Publications by authors named "Joseph Kattan"

155 Publications

The outcome of patients with serous papillary peritoneal cancer, fallopian tube cancer, and epithelial ovarian cancer by treatment eras: 27 years data from the SEER registry.

Cancer Epidemiol 2021 Oct 9;75:102045. Epub 2021 Oct 9.

School of Community Health Sciences, University of Nevada, Reno, NV, USA.

Aim: To determine the differential effect of the treatment periods on the survival of patients with stage IV serous papillary peritoneal carcinoma (SPPC), fallopian tube cancers, and epithelial ovarian cancers (EOC).

Methods: This was an exploratory, population-based observational study of all patients with stage IV SPPC, fallopian tube cancers, and EOC collected from the SEER Research Data 1973-2017. The study period was divided into three time-periods: platinum combinations before the taxane era (1990-1995), platinum plus taxane chemotherapy era (1996-2013), and bevacizumab era (2014-2017).

Results: A total of 9828 patients were eligible for analyses: SPPC (3898 patients; 39.7%), fallopian tube cancers (1290 patients; 13.1%) and EOC (4640 patients, 47.2%). In the 1990-1995 era, the 3-year cause-specific survival was 40% for SPPC, 53% for fallopian tube cancers, and 40% for POC. In the following era 1993-2013, the 3-year cause-specific survival increased to 55% for SPPC, 74% for fallopian tube cancers, and 45% for POC. The last era 2014-2017 showed a 3-year cause-specific survival of 64%, 67%, and 45% for patients with SPPC, fallopian tube cancers, and POC, respectively. The differences in cause-specific survival were statistically significant for patients with SPPC (p=0.004). Multivariable analysis showed that the treatment eras and age at diagnosis were associated with cause-specific survival.

Conclusion: The results of this study are hypothesis-generating and cannot be considered conclusive given the inherent limitations of registry analysis. Subgroup analyses of the phase III randomized controlled trials, by tumor subset (EOC, fallopian tube cancer, and SPPC) would shed more light on the differential effects of novel therapies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.canep.2021.102045DOI Listing
October 2021

Chemotherapy in the management of periosteal osteosarcoma: A narrative review.

J Bone Oncol 2021 Oct 10;30:100389. Epub 2021 Sep 10.

Gustave Roussy, Sarcoma Group, Department of Ambulatory Cancer Care, Villejuif, France.

Periosteal osteosarcoma (PO), an intermediate-grade chondroblastic osteosarcoma (OST) arising from the surface of the bones, is a rare histological subtype among primary bone sarcomas, most commonly diagnosed in young patients. It is characterized by distinct specific radiological and pathological features. The current management strategy is based on several case reports and series, without any solid international recommendations. Most sarcoma experts agree on the crucial role of an optimal complete surgical approach. However, with the paucity of available reports, the role of systemic treatment and its timing remains debatable. With this paper, we will review the available data on the actual impact of chemotherapy in PO patients with emphasis on the radiological, pathological, and therapeutic characteristics of this rare entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jbo.2021.100389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449265PMC
October 2021

Immune checkpoint inhibitors for advanced or metastatic basal cell carcinoma: how much evidence do we need?

Immunotherapy 2021 Oct 31;13(15):1293-1304. Epub 2021 Aug 31.

Department of Dermatology & Venerology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, 1100, Lebanon.

Basal cell carcinoma (BCC) is one of the most frequent and most curable tumors at its early stages. BCC rarely metastasizes and its treatment in this setting is still challenging. Hedgehog inhibitors showed an activity in advanced or metastatic disease. However, there is an unmet need for new agents. Immune checkpoint inhibitors have been assessed in melanoma and other cutaneous tumors, and very recently an anti-PD1 was approved for advanced BCC. In this paper, available data are reviewed on experimental and preclinical studies evaluating immunotherapy in BCC, as well as on the clinical evidence supporting the efficacy and safety of immune checkpoint inhibitors for advanced or metastatic BCC based on case reports, case series and clinical trials.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/imt-2021-0089DOI Listing
October 2021

Perceptions of the COVID-19 vaccine among patients with cancer: a single-institution survey.

