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Higgins Á, O'Reilly S, O'Sullivan MJ. The impact of the COVID-19 pandemic on symptomatic breast cancer presentations in an Irish breast cancer unit: a retrospective cohort study. Ir J Med Sci 2024:10.1007/s11845-024-03688-4. [PMID: 38639840 DOI: 10.1007/s11845-024-03688-4] [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: 01/18/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The coronavirus-19 (COVID-19) pandemic caused delays in the diagnosis and management of breast cancer which may have affected disease presentation. The aim of this study was to compare rates of metastatic disease, tumour characteristics and management in breast cancer patients diagnosed before and after the onset of COVID-19. METHODS A retrospective chart review was conducted on patients in a university teaching hospital who were diagnosed with invasive symptomatic breast cancer in 2019 (prepandemic control group) and in 2020, 2021, and 2022 (pandemic study groups). Rates of new metastatic presentations, tumour histopathological characteristics, operation type, and therapies administered were statistically compared. RESULTS A total of 1416 patients were identified. There was a significant increase in new metastatic breast cancer presentations in 2022 compared to 2019 (14.0% vs 3.8%, p ≤ 0.001), with non-significant increases in 2020 and 2021. Rates of adjuvant radiotherapy increased in 2020 and decreased in 2022 compared to 2019, with no significant change in neoadjuvant or adjuvant chemotherapy rates. Rates of axillary surgery increased during 2020 and 2021. There was an increase in high-grade tumours and lymphovascular invasion (LVI), and less frequent oestrogen receptor (ER) positivity in pandemic groups. No significant change was noted in BCS to mastectomy ratios, overall nodal positivity rates, or median tumour size. CONCLUSION Symptomatic breast cancers diagnosed since the onset of COVID-19 demonstrated an increase in new metastatic presentations and more aggressive histopathological characteristics when compared to a pre-pandemic control group. Rates of adjuvant radiotherapy and axillary surgery increased during the pandemic.
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Affiliation(s)
- Áine Higgins
- Department of Breast Surgery, Cork University Hospital and University College Cork, Cork, Ireland.
| | - Seamus O'Reilly
- Department of Medical Oncology, College of Medicine and Health, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
| | - Martin J O'Sullivan
- Department of Breast Surgery, College of Medicine and Health, Cork University Hospital and Cancer Research@UCC, University College Cork, Cork, Ireland
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Cioffi G, Waite KA, Price M, Neff C, Kruchko C, Ostrom QT, Barnholtz-Sloan JS. The impact of COVID-19 on 2020 monthly incidence trends of primary brain and other CNS tumors. Neuro Oncol 2024; 26:764-774. [PMID: 38167948 PMCID: PMC10995517 DOI: 10.1093/neuonc/noad235] [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: 10/02/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To mitigate disease spread, restrictions implemented in the United States surrounding the COVID-19 pandemic created an environment that led to delays in cancer diagnosis. The data needed to accurately analyze the impact of the pandemic on brain and CNS tumor incidence has not been available until now. Utilizing incidence data from the Central Brain Tumor Registry of the United States (CBTRUS) we analyzed the impact of the COVID-19 pandemic on primary brain and other CNS tumor incidence for the first year of the pandemic. METHODS Monthly age-adjusted incidence rates and incidence trends for 2019 and 2020 were determined for age at diagnosis, sex, race, ethnicity, diagnostic confirmation, behavior, tumor histopathology, and county-level urbanization. Monthly incidence rate ratios comparing 2020 and 2019 were evaluated for the same factors. RESULTS Overall, there was a notable decrease in incidence rates in March-May 2020 when compared to 2019. These decreases were driven by nonmalignant tumors, with a 50% incidence decrease between March 2020 and 2019. Individuals who were Black had a larger incidence decrease in early 2020 than individuals who were White. Radiographically confirmed tumors saw larger incidence decreases than histologically confirmed tumors. There were no changes in monthly incidence of glioblastoma in 2020 compared to 2019. CONCLUSIONS These data provide evidence that disruptions in medical care, such as governmental and health care mandates, in response to the COVID-19 pandemic resulted in an overall decreased incidence of primary brain tumors in early 2020.
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Affiliation(s)
- Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Mackenzie Price
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Corey Neff
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
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3
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Bradley E, Deepa M. The global pandemic's second deadly hit: cancer care. Am J Surg 2024; 229:34-35. [PMID: 38044252 DOI: 10.1016/j.amjsurg.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Emma Bradley
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Magge Deepa
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
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Marty S, Lamé G, Guével E, Priou S, Chatellier G, Tournigand C, Kempf E. Impact of the Sars-Cov-2 outbreak on the initial clinical presentation of new solid cancer diagnoses: a systematic review and meta-analysis. BMC Cancer 2024; 24:143. [PMID: 38287348 PMCID: PMC10823607 DOI: 10.1186/s12885-023-11795-1] [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: 07/18/2023] [Accepted: 12/25/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic might have delayed cancer diagnosis and management. The aim of this systematic review was to compare the initial tumor stage of new cancer diagnoses before and after the pandemic. METHODS We systematically reviewed articles that compared the tumor stage of new solid cancer diagnoses before and after the initial pandemic waves. We conducted a random-effects meta-analysis to compare the rate of metastatic tumors and the distribution of stages at diagnosis. Subgroup analyses were performed by primary tumor site and by country. RESULTS From 2,013 studies published between January 2020 and April 2022, we included 58 studies with 109,996 patients. The rate of metastatic tumors was higher after the COVID-19 outbreak than before (pooled OR: 1.29 (95% CI, 1.06-1.57), I2: 89% (95% CI, 86-91)). For specific cancers, common ORs reached statistical significance for breast (OR: 1.51 (95% CI 1.07-2.12)) and gynecologic (OR: 1.51 (95% CI 1.04-2.18)) cancers, but not for other cancer types. According to countries, common OR (95% CI) reached statistical significance only for Italy: 1.55 (1.01-2.39) and Spain:1.14 (1.02-1.29). Rates were comparable for stage I-II versus III-IV in studies for which that information was available, and for stages I-II versus stage III in studies that did not include metastatic patients. CONCLUSIONS Despite inter-study heterogeneity, our meta-analysis showed a higher rate of metastatic tumors at diagnosis after the pandemic. The burden of social distancing policies might explain those results, as patients may have delayed seeking care.
