The comparison of 3 approaches with neuropathic cancer pain diagnosis demands that careful etiological assessment and standardized clinical criteria be applied to this clinical condition.

ObjectivesDuring the COVID-19 pandemic, telemedicine (TM) emerged as an important mean to reduce risks of transmission, yet delivering the necessary care to patients. Our aim was to evaluate feasibility, characteristics and satisfaction for a TM service based on phone/video consultations for patients with cancer attending an outpatient palliative care clinic during COVID-19 pandemics.MethodsA longitudinal observational study was conducted from April to December 2020. Consecutive patients were screened for video consultations feasibility. Either patients or their caregivers received video/phone consultations registering reason and intervention performed. Those contacted at least twice were eligible for experience of care assessment.ResultsVideo consultations were feasible in 282 of 572 screened patients (49%, 95% CI 45% to 52%); 112 patients among the 572 had at least two phone/video consultations and 12 of them had one or more video consultations. Consultations were carried out with patients (56%), caregivers (30%) or both (14%). 63% of the consultations were requested by the patients/caregivers. Reasons for consultation included uncontrolled (66%) or new symptom onset (20%), therapy clarifications (37%) and updates on diagnostic tests (28%). Most interventions were therapy modifications (70%) and appointments’ rescheduling (51%). 49 patients and 19 caregivers were interviewed, reporting good care experience (average of 1–5 satisfaction score of 3.9 and 4.2, respectively). The majority (83% and 84%) declared they would use TM after the pandemics.ConclusionsAlthough feasibility is still limited for some patients, TM can be a satisfactory alternative to in-person visits for palliative care patients in need of limiting access to the hospital.

Objectives: The rapid fatality of pancreatic cancer is, in large part, the result of diagnosis at an advanced stage in the majority of patients. Identification of individuals at risk of developing pancreatic adenocarcinoma would be useful to improve the prognosis of this disease. There is presently no biological or genetic indicator allowing the detection of patients at risk. Our main goal was to identify copy number variants (CNVs) common to all patients with sporadic pancreatic cancer. Methods: We analyzed gene CNVs in leukocyte DNA from 31 patients with sporadic pancreatic adenocarcinoma and from 93 matched controls. Genotyping was performed with the use of the GeneChip Human Mapping 500K Array Set (Affymetrix). Results: We identified 431 single nucleotide polymorphism (SNP) probes with abnormal hybridization signal present in the DNA of all 31 patients. Of these SNP probes, 284 corresponded to 3 or more copies and 147 corresponded to 1 or 0 copies. Several cancer-associated genes were amplified in all patients. Conversely, several genes supposed to oppose cancer development were present as single copy. Conclusions: These data suggest that a set of 431 CNVs could be associated with the disease. This set could be useful for early diagnosis.

Background: Pain is a prevalent symptom in patients with advanced cancer. Recognition of prognostic factors associated with pain intensity, could help provide better assessment, leading to better pain management. Aim: identifying prognostic factors which could guide improvements on cancer pain classification. Design: a prospective observational study on chronic cancer pain, exploring the association between average mean pain intensity during a 28 days study follow-up and patients’ clinical and pain-related characteristics, including pain syndromes. To evaluate these associations, a mixed model was built. Setting/participants: Patients attending a Palliative Care and Pain Outpatient Clinic from May 2015 to June 2019 were screened. Patients with moderate to severe cancer pain who were already receiving or needed treatment with third step WHO ladder opioids were enrolled in the study. Data from 342 patients with at least one follow-up visit were analyzed. Results: Pain intensity decreased significantly for all patients during time ( p < 0.001). Age, sex, emotional distress, pain duration and neuropathic pain presence evaluated by the Douleur Neuropathique 4 Questions (DN4) questionnaire were not significantly associated to pain intensity. Breakthrough/episodic pain was associated with higher pain intensity during follow-up ( p < 0.001). The diagnosis of pain syndrome was overall significantly associated with mean pain intensity during follow-up ( p = 0.016). Particularly, the concurrent presence of visceral and soft ( p = 0.026) or soft and nervous tissue pain ( p = 0.043) were significantly related to worse outcome, whereas pain due to only soft tissue damage with better outcome ( p = 0.032). Conclusions: The recognition of specific pain syndromes may help to better classify cancer pain.

Introduction: Treatment of ovarian cancer has been long standardized with the inclusion of surgery and chemotherapy based on platinum and taxanes,\ud this strategy reaching high remission rates. However, when this treatment\ud fails, further options are available with little benefit. Since ovarian cancer\ud has specific immunologic features, actually immunotherapy is under evalua- 15\ud tion to overcome treatment failure in patients experiencing recurrence.\ud Areas covered: Immunogenicity of ovarian cancer and its relationship with\ud clinical outcomes is briefly reviewed. The kinds of immunotherapeutic strategies\ud are summarized. The clinical trials investigating immunotherapy in\ud recurrent ovarian cancer patients are reported. 20\ud Expert opinion: The results of these clinical trials about immunotherapy are\ud interesting, but little clinical benefit has been achieved until now. For this\ud reason, we could conclude that immunotherapy is quite different from other\ud treatment options and it could change the global approach for recurrent\ud ovarian cancer treatment. However, to date only fragmentary findings are 25\ud available to define the real role of immunotherapy in this setting