The family of fibroblast growth factor (FGFs) and their receptors (FGFRs) regulates vital roles in many biological processes affecting cell proliferation, migration, differentiation and survival. ...Deregulation of the FGF/FGFR signaling pathway in cancers has been better understood and the main molecular mechanisms responsible for the activation of this pathway are gene mutations, gene fusions and gene amplification. DNA and RNA-based technologies have been used to detect these abnormalities, especially in FGFR1, FGFR2 and FGFR3 and tests have been developed for their detection, but no assay has been proved ideal for molecular diagnosis. Interestingly, the increase in the molecular biology knowledge has supported and assisted the development of therapeutic drugs targeting the most important components of this pathway. Multi- and selective tyrosine kinase inhibitors (TKIs) as well as monoclonal antibodies anti-FGFR are under investigation in preclinical and clinical trials. In this article, we reviewed those aspects with special emphasis on the pathway genomic alterations related to solid tumors, and the molecular diagnostic assays potentially able to stratify patients for the treatment with FGFR TKIs.
We study 115 stocks from the Thai Stock Market (SET) from 2006 to 2015. The evolution of correlations between stocks is estimated for different periods of world major financial events and the effect ...of these global financial events on the Thai stock market is studied. A spectral analysis of the correlation matrix based on random matrix theory is done. The evolution and dynamics of threshold networks derived from the correlation matrix are studied. The entropic measure on the eigenvector gives the information contained in each eigenvector which shows that eigenvector on lower side of spectrum are highly localized as compared to higher side of spectrum. The evolution of various topological properties of network are investigated. Thai stock market is found to be less robust during the global financial crisis.
Background. Cancer anorexia-cachexia syndrome (CAS) is a significant comorbidity among all patients with cancer, increasing the mortality rate. Almost all patients with head and neck cancer ...experience this syndrome. CAS causes increased energy expenditure by increasing systemic inflammation and decreasing energy consumption due to anorexia. It leads to skeleton muscle breakdown and reduces the quality of life. Nutritional interventions and primary cancer treatment are the mainstays to manage this situation. However, a vicious cycle causes CAS to persist, especially in head and neck cancer, where tumour location and its treatment interfere with nutritional interventions. Curcumin shows anti-inflammatory effects, including modulated CAS in animal and in vitro studies. Objective. The study aimed to determine the effect of curcumin to treat cancer anorexia-cachexia syndrome among current patients with locally advanced or advanced head and neck cancer. Methods. This constitutes a randomised, double-blind, placebo-controlled phase IIa study. Twenty patients with CAS in locally advanced or advanced head and neck cancer adequately nourished via a feeding tube were enrolled and randomised in a 1 : 1 ratio to receive oral curcumin (at a dose of 4000 mg daily) (n = 10) or placebo (n = 10) for 8 weeks. The primary endpoint was body composition (muscle mass, body fat mass, and basal metabolic rate). The secondary endpoints were handgrip muscle strength, body mass index, absolute lymphocyte count, and safety and toxicity. Result. There was a statistically significant benefit from curcumin on improving muscle mass compared with placebo (2.16% 95% confidence interval; CI, −0.75 to 5.07 vs. −3.82% 95% CI, −8.2 to 0.57; P=0.019). The other parameters of body composition were not significant but tended to favour curcumin benefit. The body fat mass (−0.51 95% CI, −21.89 to 20.86 vs. −8.97% 95% CI, −19.43 to 1.49; P=0.432) and percentage of mean change in the basal metabolic rate were noted (BMR) (0.54% 95% CI, −1.6 to 2.67 vs. −1.61% 95% CI, −4.05 to 0.84; P=0.153). Notably, patients treated with curcumin exhibited less reduction in handgrip muscle strength and absolute lymphocyte count but was not significant. Similarly, most adverse events were grade 1 in both groups. Conclusion. The curcumin add-on resulted in a significant increase in muscle mass than standard nutritional support. Furthermore, it may improve and delay a decrease in the other body composition parameters, handgrip strength, and absolute lymphocyte count. Curcumin was safe and well tolerated. This constitutes an unmet need for clinical trials. This trial is registered with NCT04208334.
e24051 Background: The CurChexia study, NCT04208334, is a phase IIa randomized control trial. The study demonstrates the benefits of adding 4,000 mg of curcumin to the standard nutritional ...intervention. This addition helps to increase muscle mass and delay the decrease in other body composition parameters. However, clinicians require treatment that maintains or improves the quality of life (QoL) of head and neck cancer patients. In this report, we present the QoL data. Methods: Patients participating in the study were required to complete the EORTC QLQ-C30 version 3.0 questionnaire in the Thai edition. The questionnaire was given at the beginning of the study, at the end of week 4, at the end of the study, or in week 8. The results were scored following the EORTC scoring guidelines and compared between the group that received the curcumin add-on and the standard nutritional intervention (control). The patients needed to complete all sections of the EORTC QLQ-C30, and no data was missing. Results: Ten of the 20 patients were given curcumin, while the others were in the control group. Based on the EORTC QLQ-C30, there was an improvement in the median global health status, but it was not significant between the curcumin and control groups. However, the curcumin group improved all functional status parameters, particularly physical functioning ( p= 0.001) and emotional functioning ( p= 0.023). Regarding symptom scales, curcumin significantly reduced pain symptoms ( p= 0.033) and increased appetite ( p= 0.001) compared to the control group. The other parameters that could have affected QoL did not show significant differences between the two groups. Conclusions: The CurChexia study indicates that curcumin has shown promising results in improving muscle mass, enhancing quality of life, and increasing appetite, thereby establishing its position as a noteworthy phytonutrient. However, it is important to note that further research is necessary to understand the extent of its benefits fully. Clinical trial information: NCT04208334 .
Palliative care for patients with advanced cancer improves suffering symptoms, and quality of life (QoL). However, routine implementation of palliative care by specialty palliative care consultation ...is still an unmet need among in-patients with advanced cancer. Our study aim is to evaluate the effectiveness of a team-based approach on QoLs and readmission rate when compared to routine practice by among medical oncologists.
This study was a prospective, Quasi-Experimental design. In-patients with advanced cancer were non-randomly assigned to receive palliative care service by team-based approach or medical oncologists only. The primary endpoint was QoL. The secondary endpoint was the readmission rate at 7 and 30 days of hospital discharge.
One hundred twenty-two in-patients were enrolled. In-patients who were assessed by a team-based approach had significantly improved change scores of subjective well-being (SWB) when compared to another group (∆ SWB: -1 -19 - 11 vs 0 -9 - 15, p-value = 0.043). Furthermore, patients who were assessed under a team-based approach had significantly decreased in terms of readmission rate at 7 days of hospital discharge (4.92% in the team-based approach group vs. 19.67% in the medical oncologist group, p-value = 0.013).
Interdisciplinary collaboration is the key to success in establishing goals of care, which are supporting the best possible QoL and relieving suffering symptoms for those in-patients with advanced cancer. Furthermore, the readmission rate at 7 days of hospital discharge was significantly reduced by a team-based approach. Therefore, comprehensive palliative care assessment by interprofessional collaborative practice is required.
Thai Clinical Trials Registry (TCTR): number 20200312001. Date of first registration on 09/03/2020.
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