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Affiliation(s)
- Simon Marty
- Department of medical oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique - Hôpitaux de Paris, 1 rue Gustave Eiffel, 94000, Créteil, France
| | - Guillaume Lamé
- Laboratoire Genie Industriel, CentraleSupélec, Paris Saclay University, Gif-sur-Yvette, France
| | - Etienne Guével
- Assistance Publique - Hôpitaux de Paris, Innovation and Data, IT Department, Paris, France
| | - Sonia Priou
- Laboratoire Genie Industriel, CentraleSupélec, Paris Saclay University, Gif-sur-Yvette, France
| | - Gilles Chatellier
- Department of medical informatics, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Université de Paris, F-75015, Paris, France
| | - Christophe Tournigand
- Department of medical oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique - Hôpitaux de Paris, 1 rue Gustave Eiffel, 94000, Créteil, France
| | - Emmanuelle Kempf
- Department of medical oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique - Hôpitaux de Paris, 1 rue Gustave Eiffel, 94000, Créteil, France.
- Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Paris, France.
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Marrone G, Urciuoli S, Candi E, Bernini R, Vanni G, Masci C, Guerriero C, Mancini M, De Lorenzo A, Vignolini P, Noce A. Biological Activities of Molecules Derived from Olea europaea L. Tested In Vitro. Life (Basel) 2023; 14:49. [PMID: 38255664 PMCID: PMC10820526 DOI: 10.3390/life14010049] [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: 08/24/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Extra virgin olive oil is a typical food of the Mediterranean area, obtained by pressing Olea europaea L. fruits. Its polyphenols have been studied for their antioxidant function and protective action against cancer and chronic kidney disease. In this in vitro study, we tested titrated extracts from Olea europaea L. on a human embryonic kidney 293 (HEK-293E) cell line, regarding their pro-apoptotic and antiproliferative capacities, using " IncuCyte® S3 Live-Cell Analysis System". MATERIALS AND METHODS We selected Olea europaea L. active compounds like hydroxytyrosol (HT) and oleuropein (OLE). These extracts were tested at different concentrations and characterized by HPLC-DAD-MS for the content in secondary active metabolites. The real-time observation of cell behavior was performed by IncuCyte, which can quantitatively analyze the cell proliferation and death. RESULTS This study showed that all the tested extracts can significantly inhibit cellular growth at 50 µM but the reduced proliferation is not related to an increase in cellular apoptosis. Instead, the same analysis performed by using extracts at 100 µM reveals that they can inhibit cellular growth, further inducing cellular apoptosis. CONCLUSIONS The results on the HEK-293E cells confirmed the antiproliferative and proapoptotic actions of active compounds from an Olea europaea L. matrix in this cell line.
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Affiliation(s)
- Giulia Marrone
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Silvia Urciuoli
- PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis)—DiSIA, University of Florence, 50019 Florence, Italy; (S.U.)
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Istituto Dermatopatico Dell’Immacolata—IDI, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, Via Monti di Creta 104, 00166 Rome, Italy
| | - Roberta Bernini
- Department of Agriculture and Forest Sciences (DAFNE), University of Tuscia, Via San Camillo de Lellis, 01100 Viterbo, Italy
| | - Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, 00133 Rome, Italy
| | - Claudia Masci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cristina Guerriero
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Mara Mancini
- Istituto Dermatopatico Dell’Immacolata—IDI, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, Via Monti di Creta 104, 00166 Rome, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Pamela Vignolini
- PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis)—DiSIA, University of Florence, 50019 Florence, Italy; (S.U.)
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133 Rome, Italy
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Guével E, Priou S, Lamé G, Wassermann J, Bey R, Uzan C, Chatellier G, Belkacemi Y, Tannier X, Guillerm S, Flicoteaux R, Gligorov J, Cohen A, Benderra M, Teixeira L, Daniel C, Hersant B, Tournigand C, Kempf E. Impact of the COVID-19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study. Cancer Med 2023; 12:20918-20929. [PMID: 37909210 PMCID: PMC10709737 DOI: 10.1002/cam4.6637] [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: 07/18/2023] [Revised: 09/14/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND The SARS CoV-2 pandemic disrupted healthcare systems. We compared the cancer stage for new breast cancers (BCs) before and during the pandemic. METHODS We performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP-HP). We identified all female patients newly referred with a BC in 2019 and 2020. We assessed the timeline of their care trajectories, initial tumor stage, and treatment received: BC resection, exclusive systemic therapy, exclusive radiation therapy, or exclusive best supportive care (BSC). We calculated patients' 1-year overall survival (OS) and compared indicators in 2019 and 2020. RESULTS In 2019 and 2020, 2055 and 1988, new BC patients underwent cancer treatment, and during the two lockdowns, the BC diagnoses varied by -18% and by +23% compared to 2019. De novo metastatic tumors (15% and 15%, p = 0.95), pTNM and ypTNM distributions of 1332 cases with upfront resection and of 296 cases with neoadjuvant therapy did not differ (p = 0.37, p = 0.3). The median times from first multidisciplinary meeting and from diagnosis to treatment of 19 days (interquartile 11-39 days) and 35 days (interquartile 22-65 days) did not differ. Access to plastic surgery (15% and 17%, p = 0.08) and to treatment categories did not vary: tumor resection (73% and 72%), exclusive systemic therapy (13% and 14%), exclusive radiation therapy (9% and 9%), exclusive BSC (5% and 5%) (p = 0.8). Among resected patients, the neoadjuvant therapy rate was lower in 2019 (16%) versus 2020 (20%) (p = 0.02). One-year OS rates were 99.3% versus 98.9% (HR = 0.96; 95% CI, 0.77-1.2), 72.6% versus 76.6% (HR = 1.28; 95% CI, 0.95-1.72), 96.6% versus 97.8% (HR = 1.09; 95% CI, 0.61-1.94), and 15.5% versus 15.1% (HR = 0.99; 95% CI, 0.72-1.37), in the treatment groups. CONCLUSIONS Despite a decrease in the number of new BCs, there was no tumor stage shift, and OS did not vary.
