Colorectal cancer (CRC) is the third most diagnosed cancer and a leading cause of cancer-related mortality in Morocco, often detected at late stages. Circulating microRNAs (miRNAs) have emerged as promising non-invasive biomarkers for CRC detection, with miR-21, miR-29a, and miR-92a showing significant diagnostic potential. This study aimed to evaluate the expression levels of these miRNAs in a Moroccan population and their efficacy as diagnostic biomarkers. Methods: A prospective study was conducted using blood samples from 50 CRC patients and 50 healthy controls. Circulating miRNA expression levels were quantified through reverse transcription quantitative PCR (RT-qPCR), with normalization to miR-1228-3p. Statistical analyses, including the Mann–Whitney U test, Receiver Operating Characteristic (ROC) curve analysis, sensitivity (Sen), and specificity (Spe) evaluations, were performed to assess the diagnostic accuracy of individual miRNAs and their combined performance as panels. Results: The expression levels of miR-21, miR-29a, and miR-92a were significantly elevated in CRC patients compared to healthy controls (all p < 0.001). ROC analysis demonstrated that miR-92a exhibited the highest individual diagnostic performance (AUC: 0.938), followed by miR-21 (AUC: 0.907) and miR-29a (AUC: 0.898). Sensitivity and specificity were 88% and 90%, 92% and 56%, and 76% and 94%, respectively. Combinatorial analysis revealed that the miR-29a and miR-92a panel achieved the highest diagnostic accuracy (AUC: 0.976), surpassing individual miRNAs and other combinations, highlighting its potential as a robust, non-invasive biomarker panel for CRC. Conclusions: This study highlights the potential of the miR-29a and miR-92a combination, which achieved excellent diagnostic efficiency (AUC: 0.976). These findings underscore miRNA utility in enhancing early detection and reducing CRC-related mortality in Morocco.

Background: MicroRNAs (miRNAs) are small noncoding RNA molecules involved in the post-transcriptional regulation of genes. Deregulated expression of miRNAs is involved in different pathogenic mechanisms, particularly colorectal cancer (CRC) carcinogenesis. Due to their stability and accessibility, circulating miRNAs represent a new family of biomarkers with great potential. Therefore, certain miRNAs can be used as diagnostic biomarkers in CRC. Objective: This systematic analysis aimed to explore the individual efficacy of the most investigated blood-based miRNAs for CRC diagnosis, namely miR-21, miR-29a and miR-92a. Methods: Articles were retrieved from databases such as PubMed and Google Scholar, and studies designed to evaluate the diagnostic value of microRNAs in CRC were then selected. We subsequently explored the diagnostic accuracy of each miRNA using parameters such as (SE, SPE, PLR, NLR). The meta-analysis was performed using the Review Manager (Revman) 5.4 software and the Meta Disc software. Results: Our results suggested that serum miR-21 levels showed great potential as a diagnostic molecular marker. The overall pooled results for sensitivity, specificity, area under the curve (AUC), PLR, and NLR were 78%, 91%, 0.9519, 8.12 and 0.17 respectively. Conclusion: miRNAs have become increasingly important in the diagnosis of CRC. Based on these findings, circulating miR-21 levels may have a potential value for early detection and might be used as a novel diagnostic biomarker for CRC.

