Search

Background: Synovial sarcoma represents 8% of all soft-tissue sarcoma (STS). It is a high-grade STS, and 50% of patients develop metastasis. The most common site of metastasis is the lungs, lymph nodes followed by bones. Ifosfamide-based chemotherapy is associated with improved outcome. In this study, we report our experience of metastatic synovial sarcoma according to primary sites, metastatic pattern, and their outcome. Materials and Methods: This was a retrospective observational study carried out at our institute from January 2013 to December 2016. The aim of our study was to evaluate the pattern of metastasis, response to chemotherapy, and survival in patients with metastatic synovial sarcoma. Results: Over a period of 4 years, 43 patients with metastatic synovial sarcoma were diagnosed with median age of 30 years. Nearly 70% of patients had lung metastasis, other site of metastasis were lymph node, bone, and liver. Thirty patients received chemotherapy with a combination of ifosfamide and doxorubicin. The overall response rate was 87% with median progression-free survival of 8 months. Patients with lung only metastasis had better survival compared with nonpulmonary metastatic site (18 months vs. 12 months). The median survival was 18 months. Conclusion: Metastatic synovial sarcoma is chemoresponsive tumor with lung being the most common metastatic site. Patients with lung only metastasis had a better outcome than nonpulmonary metastasis. [ABSTRACT FROM AUTHOR]

Introduction: Bone metastasis is a rare site of metastasis, seen in only 3.7-11% of clinical cases. Isolated bone involvement has been reported very rarely in literature. Moreover, the patients who have bone metastasis at presentation are even rare.Objectives: To discuss the demographic characteristics, carcinoembryonic antigen (CEA) levels, pattern of bone involvement, and their correlation with survival in patients of colorectal cancer that have bone metastasis at the time of presentation.Materials and Methods: Retrospectively, tumor registry was analyzed for the cases of colorectal cancer presenting with bone metastasis between 2008 and 2013. Survival curves were generated by Kaplan-Meier method and analyzed using the log-rank test.Results: Ten such patients were identified (male:female = 7:3) of the total 410 patients. Median age was 41 years (22-50 years). All patients were Conclusions: In this study, the patients of colorectal cancer presenting with bone metastasis were of male sex and younger age. The factors that were associated with reduced survival were extraosseous and liver involvement. [ABSTRACT FROM AUTHOR]

Epithelioid sarcoma (ES) first described by Enzinger in 1970,[1] is a rare soft-tissue sarcoma typically presenting as a subcutaneous or deep dermal mass in distal portions of the extremities of adolescents and young adults. They are frequently mistaken for ulcers, abscesses, or infected warts that fail medical management. Patients often develop multiple local recurrences of long duration, with subsequent metastases in 30%-50% of cases.[2] We here report a case of left thumb ES that presented as an ulcer and subsequently metastasized to the forearm, arm, axillary lymph nodes, and lungs. [ABSTRACT FROM AUTHOR]

Background: After failing oxaliplatin-based first-line chemotherapy (CT), about 4-21% of patients with metastatic colorectal cancer (mCRC) respond to irinotecan-based second-line treatment. Prolonged exposure of colon cancer cells to 5-FU induces resistance, due to increased synthesis of thymidylate synthase (TS). Earlier studies have demonstrated that ATO can significantly re-sensitize resistant colon cancer cells to 5-FU by down regulating TS. Moreover, ATO can also act as a vascular disrupting agent and has synergistic effect with irinotecan on tumor growth delay. We hypothesized that a combination of ATO with FOLFIRI regimen in mCRC patients refractory to first-line FOLFOX, could further improve the outcome of second-line CT. Methods: The inclusion criteria were: age ?18 years; pathologically proven mCRC; ECOG PS ?2; refractory to first-line FOLFOX; not affording for biologic agents due to economic constraint; adequate organ functions and measurable disease according to RECIST 1.1. Major exclusion criteria were: ?2 lines of previous CT for metastatic disease; congestive cardiac failure and evidence of brain metastases. Patients were administered ATO 0.15 mg/kg/day on days 1 to 2, along with FOLFIRI regimen at standard doses every 2 weeks, until disease progression, unacceptable toxicity or patients' refusal. Responses to CT were reported according to RECIST 1.1. Adverse events were classified based on CTCAE v 4.0. Results: Between October 2016 and May 2017, 13 patients with refractory mCRC were treated with this investigational combination. The median age was 47 years (range, 32-65); 10 males and 3 females; ECOG PS 0-1/2, 12/1; site of primary tumor rectum/ colon, 8/5. Median baseline serum CEA was 78 ng/ml (range, 18- 836). The most common site of metastases was liver (n=7) followed by peritoneum (n=5), lungs (n=3) and non-regional lymph-nodes (n=3); number of involved metastatic sites 1-2/?3, 8/5. After 6 cycles of CT, overall response rate and disease control rate was 23% and 84.6% respectively (CR=0, PR=3 pts, SD=8 pts); approximately 69% of patients experienced a ?50% decline in serum CEA level. At a median follow-up of 5.5 months (range, 4-8), 7 patients had disease progression and kept on best supportive care; 6 patients were still on study drugs; and all 13 patients were alive. Median progressionfree survival was 4.5 months (95%CI 3.8-5.2), from the initiation of ATO plus FOLFIRI. The toxicities were as follows: Grade 1/2 toxicity: fatigue (4 pts.), constipation (1), nausea and vomiting (1). Grade 3 toxicity: fatigue (3), neutropenia (2), diarrhea (2), QTc prolongation (1). No patient experienced grade 4 toxicities. Conclusions: The addition of ATO 0.15 mg/kg/day on days 1 to 2, to standard FOLFIRI regimen as second-line CT in patients with refractory mCRC offers an encouraging anti-tumor effect at the cost of manageable toxicity. [ABSTRACT FROM AUTHOR]

The majority of the cancer-associated deaths is due to metastasis—the spread of tumors to other organs. Circulating tumor cells (CTCs), which are shed from the primary tumor into the circulation, serve as precursors of metastasis. CTCs have now gained much attention as a new prognostic and diagnostic marker, as well as a screening tool for patients with metastatic disease. However, very little is known about the biology of CTCs in cancer metastasis. An increased understanding of CTC biology, their heterogeneity, and interaction with other cells can help towards a better understanding of the metastatic process, as well as identify novel drug targets. Here we present a novel ex vivo 3D system for culturing CTCs from breast cancer patient blood samples using porous poly(ε-caprolactone) (PCL) scaffolds. As a proof of principle study, we show that ex vivo culture of 12/16 (75%) advanced stage breast cancer patient blood samples were enriched for CTCs identified as CK+ (cytokeratin positive) and CD45− (CD45 negative) cells. The deposition of extracellular matrix proteins on the PCL scaffolds permitted cellular attachment to these scaffolds. Detection of Ki-67 and bromodeoxyuridine (BrdU) positive cells revealed proliferating cell population in the 3D scaffolds. The CTCs cultured without prior enrichment exhibited dynamic differences in epithelial (E) and mesenchymal (M) composition. Thus, our 3D PCL scaffold system offers a physiologically relevant model to be used for studying CTC biology as well as for individualized testing of drug susceptibility. Further studies are warranted for longitudinal monitoring of epithelial–mesenchymal transition (EMT) in CTCs for clinical association. [ABSTRACT FROM AUTHOR]