Future Oncol 2021 Nov 2;17(31):4071-4079. Epub 2021 Aug 2.

Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon.

This paper reports the results of a survey assessing the acceptance of the COVID-19 vaccine among patients with cancer. In total, 111 adult patients with cancer from a single institution were asked to complete a questionnaire designed to assess their knowledge about the vaccine, their readiness to be vaccinated and the determinants of their decision. 61.3% of the patients considered themselves more vulnerable to COVID-19 than the general population. Television, radio and newspapers were the major sources of information about the vaccine. A total of 55% of the patients were ready to be vaccinated and 14.4% refused the vaccine. The main reason for refusal was incompatibility with patients' disease or treatment. Most of the patients in this institutional sample accepted the COVID-19 vaccine. Better communication of information with patients is needed to decrease vaccine hesitancy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fon-2021-0265DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328088PMC
November 2021

Clinical and genetic factors associated with anxiety and depression in breast cancer patients: a cross-sectional study.

BMC Cancer 2021 Jul 30;21(1):872. Epub 2021 Jul 30.

Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.

Background: Despite the progress in assessment and treatment of breast cancer, being diagnosed with it or receiving chemotherapy treatment is still conceived as a traumatic experience. Women develop negative thoughts about life and death with detrimental effects on their daily physical functioning/activities, emotional state and overall quality of life. The aim of our study was to evaluate the level of anxiety and depression among breast cancer patients receiving chemotherapy and explore the correlation between these psychological disorders, clinical, sociodemographic and genetic factors.

Methods: A cross-sectional study was conducted among breast cancer patients undergoing intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France hospital (November 2017-June 2019; Ethical approval number: CEHDF1016). All patients gave their written informed consent and completed several validated scales, including the Hospital Anxiety and Depression scale (HADS) for the assessment of anxiety and depression. Sleep quality, insomnia, cognitive function, fatigue and pain were also evaluated. Genotyping for certain gene polymorphisms (CLOCK, PER2, CRY2, OPRM1, ABCB1, COMT, DRD2) was performed using the Lightcycler® (Roche).

Results: A total of 112 women was included. The prevalence of depression was 43.4%, and 56.2% of the patients reported anxiety (based on the HADS classification). Multivariable analysis showed that higher cognitive scores and taking fosaprepitant were significantly associated with lower depression and anxiety scores. Moreover, being married compared to single was also associated with lower depression scores, whereas higher PSQI scores (worse sleep quality) and having the PER2 AA variant genotype compared to GG were significantly associated with higher depression scores. Finally, reporting a more severe insomnia and having the COMT Met/Met genotype were significantly associated with a higher anxiety score.

Conclusions: Our study demonstrated a strong relationship between depression scores and cognitive impairment, sleep quality, marital status, fosaprepitant intake, and PER2 polymorphism, while anxiety scores were correlated to cognitive impairment, insomnia severity, fosaprepitant intake, and COMT polymorphism. The association with PER polymorphism was not previously reported. Identification of genetic and clinical risk factors for anxiety and depression would help clinicians implement an individualized management therapy aiming at preventing and alleviating the burden of these symptoms in breast cancer patients, hence improving their overall quality of life.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12885-021-08615-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8323303PMC
July 2021

Safety, efficacy and acceptability of SARS-CoV-2 vaccines in patients with cancer.

Future Virol 2021 Jun 30. Epub 2021 Jun 30.

Department of Hematology-Oncology, Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fvl-2021-0072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246498PMC
June 2021

COVID-19 pandemic shakes the trust between oncologists and their patients.

Int J Clin Pract 2021 Oct 5;75(10):e14556. Epub 2021 Jul 5.

Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ijcp.14556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420392PMC
October 2021

Immune checkpoints inhibitors in metastatic squamous cell carcinoma of the vulva.

Future Oncol 2021 08 2;17(24):3133-3135. Epub 2021 Jul 2.

Department of Hematology & Oncology, Hammoud Hospital University Medical Centre, Saida 652, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fon-2021-0610DOI Listing
August 2021

[Acrometastasis revealing a pulmonary adenocarcinoma: Report of a case with unusual histopathological findings].

