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At least 19 recordsLinked to original sources

Evolution of Precision Oncology, Personalized Medicine, and Molecular Tumor Boards.

With multiple molecular targeted therapies available for patients with cancer that correspond to a specific genetic alteration, the selection of the best treatment is essential to ensure therapeutic efficacy. Molecular tumor boards (MTBs) play a key role in this process to deliver personalized medicine to patients with cancer in a multidisciplinary manner. Historically, personalized medicine has been offered to patients with advanced cancer, but the incorporation of molecular targeted therapies and immunotherapy into the perioperative setting requires clinicians to understand the role of the MTB. Evidence is accumulating to support feasibility and survival benefit in patients treated with matched therapy.

Humans↗

Gastroenteropancreatic Neuroendocrine Carcinoma (GEP-NEC): An Aggressive Disease Course and Limitations for Personalized Oncology.

Neuroendocrine carcinoma (NEC) is a rare, aggressive malignancy with limited treatment options and poor prognosis. We report a male patient diagnosed with a gastroenteropancreatic (GEP)-NEC with synchronous liver metastasis at the time of surgery who underwent a radical resection attempt. Despite radical-intent surgery followed by adjuvant carboplatin/etoposide, early recurrence developed with progression through multiple subsequent chemotherapy lines. During the treatment process, genetic profiling was performed twice to identify actionable genomic targets, with inclusion in the national IMPRESS study as a last resort. Comprehensive genomic profiling revealed TP53 mutation and RB1 loss but no actionable alterations. A patient-derived organoid (PDO) was successfully established from resected tumor tissue and retained key neuroendocrine and proliferative features, with partial genomic concordance to the primary tumor. Differences between the primary and subsequent PDO in variant allele frequencies suggest clonal selection during culture. Exploratory metabolomic profiling of tryptophan pathway metabolites in patient serum and PDO-culture media indicated tumor-associated metabolic alterations. We present clinical and translational efforts in difficult-to-treat NEC, illustrating both the translational challenges and the potential role of PDOs in advancing personalized treatment strategies for a cancer with very limited treatment options.

Gastroenteropancreatic neuroendocrine carcinoma↗

[Vascularized fibula transplantation in orthopedic oncology. Personal experience and review of the literature].

Primary malignant bone tumors can be treated predominantly with limb salvage. After resection of large articular segments adjacent to the dia- or metaphysis of long bones modular endoprosthetic devices are most commonly used for reconstruction. In case non-vascularized corticocancellous bone is transplanted in order to bridge extensive bone defects, the risk of pseudarthrosis and fracture of the donor bone is significantly higher in comparison to a free vascularized transplant. From 1988 until 1999 we treated 20 patients with extensive bone defects after resection of tumors affecting the upper and lower extremity using a vascularized fibular graft. In this retrospective analysis we collected the data focusing on bone integration and functional outcome. The graft union was classified according to the standards of the "International Symposium of Limb Salvage". Evaluation of the functional outcome was quantified using the Enneking-score. The stabilisation of the transplant was obtained exclusively by plate fixation in the upper extremity. In 10 in a total of 12 patients the reconstruction using a vascularized fibula transfer was reinforced with an allograft in the lower extremity. The functional evaluation score reached 73% of normal function at the last follow-up. After 18 months the radiographic evaluation of graft union was "excellent" in 75%, "good" in 11%, "fair" in 6% and "poor" in 9% according to the criteria of the ISOLS. Main complications were graft fracture in of 15% and pseudarthrosis in 14.3%. Reconstruction of extensive bone defects using free vascularized fibula grafts are a demanding operative procedure. The procedure combines a biologic form of reconstruction with a legitimate expectation of good long term outcome and a relatively low rate of complications.

Adolescent↗

Personality types of oncology nurses.

Personality type influences the choice of occupation. The breadth of specialty areas within oncology nursing allows for divergent activities and relationships and, thus, the accommodation of different personality characteristics. This exploratory study examined personality types for a convenience sample of oncology nurses predominantly employed in hospitals. According to the personality typology defined by Carl Jung, a person demonstrates a preference among four dimensions, i.e., extraversion/introversion, sensory/intuition, thinking/feeling, and judging/perceiving. The type with the strongest self-selection for these oncology nurses was ISFJ, where feeling is introverted and perception is practical, so that helping others is both a responsibility and a pleasure. The discussion relates the personality types to Jung's theory and their impact in clinical practice. Strengths and weaknesses of each personality type are described.