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Affiliation(s)
- Etienne Guével
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Sonia Priou
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
- CentraleSupélec, Laboratoire Génie IndustrielUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Guillaume Lamé
- CentraleSupélec, Laboratoire Génie IndustrielUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Johanna Wassermann
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Pitié Salpétrière University HospitalSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
| | - Romain Bey
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Catherine Uzan
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of gynecology, Pitié Salpétrière University HospitalSorbonne UniversitéParisFrance
| | - Gilles Chatellier
- Department of medical informatics, Assistance Publique Hôpitaux de Paris, Centre‐Université de Paris (APHP‐CUP)Université Paris CItéParisFrance
| | - Yazid Belkacemi
- Assistance Publique–Hôpitaux de Paris, Department of Radiation Oncology and Henri Mondor Breast Center, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Xavier Tannier
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
| | - Sophie Guillerm
- Assistance Publique–Hôpitaux de Paris, Department of radiation therapy, Saint Louis University HospitalUniversité Paris CitéCréteilFrance
| | - Rémi Flicoteaux
- Assistance Publique–Hôpitaux de ParisDepartment of medical informationParisFrance
| | - Joseph Gligorov
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Tenon University HospitalSorbonne UniversitéParisFrance
| | - Ariel Cohen
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Marc‐Antoine Benderra
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Tenon University HospitalSorbonne UniversitéParisFrance
| | - Luis Teixeira
- Assistance Publique–Hôpitaux de Paris, Department of senology, Saint Louis Teaching HospitalUniversité Paris CitéParisFrance
| | - Christel Daniel
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
| | - Barbara Hersant
- Assistance Publique – Hôpitaux de Paris, Department of plastic surgery, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Christophe Tournigand
- Assistance Publique – Hôpitaux de Paris, Department of medical oncology, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Emmanuelle Kempf
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
- Assistance Publique – Hôpitaux de Paris, Department of medical oncology, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
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7
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Siragusa L, Angelico R, Angrisani M, Zampogna B, Materazzo M, Sorge R, Giordano L, Meniconi R, Coppola A. How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons. Updates Surg 2023; 75:1711-1727. [PMID: 37578735 PMCID: PMC10435629 DOI: 10.1007/s13304-023-01613-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023]
Abstract
COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice.
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Affiliation(s)
- Leandro Siragusa
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Angelico
- HPB and Transplant Unit, Department of Surgical Sciences, University of "Rome Tor Vergata", Rome, Italy
| | - Marco Angrisani
- Department of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy
| | - Biagio Zampogna
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128, Rome, Italy
| | - Marco Materazzo
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy.
- HPB and Transplant Unit, Department of Surgical Sciences, University of "Rome Tor Vergata", Rome, Italy.
- PhD Program in Applied Medical-Surgical Sciences, Breast Oncoplastic Surgery, University of Rome Tor Vergata, Rome, Italy.
| | - Roberto Sorge
- Department of Biostatistics, University of Rome Tor Vergata, Rome, Italy
| | - Luca Giordano
- Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - Roberto Meniconi
- Department of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy
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8
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Hong Y, Nixon N, Cao JQ, Lee SL. Case report: Ultrahypofractionated palliative breast radiotherapy for a fungating invasive mammary carcinoma. Front Oncol 2023; 13:1171444. [PMID: 37350951 PMCID: PMC10282535 DOI: 10.3389/fonc.2023.1171444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Palliative radiotherapy for symptomatic and intact breast tumors must balance convenience, efficacy, and risk of acute toxicity. This case report presents a patient with metastatic breast cancer and an intact fungating primary tumor. She was treated with an ultrahypofractionated radiation therapy, 26 Gy in 5 consecutive daily fractions, with sequential palliative chemotherapy. This resulted in a minimal toxicity profile and significant reduction of tumor burden and symptoms.
