chimeric antigen receptor (CAR) immunotherapies. We further provide insight on mechanisms of resistance and how our understanding of these mechanisms may pave the way for more effective immunotherapeutics against glioblastoma.

High-grade gliomas: a literature review. Part 1. Epidemiology, classification and approaches to combination treatment

Malignant brain tumors remain one of the most complex problem in modern oncology, being among the most dangerous types of cancer not only because of their poor prognosis, but also due to the immediate consequences for quality of life and cognitive functions. It is expected that the number of such patients will increase as the life expectancy of the population increases.The mortality rate of patients with malignant gliomas remains the highest among all cancer patients. The median survival rate in this population does not exceed 24.5 months. Despite serious progress in the study of the molecular biology of this type of tumor, the question of effective application of this knowledge in the treatment process remains open.The review highlights the most advanced diagnostic methods and analyzes the effectiveness of a multidisciplinary therapeutic strategy. Special attention is given to the search for new approaches to radiosurgical treatment of highgrade gliomas in order to increase the duration and improve the quality of life of patients.The literature review is divided into 2 parts. Part 1 covers the epidemiology, clinic, and diagnosis of high-grade gliomas, as well as a combined approach to the treatment of the disease.

Anticancer Mechanism of Curcumin on Human Glioblastoma

Glioblastoma (GBM) is the most malignant brain tumor and accounts for most adult brain tumors. Current available treatment options for GBM are multimodal, which include surgical resection, radiation, and chemotherapy. Despite the significant advances in diagnostic and therapeutic approaches, GBM remains largely resistant to treatment, with a poor median survival rate between 12 and 18 months. With increasing drug resistance, the introduction of phytochemicals into current GBM treatment has become a potential strategy to combat GBM. Phytochemicals possess multifarious bioactivities with multitarget sites and comparatively marginal toxicity. Among them, curcumin is the most studied compound described as a potential anticancer agent due to its multi-targeted signaling/molecular pathways properties. Curcumin possesses the ability to modulate the core pathways involved in GBM cell proliferation, apoptosis, cell cycle arrest, autophagy, paraptosis, oxidative stress, and tumor cell motility. This review discusses curcumin’s anticancer mechanism through modulation of Rb, p53, MAPK, P13K/Akt, JAK/STAT, Shh, and NF-κB pathways, which are commonly involved and dysregulated in preclinical and clinical GBM models. In addition, limitation issues such as bioavailability, pharmacokinetics perspectives strategies, and clinical trials were discussed.

Artificial Intelligence Technology for COVID-19 Detection at Early Stage with Special Reference to Health Disparity and Socioeconomic Status

A novel coronavirus, SARS-CoV-2, was identified as the cause of an outbreak of viral pneumonia in Wuhan, China. The disease, later named coronavirus disease 2019 (COVID-19), subsequently spread globally. COVID- 19 is an aggressive disease with a low median survival rate. Ironically, the treatment process is long and very costly due to its high recurrence and mortality rates. Accurate early diagnosis and prognosis prediction of COVID-19 are essential to enhance the patient's survival rate. Mount Sinai researchers are the first in the country to use artificial intelligence (AI) combined with imaging, and clinical data to analyze patients with COVID-19. They have developed a unique algorithm that can rapidly detect COVID-19 based on how lung disease looks in computed tomography (CT scans) of the chest, in combination with patient information including symptoms, age, bloodwork, and possible contact with someone infected with the virus. AI has huge potential for analyzing large amounts of data quickly, an attribute that can have a big impact in a situation such as a pandemic. There is increasing evidence that some racial and ethnic minority groups are being disproportionately affected by COVID-19.

Primary splenic angiosarcoma: a diagnostic enigma

Primary splenic angiosarcomas (PSA) arise from splenic endothelium are rare and impose a diagnostic challenge preoperative. They can present as asymptomatic splenomegaly however; the commonest presentation is abdominal pain. The spleen can rapidly increase in size and can manifest as spontaneous rupture which would cause peritoneal dissemination of disease. Early metastasis of PSA is seen in liver, lungs, lymph nodes and gastrointestinal system. Preoperative diagnosis requires a high index of suspicion and ultrasound, contrast enhanced computerized tomography may essential to differentiate from splenic hemangioma. Splenic angiosarcoma are best treated with splenectomy with a limited disease, with care taken not to rupture and cause spillage. PSA are resistant to adjuvant radiation and chemotherapy. Mortality is high with median survival rate of only 5 months, irrespective of treatment and hence the need to diagnose before complications. Bisphosphonates, adjuvant radiation with chemotherapy have been attempted to increase disease free survival. We report a case of PSA emphasizes on early preoperative diagnosis to avoid progression of the disease.

The therapeutic potential of curcumin for the treatment of glioblastoma multiforme

Glioblastoma multiforme (GBM), a grade IV astrocytoma, is the most common and deadly type of primary malignant brain tumor, with a patien’s median survival rate ranging from 12 to 15 months. Over the last fifteen years, the treatment for GBM has included maximal safe surgical resection with combination radiotherapy and adjuvant temozolomide chemotherapy. The low efficacy of mentioned therapies has forced researchers to explore an appropriate alternative or complementary treatment for GBM. It has been shown that curcumin has therapeutic potentials to fight against GBM via affecting on cell proliferation, apoptosis, cell cycle, invasion and angiogenesis pathways. In addition, curcumin possess a synergistic impact with chemotherapeutic agents. Herein, we summarized the current findings on curcumin as potential therapeutic agent in the treatment of GBM.

Genes encoding histone proteins are differentially expressed between men and women with diffuse intrinsic pontine glioma and their expression correlates with survival.

Diffuse intrinsic pontine glioma is a pediatric brain cancer and has the lowest median survival rate of all cancers known to man (1). 99% of patients diagnosed with DIPG will expire within 5 years (1). Understanding the transcriptional behavior of tumors in DIPG is critical for the development of novel therapies. In this study, I compared the transcriptomes of tumors from men with DIPG versus that of tumors from women diagnosed with DIPG using a published dataset (2). I found that three histone genes, including HIST1H4C, HIST1H2BD, and HIST1H3D, which encode Histone H4, Histone H2B Type 1D, and Histone H3.1 were among the genes whose expression was most different between the DIPG tumors of men and women. Importantly, the expression level of two of these genes significantly correlated in a linear fashion with the amount of time the patient survived. It has previously been reported that 78% of DIPG tumors contain a mutation in Histone H3.1 (HIST1H3B) (3). This is the first report of differential expression of histone genes in tumors of patients with DIPG.