Ionut Marcel Cobec

Dr. Ionut Marcel Cobec

Diakoneo Diak Klinikum Schwäbisch Hall, Schwäbisch Hall, Baden-Württemberg, Germany
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Research Focus & Metrics

Academic Career Length

10Years (2017-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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27 August 2024 in Diagnostics
Verified
Journal Article
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VVVlad Bogdan Varzaru
Vlad Bogdan Varzaru
TVTania Vlad
Tania Vlad
Roxana PopescuRoxana Popescu
Roxana Popescu
CVCristian Sebastian Vlad
Cristian Sebastian Vlad
AMAurica Elisabeta Moatar
Aurica Elisabeta Moatar
ICIonut Marcel Cobec
Ionut Marcel Cobec
Worldwide, breast cancer (BC) is one of the most common cancers in women and is responsible for the highest number of cancer-related deaths among women, with a special clinical behavior and therapy response. Triple-negative breast cancer (TNBC) is seen as a highly invasive BC, characterized by a short survival, higher mortality, recurrence, and metastasis when it is compared to the other BC subtypes. The molecular subtyping of TNBC based on mRNA expression levels does not accurately reflect protein expression levels, which impacts targeted therapy effectiveness and prognostic predictions. Most TNBC cases exhibit a high frequency of homologous recombination (HR) DNA repair deficiency (HRD) signatures and are associated with a complex genomic profile. Biomarker research in TNBC includes investigating genetic mutations, gene expression patterns, immune system-related markers, and other factors that can provide valuable information for diagnosis, treatment selection, and patient outcomes. Additionally, these biomarkers are often crucial in the development of personalized and precision medicine approaches, where treatments are customized to each patient’s unique characteristics. This ongoing research is essential for improving the management and outcomes of TNBC, which is a challenging and heterogeneous form of breast cancer. The findings of this research have practical implications for refining treatment strategies, particularly in selecting appropriate systemic therapies and integrating traditional treatment modalities like surgery and radiotherapy into comprehensive care plans for TNBC patients.

16 July 2025 in Medicina
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Journal Article
Open access
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OBOana Maria Burciu
Oana Maria Burciu
AMAdrian Grigore Merce
Adrian Grigore Merce
SCSimona Cerbu
Simona Cerbu
AIAida Lorenta Iancu
Aida Lorenta Iancu
TPTudor-Alexandru Popoiu
Tudor-Alexandru Popoiu
GDGabriel Mihail Dimofte
Gabriel Mihail Dimofte
Background and Objectives: The objective of this review is to evaluate the current evidence regarding hormone treatments for both premenopausal and postmenopausal women with early-stage hormone receptor (HR) positive breast cancer. Materials and Methods: An in-depth exploration of the existing literature was conducted, with landmark clinical trials such as TEXT, SOFT, ATLAS, and aTTom serving as primary references. Results: Through an extensive review of the literature, our findings indicate that for premenopausal women with HR-positive, HER2-negative BC with a low risk of recurrence, standard 5-year monotherapy with tamoxifen represents the optimal therapeutic management, given its favorable clinical outcomes and lower associated toxicity. In contrast, for premenopausal women with an intermediate to high risk of recurrence with the same tumor characteristics, the most effective approach stated in the literature is a combination of ovarian suppression therapy (chemical/surgical) and an aromatase inhibitor/selective estrogen receptor modulator (tamoxifen), with a possible extension of the standard therapeutic period. In postmenopausal patients with HR-positive, HER2-negative breast cancer with a low recurrence risk, the first line of treatment is usually a standard 5-year period of treatment with aromatase inhibitors (AIs)(letrozole, anastrozole, or exemestane). On the other hand, in postmenopausal women with an intermediate to high risk, combination therapy might be needed, as well as an extension of the standard therapeutic time. Conclusions: Treatment consensus depends on pre- vs. postmenopausal status and recurrence risk.

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Journal Article
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OBOana Maria Burciu
Oana Maria Burciu
ISIoan Sas
Ioan Sas
TPTudor-Alexandru Popoiu
Tudor-Alexandru Popoiu
AMAdrian Grigore Merce
Adrian Grigore Merce
LMLavinia Cristina Moleriu
Lavinia Cristina Moleriu
ICIonut Marcel Cobec
Ionut Marcel Cobec
Breast cancer is a global health issue affecting countries worldwide, imposing a significant economic burden due to expensive treatments and medical procedures, given the increasing incidence. In this review, our focus is on exploring the distinct imaging features of known molecular subtypes of breast cancer, underlining correlations observed in clinical practice and reported in recent studies. The imaging investigations used for assessment include screening modalities such as mammography and ultrasonography, as well as more complex investigations like MRI, which offers high sensitivity for loco-regional evaluation, and PET, which determines tumor metabolic activity using radioactive tracers. The purpose of this review is to provide a better understanding as well as a revision of the imaging differences exhibited by the molecular subtypes and histopathological types of breast cancer.

