Hypothyroidism in patients with colorectal carcinoma treated with fluoropyrimidines

Genome-wide association studies of toxicity to oxaliplatin and fluoropyrimidine chemotherapy with or without cetuximab in 1800 patients with advanced colorectal cancer

Chemotherapies administered at normal therapeutic dosages can cause significant side-effects and may result in early treatment discontinuation. Inter-individual variation in toxicity highlights the need for biomarkers to personalise treatment. We sought to identify such biomarkers by conducting 40 genome-wide association studies, together with gene and gene set analyses, for any toxicity and 10 individual toxicities in 1800 patients with advanced colorectal cancer treated with oxaliplatin and fluoropyrimidine chemotherapy ± cetuximab from the MRC COIN and COIN-B trials (385 patients received FOLFOX, 360 FOLFOX + cetuximab, 707 XELOX and 348 XELOX + cetuximab). Single nucleotide polymorphisms (SNPs), genes and gene sets that reached genome-wide or suggestive significance were validated in independent patient groups. We found that MROH5 was significantly associated with neutropenia in MAGMA gene analyses in patients treated with XELOX (P = 6.6 × 10-7 ) and was independently validated in those receiving XELOX + cetuximab; pooled P = 3.7 × 10-7 . rs13260246 at 8q21.13 was significantly associated with vomiting in patients treated with XELOX (odds ratio = 5.0, 95% confidence interval = 3.0-8.3, P = 9.8 × 10-10 ) but was not independently replicated. SNPs at 139 loci had suggestive associations for toxicities and lead SNPs at five of these were independently validated (rs6030266 with diarrhoea, rs1546161 with hand-foot syndrome, rs9601722 with neutropenia, rs13413764 with lethargy and rs4600090 with nausea; all with pooled P's < 5.0 × 10-6 ). In conclusion, the association of MROH5 with neutropenia and five other putative biomarkers warrant further investigation for their potential clinical utility. Despite our comprehensive genome-wide analyses of large, well-characterised, clinical trials, we found a lack of common variants with modest effect sizes associated with toxicities.

Parotid saliva 1 H-NMR analysis for colon cancer metabolomics: A case report

BACKGROUND

A key priority in colon cancer research is the identification of molecular biomarkers to improve early diagnosis, guide prognosis, and the design of new therapeutic approaches. Saliva is a powerful diagnostic biofluid that can be used to detect systemic alterations. This study aimed to investigate the parotid saliva (PS) metabolic Proton Nuclear Magnetic Resonance (¹ H-NMR) profile of a patient diagnosed with colon cancer, and the subsequent changes 1 year after the end of chemotherapy.

CASE REPORT

We describe the ¹ H-NMR PS spectrum of a 65-year-old woman diagnosed with colon cancer (G3 pT3 pN1c) (T0), and the changes in the spectrum from PS collected 1 year after the end of chemotherapy (XELOX: capecitabine plus oxaliplatin) (T1). The data was co-analyzed with blood test cancer antigens (S-CEA; S-CA19-9) and thyroid peroxidase antibody (TPOAb) measurements obtained simultaneously in order to identify peaks and interpret the spectra. The blood cancer antigens (S-CEA; S-CA19-9) and the PS ¹ H-NMR peaks for fatty acids, lactate, acetate, N-acetyl sugars, citrate, tyrosine, saccharides, and formate decreased at T1 compared to T0. Whereas, the thyroid peroxidase antibody (TPOAb) blood values increased at T1 compared to T0 reflecting the changes in the ¹ H-NMR spectral window of 1-3.5 ppm.

CONCLUSION

PS ¹ H-NMR profiling identified modified metabolites that revealed cancer cells metabolism disturbances that subsequently decreased with time throughout treatment. These altered metabolites are potential biomarkers, providing a molecular diagnostic approach for clinical diagnosis, and prognosis of human colon cancer.

Decelerated tumor growth due to hypothyroidism with prolongation of survival in a patient with lung adenocarcinoma: a case report

Lung adenocarcinoma is a form of non-small-cell lung cancer with high mortality in the advanced stages, and is one of the most common histological subtypes of lung cancer in most countries. Prognosis of lung adenocarcinoma is generally poor, with a median survival of 4–13 months. We report a case of unusually prolonged survival of a patient with advanced lung adenocarcinoma complicated by hypothyroidism. A 71-year-old man with stage IV lung adenocarcinoma presented with hypothyroidism. Surprisingly, without any anti-tumor and anti-hypothyroidism therapy, he survived this lung cancer for longer than 2.5 years before his last follow-up visit. Patients with advanced lung adenocarcinoma rarely survive for longer than 2 years, even after therapy. We hypothesize that hypothyroidism is the cause for this discrepancy. Thyroid hormones can promote growth of carcinoma. Therefore, hypothyroidism appears to be beneficial to anti-cancer therapy. We believe that hypothyroidism, as an adverse event commonly occurring in anti-tumor therapy (e.g., an immune checkpoint inhibitor), might not be able to be completely eliminated.

Alteration of Thyroid Function in Indian HER 2-Negative Breast Cancer Patients Undergoing Chemotherapy

BACKGROUND

Thyroid hormones (TH) are regulated by the hypothalamic-pituitary axis, which plays an important role in cell growth, differentiation, development and other aspects of metabolism. It is believed that an active hypothalamic-pituitary axis increases the susceptibility of thyroid dysfunction during systemic chemotherapy. In order to investigate the relation between thyroid function and chemotherapy the present study was designed to investigate TH in breast cancer patients receiving at least three cycles of chemotherapy. The levels of TH were measured at the baseline and before each cycle of chemotherapy.

MATERIALS AND METHODS

Blood samples for estimation of TH levels were collected from 80 (pre-menopausal-40; post-menopausal-40) breast cancer patients just before they were undergoing--1st, 2nd, 3rd and 4th cycle of chemotherapy. The serum was separated and T3, T4 and TSH levels were determined by chemiluminescence method.

RESULTS

T3 and T4 were found significantly decreased and TSH was found significantly increased after 1st (p<0.001), 2nd (p<0.0001) and 3rd cycle of chemotherapy (p<0.0001). The variation of T3 levels (decreased) and TSH levels (increased) was found more in post-menopausal (p<0.0001) women then in pre-menopausal women after 3rd cycle of chemotherapy as compared to baseline (p<0.001).

CONCLUSIONS

TH were remarkably altered after each cycle of chemotherapy leading to decline in thyroid function of breast cancer patients. Further, the results also indicated that post- menopausal women were more prone towards decline in thyroid function then pre-menopausal women. The present study proposes the monitoring of TH after each cycle of chemotherapy in breast cancer patients.