Itraconazole is an oral antifungal that has a been reported to have anticancer effect in non-small cell lung cancer (NSCLC) through inhibition of angiogenesis. The aim is to evaluate the effect of using itraconazole on the clinical outcome of metastatic NSCLC. This was a prospective randomized controlled open-label study conducted on 60 chemotherapy-naive metastatic NSCLC. Patients were simply randomized to either Control group who received platinum-based chemotherapy for a maximum of six cycles or Itraconazole group who received the same chemotherapy regimen in addition to itraconazole 200 mg daily for 21 days starting from day 1 in each cycle. Primary outcome was 1-year progression-free survival (PFS) while secondary outcomes included overall response rate (ORR), 1-year overall survival (OS) and tolerability. The two groups were comparable at baseline with no significant difference between groups regarding demographics and clinical characteristics. The ORR in Control group was 66.7% versus 90% in Itraconazole group (p value 0.028). There was a significant difference between groups regarding PFS where the mean 1-year PFS was 5.415 months in Control group versus 6.556 months in Itraconazole group (p value = 0.002). However, there was no significant difference between groups with respect to 1-year OS. All adverse effects reported were tolerable except for one patient who developed grade 2 cardiotoxicity in Itraconazole group requiring itraconazole discontinuation. Itraconazole use was beneficial in NSCLC in terms of 1-year PFS and ORR which was not reflected by improvement in 1-year OS. Clinical trial.gov registration number: NCT03664115, date of registration:

Third-line treatment with trifluridine/tipiracil (FTD/TPI) is recommended for patients with metastatic colorectal cancer (mCRC) or gastric/gastroesophageal cancer (GC) who have progressed beyond first- and second-line therapy. We describe a patient with long-term survival following treatment with FTD/TPI. The patient, a 70-year-old woman diagnosed with right-sided mCRC (T3/N1) with metastases to the aortocaval and precaval lymph nodes, received first-line panitumumab and capecitabine for 6 months, followed by second-line bevacizumab and oxaliplatin. She had disease progression following 9 months of second-line therapy and began third-line treatment with FTD/TPI (50 mg bid). Three months after treatment initiation, lymph node involvement was reduced, and following 12 months of FTD/TPI treatment, her disease had stabilized, and she reported no treatment-related adverse events. She remained on the same dose of FTD/TPI for more than 27 months after initiating treatment, with maintenance of stable disease. This patient with mCRC demonstrated a survival benefit with FTD/TPI beyond those reported in published clinical trial data and real-world studies.

ObjectiveThe aim of the present study was to investigate the effect of dendritic cell (DC)/cytokine-induced killer cell (CIK) immunobiological cancer therapy in patients with triple-negative breast cancer (TNBC) who underwent adjuvant chemotherapy.MethodsFrom January 2010 to October 2013, 120 patients with postoperative TNBC were recruited and included in the study. Patients were enrolled in one of two groups according to whether they accepted DC/CIK immunobiological cancer therapy during adjuvant chemotherapy; the patients in the DC/CIK group underwent adjuvant chemotherapy combined with DC/CIK immunobiological cancer therapy, and the control group underwent adjuvant chemotherapy alone. When six cycles of adjuvant chemotherapy and six cycles of DC/CIK immunobiological cancer therapy had been completed, differences between the two groups with regard to quality of life (QoL), immunological indicators (CD3, CD4, CD8, and NK cell levels), disease-free survival (DFS), and side effects of chemotherapy and DC/CIK treatment were evaluated.ResultsIn the DC/CIK group, the proportion of NK cells and CD3+ and CD4+ T-cell subgroups significantly increased, and the proportion of CD8+ cells decreased when they were compared before and after DC/CIK therapy (P < 0.05). However, there were no significant changes in the control group. By the final follow-up, DFS of the treatment group and the control group was 38.4 and 34.2 months, respectively. The QoL improved in the patients treated with chemotherapy plus DC/CIK therapy compared with the patients treated with chemotherapy alone, and the difference between groups was significant (P < 0.05). The side effects of two groups were tolerable and not significantly different between the two groups.ConclusionThe DC/CIK treatment had potential benefits for patients with TNBC compared with the control group, and was not associated with any obvious side effects. Therefore, DC/CIK therapy is a safe and effective method for the treatment of TNBC.

