がんの科学と治療

Although cancer is recognized as an evolutionary process, cancer research lacks focus regarding the disease’s evolutionary aspect. The focus of this study is on metastatic cancer as it is difficult to treat and control. COBWEB, an agent-based simulation software, was used to determine whether adaptive therapy could control the evolutionary trajectory of the tumor and reduce further metastasis in a patient. Initial results indicated that I. drug usage could serve as a selective pressure against aggressive and resistant cells in order to extrapolate selective advantages for the less aggressive cancerous cells and that II. primitive adaptive therapy, based on the oscillation of two drugs, could provide more control over metastasis rather than conventional treatments. Overall, further research is necessary to confirm whether adaptive therapy can increase median survival rates and the quality of life for patients with metastatic cancer.

Objective: Surgery is the treatment of choice of melanoma, but in advanced stages, it is often necessary to combine this with other therapeutic options. Oncoxin-Viusid has demonstrated antitumor and immunomodulating effects in various type of cancers, in addition to boosting the antiproliferative effect of standard chemotherapy agents in experimental studies. Our study was aimed to identify the efficacy and safety of the Oncoxin-Viusid as an adjuvant treatment for patients with stage IIB-III cutaneous melanomas.

Methods: From September 2014 to June 2017, a proof of concept, open label nonrandomized and uncontrolled study was conducted at the Manuel Fajardo University Hospital (Havana, Cuba), including 20 patients with histologically confirmed diagnosis of stage IIB-III of primary cutaneous melanoma. All patients received surgical treatment with or without chemotherapy in combination with Oncoxin-Viusid 25 ml twice a day for 1 year. Progression-free survival rate with its 95% confidence interval was estimated after one year of inclusion and quality of life was measured at inclusion and after a year using QLQ-C-30 EORTC questionnaire.

Results: Most of the patients were women with a median age of 59 years, cutaneous phototypes II-III, occupations without photo exposure, without personal history of skin cancer or family of cutaneous melanoma. 40% of patients presented with superficial spreading melanoma, epithelioid presentation being histologically predominant. Adverse reactions were, for the most part, mild and short-lived. Only 2 patients progressed and one of them died. Two patients were early withdrawal to follow-up. The progression-free survival rate was 90% (95% CI: 0.65-0.97).

Conclusion: Nutritional supplement Oncoxin-Viusid showed safety; meanwhile patients kept a stable quality of life at the end of study and a high progression-free survival rate.

Oral mucositis is the presence of generalized ulcers that affect tongue, soft palate and buccal floor, commonly found in patients treated for cancer with radiotherapy associated with chemotherapy. The disease can be classified in four degrees, being the first characterized by erythema and the fourth an aggravated condition that exposes the underlying connective tissue. Oral mucositis treatment consists mostly in administration of drugs to treat the symptoms caused by the disease. Low-intensity laser can be a drug-free option to alleviate the symptoms due to its analgesic and anti-inflammatory effect, improving the quality of life of the patient and reducing the cost and hospital stay. To evaluate the effect of low-intensity laser in oral mucositis, 24 patients (3 women and 21 men) were selected for treatment and pain was evaluated by the visual analogue scale (VAS). Analyses of the VAS showed that the laser treatment significantly reduced the pain (p<0.0006). Considering gender analyses, the pain evaluation of the female gender decreased 66.5% and male gender decreased 45.1%. In the present study, we found a marked reduction in the pain indexes (VAS), a fact that is directly related to the decrease in inflammation, as well as pain analgesia, leading to an oncological patient's pain relief, as well as the possibility of improving the quality of life

Immunotherapy, including the complementary immunotherapy for cancer, can be categorized as either specific or nonspecific, both with the aim to enhance the immunity against tumors. A proper immunotherapy approach must address a patient’s individual features of complexity such as tumor’s immune suppressive and pro-inflammatory aspects, antigen heterogeneity and immunogenicity. The Active Specific Immunotherapy (ASI) is capable of rearming and boosting the immune system against cancer by exclusively regulating patient’s own immune-modulatory molecules. This article presents five distinct clinical reports of cancer patients that have undergone the ASI treatment, combined with ozone therapy, vitamins infusion and several programs of chemotherapies. As a result, the ASI improved the immune status of all patients and their overall life quality by reducing pain, fatigue and infections recurrences. Furthermore, the ASI treatment did not cause any negative side effects nor interfere whatsoever with the chemotherapy protocol. In conclusion, although further studies are urgently required in the field, ASI offers an interesting and safe strategy as integrative personalized immunotherapy.