Are audio-recordings the answer? - A pilot study of a communication intervention for non-English speaking cancer patients.

Key points

Developed a communication intervention for non-English speaking migrant cancer patients.

• Consultation audio-recording and study processes were culturally appropriate.
• Audio-recording was perceived to be effective, and replay was higher than previous studies, possibly reflecting a greater need in migrant patients.
• QPL and CIS were often forgotten by participants, suggesting the intervention should be simplified.
• Recruitment data highlighted unique characteristics of different migrant groups. Future studies should be mindful of the differences between language and cultural groups.

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MT3-MMP down-regulation promotes tumorigenesis and correlates to poor prognosis in esophageal squamous cell carcinoma

Abstract

The membrane-type matrix metalloproteinases (MT-MMPs) play an important role in degrading the extracellular matrix (ECM) and facilitating protease-dependent tumor progression and invasion. Here, we report that unlike MT1-MMP, MT3-MMP was down-regulated in esophageal squamous cell carcinoma (ESCC) as detected by real-time PCR (qPCR), Western blot analysis, and immunohistochemistry (IHC). Down-regulation of MT3-MMP was observed at protein level in 66.3% of ESCC specimens (by IHC, n = 86) for routine pathologic diagnosis, as well as at mRNA level in 63.3% of surgically resected ESCC tumors paired with surrounding nontumor tissues (by qPCR, n = 30). Notably, MT3-MMP down-regulation significantly correlated with lymph node metastasis and poor overall survival of patients with ESCC (median 5-year survival = 50.69 vs. 30.77 months for patients with MT3-MMP-negative and -positive ESCC, respectively). Mechanistically, MT3-MMP negatively regulated proliferation, colony formation, and migration of ESCC cells, in association with cell cycle arrest at G1, due to up-regulation of p21^Cip1 and p27^Kip1. Together, as a tumor suppressor in ESCC, MT3-MMP down-regulation represents an unfavorable factor for prognosis of patients with ESCC.

Collectively, our observations provide first evidence for a notion that MT3-MMP acts like a tumor suppressor to negatively regulate tumor progression and aggressiveness of esophageal squamous cell carcinoma (ESCC), and also raise the possibility that MT3-MMP down-regulation may be an independent unfavorable factor for prognosis of patients with ESCC.

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Downregulation of miR-133b predict progression and poor prognosis in patients with urothelial carcinoma of bladder

Abstract

We found microRNA-133b (miR-133b) was downregulated in urothelial carcinoma of the bladder (UCB) tissues, and it could inhibit the proliferation and induce apoptosis in UCB cells. Consequently, we intend to explore the clinical significance of miR-133b in UCB patients. Expression of miR-133b in 146 UCB specimens and matched adjacent non-neoplastic bladder tissues were measured by quantitative real-time polymerase chain reaction. The overall survival (OS) curve and progression-free survival (PFS) curve were plotted using the Kaplan–Meier method. Prognostic factors for OS and PFS were identified by univariate and multivariate analyses using the Cox proportional hazards regression model. The expression of miR-133b was significantly downregulated in UCB tissues compared with those in adjacent non-neoplastic bladder tissues (P < 0.001). Among UCB patients, low expression of miR-133b significantly correlated with aggressive clinicopathological features. Multivariate analysis indicated that the expression of miR-133b was the independent prognostic factors for predicting PFS (RR: 2.97; 95% CI: 1.78–6.44; P = 0.009) and OS (RR: 4.23; 95% CI: 1.51–11.8; P = 0.011) in patients with UCB. Our study demonstrated that downregulation of miR-133b associated with aggressive clinicopathological features and predicted unfavorable prognosis in patients with UCB, might serve as feasible biomarker for clinical outcome of UCB patients after surgery and potential therapeutic target in the future.

Our study demonstrated that downregulation of miR- 133b associated with aggressive clinicopathological features and predicted unfavorable prognosis in patients with UCB , might serve as feasible biomarker for clinical outcome of UCB patients after surgery and potential therapeutic target in the future.

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Higher preoperative serum levels of PD-L1 and B7-H4 are associated with invasive and metastatic potential and predictable for poor response to VEGF-targeted therapy and unfavorable prognosis of renal cell carcinoma

Abstract

Renal cell carcinoma (RCC) is an immunogenic and proangiogenic cancer. Although antivascular endothelial growth factor (VEGF) therapies achieve impressive responses in some patients, many tumors eventually develop resistance to such therapy. The B7 family molecules such as CTLA-4, PD-1, and PD-L1 are pivotal players in immune checkpoints that positively or negatively regulate various immune responses. Recently, immunotherapy based on blocking immune checkpoints with anti-CTLA4, anti-PD-1, or anti-PD-L1 antibodies has been proposed as a potential new approach to the treatment of metastatic RCC. Higher expression of PD-L1 and B7-H4 in the tumors is associated with a poor prognosis in RCCs, however, the clinical impact of serum levels of B7 family molecules has not been elucidated in patients with metastatic RCCs receiving VEGF-targeted agents. We assessed the preoperative serum levels of B7 family molecules, including CD80, CD86, PD-1, PD-L1, B7-H3, B7-H4, and CTLA-4, and CD28 in RCC patients, and determined their relations with various clinicopathological characteristics. Elevated preoperative serum levels of PD-L1 and B7-H4 were correlated with less differentiated tumors, higher invasive and metastatic potential, a worse response to anti-VEGF therapy, and shorter overall survival. These findings suggested that investigating preoperative serum levels of PD-L1 and B7-H4 might not only be useful to assess the biological aggressiveness of RCCs, but also to predict the efficacy of anti-VEGF therapy and the eventual prognosis, indicating the future design of clinical trials of therapies targeting immune checkpoint in advanced RCCs.

