International Journal of Cancer Management
Volume:10 Issue: 4, Apr 2017

Various studies in Iran on the role of BMI higher than normal (BMI ≥25) on breast cancer have reported different results.
The aim of this systematic review and meta-analysis is to estimate the odds ratio of overweightness and obesity as risk factors of breast cancer in studies conducted in Iran.
Evidence Acquisition: The following main databases were searched from 2004 to 2014 to find related articles: PubMed, Web of Science, Google Scholar, Scopus and Iranian databases (SID and Magiran), breast cancer conferences held in Iran, key journals, and the references of the selected articles. Keywords were: Cancer, Tumor, Neoplasm, Neoplasia, Carcinoma, Malignancy, Malignant, Benign. The combination with OR and added it to search field with AND to words such as Iran and breast was used as the search strategy. The observational studies (cohort, case-control, and cross-sectional) in Iran that had reported the relation between BMI and breast cancer in Persian and English were searched. There were no limitations in terms of age, race, ethnicity, and marital status for women. The exposure was BMI ≥ 25 (overweight and obese) and the outcome was breast cancer with pathological confirmation. Two reviewers separately used the STROBE checklist for quality assessment, critically appraised papers and extract the data. The overall estimate was the odds ratio.
Of 4396 studies, after evaluation of heterogeneity, 7 case-control studies with a sample size of 33552 were included in the meta-analysis. A significant relation was observed between obesity (OR = 1.81, 95% CI = 1.24 - 2.64) and odds of breast cancer. A significant relation was also observed between overweightness and odds of breast cancer (OR = 1.46, 95% CI = 1.13 - 1.89).
Meta-analysis results showed a significant relation between obesity and overweight with risk of breast cancer in Iranian women. We recommended Iranian women to be aware of the effect of weight on breast cancer and encouraged them to decrease their weight via physical activity and diet control.

Context: The approval of topical calcineurin inhibitors (TCIs) has been a significant breakthrough for the treatment of atopic dermatitis due to much lower systemic absorption and not causing skin atrophy even after long-term use that have made them become popular replacements for topical corticosteroids being almost equally effective. In January 2006, the US food and drug administration (FDA), followed later also by the European medicine agency (EMEA), issued the “black box” warning causing controversy regarding a potential increased risk of lymphoma in patients with atopic dermatitis and treated with TCIs.
Evidence Acquisition: PubMed and MEDLINE® databases were systematically searched utilizing a variety of terms relating to the subject matter. Articles written only in English over the past 15 years were analyzed and selected for review.
So far, no scientific evidence of the association has been found between use of TCIs, and increased incidence of skin cancers and lymphomas in patients with AD. The systematic review and meta-analysis by Legendre et al. found the role of TCIs unlikely to be a significant risk factor of lymphoma in those patients.
Despite an extensive body of evidence regarding the TCIs safety, the box warning still remains leaving the physicians and patients unduly uncertain and confused about the safety of TCI use.

Supraclavicular fossa masses have usually been malignant lesions. When fine needle aspiration biopsy results have not been satisfactory excisional biopsy of supraclavicular lymphadenopathy would be mandatory.
In this study we investigated 18 patients who had supraclavicular region metastasis from infraclavicular primary sites.
Distant metastatic sites were mostly lung in origin. Other sites were breast, prostate, pancreas, cervix, urothelial, gastric carcinoma and pleural mesothelioma. All of our patients except the one with mesothelioma have died within one year after diagnosis of supraclavicular metastasis due to disseminated disease.
Supraclavicular neck masses should be evaluated carefully, since they were mostly malignant in origin. Lung has been the most common origin site. Early diagnosis would be critical because supraclavicular metastasis indicates poor prognosis with decreased survival. Excisional biopsy should be performed promptly when fine needle aspiration biopsy was not diagnostic.