Inroduction: The question of whether tumor expression of PD-L1 and the presence of distant metastasis could influence the efficacy of immunotherapy represents a major challenge and needs to be further elucidated. The aim of this study is to evaluate the predictive significance of tumor expression of PD-L1 as well as the number and site of metastasis in non-small cell lung cancer (NSCLC) among Moroccan patients treated with immunotherapy.Material and Methods: Between January 2019 and February 2023, we recruited Moroccan patients with metastatic NSCLC. All were treated with immunotherapy, either as monotherapy or in combination with chemotherapy. Immunohistochemistry was used to assess PD-L1 (clone 22C3) and ALK (clone D5F3) status. EGFR status was established by qPCR. Tumor PD-L1 expression was classified into 2 levels: TPS <1% (negative expression) and TPS ≥1% (positive expression). Statistical analysis was performed using SPSS Statistics V.21 software. Results: The median age of patients (N=40) was 67 years (39- 92 years) and the sex ratio was 9. Disease dissemination revealed that 22.5% (N=9) of patients had a metastatic burden ≥ 3 (MB≥3). As for the sites of metastasis, the results showed that 20% (N=8), 10% (N=4), 42.5% (N=17), 22.5% (N=9), 27.5% (N=11), 45% (N=18) and 27.5% (N=11) of patients had developed lymph node, liver, bone, brain, pleural, contralateral lung and adrenal metastasis respectively. Positive PD-L1 expression was significantly associated with shorter overall survival (OS = 17.19 vs. 28.85 months, p=0.01). High metastatic burden (MB ≥ 3) was associated with lower objective response rate (ORR), shorter progression-free survival (PFS), and reduced OS, respectively (ORR = 0 vs. 58.06%, p=0.002; PFS = 10.23 vs. 25.27 months, p=0.001; and OS = 11.60 vs. 27.91 months, p=0.003). Only the presence of osseous metastasis was significantly associated with lower ORR, shorter PFS, and OS compared to other metastatic locations (ORR = 5.88 vs. 73.9%, p=0.000; PFS = 10.72 vs. 31.33 months, p=0.000; and OS = 11.39 vs. 36.17 months, p=0.000). Finally, the presence of hepatic metastasis was significantly associated with shorter PFS (10.75 months) compared to those without hepatic metastasis (22.53 months) (p=0.046). Finally, the results of the multivariate analysis revealed that the presence of bone metastasis was strongly correlated with a significant decrease in progression-free survival (p=0.001) as well as overall survival (p=0.002). Conclusion: Our results suggest that tumor expression of PD-L1 and metastatic burden should play a significant role in predicting the response to immunotherapy. Furthermore, it is important to note that the presence of osseous and hepatic metastasis could negatively influence the clinical outcomes of immunotherapy.

Background: HIV self-testing was introduced to enhance HIV testing uptake, especially among key populations. Despite the benefits, its use remains relatively low in the WHO Eastern Mediterranean Region. Aim: To assess the acceptability, usability and feasibility of HIV self-testing among key populations in Morocco. Methods: We assessed the usability and acceptability, as well as the feasibility of ordering online and picking up in pharmacies and of distribution by people living with HIV of an oral HIV self-testing kit among 3465 female sex workers, men having sex with men, and partners of newly diagnosed people living with HIV in Morocco. Data were collected using 4 questionnaires administered online anonymously and analysed using Stata version 14.0. Results: A total of 3465 individuals received the HIV self-testing kits, 54.4% male, 43.7% female and 1.9% transgender. High acceptability rates of 90.2%, 86.2% and 80.4% were reported among the female sex workers, men having sex with men, and partners of newly diagnosed people living with HIV, respectively. HIV positivity rates were 1.2% among the female sex workers and men having sex with men, and 4.3% among partners of people living with HIV. Between 44.0% and 73.4% of the participants had never been tested for HIV. Conclusion: Our findings highlight the value of extending HIV self-testing services to key populations in Morocco and possibly other countries in the Middle East and North Africa.

Introduction: The Identification of PD-L1, EGFR and ALK status is essential to guide personalized treatment of NSCLC. The objective of our study is to evaluate the implication of changing the therapeutic protocol on the prognosis of Moroccan patients with NSCLC. Methods: Between January 2019 and February 2023, 96 patients with NSCLC were recruited. Results: In our population, the patients were treated with different first-line protocols: 83.34% (N=80) with neo-adjuvant chemotherapy, 14.58% (N=14) with immunotherapy and 2.08% (N=2) with targeted therapy. Of the 82 patients who received neo-adjuvant chemotherapy (N=80), 24 were able to switch to immunotherapy. While, the 2 patients who received targeted therapy beforehand also switched to immunotherapy. The influence of the number of chemotherapy (Chemo) cycles on vital status and overall survival (OS) of the 24 patients who switched from their initial protocol to immunotherapy (IO) showed that patients who received IO after completing the 4 or 5 cycles of chemo had a good OS, with a mean of 29.07 months. In comparison, patients who received less than 4 cycles of chemo had a mean OS of 14.70 months, while those who received more than 5 cycles of chemo had a mean OS of 21.38 months. Furthermore, the association between change in treatment protocol and patient vital status was significant (p=0.013). However, there was a significant difference in OS between patients who maintained the treatment protocol (mean OS=12.43 months) and those who changed the protocol (mean OS=24.01 months) (p=0.000). Multivariate analysis indicated that maintaining the initial therapeutic protocol was independently associated with a reduced OS (p=0.003). Conclusion: Our results highlight the impact of changing the protocol on the OS of NSCLC patients taking into account the importance of choosing the right timing to switch to IO based on the number of prior chemo cures.