Predictive role of molecular subtypes in response to neoadjuvant chemotherapy in breast cancer patients

Background: Breast cancer is increasingly regarded as a heterogeneous disease which can be classified into distinct molecular subtypes with prognostic significance

Objectives: Retrospective evaluation of the response to neoadjuvant chemotherapy for patients with the major molecular subtypes of breast cancer as classified using immunohistochemical assay and to investigate the patterns of benefit from the neoadjuvant chemotherapy in different molecular subtypes

Materials and methods: ER, PR, HER2 and ki-67 were used to divide102 breast cancer patients treated with neoadjuvant chemotherapy [NCT] into 4 subtypes: luminal A [ER+,PR+,HER2-, and ki-67 14% ; ER+ and/or PR+, HER2+], HER2-overexpression [ER-, PR- and HER2+] and triple-negative [ER-, PR-,and HER2-]

Results: Of the 102 patients analyzed, 9 patients [8.8% of all patients] achieved pCR with 2.6% [2/76] for luminal subgroup, 0.0% [0/8] for HER2-overpression subgroup and 38.9% [7/18] for triple-negative subgroup with a high statistical significant value [p=0.000]

Clinicoepidemiological study and survival analysis of right versus left Sided colon cancer patients

Background: recently, there is a great attention, about the clinicopathological differences between right and left colon cancer, and how much these differences will affect the outcomes of colon cancer patients. Many epidemiological studies have demonstrated that tumor at the right and left colon, respectively, occur with different incidence in diverse region of the world. Differences in clinical presentation, patient's demographics, and tumor biology between right- and left- sided colon cancers have long been reported in the literatures

Methods: the current study was conducted in Clinical Oncology and Nuclear medicine department, Ain Shams University Hospitals, during the period from January 2011 to December 2015, data on all patients histologically confirmed with colon cancer, were evaluated right-and left-sided cancers were compared with regard to epidemiological, clinical and pathological parameters as well as survival data

Results: the study showed that, there were 129 patients, 70[54.2%] patients had left-sided colon cancers and 59[45.7%] patients had right-sided colon cancers, most of the cases were aged above 50 years 61.2%. Histopathological type was mainly adenocarcinoma 72.09%, moderately differentiated 79.8%, the mucinous carcinoma was more in right sided colon 56.25%. Comparison of progression free survival in stage IV, showed higher progression rate [58.3%] in right sided patients, than left sided patients [41.6%], this difference was not statistically significant. We also found that patients with right-sided colon cancer had a statistically significantly worse overall survival [OS] P value=0.019, than patients with left-sided colon cancer. We demonstrated that the differences in OS were significant only in patients with stage IV colon cancer

Conclusion: in conclusion, our results support evidence that there are differences in the biology and outcomes for right- and left-sided colon cancers. Significantly better survival is seen for metastatic colon cancer with a left-sided, and this was confirmed by multivariate analysis. This might have been due to several environmental and lifestyle factors, which contributed to this anatomical shift. The differences in genetic and molecular pathologic profiles in each side of the colon were observed. Stratification based on the primary site should be considered in the future for trials assessing survival for colon cancer

Relapse in patients with non-Hodgkin's lymphpma

Background: non Hodgkin Lymphoma is the most common hematologic malignancy and it is the 6th leading cause of cancer death. Relapses still occur in the majority of patients; overall, more than 30% of DLBCL will ultimately relapse

Aim of study: primary objective was to retrospectively correlate the occurrence of relapsed, refractory and in remission diffused large B cell lymphoma patients to both clinicpathological features of the disease and line of treatment received

Patients and Method: a total of 116 patients with aggressive high grade NHL patients [DLBCL] representing 86.6% of all patients presented to Clinical Oncology Department, Ain Shams University in the period between January 2009 and December 2015. Data were collected between January 2017 until Marsh 2017

Results: the mean age at diagnosis of the studied patients was 45 years. The incidence in male was higher than female [52.6% vs. 47.4%], the majority of the cases didn't have B symptoms [57.7%], high LDH level was measured among the cases [37%]and in only 36 patient's files,16.37% of the cases had positive HCV.The most common stage at diagnosis was stage IV [33.6%]followed by stage III [29.3%]. Based on response to the 1st line chemotherapy, DLBCL patients were further statistically analyzed into three categories:24 refractory patients [20.07%], 43 relapsed patients [37.1%] and 49 patients in remission [non relapsed] [42.2%]. Regarding 1st line treatment regimen by R-Chop, complete response rates were significantly higher in patients who received R-CHOP than in the group who received CHOP alone [57.1% vs 42.8%]. The median disease freesurvival in the relapsed groupwas 8 months. The median survival time for the DLBCL patients was 24 months. The survival rate after 1 year was 83.7%, while after 2 years it was 52.8% and after 3 years it was 21.3%

Conclusion: relapsed and refractory disease continues to represent the most significant challenge in treating NHL, the addition of rituximab to the CHOP regimen increased the CR rate and prolonged eventfree and overall survival