Current Cancer Therapy Reviews - Volume 18, Issue 1, 2022

The heterogeneous and complex nature of cancer is extensively revealed at molecular, genetic, and tissue microenvironment levels. Currently, co-occurrence of coronavirus disease 2019 (COVID-19) to lung cancer patients and severity of infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been understood at preclinical and clinical levels. However, molecular and cellular insights are not discussed in those papers that support the increased COVID-19 severity and comorbidities in several cancer types, including lung cancer patients. Therefore, this perspective highlights the basis of high severity and comorbidities among lung cancer patients infected by COVID-19 with an emphasis on translational aspects.

Conventional cancer therapy kills tumors by applying the maximum tolerable dose of therapy. However, it leads to the development of tumoral heterogeneity and resistance, hence leading to therapy failure and progression. It is necessary to design therapies keeping in mind the evolutionary dynamics of tumors to minimize resistance and delay progression. Mathematical models are of great importance in oncology as they assist in the recreation of the tumor microenvironment, predict the outcomes of treatment strategies and elucidate fundamentals of tumor growth and resistance development. The body of literature covering models which incorporate evolutionary dynamics is vast. This paper provides an overview of existing models of “evolutionary therapy”, including ordinary differential equations, fitness, and probability functions.

Neuroblastoma (NBL) is a highly malignant embryonal tumor that originates from the primordial neural crest cells. NBL is the most common tumor in infants and the most common extracranial solid tumor in children. The tumor is more commonly diagnosed in children of 1-4 years of age. NBL is characterized by enigmatic clinical behavior that ranges from spontaneous regression to an aggressive clinical course leading to frequent relapses and death. Based on the likelihood of progression and relapse, the International Neuroblastoma Risk Group classification system categorized NBL into very low risk, low risk, intermediate risk, and high risk (HR) groups. HR NBL is defined based on the patient's age (> 18 months), disease metastasis, tumor histology, and MYCN gene amplification. HR NBL is diagnosed in nearly 40% of patients, mainly those > 18 months of age, and is associated with aggressive clinical behavior. Treatment strategies involve the use of intensive chemotherapy (CTR), surgical resection, high dose CTR with hematopoietic stem cell support, radiotherapy, biotherapy, and immunotherapy with Anti-ganglioside 2 monoclonal antibodies. Although HR NBL is now better characterized and aggressive multimodal therapy is applied, the outcomes of treatment are still poor, with overall survival and event-free survival of approximately 40% and 30% at 3-years, respectively. The short and long-term side effects of therapy are tremendous. HR NBL carries a high mortality rate accounting for nearly 15% of pediatric cancer deaths. However, most mortalities are attributed to the high frequency of disease relapse (50%) and disease reactiveness to therapy (20%). Newer treatment strategies are therefore urgently needed. Recent discoveries in the field of biology and molecular genetics of NBL have led to the identification of several targets that can improve the treatment results. In this review, we discuss the different aspects of the epidemiology, biology, clinical presentations, diagnosis, and treatment of HR NBL, in addition to the recent developments in the management of the disease.

Background: Herbal drugs and their derived phytochemicals have been used in medicine for the preparation of different types of pharmaceutical products. Pure phytochemicals including flavonoids, alkaloids and terpenoids have been used in medicine for the treatment of different types of human disorders including cancerous disorders. Flavonoids have been well known in medicine for their anti-viral, anti-bacterial, anti-inflammatory, anti-diabetic, anti-cancer, anti-aging and cardioprotective potential. Avicularin, also called quercetin-3-α-l-arabino furanoside, is a pure flavonoid, a class of phytochemicals, found to be present in Lindera erythrocarpa and Lespedeza cuneata. Avicularin has been well known in medicine for its anti-cancer properties. Methods: In the present work, scientific data of avicularin have been collected from different databases such as Google, PubMed, Science Direct, Google Scholar and Scopus and summarized with reference to medicinal importance, pharmacological activities and analytical aspects of avicularin. The present review summarized the health beneficial properties of avicularin in medicine through data analysis of various scientific research works. Further analytical progress in medicine for the qualitative and quantitative analysis of avicularin in medicine has been also discussed in the present work. Results: Scientific data analysis of different literature work revealed the biological importance of flavonoid class of phytochemical ‘avicularin’ in medicine. Scientific data analysis revealed that avicularin was found to be present in the Lindera erythrocarpa, Lespedeza cuneata, Rhododendron schlipenbachii and Psidium guajava. Avicularin has been well known in medicine for its anti-inflammatory, anti-allergic, anti-oxidant, anti-tumor and hepatoprotective activities. Avicularin protects cardiomyocytes and hepatocytes against oxidative stress-induced apoptosis and induces cytotoxicity in cancer lines and tumor tissues. Avicularin has positive influence on human hepatocellular carcinoma and inhibits intracellular lipid accumulation. The role of avicularin in rheumatoid arthritis has been also established with its underlying molecular mechanisms in the scientific work. Recent interest in avicularin has focused on pharmacological investigations for its anti-cancer activity in the medicine. Conclusion: The present work signified the biological importance of avicularin in medicine through its medicinal uses, pharmacological activities and analytical aspects in the biological system.

