Hormone Receptor, HER2/NEU and EGFR Expression in Ovarian Carcinoma - is here a Prognostic Phenotype?

WOS: 000351056900031PubMed ID: 25520097Purpose: We aimed to evaluate the effects of hormone receptor, HER2, and epidermal growth factor receptor (EGFR) expression on epithelial ovarian cancer (EOC) prognosis and investigate whether or not phenotypic subtypes might exist. Materials and Methods: The medical records of 82 patients who were diagnosed with EOC between 2003 and 2012 and treated by platinum-based chemotherapy were retrospectively evaluated. Expression of EGFR, oestrogen (ER), progesterone (PR), and cerbB2 (HER2) receptors were assessed immunohistochemically on paraffin-embedded tissues of these patients. Three phenotypic subtypes were defined according to ER, PR, and HER2 expression and associations of these with EGFR expression, clinicopathologic features, platinum sensitivity, and survival were investigated. Results: When we classified EOC patients into three subtypes, 63.4% had hormone receptor positive (HR(+)) (considering breast cancer subtypes, luminal A), 18.3% had triple negative, and 18.3% had HER2(+) disease. EGFR positivity was observed in 37 patients (45.1%) and was significantly more frequent with advanced disease (p=0.013). However, no significant association with other clinicopathologic features and platinum sensitivity was observed. HER2(+) patients had significantly poorer outcomes than HER2(-) counterparts (triple negative and HR positive patients) (p=0.019). Multivariate analysis demonstrated that the strongest risk factor for death was residual disease after primary surgery. Conclusions: Triple negative EOC may not be an aggressive phenotype as in breast cancer. The HER2 positive EOC has more aggressive behaviour compared to triple negative and HR(+) phenotypes. EGFR expression is more frequent in advanced tumours, but is not related with poorer outcome. Additional ovarian cancer molecular subtyping using gene expression analysis may provide more reliable data.Society of Cancer Research (Izmir, Turkey)This research was supported by grants from the Society of Cancer Research (Izmir, Turkey). We thank the Chairman of this society, Ugur Yilmaz, for his valuable support. We also thank the Department of Pathology, Izmir Ataturk Research and Training Hospital, for their valuable technical assistance

Enhanced cytotoxicity and apoptosis by thymoquinone in combination with zoledronic acid in hormone- and drug-resistant prostate cancer cell lines

WOS: 000347742000030PubMed ID: 25536616Purpose: Thymoquinone (TQ), an active ingredient of black seed oil (Nigella Sativa), has been shown to possess cytotoxic activity against a variety of cancer cell lines. Our purpose was to investigate if the cytotoxic and apoptotic effect of zoledronic acid (ZA) can be enhanced by the addition of the TQ in hormone- and drug-refractory prostate cancer cells PC-3 and DU-145. Methods: XTT cell proliferation assay was used to assess cytotoxicity; DNA fragmentation and caspase 3/7 activity were also measured. Results: The combination of TQ and ZA resulted in a significant synergistic cytotoxic activity and DNA fragmentation when compared to any single agent alone, in a dose- and time-dependent manner. In addition, TQ and ZA combination increased the caspase 3/7 activity in PC-3 cell line, while this activity could not be demonstrated in DU-145 cell line. Conclusion: TQ and ZA had minimal hematological and non-hematological toxicity profile compared to cytotoxic agents. So, this combination may be an alternative approach for patients who are unable to be treated by conventional treatments because of poor performance status

The role of FOLFOXIRI in chemorefractory metastatic colorectal cancer patients

Introduction: The use of FOLFOXIRI (oxaliplatin, irinotecan, leucovorin, and 5-fluorouracil) as first-line therapy for metastatic colorectal cancer (mCRC) is well-established. However, there is no data about the effectiveness of this regimen in pretreated patients in the current literature. In this case report, we aim to evaluate the efficacy and benefit of FOLFOXIRI in patients who received standard regimens. Case report: 3 patients were treated with FOLFOXIRI and 1 patient received FOLFOXIRI + bevasizumab. Three patients had a partial response to FOLFOXIRI; one of these patients showed disease progression on this chemotherapy regimen and died. Progression free survival (PFS) of three patients was 5.5, 9 and 7.5 months respectively. One patient showed progression without any response to treatment. Conclusion: We observed a partial response in 3 patients who were treated with FOLFOXİRİ and their progression-free survival was more than 3 months. These patients were treated with FOLFOXİRİ as a third or fourth line therapy. FOLFOXIRI should be considered as an alternative option in patients who have received standard treatments with good performance status. Keywords: Colorectal cancer, FOLFOXIRI, Metastatic, Chemorefractor