Ann Pathol 2021 Jul 2;41(4):405-409. Epub 2021 Apr 2.

Service de pathologie, Hôtel-Dieu de France, université Saint-Joseph, boulevard Alfred-Naccache, 166830 Beyrouth, Liban.

Acrometastasis are rare and can be exceptionally indicative of an occult carcinoma. The prognosis is generally poor. The radiological and immunohistochemical findings can be of great value to determine the primary and to guide treatment. We report a case of a 56-years-old man with acrometastasis at the fourth finger of the left hand revealing a pulmonary adenocarcinoma. Histopathological analysis showed a cribriform adenocarcinoma with an unusual cytoplasmic co-expression of TTF1 and Hepar-1 upon immunohistochemical analysis. There was no nuclear TTF1 immunostaining. Imaging explorations showed a 6-cm mass of the left superior pulmonary lobe. The patient received immunochemotherapy. Upon follow-up, there was evidence of disease progression on chest computed tomography scan.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annpat.2021.03.003DOI Listing
July 2021

Learning by Debate: Innovative Tool in the Hematology-Oncology Fellowship Program.

J Cancer Educ 2021 Mar 31. Epub 2021 Mar 31.

Hematology and Oncology Department, Saint Joseph University, Beirut, Lebanon.

The knowledge base for medicine and medical education is continuously evolving, prominently medical oncology. These quick advances expose the oncologists to the pressing need to be up-to-date in their fields and complicate the oncology education of medical students and oncology fellows. As the international societies have developed new tools to help both practitioners and trainees stay abreast of the new advances, we have incorporated the debate teaching tool in our oncology fellowship program. A survey of the participants in the debate sessions over the last three years shows that fellows considered this teaching tool effective in consolidating and enriching their medical knowledge, enhancing their research and presentation skills, improving cognitive and communication skills as well as encouraging evidence-based learning.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13187-021-02002-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009923PMC
March 2021

Impact and Cost-Effectiveness of Oncotype DX for Guiding Adjuvant Chemotherapy Decisions in Early Breast Cancer.

Gulf J Oncolog 2021 Jan;1(35):27-35

School of Public Health, University of Alberta, Canada.

Introduction: Oncotype DX is approved in multiple countries but its cost-effectiveness is a matter of considerable health debate. Lebanon is high-middle income country according to the World Bank classification however it is facing a mounting financial and health care burden from cancer. Therefore, we conducted a costeffectiveness analysis of Oncotype DX based Lebanese on real-life data.

Methods: We updated a Canadian cost-effectiveness model of Oncotype DX by incorporating Lebanese data. The patient population was a real-life cohort of 82 women diagnosed with hormone receptor - positive and HER2 - negative early breast cancer.

Results: Overall, providing Oncotype DX to only intermediate Adjuvant! Online risk patients costs an additional $83 CAD (93,883 LBP) per additional QALY. From this point, extending provision to also cover high Adjuvant! Online risk patients costs an additional $736 CAD (831,578 LBP) per additional QALY. From this point, extending provision further to also cover low Adjuvant! Online risk patients (such that Oncotype DX is provided to all patients) costs an additional $14,562 CAD (16.46m LBP) per additional QALY. Given that most women in our population-based sample were classified as intermediate Adjuvant! Online risk patients, our study focused on this subset in the second analysis. Providing Oncotype DX to intermediate Adjuvant! Online risk patients has a relatively small additional cost compared to not providing Oncotype DX, and results in a relatively large QALY gain. The incremental cost per QALY is $2,022 CAD (2.29m LBP), implying that Oncotype DX is cost-effective for intermediate Adjuvant! Online risk patients if the willingness-to-pay for a QALY is greater than 2.29m LBP.

Conclusion: As one of the few economic evaluations to date conducted using Lebanese data, this evaluation provides information to decision makers regarding the cost-effectiveness of providing Oncotype DX to Lebanese patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2021

Clinical and Genetic Factors Associated With the Breast Cancer-Related Sleep Disorders: The "CAGE-Sleep" Study-A Cross-Sectional Study.

