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Treatments and Challenges
Published in Franklyn De Silva, Jane Alcorn, The Elusive Road Towards Effective Cancer Prevention and Treatment, 2023
Franklyn De Silva, Jane Alcorn
The proposition of exploiting the host's immune system to eliminate a disease dates back thousands of years [1185]. Although, Jenner's work in the 1700s and Coley's work in the 1800s laid down the foundation for modern immunology [1186, 1187], the understanding of the mechanisms and pathways regulating the immune system's response to chronic diseases has only expanded during the past few decades [1188]. Conventional treatment strategies such as surgery, chemotherapy, and radiotherapy have reaped substantial benefits in oncology (e.g., eradication of primary tumors [1180, 1189]), issues with disease relapse, metastases, and drug resistance, to name a few, but have precluded the ability to cure cancer [1180]. Therefore, alternative or improved treatment strategies are warranted [1180].
Deep Learning to Diagnose Diseases and Security in 5G Healthcare Informatics
Published in K. Gayathri Devi, Kishore Balasubramanian, Le Anh Ngoc, Machine Learning and Deep Learning Techniques for Medical Science, 2022
Breast cancer is the most prevalent oncology disease among women, according to the World Health Organization (WHO), with approximately 627,000 deaths each year. Many countries have implemented screening services aimed at detecting cancer at an early stage in order to save lives.
Competing Risks
Published in Catherine Legrand, Advanced Survival Models, 2021
Many examples occur in oncology, where the long follow-up of the patients and the disease history make them particularly prone to the occurrence of different event types. For example, the question of long-term adverse effects is often encountered, e.g. in case of early-stage breast cancer or prostate cancer, and often subjected to competing risks. Evaluating the risk-benefit ratio of treatment is then a complicated task as patients with better prognostic (and thus at lower risk of death as competing event) appear thus at higher risk of experiencing long-term side effects and secondary malignancy [102]. This example (and others) has led to a wide literature and has also led in the past to passionate discussions on which type of analysis to use. For example, the question of the incidence of late toxicity following radiation therapy for carcinoma of the uterine cervix has led to a famous debate in the pages of the International Journal of Radiation Oncology Physics [33, 59, 61, 62, 101]. In retrospect, as we will discuss later, it is now clear that the contention raised around the original publication of [33] was rather on the research question of interest rather than really at the level of the statistical techniques to be used, since each approaches discussed was in fact putting in light one aspect of the data while possibly obscuring the others [103].
Projecting overall survival in health-economic models: uncertainty and maturity of data
Published in Current Medical Research and Opinion, 2023
Stéphane Roze, Nicolas Bertrand, Lauriane Eberst, Isabelle Borget
Previous studies have explored the impact of extrapolations44–46. However, to our knowledge, this is the first time that OS has been extrapolated across a large (n = 15) sample of select oncology studies avoiding potential technical issues (i.e. digitization process), generating 450 different extrapolations covering a wide range of situations. Further, all selected studies had to be randomized controlled trials with mature OS data, resulting in publications in peer-reviewed, high impact factor journals. As our sample of studies included different types of cancer (both common and rare), at various stages (localized/metastatic) with various interventions (surgery, chemotherapy, immunotherapy, targeted therapy), they offer a good overview of the diversity of clinical situations that can be encountered in the field of oncology. Our process of choosing the best curved based on the combination of statistical and clinical inputs reflect commonly used methods of extrapolating OS in economic evaluations of oncology products for HTA reviews. Applying the same standard methodology to all 15 studies enabled reproducible results while reducing the heterogeneity of estimations, as opposed to a situation of a meta-analysis based on 15 single and independent experiments. Further, this process highlighted the importance of external clinical validity, and not only statistical criteria of fit, in the selection of survival curves.
Diet and Genetic Risk Factors of Colorectal Cancer in Palestine: A Case-Control Study
Published in Nutrition and Cancer, 2022
The incidence of colorectal cancer in the Arab world is relatively low, despite ranking second to breast cancer in some countries. In Palestine, CRC ranks second in cancer mortalities with 13.9% of all cancer deaths. It ranks second to breast cancer and makes up 9.9% of all cancer cases (13). This percentage is considered high in comparison with the Arab world and surrounding countries. For example, colorectal cancer makes up 9.3% in males and 5.7% in females in Saudi Arabia (3), and 9.2% in Jordan (14). During recent decades, there has been a clear shift in the Palestinian population away from a Mediterranean toward a more westernized diet, characterized by increasing consumption of red and processed meat (15). Thus, the increased incidence of CRC may be related to the change in lifestyle and nutritional status. To our knowledge, no study has been carried out in Palestine to investigate dietary factors in relation to CRC risk. Therefore, the purpose of the current study was to investigate the associations of nutrition, genetic factors, and other lifestyle factors with CRC risk among patients attending the oncology department at Beit Jala Governmental Hospital in the West Bank of Palestine.
Development of immunity-related adverse events correlates with baseline clinical factors, survival and response to anti-PD-1 treatment in patients with inoperable or metastatic melanoma
Published in Journal of Dermatological Treatment, 2022
Bożena Cybulska-Stopa, Marcin Ziętek, Anna M. Czarnecka, Karolina Piejko, Robert Dziura, Łukasz Galus, Barbara Ziółkowska, Stanisław Kieszko, Natasza Kempa-Kamińska, Jacek Calik, Joanna Seredyńska, Kamila Gądek, Tomasz Zemełka, Paweł Teterycz, Tomasz Kubiatowski, Rafał Suwiński, Jacek Mackiewicz, Piotr Rutkowski
Electronic and/or paper medical records of all patients were analyzed. Baseline parameters including age, gender, the primary location of melanoma, BRAF mutation status, Eastern Cooperative Oncology Group (ECOG) performance status, baseline serum lactate dehydrogenase levels (LDH), TNM stage (AJCC 8th Edition), location of metastases, and the number of metastatic sites at treatment initiation were recorded. Information on anti-PD-1 treatment in each patient was analyzed and collected: duration of treatment and number of nivolumab or pembrolizumab cycles. Data on the occurrence of irAEs were collected prospectively during anti-PD-1 treatment, including the time of appearance, severity, and duration. The severity of irAEs was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0 (20).