Primary mediastinal malignant germ cell tumours (PMMGCT) account for 10-15% of anterior mediastin... more Primary mediastinal malignant germ cell tumours (PMMGCT) account for 10-15% of anterior mediastinal masses. Given their uncommon occurrence, methods of primary treatment are still to be defined. We present our experience with the PMMGCT patients. Materials and methods . A retrospective analysis was performed on 15 patients (5 women and 10 men, age: 16-46 years, median age 33 yrs) treated at our institution between 1982 and 2000. This series included four cases of pure seminomas (female counterpart – dysgerminomas), five seminomas along with other components, and six non-seminomas. Thirteen patients underwent surgical procedures, including complete or incomplete resections or excisional biopsy only. All 15 patients received combined treatment consisting of platinum-based chemotherapy, followed by radiotherapy and/or surgical removal of the persistent mass. R e s u l t s. Median follow-up time of 6 months (range:1 mo.-17 yrs). Two of 4 patients with seminomas and 2 of 11 patients with...
Cancer Epidemiology, Biomarkers & Prevention, 2004
Little is known about the frequency of germ-line mutations in the breast cancer susceptibility ge... more Little is known about the frequency of germ-line mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 among Asian populations. We investigated the distribution of BRCA1 and BRCA2 germ-line mutations and polymorphisms in a cohort of women from Shanghai, China. Study subjects totaled 1306, and included 645 women with breast cancer, 342 women with benign breast disease, and 319 unaffected controls, born between 1924 and 1958, selected from women enrolled in a randomized trial of Breast Self-Examination in Shanghai, China. Women were selected without regard to family history of breast or ovarian cancer. All of the coding regions and exon-intron boundaries were screened. Data were analyzed with respect to age at diagnosis, and family history of breast and ovarian cancer. The prevalence of known disease-associated mutations in women with breast cancer was 1.1% each, for BRCA1 and BRCA2. Among breast cancer cases with a family history of breast or ovarian cancer, 8.1% and 2....
Pozytonowa emisyjna tomografia (positron emission tomography – PET) stanowi nowoczesną metodę obr... more Pozytonowa emisyjna tomografia (positron emission tomography – PET) stanowi nowoczesną metodę obrazowania czynnościowego, która umożliwia ocenę wielu różnych procesów biologicznych. Zakres zastosowań oraz czułość i swoistość zwiększyło połączenie badania PET z komputerową tomografią (PET-KT) oraz wprowadzenie nowych znaczników, oprócz dotychczas stosowanej 18F-deoksyglukozy (FDG). Trzeba podkreślić, że zwiękZalecenia w zakresie zastosowania badań pozytonowej emisyjnej tomografii w onkologii
Dla rozpoznawania i ustalenia najwa?niejszych czynnikow rokowniczych podstawowe znaczenie ma biop... more Dla rozpoznawania i ustalenia najwa?niejszych czynnikow rokowniczych podstawowe znaczenie ma biopsja wycinaj±ca podejrzanych zmian barwnikowych skory, ktore mog± byae wczesnymi czerniakami. Wczesne rozpoznanie i chirurgiczne usuniecie czerniaka nie tylko poprawia rokowanie, ale daje szanse wyleczenia u oko³o 90% chorych. Kolejne etapy postepowania terapeutycznego obejmuj± kwalifikacje chorych do radykalnego wyciecia blizny po biopsji wycinaj±cej z w³a¶ciwymi marginesami oraz wykonania biopsji wez³a wartowniczego. W przypadku przerzutow do regionalnych wez³ow ch³onnych postepowaniem z wyboru jest wykonanie radykalnej limfadenektomii. Zaleca sie w³±czanie chorych na czerniaki skory o wysokim ryzyku nawrotu do prospektywnych badan klinicznych nad leczeniem uzupe³niaj±cym. Leczenie chorych z przerzutami ma obecnie bardzo ograniczon± warto¶ae. D³ugoletnie prze?ycia dotycz± niewielu chorych (przerzuty w pozaregionalnych wez³ach ch³onnych, tkance podskornej lub p³ucach). Nie udowodniono pr...
