Publications by authors named "Shah Zeb Khan"

8 Publications

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Knowledge, Practice, and Attitudes of Physicians in Low- and Middle-Income Countries on Fertility and Pregnancy-Related Issues in Young Women With Breast Cancer.

JCO Glob Oncol 2022 Jan;8:e2100153

Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Purpose: Fertility and pregnancy-related issues are highly relevant for young (≤ 40 years) patients with breast cancer. Limited evidence exists on knowledge, practice, and attitudes of physicians from low- and middle-income countries (LMICs) regarding these issues.

Methods: A 19-item questionnaire adapted from an international survey exploring issues about fertility preservation and pregnancy after breast cancer was sent by e-mail between November 2019 and January 2020 to physicians from LMICs involved in breast cancer care. Descriptive analyses were performed.

Results: A total of 288 physicians from Asia, Africa, America, and Europe completed the survey. Median age was 38 years. Responders were mainly medical oncologists (44.4%) working in an academic setting (46.9%). Among responders, 40.2% and 53.8% reported having never consulted the available international guidelines on fertility preservation and pregnancy after breast cancer, respectively. 25.0%, 19.1%, and 24.3% of responders answered to be not at all knowledgeable about embryo, oocyte, or ovarian tissue cryopreservation, respectively; 29.2%, 23.6%, and 31.3% declared that embryo, oocyte, and ovarian tissue cryopreservation were not available in their countries, respectively. 57.6% of responders disagreed or were neutral on the statement that controlled ovarian stimulation can be considered safe in patients with breast cancer. 49.7% and 58.6% of responders agreed or were neutral on the statement that pregnancy in breast cancer survivors may increase the risk of recurrence overall or only in those with hormone receptor-positive disease, respectively.

Conclusion: This survey showed suboptimal knowledge, practice, and attitudes of physicians from LMICs on fertility preservation and pregnancy after treatment completion in young women with breast cancer. Increasing awareness and education on these aspects are needed to improve adherence to available guidelines and to promote patients' oncofertility counseling.
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http://dx.doi.org/10.1200/GO.21.00153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769103PMC
January 2022

Adequacy of Surgical Pathology Reports of Colorectal Carcinoma and Its Significance.

Cureus 2021 Aug 6;13(8):e16965. Epub 2021 Aug 6.

Medicine, Jinnah Medical and Dental College, Karachi, PAK.

Introduction Colorectal cancer is the fifth most common cancer in the world. For loco-regionally confined disease surgery is the definitive treatment. An adequate surgical pathology report is mandatory for the selection of adjuvant therapy. The objective of this study is to analyze whether adequate information is provided or not in the surgical pathology reports of colorectal carcinoma as according to College of American Pathologists (CAP) guidelines. Method This is a cross-sectional study carried out in the Department of Clinical Oncology, Jinnah Postgraduate Medical Center (JPMC) Karachi, tertiary care hospital in Pakistan. The duration of the study was from February 2020 to January 2021. A total of 153 surgical pathology reports issued by 11 different hospital-based laboratories after definitive surgery was assessed to look at its concordance rate with the checklist adapted from the CAP guidelines. Results Out of 153 surgical pathology reports, clinical information was provided in 72.5% of reports. Details of tumor extension were present in 88.2%, tumor margin in 75%, surgical procedure in 79%, and tumor deposits in 39.2% of reports. Macroscopic details including tumor perforation and evaluation of mesorectum were documented in 51.6% and 53.5% of the reports respectively. Details regarding perineural invasion along with lymphovascular invasion were present in 81.6% and 93% of the reports, respectively. The treatment effect was documented in only 25% of reports and regional lymph node status has been described in 85% of reports. Parameters described in all surgical pathology reports were: tumor site, tumor type, histologic type, and histologic grade. The pathological stage of the disease was documented in 91.5% of the reports. Conclusion This study concluded that surgical pathology reports of the majority of pathology laboratories were not fully adhered to the checklist provided by the CAP guidelines. This will affect post-operative management along with the prediction of disease prognosis.
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http://dx.doi.org/10.7759/cureus.16965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423118PMC
August 2021

Frequency and types of mutations in Moroccan patients with non-small cell lung cancer.

