A review on the efficacy and toxicity of different doxorubicin nanoparticles for targeted therapy in metastatic breast cancer.

https://link.springer.com/content/pdf/10.1186/s43046-020-0016-x.pdf

Hepatocellular Carcinoma (HCC) in Egypt: A comprehensive overview

BACKGROUND: Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known. METHODS AND FINDINGS: We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature. CONCLUSIONS: Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction.

/pdf/mammographic-density-and-ageing-a-collaborative-pooled-2ln839tgss.pdf

Mammographic density and ageing : A collaborative pooled analysis of cross-sectional data from 22 countries worldwide

In Egypt, hepatocellular carcinoma (HCC) is the most common form of cancer and direct-acting antivirals (DAA) are administered on a large scale to patients with chronic HCV infection to reduce the risk. In this unique setting, we aimed to determine the association of DAA exposure with early-phase HCC recurrence in patients with a history of HCV-related liver cancer. This was a prospective cohort study of an HCV-infected population from one Egyptian specialized HCC management centre starting from the time of successful HCC intervention. The incidence rates of HCC recurrence between DAA-exposed and nonexposed patients were compared, starting from date of HCC complete radiological response and censoring after 2 years. DAA exposure was treated as time varying. Two Poisson regressions models were used to control for potential differences in the exposed and nonexposed group; multivariable adjustment and balancing using inverse probability of treatment weighting (IPTW). We included 116 patients: 53 treated with DAAs and 63 not treated with DAAs. There was 37.7% and 25.4% recurrence in each group after a median of 16.0 and 23.0 months of follow-up, respectively. Poisson regression using IPTW demonstrated an association between DAAs and HCC recurrence with an incidence rate ratio of 3.83 (95% CI: 2.02-7.25), which was similar in the multivariable-adjusted model and various sensitivity analyses. These results add important evidence towards the possible role of DAAs in HCC recurrence and stress the need for further mechanistic studies and clinical trials to accurately confirm this role and to identify patient characteristics that may be associated with this event.

Increased recurrence rates of hepatocellular carcinoma after DAA therapy in a hepatitis C‐infected Egyptian cohort: A comparative analysis

Colorectal cancer (CRC) is a major cause of death worldwide. Novel non-invasive, high diagnostic value screening test is urgently needed to improve survival rate, treatment and prognosis. Stable, small, circulating microRNA (miRNA) offers unique opportunities for the early diagnosis of several diseases. It acts as tumor oncogenes or suppressors and involve in cell death, survival, and metastasis. Communication between miRNA and carcinogenesis is critical but it still not clear and needs further investigation. The aim of our study is to evaluate the role of miR-210, miR-21, miR-126, as non-invasive diagnostic biomarkers for screening, early detection of CRC, studying their correlation with prognostic variables, and clarifying the roles of miRNAs on HIF-1α-VEGF signaling pathway. The expression of miR-210, miR-21 and miR-126 was performed using qRT-PCR in adenocarcinoma (no = 35), adenomas (no = 51), and neoplasm free controls (no = 101). Serum levels of VEGF and HIF-1α was determined by ELISA Kit. The results show that the expression of miR-210, miR-21, VEGF, HIF-1α was significantly up-regulated while that miRNA-126 was down-regulated in both adenocarcinoma and adenomas compared with controls (p < 0.001 for each). No significant difference was noted comparing patients with adenocarcinoma and adenomas. The three miRNAs correlated with VEGF, HIF-α. The miR-210 and miR-21 associated with TNM classification and clinical staging of adenocarcinoma (p < 0.001) and they show high diagnostic value with sensitivity and specificity 88.6%, 90.1% and 91.4%, 95.0% respectively. Our study revealed that circulating miR-210, miR-21 were up-regulated while miR-126 was down-regulated in CRC and adenomas patients, they all correlated with TNM staging and they had high diagnostic value. HIF-1α VEGF signaling pathways regulated by miRNAs played a role in colon cancer initiation. To the best of our knowledge, this is the first study of this miRNAs panel in CRC in our community. These data suggested that these biomarkers could be a potential novel, non-invasive marker for early diagnosis, screening and predicting prognosis of CRC. Understanding the molecular functions by which miRNAs affect cancer and understanding its roles in modulating the signaling output of VEGF might be fruitful in reducing the incidence and slowing the progression of this dark malignancy.

