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Asakitogum DA, Nutor JJ, Pozzar R, Hammer M, Miaskowski C. Systematic Review of the Literature on Multiple Co-occurring Symptoms in Patients Receiving Treatment for Gynecologic Cancers. Semin Oncol Nurs 2024; 40:151572. [PMID: 38246840 DOI: 10.1016/j.soncn.2023.151572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Patients with gynecologic cancers experience a very high symptom burden that has a negative impact on their quality of life. This systematic review aims to identify the common co-occurring symptoms, the prevalence of common symptoms, common instruments used to measure symptoms, associated risk factors, and the symptom burden in patients with gynecologic cancers. DATA SOURCES A search of four databases (ie, PubMed, Embase, Web of Science, and CINAHL) was done from January 1, 2012, through September 5, 2022. A qualitative synthesis of the extant literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA 2020). CONCLUSION A total of 118 studies met the prespecified inclusion criteria. Ninety-six symptoms were assessed across these studies. The top six symptoms and their grand mean prevalence rates were lack of energy (64.4%), fatigue (62.1%), abdominal pain (53.3%), depression (52.6%), concentration dysfunction (52.0%), and drowsiness (51.9%). Numerous methodologic challenges were evident across studies. Future research needs to develop a disease-specific symptom assessment measure, evaluate for risk factors associated with a higher symptom burden, and determine the impact of multiple symptoms on patient outcomes. IMPLICATION FOR NURSING PRACTICE The results are relevant for oncology clinicians to assess patients with gynecologic cancers for the presence of common symptoms and risk factors for higher symptom burden in the patients and to offer effective management interventions.
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Affiliation(s)
- David Ayangba Asakitogum
- Doctoral student, Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA.
| | - Jerry John Nutor
- Assistant Professor, Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA
| | - Rachel Pozzar
- Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Marilyn Hammer
- Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA; Director, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA
| | - Christine Miaskowski
- Professor, Departments of Physiological Nursing and Anesthesia, School of Nursing and Medicine, University of California, San Francisco, CA
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Wang W, Yuan G, Wan S, Zheng Z, Liu D, Zhang H, Li J, Zhou Y, Wang X. A granularity-level information fusion strategy on hypergraph transformer for predicting synergistic effects of anticancer drugs. Brief Bioinform 2023; 25:bbad522. [PMID: 38243692 PMCID: PMC10796255 DOI: 10.1093/bib/bbad522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/08/2023] [Accepted: 12/19/2023] [Indexed: 01/21/2024] Open
Abstract
Combination therapy has exhibited substantial potential compared to monotherapy. However, due to the explosive growth in the number of cancer drugs, the screening of synergistic drug combinations has become both expensive and time-consuming. Synergistic drug combinations refer to the concurrent use of two or more drugs to enhance treatment efficacy. Currently, numerous computational methods have been developed to predict the synergistic effects of anticancer drugs. However, there has been insufficient exploration of how to mine drug and cell line data at different granularity levels for predicting synergistic anticancer drug combinations. Therefore, this study proposes a granularity-level information fusion strategy based on the hypergraph transformer, named HypertranSynergy, to predict synergistic effects of anticancer drugs. HypertranSynergy introduces synergistic connections between cancer cell lines and drug combinations using hypergraph. Then, the Coarse-grained Information Extraction (CIE) module merges the hypergraph with a transformer for node embeddings. In the CIE module, Contranorm is a normalization layer that mitigates over-smoothing, while Gaussian noise addresses local information gaps. Additionally, the Fine-grained Information Extraction (FIE) module assesses fine-grained information's impact on predictions by employing similarity-aware matrices from drug/cell line features. Both CIE and FIE modules are integrated into HypertranSynergy. In addition, HypertranSynergy achieved the AUC of 0.93${\pm }$0.01 and the AUPR of 0.69${\pm }$0.02 in 5-fold cross-validation of classification task, and the RMSE of 13.77${\pm }$0.07 and the PCC of 0.81${\pm }$0.02 in 5-fold cross-validation of regression task. These results are better than most of the state-of-the-art models.