Tumori 2021 Aug 20;107(4):335-340. Epub 2020 Oct 20.

Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.

Background: Mutations in the epidermal growth factor receptor () gene are commonly observed in non-small cell lung cancer (NSCLC), particularly in adenocarcinoma histology. The frequency of mutations is ethnicity-dependent, with a higher proportion reported in Asian populations than Caucasian populations. There is a lack of data on these mutations in north Africa.

Methods: Tumor specimens from Moroccan patients with NSCLC were collected from five pathology laboratories between November 2010 and December 2017 to determine frequency and types of mutations. Tumors were tested in a reference center for by polymerase chain reaction and sequencing of exons 18, 19, 20, and 21.

Results: A total of 334 patients were enrolled: 242 (72.5%) males and 92 females (27.5%). A total of 56.9% had a history of smoking. testing of the 334 lung adenocarcinoma samples demonstrated a wild-type in 261 (78.1%) and mutated in 73 (21.9%). Mutations were mainly detected in the exon 19 deletion (65.8%), followed by exon 21 L858 (17.8%) and other exon 21 codon mutations (5.5%) and exon 18 (6.8%), whereas primary mutations of exon 20 were less frequent (4.1%). In patients with advanced NSCLC, the detection of mutation was independently associated with sex (41.3% female vs 14.5% male; < 0.001) and smoking status (34.8% nonsmokers vs 12.9% active smokers; < 0.001). The mean age was significantly different between the two groups ( = 0.041).

Conclusion: Our findings confirm the genetic heterogeneity of NSCLC worldwide, reporting frequency of mutations in Moroccan patients with NSCLC between those of Asian and Caucasian populations.
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http://dx.doi.org/10.1177/0300891620964571DOI Listing
August 2021

Erratum: Willenbacher, E., et al. Curcumin: New Insights into an Ancient Ingredient against Cancer. 2019, , 1808.

Int J Mol Sci 2020 08 10;21(16). Epub 2020 Aug 10.

Department of Internal Medicine V: Hematology and Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria.

We would like to change the authors' names and affiliations on Page 1 of paper [...].
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http://dx.doi.org/10.3390/ijms21165725DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461099PMC
August 2020

Early postoperative recurrences for colon cancer: Results from a Pakistani rural cohort.

J Taibah Univ Med Sci 2020 Jun 3;15(3):232-237. Epub 2020 Apr 3.

Department of Clinical Research, Institute of Nuclear Medicine Oncology, Lahore, Pakistan.

Objectives: We conducted this study to determine the factors associated with early postoperative recurrence in colon cancer patients treated with curative intent.

Methods: All consecutive patients who underwent curative resection for colon cancer between January 2014 and December 2016 were reviewed. All patients received either adjuvant chemotherapy or follow-up at the Bannu Institute of Nuclear Medicine Oncology and Radiotherapy (BINOR). The patients lived in rural areas of southern Khyber Pakhtunkhwa province.

Results: We enrolled 72 patients, 28 of whom experienced a postoperative recurrence within 2 years (early recurrence). In univariate analysis, postoperative early relapse was significantly correlated with advanced age (>60 years, p = 0.030), nodal status (p = 0.012), pathological stage (p = 0.013), number of nodes removed (p < 0.001), and perineural invasion ( = 0.044). In multivariate analysis, age more than 60 years (p = 0.031) and fewer than 12 lymph nodes removed (p = 0.003) were independent predictors for early recurrence. The liver was the most common site of recurrence (42.8%) in this study.

Conclusion: Our results showed that advanced age and the removal of fewer than 12 lymph nodes during surgery were significant predictors for early postoperative recurrence. Identification of high-risk patients during follow-up with enhanced therapeutic modalities can improve disease-free survival.
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http://dx.doi.org/10.1016/j.jtumed.2020.03.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336005PMC
June 2020

The Potential of PI3K/AKT/mTOR Signaling as a Druggable Target for Endometrial and Ovarian Carcinomas.

Curr Drug Targets 2020 ;21(10):946-961

Department of Clinical Oncology, Bannu Institute Nuclear Medicine Oncology and Radiotherapy, Bannu, Pakistan.

