Phytochemicals are a non-nutritive substances that are present in plants and contribute significantly to their flavor and color. These biologically active compounds are classified into five major groups, namely phenolics, carotenoids, organosulfur compounds, nitrogen-containing compounds, and alkaloids, and are known for their potential health benefits in the prevention of various diseases, including cancer. The purpose of this review article is to explore the potential therapeutic benefits of the dietary phytochemicals, such as flavonoids, phenolic acids, phytosterols, carotenoids, and stilbenes, in cancer treatment and prevention based on the epidemiological studies and clinical trials. Although the majority of epidemiological studies report a significant advantage of the heightened phytochemical consumption and increased serum levels of these compounds, linking increased exposure with a lower cancer risk across most cancer types, these effects could not be replicated in the most available clinical trials. In fact, many of these trials were withdrawn early due to a lack of evidence and/or risk of harm. Despite the strong anticancer effect of phytochemicals, as well as their proven efficacy in multiple epidemiological studies, there is still a great need for human studies and clinical trials, with great caution regarding the safety measures. This review article provides an overview of the epidemiological and clinical evidence supporting the potential chemopreventive and anticancer properties of phytochemicals, with a focus on the need for further research in this area.

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing T-cell-mediated immune responses against tumors. However, their use can lead to immune-related adverse events (irAEs) impacting patient outcomes. This single-center, observational study investigates the relationship between immune-related adverse events (irAEs) and survival outcomes and, to our knowledge, is the first of this kind in Polish population. Data of the 151 patients treated with ICIs, with or without chemotherapy, at the Department of Clinical Oncology and Chemotherapy in the Independent Public Hospital No. 4 in Lublin were collected from electronic medical records. Statistical analyses were performed using the Kaplan–Meier estimator, log-rank test, and multivariable Cox proportional hazard model (p < 0.05). IrAEs were observed in 38% of the patients, with the most common being thyroid dysfunction (11.9%) and dermal toxicity (6.6%). The median OS for patients with irAEs was 18.7 months, compared to 13.6 months for those without irAEs, though the difference was not statistically significant (p = 0.284). Patients with moderate toxicity had the highest median OS (26 months), while those with severe toxicity had a median OS of 6.41 months. Late-onset irAEs were associated with improved OS and PFS. Pack-years of smoking significantly impacted both OS (HR = 1.01, p = 0.014) and PFS (HR = 1.01, p = 0.011). Despite results not reaching statistical significance, the findings emphasize the clinical relevance of irAEs in treatment optimization and warrant further research to better understand their role in patient outcomes.

Pulmonary pleomorphic carcinoma (PPC) is a rare subtype of primary lung cancer, accounting for less than 2% of annual diagnoses. It is characterized by a low response rate to systemic treatment, an unusual molecular profile, an average high tumor mutation burden score, and poor prognosis. This article presents four cases of patients with PPC treated with immune checkpoint inhibitors. Two patients were women diagnosed with spindle cell carcinoma, while the other two were men diagnosed with pleomorphic carcinoma. The mean age was 68.75 years, and the clinical stage varied between II and IV. Two patients received immunotherapy as a second-line treatment, while the other two received it as a first-line therapy. Most patients had a history of smoking, with half of the patients smoking during the treatment. Only one patient experienced disease progression during treatment, while three achieved partial response, and two patients maintained response for over 40 treatment cycles. The toxicity of the treatment in patients reached up to grade 3 according to the Common Terminology Criteria for Adverse Events, and involving multiple sites. Given the highly specific molecular landscape and the promising results observed in the majority of patients, immunotherapy appears to be a favorable viable treatment option for the management of this rare neoplasm. Keywords: non-small cell lung carcinoma pulmonary pleomorphic carcinoma immunotherapy immune checkpoint inhibitors nivolumab pembrolizumab

Metformin, a widely prescribed treatment for type II diabetes, offers promising benefits beyond glycemic control, including improved lipid profiles and cardiovascular outcomes. It inhibits gluconeogenesis in the liver by activating AMPK, thereby reducing glucose production and enhancing glucose uptake in muscle. Recent studies highlight its potential anticancer effects, particularly through the suppression of the mTOR pathway via LKB1-dependent AMPK activation, which inhibits cell proliferation. This review explores metformin’s role as an adjunct therapy in pancreatic cancer, summarizing evidence on its molecular mechanisms and potential efficacy. The findings suggest metformin’s broader therapeutic applications, especially in oncology, warrant further investigation. The aim: The aim of this study is to analyze the role of metformin as an adjunct therapy in the treatment of pancreatic cancer, with particular focus on its molecular mechanisms, such as AMPK activation and mTOR pathway inhibition. The study aims to summarize the current scientific evidence regarding its potential effectiveness.

Background: The type of tumor is a huge determinant of survival and treatment outcomes, particularly with immunotherapy, which uses the immune system to target cancer cells. The response to immunotherapy varies depending on tumor types and is influenced by factors such as genetic mutations and the tumor microenvironment. Materials and methods: The present retrospective study analyzed records for 151 patients who underwent immunotherapy at a single center between 2019 and 2023. The cohort included adults diagnosed with solid tumors, primarily NSCLC (non-small cell lung cancer). Immunotherapy agents included pembrolizumab, nivolumab, and others. Data on age, cancer stage, treatment response, adverse events, overall survival (OS), and progression-free survival (PFS) were collected. Statistical analyses, including the Cox proportional hazards model, assessed the impact of tumor types and subtypes on survival outcomes. Results: The median age of the cohort was 69 (SD, 10.3) years, and the majority of the patients were men (64.9%). NSCLC was the predominant tumor type (78.1% of cases). In comparison to adenocarcinoma NSCLC, squamous NSCLC showed a significantly higher hazard ratio (HR) for OS (HR 1.49) and PFS (HR 1.47). Renal cell carcinoma and bladder cancer had lower HRs, suggesting a better prognosis. Conclusions: This study highlights how responses to immunotherapy can differ widely based on tumor type, emphasizing the importance of personalized therapy approaches. These insights underscore the need for further research to tailor immunotherapy more effectively to different cancer types.

Background: Uterine carcinosarcoma represents a rare subtype of the primary tumors of the uterus, consisting of less than 5% of uterine neoplasms. The most common symptom is abnormal vaginal bleeding. Most frequently, this type of cancer occurs in women over the age of 70. Aim: The aim of the paper is to present the significance of early diagnosis and treatment of uterine carcinosarcoma and to compare treatment methods among patients with different stages of this type of cancer. Materials and methods: This paper presents a case report of a 56 yeras old patient who was admitted to the hospital due to postmenopausal bleeding. During examination, an echogenic heterogeneous tumor was spotted in the uterine cervix. The materials obtained during the uterine dilation and curettage (D&C) revealed sarcoma stromale. During the second admission, laparoscopic hysterectomy was performed. Histopathological analysis of the material recognised neoplasm as carcinosarcoma not otherwise specified (NOS). According to the decision made during consultation, the patient was qualified for chemotherapy (6 cycles), followed up with radiotherapy. Results: Uterine carcinosarcoma is characterized by its unique, bi-phasic structure, aggressive, high-grade character and poor prognosis, which all create diagnostic and therapeutic difficulties. Due to its rare occurrence, precise histopathological examination is crucial in the diagnostic process and further treatment administration. Conclusions: Carcinosarcoma is an uncommon and distinctive form of uterine tumor. Its unusual morphology can complicate the diagnostic process and histopathological evaluation, potentially delaying the final diagnosis. Furthermore, because of its biphasic nature, its treatment approach differs from that used for more typical uterine cancers.