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Affiliation(s)
- Wei Wang
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
- Key Laboratory of Artificial Intelligence and Personalized Learning in Education of Henan Province 453007, China
| | - Gaolin Yuan
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
| | - Shitong Wan
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
| | - Ziwei Zheng
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
| | - Dong Liu
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
- Key Laboratory of Artificial Intelligence and Personalized Learning in Education of Henan Province 453007, China
| | - Hongjun Zhang
- Hebi Instiute of Engineering and Technology, Henan Polytechnic University, 458030, China
| | - Juntao Li
- School of Mathematics and Information Science, Henan Normal University, 453007 Xinxiang, China
| | - Yun Zhou
- College of Computer and Information Engineering, Henan Normal University, 453007 Xinxiang, China
- Key Laboratory of Artificial Intelligence and Personalized Learning in Education of Henan Province 453007, China
| | - Xianfang Wang
- College of Computer Science and Technology Engineering, Henan Institute of Technology, 453000, China
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Pergialiotis V, Sotiropoulou IM, Liatsou E, Liontos M, Frountzas M, Thomakos N, Rodolakis A, Haidopoulos D. Quality of life of ovarian cancer patients treated with combined platinum taxane chemotherapy: a systematic review of the literature. Support Care Cancer 2022; 30:7147-7157. [PMID: 35459954 DOI: 10.1007/s00520-022-07053-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Chemotherapy is the cornerstone of adjuvant therapy in ovarian cancer. Its impact on the quality of life (QoL) has been addressed in several studies; however, several misperceptions concerning this affect patient counseling and physicians' ability to overcome patient fears. In the present systematic review, we sought to accumulate current evidence in the field in order to help establish robust information that will help physicians answer patients' questions. METHODS The present systematic review is based on the PRISMA guidelines. Studies that evaluated patient QoL pre-, during, and post-chemotherapy with the use of the QLQC-30 were selected for inclusion. Their methodological quality was assessed with the before-after studies tool that is proposed by the National Institute of Health (NIH). RESULTS Ten studies that involved 5181 patients were included in the present systematic review. The risk of bias and methodological quality of included studies was of good and fair overall quality. Retrieved data suggest there is substantial evidence that points toward improved global QoL among ovarian cancer patients treated with taxanes-platinum combination therapy. Individual outcomes evaluated with the QLQ-C30 also provide positive results, although underreporting was noted. CONCLUSION Despite the significant heterogeneity in outcome reporting, the findings of this study reveal the significant benefit of combined platinum taxane chemotherapy on the QoL of ovarian cancer patients and can be used for patients counseling in order to reduce refusals that arise from fear of adverse effects that may negatively affect QoL. Graphical abstract.
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Affiliation(s)
- Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece. .,Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece.
| | - Ioanna Myrto Sotiropoulou
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Efstathia Liatsou
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Michalis Liontos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maximos Frountzas
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Nikolaos Thomakos
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Rodolakis
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Haidopoulos
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Paclitaxel Drug Delivery Systems: Focus on Nanocrystals' Surface Modifications. Polymers (Basel) 2022; 14:polym14040658. [PMID: 35215570 PMCID: PMC8875890 DOI: 10.3390/polym14040658] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 12/13/2022] Open
Abstract
Paclitaxel (PTX) is a chemotherapeutic agent that belongs to the taxane family and which was approved to treat various kinds of cancers including breast cancer, ovarian cancer, advanced non-small-cell lung cancer, and acquired immunodeficiency syndrome (AIDS)-related Kaposi’s sarcoma. Several delivery systems for PTX have been developed to enhance its solubility and pharmacological properties involving liposomes, nanoparticles, microparticles, micelles, cosolvent methods, and the complexation with cyclodextrins and other materials that are summarized in this article. Specifically, this review discusses deeply the developed paclitaxel nanocrystal formulations. As PTX is a hydrophobic drug with inferior water solubility properties, which are improved a lot by nanocrystal formulation. Based on that, many studies employed nano-crystallization techniques not only to improve the oral delivery of PTX, but IV, intraperitoneal (IP), and local and intertumoral delivery systems were also developed. Additionally, superior and interesting properties of PTX NCs were achieved by performing additional modifications to the NCs, such as stabilization with surfactants and coating with polymers. This review summarizes these delivery systems by shedding light on their route of administration, the methods used in the preparation and modifications, the in vitro or in vivo models used, and the advantages obtained based on the developed formulations.
