Bisphosphonates and Prevention of the Perimenopausal Breast Cancer Recurrence: A Systematic Review and Meta-Analysis / 한국유방암학회지

Purpose@#Bisphosphonates (BPs) have a powerful effect on reducing bone resorption and improving the survival of patients with breast cancer. We aimed to investigate the impact of BP treatment on the prevention of recurrence, metastasis, and death of breast cancer survivors in the perimenopausal period. @*Methods@#The search strategy aimed to identify both published and unpublished studies in PubMed, Web of Science, Scopus, Embase, ProQuest, and Google Scholar in March 2021. Two independent reviewers assessed quantitative papers selected for retrieval for methodological validity before being included in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Statistical meta-analysis was performed using Review Manager (RevMan) 5.4 statistical software when the data were homogenous.Meta-analysis was performed by calculating the effect size (hazard ratio; HR) and 95% confidence intervals (CIs). @*Results@#Twenty-one studies were eligible for this systematic review and meta-analysis.The overall The HRs for disease-free survival (DFS) and overall survival (OS) in women who received BPs were 0.89 (95% CI, 0.83–0.97; p = 0.005), and 0.75 (95% CI, 0.63–0.89; p = 0.001), respectively. The results showed that BPs had a significant effect on the prevention of locoregional (HR, 0.64; 95% CI, 0.42–0.97; p = 0.04), bone (95% CI, 0.74–0.95; p ≤ 0.001), and distant metastases (HR, 0.77; 95% CI, 0.62–0.94; p = 0.01). In the subgroup analysis based on study design, the only insignificant HR in the included randomized controlled trials (RCTs) was that of locoregional metastasis. @*Conclusion@#Although BPs have a promising effect on DFS, OS, and bone metastasis of perimenopausal women survivors of breast cancer, more RCTs are needed to evaluate their effect on other survivors’ outcomes.

A general view of CD33⁺ leukemic stem cells and CAR-T cells as interesting targets in acute myeloblatsic leukemia therapy

Acute myeloblastic leukemia (AML) is the most frequent acute leukemia in adulthood with very poor overall survival rates. In the past few decades, significant progresses had led to the findings of new therapeutic approaches and the better understanding of the molecular complexity of this hematologic malignancy. Leukemic stem cells (LSCs) play a key role in the initiation, progression, regression, and drug resistance of different types of leukemia. The cellular and molecular characteristics of LSCs and their mechanism in the development of leukemia had not yet been specified. Therefore, determining their cellular and molecular characteristics and creating new approaches for targeted therapy of LSCs is crucial for the future of leukemia research. For this reason, the recognition of surface maker targets on the cell surface of LSCs has attracted much attention. CD33 has been detected on blasts in most AML patients, making them an interesting target for AML therapy. Genetic engineering of T cells with chimeric antigen receptor (CAR-T cell therapy) is a novel therapeutic strategy. It extends the range of antigens available for use in adoptive T-cell immunotherapy. This review will focus on CAR-T cell approaches as well as monoclonal antibody (mAB)-based therapy, the two antibody-based therapies utilized in AML treatment.

Mesenchymal stem cells in acute myeloid leukemia: a focus on mechanisms involved and therapeutic concepts

Drug resistance in cancer, especially in leukemia, creates a dilemma in treatment planning. Consequently, studies related to the mechanisms underlying drug resistance, the molecular pathways involved in this phenomenon, and alternate therapies have attracted the attention of researchers. Among a variety of therapeutic modalities, mesenchymal stem cells (MSCs) are of special interest due to their potential clinical use. Therapies involving MSCs are showing increasing promise in cancer treatment and anticancer drug screening applications; however, results have been inconclusive, possibly due to the heterogeneity of MSC populations. Most recently, the effect of MSCs on different types of cancer, such as hematologic malignancies, their mechanisms, sources of MSCs, and its advantages and disadvantages have been discussed. There are many proposed mechanisms describing the effects of MSCs in hematologic malignancies; however, the most commonly-accepted mechanism is that MSCs induce tumor cell cycle arrest. This review explains the anti-tumorigenic effects of MSCs through the suppression of tumor cell proliferation in hematological malignancies, especially in acute myeloid leukemia.