9 September 2025 in Biomedicines
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Journal Article
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SCSebastian Ciurescu
Sebastian Ciurescu
VBVictor Bogdan Buciu
Victor Bogdan Buciu
DSDenis Mihai Serban
Denis Mihai Serban
BEBorozan Florina Elisabeta
Borozan Florina Elisabeta
TLTomescu Larisa-Cristina
Tomescu Larisa-Cristina
ISIoan Sas
Ioan Sas
Background/Objectives: Cytokines play a fundamental role in the tumor microenvironment, influencing breast cancer progression, metastasis, and therapeutic resistance. The objective of this systematic review and meta-analysis was to evaluate the prognostic impact and therapeutic relevance of key cytokines in breast cancer, based on human studies published between 2015 and 2025. Methods: We systematically searched PubMed, Web of Science, and Scopus for eligible studies reporting on cytokine expression and clinical outcomes in breast cancer. Inclusion criteria were based on the PRISMA framework, focusing on human cohorts and excluding in vitro or animal models. Data were extracted on cytokine types, measurement methods, patient population, and outcomes. Meta-analyses were performed using random-effects models for cytokines with sufficient data, notably IL-6 and TNF-α. Results: Twenty-three studies were included. Elevated IL-6 was consistently associated with poor overall survival (pooled HR = 2.25, 95% CI 1.83–2.76), while high TNF-α levels showed a trend toward worse outcomes but without statistical significance. IL-1β, IL-8, and IL-10 were also linked to increased metastasis and reduced response to therapy. Immunosuppressive cytokines such as IL-10 and TGF-β facilitated tumor immune evasion, while IL-17 promoted inflammation and angiogenesis. Cytokines such as IL-12 and IFN-γ were associated with improved immune responses and a favorable prognosis. Conclusions: Cytokines are central mediators of breast cancer progression and immune regulation. Elevated levels of pro-inflammatory and immunosuppressive cytokines correlate with poor outcomes and may serve as prognostic biomarkers and therapeutic targets. Their integration into personalized treatment strategies holds significant clinical potential but requires further prospective validation and biomarker standardization.

1 September 2024 in Cancers
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Journal Article
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VVVlad Bogdan Varzaru
Vlad Bogdan Varzaru
DADiana-Maria Anastasiu-Popov
Diana-Maria Anastasiu-Popov
AEAnca-Elena Eftenoiu
Anca-Elena Eftenoiu
Roxana PopescuRoxana Popescu
Roxana Popescu
DVDaliborca Cristina Vlad
Daliborca Cristina Vlad
ICIonut Marcel Cobec
Ionut Marcel Cobec
Breast cancer is one of the most common cancers and the leading cause of cancer death in women. Less than 1% of breast cancer cases are male breast cancers. Although there has been significant progress made in the management of breast cancer, due to its rarity among men, the question of whether men and women with breast cancer have the same treatment response and survival rate still needs to be answered. The primary goal of this study is to compare survival outcomes between male and female breast cancer patients. Material and Method: This cohort study represents a retrospective and anonymized data analysis of 2162 breast cancer cases (19 males and 2143 females), registered over a period of 12 years, from 1 January 2010 to 31 December 2021, in the Clinic of Obstetrics and Gynecology, Diakoneo Diak Klinikum Schwäbisch Hall, Germany. Results: According to the Kaplan–Meier survival analysis, the estimated overall 3-year survival rate was 91.1% for women and 88.9% for men. The log-rank test of equality of survival distributions indicated a statistically significant difference in survival times between the two groups (p = 0.009). In the subsequent age-matched Kaplan–Meier analysis, the p-value was below the significance threshold (p = 0.068). Conclusions: Male breast cancer is a rare disease that may show some particularities in terms of survival compared to female breast cancer.

10 November 2022 in Medicina
Verified
Journal Article
Open access
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ICIonut Marcel Cobec
Ionut Marcel Cobec
VVVlad Bogdan Varzaru
Vlad Bogdan Varzaru
TKTamas Kövendy
Tamas Kövendy
LKLorant Kuban
Lorant Kuban
AEAnca-Elena Eftenoiu
Anca-Elena Eftenoiu
ARAndreas Rempen
Andreas Rempen
Background and Objectives: In recent years, the rate of caesarean section (CS) has increased constantly. Although vaginal breech delivery has a long history, breech presentation has become the third most common indication for CS. This study aims to identify factors associated with the success of external cephalic version (ECV), underline the success rate of ECV for breech presentation and highlight the high rate of vaginal delivery after successful ECV. Material and Methods: This retrospective observational study included 113 patients with singleton fetuses in breech presentation, who underwent ECV from January 2016 to March 2021 in the Clinic of Obstetrics and Gynecology, Diakonieklinikum Schwäbisch Hall, Germany. Maternal and fetal parameters and data related to procedure and delivery were collected. Possible predictors of successful ECV were evaluated. Results: The success rate of ECV was 54.9%. The overall rate of vaginal birth was 44.2%, regardless of ECV outcome. The vaginal birth rate after successful ECV was 80.6%. Overall, 79.0% of women with successful ECV delivered spontaneously without complications, 19.4% delivered through CS performed during labor by medical necessity, and 1.6% delivered through vacuum extraction. ECV was performed successfully in three of the four women with history of CS. Gravidity, parity, maternal age, gestational age, fetal weight, and amniotic fluid index (AFI) were significantly correlated with the outcome of ECV. Conclusions: ECV for breech presentation is a safe procedure with a good success rate, thus increasing the proportion of vaginal births. Maternal and fetal parameters can be used to estimate the chances of successful ECV.