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Globally, breast cancer is the most prevalent cancer and one of the leading causes of cancer-related death among women. HER2-low breast cancer represents a recently identified molecular category within breast cancer characterized by tumors displaying only slight overexpression of HER2 or lacking gene amplification. To illustrate, HER2-low tumors typically have an IHC (immune histochemistry) score of 1+ or 2+ with negative amplification. Nonetheless, recent findings indicate that even a slight amplification of HER2 could notably influence both therapeutic responses and prognostic outcomes. Our study aims to unveil the impact of HER2-low expression on the response to anthracycline and taxane-based neoadjuvant chemotherapy (NACT) in comparison to the HER2-negative group in non-metastatic breast cancer. This is a retrospective cohort study. All patients’ profiles with non-metastatic, HER2- low, and HER2-negative breast cancers who were administered neo-adjuvant chemotherapy and had surgery performed within the period spanning from 1 January 2018 to 30 August 2022 were enrolled. HER2-positive breast cancer patients were excluded. The evaluation of patients’ responses was conducted through the examination of surgical pathology reports to compare the two study groups (HER2-low and HER2-negative). The primary objective was evaluating the response to NACT comparing the objective response rate (ORR) in each of the two groups of HER2-low and HER2-negative patients. The total number of patients included was 262 patients; the majority were HER2-low 89% (233/ 262) vs. 11% (29/262) HER2-negative. An ORR (complete and partial response) to NACT was shown in 71% (185/262) of all patients. The ORR was similar in both groups, 70% (164/233) in the HER2-low group vs. 73% (21/29) in the HER2- negative group, with a statistical difference, OR: 1 (95% CI: 0.8–1), p-value 0.8. Similarly, the pathological complete response (pCR) rate was the same in both study groups at 14%, OR: 0.7 (95% CI: 0.2–3), p-value: 0.6. Interestingly, patients with hormone-positive tumors across both study groups had a higher response rate compared to hormone-negative patients. In the HER2-low cohort, the ORR was higher in patients with hormone-positive tumors in comparison with those with hormone-negative tumors [73% vs. 27%, OR: 0.8 (95% CI:0.8–1), p-value: 0.001]. Comparatively, in the HER2-negative cohort, ORR was also higher in patients with hormone-positive tumors compared to hormone-negative tumors [52% vs. 48%, OR: 2 (95% CI: 1–5), p-value: 0.05]. Subsequently, the ORR of all hormone-positive tumors with a positive outcome (CR or PR) was assessed categorizing the patients based on their HER2 expression. Concerning patients who expressed partial response (N = 115), a statistically significant difference was observed in HER2- low hormone-positive tumors as opposed to HER2-negative hormone-positive tumors [90% vs. 10%, OR: 0.7 (95% CI: 0.5–0.9), p-value: 0.001]. Remarkably, all patients with complete responses were from the HER2- low cohort. Our findings demonstrated a significant influence of HER2-low expression on the response to neoadjuvant chemotherapy among patients with hormone-positive HER2-low breast cancer within the studied cohort. Further studies are needed to evaluate the influence of hormonal expression on the response rate to NACT in the HER2-low patients in our population. [ABSTRACT FROM AUTHOR]

Background: Advances in our understanding of the tumor microenvironment have radically changed the cancer field, highlighting the emerging need for biomarkers of an active, favorable tumor immune phenotype to aid treatment stratification and clinical prognostication. Numerous immune-related gene signatures have been defined; however, their prognostic value is often limited to one or few cancer types. Moreover, the area of non-coding RNA as biomarkers remains largely unexplored although their number and biological roles are rapidly expanding.Methods: We developed a multi-step process to identify immune-related long non-coding RNA signatures with prognostic connotation in multiple TCGA solid cancer datasets.Results: Using the breast cancer dataset as a discovery cohort we found 2988 differentially expressed lncRNAs between immune favorable and unfavorable tumors, as defined by the immunologic constant of rejection (ICR) gene signature. Mapping of the lncRNAs to a coding-non-coding network identified 127 proxy protein-coding genes that are enriched in immune-related diseases and functions. Next, we defined two distinct 20-lncRNA prognostic signatures that show a stronger effect on overall survival than the ICR signature in multiple solid cancers. Furthermore, we found a 3 lncRNA signature that demonstrated prognostic significance across 5 solid cancer types with a stronger association with clinical outcome than ICR. Moreover, this 3 lncRNA signature showed additional prognostic significance in uterine corpus endometrial carcinoma and cervical squamous cell carcinoma and endocervical adenocarcinoma as compared to ICR.Conclusion: We identified an immune-related 3-lncRNA signature with prognostic connotation in multiple solid cancer types which performed equally well and in some cases better than the 20-gene ICR signature, indicating that it could be used as a minimal informative signature for clinical implementation. [ABSTRACT FROM AUTHOR]

