Journal of Current Oncology and Medical Sciences

Exploring neoantigens and genetic profiles in renal cell carcinoma: a study of Iranian patients

Mon, 30 Jun 2025 00:00:00 -0400

Introduction: Kidney cancer accounts for 3.7% of all newly diagnosed cancer cases and represents a considerable global health challenge. Although there have been advancements in treatment, renal cell carcinoma (RCC) continues to show resistance to conventional cytotoxic chemotherapy, highlighting the need for innovative therapeutic strategies. Current research is focusing on vaccine approaches that target tumor neoantigens, utilizing next-generation sequencing to pinpoint tumor-specific mutations. A deeper understanding of the molecular characteristics of RCC, particularly gene mutations such as BAP1, PBRM1, SETD2, and VHL, is essential for the development of personalized treatment modalities. This study aimed to investigate potential tumor neoantigens in samples from Iranian patients diagnosed with RCC, with an emphasis on peptide sequences that exhibit a strong binding affinity for Iranian Human Leukocyte Antigen (HLA).

Materials and methods: Databases and relevant literature were employed to identify neoantigens with the highest prevalence. Tumor samples were obtained from patients with RCC, and primary cells were isolated and cultured in RPMI complete medium. Total DNA was extracted, followed by polymerase chain reaction (PCR) using specifically designed primers, and the resulting PCR products were sequenced using Sanger sequencing.

Results: Our examination did not identify the specified nucleotide changes in the DNA sequencing chromatogram of the cell samples, indicating that the anticipated mutations were absent. Nevertheless, other mutations were observed in the analyzed regions of the genes.

Conclusion: Although certain mutations were not identified in the sequenced samples, this research highlights the necessity for further investigation. Comprehensive studies are vital to gain a complete understanding of the genetic mutation profile of RCC in Iranian patients. Mapping the gene mutation landscape among RCC patients in Iran presents significant opportunities for the development of effective cancer vaccines and tailored treatment strategies.

Scalp dosimetry as a predictor of radiation-induced alopecia in primary brain tumours: a retrospective study from a tertiary cancer centre in south India

Mon, 30 Jun 2025 00:00:00 -0400

Introduction: Radiotherapy is essential in treating primary brain tumours, but radiation-induced alopecia (RIA) remains a common side effect that significantly affects patients' quality of life (QOL). With its psychosocial impact on self-image, emotional well-being, and social interactions, alopecia warrants focused attention. This study aims to evaluate the scalp as an organ at risk by defining dose constraints that minimize RIA while maintaining optimal target coverage.

Materials and methods: A retrospective analysis was conducted on 70 patients with primary brain tumours who received focal cranial radiotherapy between January 2022 and December 2024. Scalp dose-volume histograms (DVHs) were generated from treatment planning systems, and the mean scalp dose (D mean), maximum scalp dose (D max), median volume of scalp, volume of scalp receiving ≥ 30 Gy (V30Gy), dose received by 20cc (D20cc), and 30cc (D30cc) scalp volume were recorded. RIA was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. ROC statistical analysis was performed to evaluate the predictive value of scalp dosimetric parameters for RIA severity.

Results: The median age of the cohort was 57 years, with a male-to-female ratio of 1.08:1. The median D max, D mean, V 30 Gy, D20cc were 60.4 Gy, 17.5 Gy, 19.2%, and 46.4 Gy, respectively. Grade 2 and higher RIA was observed in 63% of patients. V30Gy, either independently or in combination with Scalp D mean, was identified as a significant predictor of Grade 2 or higher RIA.

Conclusion: Optimising scalp dose parametric during radiotherapy planning may help mitigate RIA and improve QOL.

Tenosynovial giant cell tumour (diffuse type) with a background of malignant melanoma: a case report from South Africa

Rushern Ruvashin Chetty, Sanele Kunene — Mon, 30 Jun 2025 00:00:00 -0400

Introduction: Tenosynovial giant cell tumour (TGCT) is a rare mesenchymal tumour that affects joints and tendon sheaths, little is known about conditions associated with TGCT.

Case Presentation: Mr X, a 89-year-old male, known with a history of malignant melanoma was initially thought to have metastatic lung lesions from the melanoma. Following a lung biopsy, Mr X was diagnosed with a second primary lesion – TGCT: diffuse type – rather than a metastatic lesion. The patient was not considered for referral to a multidisciplinary sarcoma team due to the advanced stage of disease. Mr X deteriorated and demised after commencing Imatinib.

Discussion: Although one would think that a pulmonary lesion in a patient with a history of cancer is metastatic disease, it is not always the case. The patient may have two primary cancers that are unrelated. One other case report has previously been published on a patient with a TGCT and Melanoma.

Conclusion: TGCT is a rare condition that may or may not be associated with melanoma. We recommend that suspected metastatic melanoma lesions be biopsied to establish or refute this association.