Background The palliative role of chemoradiation in treatment of patients with locally advanced non-small-cell lung cancer remains unresolved; Controversy remains about whether long term and high doses radiotherapy provide better results than short course schedules in treatment of inoperable stage III NSCLC and negative prognostic factors poor performance status (PS), large tumor, poor pulmonary functions and comorbidities.Hypofractionated radiotherapy can expose tumors to a high dose of radiation in a short period of time. Methods One hundred and ten patients with locally advanced stage III NSCLC with poor prognosyic factors were randomized to receive either definitive chemoradiation or palliative chemoradiation in cancer department of faculty of medicine of AIN SHAMS UNIVERSITY .Arm (A) patients will receive induction chemotherapy with two cycles of carboplatin(AUC6) and paclitaxel 175mg/m²) cycles every 21 day, the third cycle administrated with radiotherapy with low dose of carboplatin(AUC 2) and paclitaxel 60 mg/m² on day 1& 8 administrated concomitant with the radiotherapy 42 Gy over 15 fraction over 3 weeks. Arm (B) patients will receive standard-dose fractionation of radiation 60Gy/6 weeks 2Gy once per day with concurrent weekly low dose of carboplatin (AUC 2) and paclitaxel 60 mg/m² followed by two cycles of full doses of carboplatin (AUC 6) /paclitaxel 175mg/ m² every 21 days.the primary end points were overall survival and progression free survival;secondary end points were health related quality of life(HRQOL) and toxicity. Results The median follow-up duration was 24 months in surviving patients’ .Median survival and 2-year OS were in concurrent palliative chemoradiation arm 4.7 and 12.3-months respectively and was 7.3 and 17.6 in concurrent definitive chemoradiatiobn arm respectively (p &lt; 0.01). HRQOL was better in the palliative arm during the treatment but remained unchanged in both arms during the follow up visits. There were more hospital admissions related to side effects in the definitive chemoradiation arm (p &lt; 0.05). Conclusions This study confirmed that the definitive chemoradiation was superior to palliative chemoradiation arm with respect to survival.the treatment related toxicity and HRQOL were better in the palliative chemoradiation arm than the definitive arm.

Background: Colorectal cancer (CRC) is the third most common cancer in men and second in women with 1.8 million new cases (1,026,000 men and 823, 3 women) and almost 881.000 deaths. Rates are substantially higher in males than in females Worldwide in 2018. Aim of the work: In this retrospective study we aimed to evaluate the prognostic impact of baseline NLR and platelet count on the clinicopathological factors and outcome in patients of all stages Colorectal cancer treated from 1st of January 2014 to the end of December 2016 in Department of Clinical Oncology and Nuclear Medicine, Ain Shams University hospitals, Cairo, Egypt. Patients and methods: Out of 409 patient's medical records in the GI oncology unit, Ain Shams Clinical Oncology Department were reviewed from the period between 1st of January 2014 to 30 December 2016. Total neutrophils, lymphocytic, and platelets' counts were available for only 169 patients. Study ended in 1st of August 2018 with median period of follow up of 27.5 month, ranging between 1/1/2014 to 1/8/2018. All patients (169) were pathologically proven colorectal adenocarcinoma, with age ranging from 18-75 years old (median age: 55.5 yrs.) Results: Out of 169 patients enrolled in this study, 124 patients were resectable and underwent curative surgeries, 44 patients tumour was right located and 80 patient's tumour located in the left sided colon. 45 patients were metastatic from the start. Postoperative Platelets ≥ 310 in our study was statistically significant regarding OS, PFS and DFS (P values <.001, <.001 and 0.007) respectively. Pre-treatment platelet revealed more frequent thrombocytosis in metastatic group than locally advanced group, yet statistically was not significant (P Value = .066). Postoperative NLR ≥ 2 was significant regarding OS, PFS and DFS among 169 enrolled patients (P values <.001, .002 and <.001) respectively. In the multivariate analysis, elevated postoperative NLR was proven as both independent prognostic and predictor factor for DFS, PFS and OAS. (sig. =.03, .03, ≤ 0.001 respectively). And platelet count is both independent prognostic factor and predictor for both PFS, OS with significance =.04, =.03 respectively). Conclusion: Abnormal NLR ratio (≥ 2) acting as a prognostic and predictor of decrease in DFS, PFS and OS in all patients groups. It also showed that abnormal platelet count (≥ 310) is prognostic and predictor of significant decrease in PFS and OS. Multidisciplinary management is needed to aware surgeons about importance of adequate lymph node dissection, our study showed a statistically significant decrease in OAS in patients underwent inadequate LNs dissection.

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