News Update on Sarcoma Research: April – 2019

Kaposi sarcoma

Kaposi malignant neoplastic disease (KS) gained public attention as AN AIDS-defining malignancy; its look on the skin was a extremely stigmatizing sign of HIV infection throughout the peak of the AIDS epidemic. The widespread introduction of effective antiretrovirals to regulate HIV by restoring immunocompetence reduced the prevalence of AIDS-related Sunflower State, though Sunflower State will occur in people with well-controlled HIV infection. Sunflower State conjointly presents in people while not HIV infection in older men (classic KS), in Black Africa (endemic KS) and in transplant recipients (iatrogenic KS). The aetiologic agent of Sunflower State is KS herpesvirus (KSHV; conjointly called human herpesvirus-8), and microorganism proteins will induce KS-associated cellular changes that alter the virus to evade the host system and permit the infected cell to survive and proliferate despite infection. Currently, most cases of Sunflower State occur in Black Africa, wherever KSHV infection is current as a result of transmission by secretion in childhood combined by the continued AIDS epidemic. Treatment for early AIDS-related Sunflower State in antecedently untreated patients ought to begin with the management of HIV with antiretrovirals, which often ends up in Sunflower State regression. In advanced-stage Sunflower State, therapy with pegylated liposomal antibiotic drug or paclitaxel is that the most typical treatment, though it’s rarely curative. In Black Africa, Sunflower State continues to possess a poor prognosis. Newer treatments for Sunflower State supported the mechanisms of its pathological process are being explored. [1]

‘When something is this rare … how do you know bad really is bad…?’—views on prognostic discussions from patients with advanced soft tissue sarcoma

Objectives Prognostic revelation among patients with cancer permits open hip to discussion concerning treatment preferences and encourages advance care designing. In rare cancers like soft tissue malignant neoplastic disease, discussions concerning prognostication are difficult. very little is thought concerning the implications of this for patients or their preferences for such data. This qualitative study explores patient-centered accounts of the worth and temporal arrangement of prognostic discussions.

Methods twenty four semistructured interviews were conducted with soft tissue malignant neoplastic disease patients attending one London cancer centre: sixty six feminine, median age fifty three (range 19–82). The study was cross-sectional and participants were at totally different stages of the advanced sickness flight. Interviews were digitally recorded, transcribed verbatim and analysed thematically exploitation the framework approach.

Results All participants understood the incurable nature of advanced malignant neoplastic disease. However, prognostic discussions were rare, continuously patient initiated and didn’t embrace renowned survival information, despite direct participant enquiry. Most participants didn’t would like to debate prognosis at initial identification however wanted to be offered the chance to discuss this at intervals of sickness progression, despite reservations it should not be useful. Participants expected discussions to be practician initiated. 3 themes emerged to elucidate this position and enclosed (1) Rarity inflicting prognostic uncertainty relating patient belief that prognostication in rare cancers was less doubtless to be correct than for common tumours; (2) Avoiding the negatives referring to a would like to not hear unfavourable data and (3) Physical symptoms an improved prognostic indicator than ‘physician guess’.

Conclusions though 17/24 participants most popular to not discuss prognosis at initial identification, they wanted to possess the chance to come back prognostic discussions at intervals of sickness progression. this might facilitate higher advance care designing and finish of life care. [2]

Patterns of sensitivity to a panel of drugs are highly individualised for undifferentiated/unclassified soft tissue sarcoma (USTS) in patient-derived orthotopic xenograft (PDOX) nude-mouse models

Undifferentiated/unclassified soft tissue malignant neoplastic disease (USTS) could be a recalcitrant disease; thus, precise individualized medical care is required. Toward this goal, we tend to antecedently established patient-derived orthotopic transplant (PDOX) models of USTS in nude mice. Here, we tend to determined the extent of individuality of drug response in a very panel on USTS PDOX models from five completely different patients. we tend to antecedently showed that three of the five patients were proof against antibiotic (DOX) despite DOX being first-line medical care. fortnight when orthotopic tumor implantation, PDOX mouse models were randomized into 5 groups: untreated management, DOX, gem-citabine/docetaxel (GEM/DOC), pazopanib (PAZ), temozolomide (TEM). 3 PDOX cases were fully proof against DOX. TEM had high effectiveness for four USTS PDOX models, together with DOX-resistant cases. GEM/DOC and PAZ were effective in 3 USTS PDOX. One case was fully proof against TEM. 2 cases were fully proof against PAZ. The results showed the drug sensitivity pattern for every USTS PDOX was extremely individualized which a minimum of one effective drug may well be found for each. The PDOX model may well be effective in precise individualized drug sensitivity testing that is particularly vital for heterogeneous cancers like USTS, and may provide the patient a larger probability to be treated with an efficient drug. [3]

A serum microRNA classifier for the diagnosis of sarcomas of various histological subtypes

