The aim of the present study is to investigate the dietary intake of vitamin D in normal-weight and overweight individuals, establishing its correlation with specific food groups. Two hundred and sixty-four individuals were studied, of which 41.3% men and 58.9% women between 19 and 60 years of age. Nutritional assessment was carried out applying 24-h recall in the months January to April in 2014 and 2015. Nutritional status was assessed by means of anthropometric indicators – anthropometric indicators and indices, whereas weight and body composition were measured by professional bioelectrical impedance using a Tanita 420 BC MA device. It was established that the average daily intake of vitamin D for the entire group of studied individuals was 6.6 µg/day (women – 5.6 µg/day and men – 10.4 µg/day). Main dietary sources of vitamin D in the diet of adults were meat and meat products, fish and fish products, eggs and milk and dairy products. In the groups based upon BMI category of participants, meat and meat products were found to be the main source of vitamin D in all groups. Average daily intake of vitamin D has values significantly below the recommended average daily intake. A policy to promote the consumption of foods rich in vitamin D in order to reduce the relative share of individuals not meeting the recommendations is required.

Introduction: Colorectal cancer is the third most common cancer type worldwide. Fluoropyrimidines and their prodrug-based regimens are widely applied as primary medications. The main enzyme responsible for the rate-limiting step in pyrimidine and for the 5-fluorouracil catabolism is dihydropyrimidine dehydrogenase (DPD). Aim: We aimed to screen DPD level and the changes of plasma antioxidant capacity of colorectal cancer patients on 5-fluorouracil regimen. Materials and methods: Human DPD Elisa Kit based on sandwich enzyme-linked immune-sorbent assay and spectrophotometric methods (FRAP and ABTS) were used in the study. Results: No statistically significant changes in plasma scavenging activity according to the results obtained in the ABTS system have been observed after evaluating all patients and considering DPD concentration. A decrease of the ferric reducing ability of patients’ plasma taken after the administered treatment was found. The increase of DPD level is accompanied by a decrease in the p values and therefore the statistical significance of the differences increases. Conclusions: Based on the aforementioned observations, it could be concluded that some aspects of plasma antioxidant capacity and individuals’ antioxidant status might be involved in the pathogenesis of the disease and could be altered by the activity of some enzymes. The cancer therapy in question, by the specificity of its mechanism of action, can modify patient’s oxidative status.

Unpredictable, dose-limiting toxicity remains a challenge in cancer treatment. We evaluated dihydropyrimidine dehydrogenase (DPD) and UDP-glucuronosyltransferase 1A1 (UGT1A1) plasma levels in the context of chemotherapy-induced toxicity and disease progression. Seventy gastrointestinal cancer patients (30 FOLFOX; 40 FOLFIRI) were enrolled. DPD and UGT1A1 plasma levels were determined using ELISA. Univariable and bivariable analyses and a general linear model (GLM) framework were used. Post-infusional reductions in white blood cell and granulocyte counts were observed. For FOLFOX, the granulocyte counts decreased by 17% (r = 0.54; p = 0.0030), while FOLFIRI caused a 41% reduction (r = 0.43; p = 0.0063). DPD levels were lower in FOLFOX than in FOLFIRI (2.543 vs. 3.579; p = 0.0363; Cohen’s d = 0.52). The multiple linear regression models associated DPD levels with cancer progression (b* = 0.258, p = 0.034). The bivariate analysis and multiple linear regression indicated some trends of association between UGT1A1 levels and reduction in white blood cell (b* = 0.359, p = 0.042) and granulocyte counts (b* = 0.383, p = 0.030) among FOLFIRI-treated patients. These preliminary observations suggest that DPD and UGT1A1 might contribute to evaluating response assessment.

Background/Objectives: Small cell lung cancer (SCLC) is a highly metastatic and lethal malignancy. Doublet chemotherapy consisting of a platinum compound and etoposide had remained the standard first-line regimen for decades, particularly for the majority of patients, who are diagnosed with extensive-stage disease. Over the past 5 years, results from the IMpower133 trial led to the approval of anti-PD-L1 agent atezolizumab as part of the first-line regimen for extensive-stage SCLC. The accumulation of real-world evidence on atezolizumab efficacy in this context is essential for corroborating trial results and further improving patient outcomes. Herein, we present real-world evidence from a Bulgarian cohort receiving atezolizumab as part of first-line extensive-stage SCLC treatment, comparing these data to the results of IMpower133. Methods: Data were extracted from the electronic health records of patients receiving atezolizumab plus chemotherapy as first-line treatment for extensive-stage SCLC in the period between 1 January 2022 and 31 December 2024. Analysis was conducted via the Danny Platform, an analytic platform for the integration of real-world evidence using embedded machine learning and LLM algorithms. Patients matching IMpower133 inclusion criteria were included in a group for comparison with trial results. Results: A total of 302 patients were included in the analysis. The real-world progression-free survival (PFS) in our study surpassed that in IMpower133 (7.6 versus 5.2 months), in addition to higher PFS rates beyond six months. A lower Objective Response Rate (ORR) (38.7% versus 65.4%) was noted in our real-world cohort, which we attribute to real-world documentation practices. Conclusions: Real-world evidence regarding PFS and treatment response generally align with the efficacy of adding atezolizumab to first-line extensive-stage SCLC treatment reported in the IMpower133 trial, while reflecting differences that may arise in routine clinical practice.

Background and Objectives: Although clinically useful, homologous recombination deficiency (HRD) testing has recently been more broadly adopted in ovarian cancer (OC) management. The VALIDATE study evaluated HRD status and treatment patterns in patients with newly diagnosed advanced OC in Bulgaria to better understand HRD prevalence and disease management. Materials and Methods: This real-world, observational, multi-centre, medical chart review study included 100 adult patients with HRD testing results available at study entry. Data collected at least 30 days after HRD results and 6 months later were descriptively analysed in the full cohort and subgroups (HRD, BRCA mutation, and genomic instability score [GIS]). Results: Mean age at diagnosis: 61.3 years; stage III: 51.0%, prevalence of HRD+ 58.0% (95% confidence intervals [CI] 47.7–67.8%) and HRD− 42.0% (95% CI 32.2–52.3%). Among the 58 HRD+ patients, 20 (34.5%) were BRCA+, whereas 38 (65.5%) were BRCA−, and 52 (89.7%) were GIS+, and 6 (10.3%) GIS−. Overall, platinum–taxane chemotherapy plus antiangiogenics was the most common front-line (FL) treatment (77.0%), regardless of subgroups (range: 66.7–85.0%). Six months later, 81 patients were alive, and 73 (90%) started maintenance therapy (MT). Antiangiogenic monotherapy (32.0%) and antiangiogenic plus PARP inhibitor (34.0%) were the most common MTs. The latter was also common across subgroups (range: 33.3–60.5%), except for HRD− (61.9% received antiangiogenic monotherapy). Conclusions: In this dataset, more than half of advanced OC patients had HRD+ status. Our study provides relevant insights into recent clinical practice patterns in advanced OC in Bulgaria that could serve as an anchor for future, more robust research in this field.