Background. Obtaining tumor specimens and re-evaluating targeted markers is recommended, if possible, in breast cancer patients who relapsed after curative treatment. The biomarker status changes in rebiopsied tumors have been demonstrated to have considerable clinical implications. Objectives. To identify the changes of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status between the primary and recurrent lesions. Materials and Methods. We conducted a study among 67 patients with recurrent breast cancer, recruited from January 2014 to September 2018 in the Vietnam National Cancer Hospital to compare ER, PR, and HER2 status between the primary and recurrent lesions. For each patient, a specimen of their primary tumor and another specimen of recurrent lesions underwent pathological assessment. Immunohistochemistry (IHC) was performed to determine ER, PR, and HER2 status in both specimens. Results. Biomarker status conversion rates (in both directions) between primary and recurrent tumors were 26.9% for ER, 38.8% for PR, and 22.4% for HER2. Overall, IHC subtypes (hormone receptor positive, HER2 amplified, and triple-negative) changed in 25 out of 67 (37.3%) cases. Conversion rates were not statistically significantly different between patients with different recurrent sites and times of recurrence. Eight out of 13 initially triple-negative patients (61.5%) had a change to positive status of either ER, PR, or HER2. Conclusion. A substantial discordance in ER, PR, and HER2 status were observed between primary breast cancer tissues and recurrent lesions. Rebiopsy could bring new therapeutic opportunities in the management of patients with recurrent breast cancer.

Background: Although primary gastrointestinal non-Hodgkin lymphoma (GI NHL) is a rare hematopoietic malignancy, it is the most common extranodal site involved by lymphoma. Treatment methods are chosen based on many factors, including site of lesion, histopathology, symptoms, and patients’ choice. Objectives: To evaluate the clinical characteristics, treatment results and prognosis for primary GI NHL in Vietnamese patients. Patients and methods: This was a retrospective descriptive study on 126 patients with primary GI NHL treated at our hospital from 2010 to 2015. Data of all patients were collected and analyzed. Results: B-cell non-Hodgkin’s lymphoma was the major pathology with rate of 93.7%, in which Diffuse Large B-Cell Lymphoma type accounted for 58.7%, followed by Mucosa-associated lymphoid tissue lymphoma type 22.2%. Less common forms were cystic type, Burkitt’s lymphoma, Mantle cell, T cell. The majority of patients receiving chemotherapy achieved a complete response, up to 70%. Overall survival and 5-year disease-free survival were 74.1% and 59.3%, respectively. Overall, stomach lymphoma had a longer survival rate than those in the small intestine. Factors including Eastern Cooperative Oncology Group score of 2–4, elevated Lactate Dehydrogenase levels at baseline, stage of widespread illness (III/IV), high malignancy histopathology, and lesion size of more than 10 cm were poor prognostic indicators. Conclusions: Gastric lesion was the most frequent site and has better prognosis than other locations. Other prognostic factors for overall survival included Eastern Cooperative Oncology Group score, Lactate Dehydrogenase levels, stage, histopathology, and lesion size.

Introduction: Lactating adenoma is a rare breast tumor which is commonly found in late pregnancy or lactation period. Despite its benign nature, lactating adenoma might develop aggressively and can be misdiagnosed as breast cancer. Case presentation: We report a case of a 25-year-old female presenting with two large, ulcerative and bleeding breast masses. An open biopsy demonstrating lactating adenoma was considered discordant and surgery was performed to confirm the diagnosis. Conclusion: Careful clinical and histological evaluations are necessary to diagnose and manage lactating adenoma. Highlights:

Background: This study aims to evaluate the efficacy of systemic chemotherapy combined with radiofrequency ablation in the treatment of inoperable colorectal cancer with liver metastasis. Materials and methods: The authors conducted a retrospective cohort analysis on 30 patients diagnosed as colorectal cancer with liver metastasis who underwent systemic chemotherapy combined with radiofrequency ablation of the liver lesions from January 2017 to August 2020 at our institution. Responses was evaluated by International Working Group on Image-guided Tumor Ablation criteria, along with progression-free survival. Results: The response rate after 4 cycles and 8 cycles of chemotherapy were 73.3% and 85.2%, respectively. All patients achieved responses after of radiofrequency therapy, with the rates of complete response and partial response were 63.3% and 36.7%. The median progression-free survival was 16.7 months. After radiotherapy ablation, all patients had mild to moderate hepatic pain, 10% of patients had fever and increased liver enzymes occurred in 90% of patients. Conclusions: Systemic chemotherapy combined with radiofrequency ablation was safe and effective in colorectal cancer with liver metastasis and warrants further large-scale studies.

Introduction and importance: Malignant melanoma has a generally poor prognosis and occurs primarily on the skin but may rarely be found in internal organs such as the small intestine, colon, or rectum. Case presentation: This report presents a case of a 78-year-old male patient with stage IV gastrointestinal melanoma, which is a rare form of melanoma. The patient received first-line pembrolizumab with a complete response. Clinical discussion: Surgery plays a crucial role in local and regional control for patients with localized stages. Immune checkpoint inhibitor therapy, including nivolumab or pembrolizumab, is a well-studied and proven effective treatment option for patients with advanced skin melanoma. In this case report, the patient with gastrointestinal melanoma also had a very good response to immunotherapy. Conclusions: Understanding gastrointestinal melanoma is still limited due to the rarity of this clinical entity. Currently, there are no standard treatment guidelines for this rare group of patients. Immune checkpoint inhibitors could be the preferred first-line therapy for patients with distant metastases.

Background and Objectives: Changes in alpha-fetoprotein (AFP) after initiating lenvatinib may reflect response in patients with hepatocellular carcinoma (HCC), but the optimal assessment time point and AFP decline threshold remain unstandardized. This study evaluated the association between AFP change at the first post-treatment measurement and imaging response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Materials and Methods: This retrospective study included 191 patients with HCC treated with lenvatinib. The primary analysis population comprised patients with pretreatment AFP ≥ 20 ng/mL and ≥1 post-treatment AFP measurement. AFP response was defined as a ≥40% decrease from pretreatment levels. The primary endpoints were the objective response rate (ORR) and disease control rate (DCR) according to mRECIST; progression-free survival (PFS) and overall survival (OS) were exploratory. Associations were assessed using multivariable logistic regression adjusted for AFP timing, albumin–bilirubin (ALBI) score, macrovascular invasion, and tumor number ≥ 5. Sensitivity and 2-month landmark analyses were also performed. Results: Of 124 patients, 47 (37.9%) achieved an AFP response. ORR was 44.7% versus 6.5% in the non-response group (OR 11.36; 95% confidence interval [CI] 3.68–42.67; p < 0.001); DCR was 83.0% versus 57.1% (OR 3.62; 95% CI 1.42–10.19; p = 0.003). After adjustment, AFP response remained independently associated with ORR (aOR 12.96; 95% CI 3.85–43.66; p < 0.001) and DCR (aOR 5.76; 95% CI 1.95–17.00; p = 0.002); findings were unchanged when restricted to cycle-1 measurements (aOR 12.27). In exploratory analyses, median PFS was 8.51 versus 4.30 months and median OS 18.53 versus 10.15 months; landmark analysis gave concordant estimates (PFS HR 0.38; OS HR 0.45). Conclusions: A ≥40% AFP decline at the first post-treatment measurement was independently associated with ORR and DCR according to mRECIST in patients with HCC and pretreatment AFP ≥ 20 ng/mL. These findings are hypothesis-generating and require confirmation in prospective, multicenter studies with independent validation before AFP kinetics can be considered in routine practice.