Publications by authors named "Flora Zagouri"

Article Synopsis
  • HER2 overexpression is a significant target for treating gynecological cancers, and Trastuzumab-Deruxtecan (T-DXd) has shown notable effectiveness against these cancers, particularly in ovarian, endometrial, and cervical malignancies.
  • A study was conducted at the Alexandra Hospital in Athens involving 10 patients with HER2-positive gynecological cancers who were treated with T-DXd, administered intravenously every 3 weeks.
  • Results indicated a median progression-free survival of 5.4 months, with 5 patients achieving a partial response, highlighting T-DXd's potential as a treatment option even for patients with prior therapies.
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Mismatch repair-deficient (dMMR) endometrial cancer (EC) is an inflamed phenotype with poor outcomes when meeting high-risk criteria and limited treatment options in the adjuvant setting. We report protocol-prespecified subgroup analysis of patients with dMMR tumors from the phase III ENGOT-en11/GOG-3053/KEYNOTE-B21 study (ClinicalTrials.gov identifier: NCT04634877) in newly diagnosed, high-risk EC after surgery with curative intent.

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Article Synopsis
  • - The phase 3 study ENGOT-cx11/GOG-3047/KEYNOTE-A18 found that adding pembrolizumab to standard chemoradiotherapy significantly improved progression-free survival in patients with advanced cervical cancer during the first interim analysis.
  • - In this study, 1060 patients with high-risk cervical cancer were randomly assigned to receive either pembrolizumab or a placebo alongside chemoradiotherapy, with treatment outcomes evaluated at the second interim analysis.
  • - The primary outcomes measured were progression-free survival and overall survival, focusing on patient mortality, with safety being a secondary consideration.
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Background/aim: The molecular classification of breast cancer has enabled targeted therapy for specific molecular subtypes. Nestin, which has been studied for its role in oncogenesis, could contribute to this direction. This study aimed to investigate the differences between serum nestin levels and molecular profiling, as well as histopathological tumor types, in women who underwent surgery for breast cancer.

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  • - Uterine leiomyosarcomas (uLMS) are common tumors in the female reproductive system, and their genetics are complex, involving the Hippo pathway, which plays a role in various cancer types through its effectors YAP1 and TAZ.
  • - A study analyzed tissue samples from 32 uLMS patients, looking at the Hippo pathway's role and its relation to clinical factors such as age, stage, and treatment outcomes.
  • - The results showed that 62.5% of patients had disrupted Hippo signaling, and this was linked to improved overall survival rates, suggesting the pathway's significance in uLMS development and prognosis.
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Cushing's syndrome (CS), as a result of ectopic adrenocorticotropic hormone (ACTH) production, constitutes a common paraneoplastic manifestation of various malignancies, with the most common being small cell lung carcinoma. In the literature, fewer than fifty cases associating ectopic CS with prostate cancer have been documented. In the present study, the case of a 76-year old man suffering from castration-resistant prostate adenocarcinoma that had been treated with enzalutamide and luteinizing hormone-releasing hormone (LHRH) analogue for the last four years is presented.

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Background: Bromodomain and extra-terminal (BET) domain proteins that bind to acetylated lysine residues of histones serve as the "readers" of DNA acetylation. BRD4 is the most thoroughly studied member of the BET family and regulates the expression of key oncogenes. BRD4 gene amplification has been identified in ovarian cancer (~18-19%) according to (TCGA) analysis.

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Article Synopsis
  • Advances in treating advanced and metastatic HR+/HER2-breast cancer have come from new therapies, especially the use of CDK 4/6 inhibitors combined with endocrine therapy.
  • There is still a demand for better treatments to address resistance to CDK 4/6 inhibitors and improve patient outcomes.
  • New oral selective estrogen receptor degraders (SERDs) show promise and this paper reviews clinical studies, treatment efficacy, and future research directions for these therapies.
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Article Synopsis
  • Pembrolizumab, an immunotherapy drug, is being tested to see if it improves the effectiveness of chemoradiotherapy in patients with locally advanced cervical cancer, based on prior success in similar cases.
  • This phase 3 trial involved multiple international centers and used a double-blind, placebo-controlled design to randomly assign participants to receive either pembrolizumab or a placebo alongside their treatment.
  • The primary goals of the study were to measure progression-free survival and overall survival, assessing treatment safety in those who received at least one dose of the study medication.
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Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors have unprecedentedly advanced hormone-dependent breast cancer treatment paradigm. In the metastatic setting, ribociclib has consistently demonstrated survival benefit in pre-, peri-, and postmenopausal patients, conjugating efficacy with health-related quality of life preservation. Accordingly, the emergence of cardiac and/or vascular adverse events related to this novel targeted agent is gaining significant interest.