Adult↗

Development of radiobiology for oncology-a personal view.

When I came into radiotherapy in 1950, I was puzzled that some patients were treated to 3000 rads (cGy) in 3 weeks but others received 4000 in 5 or 6000 in 6 weeks. When I asked why, there were no convincing answers given, except 'this is what we usually do'. It wasn't until I went to a course on 'Radiobiology for Radiotherapy' in Cambridge that I learnt about the basic theories of Douglas Lea and the very considerable history of research into radiobiology and clinical radiotherapy. And there were still some questions outstanding, such as the relative importance of intracellular repair between 'daily' fractions, whether a 2 day gap each week was a good or a bad idea, and the role of proliferation, if any, during irradiation. I thought that a few simple animal experiments might help to give answers! That led me to a continuing interest in these questions and answers, which has taken me more than 50 years to pursue. This is the very personal story of what I saw happening in the subject, decade by decade. I was happy to experience all this together with scientists in many other countries, and our own, along the way.

Animals↗

Standardized Xenograft Models for Preclinical Cancer Research.

Xenograft models are the principal in vivo platform of preclinical oncology and the most established experimental link between cell culture and clinical investigation. From the carcinogen-exposed rabbit models of the early twentieth century through the current generation of humanized patient-derived xenograft (PDX) systems, these platforms have evolved in response to the demands of translational cancer research. This review critically examines the biological principles, methodological standards, and translational applications of the principal xenograft platforms in current use. Cell line-derived xenograft (CDX) models remain the most widely used and most cost-effective modality for preclinical efficacy testing, offering the reproducibility, scalability, and accessibility that have sustained their role across oncology drug development pipelines for decades. PDX models have emerged as the preferred platform for co-clinical trial design, predictive biomarker discovery, and personalized oncology applications, preserving the genomic landscape, intratumor heterogeneity, and histological architecture of the donor tumor across serial passages. The engraftment biology of PDX systems, including immunodeficient host strain selection, implantation site, tumor source, and passage biology, is reviewed, together with humanized and autologous humanized configurations that extend the platform to immune checkpoint inhibitors, bispecific T-cell engagers, and chimeric antigen receptor T (CAR-T) cell therapy evaluation. This review addresses preclinical-to-clinical translation as a function of immunological divergence, incomplete tumor microenvironment recapitulation, and standardization. Formal frameworks, including the PDX Model Minimal Information (PDX-MI) standard and the Minimal Information for Standardization of Humanized Mice (MISHUM), are examined alongside global biobank infrastructure and emerging AI-driven translational modeling approaches.

Animals↗

Biomathematics in the development of personalized medicine in oncology.

Zvia Agur is an internationally known biomathematician whose research focuses on the dynamics of cancer and infectious diseases, and on mathematical methods for identifying improved drug regimens and improved vaccination programs. She is President of the Institute for Medical BioMathematics, Israel, and the Founder, Chairperson and Chief Scientific Officer of Optimata Ltd, Israel. Professor Agur is a former president of the Israeli Society of Theoretical and Mathematical Biology (1995-2001) and a former member of the Board of Directors of the European Society of Mathematical and Theoretical Biology (1996-2002). Her innovative research has won national awards, has been published in a long list of leading scientific journals and is recognized by the academic community worldwide. She serves on the editorial board of several scientific publications, and holds a PhD from the Hebrew University, Jerusalem, and the Université Libre, Brussels.

Biology↗

Death education for oncology professionals: a personal construct theory perspective.

Using observations from a psychosocial training program for oncology professionals, this article illustrates how one can model, while training the student, the very methods he or she can adopt in working with patients and families. One starts with an elicitation of the student's (patient's) operative personal constructs and then devises strategies to elaborate, integrate, loosen, tighten, preempt, or take other action, as needed. The very means used to promote movement within the student's own death-related constructs can be adopted for use by him or her in the clinical situation. As the helper's pathways of action and thought with regard to this domain become more comprehensive and as the helper becomes more skilled at moving freely along them, he or she becomes more perceptive and resourceful to those in need.

Attitude to Death↗

Age and sex: dual drivers remodeling the anti-tumor immune microenvironment and shaping personalized immuno-oncology.

