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  • ISSN: 2373-9436
    Volume 5, Issue 3
    Review Article
    Frances F. Wright and Olalekan O. Oluwole MD*
    Chimeric antigen receptor T cells (CARs) are a form of cellular immunotherapy whereby a patient’s T cells are re-engineered to express a chimeric tumor antigen-specific T cell receptor, leading to activation and expansion upon recognition of target antigen-bearing cells. In patients with B cell malignancies, chemotherapy may have limited efficacy in achieving the disease control necessary for undergoing hematopoietic stem cell transplant, which is often the only curative option. However, numerous phase 1 and ongoing phase 2 clinical trials have demonstrated the efficacy of CD19-targeted CARsat achieving disease control in relapsed and refractory patients with a range of B cell malignancies, with response rates as high as 60-90%. Side effects associated with CAR therapy may be severe but are manageable and include cytokine release syndrome, neurotoxicity, and B cell aplasia. In this article, we present a review of the CAR construct, early and ongoing CAR trials in B cell malignancies, the presentation, monitoring, and management of major side effects associated with CAR therapy, and future directions for CAR research and development.
    Cancer is a public health problem worldwide affecting all ages. It is the second commonest cause of death in developed countries and among the three leading causes of death in developing countries. WHO reported that about 24.6 million people live with cancer world-wide. There are 12.5% of all deaths are attributable to cancer and if the trend continues, it is estimated that by 2020, 16 million new cases will be diagnosed per annum out of which 70% will be in the developing countries. There are 11 cancer registries in Nigeria; located in various tertiary hospitals in various parts of the country. Most of these Registries are poorly funded and cancer screening program is at minimal level except probably The Ibadan Cancer Registry, however they all produce hospital-based data. This review focuses on the current trend of cancer in Nigeria which may be used to adjust the cancer control programs in order to reduce cancer deaths in the country and also to call the attention of both the clinical research based organization, institution and in individual researchers and the government to use the trend of cancer in Nigeria for setting priorities in cancer control programs/researches.
    Adeyemi OF, Osahon OD, and Okungbowa GE*
    Introduction: With a population of over 180 million, Nigeria has only seven radiotherapy centers, four of which have a Linear Accelerator, while the remaining three use Cobalt 60. It is quite unfortunate that most of these centers still embrace manual planning using anatomical landmarks. The study center is the first in Nigeria to embrace the routine use of computerized planning for most of its patients. This study is the first of its kind in Nigeria. It aims at evaluating and optimizing treatment plans of post mastectomy patients using radiobiological models.
    Method: This is a retrospective study of forty six (46) post mastectomy patients who have gone through computerised treatment planning from 2012 – 2014. Patients that have undergone chemotherapy were excluded from the study.
    Result: The study revealed that the treatment plans had high local tumor control on the target breast (99%); while the NTCP models gave higher complication probability for the lungs than the heart. Using optimized treatment plans, Hyper/Hypo fractionation schemes gave NTCP values below the QUANTEC threshold of 5% and 1% for lung and heart respectively.
    Conclusion: This study confirmed that the treatment plans of post mastectomy patients were good; as none of the computed toxicity indices showed any value above the QUANTEC standard. Also the hyper/hypo fractionation schemes gave values below the QUANTEC standard and therefore can be introduced into clinical trials for the treatment of post mastectomy patients.
    Editorial
    Heping Yan*
    Development of anti-cancer targeted therapy remains of the biggest challenges in the effective cancer treatment. In addition to surgery and chemotherapy, ionizing radiation (IR) is one of the most commonly employed treatment method for many types of human cancer.
    Chaudhry SR, Stafford JL, Levin NK, and Tainsky MA*
    Germline testing for clinical cancer care and risk assessment is commonly employed as approximately 10% of all cancers are thought to have a heritable component [1]. Due to the genetic heterogeneity of inherited cancer risk factors, current testing is performed by focusing on a panel of associated risk genes to increase the likelihood of finding a causal genetic variant. Despite the introduction of larger and more inclusive gene panels, issues of low diagnostic yield remain, and inconclusive results often generate additional burden on clinicians, patients and relatives. Our knowledge of inherited risk is still evolving, meaning that testing panels continue to be updated. Therefore, many question the utility of panels in favor of a whole genome or exome approach in which genes can be analyzed post hoc without the need for additional sampling. Genetic testing seems poised for this approach, but hesitation remains due to concerns of quality, cost and practicality. Below we weigh the advantages and disadvantages of panel testing versus whole exome sequencing (WES). In doing so, we assert that recent advances in technology indicate that the field should begin the shift to whole exome/genome sequencing, starting with the implementation of WES for those with a cancer diagnosis and suspicious family history.
    Research Article
    This study models some risk factors for some topographies of cancer in South West of Nigeria (Osun, Ondo, Ogun, Ekiti, Oyo and Lagos states). Data on various topographies of cancer are collected by transcription from cancer registry and patients’ case note of different hospitals (teaching hospitals and medical centres) across the six states. Binary logistic regression is used for modelling and probability of a patient suffering for a typical cancer is obtained with all the significant risk factors identifies in each model. Due to insignificant of frequency observed for Prostate, Rectum, and Pancreas, only models for Breast, Cervix, Colon, and Ovarian cancers are examined. Age, Marital Status, Age at first Menstruation, Use of Birth Control Pill, Consumption of High Fat Diet, Alcohol, Obesity and having multiple sexual partners are all significant factors for breast cancer. Age at first Menstruation and Consumption of High Fat Diet are the most significant factors at 5% level. Significant risk factors for cervical cancer based on the result of analyses are: Religion, Job, and Age at first Menstruation while Age, Marital Status, and Educational Status are significant factors for colon cancer. For ovarian cancer, significant risk factors are Educational Status, Residence (Urban or Rural), and Age at first menstruation, and Obesity.
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