Although PD-L1 and B7-H4 are negative regulators of T-cell-mediated antitumor response, clinical impact of serum levels of the B7 molecular family remains unclear in renal cell carcinoma (RCC). This study shows that higher preoperative serum levels of PD-L1 and B7-H4 are associated with invasive and metastatic potential of the tumors, a poor response to VEGF-targeted therapy and an unfavorable prognosis, indicating that measuring the preoperative serum levels of B7 family molecules may assist in the design and patient selection strategies of not only VEGF-targeted therapy but also clinical trials of immune checkpoint therapy targeting PD-1/PD-L1 axis.

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Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer

Publication date: August 2016
Source:European Journal of Cancer, Volume 63
Author(s): K.C. Aalders, A.C.M. van Bommel, T. van Dalen, G.S. Sonke, P.J. van Diest, L.J. Boersma, M. van der Heiden- van der Loo
IntroductionBreast cancer treatment has evolved extensively over the past two decades with a shift towards less invasive local treatment and increased systemic treatment. The present study aimed to investigate the rates of local (LR) and regional (RR) recurrence and contralateral breast cancer (CBC), evaluating the influence of contributing factors.Materials and methodsWe selected all female patients operated for unilateral primary breast cancer (anyTN, M0) between 2003 and 2008 from the Netherlands Cancer Registry. The 5-year risks of developing LR, RR and CBC were estimated using Kaplan-Meier statistics. The influence of various patient, tumour and treatment characteristics was subsequently assessed in multivariable analyses.ResultsA total of 52,626 patients were identified. The rates of LR, RR and CBC were 2.7%, 1.5% and 2.9%, respectively. The rates of LR and RR decreased significantly over time in the period 2003–2008, from 3.2% to 2.4% for LR and 1.8 to 1.3% for RR, both becoming lower than the risk of CBC of 2.8%. Multivariable analysis showed that age, tumour size, lymph node involvement, tumour histologic type, grade and hormone receptor status were significant prognosticators for LR and RR, but not for CBC. A trend towards a beneficial effect of breast conserving surgery on LR and RR was seen, while systemic therapy proved to have a protective effect on all three end-points.ConclusionsIn breast cancer patients treated between 2003 and 2008 locoregional recurrence rates decreased and have ended up lower than the risk of developing CBC.



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Primary Pulmonary Lymphoepithelioma-like Carcinoma on FDG PET/CT

Abstract

A 69-year-old male smoker was referred to ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) with the indication of a suspicious solitary pulmonary nodule. FDG PET/CT determined a 2.5 × 2-cm soft-tissue lesion (SUVmax, 16.2) with spiculated margins in the hilum of the right lung. A 1-cm diameter lymphadenopathy on the right hilum with an SUVmax of 3.2 was also determined. Transbronchial biopsy of the right hilar lymphadenopathy did not reveal any malignant features in histopathologic examination, and it was determined to be reactive. The patient underwent a right upper lobe segmentectomy, and the histopathologic evaluation revealed that the tumor was a primary lymphoepithelioma-like carcinoma (LELC) of the lung with negative Epstein-Barr virus (EBV) on in situ hybridization studies. In this case report, we mainly focus on the FDG avidity of this very rare kind of tumor comparatively with previous reports and possible explanations of discordancy in FDG avidity in relation to histopathologic characteristics.

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[Integrating patient education in your oncology practice].

[Integrating patient education in your oncology practice].

Bull Cancer. 2016 Jun 7;

Authors: Thariat J, Creisson A, Chamignon B, Dejode M, Gastineau M, Hébert C, Boissin F, Topfer C, Gilbert E, Grondin B, Guennoc H, Mari V, Buzzo S, Saja D, Duboue N, Boulahssass R, Tosi A, Verne S, Ducray J, Benard-Thiery I, Ferrero JM

Abstract
BACKGROUND: Patient education is the process by which health professionals impart information to patients and their caregivers that will alter their health behaviors; improve their health status to better manage their lives with a chronic disease. Patient education implies a profound paradigm shift in the conception of care among health professionals, and should result in structural care changes. Patient education has been promoted by the French Health system for 30years, including in the 2009 HPST law and Cancer Plan 2014-2019. A patient education program was designed in our hospital for breast cancer patients.
MATERIAL AND METHODS: A multidisciplinary and transversal team of health professionals and resource patients was trained before grant application for funding of the program by the regional health care agency. Management of the project required that a functional unit be built for recording of all patient education related activities. A customized patient education program process was built under the leadership of a coordinator and several patient education project managers during bimonthly meetings, using an accurate timeline and a communication strategy to ensure full institutional support and team engagement.
RESULTS: The grant was prepared in four months and the program started within the next four months with the aim to include 120 patients during year 1. The program includes a diagnosis of patient abilities and well-being resources, followed by collective and individual workshops undertaken in 4months for each patient.
DISCUSSION: Patient education is positively evaluated by all participants and may contribute to better health care management in the long term but the financial and human resources allocated to such programs currently underestimate the needs. Sustainability of patient education programs requires that specific tools and more commitment be developed to support health care professionals and to promote patient coping and empowerment in the long term.

PMID: 27286758 [PubMed - as supplied by publisher]

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