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Affiliation(s)
- Yejun Hong
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nancy Nixon
- Division of Medical Oncology, University of Calgary, Calgary, AB, Canada
| | - Jeffrey Q. Cao
- Division of Radiation Oncology, University of Calgary, Calgary, AB, Canada
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Baba K, Kawamoto M, Mamishin K, Uematsu M, Kiyohara H, Hirota A, Takahashi N, Fukuda M, Kusuhara S, Nakajima H, Funasaka C, Nakao T, Kondoh C, Harano K, Matsubara N, Naito Y, Hosono A, Kawasaki T, Mukohara T. The impact of the COVID-19 pandemic on perioperative chemotherapy for breast cancer. Cancer Med 2023. [PMID: 37012214 DOI: 10.1002/cam4.5898] [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: 01/30/2023] [Revised: 03/08/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Since it was first reported in December 2019, coronavirus disease 2019 (COVID-19) spread rapidly across the globe resulting in a pandemic. As of August 2022, seven outbreak peaks have been confirmed in Tokyo, and the numbers of new cases in the fifth and later outbreak periods have been far greater than in the preceding periods. This retrospective study examined the impact of the COVID-19 pandemic on perioperative chemotherapy for breast cancer. METHODS Patients with breast cancer who received perioperative chemotherapy at the National Cancer Center Hospital East were divided into 2 groups: 120 and 384 patients who started chemotherapy before and during the pandemic, respectively. The incidence of critical events that had potential detrimental effects on the prognosis, such as start of adjuvant chemotherapy ≥91 days after surgery and relative dose intensity of chemotherapy <85% were compared between groups. RESULTS No significant difference in the incidence of critical events was found. When stratified by outbreak period, the incidence of critical events was positively correlated with the increasing number of new cases of COVID-19 (r = 0.83, p = 0.04). Moreover, 25/173 patients (14%) who started perioperative chemotherapy during the fifth and sixth outbreak periods developed COVID-19 infection, 80% of whom (20/25) had a delay or interruption to their surgery or other perioperative treatments. CONCLUSIONS Although the impact of the COVID-19 pandemic on perioperative chemotherapy on whole groups of patients was not evident when comparing periods before and after the pandemic, the impact is becoming prominent in parallel with increasing numbers of new COVID-19 cases.
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Affiliation(s)
- Kaede Baba
- Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Megumi Kawamoto
- Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Kanako Mamishin
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Mao Uematsu
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Hikari Kiyohara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Akira Hirota
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Nobuyuki Takahashi
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Misao Fukuda
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Shota Kusuhara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Hiromichi Nakajima
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Experimental Therapeutics, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Chikako Funasaka
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Experimental Therapeutics, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Takehiro Nakao
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Experimental Therapeutics, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Chihiro Kondoh
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Kenichi Harano
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Experimental Therapeutics, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Nobuaki Matsubara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Yoichi Naito
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Experimental Therapeutics, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of General Internal Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Ako Hosono
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Pediatric Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Toshikatsu Kawasaki
- Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Toru Mukohara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
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10
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Mangone L, Marinelli F, Bonfante G, Bisceglia I, Morabito F, Masini C, Bergamaschi FAM, Pinto C. The Impact of COVID-19 on New Kidney Cancer Diagnosis: Stage and Treatment in Northern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4755. [PMID: 36981664 PMCID: PMC10048571 DOI: 10.3390/ijerph20064755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the impact of COVID-19 on new renal carcinoma (RC) diagnoses using data from the Reggio Emilia Cancer Registry in 2018-2020. A total of 293 RCs were registered, with roughly 100 cases yearly. The distribution by age shows a significant decrease in the 30-59 age group (33.7% in 2018, 24.8% in 2019, and 19.8% in 2020). The incidence of Stage I was 59.4%, 46.5%, and 58.2% in 2018, 2019, and 2020, respectively, whereas the Stage II rate had values of 6.9%, 7.9%, and 2.2% in the years 2018, 2019, and 2020, respectively. Slight non-significant variations were observed in Stages III and IV. Surgery was performed in 83.2% of cases in 2018, 78.2% in 2019, and 82.4% in 2020; the surgery distribution by stage showed no significant differences. Chemotherapy showed an increase in 2020, which was statistically significant only for Stage IV. The gender incidence trends over the last 25 years showed an increase in the male sex in the first period; then, a decline was documented, likely due to a decrease in cigarette consumption. In females, the trend was constant. The RC mortality trend significantly dropped in both genders over the entire study period.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Giulia Bonfante
- Unit of Urology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Cristina Masini
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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11
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Song X, Yang Y. Analysis of the current situation and related influencing factors of cervical precancer screening under the COVID-19. Biotechnol Genet Eng Rev 2023:1-13. [PMID: 36641596 DOI: 10.1080/02648725.2023.2166723] [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: 12/02/2022] [Accepted: 01/05/2023] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study aims to compare the results of cervical cancer screening in Shanghai General Hospital before and after the COVID-19 epidemic, and analyze the current status and related influencing factors of precervical cancer screening in our hospital under the COVID-19 pandemic. METHODS The data of 13,748 women of cervical precancer screening with HPV in Shanghai General Hospital were selected.The data included human papillomavirus (HPV), thin-layer liquid-based cytology test (TCT), colposcopy and cervical biopsy, and pathological diagnosis results after trachelectomy in 2019 and 2020, and were analyzed and compared. RESULTS The detection rates of precancerous lesions and cervical cancer were 2.9061/10,000 and 29.26/10,000 respectively. There was a significant difference in the rate of comparison (χ2 = 30.361, P = 0.000; χ2 = 7.682, P = 0.006);(2) Missing detection rate: In 2020, other positive subtypes other than HPV 16 and 18 who need TCT, the colposcopy, and the histopathological examination missing detection rate were higher than those in 2019 (P < 0.05);(3) Abnormal rate of examination: the abnormal rate of HPV, TCT, and histopathology in 2020 was higher than those in 2019 (P < 0.05);(4) Histopathological analysis: The detection rate of high-grade lesions and invasive cancer in 2020 was higher than those in 2019, and the detection rate of low-grade lesions was lower than that in 2019 (P < 0.05); Conclusion: Health authorities should formulate intervention measures to cope with the safe and timely implementation of cervical cancer screening and subsequent follow-up management during public health emergency.