Nudności i wymioty indukowane leczeniem są wymieniane przez chorych rozpoczynających chemioterapi... more Nudności i wymioty indukowane leczeniem są wymieniane przez chorych rozpoczynających chemioterapie jako objawbudzący najwiekszy strach. Źle kontrolowane wymioty przeszkadzają w wypelnianiu codziennych obowiązkow,zwiekszają zapotrzebowanie na rozne procedury medyczne i niejednokrotnie stanowią przeszkode w kontynuowaniuterapii. Z tego powodu skuteczna profilaktyka nudności i wymiotow indukowanych leczeniem jest jednym z najwazniejszychzadan wspomagającego terapii. W pracy przedstawiono informacje na temat procesow patofizjologicznych,dostepnych nowych lekow oraz obecnych standardow zapobiegania i leczenia nudności i wymiotow indukowanychleczeniem.
ABSTRACT Spinal cord ependymomas are relatively rare tumours and their management is not well est... more ABSTRACT Spinal cord ependymomas are relatively rare tumours and their management is not well established. This retrospective analysis was performed to examine the outcome of patients treated for this malignancy at our institution between 1982 and 2004.
Introduction: Cabozantinib and ramucirumab are approved for the treatment of adults with hepatoce... more Introduction: Cabozantinib and ramucirumab are approved for the treatment of adults with hepatocellular carcinoma (HCC) following prior sorafenib treatment; ramucirumab is restricted to use in patients with serum alpha-fetoprotein (AFP) C 400 ng/mL. This matching-adjusted indirect comparison evaluated the efficacy and safety of both drugs after sorafenib in patients with HCC and AFP C 400 ng/mL. Methods: Individual patient data (IPD) from the CELESTIAL trial (cabozantinib) and population-level data from the REACH-2 trial (ramucirumab) were used. To align with REACH-2, the CELESTIAL population was limited to patients who received first-line sorafenib only and had baseline serum AFP C 400 ng/mL. The IPD from CELESTIAL were weighted to balance the distribution of 11 effect-modifying baseline characteristics with those of REACH-2. Overall survival (OS; primary endpoint) and progres-Supplementary Information The online version contains supplementary material available at
International Journal of Environmental Research and Public Health
Malignant neoplasms are among the most common diseases and are responsible for the majority of de... more Malignant neoplasms are among the most common diseases and are responsible for the majority of deaths in the developed world. In contrast to men, available data show a clear upward trend in the incidence of lung cancer in women, making it almost as prevalent as breast cancer. Women might be more susceptible to the carcinogenic effect of tobacco smoke than men. Furthermore, available data indicate a much more frequent mutation of the tumor suppressor gene-p53 in non-small cell lung cancer (NSCLC) female patients compared to males. Another important factor, however, might lie in the female sex hormones, whose mitogenic or carcinogenic effect is well known. Epidemiologic data show a correlation between hormone replacement therapy (HRT) or oral contraceptives (OCs), and increased mortality rates due to the increased incidence of malignant tumors, including lung cancer. Interestingly, two types of estrogen receptors have been detected in lung cancer cells: ERα and ERβ. The presence of ER...
Background: Cancer disease is usually associated with impaired nutritional status, which is one o... more Background: Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. Objectives: The aim of the study was to determine whether nutritional support with high protein (ONS) in adult oncologic patients in the first step of cancer cachexia-asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. Materials and Methods: A total of 114 persons aged 40-84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group) and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening), SGA (Subjective Global Assessment), SCRINIO (SCReenIng the Nutritional status In Oncology) Working Group classification, VAS (Visual Analog Scale) for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy) questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Results: Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group) score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed (increased appetite VAS, p = 0.05; increased points in SGA, p = 0.015, and increased levels of albumin and prealbumin, p = 0.05). In Control group nutritional status was stable during observation. The performance status and quality of life were stable in both groups. No statistical differences between groups (ONS vs. Control) in the numbers for disqualification, resignation, delay in treatment, or dose reduction were observed. Conclusions: Results of the study did not indicate that nutritional support in precachectic oncologic patients influenced the toxicity of systemic therapy. High protein nutritional support improved nutritional status assessed by SGA, VAS for appetite, albumin, and prealbumin. The performance status and quality of life were stable throughout the observation and were not changed under the supplementation.
