Summary To characterize somatic alterations in colorectal carcinoma (CRC), we conducted genome-scale analysis of 276 samples, analyzing exome sequence, DNA copy number, promoter methylation, mRNA and microRNA expression. A subset (97) underwent low-depth-of-coverage whole-genome sequencing. 16% of CRC have hypermutation, three quarters of which have the expected high microsatellite instability (MSI), usually with hypermethylation and MLH1 silencing, but one quarter has somatic mismatch repair gene mutations. Excluding hypermutated cancers, colon and rectum cancers have remarkably similar patterns of genomic alteration. Twenty-four genes are significantly mutated. In addition to the expected APC, TP53, SMAD4, PIK3CA and KRAS mutations, we found frequent mutations in ARID1A, SOX9, and FAM123B/WTX. Recurrent copy number alterations include potentially drug-targetable amplifications of ERBB2 and newly discovered amplification of IGF2. Recurrent chromosomal translocations include fusion of NAV2 and WNT pathway member TCF7L1. Integrative analyses suggest new markers for aggressive CRC and important role for MYC-directed transcriptional activation and repression.
Introduction Cancer patients are presumed a frail group at high risk of contracting coronavirus disease (COVID-19), and vaccination represents a cornerstone in addressing the COVID-19 pandemic. However, data on COVID-19 vaccination in cancer patients are fragmentary and poor. Methods An observational study was conducted to evaluate the seropositivity rate and safety of a two-dose regimen of the BNT162b2 or mRNA-1273 vaccine in adult patients with solid cancer undergoing active anticancer treatment or whose treatment had been terminated within 6 months of the start of study. The control group was composed of healthy volunteers. Serum samples were evaluated for SARS-COV-2 antibodies prior vaccinations and 2-6 weeks after the administration of the second vaccine dose. Primary endpoint: seropositivity rate. Secondary endpoints: safety, factors influencing seroconversion, IgG titers of patients versus healthy volunteers, COVID-19 infection. Results Between 20 March 2021 and 12 June 2021, 293 consecutive cancer patients with solid tumors underwent a program of COVID-19 vaccinations: of these, 2 patients refused vaccination, 13 did not receive the second dose of the vaccine due to cancer progression and 21 had COVID-19 antibodies at baseline and were excluded. The 257 evaluable patients had a median age of 65 years (range 28-86), 66.15% with metastatic disease. Primary endpoint: seropositivity rate in patients was 75.88%, versus 100% in the control group. Secondary endpoints: no grade 3-4 side effects, no COVID-19 infections were reported. Patients median IgG titer was significantly lower than in the control group, male sex and active anticancer therapy influenced negatively seroconversion. BNT162b2 or mRNA-1273 vaccines were immunogenic in cancer patients, showing good safety profile.
BackgroundNew chemotherapic agents and new protocols in oncology have led to an increasing survival rate in patients affected by tumors. However, this increased use has been accompanied by a growth in the incidence of cutaneous side effects and a worsening of patients’ quality of life. Appropriate management of skin toxicity associated with chemotherapic agents is therefore necessary for suitable drug administration and to improve quality of life and clinical outcomes.MethodsWe have clinically examined 100 patients affected by cancer, determining type, frequency, treatment, and evolution of side effects related to chemotherapy.ResultsThe prevalent cutaneous side effects in patients undergoing chemotherapy are skin rash, xerosis, pruritus, paronychia, hair abnormality, and mucositis. The clinical cases are reported in detail.ConclusionOncological therapies have become more selective and have low systemic toxicity because of their high specificity, but cutaneous side effects are common and may worsen the quality of life of these patients.
Our results underline that teledermoscopy of 'pink' lesions does not provide a similar degree of diagnostic accuracy as otherwise in face-to-face diagnosis perhaps due to the absence of typical criteria. Atypical skin lesions are characterized by the absence of typical dermoscopic patterns, and their teleconsultation does not always increase the diagnostic accuracy.
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