Glioblastoma Multiform has been a common and fatal brain tumor. In this regard, there was ambiguity around patient survival rates in Iran que to data insufficiency. In this study, we have analyzed the overall and progression free survival in GBM patients at Milad Tehran hospital.
In this retrospective study, we have considered survival, clinical characteristics and prognostic factors in 123 primary GBM patients who underwent surgical procedure (Biopsy or Resection) between February 2010 and June 2015 at Milad hospital, Tehran, Iran. All patients have pathologically proven as primary GBM. The overall survival and progression free survival has calculated using the Kaplan-Meier method. The Cox proportional hazards model has used for univariate analysis of prognostic factors. Age, gender, first symptom of the disease, tumor location and size, treatment protocol, and surgery have considered in the Cox model as prognostic factor.
One hundred and one patients have been studied. The mean age of the patients was 52.12 1.64, 67% of the patients were male, and 20% of the patients has not included in adjuvant therapy due to the patients low performance status after surgery. Patient median survival time was approximately 10.1 (6.3 - 11.8); 80% of the patient survive more than a month; and 57% of the patient has survived for six month, and one year survival of the patients was about 37%. Median progression free survival time was about 6.3 month, one-month progression free survival was 70%, and six months and one year progression free survival rates were 50% and 26%, respectively. Patients higher than 50 years have shown significant, 2 times more chance of death (HR = 2.00 CI 95% (1.3 - 3.2)) or disease progression (HR 1.94 CI 95% (1.3 - 3.2)). Correspondingly, patients who has not included in adjuvant therapy had 3.9 CI 95% ( 2.3 - 6.8) more hazard of death and 2.8 CI 95% (1.6 - 4.8) more chances of disease progression than who included in adjuvant therapy with TMZ and radiotherapy. Gender, symptom, tumor location or surgery type have not significantly affected patient prognosis.
GBM patient’s survival would be quite poor. Nevertheless, this result was similar to the other reports from other centers and countries.

A prospective study was conducted to investigate the response rate of patients newly diagnosed with acute myeloid leukemia (AML) to modified intermediate-dose cytarabine with daunorubicin.
A total of 45 patients received cytarabine at a modified intermediate-dose (115 mg/m2) given by continuous intravenous infusion for 12 hours twice daily over 7 days and daunorubicin 45 mg /m2 given on days 1, 2, and 3 of induction therapy. Patients with a complete response received reinduction with cytarabine at the same dose and infusion over 5 days with 2 doses of daunorubicin. After remission, patients who were socioculturoeconomically eligible for transplantation were evaluated for other prognostic factors, except for cytogenetic factors that were not available in the study center, to identify patients that were eligible for stem cell transplantation.
Patients were 17 to 60 years of age. 6 patients had early death due to complications and treatment failure. 39 patients (87%) achieved complete remission. Only 16 patients were eligible for transplantation on evaluation and underwent allogeneic stem-cell transplantation. 18 patients were not eligible for this transplantation and underwent consolidation therapy with chemotherapy. 5 patients did not receive any treatment and died during the follow up. In the follow up period between April 2006 and January 2014 in 39 out of 45 patients (min 0.2 yr, max 7. 8 yr) 31 % of patients were alive.
Modified intermediate dose cytarabine was effective for the treatment of AML, achieving a high rate of complete remission, and might improve outcomes in patients.

Skin cancer is one of the most common types of cancer worldwide and non-steroidal anti-inflammatory drugs (NSAIDs) have been proposed for prevention and treatment of a variety of cancers. In this study we aimed to evaluate the cytotoxic effects of piroxicam (a non-selective cyclooxygenase (COX) inhibitor) and nimesulide (a highly selective COX-2 inhibitor) on A431 human squamous carcinoma cell line.
Squamous carcinoma cell line (A431) was cultured in RPMI medium containing 10% FBS and penicillin-streptomycin at 37°C and 5% CO2. Cells were treated with different concentrations of piroxicam and nimesulide (100 - 1000 µmol/L) for 24, 48 and 72 hours (h). Anti-proliferative effects were determined using MTT colorimetric assay.
Piroxicam and nimesulide reduced cell viability in a time and concentration dependent manner. The most cytotoxic effect was produced in 72 hours incubation time. The IC50 value of nimesulide was significantly lower than piroxicam in 24 and 72 hours, but not in 48 hours treatment duration.
This study demonstrates that the administration of a highly selective COX-2 inhibitor could probably be more effective than a non-selective NSAID in reducing cancer cells proliferation and that COX-2 can possibly play an important role in skin cancer development.