470 Background: Clinical activity and tolerability of the anti-CTLA-4 antibody, tremelimumab, has... more 470 Background: Clinical activity and tolerability of the anti-CTLA-4 antibody, tremelimumab, has yet to be established in metastatic pancreatic ductal adenocarcinoma (mPDAC). In a Phase 2, multicenter, open label study (NCT02527434), tremelimumab was evaluated in pts with advanced solid tumors. We report a planned analysis of the safety and efficacy of tremelimumab monotherapy in a cohort of pts with mPDAC. Methods: Eligible pts were adults with histologically or cytologically confirmed mPDAC with tumor progression following prior standard first-line 5-FU- or gemcitabine-containing chemotherapy. Pts received tremelimumab 750 mg IV Q4W for 7 doses, followed by 750 mg Q12W for 2 doses, for up to a total of 12 mo (total 9 doses in 12 mo) or until disease progression or unacceptable toxicity. Pts were radiographically assessed Q6 wks relative to first dose. The primary endpoints were safety (evaluated by CTCAE v4.0) and objective response rate (ORR) by investigator assessments (evaluat...
INTRODUCTION Non-small cell lung cancer (NSCLC) is the most common lung tumor. Conventional conse... more INTRODUCTION Non-small cell lung cancer (NSCLC) is the most common lung tumor. Conventional conservative treatment in medically inoperable patients with early stage NSCLC has poor outcome. To improve treatment efficacy, stereotactic ablative radiotherapy (SABR) has been developed, which enables the delivery of high-dose radiation to the tumor. OBJECTIVES This prospective study was conducted to confirm the hypothesis that a sudden death of cancer cells after SABR may lead to changes in systemic immune response. PATIENTS AND METHODS We enrolled 89 treatment-naive patients with stage T1/2aN0 NSCLC. All patients received SABR, in accordance with treatment standards at our department. Blood samples were collected 3 times: before treatment (n = 89), and then at 2 (n = 86) and 12 weeks (n = 75) after treatment completion to assess the proportion of CD4(+) and CD8(+) T cells, and the expression of T-lymphocyte transcription factors: T-bet, GATA-3, ROR-γt, and FoxP3. Serum C-reactive protein (CRP) levels, absolute neutrophil count (ANC), absolute lymphocyte count, and white blood cell (WBC) count were measured to exclude the impact of nonspecific inflammatory reaction. The expression levels of lymphocyte antigens were measured by flow cytometry. RESULTS Serum CRP levels, ANC, and WBC count remained stable during the study. We observed slight lymphopenia, which correlated with irradiated lung volume. After SABR, the proportion of CD8(+), CD4(+), as well as the proportion of CD4(+) T cells expressing GATA-3(+), T-bet(+), or ROR-γt(+) increased, while the number of CD4(+)FoxP3(+) cells (specific for regulatory T cells) decreased. CONCLUSIONS Our findings may suggest that SABR enhances the systemic immune response by increasing the proportion of proinflammatory T-cell subpopulations.
The aim of this prospective study was to evaluate the level of anxiety, depression, and quality o... more The aim of this prospective study was to evaluate the level of anxiety, depression, and quality of life (QoL) in medically inoperable patients with early stage non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR). Background: Prolonged survival is equally important as maintaining high QoL and good psychological functioning during the treatment of lung cancer. Nowadays available SABR has markedly changed clinical care and outcomes in the group of medically inoperable patients. To our knowledge, analysis of QoL and psychological state has not been performed in Polish patients with early NSCLC treated with SABR. Materials and methods: Research group consisted of medically inoperable, early NSCLC (T1-2aN0M0) patients qualified to SABR. Patients were asked to complete Polish versions of the European Organization for Research and Treatment of Cancer Quality of Life-Core Questionnaire (EORTC QLQ-C30) with the Lung Cancer Questionnaire (LC13) and Hospital Anxiety and Depression Scale (HAD). These questionnaires were repeated 2 weeks and then 3 months after treatment completion. Results: We enrolled 51 patients who met the inclusion criteria. SABR did not deteriorate QoL and psychological functioning. On the contrary, clinically meaningful improvement was observed in emotional functioning, level of insomnia, anxiety and depression. Significantly worse improvement was shown in patients with chronic obstructive pulmonary disease (COPD). Conclusions: Our results confirm that SABR is well tolerated and does not have a deleterious effect on QoL and psychological state. Results of our study indicate the importance of additional psychological care in the group of patients with COPD.