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Affiliation(s)
- Xiaohong Song
- Department of Gynecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR, China
| | - Yongbin Yang
- Department of Gynecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, PR, China
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12
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Giorgi Rossi P, Carrozzi G, Falini P, Sampaolo L, Gorini G, Zorzi M, Armaroli P, Senore C, Sassoli de Bianchi P, Masocco M, Zappa M, Battisti F, Mantellini P. The impact of the COVID-19 pandemic on Italian population-based cancer screening activities and test coverage: Results from national cross-sectional repeated surveys in 2020. eLife 2023; 12:81804. [PMID: 36734526 PMCID: PMC9934859 DOI: 10.7554/elife.81804] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Background In Italy, regions have the mandate to implement population-based screening programs for breast, cervical, and colorectal cancer. From March to May 2020, a severe lockdown was imposed due to the COVID-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020 overall and by socioeconomic characteristics. Methods The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, collects information about screening test uptake by test provider (public screening and private opportunistic). Test coverage and test uptake in the last year were computed by educational attainment, perceived economic difficulties, and citizenship. Results A reduction of subjects invited and tests performed, with differences between periods and geographical macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening programs. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening programs. Compared with the pre-pandemic period, there was a greater difference according to the level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests. Conclusions The lockdown and the ongoing COVID-19 emergency caused an important delay in screening activities. This increased the preexisting individual and geographical inequalities in access. The opportunistic screening did not mitigate the impact of the pandemic. Funding This study was partially supported by Italian Ministry of Health - Ricerca Corrente Annual Program 2023 and by the Emilian Region DGR 839/22.
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Affiliation(s)
- Paolo Giorgi Rossi
- Azienda Unità Sanitaria Locale - IRCCS di Reggio EmiliaReggio EmiliaItaly
| | | | - Patrizia Falini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | | | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | - Manuel Zorzi
- Registro Tumori del Veneto, Azienda ZeroPaduaItaly
| | - Paola Armaroli
- Centro di Prevenzione Oncologica, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di TorinoTurinItaly
| | - Carlo Senore
- Centro di Prevenzione Oncologica, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di TorinoTurinItaly
| | - Priscilla Sassoli de Bianchi
- Servizio Prevenzione Collettiva e Sanità Pubblica, Direzione Generale Cura della Persona, Salute e Welfare, Regione Emilia-RomagnaBolognaItaly
| | | | - Marco Zappa
- Osservatorio Nazionale ScreeningFlorenceItaly
| | - Francesca Battisti
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | - Paola Mantellini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly,Osservatorio Nazionale ScreeningFlorenceItaly
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13
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Al-Hussaini M, Al-Ani A, Hammouri M, Al-Huneidy L, Mansour A. Investigating the impact of COVID-19 on patients with cancer from areas of conflict within the MENA region treated at King Hussein Cancer Center. Front Oncol 2023; 13:1088000. [PMID: 36910625 PMCID: PMC9995942 DOI: 10.3389/fonc.2023.1088000] [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: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
Background There is a paucity of evidence regarding the impact of COVID-19 on cancer care among refugees or patients from areas of conflict. Cancer care for these populations remains fragmented due to resource scarcity and limited infrastructure. Aims To explore the effect of COVID-19 on cancer care among patients from areas of conflict treated at King Hussein Cancer Center (KHCC). Methodology We performed a retrospective chart review of all patients from areas of conflict, treated at KHCC from 2018 to 2021. Patients' demographics and clinical characteristics are presented in the form of descriptive statistics. Interrupted Time Series (ITS) analysis was utilized to investigate the impact of COVID-19 on the number of admissions throughout the study's period. Results A total of 3317 patients from areas of conflict were included in the study. Among these, 1546 were males (46.6%) while 1771 (53.4%) were female. Libyans (34.6%), Palestinians (24.8%), Iraqis (24.5%), Syrians (15.3%), and Sudanese patients (0.9%) constituted our study sample. ITS analysis demonstrated that the start of the COVID-19 lockdown significantly decreased admissions by 44.0% (p = 0.020), while the end of the COVID-19 restriction significantly improved admissions by 43.0% (p = 0.023). Among those with available SEER stages, more than a quarter of patients had distant metastasis (n = 935, 28.2%) irrespective of age and biological sex. Advanced presentations during 2020 had approximately a 16% and 6% increase compared to 2018 and 2019, respectively. Breast cancer (21.4%), hematolymphoid cancers (18.1%), and cancers of the digestive system (16.5%) were the most common cancers among our cohort. Conclusion Restrictions associated with COVID-19 had a significant effect on the number of admissions of patients from areas of conflict. In the long term, this effect may impact the survival outcomes of affected patients.
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Affiliation(s)
- Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | | | | | - Asem Mansour
- Department of Radiology, King Hussein Cancer Center, Amman, Jordan
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14
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Cui L, Renzi S, Quagliarini E, Digiacomo L, Amenitsch H, Masuelli L, Bei R, Ferri G, Cardarelli F, Wang J, Amici A, Pozzi D, Marchini C, Caracciolo G. Efficient Delivery of DNA Using Lipid Nanoparticles. Pharmaceutics 2022; 14:pharmaceutics14081698. [PMID: 36015328 PMCID: PMC9416266 DOI: 10.3390/pharmaceutics14081698] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
DNA vaccination has been extensively studied as a promising strategy for tumor treatment. Despite the efforts, the therapeutic efficacy of DNA vaccines has been limited by their intrinsic poor cellular internalization. Electroporation, which is based on the application of a controlled electric field to enhance DNA penetration into cells, has been the method of choice to produce acceptable levels of gene transfer in vivo. However, this method may cause cell damage or rupture, non-specific targeting, and even degradation of pDNA. Skin irritation, muscle contractions, pain, alterations in skin structure, and irreversible cell damage have been frequently reported. To overcome these limitations, in this work, we use a microfluidic platform to generate DNA-loaded lipid nanoparticles (LNPs) which are then characterized by a combination of dynamic light scattering (DLS), synchrotron small-angle X-ray scattering (SAXS), and transmission electron microscopy (TEM). Despite the clinical successes obtained by LNPs for mRNA and siRNA delivery, little is known about LNPs encapsulating bulkier DNA molecules, the clinical application of which remains challenging. For in vitro screening, LNPs were administered to human embryonic kidney 293 (HEK-293) and Chinese hamster ovary (CHO) cell lines and ranked for their transfection efficiency (TE) and cytotoxicity. The LNP formulation exhibiting the highest TE and the lowest cytotoxicity was then tested for the delivery of the DNA vaccine pVAX-hECTM targeting the human neoantigen HER2, an oncoprotein overexpressed in several cancer types. Using fluorescence-activated cell sorting (FACS), immunofluorescence assays and fluorescence confocal microscopy (FCS), we proved that pVAX-hECTM-loaded LNPs produce massive expression of the HER2 antigen on the cell membrane of HEK-293 cells. Our results provide new insights into the structure–activity relationship of DNA-loaded LNPs and pave the way for the access of this gene delivery technology to preclinical studies.