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Sarkar S, Sahoo PK, Pal R, Mistry T, Mahata S, Chatterjee P, Vernekar M, Mandal S, Bera T, Nasare VD. Assessment of quality of life among advanced ovarian cancer patients in a tertiary care hospital in India. Support Care Cancer 2022; 30:3371-3378. [PMID: 34988703 DOI: 10.1007/s00520-021-06735-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The study aims to record the quality of life (Qol) and its changes while ovarian cancer (OC) patients undergo debulking surgeries and chemotherapy in a tertiary care hospital of Eastern India. METHODS Patients with advanced epithelial OC (FIGO stages III-IV) were recruited. They underwent primary/interval debulking surgeries with classical chemotherapy (adjuvant/neoadjuvant) of intravenous tri-weekly doses of paclitaxel + carboplatin. QoL was assessed using Fact- O + FACIT-Sp-12 questionnaire with a set of 51 questions in different domains (spiritual, physical, social, emotional, and functional factors) and a special set for OC patients under the heading "Additional concerns." The responses from patients were recorded at baseline (diagnosis/study entry), 2, 4, and 6 months during the treatment visits. Overall survival (OS) was assessed using Kaplan Meier curve. RESULTS A majority of patients were 49.15±10.8 years of age, school-educated (54%), unemployed/homemakers (73.5%), belonging from rural setup (64.6%) with a monthly income of Rs. 2000/- to Rs. 5000/-. There was no statistically significant (p>0.05) improvement found in Qol from the baseline till the end of the study, neither overall nor in subsets (responders (Rs)/partial responders (PRs)/non-responder (NRs) groups or the adjuvant and neoadjuvant chemotherapy groups). The common toxicities like anemia, constipation, and weight loss were significantly (p<0.05) correlated with the patients' physical, functional, emotional, and social well-being. CONCLUSION Ovarian cancer patients represent a poor functional, social, and disease-specific quality of life that needs to be addressed, identified, and improved by the growing nexus of healthcare providers and researchers.
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Affiliation(s)
- Sinjini Sarkar
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India.,Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Rd, Kolkata, 700032, India
| | - Pranab K Sahoo
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Ranita Pal
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Tanuma Mistry
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Sutapa Mahata
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Puja Chatterjee
- Department of Gynaecological Oncology, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Manisha Vernekar
- Department of Gynaecological Oncology, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Syamsundar Mandal
- Department of Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India
| | - Tanmoy Bera
- Department of Pharmaceutical Technology, Jadavpur University, 188, Raja S. C. Mallick Rd, Kolkata, 700032, India
| | - Vilas D Nasare
- Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, 700026, India.
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Hirte H, Poon R, Yao X, May T, Ethier JL, Petz L, Speakman J, Elit L. Neoadjuvant and adjuvant systemic therapy for newly diagnosed stage II- IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma: A systematic review. Crit Rev Oncol Hematol 2021; 162:103324. [PMID: 33862245 DOI: 10.1016/j.critrevonc.2021.103324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To systematically review neoadjuvant and adjuvant therapy options for women with newly diagnosed stage II-IV ovarian cancer. METHODS Phase III trials were searched using MEDLINE, EMBASE, and Cochrane Library. Maintenance therapies were excluded. RESULTS Thirty-three trials were included. For women with high-risk profiles that would contraindicate upfront cytoreductive surgery, neoadjuvant chemotherapy can be an option. In the post-surgical adjuvant setting, the three-weekly regimen consisting of paclitaxel and carboplatin remains the standard of care. Docetaxel may be offered to those who are unable to tolerate paclitaxel. Intraperitoneal cisplatin and paclitaxel increased OS for stage III optimally debulked women (GOG 172). The intraperitoneal regimens in GOG 252 offered no survival benefit and some harms in terms of toxicity and quality of life. CONCLUSIONS There is no evidence to support adding a third agent to the standard carboplatin and paclitaxel. Results of the iPocc study will clarify the role of intraperitoneal chemotherapy.
