Open Access Minireview Article

Chimeric Antigen Receptor-T Cell (CAR-T Cell) Therapy in Advanced Renal Cell Carcinoma

Brian Mark Churchill, Pallavi Patri, Jula K. Inrig, Anju Gopan, Ekaterina Vorozheikina, Luis Mendoza, Lara Kristina Donato, Ruma Pal Ghosh

International Research Journal of Oncology, Page 40-48

With introduction of immunotherapy, the treatment of advanced renal cell carcinoma has undergone a substantial change. Immunotherapeutic agents including nivolumab, ipilimumab, pembrolizumab, have been introduced and approved for therapy of this life-threatening malignancy. Chimeric antigen receptor- T cells produced using adoptive cell transfer genetic engineering technology, have shown significant benefits over previous immunotherapies, but their toxicity profile needs to be carefully weighed.  While they have shown significant benefit in hematological malignancies, their role in solid tumors has shown mixed results. Several clinical trials are ongoing to evaluate their safety and efficacy in several malignancies, including advanced renal cell carcinoma.

This paper reviews in brief the immunotherapy and CAR-T cell therapy in renal cell carcinoma.

Open Access Original Research Article

Endometrial Cancer in a Tertiary Hospital in South-South, Nigeria: A 5-Year Review

P. C. Oriji, D. O. Allagoa, L. Obagah, O. S. Ohaeri, E. S. Tekenah, A. S. Afolabi, C. Njoku, K. M. Mbah, O. Izevbigie, M. Chika, G. Atemie, B. Eneni

International Research Journal of Oncology, Page 21-29

Background: Endometrial cancer is the most common gynaecological malignancy in developed countries. In sub-Sahara Africa, it is the third commonest gynaecological cancer after carcinoma of cervix and ovary. It affects women in the peri- and post-menopausal years with peak incidence of 50 – 65 years.

Objective: To determine the prevalence, characteristics, prognostic factors, and outcomes of patients treated for endometrial cancer at the Federal Medical Centre (FMC), Yenagoa, Bayelsa State, Nigeria.

Materials and Methods: It was a descriptive study of all the patients with endometrial cancer managed at the gynaecological unit of the FMC, Yenagoa from 1st January, 2016 to 31st December, 2020. Data was extracted from the gynaecological records and entered into a predesigned proforma. All available data were retrospectivelyanalysed using statistical software package and results were then presented in tables and frequencies.

Results: There were 17 cases of endometrial cancer. In the same period, 2,487 gynaecological patients were seen, and the prevalence of endometrial cancer was 0.68%. Endometroid adenocarcinoma was the most common type of the cancer (70.6%), and a majority were diagnosed in Stage 1A of the disease. Sixteen of the women (94.1%) had surgery (laparotomy + hysterectomy) and mean duration of surgery was 116.8±15.5 minutes. One patient had chemotherapy alone.

Conclusion: The overall prognosis as seen in our study is better when compared to cervical and ovarian cancers, not because it is a less malignant tumour, but because presentation to the hospital was earlier, and treatment was also given earlier. Post-menopausal bleeding is much more difficult to ignore than the irregular vaginal bleeding in the younger woman.

Open Access Original Research Article

Overall Survival Rate and Recurrence Free Survival Rate in Breast Sarcoma Patients: Single Center 5-Years Retrospective Study

Mia Rachmi Widyaningrum, Widyanti Soewoto, Ida Bagus Budi Surya Adnyana

International Research Journal of Oncology, Page 30-39

Background: Overall survival rates of breast sarcoma patient in 10 years was 62%. 5-years and 10-year recurrence-free survival was 47% and 42%, respectively. The differences survival rate of  breast sarcoma patient depend on  age, stage, chemotherapy history and radiotherapy history that correlates with the natural history of the disease or well known as prognostic factor of the patient. The purposes of this study is to identify different prognostic factors and their impact to overall survival rates and recurrence-free survival rates on breast sarcoma patient.

Methods: This study was conducted on all patients of all breast sarcoma patients in 2015 - 2016 who were treated by the Subdivision of Surgical Oncology at Dr. Moewardi General Hospital Surakarta (21 patients). The required data were retrieved from medical records. Overall survival rate and recurrent survival rate were analyzed using Kaplan Meier and bivariate analysis using log-rank analysis.

Results: The results of the log-rank analysis of the prognostic factors of age, histopathology (phylloides tumor and angiosarcoma tumor), stage, chemotherapy (administration of doxorubicin), radiotherapy, systemic disease, herbal treatment, and duration of the patient before taking any medication. With the overall survival rate showed P-values of 0.681, 0.007, 0.037, 0.034, 0.505, 0.891, 0.012, and 0.903, respectively. The results of the log-rank analysis of the prognosis factors with the recurrence-free survival rate showed that the P-values were 0.962, < 0.001, 0.059, 0.097, 0.537, 0.596, 0.021, and 0.274, respectively.

