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Even with the decreasing incidence of colorectal cancer (CRC), data showing that the rate of incidence of CRC is declining with 2.9% every year starting with 2005 until 2014, CRC remains one of the most frequent neoplasia all over the world. Almost a quarter of patients with CRC present with stage IV disease at diagnosis and nearly 30% of patients with localized disease will progress within 5 years. Our study included 129 patients with metastatic CRC that received chemotherapy � bevacizumab, from January 2017 until December 2018. Patients received fluropirimidine-based chemotherapy plus or minus bevacizumab. No significant differences was registered between groups with respects of age, sex, tumor localization, chemotherapy regimen used. Also no significant difference was found in our groups regarding risk factors for bleeding and medical history. No remarkable differences were registered between the two groups regarding common adverse reactions to chemotherapy, with the exception of physical asthenia which was found in a greater proportion of patients that received bevacizumab in combination with chemotherapy. In our study most frequent adverse events related to bevacizumab were grade 1 or 2, only few adverse events were grade 3 or 4 and lead to discontinuation of bevacizumab treatment, and these were mainly thromboembolic events and bleeding.

Head and neck cancers are still one of the most common types of cancer in the world. They rank in the leading sixth place in terms of incidence globally, and the incidence continues to rise. The mortality rates remain at high levels. Pathological subclassification places squamous cell carcinoma of the head and neck (HNSCC) in the first place concerning the histological forms of head and neck cancers; a tumor with extremely aggressive behavior and high mortality rates. The tumor microenvironment is a very complex ecosystem of cellular and non-cellular components, characterized by unique features, that contribute to the appearance of immunosuppression and diminished anticancer immunity, impacting patient prognosis and treatment outcome. Despite many important advances in therapy, resistance to therapy represents a difficult challenge in HNSCC patients. Tumor progression, metastasis, and response to therapy are all influenced by the complex ecosystem represented by the tumor microenvironment and by the interactions between cellular and non-cellular components of this system. Therefore, the tumor microenvironment, in the light of recent data, is not an innocent bystander. In the last few years, there has been a sustained effort to characterize the tumor microenvironment, to identify targets of response and identify other mechanisms of tumor-specific immune responses, or to discover other biomarkers of response. There is an urgent need to understand how to properly select patients, the therapy sequence, and how to use feasible biomarkers that can help to identify the patient who may obtain the most benefit from available therapies.

Background The coronavirus disease 2019 (COVID-19) pandemic outbreak forced cancer care providers to face different challenges in terms of prevention and treatment management due to specific precautions implemented for oncological patients. We aimed to describe the level of knowledge, attitude and practices (KAP) among cancer patients, with the purpose to provide an image of the impact of COVID-19 and evaluate the effectiveness of pandemic response measures. Patients and methods We developed a cross-sectional multicentric study that targeted adults with active cancer during the COVID-19 outbreak, aiming to describe KAP related to COVID-19 among Romanian oncological patients. A questionnaire investigating 64 items on KAP related to the novel coronavirus was designed and applied in seven Romanian hospitals. The group of participants consisted of 1585 oncological patients who completed the questionnaire during the outbreak (April-May 2020). Results Only 172 patients (10.8%) had very good knowledge about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection symptoms, treatment options and incubation period. Only 44.3% of patients identified diarrhoea as a sign of COVID-19. About one-third of patients (32.6%) declared that they are ‘very worried’ about getting infected with the novel coronavirus. More than two-thirds of participants (68%) considered that having cancer represents an additional risk for infection with SARS-CoV-2, but 27.8% would rather not vaccinate against SARS-CoV-2 should a vaccine be available. A small percentage (8.8%) believed that the risk of infection justifies delaying/stopping oncological treatment until after the pandemic. Around half of the participants (55.5%) declared being compliant with all the protective measures against coronavirus infection listed in the questionnaire. Conclusion Romanian oncological patients have a less than expected knowledge about SARS-CoV-2, appropriate prevention behaviours, with limited trust in their efficacy, optimistic attitudes towards COVID-19 and low level of trust in information sources. Good COVID-19 knowledge was associated with appropriate practices towards COVID-19 and optimistic attitudes., Highlights • Romanian oncological patients included in the study had a less than expected knowledge about coronavirus. • Appropriate prevention behaviours were noted among patients, but with limited trust in their efficacy. • Some patients would rather stop the oncological treatment for the duration of the pandemic. • Patients with low socioeconomic status or higher education were more worried that they might get infected with SARS-CoV-2. • The results suggest the need for implementation of better health education programs aimed at improving COVID-19 knowledge.

