Journal of Integrative Oncology

Background: This phase II study investigated the safety and efficacy of an oxaliplatin, fluorouracil, and lleucovorin regimen (FOLFOX6) in Japanese patients with previously untreated, unresectable metastatic colorectal cancer because oxaliplatin of FOLFOX6 was given at a previously untested dose of 100 mg/m2.
Methods: Patients with metastatic colorectal cancer received FOLFOX6, consisting of oxaliplatin at a dose of 100 mg/m2 in combination with l-leucovorin 200 mg/m2 over 2 hours, and fluorouracil 400 mg/m2 intravenous bolus followed by fluorouracil 2400 mg/m2 over a 46-hour infusion, with cycles every 2 weeks until disease progression or unacceptable toxicity. The primary endpoint was to evaluate the objective response rate.
Results: Among 49 patients enrolled, two patients were considered unsuitable against the inclusion criteria due to non-measurable lesion and prior treatment, and one patient was unable to start treatment due to clinical disease progression. Accordingly, safety and efficacy were assessed in 46 and 47 patients, respectively. There was one complete response and 22 partial responses, resulting in an overall response rate of 49% (95% CI 34–64%). The median progression-free survival time was 8.8 months, and the median survival time was 24.5 months. Grade 3 or higher neutropenia and thrombocytopenia occurred in 50% and 2% of patients, respectively, and febrile neutropenia occurred in one patient. Grade 3 sensory neuropathy occurred in 13% of patients.
Conclusion: FOLFOX6 with oxaliplatin at 100 mg/m2 was well-tolerated and effective in Japanese patients with unresectable metastatic colorectal cancer.

Research Electronic Data Capture (REDCap), a web-based approach, provides an easy and efficient way for trained individuals to enter, maintain, and use project data. It also offers the capacity to use surveys and common data collection forms in a way that saves researchers time and money. We found these strengths and the ability to store all study data in one place so as to reduce data safety and confidentiality concerns very supportive of our patient-centered outcomes research (PCOR), with emphasis on patient-centeredness. This article describes our development of a web-base, patient-centered data collection and management approach for our multi-center lung cancer PCOR.

Malignant transformation in a mature cystic teratoma is rare and sarcomatous change is even rarer. We report a case of 57 year old post-menopausal woman who presented with tender abdominal mass and fever. She underwent Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy. Left ovary showed a mature cystic teratoma with solid areas. Histopathology of these solid areas showed a high grade spindle cell sarcoma which exhibited Vimentin and SMA positivity on Immunohistochemistry and was thus diagnosed as leiomyosarcoma.
In most instances malignant transformation cannot be diagnosed pre-operatively. Most of these tumors are considered resistant to radiation and systemic chemotherapy and carry a poor prognosis.

Two male aged 37 years and 29 years presented with generalized itching followed by thickening and reddening of whole body for 3 and 6 months respectively. On examination generalized erythroderma, lymphadenopathy and hepato-splenomegaly were found. In both cases leucocyte count was high and of which 80-90% were morphologically Sezary cells. Peripheral blood absolute CD4+ lymphocytes were very high in both the cases. Skin biopsy showed dense infiltrate of lymphocytes in the dermis with intraepidermal collection of lymphocytes. Bone marrow was infiltrated with Sezary cells.

The goal of immunotherapy is to eliminate cancer cells through the transfer of ex vivo expanded and activated immune cells. Immune cells such as Dendritic Cells (DCs), Natural Killer (NK) cells, Cytotoxic T-cells, and Cytokine Induced Killer (CIK) cells have been investigated for active immunotherapy against cancer. Besides, the passive transfer of Monoclonal Antibodies has been an effective treatment for some cancers. However, for immunotherapy to become the mainstay of treating various cancers, it is pertinent that encouraging data on the clinical trials are available that clearly demonstrate the importance of immunotherapy in enhancing patient survival rate for different cancers and improving their quality of life. Promising trials evaluating the safety and efficacy of immunotherapy for prostate cancer, renal cell carcinoma, gastric and colorectal cancers has opened the door to research in oncoimmunology for integrating immunotherapy with conventional cancer treatments.

Colorectal cancer is the second most common cause of cancer-related death in Western countries. One third of these patients develop liver metastasis and 15-25% have liver metastasis at diagnosis. Resection and chemotherapy are gold standard for colorectal liver metastases. More effective chemotherapy regimens and advanced surgical techniques confer longer survival to patients with colorectal liver metastases. The role of laparoscopy in the diagnosis and treatment of these patients is increasing. With advances in technology and growing experience, laparoscopic approaches have come into prominence because of their superiority over open surgery, including decreased postoperative pain, lower morbidity, reduced time for return to ordinary daily life, and shorter hospitalization.

Objective: This study was undertaken to investigate the clinicopathological factors that influence the growth of a small renal mass (SRM) in patients subjected to a delayed surgery intervention.
Methods: We reviewed the clinical records of 37 patients with SRM 4 cm at diagnosis, who underwent delayed surgical intervention during surveillance from January 2000 to December 2013. Radiographic evaluation using computed tomography (CT) scan, magnetic resonance imaging (MRI) were performed at least every 6 months and the tumor size was determined at least twice.
Results: Histopathological analysis revealed that in 35 of the 37 patients the tumor was malignant in stage pT1aN0M0. There were 28 clear cell carcinomas and 7 non clear cell carcinomas. There was a significant difference in the time to tumor doubling (TTD) among clear cell carcinomas (p=0.033). There was also a significant difference in the tumor growth rate (mm/year) of clear cell carcinomas between male and female patients (p=0.028).
Conclusion: The growth rate of small renal mass was slow in the majority of our patients. Pathological grade and gender significantly influenced the growth of clear cell carcinomas.