Aims: In this narrative review, we summarize the role and significance of PI3K-AKTmTOR (PAM) pathway in ovarian and endometrial cancers, providing the most recent and relevant literature on the topic and addressing options for targeting PAM along with future perspectives of drug development.

Background: Alterations of the PAM-pathway are common in both endometrial and ovarian cancers, and are described in specific histology-defined subtypes. PAM seems to be involved in critical steps of endometrial and ovarian carcinogenesis, often mechanistically involved in the acquisition of a phenotype of treatment resistance, which could be targetable. However, early clinical trials with PAMinhibitors (PAMi) have provided disappointing results, particularly when non isoform-specific inhibitors were tested in unselected populations, accompanied by an adverse safety profile. Since then, more encouraging observations have been collected when targeting specific isoforms of PAM proteins with more selective drugs, resulting in encouraging activity and more manageable toxicity.

Conclusion: Although the rationale of inhibiting the PAM-pathway has been demonstrated in several promising preclinical studies, no Phase III clinical trial is available to demonstrate a significant benefit of PAM-inhibitors. A way to manage targeted agents is to tailor their use to particular subpopulations most likely to obtain a considerable benefit, namely pursuing an individualized, precision-medicine approach.
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http://dx.doi.org/10.2174/1389450120666191120123612DOI Listing
July 2021

Smokeless tobacco use and risk of oral cavity cancer

Turk J Med Sci 2020 04 9;50(1):291-297. Epub 2020 Apr 9.

Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan

Background/aim/aim: Smokeless tobacco has been associated with oral cavity cancer for several decades. The incidence of oral cavity cancer is higher in some parts of the world especially South and South-East Asia including Pakistan. The aim of current study was to evaluate the risk of oral cavity cancer among smokeless tobacco users in our country.

Materials And Methodsand Methods: A case-control study was conducted between November 2016 and September 2017. Patients diagnosed with oral cavity cancer receiving treatment were included as cases and the attendants of various cancer patients visiting the hospital during the study period were included in the study as controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated and all reported P-values were considered significant at < 0.05.

Results: The crude OR for the “ever smokeless tobacco users” among cases and controls came out to be 4.98 (95%CI; 2.76–9.01). The OR for snuff users among cases and controls was 4.82 (95%CI; 2.37–9.80) and that for betel leaf users was 4.42 (95%CI; 1.66–11.91) after adjusting for smoking and age.

Conclusion: Our study provided strong evidence for snuff and betel leaf to be independent risk factors for oral cavity cancer.
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http://dx.doi.org/10.3906/sag-1809-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7165244PMC
April 2020

Curcumin: New Insights into an Ancient Ingredient against Cancer.

Int J Mol Sci 2019 Apr 12;20(8). Epub 2019 Apr 12.

Department of Internal Medicine V: Hematology and Oncology, Medical University of Innsbruck, Innsbruck 6020, Austria.

Cancer patients frequently use complementary medicine. Curcumin (CUR) and its derivates (from the extract of L.) represent some of the most frequently used ones, having a long history in traditional Asian medicine. CUR was demonstrated, both in vitro and in vivo, to have significant anti-inflammatory effects, thus potentially counteracting cancer-promoting inflammation, which is a hallmark of cancer. CUR modulate a plethora of signaling pathways in cancer cells, comprising the NF-κB (nuclear factor k-light-chain-enhancer of activated B cells), the JAK/STAT (Janus-Kinase/Signal Transducers and Activators of Transcription), and the TGF-β (transforming growth factor-β) pathways. Furthermore, CUR confers properties of electron receptors, which destabilize radical oxygen species (ROS), explaining its antioxidant and anti-apopototic effects. Although CUR has a low bioavailability, its role in advanced cancer treatment and supportive care was addressed in numerous clinical trials. After promising results in phase I⁻II trials, multiple phase III trials in different indications are currently under way to test for direct anti-cancer effects. In addition, CUR exerts beneficial effects on cancer treatment-related neurotoxcity, cardiotoxicity, nephrotoxicity, hemato-toxicity, and others. More efficient galenic formulations are tested to optimze CUR's usability in cancer treatment. This review should provide a comprehensive overview of basic science, and pre-clinical and clinical data on CUR in the field of oncology.
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http://dx.doi.org/10.3390/ijms20081808DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514995PMC
April 2019
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