J Pain Symptom Manage 2021 09 22;62(3):e46-e55. Epub 2021 Feb 22.

Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon; Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Saint-Joseph University, Beirut, Lebanon.

Context: Despite being among the most reported concerns in breast cancer patients, sleep disturbances are still poorly assessed and managed in routine clinical practice. Correctly evaluating these symptoms and understanding the underlying clinical and genetic factors would help medical teams develop an adequate treatment strategy for each patient.

Objectives: 1) To explore the severity of insomnia as well as sleep quality in a sample of Lebanese women with breast cancer undergoing chemotherapy; 2) To examine the correlation between sociodemographic, clinical, psychiatric (anxiety and depression), genetic factors, and alterations in sleep patterns.

Methods: A cross-sectional study was carried out using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) (December 2017-June 2019; Ethical reference number: CEHDF1016). All patients gave their written consent and were genotyped for several polymorphisms in CLOCK, CRY2, PER2, COMT, DRD2, OPRM1, and ABCB1 genes using Lightcycler® (Roche).

Results: Our sample included a total of 112 women. Almost half of the patients reported insomnia problems (with 20.5% moderate insomnia and 7.1% severe insomnia). Multivariable analyses taking the PSQI score as the dependent variable, showed that higher depression score and dyslipidemia (yes versus no) were significantly associated with higher PSQI scores (worse sleep quality), whereas having the DRD2 CT genotype versus CC and a higher chemotherapy cycle number were significantly associated with lower PSQI scores (better sleep quality). Depression was also significantly associated with higher ISI scores. When forcing all the genes in each model, the results remained the same except for depression that has been replaced by anxiety in the multivariable analysis.

Conclusion: Our study confirms the relationship between anxiety/depression, cycle number, dyslipidemia and DRD2 polymorphism with insomnia and highlights the importance of treating all associated factors to improve the overall QOL of patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpainsymman.2021.02.022DOI Listing
September 2021

Narrative review on serous primary peritoneal carcinoma of unknown primary site: four questions to be answered.

Ann Transl Med 2020 Dec;8(24):1709

University of Ioannina, Stavros Niarchou Avenue, Ioannina, Greece.

Serous peritoneal papillary carcinoma (SPPC) represents a particular cancer of unknown primary (CUP) entity that arises in the peritoneal surface lining the abdomen and pelvis without a discriminative primary tumor site. In this review, we discuss the validity of SPPC as a distinct entity. Clinically, patients with SPPC are older, have higher parity and later menarche, are more often obese and probably have poorer survival compared to those with primary ovarian cancer. Pathologically, SPPC is more anaplastic and multifocal, unlike primary ovarian cancer which is commonly unifocal. Biologically, it presents a higher expression of proliferative signals and similar cell cycle and DNA repair protein expression. These differences hint towards SPPC and primary ovarian cancer being as a spectrum of disease. Patients with SPPC are traditionally managed similarly to stage III-IV ovarian cancer. The recommended approach integrates aggressive cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, and systemic chemotherapy to remove the macroscopic tumor, eradicate the microscopic residual disease, and control the microscopic metastasis. However, the available evidence lacks proper randomized or prospective studies on SPPC and is limited to retrospective series. The diligent identification of SPPC is warranted to design specific clinical trials that eventually evaluate the impact of the new therapeutics on this distinct entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/atm-20-941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812188PMC
December 2020

Current Status of Cancer-Related Pain and Opioid use in South Lebanon: A Pilot Study.

Gulf J Oncolog 2020 Sep;1(34):52-57

Department of Hematology-Oncology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.

Objective: This study aimed to evaluate the patients and health providers' (doctors and nurses) knowledge and understanding of the disease-related pain, and the perception of pain drugs (opioids) in South Lebanon.

Patients And Methods: This was a pilot study conducted at different hospitals in South Lebanon among patients with confirmed cancer diagnosis and providers. Data was collected using patients' and providers' questionnaires.