Despite breakthrough advancements in cancer immunotherapy, significant inter-individual heterogeneity in clinical outcomes persists, bringing the regulatory roles of intrinsic host biological variables into sharp focus. Accumulating fundamental and clinical evidence indicates that age and sex play crucial roles in determining tumor susceptibility, disease progression, and the remodeling of the anti-tumor immune microenvironment. This review systematically delineates the profound impacts of the dual dimensions of age and sex on anti-tumor immune responses and immune evasion mechanisms. In the dimension of age, this article outlines the progressive functional decline of T/B lymphocytes and innate immune subsets driven by immunosenescence, and emphatically reveals how inflammaging and its associated senescence-associated secretory phenotype (SASP) orchestrate the formation of an immunosuppressive tumor microenvironment. In the dimension of sex, we deeply explore four core mechanisms comprising sex chromosome genomics (e.g., escape from X-chromosome inactivation and loss of Y chromosome), sex hormone networks, microenvironmental metabolic reprogramming, and the host gut microbiome, elucidating the molecular basis driving the disparities in innate and adaptive immunity between males and females. In summary, thoroughly deciphering the complex immune regulatory networks driven by age and sex not only helps elucidate the disparities in efficacy and toxicity observed in patients undergoing immune checkpoint inhibitors, but also provides crucial theoretical foundations and translational insights for the future development of "age-tailored" and "sex-specific" strategies in personalized immuno-oncology.

Humans↗

Digital imaging in the radiation oncology environment: a personal computer local area network solution.

Personal computer (PC) driven digital imaging devices are now becoming available in the market place for use in radiation oncology to produce what are known as real time portal images. These limited contrast images are used to verify the patient anatomy under treatment by megavoltage x-rays and are a vital part of the patient treatment. The current generation of devices can produce both single and movie loop images in real time for physician review and approval. To disseminate these images and other digital images used in the planning and delivery of radiation therapy, a PC-based picture archiving and communications system has been developed that is tailored to the special needs of radiation oncology.

Humans↗

2nd FY Khoo Memorial Lecture. Brachytherapy--one man's meat, a personal journey in radiation oncology.

The Lecture covers the author's personal experience in brachytherapy in radiation oncology, beginning with low-dose rate (LDR) treatments using 226Ra "hot" sources, in the 1960s and early 1970s, through manual afterloading for treating gynaecological cancers with the same sources in the 1970s and 1980s, to high-dose rate (HDR) remote afterloading on a microSelectron HDR machine, from 1989 on. This progression in brachytherapy is discussed, and specific applications to various tumour sites are presented, including long-term results of a personal series of 106 patients with cancer of the uterine cervix, treated with radiotherapy incorporating HDR brachytherapy. The Lecture rounds off with an unusual case of equine sarcoid, treated with a postoperative implant, using 192Ir LDR brachytherapy.

Animals↗

Applications of a human tumour clonogenic cell culture system in gynaecological oncology: review and personal experience.

Current and future clinical applications of the Human Tumour Clonogenic Cell Culture (HTC3) system are presented. Advanced gynaecological cancers, especially ovarian, endometrial and cervical carcinomas, require extensive systemic chemotherapy. The HTC3 system seems to be an adequate instrument for individualized chemosensitivity testing in order to choose proper cytostatic treatments; that is, maximum tumour cell kill with minimal side-effects. Furthermore, this system helps in assessing the response after treatment by detection of remaining clonogenic, and thus viable, tumour cells. Other clinical applications of the system include grading of the tumour and recognition of the histologic type. Thus the HTC3 provides a potential tool in diagnosis, treatment and follow-up of gynaecologic malignancies.

Antineoplastic Agents↗

Up close and personal: molecular diagnostics in oncology.

The almost overwhelming volume of information and new technological developments that has demanded so much of our scientific attention over the last decade will shortly revolutionize clinical diagnostics. Some of these developments are already affecting the working lives of scientists and clinicians alike, but will eventually require a greater understanding and acceptance from a much wider audience. Therefore it is important in our current scientific endeavor and commercial enthusiasm for molecular diagnostics that we maintain some awareness of the significant obstacles that must be overcome if we are to see an appropriate, timely and widespread adoption of molecular diagnostic testing in oncology. This article presents a brief commentary on the current state of the art in molecular diagnostics in oncology and how this relates to a more personalized approach to treatment.

Chromosome Mapping↗