The standard treatment of ovarian cancer (OC) patients, including debulking surgery and first-line chemotherapy, is unsatisfactory because of recurrent episodes in the majority (~70%) of patients with advanced OC. Clinical trials have shown only a modest (10–15%) response of OC individuals to treatment based on immune checkpoint inhibitors (ICIs). The resistance of OC to therapy is caused by various factors, including OC heterogeneity, low density of tumor-infiltrating lymphocytes (TILs), non-cellular and cellular interactions in the tumor microenvironment (TME), as well as a network of microRNA regulating immune checkpoint pathways. Moreover, ICIs are the most efficient in tumors that are marked by high microsatellite instability and high tumor mutation burden, which is rare among OC patients. The great challenge in ICI implementation is connected with distinguishing hyper-, pseudo-, and real progression of the disease. The understanding of the immunological, molecular, and genetic mechanisms of OC resistance is crucial to selecting the group of OC individuals in whom personalized treatment would be beneficial. In this review, we summarize current knowledge about the selected factors inducing OC resistance and discuss the future directions of ICI-based immunotherapy development for OC patients.
The prognosis for ovarian cancer (OC) patients is poor and the five-year survival rate is only 47%. Immune checkpoints (ICPs) appear to be the potential targets in up-and-coming OC treatment. However, the response of OC patients to immunotherapy based on programmed cell death pathway (PD-1/PD-L1) inhibitors totals only 6–15%. The promising approach is a combined therapy, including other ICPs such as the T-cell immunoglobulin and ITIM domain/CD155/DNAX accessory molecule-1 (TIGIT/CD155/DNAM-1) axis. Preclinical studies in a murine model of colorectal cancer showed that the dual blockade of PD-1/PD-L1 and TIGIT led to remission in the whole studied group vs. the regression of the tumors with the blockade of a single pathway. The approach stimulates the effector activity of T cells and NK cells, and redirects the immune system activity against the tumor. The understanding of the synergistic action of the TIGIT and PD-1/PD-L1 blockade is, however, poor. Thus, the aim of this review is to summarize the current knowledge about the mode of action of the dual TIGIT and PD-1/PD-L1 blockade and its potential benefits for OC patients. Considering the positive impact of this combined therapy in malignancies, including lung and colorectal cancer, it appears to be a promising approach in OC treatment.
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the main and most prevalent side effects of chemotherapy, significantly affecting the quality of life of patients and the course of chemotherapeutic treatment. Nevertheless, despite its prevalence, the management of the CIPN is considered particularly challenging, with this condition often being perceived as very difficult or even impossible to prevent with currently available agents. Therefore, it is imperative to find better options for patients diagnosed with this condition. While the search for the new agents must continue, another opportunity should be taken into consideration—repurposing of the already known medications. As proposed, acetyl-L-carnitine, vitamins (group B and E), extracts of medical plants, including goshajinkigan, curcumin and others, unsaturated fatty acids, as well as the diet composed of so-called “sirtuin-activating foods”, could change the typical way of treatment of CIPN, improve the quality of life of patients and maintain the continuity of chemotherapy. This review summarizes currently available data regarding mentioned above agents and evaluates the rationale behind future research focused on their efficacy in CIPN.
1 December 2022 in Current Issues in Pharmacy and Medical Sciences
Glioblastomas are the most common and most lethal forms of malignant primary brain tumor. We present a case report of a patient with III-grade glioma who achieved stable disease (SD) and clinical improvement after trametinib administration. We also report a review of the literature to Current Treatment Guidelines of Glioblastoma and new therapeutic strategies based on molecularly targeted therapy. Traditional treatments, including surgery, radiotherapy, and chemotherapy, have many limitations concerning the prognosis of patients with glioblastomas. Unfortunately, these tumors’recur after primary resection in the majority of cases. There is no standard therapy for recurrence of GBM. Targeted therapy offers a promising new treatment strategy. Regardless of those outstanding results much more can be done in the field of therapeutic options. Most urgent concerns include potent combining molecular targeted therapy with other types of treatments, selecting a group of patients for whom they turn out to be the most beneficial, and addressing adverse events of these molecules.
20 May 2023 in Journal of Education, Health and Sport
Introduction: Multiple sclerosis (MS) is a chronic, multifocal, inflammatory disease of the central nervous system (CNS) with an autoimmune basis. There is a strong correlation between vitamin D deficiency and the onset of multiple sclerosis and a more severe course of the disease and more severe comorbid symptoms. Many studies have investigated vitamin D supplementation to compensate for low 25(OH)D levels in MS patients. Methods of research: A literature review was conducted based on PubMed, Google Scholar databese. Articles were researched using following keywords: multiple sclerosis; vitamin D; multiple sclerosis prevention; vitamin D deficiency. The results: The results of these studies have provided important information on the safety and efficacy of vitamin D therapy in MS. Dietary vitamin D supplementation can therefore serve as a prevention of MS and as an adjunct to traditional MS therapy. However, it is important to emphasize the need to assess the risks and benefits individually for each patient.
9 November 2022 in Journal of Education, Health and Sport
Introduction and purpose: The Covid-19 pandemic has spread rapidly across the globe, resulting in more than 6 million deaths worldwide. Oncological patients are considered to be at increased risk of SARS-CoV-2 coronavirus infection and the severe course of the disease. The current understanding of the correlation between COVID-19 and cancer is limited. In this study, we attempted to analyze the course of SARS-CoV-2 infection in cancer patients who were treated at the Department of Clinical Oncology and Chemotherapy SPSK4 in Lublin in the period from November 2020 to March 2022. Material and methods: This retrospective study included patients in the age rage from 36–79 years old. All necessary information were obtained from electronic medical records. Subsequently collected data were submitted to statistical calculations. Results: A varied course of COVID-19 infection in oncology patients has been observed. Preliminary observations showed that, in many cases COVID-19 infection caused a delay in the administration of the next dose of a therapeutic agent during the course of systemic anticancer treatment, but this delay was not observed to have a significant impact on reducing the effectiveness of oncology treatment Conclusions: In the light of our own presented observations, global statistics and reports of other authors, the role of certain individual characteristics of patients is visible, which increase the risk of more severe course of SARS-CoV-2 infection and / or increased mortality . It is necessary to continue the search for an optimal diagnostic regimen that would identify cancer patients with a particular risk of the most severe complications of SARS-CoV-2 infection.