Associations of anthropometric measures on breast cancer risk in pre- and postmenopausal women : a case-control study

Background: The type of silhouette and quantity of fat tissue are correlated with hormonal imbalance which plays a substantial role in breast carcinogenesis. The goal of the study was to investigate the association between various anthropometric characteristics and breast cancer risk. Methods: Detailed anthropometric assessment was conducted on 487 women of whom 193 had diagnosed breast cancer and were consecutive patients in the Oncology Center, Cracow, Poland between 2002 and 2004. Measurements were divided into four categories: overall body size (body mass index [BMI], waist circumference [WC], waist-hip ratio [WHR]), regional body sizes (skinfold thicknesses, circumferences), thickness of the skeleton (widths, chest diameters), and body proportions. Additionally, results were analyzed in regar, to menopausal status. Differences between groups were assessed using Student’s t test and Mann-Whitney’s test. Models of logistic regression for selected data were built to estimate the odds ratio. Results were considered statistically significant when the P value was less than 0.05. Results: The BMI in both groups was negatively associated with the risk of cancer. Among premenopausal women, WHR increased the risk of breast cancer (WHR > 0.83, OR, 2.72; 95 % CI, 1.01-7.27). Anthropometric indices of hip-to-shoulder ratio in postmenopausal (≥84.2 mm, OR, 0.02; 95 % CI, 0.01-0.11) and trunk-to-height ratio in both premenopausal women (≥32.76, OR, 0.09; 95 % CI, 0.03-0.28) and postmenopausal women (≥32.76, OR, 0.13; 95 % CI, 0.05-0.33) were strongly related to a decreased risk of breast cancer. Thicknesses of the triceps and subscapular skinfolds increased the risk of breast cancer. Conclusions: Women with breast cancer present with an obese type of silhouette with a specific concentration of fat tissue in the central and upper parts of the body

Leczenie przerzutowego, hormonozależnego, HER-2 ujemnego raka piersi – czy jest miejsce dla ewerolimusu? Opis przypadku

Rak piersi jest najczęściej występującym na świecie nowotworem złośliwym u kobiet. Obecnie standardem postępowania w leczeniu rozsianego, hormonozależnego, HER-2 ujemnego raka piersi, bez cech kryzy trzewnej jest terapia hormonalna z inhibitorami kinaz cyklinozależnych (CD4/6). Ewerolimus, pochodna rapamycyny, nie jest obecnie rutynowo stosowany w praktyce klinicznej, jednak wykazano jego skuteczność w skojarzeniu z hormonoterapią. W artykule zaprezentowano przypadek pacjentki z nawrotowym, hormonoopornym rakiem piersi, u której zastosowano ewerolimus z eksemestanem w ramach terapii niestandardowej po dwóch liniach paliatywnej hormonoterapii (inhibitor aromatazy i fulwestrant) i chemioterapii FAC (fluorouracyl, adriamycyna, cyklofosfamid). Zastosowane leczenie zapewniło 24-miesięczny czas wolny od nawrotu choroby. Miejsce ewerolimusu w leczeniu zaawansowanego raka piersi w obecnej erze leczenia cyklibami (inhibitory cyklin CD4/6) jest poddawane ocenie w toczących się badaniach klinicznych.Among females, breast cancer is across the world the most common malignancy. Currently, the standard in the treatment of metastatic, hormone receptor-positive HER2-negative breast cancer without visceral crisis, is hormonal therapy with cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors. Everolimus, a rapamycin derivative, is not routinely used in clinical practice but together with hormonal therapy it has been found to be an effective treatment option. We present a patient with recurrent, hormone-resistant breast cancer who was treated with everolimus with exemestane in beyond-standard therapy after two lines of palliative hormonal therapy (aromatase inhibitor and fulvestrant) and chemotherapy FAC (fluorouracil, adriamycin, cyclophosphamide). This treatment provided 24-months of progression-free survival. The place of everolimus in the treatment of advanced breast cancer in the era of CDK 4/6 inhibitors is being investigated in clinical trials

Anti-cancer agents and endothelium

Recent advances in oncology have improved the treatment outcomes and life expectancy of cancer patients; therefore, late effects of oncological treatment are of high clinical importance. Recent studies have shown that cardiovascular events are among the leading causes of premature morbidity in cancer survivors. Cardiotoxicity of some chemotherapeutic agents have been already confirmed; however, this issue seems to be more complex. Endothelium dysfunction is one of the first recognisable signs of atherosclerosis, which occurs long before the development of overt cardiovascular disease. Thus, it could be considered as an initial step, leading to increased risk of cardiovascular events. This process is not easy to recognise; however, there are some laboratory tests and imagining techniques that provide an insight into the progression of endothelial dysfunction. In this review we discuss the influence of oncological treatment on endothelium, according to the hypothesis that it increases cardiovascular morbidity and mortality in cancer survivors. Additionally, we present diagnostic and therapeutic measures that could reduce cardiovascular risk in cancer patients

Wnt pathways in focus – mapping current clinical trials across the cancer spectrum

The Wnt pathway has a pivotal function in tissue development and homeostasis, overseeing cell growth or differentiation. Aberrant Wnt signalling pathways have been associated with the pathogenesis of diverse malignancies, influencing cell proliferation, differentiation, cancer stem cell renewal, the tumour microenvironment and thereby significantly im­pacting tumour development and therapeutic responsiveness. Promisingly, current research underscores the potential therapeutic value of targeting Wnt pathways, particularly canonical Wnt/β-catenin signalling, in the context of numerous cancer types. Key constituents of the Wnt pathway, such as the Wnt/receptor, β-catenin degradation or transcription complexes, have been focal points for interventions in preclinical studies. To comprehend potential therapeutic strate­gies, we conduct an analysis of ongoing clinical trials that specifically aim to target components of the Wnt pathways across a diverse spectrum of cancer types. By scrutinizing these trials, including their respective phases, targeted pa­tient populations ,and observed outcomes, this review provides a consolidated overview of the current translational landscape of Wnt-targeted therapies, thus offering a roadmap for future research endeavours