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Affiliation(s)
- Hal Hirte
- Division of Medical Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
| | - Raymond Poon
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
| | - Xiaomei Yao
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Taymaa May
- Department of Obstetrics and Gynecology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Josee-Lyne Ethier
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Cancer Centre of Southeastern Ontario, Department of Oncology and Medicine, Queen's University, Kingston, Ontario, Canada
| | - Lauri Petz
- Patient Representative, North Bay, Ontario, Canada
| | - Jane Speakman
- Patient Representative, Sutton West, Ontario, Canada
| | - Laurie Elit
- Department of Obstetrics and Gynecology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
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Levit SL, Tang C. Polymeric Nanoparticle Delivery of Combination Therapy with Synergistic Effects in Ovarian Cancer. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:1048. [PMID: 33923947 PMCID: PMC8072532 DOI: 10.3390/nano11041048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 12/23/2022]
Abstract
Treatment of ovarian cancer is challenging due to late stage diagnosis, acquired drug resistance mechanisms, and systemic toxicity of chemotherapeutic agents. Combination chemotherapy has the potential to enhance treatment efficacy by activation of multiple downstream pathways to overcome drug resistance and reducing required dosages. Sequence of delivery and the dosing schedule can further enhance treatment efficacy. Formulation of drug combinations into nanoparticles can further enhance treatment efficacy. Due to their versatility, polymer-based nanoparticles are an especially promising tool for clinical translation of combination therapies with tunable dosing schedules. We review polymer nanoparticle (e.g., micelles, dendrimers, and lipid nanoparticles) carriers of drug combinations formulated to treat ovarian cancer. In particular, the focus on this review is combinations of platinum and taxane agents (commonly used first line treatments for ovarian cancer) combined with other small molecule therapeutic agents. In vitro and in vivo drug potency are discussed with a focus on quantifiable synergistic effects. The effect of drug sequence and dosing schedule is examined. Computational approaches as a tool to predict synergistic drug combinations and dosing schedules as a tool for future nanoparticle design are also briefly discussed.
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Affiliation(s)
- Shani L Levit
- Chemical and Life Science Engineering Department, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Christina Tang
- Chemical and Life Science Engineering Department, Virginia Commonwealth University, Richmond, VA 23284, USA
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Yuan D, Zhou H, Sun H, Tian R, Xia M, Sun L, Liu Y. Identification of key genes for guiding chemotherapeutic management in ovarian cancer using translational bioinformatics. Oncol Lett 2020; 20:1345-1359. [PMID: 32724377 PMCID: PMC7377160 DOI: 10.3892/ol.2020.11672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/01/2020] [Indexed: 12/13/2022] Open
Abstract
The emergence of resistance to chemotherapy drugs in patients with ovarian cancer is still the main cause of low survival rates. The present study aimed to identify key genes that may provide treatment guidance to reduce the incidence of drug resistance in patients with ovarian cancer. Original data of chemotherapy sensitivity and chemoresistance of ovarian cancer were obtained from the Gene Expression Omnibus dataset GSE73935. Differentially expressed genes (DEGs) between sensitive and resistant ovarian cancer cell lines were screened by Empirical Bayes methods. Overlapping DEGs between four chemoresistant groups were identified by Venn map analysis. Protein-protein interaction networks were also constructed, and hub genes were identified. The hub genes were verified by in vitro experiments as well as The Cancer Genome Atlas data. Results from the present study identified eight important genes that may guide treatment decisions regarding chemotherapy regimens for ovarian cancer, including epidermal growth factor-like repeats and discoidin I-like domains 3, NRAS proto-oncogene, hyaluronan and proteoglycan link protein 1, activated protein C receptor, CD53, cyclin-dependent kinase inhibitor 2A, insulin-like growth factor 1 receptor and roundabout guidance receptor 2 genes. Their expressions were found to have an impact on the prognosis of different treatment groups (cisplatin, paclitaxel, cisplatin + paclitaxel, cisplatin + doxorubicin and cisplatin + topotecan). The results indicated that these genes may minimise the occurrence of ovarian cancer drug resistance and may provide effective treatment options for patients with ovarian cancer.
