Journal of Cancer & Allied Specialties https://journals.sfu.ca/jcas/index.php/jcas <p>The <em>Journal of Cancer &amp; Allied Specialties </em>is a double blind peer-reviewed open access electronic journal which focuses on all aspects of <em>cancer care</em>.</p> en-US <p>Authors retain copyright and grant the Journal of Cancer &amp; Allied Specialties (JCAS) right-of-first publication. In addition, the work will be simultaneously licensed under a <a href="https://creativecommons.org/licenses/by-nc-sa/4.0/">Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license</a>. This license allows others to share the work in whole or part (for non-commercial purpose), with an acknowledgement of the work’s authorship and initial publication in JCAS.</p> <p>Furthermore, authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.</p> <p>Authors are permitted and encouraged to share their work online or in medical or scientific conferences prior to or during submission process.</p> editor@skm.org.pk (Khawaja S. Nasir) sanaq@skm.org.pk (Ms Sana Qamar) Fri, 13 Jan 2023 21:12:19 -0800 OJS 3.1.2.1 http://blogs.law.harvard.edu/tech/rss 60 Indoleamine 2,3- Dioxygenase: A Novel Immunotherapeutic Target for Osteosarcoma https://journals.sfu.ca/jcas/index.php/jcas/article/view/501 <p><strong>Introduction: </strong>Tumour-emitted molecules induce immunosuppression in the tumour microenvironment. An immunosuppressive enzyme, indoleamine 2,3-dioxygenase (IDO/IDO1), facilitates immune escape in several malignant tumours, including osteosarcoma. Upregulation of IDO establishes a tolerogenic environment in the tumour and the tumour-draining lymph nodes. IDO-induced downregulation of effector T-cells and upregulation of local regulatory T-cells creates immunosuppression and promotes metastasis. <strong>Observations: </strong>Osteosarcoma is the most common bone tumour characterised by immature bone formation by the tumour cells. Almost 20% of osteosarcoma patients present with pulmonary metastasis at the time of diagnosis. The improvement in therapeutic modalities for osteosarcoma has been in a stagnant phase for two decades. Therefore, the development of novel immunotherapeutic targets for osteosarcoma is emergent. High IDO expression is associated with metastasis and poor prognosis in osteosarcoma patients. <strong>Conclusion and Relevance: </strong>At present, only a few studies are available describing IDO’s role in osteosarcoma. This review describes the prospects of IDO not only as a prognostic marker but also as an immunotherapeutic target for osteosarcoma.</p> Asim Farooq, Bilal Zulfiqar, Kashif Asghar Copyright (c) 2023 Asim Farooq, Bilal Zulfiqar, Kashif Asghar https://creativecommons.org/licenses/by-nc-sa/4.0 https://journals.sfu.ca/jcas/index.php/jcas/article/view/501 Fri, 30 Sep 2022 07:14:30 -0700 Risk Factors for Bladder Cancer: Results of a Survey of Hospital Patients https://journals.sfu.ca/jcas/index.php/jcas/article/view/485 <p><strong>Introduction: </strong>Several risk factors have been identified in the occurrence of bladder cancer. These include genetic and hereditary factors, smoking and tobacco use, increased body mass index, occupational exposure to certain chemicals and dyes, medical conditions such as chronic cystitis and infectious diseases such as schistosomiasis. This study aimed to evaluate risk factors in patients with bladder cancer. <strong>Materials and Methods: </strong>All patients presenting to the uro-oncology department of the hospital with imaging and histology confirmed bladder cancer were included in the study. Age- and gender-matched patients presenting to the department of urology with benign disorders were prospectively included as controls. All the study subjects and the controls completed a self-administered structured questionnaire. <strong>Results: </strong>Seventy-two (67.3%) of the participants with bladder cancer were males. The mean age of participants with bladder cancer was 59.24 ± 16.28 years. Most participants with bladder cancer worked as farmers (35.5%) or industrial workers (24.3%). Recent history of recurrent urinary tract infections was seen in 85 (79.4%) of the participants with bladder cancer and 32 (30.8%) of controls. Diabetes mellitus was more common among participants with bladder cancer. A significant number of participants with bladder cancer used tobacco and smoked compared to controls. <strong>Conclusions: </strong>This study highlights numerous potential biological and epidemiological factors that may act as a risk factors for bladder cancer. These factors could explain the gender differences observed in the incidence of bladder cancer. In addition, the study indicates the intense.