Results: 43 patients and 42 providers were included. 22 (52%) patients were male. Nine (21%) patients were aware of their diagnosis and only 60% talked about their pain to their oncologist. Pain was not optimally controlled with 25 (58%) patients having uncontrolled pain and 18 (42%) patients having continuous pain. Morphine was negatively perceived with 55.8% of patients believing that morphine causes addiction and 59% taking pain medications only when the pain is maximal. This led to a 58% short duration control of intermittent pain. 60% of the providers were certain that cancer pain cannot be relieved by morphine while only 33% believed that morphine can cause complete relief. Addiction seemed to be the main obstacle for morphine use with 37 (89%) thinking that narcotics causes addiction and 51% considering morphine withdrawal if side effects appear. Finally, 30% suggested to discontinue morphine in the terminal stages of cancer.

Discussion And Conclusion: Major misconceptions in cancer patients are observed in the approach to antalgic treatment in our population. With good education, better knowledge and optimal palliative care units, misconceptions about opioids can be corrected with best management of cancer pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2020

Maintenance avelumab in metastatic bladder cancer as a step towards sequencing immunotherapy.

Immunotherapy 2021 03 5;13(4):271-275. Epub 2021 Jan 5.

Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/imt-2020-0261DOI Listing
March 2021

Cancer Patients in the Era of Coronavirus: What to Fear Most?

J Patient Saf 2021 01;17(1):e35-e38

From the Departments of Hematology-Oncology.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to a worldwide medical crisis, affecting mostly immunocompromised patients, such as cancer patients. Various cancer societies have issued recommendations regarding patients care, but few studies addressed the perception of cancer patients regarding this pandemic.

Objective: The aim of the study was to assess the perception of cancer patients regarding their health risks during this pandemic and the preventive measures taken.

Materials And Methods: An anonymous survey was conducted among cancer patients presenting for their treatment, during 10 consecutive working days, at the one-day clinic of Hotel-Dieu de France University hospital in Beirut. We evaluated their state of disease, comorbidities, precautions taken, and their concerns regarding the virus spread.

Results: A total of 216 patients responded with a mean age of 60 years. The majority had a good performance status (performance status = 0-1 in 79.6%), 51.4% had metastatic disease, and chemotherapy was the main therapy used (65.7%). A total of 52.3% of patients considered themselves to be at increased risk of contracting the virus. A total of 55.1% were more worried about the coronavirus rather than their disease. The priority was for the treatment of their cancer in 47.7% of the total patients studied. Of note, only 2.8% of planned one-day clinic reservations were canceled or postponed to avoid COVID-19 exposure.

Conclusions: Although cancer is a disease with a high mortality rate, many patients are more concerned about the actual pandemic rather than their disease. Nevertheless, the absenteeism from their treatment sessions during the COVID-19 atmosphere was minimal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PTS.0000000000000797DOI Listing
January 2021

Is blood transfusion safe during the COVID-19 pandemic?

Future Sci OA 2020 Sep 17;6(9):FSO626. Epub 2020 Sep 17.

Hematology-Oncology Department, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2144/fsoa-2020-0116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505015PMC
September 2020

Efficacy and safety-in analysis of short-course radiation followed by mFOLFOX-6 plus avelumab for locally advanced rectal adenocarcinoma.

Radiat Oncol 2020 Oct 7;15(1):233. Epub 2020 Oct 7.

Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Neoadjuvant chemotherapy and short-course radiotherapy followed by resection has been gaining recognition in the treatment of rectal cancer. Avelumab is a fully human immunoglobulin that binds Programmed Death-Ligand 1 (PD-L1) and prevents the suppression of the cytotoxic T cell immune response. This phase II trial evaluates the safety and pathologic response rate of short-course radiation followed by 6 cycles of mFOLFOX6 with avelumab in patients with locally advanced rectal cancer (LARC).

Methods: This study is prospective single-arm, multicenter phase II trial adopting Simon's two-stage. Short-course radiation is given over 5 fractions to a total dose of 25 Gy. mFOLFOX6 plus avelumab (10 mg/kg) are given every 2 weeks for 6 cycles. Total mesorectal excision is performed 3-4 weeks after the last cycle of avelumab. Follow up after surgery is done every 3 months to a total of 36 months. Adverse event data collection is recorded at every visit.