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Affiliation(s)
- Danni Yuan
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Haohan Zhou
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hongyu Sun
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Rui Tian
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Meihui Xia
- Department of Obstetrics, First Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Liankun Sun
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yanan Liu
- Key Laboratory of Pathobiology, Department of Pathophysiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
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Kumar S, Long J, Kehoe S, Sundar S, Cummins C. Quality of life outcomes following surgery for advanced ovarian cancer: a systematic review and meta-analysis. Int J Gynecol Cancer 2019; 29:1285-1291. [DOI: 10.1136/ijgc-2018-000125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/27/2019] [Accepted: 06/03/2019] [Indexed: 11/03/2022] Open
Abstract
BackgroundQuality of life after ovarian cancer treatment is an important goal for patients. Complex debulking surgeries and platinum based chemotherapy are often required but quality of life after surgery is rarely reported.ObjectivesTo describe quality of life outcomes after surgery for advanced ovarian cancer in a systematic review and meta-analysis.Search strategyMEDLINE, EMBASE, and CENTRAL through March 2019 with no language restrictions.Selection criteriaIncluded studies reported quality of life in women diagnosed with primary advanced ovarian cancer, fallopian tube carcinoma or primary peritoneal cancer undergoing cytoreduction surgery.Data collection and analysisData on extent and timing of surgery, quality of life outcomes, and surgical complications were extracted and study quality assessed.ResultsThree randomized controlled trials comparing primary surgery to neoadjuvant chemotherapy had heterogeneous quality of life outcomes with no difference between arms, although there was a clinical improvement in global quality of life scores in both arms at 6 months compared with baseline. Data from two observational studies showed no meaningful difference in quality of life scores between patients undergoing standard or extensive surgery at 6 months.ConclusionsThere was no clinically important difference in the quality of life of patients undergoing either primary debulking surgery or neoadjuvant chemotherapy. There is insufficient evidence on quality of life outcomes of patients undergoing extensive or ultra-radical surgery compared with those undergoing less extensive surgery. Quality of life outcomes matter to patients, but there is little evidence to inform patient choice regarding the extent of surgery.
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11
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Atrial fibrillation following treatment with paclitaxel: A case report. Biomed Rep 2018; 9:540-544. [PMID: 30546883 DOI: 10.3892/br.2018.1158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/10/2018] [Indexed: 11/05/2022] Open
Abstract
Paclitaxel (PTX) is an antimicrotubule agent, and is effective in treating a wide range of solid tumors. However, its use may lead to cardiovascular toxicities, the manifestations of which include arrhythmia, heart failure, acute myocardial ischemia and atrial fibrillation (AF). AF is among the severe reactions to the PTX cardiotoxicity, and a cause for substantial morbidity and mortality. However, the incidence of PTX-induced AF is reportedly low (1.0-1.7% worldwide), and few cases have been reported in the literature. Thus, to emphasize the need for awareness of this side effect of PTX among clinicians, the report herein presents a case of AF induced by PTX in a patient with non-small-cell carcinoma. A 51-year-old man experienced AF following treatment with PTX. Amiodarone and metoprolol were administered to the patient to control cardiac rhythm and rate. After 3 days, the electrocardiogram was normalized and indicated normal heart rate and rhythm. According to this case, thorough attention should be paid during PTX treatment to monitor for signs of AF or other abnormalities in cardiac function.
