Are taxane based regimens better than non-taxane fluoropyrimidine based regimens in advanced gastric cancer? Findings from an observational multicentre study, South India

Background: Capecitabine, 5 Fluorouracil, platinum agents and taxanes are either used alone or in combination in advanced gastric cancers (AGC). Data on tolerability and efficacy of these regimens are minimal. We aimed to report proportion of AGC patients opting for best supportive care upfront and tolerability and efficacy of taxane and non-taxane fluoropyrimidine based regimens from three oncology centers, South India.Methods: Case records of AGC patients initiated on either taxane or non-taxane fluoropyrimidine based chemotherapy during May 2016 to Dec 2017 in three private tertiary cancer care centers across two states in south India were reviewed. Information on clinical characteristics, regimen used, radiological and clinical response, toxicity and its related hospital admissions were extracted. Statistical analysis was done by categorical variables that were summarized using proportions. Median survival was calculated using Kaplan Meier curves and comparison between the groups were done using log-rank test.Results: Of 88 AGC patients, 27 patients (30.7%) opted for best supportive care; 19 and 41 patients received paclitaxel based and non-taxane fluoropyrimidine based regimens respectively. There was no statistically significant difference in pain symptoms, vomiting, hospital admissions and intensive care admissions between the two regimens. Median (inter quartile range) survival of patients receiving best supportive care, taxane based regimen and non-taxane fluoropyrimidine regimen were 3.1 (1.5-16.1), 7.4 (1.6-15.0) and 11.6 (3.2-29.3) months respectively. Median (range) survival on any chemotherapy was 10.3 (1.6-29.3) months and it was significantly higher compared to best supportive care (p<0.001)Conclusions: AGC patients on chemotherapy had improved overall survival compared to stand alone best supportive care. Fluoropyrimidine based regimens offered better survival than taxane based regimen

Late recurrence in orbital rhabdomyosarcoma: Complete remission after multimodality management

A case of orbital rhabdomyosarcoma had a localised recurrence 13 years after being treated with chemo radiotherapy. Late recurrences are rare in orbital RMS. Only two cases have been reported to have recurred after five years of follow up. Pathological similarity of both the lesions and occurrence outside the irradiated field excluded a radiationinduced second neoplasm. Immunohistochemistry staining with p 53 was positive. Patient had good response to chemotherapy and radiotherapy. Surgical resection of residue showed complete necrosis. Retreatment with combined modality therapy resulted in complete remission and the patient is on follow up

Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults: A Multicenter Study From India

PURPOSEColorectal cancer (CRC) in young adults is a rising concern in developing countries such as India. This study investigates clinicopathologic profiles, treatment patterns, and outcomes of CRC in young adults, focusing on adolescent and young adult (AYA) CRC in a low- and middle-income country (LMIC).METHODSA retrospective registry study from January 2018 to December 2020 involved 126 young adults (age 40 years and younger) with CRC. Patient demographics, clinical features, tumor characteristics, treatment modalities, and survival outcomes were analyzed after obtaining institutional ethics committees' approval.RESULTSAmong 126 AYA patients, 62.70% had colon cancer and 37.30% had rectal cancer. Most patients (67%) were age 30-39 years, with no significant gender predisposition. Females had higher metastatic burden. Abdominal pain with obstruction features was common. Adenocarcinoma (65%) with signet ring differentiation (26%) suggested aggressive behavior. Limited access to molecular testing hindered mutation identification. Capecitabine-based chemotherapy was favored because of logistical constraints. Adjuvant therapy showed comparable recurrence-free survival in young adults and older patients. For localized colon cancer, the 2-year median progression-free survival was 74%, and for localized rectal cancer, it was 18 months. Palliative therapy resulted in a median overall survival of 33 months (95% CI, 18 to 47). Limited access to targeted agents affected treatment options, with only 27.5% of patients with metastatic disease receiving them. Chemotherapy was generally well tolerated, with hematologic side effect being most common.CONCLUSIONThis collaborative study in an LMIC offers crucial insights into CRC in AYA patients in India. Differences in disease characteristics, treatment patterns, and limited access to targeted agents highlight the need for further research and resource allocation to improve outcomes in this population