No abstract

Tumor-infiltrating lymphocytes (TILs) play an important role in mediating treatment response in pancreatic cancer. This meta-analysis investigated the prognostic significance of TIL subsets on overall survival (OS) and disease-free survival (DFS) of patients with pancreatic cancer. Studies were gathered via search of PubMed, Google Scholar, and Cochrane Library databases up to August 1, 2019. Using Review Manager version 5.3.5, pooled hazard ratios and 95% confidence intervals (CIs) were calculated using random or fixed-effects models, depending on the heterogeneity of studies. A total of 11 studies comprising 1760 patients were included in the meta-analysis. Pooled analysis revealed that high CD8+ TILs were associated with improved OS [hazard ratio (HR)=0.59, 95% CI=0.51–0.69, P<0.00001] and DFS (HR=0.60, 95% CI=0.50–0.73, P<0.00001). Similarly, high CD3+ TILs correlated with better OS (HR=0.64, 95% CI=0.54–0.75, P<0.00001) and DFS (HR=0.53, 95% CI=0.31–0.92, P<0.0001). In contrast, high FoxP3+ TILs were associated with worse OS (HR=1.39, 95% CI=1.03–1.88, P=0.03). Finally, high CD4+ TILs showed significant improvement in OS (HR=0.74, 95% CI=0.63–0.86, P=0.0001). TILs are a promising prognostic biomarker in pancreatic cancer. Prospective studies evaluating TILs are recommended as well as the establishment of standards in the assessment of TILs.

PURPOSE Several factors affect how medical oncologists in the Philippines use biomarkers in real-world practice. This study describes patterns of biomarker testing for the management of breast, colorectal, and lung cancers among medical oncologists in the Philippines. METHODS A cross-sectional survey was performed among practicing medical oncologists in the Philippines from November to December 2019. The questionnaire determined the ideal and practical use of biomarkers as perceived by the respondents. Responses were summarized. Associations between biomarker use across select conditions were determined. RESULTS A total of 127 respondents (38% of medical oncologists in the Philippines) participated in this study. In actual practice, 97% of the respondents requested estrogen receptor/progesterone receptor testing, and 93% requested human epidermal growth factor receptor 2 testing. For colorectal cancer, the respondents would use KRAS and mismatch repair/microsatellite instability, but 59.84% had never used BRAF. For lung cancer, 97.64% of respondents would test for epidermal growth factor receptor ( EGFR), 88.19% would test for PD-L1, 80.31% for anaplastic lymphoma kinase, 58.27% for ROS1, and 33.07% for BRAF. In actual practice, EGFR was the most frequently ordered test (67.72%), while 44.80% of medical oncologists had never used ROS1. The most common reason for testing was adherence to international guidelines (96%). The most commonly cited barrier to biomarker use was patients’ financial constraints (94.49%). Overall, the respondents’ use of biomarkers was not significantly associated with institutional affiliation, the number of patients they saw monthly, and the availability of biomarker tests in their areas of practice. CONCLUSION Medical oncologists in the Philippines would use biomarkers in treating breast, colorectal, and lung cancers if these were clinically indicated and if cost were not a factor. Financial difficulty experienced by patients was the most commonly cited barrier to biomarker use.

Background: This study assessed the efficacy of immersive virtual reality (VR) as an adjunct in the management of treatment-related anxiety and depression among breast cancer outpatients undergoing chemotherapy at the University of the Philippines -Philippine General Hospital Cancer Institute. Methods:In this open-label phase II randomized control trial, participants were randomly assigned into two groups during their first cycle of chemotherapy e the intervention group who were subjected to immersive VR experience using VR Box 3D goggle sets plus standard-of-care and the control group who received standard-ofcare only. Anxiety and depression scores of at-risk breast cancer patients were measured using the Hospital Anxiety and Depression Scale -Pilipino (HADS-P) questionnaire before and after chemotherapy. The influence of clinico-demographic factors on the mean difference of HADS-P scores was explored. Pre-and postchemotherapy blood pressures, heart rates, and respiratory rates were also determined. Results:The investigators were able to screen 114 patients and 65.8% (n¼75) had a HADS-P score of 11. The proportion of patients who were at-risk to develop treatment-related anxiety and depression was 73.5% (n¼50) and 22.1% (n¼15), respectively. A total of 68 patients were included in the randomization. Statistically significant mean differences of j-2.71j and j-4.74j (p<0.05) in the pre-and postchemotherapy HADS-P scores between the control group and intervention group were reported. Changes in mean arterial pressures, heart rates, and respiratory rates pre-and post-chemotherapy were not statistically significant.Conclusions: In this study, the investigators observed that immersive VR could potentially decrease the level of treatment-related anxiety and depression of at-risk breast cancer outpatients undergoing chemotherapy.