がん臨床試験ジャーナル

Background: Prostate cancer is the most common cancer in men. With advances in surgery, more and more patients are undergoing radical prostatectomy and one important side effect of surgery is erectile dysfunction. We assess men’s’ post-operative psychosexual needs in two cancer centres in England; co-design and implement a psychosexual pathway in one centre and compare patient experiences and outcomes between the bespoke and usual care pathways.

Method: A systematic review was conducted of prostate cancer survivorship and psychosexual care, to support the development of a psychosexual pathway. Population: men post-surgery with prostate cancer post robotic surgery. Intervention: psychosexual care interventions for men post robotic surgery for prostate cancer.

Outcome measurements: impact of pathway on psychosexual care to be assessed using IIEF, secondary outcomes health related quality of life and acute and chronic co-morbidities to be assessed.

Results: The systematic review elicited over 1200 papers, 27 of which conformed to the search criteria. The psychosexual concerns after prostate cancer surgery were identified from the systematic review by patients as an unmet need. Additionally, very few papers addressed interventions to manage psychosexual concerns for men post robotic prostate cancer surgery.

Conclusion: This systematic review demonstrated a large unmet need for psychosexual care in men with prostate cancer post-surgery. Poor health related quality of life was also strongly associated with psychosexual concerns and also co-morbidities, within the systematic review.

Glioblastomas (GB) are the most common primary tumors of the brain. GB is highly invasive and shows a high degree of cellular and genetic heterogeneity. Unfortunately, the biological and genetic properties of GB hinder the ability of conventional therapies to completely eradicate these tumors. To improve patient survival, researchers have devised multiple therapeutic strategies that take advantage of the inherent ability of immune cells to initiate powerful anti-tumor immune responses. Amongst the various forms of immunotherapy for brain tumors, adoptive T cell therapy (ATCT) involves the direct transfer of ex vivo activated and tumor-specific T lymphocytes to tumor patients. One advantage of ATCT is that the transfer of tumor-reactive T cells allows for rapid tumor targeting that minimizes the deployment of tumor immune evasion mechanisms. New technological breakthroughs such as the ability to genetically engineer T cells with T cell receptors and chimeric antigen receptors (CAR) against shared tumor antigens have sparked new interest and enthusiasm for ATCT. Here, the different ATCT approaches that have been developed and tested for GB are discussed.

Microangiopathic haemolytic anaemia (MAHA) occurs seldom as a paraneoplastic syndrome in some solid tumors, but MAHA companionship by signet ring cell carcinoma (SRCC) of gastric origin is very rare. This case report describes a 46-year-old man who initially presented with unendurable back and abdomen pain, he has also jaundice, anaemia, thrombositopenia, elevated bilirubin-D-dimer and alkaline phoshatase levels. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anaemia with schistocytes, and a negative direct Coombs’ test. Bone marrow and peripheral blood smear examinaton of the patients revealed out the diagnosis which was performed because of the progression of anaemia and thrombositopenia. However, the primary origin of this signet ring cell carcinoma (SRCC) was found in the stomach.

Epithelial-to-mesenchymal transition (EMT) is a multi-step reprograming process resulting in a phenotype switch from an epithelial to a mesenchymal state. This phenotype switching of cells, long been studied for its role in development, is now emerging as a crucial process that endows tumor cells with migratory and invasive properties, enriches stem cell-like attributes, enhances drug resistance, prevents apoptosis and contribute to immunosuppression. A comprehensive understanding of EMT cellular program will enable identification and development of potential EMT-targeted antitumor therapeutic strategies. This Editorial briefly describes recent evidence of EMT as a driver of malignancy and evaluates various strategies to target EMT in cancer.