Erratum: Associations between Dietary Allium Vegetables and Risk of Breast Cancer: A Hospital-Based Matched Case-Control Study / 한국유방암학회지

This article was initially published on the Journal of Breast Cancer with a misspelled author name and affiliation of the seventh author.

Influence of chemotherapy on the lipid peroxidation and antioxidant status in patients with acute myeloid leukemia

Chemotherapeutic agents used in patients with cancer cause to generate the enormous amounts of free radicals associated with cell injury. In this study we assess the effects of chemotherapy regimen on oxidant/antioxidant status in patients with acute myeloid leukemia [AML]. 38 newly diagnosed patients with acute myeloid leukemia were recruited in this study. All patients received cytarabine and daunorubicin as chemotherapy regimen. Plasma levels of malondialdehyde [MDA], total antioxidant status [TAS], and the levels of erythrocyte activity of superoxide dismutase [SOD] and glutathione peroxidase [GPx] were determined before chemotherapy and 14 days after chemotherapy with cytarabine and daunorubicin. Plasma MDA concentrations increased significantly [from 2.68 +/- 0.89 nmol/L to 3.14 +/- 1.29 nmol/L] during the 14days post-chemotherapy period [P=0.04]. Plasma TAS concentrations changed with chemotherapy from 1.09 +/- 0.15 mmol/L to 1.02 +/- 0.14 mmol/L with P=0.005. Erythrocyte SOD and GPX activity decreased overtime from 1157.24 +/- 543.61 U/g Hb to 984.01 +/- 419.09 U/g Hb [P=0.04] and 46.96 +/- 13.70 U/g Hb to 41.40 +/- 6.44 U/g Hb [P=0.02] respectively. We report here that there is an increase in malondialdehyde levels and a decrease in the levels of antioxidant enzymes and total antioxidant status. This suggests that chemotherapy causes these changes as a result of enormous production of reactive oxygen species in the patients with AML. Antioxidant supplementation must be approached with caution because of the probability of reduction the therapeutic efficacy of these cytotoxic drugs.

Arsenic trioxide in patients with refractory multiple myeloma: a prospective, phase II, single-arm study

Multiple myeloma [MM] characterized by proliferation of plasma cells in bone marrow and production of monoclonal immunoglobulin's. Recently, arsenic trioxide [ATO], has been considered for treatment refractory MM. We assessed the safety and efficacy of ATO for patients with refractory MM. A phase 2, study of arsenic trioxide was conducted in 12 MM patients, whose refractory to two standard therapy. Patients received arsenic trioxide, 0.25 mg/kg/d for 5 d/week during the first 2 consecutive weeks of each 4-week cycle with 2 week rest. Patients who completed one 4-week cycle were evaluated for response to treatment. Twelve patients with refractory multiple myeloma received ATO. Disease assessment was based the amount of serum proteins electrophoresis. Of the10 patients; stable disease was observed in four patients[33%], progression disease in five patients [41.6%], complete response in one patient [3.8%] and the remaining two patients could not be assessed for a response [because of increased liver enzymes after the first week]. Some adverse events: increase liver enzymes and serum creatinine, neutropenia, pruritus, nausea, vomiting, lower extremities edema, noninfectious diarrhea was observed. These results indicate that ATO is active and well tolerated as a single-agent salvage therapy, even in patients with late-stage, refractory MM

Low-dose cytosine arabinoside; disease free survival and overall survival in the elderly patients with acute myeloid leukemia

The median age of the patients with acute myeloid leukemia [AML] is 65 years. Studies have revealed that the prognosis of the elderly patients [over 60 years] is not satisfying. The aim of this study was to evaluate the survival of AML patients being treated with Low-dose Cytosine arabinoside. In this cross-sectional study, 20 AML patients treated with Low-dose Cytosine arabinoside. Disease free survival and overall five-year survival ratios were identified. In this study there were 11 males [55%] and nine female [45%] with a mean age of 63.3 +/- 18.4 years. The median of disease free survival was 12.4 months and five-year survival was 1.7 years. Apparently disease-free survival and overall five-year survival in the AML patients being treated with Low-dose Cytosine arabinoside are similar to that of cases being treated with intense chemotherapy regimens