Patients diagnosed with cancer often experience an abnormal occurrence of venous thromboembolism (VTE) and its related complications. In order to evaluate the safety and effectiveness of both treatment approaches, we conducted a comprehensive systematic review and meta-analysis within the realm of cancer-associated thromboembolism. A thorough search was conducted across PubMed, the Cochrane Library, and Embase databases to find studies comparing direct oral anticoagulants (DOACs) with low molecular weight heparins (LMWHs) for the treatment of VTE in patients with malignancy. The analyses utilized the random-effects model. This meta-analysis included 11 studies. The results showed that DOACs were associated with a significantly reduced risk of VTE recurrence (RR: 0.67; 95% CI: 0.55, 0.81, p<0.0001; I2: 0%) and deep vein thrombosis (DVT) (RR: 0.63; 95% CI: 0.46, 0.86, p<0.0001; I2: 0%) compared to LMWHs. However, there was no significant difference in the risk of pulmonary embolism (PE) (RR: 0.76; 95% CI: 0.54, 1.06, p=0.11; I2: 11%) between the two groups. The use of DOACs was also associated with a nonsignificant increase in the risk of major bleeding events (RR: 1.

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Introduction/Objective Adrenal Cortical Carcinoma (ACC) is a rare malignant neoplasms originating from adrenal cortical tissue with an annual incidence rate of 1 to 2 cases per million individuals. These tumors have poor prognosis with 5-year disease free survival being 30% after complete resection in Stage I to Stage III patients. Hence, there is a need for identifying prognostic markers for effective management of disease in these patients. Methods We analyzed the data in The Cancer Genome Atlas of 1141 ACC individuals, using cbioportal.org, a web- based platform for analysis of large-scale cancer genomics data sets, and derived correlation between prognosis and genetic alterations in approximately 51,309 genes. Results We identified 15 signature genes (NOTCH1, TP53, ZNRF3, LRP1, KIF5A, MDM2, LETMD1, MTOR, NOTCH3, RERE, SMARCC2, LDLR, HRNR, AVPR1A and PCDH15), alterations in which indicated a poor prognosis for ACC individuals. Analysis of 15 signature genes demonstrated that disease specific median survival for the patients with ACC, was reduced to 39.5 months (p value &lt; 8 x 10 -9 and sensitivity of 93%) when any one or more of these genes was altered. Whereas, disease specific median survival was greater than 180 months (90% survival being 180 months) with no alteration in our signature genes. In addition, our analysis of our signature genes demonstrates reduced overall survival, disease free survival and progression free survival in individuals having alterations in our signature genes. Moreover, our set of 15 genes belonged mainly to MDM2-TP53, NOTCH and mTOR pathways, and small molecule modulators of these pathways are in process of development. Conclusion Our 15 gene signature was not only able to predict poor prognosis in ACC, but also has the potential to serve as a molecular marker set for initiation of NOTCH and mTOR specific targeted therapies in these patients.

Lung cancer continues to be responsible for a major proportion of cancer-related morbidity and mortality worldwide. Adenocarcinoma is known to be the predominant histologic type in patients with lung cancer. There is a need to develop unique prognostic indicators in lung adenocarcinoma as this would help clinicians to identify patients who will benefit the most from aggressive treatments and prevent unnecessary treatment-related toxicity in those who will not benefit as much. METHODS:The human gene list was downloaded from Ensembl genes 99 database using Human genes (GRCh38.p13 dataset). The cancer genome atlas database has genomic characterization of 2167 cases of Lung Adenocarcinoma from 6 different studies. We combined all the datasets and analyzed the mutational profile of each individual genes in 62358 gene set and determined whether each gene in our dataset is altered in the Lung Adenocarcinomas, number of cases in which the gene is altered, whether alteration is associated with increased or decreased survival and median overall survival associated with the alteration using cbioportal.org. http://www.cbioportal.org/ is a web-based platform designed by Memorial Sloan Kettering Cancer Centers Computational Biology Center. We reviewed a set of 25,460 genes in which the survival was altered. Out of 25,460 genes, we identified a unique 15 gene signature, alterations in at least one of which were found to be of prognostic value in these patients. Data was statistically analyzed, validated and Kaplan-Meir curves were constructed to demonstrate differences in outcomes between patients with alteration in at least 1 gene from the signature and those without any alterations.