Background: Literature suggests that high body mass index can be correlated with better response to immune checkpoint inhibitors. On the other hand, sarcopenia seems to be a negative predictive marker. Materials and methods: The present analysis is a retrospective, multicenter trial that included patients with metastatic melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma treated with nivolumab between 2018 and 2020. Patients were stratified by creatinine levels both at treatment initiation and at first follow-up (at three months) and by BMI for the same intervals, as recorded in the patients&rsquo, charts. Creatinine was considered a surrogate marker for sarcopenia. IBM SPSS version 20 was used for statistical analysis. Results: A total of 57 (n = 57) patients were included in the trial. Overall response rate (ORR) for the entire population was 38.59% (p = 0.02). Patients with BMI lower than 25 had an ORR of 28.5% (p = 0.003), whereas patients with BMI higher than 25 had an ORR of 42.3% (p = 0.002). Patients who gained weight during treatment had a lower probability of having progressive disease (OR = 0.4 [95% CI, 0.4&ndash, 1.2]), as did patients with creatinine higher than 0.9 (OR = 0.39 [95% CI: 0.13&ndash, 1.14]). No superiority was found in progression-free survival (PFS) when patients were dichotomized for BMI = 25 or BMI = 18.5. Mean PFS in the BMI under 18.5 group was 10.2 months [95% CI: 5.8&ndash, 23.1], versus 11.2 for BMI over 18.5 [95% CI: 5.3&ndash, 25.3], p &lt, 0.03. Mean PFS for the BMI under 25 was 11.2 months [95% CI: 7.2&ndash, 20.1], vs. 13.3 months [95% CI: 6.4&ndash, 22] for the BMI over 25, p &lt, 0.001. There were also differences in PFS in the patients with baseline creatinine over 0.9 when compared with under 0.9 values. Mean PFS in the first group was 19.78 months [95% CI: 16.23&ndash, 22.9] vs. 16.1 [95% CI: 12.2&ndash, 20.3], p &lt, 0.001. Conclusion: Patients treated with nivolumab who have weight gain during treatment have a better PFS than the ones who do not. Creatinine levels of over 0.9 at treatment initiation also have positive predictive value.

The main objective of this analysis is to evaluate the impact of lung cancer and diabetes association on cancer treatment and outcome of lung cancer patients. Lung cancer, as well as diabetes mellitus, are two diseases with very high prevalence. Lung cancer, despite the improvement in diagnosis and therapeutic methods, is still the 1st cause of cancer-related deaths. The influence of diabetes on cancer patients survival is well established among patients with hepatic, pancreatic or breast cancer. Diabetes implication on lung cancer outcome is not well known. Several studies reported a negative impact, whereas other studies reported a better prognosis for these patients. Our study took place in the Oncology Department of the Clinical Emergency Hospital of Constanta, Romania. 80 patients with diagnosis of non-small cell lung cancer were elected to participate in this study; 29 patients had also diabetes. Selected patients were divided in 2 groups, one group of lung cancer and diabetes, and one group without diabetes. Features of the patients among both groups were analyzed. Our study showed that preexisting diabetes is an unfavorable factor, and has influence on lung cancer prognosis, treatment adhesion and quality of life. To amend the outcome of patients with lung cancer, a better evaluation of patients� co-morbidities, including diabetes mellitus, is required.

Lung cancer is the most common cause of cancer-related mortality, and non-small cell lung cancer (NSCLC) represents about 85% of all lung cancers. In the last years, novel targeted therapies have been developed and approved in the treatment of NSCLC. Angiogenesis is a very complex process, and cancer angiogenesis is the most important event concerning cancer growth, invasion and metastasis. VEGF signalling pathway plays a significant role in cancer angiogenesis, and it is demonstrated that VEGF levels are correlated with increased angiogenesis and with poor prognosis and metastasis in NSCLC patients. Bevacizumab is a recombinant humanised monoclonal IgG1 antibody, it is one of the first agent used for anti-angiogenic treatment, and it was approved for the treatment of non-squamous NSCLC in combination with chemotherapy.

NSCLC accounts around 80% of all lung cancers. NSCLC patients have usually a lousy quality of life (QoL), influenced by the malignant disease itself and by cancer treatment modalities. We conducted an observational study in Oncology Department, Clinical Emergency Hospital, Constanta, on a sample of 50 patients diagnosed with NSCLC one year. Our study data showed that younger patients have a better QoL regarding social/family well-being, but without other significant differences. Also, patients living in the urban area have a better QoL regarding social/family well-being. Patients having better performance status obtain higher scores from all subscales of the FACT- G questionnaire and, also a higher FACT-G total scale, these results are showing that better the performance status and general status of the patient, better the QoL. We detected a significant relationship between QoL and disease stage or presence of metastasis. We found no clinical significance between QoL scores with respect with chemotherapy protocol or the number of cycles of chemotherapy. We aimed to show that factors influencing the QoL of NSCLC patients are stage of the disease and performance status of the patients. To diminish the negative impact, one important step in ameliorating the QoL of NSCLC patients is to detect all factors influencing it and offer psychological spiritual and social support.