Lung cancer cells harboring multiple mutations as a consequence of long-term damage by different ... more Lung cancer cells harboring multiple mutations as a consequence of long-term damage by different etiologic factors are responsible for high immunogenicity. Immune checkpoint inhibitors significantly improve treatment results in non-small cell lung cancer (NSCLC). Unfortunately, the role of T-lymphocytes in early NSCLC has not been sufficiently elucidated. The aim of this study was to characterize peripheral blood T cells expressing several selected surface antigens (CD4, CD8, CD25, CD28, PD-1, CTLA-4) and transcription factors (T-bet, ROR-yt, Fox-P3, GATA-3) in this patient population. The study group (LC) consisted of 80 treatment-naïve patients with T1/2aN0M0 NSCLC and was compared with 40 cancer-free patients matched for non-oncological diseases and demographic parameters (CG). Significantly higher counts of CTLA-4+cells (in both CD4+and CD8+subtypes), a lower proportion of PD-1 expressing cells and a significantly higher percentage of Fox-P3+CD4+cells were found in the LC group. The high proportion of CD4+PD-1+cells significantly correlated with poor outcomes in LC group, while low CD4/CD8 ratio predicted a better prognosis. Based on our results it seems that NSCLC even at early stages of development initiate changes in the proportions of T cells that may have a significant impact on the clinical outcome.
Colorectal cancer is the second most common cause of cancer deaths worldwide. Although progress i... more Colorectal cancer is the second most common cause of cancer deaths worldwide. Although progress in the development of new drugs over the last two decades has expanded treatment options for this disease, many significant problems relating to their optimization remain to be solved. Data on the cancer knowledge and the healthy behavior and lifestyle in patients with colorectal cancer in Poland is missing. We analyzed the course and results of treatment of first-line chemotherapy in 165 patients diagnosed with colorectal cancer treated between May 2010 and December 2013. The respondent's knowledge in the field of cancer and their lifestyle before and after the treatment were rated. The results were compared with a control group. Mean age was 60.89 ± 8.69 years, median 59 years. The general knowledge about cancer and the level of healthy lifestyle before treatment were low. After treatment, both the knowledge about cancer and the level of healthy lifestyle increased compared to the control group. There was a clear relationship between the level of knowledge about cancer and the willingness to adopt attitudes and healthy behavior by patients. In our analysis, the overall quality of life in patients treated with first-line palliative chemotherapy of colorectal cancer did not change during treatment. Our results indicate the need to implement an educational program on cancer prevention in treated patients, and the analysis of quality of life and other factors than treatment effect remains controversial.
Primary mediastinal malignant germ cell tumours (PMMGCT) account for 10-15% of anterior mediastin... more Primary mediastinal malignant germ cell tumours (PMMGCT) account for 10-15% of anterior mediastinal masses. Given their uncommon occurrence, methods of primary treatment are still to be defined. We present our experience with the PMMGCT patients. Materials and methods . A retrospective analysis was performed on 15 patients (5 women and 10 men, age: 16-46 years, median age 33 yrs) treated at our institution between 1982 and 2000. This series included four cases of pure seminomas (female counterpart – dysgerminomas), five seminomas along with other components, and six non-seminomas. Thirteen patients underwent surgical procedures, including complete or incomplete resections or excisional biopsy only. All 15 patients received combined treatment consisting of platinum-based chemotherapy, followed by radiotherapy and/or surgical removal of the persistent mass. R e s u l t s. Median follow-up time of 6 months (range:1 mo.-17 yrs). Two of 4 patients with seminomas and 2 of 11 patients with...
Cancer Epidemiology, Biomarkers & Prevention, 2004
Little is known about the frequency of germ-line mutations in the breast cancer susceptibility ge... more Little is known about the frequency of germ-line mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 among Asian populations. We investigated the distribution of BRCA1 and BRCA2 germ-line mutations and polymorphisms in a cohort of women from Shanghai, China. Study subjects totaled 1306, and included 645 women with breast cancer, 342 women with benign breast disease, and 319 unaffected controls, born between 1924 and 1958, selected from women enrolled in a randomized trial of Breast Self-Examination in Shanghai, China. Women were selected without regard to family history of breast or ovarian cancer. All of the coding regions and exon-intron boundaries were screened. Data were analyzed with respect to age at diagnosis, and family history of breast and ovarian cancer. The prevalence of known disease-associated mutations in women with breast cancer was 1.1% each, for BRCA1 and BRCA2. Among breast cancer cases with a family history of breast or ovarian cancer, 8.1% and 2....