</p> Rangrez Shadab, Rajendra Nerli, Saziya Bidi, Shridhar Ghagane Copyright (c) 2023 Shadab Rangrez, Rajendra Nerli, Saziya Bidi, Shridhar Ghagane https://creativecommons.org/licenses/by-nc-sa/4.0 https://journals.sfu.ca/jcas/index.php/jcas/article/view/485 Fri, 30 Sep 2022 00:00:00 -0700 Utilisation Patterns and Treatment Outcomes of EGFR-Tyrosine Kinase Inhibitors in EGFR-mutant Advanced Lung Carcinoma in the Pakistani-Asian Population: A Real-world Data Study https://journals.sfu.ca/jcas/index.php/jcas/article/view/491 <p><strong>Introduction: </strong>Data on the utilisation of epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) and their clinical outcomes in a heterogeneous Pakistani-Asian population have not been previously reported. This manuscript presents the first account of the clinical outcomes of EFGR-TKIs in EGFR-mutant lung adenocarcinoma among Pakistani- Asians. <strong>Materials and Methods: </strong>A real-world data study was conducted on all advanced lung cancer patients harbouring EGFR-mutations from the cancer registry of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. We identified three different patterns of the use of EGFR-TKIs (Groups 1, 2 and 3) that reflect the ground realities of cancer care and delivery in Pakistan. We also noted a significant proportion of patients (Group 4) without access to EGFR TKIs. We compared the objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) of each of the four groups and reported their toxicity profile. <strong>Results: </strong>Within the limitations of a retrospective analysis, we saw differences in the frequency of EGFR mutations in this population. However, response rates and long-term outcomes of EGFR TKI therapy were comparable with the existing data. The overall use of EGFR TKIs led to a superior outcome in ORR, PFS and OS compared to chemotherapy alone; (77.8% vs. 50.0%, 16.3 vs. 10.7 months; <em>P </em>= 0.099; 85.6 vs. 25.9 months, respectively; <em>P </em>= 0.13). <strong>Conclusion: </strong>Except for modest differences, EGFR-mutant advanced lung adenocarcinoma outcomes among Pakistani-Asians are comparable to those of other populations.</p> Kiran Munawar, Romena Qazi, Hassan Shahryar Sheikh Copyright (c) 2023 Hassan Shahryar Sheikh, Kiran Munawar, Romena Qazi https://creativecommons.org/licenses/by-nc-sa/4.0 https://journals.sfu.ca/jcas/index.php/jcas/article/view/491 Thu, 10 Nov 2022 00:00:00 -0800 An Insight into the Lynch Syndrome: Retrospective Study of the Pattern of Presentation and Management of Lynch Syndrome in Pakistan https://journals.sfu.ca/jcas/index.php/jcas/article/view/503 <p><strong>Introduction: </strong>The primary objective of this study was to evaluate the baseline characteristics of Lynch syndrome (LS). Furthermore, the study aimed to evaluate overall survival (OS) among patients with LS. <strong>Materials and Methods</strong>: This was a retrospective study of colorectal cancer patients registered from January 2010 to August 2020 with an immunohistochemical diagnosis of LS. <strong>Results: </strong>A total of 42 patients were assessed. The mean age at presentation was 44 years, with male predominance (78%). Demographic preponderance was from the North of Pakistan (52.4%). The family history was positive in 32 (76.2%) patients. The colonic cancer distribution was 32 (76.2%) on the right side. Most of the patients presented with Stage II disease (52.4%), and the common mutations were MLH1 + PMS2 16 (38.1%) followed by MSH2 + MSH6 9 (21.4%). The 10-year OS was found to be 88.1%. However, the OS was 100% post pancolectomy. <strong>Conclusion: </strong>LS is prevalent in the Pakistan population, especially in the North of Pakistan. Clinical presentation and survivals are similar to the Western population.</p> Faraz Faisal Khan, Sarah Khan, Mujeeb Ur Rahman, Maria Qubtia, Amer Rehman Farooqi Copyright (c) 2023 Authors https://creativecommons.org/licenses/by-nc-sa/4.0 https://journals.sfu.ca/jcas/index.php/jcas/article/view/503 Wed, 07 Dec 2022 22:37:55 -0800 Large Bowel Perforation in Patients with Colorectal Cancer: A South African Perspective https://journals.sfu.ca/jcas/index.php/jcas/article/view/517 <p><strong>Introduction: </strong>Large bowel perforation (LBP) occurs in up to 10% of colorectal cancer (CRC) patients and is a potential surgical emergency. Data on LBP in CRC patients from resource-limited countries are required to improve the management of this condition in these settings. Our study aimed to describe LBP amongst CRC patients in KwaZulu-Natal, South Africa. <strong>Materials and Methods: </strong>This was a descriptive sub-analysis of LBP data from an ongoing CRC registry. This study explores free and contained perforations and describes LBP characteristics, surgical management, histological findings, overall survival, and CRC recurrence. <strong>Results: </strong>Ninety-four out of 2523 CRC patients had LBP (3.7%). The median age was 53.0 years (interquartile range: 43.0–64.0). The male-to-female ratio was 1.4:1. Thirty-three patients (35.1%) had a coexisting bowel obstruction. Tumor site perforations occurred in 87 patients (92.6%) and were mostly in the sigmoid colon (36.2%). Perforations were contained in 77 patients (81.9%). Eighty-nine patients (94.7%) underwent resection (elective resection: 76/89 patients, 85.4%). The post-operative inpatient mortality rate was 2.2%. Most patients had Stage III CRC (46 patients, 48.9%) and moderately differentiated tumors (77 patients, 81.9%). Overall survival at 12 months following CRC diagnosis was 55.4%. The early recurrence rate for CRC disease was 5.4%. <strong>Conclusion: </strong>Tumor site perforations predominated, and most were contained. Patients were younger when compared with the international literature. We reaffirm that diastatic-free and contained perforations are two distinct clinical entities.</p> Jocelynn Norman, Yoshan Moodley Copyright (c) 2023 Yoshan Moodley, Jocelynn Norman https://creativecommons.org/licenses/by-nc-sa/4.0 https://journals.sfu.ca/jcas/index.php/jcas/article/view/517 Thu, 05 Jan 2023 21:38:34 -0800