Pathologic complete response in patients with localized soft tissue sarcoma treated with neoadjuvant therapy and its correlation with clinical outcomes : a systematic review

Soft tissue sarcomas (STS), comprising approximately 1% of adult solid malignancies, are primarily treated with surgery, with the choice of perioperative treatment being a challenging and highly individualized decision. Clinical trials assessing neoadjuvant modalities in STS predominantly use clinical outcomes or radiologic response as endpoints, with pathologic complete response (pCR) not being employed as a designated study endpoint. Our systematic review aimed to assess the rates of pCR in clinical trials of different neoadjuvant modalities for STS and its correlation with patient clinical outcomes. 23 phase I, II and III studies were included, from which data regarding rates of pCR with each treatment, as well as correlation of pCR with clinical outcomes were retrieved. In 16 trials that assessed pCR, the percentage of patients who achieved a pCR ranged from 8 to 58%. Most of these trials did not aim to establish an association between pCR and clinical outcomes. However, among those that did investigate this correlation, a positive association was identified between pCR and both 5-year disease-specific survival (DSS) and 5-year overall survival (OS). While pCR serves as a crucial marker guiding treatment decisions in other neoplasms like triple negative breast cancer and urothelial cancer, it is not yet used in a similar setting for STS. Our findings indicate variability in patients achieving pCR across different neoadjuvant treatments for STS and a possible positive correlation with patient outcomes. Consequently, we propose considering pCR as a surrogate endpoint in future prospective trials for STS

Meta-analysis of BCOR rearranged sarcomas: challenging the therapeutic approach

Introduction: BCOR rearranged sarcomas comprise a group of malignant mesenchymal tumors that until recently were classified as Ewing sarcomas or as undifferentiated round cell sarcomas. The identification of alterations involving BCOR gene such as BCOR-CCNB3, BCOR-MAML3, ZC3H7B-BCOR fusion genes and BCOR internal tandem duplication (ITD) is characteristic for the differential diagnosis of BCOR rearranged sarcomas. Due to the rarity of these tumors there is no consensus or guidelines regarding the optimal therapeutic algorithm, that clinicians should follow. Patients and methods: Herein we have conducted a meta-analysis of the current reports dealing with the therapeutic approach of BCOR rearranged sarcomas. Results: Meta-analysis of the 57 eligible cases from 10 studies resulted to similar Incidence Rate Ratio (IRR) and overall survival (OS) for patients who received Ewing protocols and non-Ewing oriented treatment. Further similar death rate was reported for both strategies (non-Ewing 20% Vs Ewing 21.8%). Conclusion: Our data support that non-Ewing treatment strategy can be considered a safe option, being at least equal to Ewing protocols. The current study provides a hint toward the optimal therapeutic approach of BCOR rearranged sarcomas. Further, the present study challenges the use of the term Ewing-like sarcomas, since the current literature supports that BCOR rearranged sarcomas deserve their own distinct classification in terms of genetics, pathology and therapy. © 2021 Acta Oncologica Foundation

Experimental Assessment of a Modal-Based Multi-Parameter Method for Locating Damage in Composite Laminates

The low specific weight of composite materials, together with their excellent mechanical properties, make them suitable to be widely used in many modern engineering structures. However, composite materials are quite sensitive to impacts: a specific kind of damage, called Barely Visible Impact Damage (BVID), may occur, constituting an unsafe failure of difficult assessment. In the past few years several methods have been developed aiming at assessing this type of damage. In this paper, a vibration-based technique that combines both the natural frequencies and the modal damping factors as damage sensitive features is tested for locating impact damage in carbon fibre reinforced laminates. The method is intended to be used for locating damage in real laminated composite structures that undergo in-service impacts, such as an airplane's fuselage or wings. Assessing a minimum of one response coordinate is the strict requirement during each inspection, because it uses the dynamic global parameters of the structure as damage features. This is possible because the method assumes that, at least for BVID, the mode shapes remain practically unchanged. The theory is summarized and the method is tested using experimental setups where damage is introduced at different locations. Additionally, the hypothesis that different damage morphologies on composite materials have different contributions to the damage features is addressed.Peer reviewedFinal Accepted Versio

The systemic treatment of uterine leiomyosarcomas A systematic review. No news is good news?

