The interactions of nanomaterials with biological materials such as immortalized cell lines are recently on the rise. Owing to this superiority, the biosynthesis of AgNPs using gallic acid as a reductant was implemented in this study. After being synthesized, the AgNPs were characterized using techniques such as dynamic light scattering, transmission electron microscopy, selected area electron diffraction, and X-ray diffraction methods. Furthermore, the AgNPs were assessed for their cytotoxic effects on the colorectal adenocarcinoma cell line HT-29. The mechanisms of such cell-killing effect were investigated by analyzing the expressions of 14 mRNAs using quantitative polymerase chain reaction. The outcomes indicate that the synthesized AgNPs were cytotoxic on HT-29 cells. The expressions of all apoptotic genes analyzed including cyt-C, p53, Bax, Bcl2, CASP3, CASP8, CASP9, and CASP12 were upregulated. With regard to the autophagy-related genes, Beclin-1, XBP-1, CHOP, and LC3-II were upregulated, whereas the expressions of ATG3 and ATG12 were downregulated. To conclude, the AgNPs induced mitochondria-dependent apoptosis and non-canonical autophagy in HT-29 cells. A crosstalk did occur between autophagy and apoptosis in such a cell-killing effect. Hence, further studies are required to elucidate the exact mechanisms in animal models for further use of AgNPs in clinical medicine for the treatment of neoplasms of the digestive tract.

Immune checkpoint inhibitors such as monoclonal antibodies have been used recently with greater effect for the management of non-small cell lung cancer (NSCLC). Sintilimab, a fully human IgG4 monoclonal antibody is specific for the immune checkpoint protein programmed cell death receptor-1 (PD-1). It is a common medication adopted for treating Hodgkin’s lymphoma and NSCLC. The adverse effects associated with the use of monoclonal antibodies should be closely monitored and in the current report, the use of sintilimab for treating NSCLC led to skin-associated adverse effects such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Genetic testing showed that genes such as KRAS, CREBBP, NTRK1, RAF1, and TP53 were mutated. Initial visible symptom included the formation of a vesicular rash on the skin that had spread to the upper limbs, chest, and dorsum 1 week after the administration of sintilimab. The patient received anti-inflammatory agents to prevent worsening of the rashes and further infections. When the vesicles in back and limbs enlarged and the neck skin began to desquamate, the patient was diagnosed with Stevens-Johnson syndrome and sintilimab-induced toxic epidermal necrolysis. Toxic epidermal necrolysis was diagnosed via clinical symptoms and physical examination. The patient also reported the symptoms of oral mucositis. As soon as the dose of sintilimab was reduced to 20 mg/day, the skin-associated condition of the patient began to improve. Although the lump in the lungs decreased considerably 45 days after initial administration of sintilimab, the medication was stopped from use as soon as the skin-related symptoms improved after its withdrawal. This report suggests that close monitoring, personal care, and proper use of medications such as sintilimab should be implemented to avoid such rare skin-associated toxicities as an adverse effect.

Background and Aim: Colorectal cancer (CRC) in elderly patients is a severe global concern, and palliative care provided by nurses is in high demand at the end-of-life stage. A review to address this critical and under-researched area is warranted, and hence, we chose this as our novel objective. This review will therefore help advance the overall knowledge on nursing education and palliative care by nurses in oncology settings for geriatrics with CRC. Methods: PubMed, Web of Science, and Cochrane Library databases were used as the search tools for the literature survey. The study adopted Arksey and O’Malley’s six-step framework, besides study identification through PRISMA-ScR flow, and adhered to Standards for Quality Improvement Reporting Excellence (SQUIRE). A total of 18,859 articles were screened, and 65 articles were finalised for deriving the outcomes of the review. Results: Nurses play a critical role in CRC via assisting in early detection, treatment, and improving survival. They must therefore be clinically competent. Also, experts in nursing science should take care of patients until the end of their lives at home, preferably addressing the physical needs of the patient. They must make decisions in palliative care provided to the patient and assist their family in the management and alleviation of symptoms, including pain. Conclusion: Healthcare providers, such as nurses, can plan for caring for a cancer patient, providing mental and physical support in patient care. This will improve the overall survival of patients with limited adverse effects. Cancer rehabilitation evaluation to address the needs of elderly cancer patients must be utilised by nurses via several surveys and questionnaires. Hence, nursing education remains very important in cancer care for geriatrics.