Ajit Venniyoor

Bio: Ajit Venniyoor is an academic researcher. The author has contributed to research in topics: Cancer & Renal cell carcinoma. The author has an hindex of 2, co-authored 4 publications receiving 7 citations.

High Occurrence of Non-Clear Cell Renal Cell Carcinoma in Oman.

Abstract: It is conventionally accepted that renal cell carcinoma (RCC) occurs in older patients and the clear cell type is the most common histology. However, ethnic variations exist and this study was carried out to determine the epidemiological pattern of RCC in Oman. Ninety RCC patients who presented to a tertiary care center in the Sultanate of Oman from 2010 to 2014 were studied. The main findings were that the median age of presentation was low, more patients presented with localized stage, and there was a higher incidence of non-clear (especially papillary) histology. Data from other Gulf countries and possible reasons for the different profile are discussed.

Minocycline Improves the Efficacy of EGFR Inhibitor Therapy: A Hypothesis.

Abstract: Skin rash is a side effect of drugs that inhibit Epithelial Growth Factor Receptor (EGFR) as a part of targeted therapy of cancer It’s appearance and severity correlates with survival Minocycline, an oral tetracycline antibiotic, is recommended as treatment (and increasingly, for prevention) of the rash, though infection is seen in only one-third of the patients Minocycline has additional anti-cancer properties such as poly (ADP-ribose) polymerase (PARP) inhibition It is proposed that such properties contribute to the efficacy of EGFR-inhibitors, and can also explain the positive correlation between grade of rash and survival as patients with higher grades of rash are more likely to receive minocycline Early concurrent administration of minocycline is recommended in patients planned for EGFR therapy while awaiting trials proving this hypothesis

The Troubling Link Between Non-alcoholic Fatty Liver Disease (NAFLD) and Extrahepatic Cancers (EHC).

Abstract: Non-alcoholic fatty liver disease (NAFLD) is a fast-spreading epidemic across the globe and has serious implications far beyond that of a "benign" liver condition. It is usually an outcome of ectopic fat storage due to chronic positive energy balance leading to obesity and is associated with multiple health problems. While association with cardiovascular disease and hepatocellular cancer is well recognized, it is becoming clear the NAFLD carries with it an increased risk of cancers of extrahepatic tissues. Studies have reported a higher risk for cancers of the colon, breast, prostate, lung, and pancreas. Fatty liver is associated with increased mortality; there is an urgent need to understand that fatty liver is not always benign, and not always associated with obesity. It is, however, a reversible condition and early recognition and intervention can alter its natural history and associated complications.

Early Chemotherapy in Metastatic Prostate Cancer Improves Survival: a Quick Note to Surgical Colleagues

Abstract: Metastatic prostate cancer is a hormone sensitive cancer. For patients with prostate cancer, general surgeons and urologists are the points of first contact. Historically, restricted treatment options meant that such patients were started on, and continued hormonal therapy with them. Chemotherapy is started once these tumours became hormone-refractory, with limited survival benefits. However, three recently published randomized, Phase III trials (GETUG-AFU15, CHAARTED, STAMPEDE) have provided Level I evidence that upfront chemotherapy in hormone sensitive metastatic prostate cancer dramatically improves survival, especially in those with heavy volume disease (an increase of up to 22 months). The authors recommend that general surgeons and urologists discuss patients in multi-disciplinary tumour boards so that fit patients can receive the benefits of upfront chemotherapy.

EGFR Inhibitors and Cutaneous Complications: A Practical Approach to Management

Abstract: Epidermal growth factor receptor inhibitors (EGFRIs) are increasingly being used for malignancies of epithelial origin. Though these therapies are better tolerated than conventional chemotherapy, they have unique side-effect profiles that are related to their mechanism of action. Given the function of the epidermal growth factor receptor in the skin, nails, and hair, dermatologic side effects are commonly seen with the use of EGFRIs. This review includes a practical approach to recognizing and treating the most common dermatologic side effects seen with EGFRIs, including papulopustular eruptions, nail changes, xerosis and pruritus, hair changes, mucositis, and radiation dermatitis exacerbations.