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Affiliation(s)
- Lishan Cui
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy
| | - Serena Renzi
- NanoDelivery Lab, Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Erica Quagliarini
- NanoDelivery Lab, Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Luca Digiacomo
- NanoDelivery Lab, Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Heinz Amenitsch
- Institute of Inorganic Chemistry, Graz University of Technology, 8010 Graz, Austria
| | - Laura Masuelli
- Department of Experimental Medicine, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Roberto Bei
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Gianmarco Ferri
- National Enterprise for NanoScience and NanoTechnology (NEST), Scuola Normale Superiore, 56127 Pisa, Italy
| | - Francesco Cardarelli
- National Enterprise for NanoScience and NanoTechnology (NEST), Scuola Normale Superiore, 56127 Pisa, Italy
| | - Junbiao Wang
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy
| | - Augusto Amici
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy
| | - Daniela Pozzi
- NanoDelivery Lab, Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cristina Marchini
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy
- Correspondence: (C.M.); (G.C.)
| | - Giulio Caracciolo
- NanoDelivery Lab, Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence: (C.M.); (G.C.)
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15
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Prompt Resumption of Screening Programme Reduced the Impact of COVID-19 on New Breast Cancer Diagnoses in Northern Italy. Cancers (Basel) 2022; 14:cancers14123029. [PMID: 35740694 PMCID: PMC9221346 DOI: 10.3390/cancers14123029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The aim of this study was to compare 2020 tumours with 2019 tumours by age, stage and treatment in four different periods. In 2020 there was no decrease of invasive tumours nor in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and an increase in neoadjuvant chemotherapy (p = 0.016). During the Italian lockdown period (March–May), we observed a decrease in all ages and a significant one among people aged 75+ [IRR 0.45 (95% CI 0.25–0.79)], but in the last period there was a significant increase among people of the screening age range of 45–74 [IRR 1.48 (95% CI 1.11–1.98)]. Screening activities were suspended from March to May, but over the summer and the autumn the backlog was eliminated. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses. Abstract The aim of this study is to evaluate the real impact of COVID-19 during the entire 2020 period, compared with 2019. The data comes from a Cancer Registry in Northern Italy and we compared clinical and treatment characteristics of breast cancer by age, stage, treatment, and status screening. In 2020 there was no decrease in invasive tumours nor in in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and increase in neoadjuvant chemotherapy (p = 0.016). In the screening range (aged 45–74), no change in stage and grading was observed. In the four periods examined there was an increase in new diagnoses during pre-lockdown, a decrease in tumours especially at age 75+ [IRR 0.45; 95%CI 0.25–0.79] during lockdown, a recovery of new diagnoses in women 45+ in the low incidence period while in the last period there was a significant increase only for ages 45–74 [IRR 1.48; 95% CI 1.11–1.98]. Screening activities were suspended from March to May, but over the summer and autumn the backlog was addressed. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses.
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16
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Jacob L, Kalder M, Kostev K. Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany. J Cancer Res Clin Oncol 2022; 148:3117-3123. [PMID: 35041059 PMCID: PMC8764247 DOI: 10.1007/s00432-022-03922-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/11/2022] [Indexed: 12/17/2022]
Abstract
Purpose Little is known on how coronavirus disease 2019 (COVID-19) has impacted cancer diagnosis in Germany since the first lockdown in March 2020. Therefore, this retrospective study aimed to compare the number of patients newly diagnosed with cancer in general and specialized practices in Germany between April 2020–March 2021 and April 2019–March 2020. Methods Patients aged ≥ 18 years with at least 1 visit to 1 of 1403 general and specialized practices in Germany in April 2020–March 2021 (n = 3,804,596) and April 2019–March 2020 (n = 3,913,386) were included in this retrospective study. Specialized practices were composed of gynecology, dermatology and urology practices. Cancer diagnoses included all types of cancer documented using the International Classification of Diseases, 10th revision (ICD-10 codes: C00-C97). The number of patients newly diagnosed with cancer per practice was compared between April 2020–March 2021 and April 2019–March 2020 using Wilcoxon tests. Results There were 126,379 and 138,996 patients diagnosed with cancer in April 2020–March 2021 and April 2019–March 2020, respectively. The number of patients diagnosed with cancer decreased in all types of practice, and this decrease was significant in general practices (− 7.1%, p value = 0.038). In terms of cancer type, this decrease was particularly pronounced for skin cancers (− 12.8%, p value = 0.025). Conclusion The COVID-19 pandemic has been associated with a decrease in the number of patients newly diagnosed with cancer in general and specialized practices in Germany. Public health interventions are urgently warranted to mitigate the deleterious effects of this health crisis on cancer diagnosis.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps University of Marburg, 35037, Marburg, Germany
| | - Karel Kostev
- Department of Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt am Main, Germany.