Pozytonowa emisyjna tomografia (positron emission tomography – PET) stanowi nowoczesną metodę obr... more Pozytonowa emisyjna tomografia (positron emission tomography – PET) stanowi nowoczesną metodę obrazowania czynnościowego, która umożliwia ocenę wielu różnych procesów biologicznych. Zakres zastosowań oraz czułość i swoistość zwiększyło połączenie badania PET z komputerową tomografią (PET-KT) oraz wprowadzenie nowych znaczników, oprócz dotychczas stosowanej 18F-deoksyglukozy (FDG). Trzeba podkreślić, że zwiękZalecenia w zakresie zastosowania badań pozytonowej emisyjnej tomografii w onkologii
Dla rozpoznawania i ustalenia najwa?niejszych czynnikow rokowniczych podstawowe znaczenie ma biop... more Dla rozpoznawania i ustalenia najwa?niejszych czynnikow rokowniczych podstawowe znaczenie ma biopsja wycinaj±ca podejrzanych zmian barwnikowych skory, ktore mog± byae wczesnymi czerniakami. Wczesne rozpoznanie i chirurgiczne usuniecie czerniaka nie tylko poprawia rokowanie, ale daje szanse wyleczenia u oko³o 90% chorych. Kolejne etapy postepowania terapeutycznego obejmuj± kwalifikacje chorych do radykalnego wyciecia blizny po biopsji wycinaj±cej z w³a¶ciwymi marginesami oraz wykonania biopsji wez³a wartowniczego. W przypadku przerzutow do regionalnych wez³ow ch³onnych postepowaniem z wyboru jest wykonanie radykalnej limfadenektomii. Zaleca sie w³±czanie chorych na czerniaki skory o wysokim ryzyku nawrotu do prospektywnych badan klinicznych nad leczeniem uzupe³niaj±cym. Leczenie chorych z przerzutami ma obecnie bardzo ograniczon± warto¶ae. D³ugoletnie prze?ycia dotycz± niewielu chorych (przerzuty w pozaregionalnych wez³ach ch³onnych, tkance podskornej lub p³ucach). Nie udowodniono pr...
Nudności i wymioty indukowane leczeniem są wymieniane przez chorych rozpoczynających chemioterapi... more Nudności i wymioty indukowane leczeniem są wymieniane przez chorych rozpoczynających chemioterapie jako objawbudzący najwiekszy strach. Źle kontrolowane wymioty przeszkadzają w wypelnianiu codziennych obowiązkow,zwiekszają zapotrzebowanie na rozne procedury medyczne i niejednokrotnie stanowią przeszkode w kontynuowaniuterapii. Z tego powodu skuteczna profilaktyka nudności i wymiotow indukowanych leczeniem jest jednym z najwazniejszychzadan wspomagającego terapii. W pracy przedstawiono informacje na temat procesow patofizjologicznych,dostepnych nowych lekow oraz obecnych standardow zapobiegania i leczenia nudności i wymiotow indukowanychleczeniem.
ABSTRACT Spinal cord ependymomas are relatively rare tumours and their management is not well est... more ABSTRACT Spinal cord ependymomas are relatively rare tumours and their management is not well established. This retrospective analysis was performed to examine the outcome of patients treated for this malignancy at our institution between 1982 and 2004.
Introduction: Cabozantinib and ramucirumab are approved for the treatment of adults with hepatoce... more Introduction: Cabozantinib and ramucirumab are approved for the treatment of adults with hepatocellular carcinoma (HCC) following prior sorafenib treatment; ramucirumab is restricted to use in patients with serum alpha-fetoprotein (AFP) C 400 ng/mL. This matching-adjusted indirect comparison evaluated the efficacy and safety of both drugs after sorafenib in patients with HCC and AFP C 400 ng/mL. Methods: Individual patient data (IPD) from the CELESTIAL trial (cabozantinib) and population-level data from the REACH-2 trial (ramucirumab) were used. To align with REACH-2, the CELESTIAL population was limited to patients who received first-line sorafenib only and had baseline serum AFP C 400 ng/mL. The IPD from CELESTIAL were weighted to balance the distribution of 11 effect-modifying baseline characteristics with those of REACH-2. Overall survival (OS; primary endpoint) and progres-Supplementary Information The online version contains supplementary material available at
International Journal of Environmental Research and Public Health
Malignant neoplasms are among the most common diseases and are responsible for the majority of de... more Malignant neoplasms are among the most common diseases and are responsible for the majority of deaths in the developed world. In contrast to men, available data show a clear upward trend in the incidence of lung cancer in women, making it almost as prevalent as breast cancer. Women might be more susceptible to the carcinogenic effect of tobacco smoke than men. Furthermore, available data indicate a much more frequent mutation of the tumor suppressor gene-p53 in non-small cell lung cancer (NSCLC) female patients compared to males. Another important factor, however, might lie in the female sex hormones, whose mitogenic or carcinogenic effect is well known. Epidemiologic data show a correlation between hormone replacement therapy (HRT) or oral contraceptives (OCs), and increased mortality rates due to the increased incidence of malignant tumors, including lung cancer. Interestingly, two types of estrogen receptors have been detected in lung cancer cells: ERα and ERβ. The presence of ER...
