Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma

Abstract

IntroductionPrimary breast marginal zone lymphoma (PBMZL) is a rare occurrence and less is known about its characteristics, treatments, and outcomes.MethodsWe retrospectively reviewed 370 cases of early-stage PBMZL from the Surveillance, Epidemiology, and End Results database. Statistical analyses were performed to describe clinical features, determine prognostic factors, and compare different therapeutic strategies.ResultsAt a median follow-up of 68.5 months, the 5-year overall survival (OS) and disease-specific survival (DSS) rate were 81.2 and 95.4%, respectively. We divided the cohort into four treatment groups and compared their characteristics and survival: radiotherapy (RT) ± surgery (Sx) (n = 142, 38.4%), Sx alone (n = 71, 19.2%), any chemotherapy (CT) (n = 63, 17.0%), and none of the above (n = 94, 25.4%). Age of onset and laterality of lesions tended to relate to the choice of different treatments. Multivariate Cox analysis showed that advanced age (>60 years), concomitant tumor, and any CT (vs RT ± Sx) predicted poorer OS, while for DSS, there was no meaningful indicator (P > 0.05). Patients aged >60 years or treated with any CT seemed to have shorter DSS, but the difference only approached statistical significance. Then we applied a propensity score-matched analysis to demonstrate that neither RT- nor Sx-containing therapy could bring a better OS or DSS. The competing risk model suggested that CT was the only contributor to higher PBMZL-specific mortality.ConclusionOur results show an indolent behavior of early-stage PBMZL with long-term survival. Conventional oncological treatments fail to bring survival benefits; especially CT is detrimental to survival, suggesting that observation may be advisable in the management of early-stage PBMZL, and further research on novel targeted agents is warranted for patients in need.

VCAM1-α4β1 integrin interaction mediates interstitial tissue reconstruction in 3-D re-aggregate culture of dissociated prepubertal mouse testicular cells

“…Loss of CD34 + cells in a re-aggregate during a re-aggregation process should have accompanied the loss of ALCs in the culture. VCAM1 was first identified as a cell adhesion glycoprotein molecule 41 – 43 and is one of the ligands for α4β1 as well as α9β1 integrin 21 . In inflammation, Tumor Necrosis Factor (TNF)-α induces vascular endothelial cells to express VCAM1, which directly interacts with α4β1 integrin on leucocytes, followed by their firm adhesion to the endothelium, rolling and transendothelial migration 41 , 42 .…”

“…Addition of VCAM1 antibody to the culture reduced the frequency of CD34 + cells which approached and entered into the ALC-CD34 + cell-aggregates, indicating a possibility that VCAM1 acts as an attractant for CD34 + cells. VCAM1 is involved in the development of some malignant tumors, and overexpression of VCAM1 facilitates metastasis by promoting epithelial-mesenchymal transformation and transendothelial migration by enhancing pseudopodia formation 43 . Some types of cancer cells, such as pancreatic cancer cells, secrete VCAM1, which attracts macrophages to the tumor environment 44 .…”

“…It may be reasonable to assume that filopodia that are frequently observed in CD34 + cells and extended toward ALC-CD34 + cell-aggregates respond to the haptotic gradient of VCAM1 45 . α4β1 integrin plays an important role in adhesion of leukocytes to endothelial cells and their transmigration through binding to VCAM1 41 – 43 . Hence, we propose, based on the current findings, a possibility that ALCs release VCAM1 as an attractant to which CD34 + cells respond, and thus CD34 + cells come to enclose them.…”

Clinical applications of artificial intelligence and machine learning in cancer diagnosis: looking into the future

“…With the technological impact of biomedical engineering and bioinformatics, NGS technology offered 2nd generation sequencing approach in 2005, processing large-scale sequencing data in a limited time and at affordable cost. Whole genome, whole exome, whole transcriptome, RNA, and short-gun methylation sequencing are the fascinating new applications of NGS and have widely used in cancer research and diagnostics to recognize mutant genes and aberrant molecular pathways for new targeted drug discovery [ 44 , 45 ]. Large scale molecular profiling of RNA has been increasingly accepted to be used in a wide range of cancer therapies and proved to be the standard care for cancer patients.…”

iRGD Tumor-Penetrating Peptide-Modified Nano-Delivery System Based on a Marine Sulfated Polysaccharide for Enhanced Anti-Tumor Efficiency Against Breast Cancer

“…JQ1 is a bromodomain and extra-terminal (BET) inhibitor that could effectively decrease the expression of PD-L1 on the tumor cell surface via reducing the c-MYC transcription, thus blocking the PD-1/PD-L1 interaction. [19][20][21][22][23] Furthermore, JQ1 also shows strong anti-proliferative activity against tumor cells. 24,25 ORI, a bioactive diterpenoid derived from traditional Chinese medicine herb Rabdosia rubescens, exhibits potent anti-cancer activities against a variety of tumor cells.…”