Due to their rarity and variety, sarcomas are tough to diagnose. Consequently, there’s associate degree pressing demand for a completely unique assay for these cancers. during this study, we have a tendency to investigated humor miRNA profiles from 1002 patients with bone and soft tissue tumors representing quite forty three microscopic anatomy subtypes, together with sarcomas, intermediate tumors, and benign tumors, to see whether or not humor miRNA profiles may well be wont to specifically notice sarcomas. current humor miRNA profiles in malignant neoplastic disease patients were clearly distinct from those in patients with different kinds of tumors. exploitation the humor levels of seven miRNAs, we have a tendency to developed a molecular detector, Index VI, that might distinguish malignant neoplastic disease patients from benign and healthy controls with remarkably high sensitivity (90%) and specificity (95%), no matter microscopic anatomy subtype. Index VI provides associate degree approach to the first and precise detection of sarcomas, probably resulting in curative treatment and longer survival.[4]

Delayed Presentation of Bone and Soft Tissue Sarcoma of the Extremity in Makurdi: Do Traditional Bone Setters Play a Role?

Background: Soft tissue and bone sarcomas are rare however are related to high death rate after they occur. this can be partially thanks to delay in presentation to a specialist center .Some tips are introduced to assist early designation of those tumours, however, these tips aren’t continually discovered pro re nata. This study is aimed toward highlight the rising role ancient bone setters could also be taking part in in delaying presentation of patients with sarcomas of the extremity.

Methods: A five year retrospective review of histologically confirmed soft tissue and bone cancer patients was conducted at our hospital. information obtained enclosed socio-demographic characteristics, date symptoms were initial detected, date of initial consultation with a specialist, date of initial specific treatment and history of ancient intervention. growth size, location on the limb, fungation/ ulceration at presentation yet as variety of treatment were noted. Descriptive statistics was done to show frequency and measures of central tendency.

Results: there have been sixteen patients between ages three and sixty five years. Fifteen had soft tissue cancer whereas one was associate degree sarcoma. there have been ten males and half dozen feminines giving a male to female quantitative relation of one.6:1.Mean Patient Delay was fifty six.4 weeks and Mean growth size was twenty five.3 cm. there have been 12(75%) rhabdomyosarcomas and 2(12.5%) Kaposi sarcomas. Seven of the tumours were set within the thigh (43.7%), 2(12.5%) every within the striated muscle region, knee and leg. Out of the half dozen that unhealthy, 5(83.3%) had ancient bone setters intervention with incisions created. Seven had Wide native excision and a couple of had amputation when diagnostic test. Four patients had adjuvant therapy with one year survival in one.

Conclusion: Delay in presentation of cancer is detected a lot of normally among patients with tiny size tumours and people United Nations agency have had ancient bone setters treatment. [5]

Reference

[1] Cesarman, E., Damania, B., Krown, S.E., Martin, J., Bower, M. and Whitby, D., 2019. Kaposi sarcoma. Nature Reviews Disease Primers, 5(1), p.9. (Web Link)

[2] Gough, N., Ross, J.R., Riley, J., Judson, I. and Koffman, J., 2019. ‘When something is this rare… how do you know bad really is bad…?’—views on prognostic discussions from patients with advanced soft tissue sarcoma. BMJ supportive & palliative care, 9(1), pp.100-107. (Web Link)

[3] Kawaguchi, K., Igarashi, K., Miyake, K., Kiyuna, T., Miyake, M., Singh, A.S., Chmielowski, B., Nelson, S.D., Russell, T.A., Dry, S.M. and Li, Y., 2019. Patterns of sensitivity to a panel of drugs are highly individualised for undifferentiated/unclassified soft tissue sarcoma (USTS) in patient-derived orthotopic xenograft (PDOX) nude-mouse models. Journal of drug targeting, 27(2), pp.211-216. (Web Link)

[4] A serum microRNA classifier for the diagnosis of sarcomas of various histological subtypes

Naofumi Asano, Juntaro Matsuzaki, Makiko Ichikawa, Junpei Kawauchi, Satoko Takizawa, Yoshiaki Aoki, Hiromi Sakamoto, Akihiko Yoshida, Eisuke Kobayashi, Yoshikazu Tanzawa, Robert Nakayama, Hideo Morioka, Morio Matsumoto, Masaya Nakamura, Tadashi Kondo, Ken Kato, Naoto Tsuchiya, Akira Kawai & Takahiro Ochiya

Nature Communicationsvolume 10, Article number: 1299 (2019) (Web Link)

[5] Yongu, W. T., Elachi, I. C., Mue, D. D., Kortor, J. N., Soo, C. T., Ahachi, C. N., Ojo, B. A. and Ngbea, J. (2017) “Delayed Presentation of Bone and Soft Tissue Sarcoma of the Extremity in Makurdi: Do Traditional Bone Setters Play a Role?”, Journal of Advances in Medicine and Medical Research, 22(10), pp. 1-8. doi: 10.9734/JAMMR/2017/33753. (Web Link)