Background: Cancer disease is usually associated with impaired nutritional status, which is one o... more Background: Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. Objectives: The aim of the study was to determine whether nutritional support with high protein (ONS) in adult oncologic patients in the first step of cancer cachexia-asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. Materials and Methods: A total of 114 persons aged 40-84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group) and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening), SGA (Subjective Global Assessment), SCRINIO (SCReenIng the Nutritional status In Oncology) Working Group classification, VAS (Visual Analog Scale) for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy) questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Results: Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group) score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed (increased appetite VAS, p = 0.05; increased points in SGA, p = 0.015, and increased levels of albumin and prealbumin, p = 0.05). In Control group nutritional status was stable during observation. The performance status and quality of life were stable in both groups. No statistical differences between groups (ONS vs. Control) in the numbers for disqualification, resignation, delay in treatment, or dose reduction were observed. Conclusions: Results of the study did not indicate that nutritional support in precachectic oncologic patients influenced the toxicity of systemic therapy. High protein nutritional support improved nutritional status assessed by SGA, VAS for appetite, albumin, and prealbumin. The performance status and quality of life were stable throughout the observation and were not changed under the supplementation.
470 Background: Clinical activity and tolerability of the anti-CTLA-4 antibody, tremelimumab, has... more 470 Background: Clinical activity and tolerability of the anti-CTLA-4 antibody, tremelimumab, has yet to be established in metastatic pancreatic ductal adenocarcinoma (mPDAC). In a Phase 2, multicenter, open label study (NCT02527434), tremelimumab was evaluated in pts with advanced solid tumors. We report a planned analysis of the safety and efficacy of tremelimumab monotherapy in a cohort of pts with mPDAC. Methods: Eligible pts were adults with histologically or cytologically confirmed mPDAC with tumor progression following prior standard first-line 5-FU- or gemcitabine-containing chemotherapy. Pts received tremelimumab 750 mg IV Q4W for 7 doses, followed by 750 mg Q12W for 2 doses, for up to a total of 12 mo (total 9 doses in 12 mo) or until disease progression or unacceptable toxicity. Pts were radiographically assessed Q6 wks relative to first dose. The primary endpoints were safety (evaluated by CTCAE v4.0) and objective response rate (ORR) by investigator assessments (evaluat...
INTRODUCTION Non-small cell lung cancer (NSCLC) is the most common lung tumor. Conventional conse... more INTRODUCTION Non-small cell lung cancer (NSCLC) is the most common lung tumor. Conventional conservative treatment in medically inoperable patients with early stage NSCLC has poor outcome. To improve treatment efficacy, stereotactic ablative radiotherapy (SABR) has been developed, which enables the delivery of high-dose radiation to the tumor. OBJECTIVES This prospective study was conducted to confirm the hypothesis that a sudden death of cancer cells after SABR may lead to changes in systemic immune response. PATIENTS AND METHODS We enrolled 89 treatment-naive patients with stage T1/2aN0 NSCLC. All patients received SABR, in accordance with treatment standards at our department. Blood samples were collected 3 times: before treatment (n = 89), and then at 2 (n = 86) and 12 weeks (n = 75) after treatment completion to assess the proportion of CD4(+) and CD8(+) T cells, and the expression of T-lymphocyte transcription factors: T-bet, GATA-3, ROR-γt, and FoxP3. Serum C-reactive protein (CRP) levels, absolute neutrophil count (ANC), absolute lymphocyte count, and white blood cell (WBC) count were measured to exclude the impact of nonspecific inflammatory reaction. The expression levels of lymphocyte antigens were measured by flow cytometry. RESULTS Serum CRP levels, ANC, and WBC count remained stable during the study. We observed slight lymphopenia, which correlated with irradiated lung volume. After SABR, the proportion of CD8(+), CD4(+), as well as the proportion of CD4(+) T cells expressing GATA-3(+), T-bet(+), or ROR-γt(+) increased, while the number of CD4(+)FoxP3(+) cells (specific for regulatory T cells) decreased. CONCLUSIONS Our findings may suggest that SABR enhances the systemic immune response by increasing the proportion of proinflammatory T-cell subpopulations.