Results: 13 out of 44 patients with LARC were enrolled in the first stage of the study (30% from total sample size). All patients met the inclusion criteria and received the full short-course radiation course followed by 6 cycles of mFOLFOX6 plus avelumab. 12 out of the 13 patients completed TME while one patient had progression of disease and was dropped out of the study. The sample consisted of 9 (69%) males and 4 (31%) females with median age of 62 (33-73) years. The first interim analysis revealed that 3 (25%) patients achieved pathologic complete response (pCR) (tumor regression grade, TRG 0) out of 12. While 3 (25%) patients had near pCR with TRG 1. In total, 6 out of 12 patients (50%) had a major pathologic response. All patients were found to be MMR proficient. The protocol regimen was well tolerated with no serious adverse events of grade 4 reported.

Conclusion: In patients with LARC, neoadjuvant radiation followed by mFOLFOX6 with avelumab is safe with a promising pathologic response rate. Trial Registration Number and Date of Registration ClinicalTrials.gov NCT03503630, April 20, 2018. https://clinicaltrials.gov/ct2/show/NCT03503630?term=NCT03503630&draw=2&rank=1 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13014-020-01673-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542723PMC
October 2020

Bladder cancer during the COVID-19 pandemic: the calm before the storm?

Future Sci OA 2020 Aug 3;6(8):FSO615. Epub 2020 Aug 3.

Department of Urology, Saint Joseph Hospital, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2144/fsoa-2020-0101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434225PMC
August 2020

Short-course radiation followed by mFOLFOX-6 plus avelumab for locally-advanced rectal adenocarcinoma.

BMC Cancer 2020 Sep 1;20(1):831. Epub 2020 Sep 1.

Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Current standard practice for locally advanced rectal cancer (LARC) entails a multidisciplinary approach that includes preoperative chemoradiotherapy, followed by total mesorectal excision, and then adjuvant chemotherapy. The latter has been accompanied by low compliance rates and no survival benefit in phase III randomized trials, so the strategy of administering neoadjuvant, rather than adjuvant, chemotherapy has been adapted by many trials, with improvement in pathologic complete response. Induction chemotherapy with oxaliplatin has been shown to have increased efficacy in rectal cancer, while short-course radiation therapy with consolidation chemotherapy increased short-term overall survival rate and decreased toxicity levels, making it cheaper and more convenient than long-course radiation therapy. This led to recognition of total neoadjuvant therapy as a valid treatment approach in many guidelines despite limited available survival data. With the upregulation (PDL-1) expression in rectal tumors after radiotherapy and the increased use of in malignant melanoma, the novel approach of combining immunotherapy with chemotherapy after radiation may have a role in further increasing pCR and improving overall outcomes in rectal cancer.

Methods: The study is an open label single arm multi- center phase II trial. Forty-four recruited LARC patients will receive 5Gy x 5fractions of SCRT, followed by 6 cycles of mFOLFOX-6 plus avelumab, before TME is performed. The hypothesis is that the addition of avelumab to mFOLFOX-6, administered following SCRT, will improve pCR and overall outcomes. The primary outcome measure is the proportion of patients who achieve a pCR, defined as no viable tumor cells on the excised specimen. Secondary objectives are to evaluate 3-year progression-free survival, tumor response to treatment (tumor regression grades 0 & 1), density of tumor-infiltrating lymphocytes, correlation of baseline Immunoscore with pCR rates and changes in PD-L1 expression.

Discussion: Recent studies show an increase in PD-L1 expression and density of CD8+ TILs after CRT in rectal cancer patients, implying a potential role for combinatory strategies using PD-L1- and programmed-death- 1 inhibiting drugs. We aim through this study to evaluate pCR following SCRT, followed by mFOLFOX-6 with avelumab, and then TME procedure in patients with LARC.

Trial Registration: Trial Registration Number and Date of Registration: ClinicalTrials.gov NCT03503630, April 20, 2018.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12885-020-07333-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466814PMC
September 2020

Screening Strategies for COVID-19 in Patients With Hematologic Malignancies.

Front Oncol 2020 3;10:1267. Epub 2020 Jul 3.

Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France.

