Irinotecan and cisplatin is considered to be an effective and safe chemotherapeutic regimen when used concurrently with thoracic radiation therapy for the treatment of patients with LD-SCLC.

Introduction: One of the most important regulators of immune response is the programmed death receptor 1 (PD-1) and its interaction with its ligand (PD-L1), which negatively influences the immune response. Objectives: This study aims to clarify PD-L1 expression levels and the associated tumor infiltrating lymphocytes (TILs) in patients with metastatic breast cancer, and to assess their influence on the prognosis of these patients and the association with clinico-pathologic criteria. Patients and Methods: PD-L1 expression was analyzed using immunohistochemistry (IHC) while TILs count was assessed by histopathological examination of the hematoxylin and eosin (H & E) stained full tumor sections from 50 patients diagnosed with stage IV breast cancer at Ain Shams University hospital, Cairo, Egypt. Results: PD-L1 expression was demonstrated on TILs in 21 of 50 specimens, and on tumor cells in 13 of 50 specimens. Triple negative breast cancer (TNBC) and ER-/Her2+ subtypes were significantly associated with TIL infiltration and PD-L1 expression (on TILs and tumor cells). High TIL infiltration was significantly associated with worse overall survival (OS) and progression free survival (PFS) (P=0.0238 [HR 4.7, 95% CI: 1.22-18.11] and P=0.0262 [HR 3.1, 95% CI: 1.14-8.59] respectively). No correlation was found between PD-L1 expression (on tumor or TILs) and the survival of the patients (OS nor PFS). Conclusion: High TIL count infiltrating the breast tumor is associated with worse OS and PFS in patients with metastatic breast cancer. High PD-L1 expression correlated with high counts of TIL levels around the tumor. These findings have major clinical implications in using immune-checkpoint inhibitors in treating breast cancer patients.

Background: Head and neck squamous cell carcinoma (HNSCC) are a heterogeneous group of malignancy. Their incidenceincreases with age. Therefore, elderly HNSCC patients represent a large population who need special care and treatment considerations. Aim of work:To correlate clinicopathologic factors of nonnasopharyngeal HNSCC geriatric patients with disease free survival (DFS) and overall survival (OS). Patients and methods:A retrospective analysis of fifty nonnasopharyngeal HNSCC elderly patients (≥ 65 years) treated at the head and neck cancer unit at the clinical oncology department, Ain Shams University Hospitals from June 2014 to June 2019. The study correlatedpatients' age, comorbidities, tumor stage and Eastern Cooperative Oncology Group performance state (ECOG PS) with disease free survival (DFS) and overall survival (OS). Results:Three years DFS rate among the patients aged 65-75 years was 73% versus 40% among patients aged 76-80 years and three years OS rate decreased from 48.2% to 40% respectively. The median OS was 39.5 months for patients without co-morbidities compared to 32.5 months for patients with associated co-morbidities (P=0.9) and the median DFS was nearly about 40 months for both groups (p=0.7).Three years DFS was 78.7% among the patients with PS I and 54% among PS II and III (P=0.56) while three years OS rate was 60.7% among patients with PS I but it was 42% for PS II and III (p=0.5). The mean DFS dropped from 43.9 months to 18.4 months for early stages and locally advanced respectively but with no statistical significance association (P=0.49). There was marked decrease of 2years OS from 100% for early stages to 40.3% for locally advanced stages (p=0.009). Conclusion: In HNSCC geriatric patients age >75 years and locally advanced stages were poor prognostic factors for DFS and OS while co-morbidities and ECOG PS didn't affect treatment outcome.

Background HER2 amplification or protein over-expression is found in 20% of invasive breast cancers. It’s clearly associated with accelerated cell growth and proliferation and poor clinical outcome. The amplification of HER2 was historically an adverse prognostic factor associated with a higher risk of recurrence, lack of or lower levels of ER expression, and relative resistance to endocrine therapy and CMF based chemotherapy. Objectives We aimed in this study to assess the impact of delaying the initiation of adjuvant Trastuzumab for more than three months after the diagnosis of breast cancer and the effect of irregular and interrupted doses of adjuvant Trastuzumab, on progression free Survival, relapse, and overall survival (OS) among patients with breast cancer. Patients and Methods A Retrospective cohort study was conducted in Ain Shams University Hospitals. The study included one hundred patients with HER2 positive breast cancer. from January 2011 till December 2016 at the" Department of Clinical Oncology and Nuclear Medicine, Ain Shams University Hospitals". Results The median time to progression in group I was 19 months compared to 30 months in group II. There was statistically significant decrease median of group I compared to group II according to PFS. Conclusion We concluded that delays in the initiation of adjuvant treatment may be particularly harmful in patients with more aggressive tumor types.