The aim of this prospective study was to evaluate the level of anxiety, depression, and quality o... more The aim of this prospective study was to evaluate the level of anxiety, depression, and quality of life (QoL) in medically inoperable patients with early stage non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR). Background: Prolonged survival is equally important as maintaining high QoL and good psychological functioning during the treatment of lung cancer. Nowadays available SABR has markedly changed clinical care and outcomes in the group of medically inoperable patients. To our knowledge, analysis of QoL and psychological state has not been performed in Polish patients with early NSCLC treated with SABR. Materials and methods: Research group consisted of medically inoperable, early NSCLC (T1-2aN0M0) patients qualified to SABR. Patients were asked to complete Polish versions of the European Organization for Research and Treatment of Cancer Quality of Life-Core Questionnaire (EORTC QLQ-C30) with the Lung Cancer Questionnaire (LC13) and Hospital Anxiety and Depression Scale (HAD). These questionnaires were repeated 2 weeks and then 3 months after treatment completion. Results: We enrolled 51 patients who met the inclusion criteria. SABR did not deteriorate QoL and psychological functioning. On the contrary, clinically meaningful improvement was observed in emotional functioning, level of insomnia, anxiety and depression. Significantly worse improvement was shown in patients with chronic obstructive pulmonary disease (COPD). Conclusions: Our results confirm that SABR is well tolerated and does not have a deleterious effect on QoL and psychological state. Results of our study indicate the importance of additional psychological care in the group of patients with COPD.
Lung cancer cells harboring multiple mutations as a consequence of long-term damage by different ... more Lung cancer cells harboring multiple mutations as a consequence of long-term damage by different etiologic factors are responsible for high immunogenicity. Immune checkpoint inhibitors significantly improve treatment results in non-small cell lung cancer (NSCLC). Unfortunately, the role of T-lymphocytes in early NSCLC has not been sufficiently elucidated. The aim of this study was to characterize peripheral blood T cells expressing several selected surface antigens (CD4, CD8, CD25, CD28, PD-1, CTLA-4) and transcription factors (T-bet, ROR-yt, Fox-P3, GATA-3) in this patient population. The study group (LC) consisted of 80 treatment-naïve patients with T1/2aN0M0 NSCLC and was compared with 40 cancer-free patients matched for non-oncological diseases and demographic parameters (CG). Significantly higher counts of CTLA-4+cells (in both CD4+and CD8+subtypes), a lower proportion of PD-1 expressing cells and a significantly higher percentage of Fox-P3+CD4+cells were found in the LC group. The high proportion of CD4+PD-1+cells significantly correlated with poor outcomes in LC group, while low CD4/CD8 ratio predicted a better prognosis. Based on our results it seems that NSCLC even at early stages of development initiate changes in the proportions of T cells that may have a significant impact on the clinical outcome.
Colorectal cancer is the second most common cause of cancer deaths worldwide. Although progress i... more Colorectal cancer is the second most common cause of cancer deaths worldwide. Although progress in the development of new drugs over the last two decades has expanded treatment options for this disease, many significant problems relating to their optimization remain to be solved. Data on the cancer knowledge and the healthy behavior and lifestyle in patients with colorectal cancer in Poland is missing. We analyzed the course and results of treatment of first-line chemotherapy in 165 patients diagnosed with colorectal cancer treated between May 2010 and December 2013. The respondent's knowledge in the field of cancer and their lifestyle before and after the treatment were rated. The results were compared with a control group. Mean age was 60.89 ± 8.69 years, median 59 years. The general knowledge about cancer and the level of healthy lifestyle before treatment were low. After treatment, both the knowledge about cancer and the level of healthy lifestyle increased compared to the control group. There was a clear relationship between the level of knowledge about cancer and the willingness to adopt attitudes and healthy behavior by patients. In our analysis, the overall quality of life in patients treated with first-line palliative chemotherapy of colorectal cancer did not change during treatment. Our results indicate the need to implement an educational program on cancer prevention in treated patients, and the analysis of quality of life and other factors than treatment effect remains controversial.
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Papers by Renata Zaucha