The poor prognosis of breast cancer is due to its resistance to the conventional treatments. Therefore, researchers are studying about herbs which have anticancer effects. Emodin is a hydroxy-anthraquinone that is found in many medicinal plants and has biological and anticancer effects. According to previous studies, it inhibited the growth of cancer cells by apoptosis.
In this study, we aimed to determine the effect(s) of emodin on growth and proliferation of SKBR3 cancer cells.
SKBR3 cells were cultivated for 24 hours. Then different concentrations of emodin (0, 10, 25 and 50 µM) were added to the test wells and incubated for 24, 48 and 72 hours. Cell viability was examined by MTT assay after 24, 48 and 72 hours. Apoptosis was determined in cells treated with emodin (0, 10, 25 and 50 µM) using flow cytometric assay. Alterations in expression of apoptotic-related genes (Caspase 3, 8, 9, Bcl2 and Bax) were determined by real time PCR. Caspase 3 activity was measured using a colorimetric assay.
Emodin had inhibitory effects on the proliferation of SKBR3 cells with IC50 value of 25 µM. Emodin induced apoptosis and increased the mRNA expression of Caspase 3, 8, 9 and Bax and decreased the mRNA expression of Bcl2 in SKBR3 cells. It also increased the activity of Caspase 3.
Emodin had an inhibitory effect on the growth of SKBR3 cell line in a dose and time dependent manner. This study indicated that emodin induces apoptosis in SKBR3 cells through the alterations of the expression of apoptosis-related genes and increases the activity of Caspase 3.

The endometrial cancer (EC) is the seventh most common malignancies worldwide among females with good prognosis in early stages of the disease. The CpG Island in the promoter region of tumor-suppressor genes are frequently methylated in various types of human cancers. In the present study, we investigated the methylation pattern in promoter region of RASSF1A and RASSF2A genes in Endometrial cancer patients in Iranian women to identify correlations among promoter hypermethylation, disease risk and clinicopathological parameters.
28 patients and 22 healthy controls were studied. Isolation of genomic DNA from FFPE and peripheral blood was performed and Methylation-Specific PCR (MSP) was applied for analysis of the promoter CpG methylation status of RASSF1A and RASSF2A genes in the studied population.
A significant difference was found among the study groups and the presence of promoter CpG hypermethylation status in the RASSF1A (P = 0.0321) and RASSF2A (P = 0.0003) genes. RASSF1A, and RASSF2A gene promoter methylations were present in 53.57% and 42.85% of EC samples when compared to those in the controls with 31.81% and 9.09% respectively. Furthermore, methylation status between tissue and blood samples of RASSF1A, and RASSF2A genes was not significant (P = 0.49 and 0.09 respectively). Our results indicated a corollation between ages, menosososal state and tumor grade with RASSF1A, and RASSF2A promoter methylation.
In our study, Hypermethylation of both RASSF1A and RASSF2A genes are important events in carcinogenesis of endometrial cancer. Epigenetic alternations may have diagnostic value for early diagnosis and better clicinal management of susceptibility to endometrial malignancies.

Overexpression of human leukocyte antigen G (HLA-G) in several malignant tumors has been reported. The aim of our study was to investigate HLA-G expression in colorectal cancer tumors and determine HLA-G expression relation between clinico-pathological characteristics and survival time.
HLA-G expression was evaluated by immunohistochemistry (IHC) using anti-HLA-G antibody in 100 primary tumors of colorectal cancer with different stages.
Our results showed that 25% of the colorectal cancer tissues had positive HLA-G expression and 75% no stained with anti-HLA-G antibody. The HLA-G expression in advanced stages (III and IV) was more prevalent than those in earlier clinical stages (I and II) (P = 0.0001). Results showed that HLA-G expression can serve as an independent factor for overall survival (OS). In this study, patients with HLA-G expression had significantly shorter survival time than those with negative expressions (P = 0.023).
HLA-G expression can serve as an independent factor for OS and its expression may be directly related to aggressive tumor behavior via escape from the host antitumor immune defense. Protein expression of HLA-G correlates with poor prognosis in colorectal cancer.

Renal cell carcinoma (RCC) has known as the most frequent urological malignancy among adults, which occured mostly among male patients. Sunitinib malate (SUTENT®, Pfizer Inc., New York, NY, USA) is an oral, multitargeted tyrosine kinase inhibitor (TKI) which acts on VEGF receptors 1–3. Herein, we have presented two simultaneous adverse effects (nail changes and erythematous lesions over the knuckles) of 26-year-young woman with a high risk RCC during the sunitinib therapy.
Our patient was a 26-year-young woman, who has undergone left radical nephrectomy in December 2013. Microscopic pathological analysis has shown a 40 mm clear cell carcinoma of grade 2. She has started on target therapy with sunitinib, at over 3 months of TKI Sutent 50 mg four weeks on and two weeks off in this drug. We have seen, nails changes and erythematous lesions over the knuckles. After decreasing the dosage of the drug to 12.5 mg four weeks on and two weeks off the severity of lesions have decreased and subside the complaints of patients.
Sunitinib therapy could have different side effects among patients. We have not known that a benign side effect could affect a female patient like discoloration despite, or not. This matter that you had not any interference for its treatment, but it has exited so we must try to know more about it.