Autophagy is a protein degradation process within the cell and its deregulation has been linked to various diseases and the formation of cancer. Both mTOR and Beclin-1 are important proteins involved in the regulation of autophagy process and tumorigenesis. The aims of the study were to assess the expression of autophagic-related proteins in breast cancer tissues and normal breast tissues adjacent to the tumor. Immunohistochemical staining with anti-mTOR, anti-p-mTOR and anti-Beclin-1 antibody was carried out on tissue samples of 24 patients from our local hospitals. The results showed that mTOR and Beclin-1 proteins were present in both types of tissues in all the cases. However, a significant majority of the adjacent normal breast tissues were found to have stronger immunoreactivity towards phosphorylated mTOR (p-mTOR) as compared to the corresponding tumor tissues. Since increased expression of p-mTOR is known to be correlated with tumorigenesis, this may indicate the presence of molecular changes in these cells adjacent to the tumor tissues. Patients with mTOR positive tumors may benefit from use of mTOR inhibitors as part of their pharmacotherapy management.
Aims/Objectives: Cervical cancer is the second most cancer in women in India. Patients presenting with stage IVa have 5 year survival rates of only 16% and are not able to complete the full course of radiation due to advance disease. The aim of this retrospective study is to study the compliance of the stage IVa patients to neoadjuvant chemotherapy (NACT) followed by concurrent chemo radiotherapy and their completion of radical dose of radiation and subjective response in comparison to patients without NACT. Materials and Methods: We retrospectively studied stage IVa cervical cancer patient's case sheets from January 2019 to June 2020. The patients are divided in to 2 arms: Arm-A : 11 patients - who received NACT with Paclitaxel 175mg/m2 and carboplatin AUC 6 every 3 weeks of 4 cycles followed by external beam radiotherapy(EBRT) of 50 Gy/25 fractions with weekly cisplatin of 40 mg/m2, followed by brachytherapy of 700cGy of 3 fractions. Arm-B: 9 patients-who received external beam radiotherapy (EBRT) of 50 Gy/25 fractions with weekly cisplatin of 40 mg/m2, followed by brachytherapy of 700cGy of 3 fractions. The compliance to complete radical dose of radiotherapy with concurrent chemotherapy and response in patients with and without NACT were compared Results: Arm A: 10 patients (91%) completed radical dose of RT and weekly cisplatin, one patient (9%) defaulted for EBRT, all patients tolerated 4 cycles of NACT. During 3 months follow up 1 patient (9%) developed liver secondaries and 1 patient (9%) developed other complication (jejunal obstruction) 2 patients suffered dysuria(18%) and 7 (64%) patients asymptomatic. Arm B: 4 patients (44.5%) completed radical dose of RT and 5 patients (55.5%) defaulted radiation [one for EBRT and 4 for HDR] During 3 months follow up one patient (11%) developed liver secondaries and 1(11%) developed uraemia and died (both these patients completed radical dose), 2 (22.2%) patients with dysuria,2 (22.2%) patients with bleeding p/v and 3(33.3%) patients are asymptomatic. Patients who defaulted for radical dose of concurrent RT were more in arm -B (55%) when compared to arm- A(9%) More patients are asymptomatic in arm-A(64%) than arm-B(33%). Conclusions: Response and compliance to treatment was better in the patients who received NACT followed by concurrent chemo radiation and are able complete treatment and majority of them are asymptomatic. From this it may be concluded that NACT may be considered in stage IVa cervical cancer. However a prospective trial with large number of patients is needed to come to a conclusion.
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