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  • ISSN: 2373-9436
    Volume 3, Issue 4
    Short Communication
    M. C. Riesco-Martinez, W. Hanna, Z. Ghorab and E. Warner*
    Abstract:
    Background: There is recent interest in the use of antiandrogen therapy to treat metastatic androgen receptor positive (AR+) ‘triple negative' metastatic breast cancer. Since AR testing is not routinely done, we conducted a pilot study to determine whether there was any evidence of a correlation between AR expression and response to antiestrogen treatment in estrogen receptor positive (ER+) metastatic breast cancer (MBC) patients. Such a correlation might identify ER+ MBC patients who are candidates for AR testing and a trial of antiandrogen therapy for AR+ tumors.
    Methods:  A retrospective study was conducted of 46 randomly selected patients treated with anti-estrogen therapy for ER+ Her2-ve MBC who had an available tumor biopsy. Immunohistochemical assessment of AR expression was performed on all available primary and metastatic tumor specimens for each patient. Patients were classified into two categories according to their total duration of clinical benefit from anti-estrogen treatment: A) = 6 months (m) and B) <6 m.
    Results:  AR was +ve in all 20 primary tumor samples available and in 85% (40/47) of the metastatic lesions.  There were 39 (85%) and 7 (15%) patients in endocrine response categories A and B respectively.  No statistically significant differences were found between the presence and intensity of AR staining in the metastases and the duration of benefit from hormone therapy.
    Conclusion:  Our results do not suggest that response to anti-estrogen treatment can determine possible candidates for AR testing and a trial of anti-androgen therapy for ER+ AR+ HER2- patients. A significant minority of metastases from ER+ AR+ primary tumours become AR-.
    Research Article
    Faustine Williams*
    Abstract:
    Introduction: Breast cancer has remained the most commonly diagnosed disease among women globally. Despite the advancement in biomedical sciences leading to improve survival outcomes, some patients endure longer wait periods prior to initiation of treatment.
    Objective: To elucidate the impact of treatment delay on breast cancer patient's quality of life and survivorship. Second was to determine the optimum length of time (delay) between breast cancer diagnosis and start of first treatment in order to improve prognosis and general health and well-being of survivors.
    Methods: Systematic search of the literature was conducted across five electronic databases: Pub Med, EMBASE, CINAHL, Scopus and Science Direct as well as the reference list of all articles retrieved.
    Results: A total of 33 articles were included in the evidence based systematic review, which comprised of 255,366 observations. The results of the studies were categorized under five main themes as: study characteristics, cancer staging and classification, treatment delay time definition and interval, treatment regimen classification and delay impact on quality of life and survival. Analyzed wait times from diagnosis to the initiation of first therapy ranged from 7 days to a period of over 180 days. Combinations of standardized treatment including loco-regional radiotherapy, systemic chemotherapy surgery as well as hormonal therapy were examined. Even though some of the studies showed mixed results, overall, findings indicated that early detection, diagnosis and initiation of treatment within 90 days increase survival.
    Conclusions: Evidence revealed that delaying the initiation of treatment for breast cancer more than 90 days after diagnosis has a detrimental effect on disease free and overall well-being of survivors.
    Canizares Perez AC, Deleu M, Verjans M, Cornelis A, Delcour C and Janssens J*
    Abstract:
    Personalized medicine, the selection of both patient and treatment, is based on a multitude of ‘in-vitro' pathology and molecular biology analyses that are almost exclusively performed on sliced and homogenized diseased tissues. Appropriate technologies are crucial to comply with increasingly demanding clinical needs. The direct and frontal (D&F) biopsy technology, used under the most modern imaging guidance, is evaluated for this purpose. 1209 biopsies in 909 patients were evaluated in two clinical centers for various organs with regard to efficacy, comfort and safety in about 97% of the patients assessed with the D&F technology, surgery can be avoided without loss of diagnostic accuracy. Samples up to 300 mg and with average diameter of 3.81 mm are consistently harvested for various organs. The tools are easy to use, well tolerated, and relatively low in cost. It is concluded that optimal personalized diagnostics and treatments are available now for almost every cancer patient in every stage of the disease without surgery.
    Review Article
    Awad Shamma* and Hayato Muranaka
    Abstract:
    Genetic and epigenetic alterations have important implications inhuman cancer. Genetic aberrations are associated with wide spread variations in deregulation of cellular functions that lead to cancer. However, there has been clear evidence that epigenetic alterations have profound influence on malignant progression. The genetic and epigenetic alteration shave been long considered as two independent mechanisms and the interplay between the two systems in cancer is poorly understood. In this review, we summarize the molecular links between the genetic and epigenetic events that lead to cancer and discuss the Rb-ATM-DNMT1 nexus as a novel pathway linking genetic aberration of two genes commonly inactivated in human cancer into epigenetic events indispensable for tumor evolution.
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