aiman,1 Gayan Melikyan,2 Hanan Farghaly,3 Zsolt Lengyel,4 Yousef Al Rimawi,5 Dina Soliman,6 Nabil Elhadi Omar71Department of Medical Oncology, Hamad Medical Corporation, National Center Cancer Care and Research, Doha, Qatar; 2Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 3Department of Pathology and Laboratory Medicine, Hamad Medical Corporation, Doha, Qatar; 4Department of Body Imaging, Hamad Medical Corporation, Doha, Qatar; 5Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar; 6Department of Hematology, Hamad Medical Corporation, National Center for Cancer Care and Research, Doha, Qatar; 7Pharmacy Department, Hamad Medical Corporation, National Center for Cancer Care and Research, Doha, QatarCorrespondence: Nabil Elhadi OmarPharmacy Department, Hamad Medical Corporation, National Center for Cancer Care and Research, Doha 3050, QatarEmail Nabilelhady@gmail.com Background: Clear cell carcinoma of the endometrium (CCE) has a tendency to occur in a mismatch repair protein deficient molecular background. Treatment with immunotherapy can predict a favorable response. Case presentation: We are presenting a 53-year-old female, diagnosed with CCE 17 years ago, who was treated initially with hysterectomy and left salpingo-oophorectomy, who relapsed a few months later, and was then treated with left pelvic mass excision and sigmoidectomy. Recently, the disease recurred as a retroperitoneal lymphadenopathy, which was resected but then relapsed locally, spread to the lungs, and progressed further after three lines of chemotherapy. On pathological review of the tumor, it was found to harbor loss of nuclear expression of MLH-1 and PMS-2. Based on a strong predictor of response to immunotherapy, pembrolizumab was tried. However, within a few days of the single dose of pembrolizumab, immune thrombocytopenia followed by pancytopenia, recurrent seizures, visual hallucination, and cerebellar signs consistent with limbic encephalitis developed, which were not responding to steroid and intravenous immunoglobulin. Conclusion: We are presenting a case of a CCE with deficient mismatch repair that developed two autoimmune side effects, pancytopenia and limbic encephalitis, within a few days of a single injection of pembrolizumab. [ABSTRACT FROM AUTHOR]

This article presents an overview of the cancer genetics program in Qatar. In addition to summarizing clinical, research, educational, and other aspects, data related to testing outcomes (over the course of approximately 5.5 years) are presented. [ABSTRACT FROM AUTHOR]