Background: Uterine leiomyosarcomas are rare malignant mesenchymal tumors. The systemic treatment of these tumors includes chemotherapy and radiotherapy. However, there are still a lot of unanswered questions regarding the ideal therapeutic approach. Methods: We have conducted a systematic review of the treatment strategies of uterine leiomyosarcomas for the last ten years. Results: Adjuvant chemotherapy is still a matter of dilemma. Doxorubicin based chemotherapy or the combination of Gemcitabine- Docetaxel are the regimens of choice for the first line setting. Beyond the first line, there are several options;, including chemotherapy, targeted therapy, and recently efforts of introducing immunotherapy to the therapeutic armamentarium of clinicians treating uterine leiomyosarcomas. Conclusions: Despite the efforts of the clinicians dealing with uterine leiomyosarcomas, the optimal therapeutic algorithm is yet to be described. Abbreviations: DFS = disease-free survival, EORTC = European Organization of Research and Therapy in Cancer, ESMO = European society of medical oncology, ISGE = International Society of Gynecologic Endoscopy, NCCN = national comprehensive cancer network, OS = overall survival, PFS = progression free survival, PR = partial response, PS = performance status, RT = radiotherapy, SD = stable disease, uLMS = uterine leiomyosarcomas, VEGF = vascular endothelial growth factor. © 2015 Hogrefe Verlag GmbH & Co. KG. All rights reserved

Gefitinib: an “orphan” drug for non-small cell lung cancer

Introduction: The discovery of sensitizing mutations in epidermal growth factor receptor (EGFR) and the rapid development of EGFR tyrosine kinase inhibitors (TKIs) have substantially changed the management of non-small-cell lung cancer (NSCLC), leading to a tailored therapeutic approach for patients with advanced EGFR-mutant NSCLC. Gefitinib is an EGFR-directed TKI, approved by U.S. Food and Drug Administration (FDA) for the first-line treatment of patients with metastatic NSCLC whose tumors harbor specific EGFR gene mutations, as detected by an FDA-approved test. Areas covered: Here, we will focus on the approval of gefitinib as an effective EGFR-directed TKI option, describing the drug development to its currently established use. In parallel, based on the latest evidence, we will present its efficacy and its toxicity profile on selected NSCLC patients harboring specific EGFR driver mutations and we will try to reply to all open questions about gefitinib administration. Expert opinion: Gefitinib in NSCLC is an example of a more personalized approach to cancer therapeutics, where understanding of the molecular background of the cancer led to the appropriate evaluation of the drug into a selected patient population. © 2017 Informa UK Limited, trading as Taylor & Francis Group

Clinical biomarkers directing the management of patients with colon and lung cancer (beyond oncogene-addicted NSCLC)

Treatment personalisation plays a key role in the current management of patients with cancer. Several biomarkers have shown clinical utility and may guide therapeutic decisions. Amongst patients with lung cancer, the level of expression of programmed death ligand 1 (PD-L1) has both prognostic and predictive values in terms of response to the inhibition of programmed cell death protein 1 (PD-1). Depending on the clinical setting, the expression of PD-L1 ≥1% or ≥50% has been associated with improved outcomes amongst patients receiving pembrolizumab. Regarding patients with colorectal carcinoma, mutations in the KRAS oncogene predict the responsiveness to the inhibition of epidermal growth factor receptor (EGFR). Only patients with wild-type KRAS tumours derive benefit from cetuximab and panitumumab in terms of response and survival. In conclusion, future research should aim in the optimisation of the use of biomarker in the clinical practice in order to provide the optimal drug combination to each individual patient

Clinical biomarkers directing the management of patients with colon and lung cancer (beyond on-cogene-addicted NSCLC)

Treatment personalisation plays a key role in the current management of patients with cancer. Several biomarkers have shown clinical utility and may guide therapeutic decisions. Amongst patients with lung cancer, the level of expression of programmed death ligand 1 (PD-L1) has both prognostic and predictive values in terms of response to the inhibition of programmed cell death protein 1 (PD-1). Depending on the clinical setting, the expression of PD-L1 ≥1% or ≥50% has been associated with improved outcomes amongst patients receiving pembrolizumab. Regarding patients with colorectal carcinoma, mutations in the KRAS oncogene predict the responsiveness to the inhibition of epidermal growth factor receptor (EGFR). Only patients with wild-type KRAS tumours derive benefit from cetuximab and panitumumab in terms of response and survival. In conclusion, future research should aim in the optimisation of the use of biomarker in the clinical practice in order to provide the optimal drug combination to each individual patient. © 2020 WDG. All rights reserved

Consumers’ Trust and Preferences Regarding Local Plant Varieties and Indigenous Farm Animal Breeds in Western Macedonia, Greece

The value of rearing indigenous animal breeds and cultivating local plant varieties is extremely high in terms of regional economy and heritage preservation. The purpose of the present research was to investigate the preferences and opinions of consumers in Western Macedonia regarding local varieties and indigenous breeds. For this purpose, an appropriate questionnaire was designed and distributed to a sample of 80 consumers from Western Macedonia. The questions combined the demographic, psychographic and institutional characteristics of consumers. According to our findings, most participants recognize the importance of the conservation of indigenous animal breeds and local plant varieties as well as the products derived from them. Additionally, a large percentage showed a preference for these products for the purpose of supporting the local economy. Nevertheless, particularly for indigenous animal breeds, despite the recognition of their high value and need for conservation, only a small proportion of the participants could name some of the indigenous breeds correctly. Conversely, this was not observed concerning local plant varieties, of which participants were more aware. Thus, better promotion and overall better marketing could enhance the recognition of these resources, emphasizing their high value