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Abstract Background Precise prognostication is the key to optimum and effective treatment planning for early-stage hormone receptor (HR) positive, HER2/neu negative breast cancer patients. Differences in the breast cancer incidence and tumor anatomical features at diagnosis, pharmacogenomics data between Western and Indian women along with the vast diversity in the economic status and differences in insurance policies of these regions; suggest recommendations put forward for Western women might not be applicable to Indian/Asian women. Opinions from oncologists through a voting survey on various prognostic factors/tools to be considered for planning adjuvant therapy are consolidated in this report for the benefit of oncologists of the sub-continent, SAARC and Asia’s LMIC (low and middle-income countries). Methods A three-phase DELPHI survey was conducted to collect opinions on prognostic factors considered for planning adjuvant therapy in early-stage HR+/HER2/neu negative breast cancer patients. A panel of 25 oncologists with expertise in breast cancer participated in the survey conducted in 2021. The experts provided opinions as ‘agree’ or disagree’ or ‘not sure’ in phases-1 and 2 which were conducted virtually; in the final phase-3, all the panel experts met in person and concluded the survey. Results Opinions on 41 statements related to prognostic factors/tools and their implications in planning adjuvant endocrine/chemotherapy were collected. All the statements were supported by the latest data from the clinical trials (prospective/retrospective). The statements with opinions of consensus less than 66% were disseminated in phase-2, and later in phase-3 with supporting literature. In phase-3, all the opinions from panelists were consolidated and guidelines were framed. Conclusions This consensus guideline will assist oncologists of India, SAARC and LMIC countries in informed clinical decision-making on adjuvant treatment in early HR+/HER2/neu negative breast cancer patients.

We present the 2017 Oncology Gold Standard Practical Consensus Recommendation for use of monoclonal antibodies in the management of advanced squamous cell carcinoma of head neck region.

This manuscript captures the discussion and recommendations that came out of a special Afro Asian symposium involving 13 countries. Unmet needs and cost-effective solutions with special emphasis on training form the backbone of practical next steps.

Background: Although Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) infections in immunocompromised hosts have been recognised, clinical data detailing these infections remain limited, especially from India. Antimicrobial susceptibility data on E. meningoseptica remain very limited, with no established breakpoints by Clinical and Laboratory Standards Institute (CLSI). The organism is usually multidrug resistant to antibiotics usually prescribed for treating Gram-negative bacterial infections, a serious challenge to the patient and the treating clinicians. Materials and Methods: The analysis was done in a tertiary care oncology and stem cell transplant center. Susceptibility testing and identification of E. meningoseptica was done using Vitek auto analyzer. Records of immunocompromised patients with E. meningoseptica bacteremia were analysed from January 2009 to March 2012. Results: A total of 29 E. meningoseptica bacteremia cases were documented between 2009 and 2012. Eleven patients were immunocompromised. Three were post stem cell transplant and one was post cord blood transplant. The mean age of the patients was 48.4 years. Mean Charlson′s comorbidity index was 5.7. Four had solid organ malignancies, five had hematological malignancies, and two had lymphoreticular malignancy. Eight patients had received chemotherapy. Mean Apache II score was 18. Mean Pitts score for bacteremia was 4.7. Two were neutropenic (one post SCT, one MDS post chemo) with a mean white blood cell (WBC) count of 450/mm 3 . Ten had a line at the time of bacteremia. Mean duration of the line prior to bacteremia was 8 days. Eight had line-related bacteremia. Three had pneumonia with secondary bacteremia. All received combination therapy with two or more antibiotics which included cotrimoxazole, rifampicin, piperacillin-tazobactam, tigecycline, or cefepime-tazobactam. All the isolates showed in vitro resistance to ciprofloxacin. Five patients died, but a multivariate analysis was not done to calculate the attributable mortality. Conclusion: In our study, central line was the commonest risk factor for E. meningosepticum bacteremia, although a multivariate analysis was not done. There has not been much of a change in the susceptibility pattern of these organisms over 3 years, with good susceptibility to piperacillin-tazobactam and cotrimoxazole. Even though uncommon, E. meningoseptica is an important pathogen, especially in immunocompromised hosts with indwelling devices.

Primary signet ring cell adenocarcinoma (PSRCC) of the bladder is a relatively rare variant of adenocarcinoma of the bladder with poor prognosis. Also PSRCC of the bladder presenting with spontaneous urinary extravasation is very rare. We present the case of a 48-year male who presented with spontaneous urinary extravasation and was diagnosed to have PSRCC of the urinary bladder on evaluation. He was treated with radical cystectomy and adjuvant chemotherapy. This report emphasizes the need to rule out other primary sites of adenocarcinoma in the body, which may metastasize to the urinary bladder.

Hidden markov model (HMM) is a statistical markov model in which the system being modeled and is assumed to be a markov process with unobservable (i.e., Hidden) states. In HMM, the state is not directly visible but the output depend on the state is visible. Each state has a probability distribution over the possible output tokens. The model is referred to as a hidden markov model even if these parameters are known exactly. The viterbi is one of the estimate underlying state path in hidden markov models. In this paper, viterbi path is derived using hidden markov model. [ABSTRACT FROM AUTHOR]

This current analysis demonstrates the development of the related substances (RS) method for separating and quantifying BSL and its related substances from plasma using the UPLC technique. The solid phase extraction (SPE) method was employed to extract the belumosudil (BSL) and related impurities from plasma. This SPE method has been shown to have high recovery values for BSL and its related impurities. The method employed a column from Waters, specifically the X-Bridge BEH C18 150x4.6mm, 3.5µm, with a mobile phase flow rate (0.8 mL/min) and a UV-wavelength (250 nm). In this method, BSL and its impurities show good peak shapes and high resolutions. This developed method shows high sensitivity, accuracy, and precision values. While performing the stability studies, the drug was stable and it showed less than 4.53% degradation. Six different concentration solutions (BSL (25-250µg/mL) and impurities (3-18µg/mL)) were prepared for constructing linearity plots. The obtained linearity plot shows the accepted correlation coefficient (R2) value (=0.999). The Limit of detection (LOD) and Limit of quantification (LOQ) were determined using the signal-to-noise (S/N) ratio method. This UPLC method was validated according to ICH guidelines. [ABSTRACT FROM AUTHOR]