The prognostic significance of bone marrow metastases: Evaluation of 58 cases

Background: Bone marrow biopsy is widely used method for diagnosis, follow-up and staging of hemato-oncologic diseases. This procedure is also used for determining the bone marrow metastasis in patients with solid tumors. In this study, clinical, hematological, and pathological features of 58 patients with bone marrow metastases diagnosed by bone marrow biopsies were examined retrospectively Materials and Methods: Among 3345 bone marrow biopsies performed in our hospital between January 2006 and August 2013, 58 cases with solid tumor metastasized to bone marrow were included in this study. Results: Among 58 cases with solid organ carcinoma metastasis in bone marrow, mean age was 59.9. Thirty-nine cases were found to have a known primary tumor focus. The most common tumors metastasized to bone marrow were breast carcinomas (23 patients, 59%), gastric carcinomas (6 patients, 15.3%), prostate carcinomas (4 patients, 10,2%), and lung carcinomas (3 patients, 7.7%), respectively. Nineteen patients were firstly diagnosed from bone marrow biopsies as metastatic carcinomas. The median overall survival after bone marrow metastasis was 28 days (95% confidence interval: 7.5-48.4). The median overall survival difference was not statistically significant between patients with primary known and unknown tumor (P = 0.973). Statistically significant difference was observed between the survival of breast cancer and gastric cancer (P = 0.028). The most common hematologic symptom was the coexistence of anemia and thrombocytopenia (31%), thrombocytopenia (27.6%) and anemia (20.7%) alone. The median overall survival difference was statistically significant between patients who have anemia and thrombocytopenia (P < 0.005). Conclusion: Bone marrow biopsy is an easily accessible, easily applied, a useful procedure for diagnosing metastatic diseases in patients with hematologic symptoms such as anemia and thrombocytopenia besides being an uncomfortable procedure for patients. Furthermore, it is useful in predicting the prognosis and short survey after diagnosing bone marrow metastasis

Bisphosphonate (Zoledronic Acid) Associated Adverse Events: Single Center Experience

WOS: 000282400900001Zoledronic acid is an efficacy-proven bisphosphonate used in the patients who develop bone metastasis. In our study, we planned to evaluate side effects occurring in the patients who receive zoledronic acid. The records of a total of 5.482 patients diagnosed with solid tumor who were admitted to oncology out-patients' clinic between January 2001 and January 2007 were scanned. It was found that 256 patients received zoledronic acid. Zoledronic acid is administered in 4 mg doses for a period of 15 minutes as intravenous infusion once in 21/28 days. Side effects such as hypocalcemia, symptomatic hypocalcemia, impairment in renal functions and osteonecrosis of the jaw, were evaluated retrospectively. Zoledronic acid was administered due to bone metastasis in 248 patients, malign hypercalcemia in 6 patients and ostoporosis in 2 patients. Four patients (1.5%) were diagnosed with jaw osteonecrosis, 22 patients (8.5%) were diagnosed with hypocalcemia, 19 patients (7.4%) were diagnosed with impairment in renal functions, and 2 patients were (0.7%) diagnosed with symptomatic hypocalcemia. Zoledronic acid is a bisphosphonate which has been proven to reduce complications which may develop depending on the bone metastasis, such as pathological fracture, spinal chord impression andhypercalcemia. On the other hand, side effects may occur in the patients receiving zoledronic acid. It will be appropriate to inform the patients who are planned to start administering zoledronic acid of the benefits to be obtained and the side effects to take place

Malignant epithelioid hemangioendothelioma progressing after chemotherapy and Interferon treatment: A case presentation and a brief review of the literature

Epithelioid hemangioendothelioma is a rare, low-grade malignant vascular tumour. It is frequently seen in the liver, but can occur in the lungs, bones, and other soft tissues. Although survival time might be reasonable in cases that can undergo liver transplantation, there is no consensus on the treatment of metastatic patients. We report a 24-year-old female patient with rapidly progressing malignant epithelioid hemangioendothelioma that presented with acute abdominal distension. The patient was refractory to anthracycline and Interferon treatment and died 6.5 months after the diagnosis