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Brozou V, Vadalouca A, Zis P. Pain in Platin-Induced Neuropathies: A Systematic Review and Meta-Analysis. Pain Ther 2017; 7:105-119. [PMID: 29196945 PMCID: PMC5993684 DOI: 10.1007/s40122-017-0092-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 01/01/2023] Open
Abstract
Introduction Platin-induced peripheral neuropathy (PIPN) is a common cause of PN in cancer patients. The aim of this paper is to systematically review the current literature regarding PIPN, with a particular focus on epidemiological and clinical characteristics of painful PIPN, and to discuss relevant management strategies. Methods A systematic computer-based literature search was conducted on the PubMed database. Results This search strategy resulted in the identification of 353 articles. After the eligibility assessment, 282 articles were excluded. An additional 24 papers were identified by scanning the reference lists. In total, 95 papers met the inclusion criteria and were used for this review. The prevalence of neuropathic symptoms due to acute toxicity of oxaliplatin was estimated at 84.6%, whereas PN established after chemotherapy with platins was estimated at 74.9%. Specifically regarding pain, the reported prevalence of pain due to acute toxicity of oxaliplatin was estimated at 55.6%, whereas the reported prevalence of chronic peripheral neuropathic pain in PIPN was estimated at 49.2%. Conclusion Peripheral neuropathy is a common complication in patients receiving platins and can be particularly painful. There is significant heterogeneity among studies regarding the method for diagnosing peripheral neuropathy. Nerve conduction studies are the gold standard and should be performed in patients receiving platins and complaining of neuropathic symptoms post-treatment.
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Affiliation(s)
| | | | - Panagiotis Zis
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Liu R, Chang YN, Xing G, Li M, Zhao Y. Study on orally delivered paclitaxel nanocrystals: modification, characterization and activity in the gastrointestinal tract. ROYAL SOCIETY OPEN SCIENCE 2017; 4:170753. [PMID: 29291067 PMCID: PMC5717641 DOI: 10.1098/rsos.170753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
Drug nanocrystals (NCs) can improve the solubility and bioavailability of insoluble drugs for oral administration. However, the biocompatibility and mechanisms of transmittance of drug NCs through the intestinal epithelial tissue are still not well understood. In this work, the physico-chemical properties and interactions with biomolecules in oral delivery pathways, as well as the transmittance through mimical intestinal epithelial cells, of NCs of paclitaxel (PTX) are investigated. PTX was previously demonstrated to be an effective anti-cancer drug. It is found that maximum 1% (w/v) poly(styrenesulfonate) is sufficient to keep PTX NCs monodisperse in varied biological environments and presents no significant interaction with extracellular biomolecules for at least 24 h. The concentration of PTX NCs is kept carefully controlled to avoid serious toxicity to cells (10 µg ml-1 in our experiments but this also depends on NC size). The transmittance of PTX NCs through mimical intestinal epithelial reached 25% in 6 h, demonstrating its comparatively high oral bioavailability in the human body. This work demonstrates the great potential of PTX NC treated in oral delivery.