Renal Cell Carcinoma metastasizing to larynx: a case report.

Abstract: Renal Cell Carcinoma (RCC) is a malignant tumor occurring in 5th-6th decade of life with an increasing incidence reported in the US but stable in Europe. The metastasis of RCC to head and neck region is infrequent and very rarely seen in larynx. Very few cases of RCC metastasizing to larynx are reported in literature. We report a case of RCC in a middle aged male with metastasis to larynx, 7 years after initial diagnosis and nephrectomy. These unusual tumor metastases have unique pathobiology and route of metastasis, and there can be a long interval from initial diagnosis of primary tumor. The diagnosis of metastatic RCC in unusual locations is often not easy. Treatment options include metastasectomy, radiotherapy and systemic chemotherapy but with a poor outcome. A differential diagnosis should always be considered in metastatic head and neck tumors. The need for prompt accurate diagnosis, risk stratification at initial primary diagnosis, surveillance, and long term regular follow up is emphasized.

Survey of cutaneous adverse reactions to targeted cancer therapies: value of dermatological advice.

Abstract: BACKGROUND Target-therapy offers a better efficacy for several cancers, with less toxic adverse effects, if compared with traditional chemotherapy. However cutaneous complications are increased in number and complexity. The severity of these reactions positively correlates with efficacy, and the management of these reactions is challenging. METHODS This was a multicenter cross-sectional study on a consecutive series of adult patients with incident cutaneous reactions linked to targeted cancer therapies observed in five referral centers for cancer treatment in the province of Bergamo and Brescia in northern Italy. Each center was asked to collect data on the first 5 consecutive cases of severe adverse cutaneous events observed during a one-week surveillance period. RESULTS From June to October 2012, 25 patients with cutaneous adverse reactions linked to targeted therapies were included in the study. The main prescribed drugs were cetuximab (52%) and erlotinib (20%) and the most common reactions were folliculitis/pustules (40%) and rash/erythema (40%). Hand-foot reaction syndrome was present in 8% of patients. A total of 30% of patients treated for a cutaneous reaction underwent a consultation by a dermatologist. In these patients the rate of oncologic therapy continuation without regimen modifications was higher (100%), while it was progressively lower in patients treated by oncologists (71%) or without any specific treatment (60%). CONCLUSIONS Adverse reaction should be recognized by both dermatologists and oncologists and a multidisciplinary approach is mandatory.

Irisin Is Related to Non-Alcoholic Fatty Liver Disease (NAFLD)

Abstract: Irisin is a cytokine involved in many metabolic pathways occurring, among others, in muscles, adipose tissue and liver. Thus, fluctuations in irisin levels are suggested to be related to metabolic diseases. Therefore, the purpose of our study was to evaluate whether irisin may be associated with non-alcoholic fatty liver disease (NAFLD). A total of 138 patients (70/68 male/female, mean age 65.61 ± 10.44 years) were enrolled in the study. The patients were assigned to the NAFLD group (n = 72, including 46 patients with type 2 diabetes (T2DM]) and the group without NAFLD (n = 66, 31 patients with T2DM). NAFLD was diagnosed based on ultrasound examination, Hepatic Steatosis Index (HSI) and Fatty Liver Index. Baseline anthropometric, blood pressure and biochemical parameters were collected. The serum irisin level was determined using an ELISA test. We observed that NAFLD was associated with an increased concentration of irisin. Moreover, Spearman correlations and linear regression analysis revealed that irisin level correlates with some anthropometric and biochemical parameters such as body mass index, glycated hemoglobin, aspartic aminotransferase, creatinine and urea. Logistic regression analysis depicted that odds for NAFLD increase 1.17 times for each 1 μg/mL rise of irisin concentration. Finally, ROC analysis showed that the concentration of irisin possesses a discriminate capacity for NAFLD and optimal cut points concentration could be designed. The risk of NAFLD in the subgroup with irisin concentration above 3.235 μg/mL was 4.57 times higher than in patients with the lower concentration of irisin. To conclude, the obtained results suggest that irisin concentration is associated with some anthropometric and biochemical parameters and should be further investigated toward its usage as a diagnostic biomarker of NAFLD.