Multiple Primary Cancers in North Tunisia, 2000 - 2009

Aim: to evaluate and report the frequency, epidemiologic and antaomo -clinical features of patients who developed MPM from the data of North Tunisia Cancer Registry, during the period 2000-2009.Materials and methods: From a population of 53757 new patients of the North Tunisia National Cancer Registry database presenting new cases of cancers during the period 2000-2009 in North Tunisia, we collected and analyzed those with MPMTs. We used for MPMT the international IARC diagnosis criteria are published in ICD-O Third Edition. Results:  In the 53757 new cancer cases registered from 2000-2009, we collected 528 cases (1.0%) of MPM. Mean age at diagnosis of the 1st cancer was 61 years (22-99) and sex-ratio at  1.08 (275M/253F) while mean age at the 2nd cancer diagnosis was 62 years(29 to 99). Among the 528 cases, the most frequent 1st cancer site was breast in females (147 pts, 58.1%) and urinary tract for males (56 patients, 20.4%). In the 528 MPM cases, 321 (60.8%) were synchronous and 207 cases (39.2%) were metachronous tumors. The median time from 1st to 2nd cancer was 1.98 months (range 0-140). The most associated 1st-2nd cancer sites were breast in 110 patients (43.3%) in females and for males’ urinary tract -prostate cancers (45 patients, 16.3%). Conclusions: The coexistence of a synchronous or metachronous MPM is possible and have to be considered during pretreatment evaluation. A close follow-up should be recommended to detect second malignancies in patients treated for a 1st cancer.Keywords: Multiple primary malignancies , clinical features , North Tunisi

Whole and Purified Aqueous Extracts of <i>Nigella sativa</i> L. Seeds Attenuate Apoptosis and the Overproduction of Reactive Oxygen Species Triggered by p53 Over-Expression in the Yeast <i>Saccharomyces cerevisiae</i>

Plants are an important source of pharmacologically active compounds. In the present work, we characterize the impact of black cumin (Nigella sativa L.) aqueous extracts on a yeast model of p53-dependent apoptosis. To this end, the Saccharomyces cerevisiae recombinant strain over-expressing p53 was used. The over-expression of p53 triggers the expression of apoptotic markers: the externalization of phosphatidylserine, mitochondrial defect associated with cytochrome-c release and the induction of DNA strand breaks. These different effects were attenuated by Nigella sativa L. aqueous extracts, whereas these extracts have no effect on the level of p53 expression. Thus, we focus on the anti-apoptotic molecules present in the aqueous extract of Nigella sativa L. These extracts were purified and characterized by complementary chromatographic methods. Specific fluorescent probes were used to determine the effect of the extracts on yeast apoptosis. Yeast cells over-expressing p53 decrease in relative size and have lower mitochondrial content. The decrease in cell size was proportional to the decrease in mitochondrial content and of mitochondrial membrane potential (ΔΨm). These effects were prevented by the purified aqueous fraction obtained by fractionation with different columns, named C4 fraction. Yeast cell death was also characterized by reactive oxygen species (ROS) overproduction. In the presence of the C4 fraction, ROS overproduction was strongly reduced. We also noted that the C4 fraction promotes the cell growth of control yeast cells, which do not express p53, supporting the fact that this purified extract acts on cellular mediators activating cell proliferation independently of p53. Altogether, our data obtained on yeast cells over-expressing p53 demonstrate that anti-apoptotic molecules targeting p53-induced apoptosis associated with mitochondrial dysfunction and ROS overproduction are present in the aqueous extracts of Nigella seeds and in the purified aqueous C4 fraction

Unresectable HCC patients disposal in the new era of immunotherapy from the elitor study based on the french chief cohort

International audienc

Unresectable HCC patients disposal in the new era of immunotherapy from the elitor study based on the french chief cohort

International audienc

Unresectable hepatocellular carcinoma at dawn of immunotherapy era: real-world data from the French prospective CHIEF cohort

International audienceBackground and objectives Hepatocellular carcinoma epidemiological data are limited in France. The Epidemio Liver Immunotherapy Tecentriq outcome research (ELITor) retrospective study, based on real-world data from the Carcinome HépatocellulaIrE en France (CHIEF) French cohort of hepatocellular carcinoma patients, aimed to get insight into the treatment patterns, the sociodemographic, clinical, biological, and etiological characteristics, and the quality of life of patients with unresectable hepatocellular carcinoma. Methods and results Between 1 September 2019 and 4 December 2020, 367 patients from the CHIEF cohort received at least one locoregional (52.8%) chemoembolization or radioembolization or systemic treatment (88.3%) and were selected for ELITor. Most patients had a Barcelona Clinic Liver Cancer (BCLC) C (93.2%) hepatocellular carcinoma stage and were affected by cirrhosis (67.7%). Alcohol was confirmed as the main etiology both as a single etiology (29.1%) and in association with other risk factors (26.9%), mainly metabolic disorders (16.2%). Tyrosine-kinase inhibitors, mainly sorafenib, were the most administered systemic treatments in first line. Patients who received at least one combination of atezolizumab and bevacizumab during the study period ( N = 53) had a better performance status and less portal hypertension frequency than the overall population and more hepatitis B virus infection and fewer metabolic disorders as single etiology. Overall, the global health score before treatment (62.3 ± 21.9) was in line with that of reference cancer patients and worsened in 51.9% of the cases after first-line palliative-intent treatment. Conclusion This study provided real-life data on advanced hepatocellular carcinoma characteristics and treatment patterns and described the first patients to receive the atezolizumab-bevacizumab combination before it became the new standard of care for advanced hepatocellular carcinoma