COVID-19 has been declared a pandemic by the world health organization. Patients with cancer, and particularly hematologic malignancies may be at higher risk for severe complications due to their malignancy, immune dysregulation, therapy, and associated comorbidities. The oncology community has been proactive in issuing practice guidelines to help optimize management, and limit infection risk and complications from SARS-COV-2. Although hematologic malignancies account for only 10% of all cancers, their management is particularly complex, especially in the time of COVID-19. Screening or early detection of COVID-19 are central for preventative/mitigation strategy, which is the best current strategy in our battle against COVID-19. Herein, we provide an overview of COVID-19 screening strategies and highlight the unique aspects of treating patients with hematologic malignancies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2020.01267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348065PMC
July 2020

Epidemiologic and histologic characteristics of CNS lesions: a 20-year experience of a tertiary center in Lebanon.

CNS Oncol 2020 06 30;9(2):CNS55. Epub 2020 Jun 30.

Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

Report the epidemiologic and histologic characteristics of CNS lesions in the Lebanese population. We conducted a retrospective study evaluating 2025 CNS lesions diagnosed between 1998 and 2017 in the pathology laboratory of a Lebanese tertiary center. 52.2% of patients were men with a median age of 50 years. The most frequent symptoms were epilepsy (22.5%), headache (20.6%) and motor impairment (19.9%). 90.7% of tumors were primary. Lung (35.6%) and breast (16.5%) were the most frequent primaries of metastases. 46.2% of primary CNS tumors were glial, predominantly astrocytic (56.4%), and (42.5%) were nonglial, predominantly meningeal tumors (58%). Compared with Western literature, the Lebanese population is characterized by a younger age of onset of brain tumors, a lower rate of meningiomas and a higher rate of gliomas.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/cns-2020-0001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341156PMC
June 2020

Targeting CDK4 (cyclin-dependent kinase) amplification in liposarcoma: A comprehensive review.

Crit Rev Oncol Hematol 2020 Sep 18;153:103029. Epub 2020 Jun 18.

French Sarcoma Group, Gustave Roussy Cancer Campus, Villejuif, France.

Well-differentiated/dedifferentiated (WD/DD) liposarcomas, the most common form of liposarcomas, constitute up to 20 % of all soft tissue sarcomas. Several oncogenes are thought to be involved in liposarcoma pathogenesis, mainly MDM2, CDK4 and HMGA2. While MDM2 inhibitors are now tested in clinical trials, a second actionable and promising target appears to be cyclin-dependent kinase 4 (CDK4), which is amplified in up to 90 % of well differentiated or dedifferentiated (WD/DD) liposarcoma. With the paucity of available therapeutic options, the inhibition of CDK4 represent a potential therapeutic option. In this paper, we review the role of CDK4/6 inhibitors in targeting the commonly identified CDK4 amplification in WD/DD liposarcoma, with an emphasis on the published and currently ongoing trials.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.critrevonc.2020.103029DOI Listing
September 2020

Epithelioid sarcoma as the prototype for personalized therapy in soft tissue sarcoma.

Per Med 2020 07 26;17(4):241-244. Epub 2020 Jun 26.

Saint-Joseph University, Faculty of medicine, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/pme-2020-0006DOI Listing
July 2020

Should immune checkpoint inhibitors be contraindicated in lung cancer patients with latent tuberculosis?

Immunotherapy 2020 08 9;12(11):759-762. Epub 2020 Jun 9.

Department of Hematology of Oncology, Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/imt-2020-0069DOI Listing
August 2020

Targeted therapies for cancer during the COVID-19 pandemic: a threat or a blessing?

Pharmacogenomics 2020 07 10;21(11):731-733. Epub 2020 Jun 10.

Department of Hematology & Oncology, Faculty of Medicine, Saint Joseph University, Beirut, 17-5208, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/pgs-2020-0059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286355PMC
July 2020

Peritoneal Carcinomatosis of Colorectal Origin in Cyclosporine Immunosuppressed Rats.

Gulf J Oncolog 2020 May;1(33):27-30

Surgical Research Laboratory, Saint Joseph University, Beirut, Lebanon.

Objective: We evaluate the seeding step of peritoneal carcinomatosis cancer as a surrogate for the role of the omentum in colorectal tumors.