Background: An insufficient number of studies have been carried out in the Middle East to evaluate the role of structured psychotherapeutic interventions in enhancing breast cancer patients' psychological well-being, quality of life and treatment compliance. This study has been designed to address this limitation by exploring the benefit of two structured psychotherapeutic interventions, crisis counseling and psychoeducation, in enhancing breast cancer patients' psychological well-being, quality of life and treatment compliance in Qatar. Methods: A total of 201 women with early-stage breast cancer from the state of Qatar were recruited and randomized into either the control group or one of the treatment groups (crisis counseling or psychoeducation). Each of the two treatment interventions consisted of a total of six 60- to 90-minute sessions, which were provided over a period of 12 weeks. The short- and long-term benefits of the crisis counseling and psychoeducation interventions were evaluated in terms of improving patients' psychological well-being, quality of life and treatment compliance by asking all the patients to complete the Depression, Anxiety and Stress Scale, 21 item version (DASS-21) and European Organization for Research and Treatment of Cancer Quality of Life scale (QLQ-C30) instruments at different points in time and by monitoring their compliance to chemotherapy and radiotherapy treatment. Results: This study revealed that both of the study interventions, crisis counseling and psychoeducation, were effective in improving women's psychological well-being and quality of life over time in comparison to the control group, but had no significant impact on patients' compliance with treatment. In addition, the study showed that psychoeducation conferred a greater advantage than did the crisis counseling model, especially in improving women's psychological well-being over time. Conclusion: This study is considered the first of its kind in Qatar to provide evidence on the benefit of crisis counseling and psychoeducation interventions in improving the psychological well-being and quality of life of women with early-stage breast cancer in Qatar. In addition, this study has provided innovative research that can be used as evidence to propose changes to the psychotherapy services for breast cancer patients in Qatar. This research study aims to provide a first step toward further research in the future, which will hopefully lead to a better health care system for cancer patients in Qatar. [ABSTRACT FROM AUTHOR]

Objectives: In the Middle East, Qatar in particular, the incidence of breast cancer has substantially increased in recent years, and is expected to double by 2030. This diagnosis also occurs at a later stage in the disease. Early detection along with proper treatment reduces radical mastectomy and mortality rates, yet only one-third of Arab women in Qatar participate in breast cancer screening (BCS) activities of any sort. Many women in the conservative Qatari society rely on male family members for support and protection. This study investigates the attitudes and perceptions of Arab men in regards to breast cancer screening and what they see as both incentives and barriers to women’s participation in BCS activities. Design: A qualitative methodology using purposive sampling technique was chosen in order to explore participant’s attitudes, beliefs and health-related actions. Individual in-depth interviews with open-ended questions were conducted with 50 Arab men during October 2011 to May 2012. Data collection, analysis, and interpretation occurred simultaneously. NVivo 9, a qualitative data analysis software program was used to organize themes and subthemes. Results: It was found that most men understood the importance of regular BCS in early detection of breast cancer. They felt they had an important role in encouraging the women in their lives to participate in BCS activities, but were adamant that any examination must be done by a female health care professional. Few knew details about screening guidelines in Qatar, but most had a basic knowledge of some screening activities. Most indicated an interest in learning more about BC and screening activities in order to better help and inform their female family members. Conclusion: Because Arab men perceive that their opinions and support are a major factor influencing female family members’ participation in breast cancer screening, it is important that any program instituted to increase such screening participation be aimed at both men and women. More information is needed by both sexes as to the need for and benefits of regular screening activities, the techniques used, and the newly revised guidelines in Qatar. Such a program needs to be introduced in the near future in order to avert, at least partially, the expected doubling in breast cancer cases by 2030 in the Middle East. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. Setting: A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were 2 estimated using ? tests and multivariate logistic regression analyses. Results: Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Conclusions: Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Recommendations: Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. [ABSTRACT FROM AUTHOR]

Background Despite rising breast cancer incidence and mortality rates, breast cancer screening (BCS) rates among women in Qatar remain low. Previous studies indicate the need to better understand the many complex beliefs, values, and attitudes that influence Arab women's health seeking behavior for the development of culturally appropriate and effective intervention strategies to address breast cancer in the Middle East. This study investigates beliefs, attitudes, and BCS practices of Arabic-speaking women in Qatar. Methods A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) Arabicspeaking female Qatari citizens and non-Qatari residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Associations between beliefs and BCS practice were estimated using chi-square tests and multivariate logistic regression analyses. Participants who adhered to BCS guidelines (BCS practice = Yes) were compared to those who did not (BCS practice = No). Results In addition to low levels of awareness and low participation rates in BCS, one quarter of the participants stated their doctors talked to them about breast cancer, and less than half of the women interviewed believed breast cancer can be prevented. Women who engaged in BCS practice were more likely to have a doctor who talked to them about breast cancer, to believe they were in good-excellent health, that cancer can be prevented, or that cancer might be hereditary. The majority wanted to know if they had cancer and felt their health care needs were being met. The main reasons given for not planning BCS were lack of a doctor's recommendation, fear, and embarrassment. Conclusions These findings indicate that a variety of channels (health care providers, media, breast cancer survivors, community leaders) should be utilized to create culturally appropriate breast cancer intervention programs and increased awareness of breast cancer, BCS, and the benefits of early detection of breast cancer. Employment of these measures will reduce breast cancer mortality rates among Arabic-speaking women living in the State of Qatar. [ABSTRACT FROM AUTHOR]