Role of miRNA-210, miRNA-21 and miRNA-126 as diagnostic biomarkers in colorectal carcinoma: impact of HIF-1α-VEGF signaling pathway

Background. This paper aims to present cancer incidence rates at national and regional level of Egypt, based upon results of National Cancer Registry Program (NCRP). Methods. NCRP stratified Egypt into 3 geographical strata: lower, middle, and upper. One governorate represented each region. Abstractors collected data from medical records of cancer centers, national tertiary care institutions, Health Insurance Organization, Government-Subsidized Treatment Program, and death records. Data entry was online. Incidence rates were calculated at a regional and a national level. Future projection up to 2050 was also calculated. Results. Age-standardized incidence rates per 100,000 were 166.6 (both sexes), 175.9 (males), and 157.0 (females). Commonest sites were liver (23.8%), breast (15.4%), and bladder (6.9%) (both sexes): liver (33.6%) and bladder (10.7%) among men, and breast (32.0%) and liver (13.5%) among women. By 2050, a 3-fold increase in incident cancer relative to 2013 was estimated. Conclusion. These data are the only available cancer rates at national and regional levels of Egypt. The pattern of cancer indicated the increased burden of liver cancer. Breast cancer occupied the second rank. Study of rates of individual sites of cancer might help in giving clues for preventive programs.

/pdf/cancer-incidence-in-egypt-results-of-the-national-population-1jxp00cfdw.pdf

Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program

AML is a complex and dynamic disease whose prognosis depends upon a panel of cytogenetics and molecular abnormalities. The OS in AML is evaluated with a number of driver mutations as NPM1, CEBPA, FLT3-ITD, chromatin and RNA splicing genes, TP53 mutation, chromosomal aneuploidy all together with cytogenetic abnormalities and age. The specific mechanisms underlying leukemogenesis in AML are still poorly understood. Recently, there have been important advances in understanding AML pathogenesis (Döhner et al., 2015; Watts and Nimer 2018) Comprehensive genomic analysis at diagnosis allows AML classification, risk stratification, prognosis, and permits for more selective therapeutic interventions (Thol et al., 2014; Metzeler et al., 2016; Papaemmanuil et al., 2016). In addition molecular profiling has a particularly important role in re-categorizing patients with CN-AML representing half of the newly diagnosed AML patients (Niparuck et al., 2019). CN-AML with mutated NPM1 or a mutated CEBPA, in the absence of FLT3-ITD, has been considered as a low risk AML (Niparuck et al., 2019). The favorable prognostic impact of CEBPA mutations has been further refined to biallelic mutations only (Li et al., 2015). Abstract

IDH Mutations in AML Patients; A Higher Association with Intermediate Risk Cytogenetics

P227 Determination of HLA -A, -B and - DRB1 alleles and HLA-A -B haplotype frequencies in Egyptians based on family study

This study was carried out to investigate if quantification of CMV antigen can be used to risk adapt the prophylaxis for CMV infection in stem cell transplant recipients in order to reduce the cost and the number of patients who are exposed to ganciclovir. Assay for CMV early antigen pp65 on circulating leukocytes was used to monitor early CMV infection in 54 consecutive patients undergoing peripheral blood stem cell transplantation (PBSCT). A total of 201 samples were examined for CMV antigen in peripheral blood leukocytes by the slide method and 40 samples were additionally investigated by flow cytometry. Of 54 patients examined, twenty five patients (46%) were positive for CMV pp65 antigen. Eleven of these patients developed CMV disease following PBSCT. Patients who suffered from CMV disease showed statistically significantly higher OT levels (p = 0.003), higher frequency of complications (p = 0.008) and unfavorable outcome (p = 0.002). Patients who were positive for CMV antigen had a 4.5 times higher risk to develop GVHD. In multivariate analysis, we found that CMV pp65 antigen positivity was the only factor which was independently related to GVHD. On comparing the detection of antigenemia by the slide method to that by flow cytometry, the slide method was statistically significantly more sensitive in diagnosing patients who manifested with CMV-related disease (p = 0.01). Thus, antigenemia can be used to assign PBSCT recipients at risk for CMV disease and risk adapted prophylaxis for CMV can be carried out according to the level of CMV positive leukocytes.

Hossam Kamel

Papers

Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program

IDH Mutations in AML Patients; A Higher Association with Intermediate Risk Cytogenetics

P227 Determination of HLA -A, -B and - DRB1 alleles and HLA-A -B haplotype frequencies in Egyptians based on family study

Level and Onset of CMV-pp65 Antigenemia as Determinants of Risk for CMV-Related Complications in Stem Cell Transplant Recipients

Imatinib Generic in Newly Diagnosed Patients with Chronic Myeloid Leukemia in Chronic Phase: Egyptian National Cancer Institute Experience