Uszkodzenie śródbłonka naczyń przez leki przeciwnowotworowe

Rozwój onkologii w ostatnich latach przełożył się na znaczącą poprawę skuteczności leczenia i rokowanie chorych na nowotwory złośliwe. Z tego względu coraz większą uwagę przykłada się do późnych następstw leczenia onkologicznego. Wyniki badań wskazują, że powikłania sercowo-naczyniowe są najczęstszą przyczyną przedwczesnych zgonów u chorych wyleczonych z choroby nowotworowej. Chociaż kardiotoksyczność niektórych chemioterapeutyków jest znanym zjawiskiem, to wydaje się jednak, że patofizjologia wielu powikłań kardiologicznych leczenia onkologicznego może być bardziej złożona. Zaburzenia czynności śródbłonka są pierwszym etapem rozwoju miażdżycy naczyń i pojawiają się one jeszcze przed klinicznie jawną manifestacją chorób sercowo-naczyniowych. Rozpoznanie tych zaburzeń w codziennej praktyce lekarskiej nie jest łatwe, jednak istnieją metody badań laboratoryjnych i obrazowych, które umożliwiają skuteczną ocenę stanu śródbłonka naczyniowego. W przedstawionej pracy przeglądowej omówiono wpływ leczenia onkologicznego na funkcje śródbłonka. Przedstawiono także dostępne metody detekcji uszkodzenia śródbłonka oraz działania mogące zredukować ryzyko następstw sercowo-naczyniowych u chorych onkologicznych

Wnt pathways in focus – mapping current clinical trials across the cancer spectrum

The Wnt pathway has a pivotal function in tissue development and homeostasis, overseeing cell growth or differentiation. Aberrant Wnt signalling pathways have been associated with the pathogenesis of diverse malignancies, influencing cell proliferation, differentiation, cancer stem cell renewal, the tumour microenvironment and thereby significantly im­pacting tumour development and therapeutic responsiveness. Promisingly, current research underscores the potential therapeutic value of targeting Wnt pathways, particularly canonical Wnt/β-catenin signalling, in the context of numerous cancer types. Key constituents of the Wnt pathway, such as the Wnt/receptor, β-catenin degradation or transcription complexes, have been focal points for interventions in preclinical studies. To comprehend potential therapeutic strate­gies, we conduct an analysis of ongoing clinical trials that specifically aim to target components of the Wnt pathways across a diverse spectrum of cancer types. By scrutinizing these trials, including their respective phases, targeted pa­tient populations ,and observed outcomes, this review provides a consolidated overview of the current translational landscape of Wnt-targeted therapies, thus offering a roadmap for future research endeavours

Immunotherapy or targeted therapy as first-line treatment of patients with advanced/metastatic melanoma with the BRAF mutation — a single-center analysis

Introduction. One of the most important achievements of contemporary oncology is the discovery of new therapeutic possibilities: targeted therapy and immunotherapy associated with checkpoint inhibitors. It has not been unequivocally determined so far which therapy should be used as first-line treatment in patients with advanced/metastatic melanoma with the BRAF mutation. Material and methods. 137 patients with advanced/metastatic melanoma with the BRAF mutation were analyzed. They received anti-PD1-1 therapy (IT) or molecularly targeted therapy iBRAF ± iMEK (TT) as first-line treatment in the scope of the national drug program. IT and TT therapies used as first-line treatment were compared. Results. Median OS and PFS in the group were 14.0 and 7.3 months. Unfavorable prognostic factors for OS and PFS were metastases to the central nervous system, increased LDH levels and performance status > 1. Metastatic sites in > 2 locations were only unfavorable prognostic factors for OS. A statistically significant difference was found between TT and IT for OS (p = 0.0011; median for TT was 12.6 months and was not reached for IT). It should be noted that the group treated with TT was characterized by a worse prognostic factors. No differences in PFS were observed (p = 0.292, medians 7.2 and 9.0 months, respectively). Conclusion. In patients with advanced/metastatic melanoma with a BRAF mutation without rapid progression, IT should be considered as first-line therapy.Introduction. One of the most important achievements of contemporary oncology is the discovery of new therapeutic possibilities: targeted therapy and immunotherapy associated with checkpoint inhibitors. It has not been unequivocally determined so far which therapy should be used as first-line treatment in patients with advanced/metastatic melanoma with the BRAF mutation. Material and methods. 137 patients with advanced/metastatic melanoma with the BRAF mutation were analyzed. They received anti-PD1-1 therapy (IT) or molecularly targeted therapy iBRAF ± iMEK (TT) as first-line treatment in the scope of the national drug program. IT and TT therapies used as first-line treatment were compared. Results. Median OS and PFS in the group were 14.0 and 7.3 months. Unfavorable prognostic factors for OS and PFS were metastases to the central nervous system, increased LDH levels and performance status > 1. Metastatic sites in > 2 locations were only unfavorable prognostic factors for OS. A statistically significant difference was found between TT and IT for OS (p = 0.0011; median for TT was 12.6 months and was not reached for IT). It should be noted that the group treated with TT was characterized by a worse prognostic factors. No differences in PFS were observed (p = 0.292, medians 7.2 and 9.0 months, respectively). Conclusion. In patients with advanced/metastatic melanoma with a BRAF mutation without rapid progression, IT should be considered as first-line therapy