がんの科学と治療

Introduction: Imatinib is approved for the treatment of chronic myeloid leukemia and for gastro intestinal stromal tumors. It is generally well tolerated with mild common toxicities such as diarrhea, fatigue, skin rash and edema, however pulmonary complications are uncommon.

Case presentation: In May 2013, a Moroccan 81-year-old man without medical history underwent an emergency wedge resection of the stomach for severe hematemesis with hemodynamic instability. The pathology report showed a gastric gastro intestinal stromal tumor. In July 2013, Imatinib 400 mg per day was started, the patient showed good tolerance to the drug, although mild diarrhea was present. After 16 months, the patient showed a sudden alteration of his performance status, dyspnea, productive cough and fever. Chest X-rays and computed tomography revealed a left pulmonary interstitial syndrome with bilateral pleural effusions. As these findings were highly suggestive of Imatinib-induced interstitial pneumonitis, Imatinib was discontinued. In the meantime, the patient was given oral prednisone: 60mg daily for 10 days. Under the corticosteroid therapy, his symptoms and radiological findings were resolved. The patient comes in regularly for symptomatic control without any signs of tumor’s relapse.

Conclusion: Physicians should consider the possibility of Imatinib-induced pulmonary toxicities when patients develop respiratory symptoms or abnormal radiologic features during Imatinib treatment. The usual treatment is to discontinue the drug, and administer corticosteroids.

Innocence of youth and lack of awareness of danger can sometimes lead to fatal endings. Our case meets these conditions. Patient aged 15 years who is well-developed believe that nothing bad can happen. The increase in size of a testicle is considered by him as a sign of manhood and masculinity. The boy ignored this problem for 6 months. Only after six months of testicular tumor development, due to the occurrence of a troublesome cough and dyspnoea of effort present at a local medical service. Because of the symptoms described it is performed a chest radiograph which detect many well-defined opacities,with precise contours. Doctors suspected a possible Koch bacillus pneumonia and guided the case for investigation to our pediatric service. At the first consultation the patient does not mention of any testicular tumor. He totally ignores the issue, although in the last month due to the increase in size of the testicle have started pain and discomfort in walking. It is established the diagnosis of testicular tumor with multiple lung metastases and the case is referred to a specialized department of oncology for staging and initiation of appropriate therapy. Patient was diagnosed with testicular germ cell tumor for which appropriate treatment have been initiated.

Increasing cancer rates particularly in the developed world are associated with related lifestyle and environmental exposures. Combined immunotherapy and targeted therapies are the main treatment approaches in advanced and recurrent cancer. An alternate approach, energy medicine is increasingly used in life threatening problems to promote human wellness. This study aimed to investigate the effect of biofield treatment on cancer biomarkers involved in human endometrium and prostate cancer cell lines. Each cancer cell lines were taken in two sealed tubes i.e. one tube was considered as control and another tube was subjected to Mr. Trivedi’s biofield treatment, referred as treated. Control and treated samples were studied for the determination of cancer biomarkers such as multifunctional cytokines viz. interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), interleukin-2 receptor (IL-2R), prostate specific antigen (PSA), and free prostate specific antigen (FPSA) concentrations using ELISA assay on day 10. Experimental results showed a significant reduction of IL-6 level in endometrium (12%) and prostate (98.8%) cancer cell lines while a significant increase was observed in TNF-α level in endometrium (385%) and prostate (89.8%) cancer cell lines as compared to control. No alteration of PSA level was observed in biofield treated endometrium and prostate cell line. Similarly, no alterations were evident in IL-2R and FPSA levels in endometrium and prostate cell lines after biofield treatment as compared to control. In conclusion, results suggest that biofield treatment has shown significant alterations in the level of cytokines (IL-6 and TNF-α) in both endometrium and prostate cancer cell lines.

Objective: There is an increased risk of developing ovarian cancer (OC) in patients with endometriosis. Hence, development of new biomarkers may provide a positive clinical outcome for early detection. MicroRNAs (miRNAs) are small non-coding RNAs that play an important role in biological and pathological process and are currently used as diagnostic and prognostic markers in various cancers. In the current study, we assessed the differential expression of miRNAs from 19 paired ovarian cancer and its associated endometriosis tissue samples. In addition we also analyzed the downstream targets of those miRNAs.

Methods: Nineteen paired cases of ovarian cancer and endometriosis foci were identified by a gynecologic pathologist and macro-dissected. The total RNAs were extracted and subjected to comprehensive miRNA profiling from the pooled samples of these two different entities using microarray analysis. Later, the abnormal expressions of few selected miRNAs were validated in individual cases by quantitative real-time PCR (qRT-PCR). Ingenuity pathway analysis revealed target mRNAs which were validated by qRT-PCR.

Results: The miRNA profiling identified deregulation of greater than 1156 miRNAs in OC, of which the top seven were further validated by qRT-PCR. The expression of miR-1, miR-133a, and miR-451 were reduced significantly (p<0.0001) in the OC patients compared to its associated endometriosis. In contrast, the expression of miR-141, miR-200a, miR-200c, and miR-3613 were elevated significantly (p<0.05) in most of the OC patients. Furthermore, among the downstream mRNAs of these miRNAs, the level of PTEN expression was significantly (p<0.05) reduced in OC compared to endometriosis while no significant difference was observed in NF-κB expression.

Conclusion: The expression of miRNAs and mRNAs in OC were significantly different compared to its concurrent endometriosis. These differential expressed miRNAs may serve as potential diagnostic and prognostic biomarkers for OC associated with endometriosis.

Phospholipase A2 (PLA2) (EC 3.1.1.4) is the initial enzyme of arachidonic acid cascade, has key role in inflammation and cancer. Hence, PLA2 inhibitors have wide medicinal importance. This short review focused on PLA2 structure, function and role in inflammation and cancer. Further we tried to collect PLA2 inhibitors from the previous literature and explained the possibility of their utility as anti-inflammatory and anticancer agents.

Background: Conventional cytogenetic studies have been viewed as the standard follow-up method for Chronic Myeloid Leukemia patients on Imatinib. However, this approach is beset with high probability of poor metaphase index. In this study, we evaluated the application of Phytohemagglutinin (PHA)-induced peripheral blood culture based cytogenetic analysis (Karyotyping) in diagnosis and Imatinib treatment monitoring of the Chronic Phase CML patients.

Methods: The patient samples were subjected to the PHA-induced peripheral blood culture based cytogenetic technique (Karyotyping) to establish their baseline cytogenetic status followed by their follow up Karyotyping twice at the end of 3 and 6 months of treatment. The simultaneous quantitative PCR (q-PCR) assay for BCR-ABL fusion gene transcript on the samples corresponding to their baseline as well as the follow up cytogenetic status was also carried out to authenticate the cytogenetic findings.

Results: Complete Cytogenetic Response (CCR) and Partial Cytogenetic Response (PCR) was initially observed in 09 (30%) and 16 (53.3%) respectively of 30 CML patients with 05 (16.6%) patients showing no such response at the end of 3 months. At 6 months, 25 (83.3%) and 02 (6.6%) showed CCR and PCR respectively with 03 (10%) of patients without any response. The findings completely correlated with the hematological response, the q-PCR assay as well as the overall disease condition observed in the patients.

Conclusion: As acquiring bone-marrow sample involves morbid consequences for patients and metaphases yielded thereby are difficult to analyze, PHA-induced peripheral blood Karyotyping was explored as an alternative. It was found to have significant potential in serving as a valid tool in the diagnosis and assessment of follow up response to Imatinib mesylate treatment of patients with chronic phase CML.