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17
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Kanduc D. From Anti-Severe Acute Respiratory Syndrome Coronavirus 2 Immune Response to Cancer Onset via Molecular Mimicry and Cross-Reactivity. Glob Med Genet 2021; 8:176-182. [PMID: 34877576 PMCID: PMC8635832 DOI: 10.1055/s-0041-1735590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022] Open
Abstract
Background and Objectives Whether exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may predispose to the risk of cancer in individuals with no prior cancers is a crucial question that remains unclear. To confirm/refute possible relationships between exposure to the virus and ex novo insurgence of tumors, this study analyzed molecular mimicry and the related cross-reactive potential between SARS-CoV-2 spike glycoprotein (gp) antigen and human tumor-suppressor proteins. Materials and Methods Tumor-associated proteins were retrieved from UniProt database and analyzed for pentapeptide sharing with SARS-CoV-2 spike gp by using publicly available databases. Results An impressively high level of molecular mimicry exists between SARS-CoV-2 spike gp and tumor-associated proteins. Numerically, 294 tumor-suppressor proteins share 308 pentapeptides with the viral antigen. Crucially, the shared peptides have a relevant immunologic potential by repeatedly occurring in experimentally validated epitopes. Such immunologic potential is of further relevancy in that most of the shared peptides are also present in infectious pathogens to which, in general, human population has already been exposed, thus indicating the possibility of immunologic imprint phenomena. Conclusion This article described a vast peptide overlap between SARS-CoV-2 spike gp and tumor-suppressor proteins, and supports autoimmune cross-reactivity as a potential mechanism underlying prospective cancer insurgence following exposure to SARS-CoV-2. Clinically, the findings call for close surveillance of tumor sequelae that possibly could result from the current coronavirus pandemic.
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Affiliation(s)
- Darja Kanduc
- Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, Bari, Italy
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18
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Bonadio RC, Messias AP, Moreira OA, Leis LV, Orsi BZ, Testa L, Estevez-Diz MDP. Impact of the COVID-19 pandemic on breast and cervical cancer stage at diagnosis in Brazil. Ecancermedicalscience 2021; 15:1299. [PMID: 34824622 PMCID: PMC8580713 DOI: 10.3332/ecancer.2021.1299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Indexed: 12/01/2022] Open
Abstract
Background The COVID-19 pandemic has led to the need for health services adjustments, which may have compromised management of other diseases. For cancer patients, delays may significantly impair outcomes in some situations. We aimed to assess the impact of the COVID-19 pandemic in breast and cervical cancer diagnosis and treatment compared to the same period prior to the pandemic. Methods Data were collected from patients attending their first visit to a Brazilian cancer centre from 1 September 2020 to 31 January 2021 and from 1 September 2019 to 31 January 2020. The pandemic started in February 2020 in Brazil and is still ongoing. We considered this period (September/20–January/21) to be representative of the pandemic impact on cancer management. The primary endpoint was breast and cervical cancer stages at diagnosis. Results A total of 268 breast cancer patients and 44 cervical cancer patients had their first consult in our cancer centre from September/20 to January/21; 457 and 60, respectively, occurred from September/19 to January/20. Patients who attended their first visit during the pandemic (September/20–January/21) presented with more advanced-stage breast cancer (p < 0.001) and cervical cancer (p = 0.328) than those in the period prior to the pandemic (September/19–January/20), although the difference was not statistically significant for cervical cancer. The proportion of cervical cancer patients diagnosed with locally advanced disease (stages III–IVA) was 56.8% (N = 25) in September/20–January/21 compared to 43.3% (N = 26) in September/19–January/20. Similarly, 37.3% (N = 100) of breast cancer patients had stage III disease in September/20–January/21 compared to 23.2% (N = 106) in September/19–January/20. Fewer breast cancer patients (13.7%) were diagnosed due to screening tests during the pandemic than before it (25.5%) (p < 0.001). Conclusions Breast and cervical cancer patients had more advanced-stage diseases in their first visit to a cancer centre during the COVID-19 pandemic compared to a similar period prior to the pandemic. Efforts should be made not to compromise essential cancer services since this results in long-term negative impacts for oncologic patients.
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Affiliation(s)
| | | | - Otavio Augusto Moreira
- Medical Oncology - Instituto do Cancer do Estado de Sao Paulo (ICESP), Av. Dr. Arnaldo, 251, São Paulo - SP, 01246-000, Brazil.,These authors contributed equally to this work
| | - Letícia Vecchi Leis
- Medical Oncology - Instituto do Cancer do Estado de Sao Paulo (ICESP), Av. Dr. Arnaldo, 251, São Paulo - SP, 01246-000, Brazil.,These authors contributed equally to this work
| | - Bruna Zanin Orsi
- Medical Oncology - Instituto do Cancer do Estado de Sao Paulo (ICESP), Av. Dr. Arnaldo, 251, São Paulo - SP, 01246-000, Brazil.,These authors contributed equally to this work
| | - Laura Testa
- Medical Oncology - Instituto do Cancer do Estado de Sao Paulo (ICESP), Av. Dr. Arnaldo, 251, São Paulo - SP, 01246-000, Brazil.,These authors contributed equally to this work
| | - Maria Del Pilar Estevez-Diz
- Medical Oncology - Instituto do Cancer do Estado de Sao Paulo (ICESP), Av. Dr. Arnaldo, 251, São Paulo - SP, 01246-000, Brazil.,These authors contributed equally to this work
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Yoshimoto N, Takayama S, Sakamoto M, Ishikawa K, Katada T, Kawate A, Takura K, Takayama S, Yamashita M, Yamamoto S, Yokoyama K, Kani H. COVID-19 Screening of Breast Cancer Patients During Treatment: A Single Center Experience in Japan. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:423-425. [PMID: 35403168 PMCID: PMC8962867 DOI: 10.21873/cdp.10056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Breast cancer treatment mainly involves interventional methods such as surgical resection and chemotherapy. How to best perform these treatments during the COVID-19 pandemic remains to be established. PATIENTS AND METHODS Patients with breast cancer who received SARS-CoV-2 PCR screening before cancer treatment from December 2020 to April 2021 were included. PCR screening was performed within 72 hours of the scheduled admission time and treatment. RESULTS A total of 19 tests in 15 patients were analysed. Fourteen cases displayed no symptoms, and five cases had some symptoms. COVID PCR tests were negative in all cases. CONCLUSION COVID-19 screening can ensure that breast cancer patients do not miss scheduled treatments as a result of the pandemic. Diagnosis of patients with symptoms that are shared by COVID-19 infection, chemotherapy, and breast cancer recurrence must be performed carefully.