Stereotactic fractionated radiotherapy for multiple brain metastasis treated with single isocenter multitargeted approach: a case report

Siddharth Arora, Kriti Grover — Mon, 30 Jun 2025 00:00:00 -0400

Introduction: Adult patients with solid cancers frequently develop brain metastases. Whole brain radiotherapy (WBRT) alone or Stereotactic radiosurgery/radiotherapy (SRS/SRT) alone or in combination can be considered in Brain metastasis. Stereotactic radiosurgery has been effective in brain metastasis. Linac-based stereotactic radiosurgery has made use of volumetric modulated arc therapy (VMAT), which enables the simultaneous treatment of many targets with a single plan and isocenter.

Case presentation: A 62-year-old Asian presented to us with complaints of headache and blurring of vision. Disease mapping with positron emission tomography (PET) revealed Lung primary. Magnetic resonance imaging (MRI) of brain revealed multiple brain metastasis. He was planned with fractionated stereotactic radiotherapy. Plan involved volumetric arc therapy - Stereotactic radiosurgery (VMAT-SRS) treatment with single isocenter multiple target stereotactic fractionated radiotherapy, which was delivered post stringent quality assurance.

Discussion: SRS immobilization System has become more patient specific. Multiple challenges are encountered with single isocenter multiple target stereotactic fractionated radiotherapy. Essential yet challenging aspect of SRS is dosimetry. It requires a comprehensive Quality assurance to treatment planning to its delivery.

Conclusion: LINAC based VMAT SRS plans are more conformal with prescribed isodose line up to 75%. Hence, optimization strategies should be applied for better plan outcome. Our patient completed treatment without any major side effects. Planned imaging with the CEMRI brain showed complete response with no new findings.

Risk of hepatocellular carcinoma in adults exposed to oral antidiabetic drugs: a systematic review

Mon, 30 Jun 2025 00:00:00 -0400

Introduction: An increasing amount of clinical research is being conducted on the association between antidiabetic medications and the outcomes of hepatocellular carcinoma. By offering a thorough synthesis of the available data and pinpointing topics for further investigation, this systematic review seeks to assess any possible correlations between the results.

Methods: According to a registered protocol on the Open Science Framework, we carried out a systematic review of research published between January 2015 and February 2025. We reviewed several databases to identify English-language research employing a range of study designs, including observational studies, cohort studies, and clinical trials. After a thorough screening procedure, 18 studies were chosen from 1089 records. Following the parameters of this study, the main objective was to summarise the evidence without doing a formal quality assessment.

Results: Our analysis found possible connections between liver cancer outcomes and several antidiabetic groups, including insulin, metformin, thiazolidinediones, sodium-glucose cotransporter 2 (SGLT2) inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors. Metformin, GLP-1 receptor agonists, and SGLT2 inhibitors were consistently associated with reduced risk of hepatocellular carcinoma (HCC) and improved survival outcomes. In contrast, insulin use in cirrhotic patients was linked to increased all-cause mortality and higher liver-related complications. Thiazolidinediones showed a time-dependent protective effect, with longer use correlating with lower HCC risk. The results suggest that some antidiabetic drugs may affect overall survival, recurrence rates, and mortality specific to liver cancer. We discovered that rather than being an initiating factor, the majority of antidiabetic medications have decreased the risk of liver cancer.

Conclusion: This systematic review contributes to a better understanding of the complex relationship between antidiabetic medications and liver cancer outcomes. Important conclusions imply that medical professionals ought to think about the possible effects of particular antidiabetic medications in liver cancer patients. More extensive randomised controlled trials with longer follow-up are advised to elucidate these correlations and guide treatment recommendations.

The relationship between antidiabetic and renal cancer: a systematic review

Mon, 30 Jun 2025 00:00:00 -0400

Introduction: Antidiabetic medications have been studied for potential effects beyond glycemic control, including their role in cancer development and progression. Renal cell carcinoma (RCC) is a critical concern in diabetic patients due to overlapping metabolic risk factors. This systematic review evaluates the association between antidiabetic drug use and the incidence or mortality of RCC compared to no use or alternative therapies.

Methods: A systematic search was conducted across major databases to identify observational and experimental studies examining the relationship between antidiabetic drug exposure and RCC risk or survival. Eligible studies included cohort, case-control, randomized controlled trials, meta-analyses, and preclinical investigations. Data extraction focused on study design, population characteristics, drug class exposure, renal cancer-related outcomes, and study quality.

Results: Eleven studies met inclusion criteria. Most were observational in nature, with one randomized trial and several meta-analyses. Evidence regarding RCC risk and outcomes was mixed across different antidiabetic agents. Some cohort studies indicated a potential protective association between antidiabetic use and RCC incidence, with dose-response effects observed. Preclinical data supported mechanistic plausibility for anticancer activity, though human data remained inconclusive. Methodological heterogeneity—including varied exposure definitions, follow-up durations, and confounding adjustment—limited comparability.

Conclusion: Current evidence suggests a possible link between antidiabetic medication use and altered RCC risk or survival, but findings remain inconsistent and non-causal due to the predominance of observational data. Future research should prioritize well-designed randomized controlled trials and mechanistic studies to clarify these associations and inform personalized therapeutic strategies.