Background: The aim of this study was to analyze the clinicopathological features of malignant pleural mesothelioma (MPM) and evaluate the therapeutic measures offered to patients with MPM and their impact on survival. Methods: Data was retrospectively collected from the medical records of 304 patients who presented to the Department of Clinical Oncology and Nuclear Medicine, Ain Shams University between January 2003 and December 2008. Results: The mean age of patients was 52.1 years (range 24-87 years). One hundred and ninety patients (62.5%) came from endemic areas and/or gave history of occupational asbestos exposure. One hundred and sixty-nine patients received chemotherapy. There was a significant difference between the median survival for patients who received chemotherapy (9 months, 95% CI 7.69-10.30) and those who were offered best supportive care (2 months, 95% CI 0.09-3.91). Other factors that affected the survival negatively were: non-epithelial pathology (P = 0.001); age >50 years (P = 0.012); bad performance status (P = 0.001); non-platinum based chemotherapy (P = 0.0001); and progressive disease (P = 0.000). Cox regression analysis revealed that the factors that predicted shorter survival were patients being offered best supportive care rather than chemotherapy and progressive disease. Conclusion: MPM is a growing health problem in Egypt that needs more attention. The current analysis of data reflects the importance of maintaining a high index of suspicion to allow for early diagnosis, especially for cases that live in areas with high asbestos exposure and for people who work in occupations that expose them to asbestos as well as their family members. Prospective randomized trials comparing multimodality approaches to other forms of treatment and including quality of life assessment are warranted.

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Rationale: This phase III study was conducted to compare fluorouracil, leucovorin, oxaliplatin and irinotecan (FOLFOXIRI) with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first line management of metastatic colorectal carcinoma. Methods: Sixty patients with unresectable metastatic colorectal adenocarcinoma were randomly assigned to FOLFOXIRI (n = 30) or FOLFIRI (n = 30) as first line for metastatic disease. The primary end point was response rate (RR) and secondary end points were progression free survival (PFS), overall survival (OS), post chemotherapy RO surgical resection (complete resection with safety margin), and toxicity. Results: The RR was significantly higher for FOLFOXIRI arm 60% (18/30) compared to FOLFIRI (33%) (p = 0.007). The rate of progression was significantly lower for patients treated with FOLFOXIRI (11% vs. 24%; p = 0.02), 5 patients (16%) underwent radical (RO) surgery of metastases in the FOLFOXIRI arm compared with one patient (3%) in the FOLFIRI arm (p = 0.02). FOLFOXIRI resulted in an increased PFS, with median PFS of 10 month vs. 7.5 months (p = 0.0099) with an HR for progression of 2.58 (95% CI, 1.2 to 5.3). The rate of early progression (patients who progressed within six months from the treatment onset) was significantly lower in the FOLFOXIRI arm (18% vs. 45%; p < 0.0001); OS is significantly longer for FOLFOXIRI (22.6 vs. 16.7 months; p = 0.032) corresponding to an HR for death of 0.70 (95% CI, 0.50 to 0.96). Patients who received FOLFOXIRI were subjected to significantly higher incidence of adverse events; grade 2 to 3 peripheral neurotoxicity (0% vs. 20%; p < 0.001) and grade 3 to 4 neutropenia (26% vs. 53%; p < 0.001). Febrile neutropenia was comparable between the two arms (3% vs. 6%) of patients; p = 2. Conclusion: Compared to FOLFIRI regimen; FOLFOXIRI regimen has significantly higher RR, PFS, OS, and improved chance for resection of metastases, with higher but tolerable toxicity in patients with metastatic colorectal cancer.

Background: COVID-19 pandemic scares everybody especially cancer patients. This affects the treatment protocols for some patients Aim of the work:To translate the questionnaire to Arabic and to validate it. Also to assess the patients' knowledge, attitude and perception about the COVID-19 pandemic and their willingness about continuation of anti-cancer treatment. Patients & methods:A pilot study on 50 breast cancer patients who are actively receiving chemotherapy in the department of clinical oncology, Ain Shams University were included from November 1 st , 2020 to March 1 st , 2021, during the COVID-19 pandemic were included to answer the questionnaire. The study correlated sociodemographic data, stage and treatment plan of the patients with their answers in the questionnaire.Results: knowledge about COVID-19 among breast cancer patients was significantly correlated with age < 50 years old (P = 0.0293). Nearly half of patients (46%) have good knowledge about COVID-19 regarding spread, symptoms and outcome. All of the patients wanted to continue their chemotherapy. Nearly half of our patients (48%) had no worry about catching COVID-19. One third of the patients (32%) were bothered about cancer progression, almost one third (28%) were bothered about deferring chemotherapy and the other one third (28%) nothing was bothering them. Most of the patients (72%) knew that chemotherapy causes immunosuppression which increase the risk of complications in case of catching COVID-19. Most of the patients (90%) fear suffering from cancer progression if treatment stopped. Majority of our patients were taking personal protective measures. Conclusion:This study shows that breast cancer patients are more worried about disease progression than COVID-19 and wish to continue chemotherapy during this pandemic.

Objectives. Assessment of gemcitabine/carboplatin combination in patients with advanced-stage hepatocellular carcinoma (HCC) in a phase II trial for safety and efficacy. Methods. Forty patients with previously untreated advanced-stage HCC were prospectively enrolled and subjected to gemcitabine/carboplatin regimen which consisted of gemcitabine 1000 mg/m2 on days 1 and 8, and carboplatin AUC 6 on day 1. The treatment was repeated every 3 weeks until disease progression or limiting toxicity. Results. Forty patients were assessable for efficacy and toxicity. In all, 276 treatment cycles were administered. No toxic deaths occurred. Hematological grade 3-4 toxicity consisted of thrombocytopenia (27% of patients) and neutropenia (24%), including 2 febrile neutropenia and anemia (9%). Grade 3 carboplatin-induced neurotoxicity was observed in 3 (9%) patients. ORR was 23% (95% CI, 0.10–0.29) with 9 partial responses and disease stabilization was observed in 46% (95% CI, 0.22–0.42) of patients, giving a disease control rate of 69%. Median progression-free and overall survival times were, respectively, 5 months (95% CI: 3–8 months) and 8 months (95% CI: 6–18 months). Conclusion. The gemcitabine/carboplatin regimen seems to be effective, well tolerated, and active in advanced HCC.