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Affiliation(s)
- Nobuyasu Yoshimoto
- Department of Breast Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Satoru Takayama
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Masaki Sakamoto
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Ken Ishikawa
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Takeyasu Katada
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Akifumi Kawate
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Kohei Takura
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Shoryu Takayama
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | | | - Shinya Yamamoto
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Kioto Yokoyama
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Hisanori Kani
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
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20
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Iles KA, Thornton M, Park J, Roberson M, Spanheimer PM, Ollila DW, Gallagher K. Bridging Endocrine Therapy for HR+/HER2- Resectable Breast Cancer: Is it Safe? Am Surg 2021; 88:471-479. [PMID: 34587799 DOI: 10.1177/00031348211047205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic has required new treatment paradigms to limit exposures and optimize hospital resources, including the use of neoadjuvant endocrine therapy (NAET) as bridging therapy for HR+/HER2-invasive tumors and DCIS. While this approach has been used in locally advanced disease, it is unclear how it may affect outcomes in resectable HR+/HER2- tumors. METHODS Women ≥18 years diagnosed with in situ (Tis) or non-metastatic HR+/HER2- breast cancer from March-May 2019 and 2020 were included. Fisher's exact test and two-sample t test were used to compare baseline characteristics and surgical outcomes between strata. Sub-analysis was performed between patients who received primary surgery vs a bridging NAET approach. RESULTS Despite similar clinical characteristics, patients in 2019 were more likely to have a surgery-first approach (75% vs 42%, P-value = .0007), receive surgery sooner (22 vs 29 days, P-value < .001), and within 60 days from diagnosis date (100% vs 85%, P-value = .0301). Neoadjuvant endocrine therapy was a more prevalent approach in 2020 (48% vs 7%, P-value < .0001). Rates of clinical to pathologic up-staging remained consistent across primary surgery vs bridging NAET subgroups (P-value = .9253). DISCUSSION Pandemic-driven treatment protocols provide a unique opportunity to assess the utility of bridging endocrine therapy for resectable HR+/HER2- tumors. Differences in clinical and pathologic staging were similar across groups and did not appear to be affected by receipt of NAET. Our limited cohort demonstrates this strategic therapeutic avenue can optimize health care utilization and may be a reasonable approach when delaying surgery is preferred.
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Affiliation(s)
- Kathleen A Iles
- Department of Surgery, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Madeline Thornton
- Department of Surgery, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jihye Park
- Department of Epidemiology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mya Roberson
- Department of Epidemiology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Philip M Spanheimer
- Department of Surgical Oncology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David W Ollila
- Department of Surgical Oncology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristalyn Gallagher
- Department of Surgical Oncology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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21
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Terceiro LEL, Edechi CA, Ikeogu NM, Nickel BE, Hombach-Klonisch S, Sharif T, Leygue E, Myal Y. The Breast Tumor Microenvironment: A Key Player in Metastatic Spread. Cancers (Basel) 2021; 13:4798. [PMID: 34638283 PMCID: PMC8507966 DOI: 10.3390/cancers13194798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/12/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022] Open
Abstract
The tumor microenvironment plays a pivotal role in the tumorigenesis, progression, and metastatic spread of many cancers including breast. There is now increasing evidence to support the observations that a bidirectional interplay between breast cancer cells and stromal cells exists within the tumor and the tumor microenvironment both at the primary tumor site and at the metastatic site. This interaction occurs through direct cell to cell contact, or by the release of autocrine or paracrine factors which can activate pro-tumor signaling pathways and modulate tumor behavior. In this review, we will highlight recent advances in our current knowledge about the multiple interactions between breast cancer cells and neighboring cells (fibroblasts, endothelial cells, adipocytes, innate and adaptive immune cells) in the tumor microenvironment that coordinate to regulate metastasis. We also highlight the role of exosomes and circulating tumor cells in facilitating breast cancer metastasis. We discuss some key markers associated with stromal cells in the breast tumor environment and their potential to predict patient survival and guide treatment. Finally, we will provide some brief perspectives on how current technologies may lead to the development of more effective therapies for the clinical management of breast cancer patients.
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Affiliation(s)
- Lucas E. L. Terceiro
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; (L.E.L.T.); (C.A.E.); (T.S.)
| | - Chidalu A. Edechi
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; (L.E.L.T.); (C.A.E.); (T.S.)
| | - Nnamdi M. Ikeogu
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0T5, Canada;
| | - Barbara E. Nickel
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
| | - Sabine Hombach-Klonisch
- Department of Human Anatomy and Cell Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
| | - Tanveer Sharif
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; (L.E.L.T.); (C.A.E.); (T.S.)
| | - Etienne Leygue
- Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0T5, Canada;
| | - Yvonne Myal
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; (L.E.L.T.); (C.A.E.); (T.S.)
- Senior Scientist, CancerCare Manitoba Research Institute, Winnipeg, MB R3E 0V9, Canada
- Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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