Background: Dysregulated cancer metabolism is associated with acquired resistance to chemotherapeutic treatment and contributes to the activation of cancer survival mechanisms. However, which metabolic pathways are activated following treatment often remains elusive. The combination of chicken embryo tumor models (in ovo) with metabolomics phenotyping could offer a robust platform for drug testing. Here, we assess the potential of this approach in the treatment of an in ovo triple negative breast cancer with doxorubicin. Methods: MB-MDA-231 cells were grafted in ovo. The resulting tumors were then treated with doxorubicin or dimethyl sulfoxide (DMSO) for six days. Tumors were collected and analyzed using a global untargeted metabolomics and comprehensive lipidomics. Results: We observed a significant suppression of tumor growth in the doxorubicin treated group. The metabolic profiles of doxorubicin and DMSO-treated tumors were clearly separated in a principle component analysis. Inhibition of glycolysis, nucleotide synthesis, and glycerophospholipid metabolism appear to be triggered by doxorubicin treatment, which could explain the observed suppressed tumor growth. In addition, metabolic cancer survival mechanisms could be supported by an acceleration of antioxidative pathways. Conclusions: Metabolomics in combination with in ovo tumor models provide a robust platform for drug testing to reveal tumor specific treatment targets such as the antioxidative tumor capacity. [ABSTRACT FROM AUTHOR]

Background: Despite rising breast cancer incidence and mortality rates, breast cancer screening (BCS) rates among women in Qatar remain low. Previous studies indicate the need to better understand the many complex beliefs, values, and attitudes that influence Arab women's health seeking behavior for the development of culturally appropriate and effective intervention strategies to address breast cancer in the Middle East. This study investigates beliefs, attitudes, and BCS practices of Arabic-speaking women in Qatar.Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) Arabic-speaking female Qatari citizens and non-Qatari residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Associations between beliefs and BCS practice were estimated using chi-square tests and multivariate logistic regression analyses. Participants who adhered to BCS guidelines (BCS practice = Yes) were compared to those who did not (BCS practice = No).Results: In addition to low levels of awareness and low participation rates in BCS, one quarter of the participants stated their doctors talked to them about breast cancer, and less than half of the women interviewed believed breast cancer can be prevented. Women who engaged in BCS practice were more likely to have a doctor who talked to them about breast cancer, to believe they were in good-excellent health, that cancer can be prevented, or that cancer might be hereditary. The majority wanted to know if they had cancer and felt their health care needs were being met. The main reasons given for not planning BCS were lack of a doctor's recommendation, fear, and embarrassment.Conclusions: These findings indicate that a variety of channels (health care providers, media, breast cancer survivors, community leaders) should be utilized to create culturally appropriate breast cancer intervention programs and increased awareness of breast cancer, BCS, and the benefits of early detection of breast cancer. Employment of these measures will reduce breast cancer mortality rates among Arabic-speaking women living in the State of Qatar. [ABSTRACT FROM AUTHOR]

Breast cancer is a public health threat in the State of Qatar. It is the most common cancer and the incidence rate is increasing. It has been found that women often present with breast cancer at advanced stages in Qatar. Early detection of breast cancer is an important prognostic factor and breast cancer screening has been found successful in decreasing mortality rates. The percentage of women in Qatar engaging in screening activities is alarmingly low. A study has been designed to examine barriers and facilitators that are potentially influencing women in participating in breast cancer screening activities. Understanding these barriers and facilitators is essential in order to create a culturally appropriate and effective intervention that can encourage women in Qatar to participate in screening activities. In this paper the background to the study is presented which highlights the magnitude of the breast cancer problem in Qatar and offers the rationale and information for this potentially groundbreaking study. [ABSTRACT FROM AUTHOR]