The Effect of coronavirus (COVID-19) on breast cancer teamwork: A multicentric survey

Background/Aim: Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). Patients and Methods: In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. Results: A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. Conclusion: Working in a COVID-19-hospital represents a factor that negatively affects psychosocial wellbeing. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP

Impact of gastrointestinal side effects on patients’ reported quality of life trajectories after radiotherapy for prostate cancer: Data from the prospective, observational pros-it CNR study

Radiotherapy (RT) represents an important therapeutic option for the treatment of localized prostate cancer. The aim of the current study is to examine trajectories in patients’ reported quality of life (QoL) aspects related to bowel function and bother, considering data from the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study, analyzed with growth mixture models. Data for patients who underwent RT, either associated or not associated with androgen deprivation therapy, were considered. QoL outcomes were assessed over a 2-year period from the diagnosis, using the Italian version of the University of California Los Angeles-Prostate Cancer Index (Italian-UCLA-PCI). Three trajectories were identified for the bowel function; having three or more comorbidities and the use of 3D-CRT technique for RT were associated with the worst trajectory (OR = 3.80, 95% CI 2.04–7.08; OR = 2.17, 95% CI 1.22–3.87, respectively). Two trajectories were identified for the bowel bother scores; diabetes and the non-Image guided RT method were associated with being in the worst bowel bother trajectory group (OR = 1.69, 95% CI 1.06–2.67; OR = 2.57, 95% CI 1.70–3.86, respectively). The findings from this study suggest that the absence of comorbidities and the use of intensity modulated RT techniques with image guidance are related with a better tolerance to RT in terms of bowel side effects

SBRT: A viable option for treating adrenal gland metastases

The management strategy of adrenal metastases depends on different clinical situations. Adrenal metastasectomy in selected patients with isolated adrenal metastases is considered the treatment of choice, showing prolonged survival compared to chemotherapy alone. More recently, Stereotactic Body Radiation Therapy (SBRT) has emerged as an alternative local ablative treatment modality although limited data are available on the use of SBRT in treating adrenal gland metastases. Preliminary results are, however, encouraging, especially in selected patients with oligometastatic disease. We herewith review and discuss the potential role of SBRT as a local ablative treatment modality for adrenal metastases

The effect of FK506 on transforming growth factor beta signaling and apoptosis in chronic lymphocytic leukemia B cells.

Background and objectives. Loss of response to TGF-b is thought to contribute to B cell chronic lymphocytic leukemia (BCLL) progression. Recent findings of over-activation of the TGF-b signal in FKBP12-knockout mouse prompted us to investigate if FK506, the canonical ligand of FKBP, can activate the TGF-b signal in BCLL. Design and Methods. We studied 62 BCLL samples with RAI/Binet stage of 0 to 4. The TGF-b signal was investigated by Western blot and flow cytometry. The levels of Bcl2-family members and death-associated-protein (DAP) kinase were also investigated by Western blot, whereas apoptosis was studied in flow cytometry. Downmodulation of FKBP12 was obtained by gene silencing with short interfering RNA. Results. Twenty-two out of 62 BCLL samples were sensitive to TGF-b-induced apoptosis. All but two of the responder samples underwent apoptosis also when cultured with FK506, but not with cyclosporine. Thirteen samples non sensitive to TGF-b were sensitive to FK506. Overall, response to FK506 occurred in 33 samples. FK506 induced Smad2 phosphorylation and nuclear translocation. Accordingly, death-associated-protein kinase, a transcriptional target of Smad, was induced. At the same time, Bcl-2 and Bcl-xL levels decreased whereas Bim and Bmf increased. A loss of mitochondrial membrane potential preceded caspase activation and cell death. Our study shows that FK506 removed FKBP12 from its binding to the TGF-b-receptor. FKBP12 release activated the receptor-kinase activity as suggested by the enhanced levels of phospho-Smad found in cells depleted of FKBP12. Interpretation and Conclusions. Our study shows that most BCLL cells escape the homeostatic control of TGF-b and that FK506 restores the TGF-b signal in a proportion of non responder samples. We demonstrate that FK506 activates the TGF-b receptor I kinase activity in BCLL which transduces apoptosis by a mitochondrial-dependent pathway