Methods: The study included 5 groups of adult male Sprague Dawley rats: immunocompetent rats (group 1), immunosuppressed rats without omentectomy (group 2), immunosuppressed rats with omentectomy (group 3), immunosuppressed rats with omentectomy receiving NSAID (group 4), and immunosuppressed rats without omentectomy receiving NSAID (group 5). Except for group 1, the rats were immunosuppressed using cyclosporine orally at a dose of 25 mg/kg/day that was started 48 hours before tumor cell infiltration in the peritoneum. All the rats received an intraperitoneal suspension of 10 million Caco-2 cancer cells. Rats in groups 1, 2, and 3 were followed up without further interventions and rats in groups 4 and 5 received naproxen 180mg/kg until rat sacrifice. Cyclosporine and naproxen were continued in the corresponding groups until the killing after 21 days of tumor cell infiltration.

Results: Fourteen rats survived the experiment during the observation period and remained in good clinical condition except for one rat (from group 4) that deceased at week 2. At day 21 before sacrifice, mean weight variations showed a +4% in group 0, -9% in group 1, -18% in group 2, -31% in group 3 and -36% in group 4. Light microscopy did not identify any tumor cells in the abdominal cavity or thorax solid organs but showed a granulomatous reaction that involved the majority of the organs.

Conclusion: The conclusions of this study are limited by the small number of rats as it is a pilot study to design an animal model with peritoneal carcinomatosis. Further steps in this study will include more aggressive cancer cell lines such as HT29 and more aggressive immunosuppression in a larger number of rats.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2020

Hematopoietic stem cell transplantation dilemma during the COVID-19 era.

Future Oncol 2020 08 27;16(22):1569-1573. Epub 2020 May 27.

Hotel-Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fon-2020-0414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255427PMC
August 2020

The management of patients with metastatic prostate cancer during the COVID-19 pandemic.

Future Oncol 2020 Jul 15;16(20):1455-1461. Epub 2020 May 15.

Department of Hematology-Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, BP 17-5208, Lebanon.

During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), the benefit of treating patients with cancer must be weighed against the COVID-19 infection risks to patients, staff and society. Prostate cancer is one of the most common cancers among men and raises particular interest during the pandemic as recent reports show that the TMPRSS2 (and other serine proteases), which facilitate the entry, replication and budding of the virion from a cell, can be inhibited using androgen deprivation therapy. Nevertheless, patients with metastatic prostate cancer commonly receive chemotherapy which may compromise their immune system. This paper aims to address the current status of the COVID-19 in patients with cancer overall and suggests an optimal approach to patients with metastatic prostate cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/fon-2020-0361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426764PMC
July 2020

Docetaxel Rechallenge in Patients with Metastatic Prostate Cancer: A Comprehensive Review.

Oncol Res Treat 2020 7;43(6):299-306. Epub 2020 May 7.

Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

Background: Recent years have witnessed a huge shift in the management and prognosis of metastatic prostate cancer with the advent of new-generation anti-hormonal treatments. Docetaxel, which was initially approved in the castrate-resistant prostate cancer setting, has been approved in the earlier course of the disease as it is still castrate sensitive.

Summary: Apart from cabazitaxel and in the absence of other effective chemotherapies, docetaxel rechallenge (DR) in patients with proved sensitivity to docetaxel in the earlier stage of the disease remains a possible option. Unfortunately, the pivotal trials rarely reported on the outcomes of docetaxel retreatment which seems a plausible option in patients initially responding to docetaxel and maintaining a minimum progression-free interval of 3-6 months. In this review, a summary of the clinical evidence and potential concerns for the use of DR in patients with metastatic prostate cancer will be presented. Key Messages: Pivotal trials of docetaxel in metastatic castrate-sensitive prostate cancer as well as metastatic castrate-resistant prostate cancer have not reported on the outcomes of DR except in the GETUG-AFU 15 trial where the outcomes were disappointing. Based on the published retrospective data, DR may be effective in patients who initially responded to docetaxel and maintained a progression-free interval exceeding 6 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000506693DOI Listing
September 2020
-->