Conclusions: There was a significant difference of patient’s overall survival rate in prognostic factors of chemotherapy history, histopathology, use of herbal treatment, and stage of the sarcoma. Histopathology, herbal treatment, and duration of the patient before taking any medication.showed a significant patient’s recurrence-free survival rate difference.

Open Access Review Article

Kinetics of Novel Drug Delivery in Cancer Chemotherapy

A. O. Ogbonna, M. O. Nwokike, C. A. Anusiem, C. O. Arinze

International Research Journal of Oncology, Page 1-12

Cancer, the uncontrolled proliferation of cells, is one of the most serious fatal diseases in today’s world that kills millions of people every year. It is one of the major health concerns of the 21st century which can affect any organ of people without regard to race, age or sex. Conventional chemotherapy has been successful to some extent in the treatment of cancer but their efficacy is limited by poor release pattern of drugs, poor bioavailability due to low water solubility or cell membrane permeability, high-dose requirements, adverse side effects, low therapeutic indices, development of multiple drug resistance and non-specific targeting. New drug-delivery technologies based on nanomaterials may be a ray of hope to overcome these challenges. The main goal of nanomedicine is to produce nanometre scale multifunctional entity, by engineering and designing the appropriate targeting agent which can diagnose, deliver the therapeutic agent, and monitor the treatment. Dendrimers have been investigated for encapsulation and controlled delivery of various anticancer drugs attributed to their high drug loading capacity, easy synthesis, stability, transdermal ability and oral drug-delivery potentials. Efficacy of cancer therapy may be enhanced by improved delivery kinetics. This review discusses the kinetics of drug delivery in cancer chemotherapy; which describes how the body handles anti-cancer drugs and accounts for their processes of absorption, distribution, metabolism and excretion.

Open Access Review Article

Wound Healing, Evolution of Cancer and War on Cancer

Ming C. Liau, Linda Liau Baker

International Research Journal of Oncology, Page 13-20

This review highlights wound healing, evolution of cancer, and war on cancer. Wound healing requires the proliferation and the terminaldifferentiation (TD) ofprogenitor stem cells (PSCs), which are theprecursors of cancerstem cells (CSCs).Healing wound is not a big deal. If the functionality of chemo-surveillance is intact such as healthy people who can maintain a steady level of wound healing metabolites functioning as differentiation inducers (DIs) and differentiation helper inducers (DHIs).Wounds are always successfully healed without having to put up any effort, just to let the nature to do the healing. Medications such as suture and antibiotics are subsidiary to speed up the healing or to prevent infection. Acute wound affects the functionality of chemo-surveillance only temporarily, which is quickly recovered to return to the normal state. It is the chronic wound such as persistent infectious diseases or exposure to toxic chemicals including carcinogens for a long time that produces damaging effect on the functionality of chemo-surveillance.Chronic wound prompts the production of inflammatory cytokines to cause excessive urinary excretion of wound healing metabolites to affect wound healing. Without sufficient wound healingmetabolites to terminate the proliferation of PCSs, it is very easy for PSCs to evolve into CSCs. It takes only a single hit to silence TET-1 enzyme to complete the transition, which is well within the reach of PSCs equippedwith abnormally active methylation enzymes (MEs).CSCs can then progress to faster growing cancer cells bythe activation of oncogenes or the inactivationof suppressor genes. These are exactly the processes that leadto myelodysplastic syndrome (MDS) and acute myeloidleukemia (AML). Cancer due to wound not healing properly is not unique to MDS and AML. It is rather a common phenomenon.War on cancer can be easily won if the battle is conducted following the nature’s course to heal the wound, just like the success of wound healing without having to put up any effort in healthy people.Therefore, the best strategy to win the war oncancer is to restore the functionality of chemo-surveillanceby the employmentof DIs and DHIs and to preventthe loss of wound healing metabolites through anti-cachexia chemicalssuch as phenylacetylglutamine. Thenthenature will take its course to stop the proliferationof cells with abnormal MEs that include CSCs, PSCs,and all cancer cells. Destruction strategy to kill cancer cells is definitely counter indication. It creates moredamages to the functionalityof chemo-surveillance to stop the growth of cells with abnormal MEs. Inabilityof destruction strategy to putaway CSCsis a decidingfactor to deny the success of destruction strategy to win the war on cancer.