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Affiliation(s)
| | | | | | - Min Li
- Author for correspondence: Min Li e-mail:
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Jiang XP, Rui XH, Guo CX, Huang YQ, Li Q, Xu Y. A network meta-analysis of eight chemotherapy regimens for treatment of advanced ovarian cancer. Oncotarget 2017; 8:19125-19136. [PMID: 27835912 PMCID: PMC5386673 DOI: 10.18632/oncotarget.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/19/2016] [Indexed: 11/25/2022] Open
Abstract
This study compared the short-term efficacies of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) through pair-wise and network meta-analyses (NMA). Randomized controlled trials (RCTs) identified in a comprehensive online literature search met our inclusion criteria. Direct and indirect evidence was combined to compare odds ratios (OR) and surfaces under the cumulative ranking curves (SUCRA) across the different treatment regimens. Twelve eligible RCTs were finally included, involving eight regimens (Paclitaxel + Carboplatin [PC], Gemcitabine + Carboplatin [GC], Carboplatin, Pegylated Liposomal Doxorubicin + Carboplatin [PLD + Carboplatin], Paclitaxel, Paclitaxel + Carboplatin + Topotecan [PC + Topotecan], Paclitaxel + Carboplatin + Epirubicin [PC + Epirubicin] and Docetaxel + Carboplatin [DC]). The NMA results revealed that in terms of overall response rate (ORR) and disease control rate (DCR), PC (ORR: OR=2.59, 95%CI=1.20-6.22; DCR: OR=2.58, 95%CI=1.05-6.82) and GC (ORR: OR=2.08, 95%CI=1.08-4.37; DCR: OR=2.43, 95%CI=1.07-5.80) were more effective against AOC than Carboplatin alone. Similarly, PC (OR=0.21, 95%CI=0.05-0.69), GC (OR=0.31, 95%CI=0.09-0.90) and PLD + Carboplatin (OR=0.22, 95%CI=0.04-0.92) slowed disease progression better than Carboplatin alone. We also found that PC was more efficacious against AOC than Carboplatin or Paclitaxel single-agent chemotherapy. Combination chemotherapy is thus recommended for AOC, and should guide subsequent drug development and treatment strategies.
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Affiliation(s)
- Xi-Ping Jiang
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
| | - Xiao-Hui Rui
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
| | - Cai-Xia Guo
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
| | - Ya-Qing Huang
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
| | - Qin Li
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
| | - Yun Xu
- Department of Gynecology, the First People's Hospital of Changzhou, Changzhou 213003, P. R. China
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15
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Wang F, Du X, Li X, Liu N, Yu H, Sheng X. Effects of sequential paclitaxel-carboplatin followed by gemcitabine-based chemotherapy compared with paclitaxel-carboplatin therapy administered to patients with advanced epithelial ovarian cancer: A retrospective, STROBE-compliant study. Medicine (Baltimore) 2016; 95:e5696. [PMID: 28002342 PMCID: PMC5181826 DOI: 10.1097/md.0000000000005696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We aimed to compare the efficacy of paclitaxel and carboplatin followed by gemcitabine-based combination chemotherapy with paclitaxel-carboplatin for treating advanced epithelial ovarian cancer in this retrospective, STROBE-compliant study. Patients' tolerance to treatment was also assessed.We retrospectively analyzed the records of 178 women who underwent initial optimal debulking surgery between January 2003 and December 2011 to treat FIGO stage IIIc epithelial ovarian cancer. Patients in arm 1 (n = 88) received 4 cycles of paclitaxel and carboplatin followed by 2 to 4 cycles of gemcitabine-based combination chemotherapy. Patients in arm 2 (n = 90) received 6 to 8 cycles of paclitaxel and carboplatin. The granulocyte-colony stimulating factor was administered prophylactically to all patients.The median follow-up for both arms was 62 months. Medianprogression-free survival (PFS) between arms 1 and 2 (28 and 19 months [P = 0.003]) as well as 5-year OS (34.1% and 18.9% [P = 0.021]) differed significantly. The neurotoxicity rate was significantly higher in arm 2 than in arm 1 (45.2% vs 27.1%, P = 0.026). There was no significant difference between study arms in hematological toxicity.The sequential regimen significantly improved PFS and 5-year OS with tolerable toxicity compared with the single regimen, and offers an alternative for treating patients with advanced epithelial ovarian cancer.
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Affiliation(s)
- Fei Wang
- School of Medicine and Life Sciences, University of Jinan, Shandong Academy of Medical Sciences
- Department of Gynecologic Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan
| | - Xuelian Du
- Department of Gynecologic Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan
| | - Xiaoxia Li
- Department of Obstetrics and Gynecology, People's Hospital of Wenshang, Jining, Shandong, China
| | - Naifu Liu
- Department of Gynecologic Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan
| | - Hao Yu
- Department of Gynecologic Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan
| | - Xiugui Sheng
- Department of Gynecologic Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan
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