Background: Recently, a novel therapeutic technique has been revealed to recruit PDL1 and PD1 inhibitors to promote and enhance the cytotoxic T cell activity in combating the tumor. But unfortunately, several followed patients who didn’t tolerate the drug appeared unfavorable autoimmune side effects, such as anemia, pneumonitis, hepatitis, colitis, in addition to fatigue/ asthenia, decreased appetite, nausea, cough, dyspnea, constipation. Aim: To assess the severity of the adverse reactions of PD-1 and PD-L1 inhibitors in treating patients with positive PD-1 or PD-L1; non-small cell lung cancer patients (NSCLCs), small cell lung cancer (SCLC), nodular sclerosis Hodgkin lymphoma, classic Hodgkin's lymphoma, gastric cancer, renal cell carcinoma, caecal carcinoma, buccal mucosa carcinoma, nasopharyngeal carcinoma, laryngopharynx cancer, bladder cancer, cervical cancer, and melanoma. Materials and Methods: The study data was collected and analyzed randomly from the period of January 2019 to November 2020 from the Mordovian oncological dispensary. The data are collected from the electronic archive of the hospital. Then, we followed up with the patients for the same period, and we recorded the presented adverse reactions. The patients received anti-tumor drug; PD-L1/PD-L inhibitors (Atezolizumab; 1200mg, Pembrolizumab; 200mg, and Nivolumab; 240mg or 3 mg/kg) every 21 or 14 days they got IV infusion of PD-1 and/or PD-L1 inhibitors. After the progression and metastasis of the tumor, the patients received a combination of chemotherapy prior to the immunotherapy. Results: The analyzed data have shown 7.14% of the studied patients (n=28) have developed adverse reactions that ranged from mild to moderate severity (anemia and biochemical tests deviation). Conclusion: These clinical findings supported the moderate risk of developing life-threatening adverse reactions after administration of immune checkpoint inhibitors (Nivolumab, Pembrolizumab, Atezolizumab) to patients with advanced-stage tumors. The patients who were treated with PD-1 inhibitors developed less severe adverse reactions than patients who were treated with PD-L1 inhibitors. The adverse reaction severity depends on the period of administration and the type of the treated tumor, which consequently determines the dose of immunotherapy. Also, the aggressiveness of the autoimmune reactions depends on the patient's immune state and its reactivity.

Background: In recent years, novel metabolites isolated from botanical sources have been attracted much attention due to their traditional and therapeutic significance. The ethnopharmacological studies suggest that Ziziphus mauritiana is a common remedy against several kinds of ailments. Objective: The current study has evaluated the MeOH extract of Ziziphus mauritiana leaves (ZME) through physicochemical, phytochemical, and chromatographic fingerprinting analysis, which displayed an array of biometabolites of pharmacological significance, including flavonoids. Methods: The extract was further examined for anticancer activities, which revealed promising anticancer properties against human lung epithelial carcinoma cells (A549) and induction of apoptosis impart by ROS. The oxidative stress was evaluated in terms of production and accumulation of cytosolic extent of ROS, whereas anticancer perspective was determined by MTT assay, cell morphology analysis, followed by nuclear condensation for the examination of apoptosis induction. Results: Finding suggests that the MeOH extract of ZME markedly exhibited promising anticancer activity against the A549 lung epithelial carcinoma cell. The ZME was found to be most active in the MTT assay against A549 cells, while it was less toxic to normal cells. The intracellular ROS generation was remarkably induced by ZME, which correlated with the ability of the flavonoidrich fractions in the MeOH extract to inhibit cell growth and might induce apoptosis. Conclusion: The present study provides useful insight concerning the promising anticancer potential of ZME against A549 lung carcinomas. However, the clinical correlation will be required for its authorization and the discovery of significant and least noxious novel agents against lung carcinomas.

Objective: The objective of this study is to analyze the characteristics of insertion and maintenance of 163 peripherally inserted central venous catheters in juvenile patients oncological. Methods: This is an observational study of a cross-sectional and longitudinal collection, with quantitative approach of secondary data from patient’s medical records that underwent the procedure for a peripheral insertion central catheter implantation, carried out in a non-profit Health Institution (HI) in Sao Paulo, Brazil, specialized in the treatment of childhood-juvenile cancer, and which attends children and adolescents from all regions of Brazil. Results: The measurement of the external catheter, when greater than 2 centimeters, negatively influences the period of the segment used (p = 0.007) and is associated with catheter removal for unforeseen causes (p = 0.013); displacement was the main cause of unexpected removal of peripherally inserted central venous catheter. Conclusion: Peripherally inserted central venous catheter is a safe option when the entire therapeutic trajectory is reached.