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Article Synopsis
  • Dose-dense sequential (dds) chemotherapy has positively impacted long-term survival rates in early breast cancer patients, as shown in the observational trial HE 10/10.
  • The study analyzed the role of tumor infiltrating lymphocytes (TILs) and CD8 lymphocytes in predicting outcomes, finding that higher levels are linked to better survival.
  • With a median follow-up of over 10 years, the study reported disease-free survival (DFS) at 78.4% and overall survival (OS) at 81.7%, highlighting the regimen's efficacy and safety.
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One of the most common adverse effects of cancer and its therapeutic strategies is sarcopenia, a condition which is characterised by excess muscle wasting and muscle strength loss due to the disrupted muscle homeostasis. Moreover, cancer-related sarcopenia may be combined with the increased deposition of fat mass, a syndrome called cancer-associated sarcopenic obesity. Both clinical conditions have significant clinical importance and can predict disease progression and survival.

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Context: Unlike other cancers, the concept of oligometastatic disease (OMD) in bladder cancer (BC) has not been systematically investigated. There is therefore a need to develop universally accepted definitions and guidelines for the management of oligometastatic BC (OMBC).

Objective: To conduct a systematic review to assist a European consensus group in producing a definition of OMBC and to provide recommendations on staging and local therapies.

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Background: Cardiotoxicity restricts anthracycline and trastuzumab treatment of Human Epidermal Growth Factor Receptor 2 positive early breast cancer. Endothelial dysfunction and arteriosclerosis are significant cardiovascular risk factors.

Objectives: We studied the effect of anthracycline-based chemotherapy, with or without trastuzumab, on endothelium and arteriosclerosis in patients with breast cancer.

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Background: There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC).

Methods: We retrospectively identified patients with stage IIIC/IV HGSC who received NACT followed by IDS during a 15-year period (January 2003-December 2018) in our Institution.

Results: Overall, 115 patients with stage IIIC/IV HGSC were included.

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Cancer-associated retinopathy (CAR) is a rare paraneoplastic disorder mediated by auto-antibodies that cross-react with retinal antigens leading to gradual visual defects. Early diagnosis and initiation of treatment is crucial to avoid permanent visual loss. Although most patients with CAR respond to intravenous steroids and intravenous immunoglobulin (IVIG), there are some cases refractory to the aforementioned treatment strategies.

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Background: Third-generation aromatase inhibitors (AIs) are the mainstay of treatment in hormone receptor (HR)-positive breast cancer. Even though it is considered to be a well-tolerated therapy, AI-induced musculoskeletal symptoms are common and may be accused for treatment discontinuation. Recently, selective cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors changed the therapeutic setting, and currently, ribociclib, palbociclib, and abemaciclib are all approved in combination with nonsteroidal AIs in patients with ER-positive, HER2-negative advanced or metastatic breast cancer.

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Metaplastic carcinoma of the breast (MpBC) is a very rare and aggressive type of breast cancer. Data focusing on MpBC are limited. The aim of this study was to describe the clinicopathological features of MpBC and evaluate the prognosis of patients with MpBC.

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Article Synopsis
  • The DESTINY-Breast02 trial aimed to evaluate the effectiveness and safety of trastuzumab deruxtecan compared to physician's choice treatments in patients with HER2-positive metastatic breast cancer who had previously been treated with trastuzumab emtansine.
  • Conducted at 227 sites across multiple countries, this phase 3 trial involved randomly assigning 608 eligible patients to either trastuzumab deruxtecan or a choice of other drugs, with the primary goal of assessing progression-free survival.
  • Findings showed that 608 patients were analyzed, with a median age of 54.2 years, highlighting the trial's significance for a population lacking treatment options.
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Neurological paraneoplastic syndromes are a rare subgroup of diseases commonly related to neuroendocrine tumors. However, they have been associated with uterine malignancies (sarcomas, endometrial carcinomas, and neuroendocrine cancers). Their presentation often correlates with a cancer diagnosis or cancer recurrence underlining their clinical significance.

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The causal relationship between HPV and cervical cancer in association with the high prevalence of high risk HPV genotypes led to the design of HPV vaccines based on the major capsid L1 protein. In recent years, capsid protein L2 has also become a focal point in the field of vaccine research. The present review focuses on the variability of HPV16 L1 and L2 genes, emphasizing the distribution of specific amino acid changes in the epitopes of capsid proteins.

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Objective: Immune checkpoint inhibitors have been widely implemented in the treatment of solid tumors. Combinations of immune checkpoint inhibitors with chemotherapy, anti-vascular endothelial growth factor (VEGF) compounds, and poly-adenosine diphosphate-ribose polymerase inhibitors (PARP) are under evaluation in ovarian cancer. We aim to explore the efficacy of pembrolizumab in combination with bevacizumab and oral cyclophosphamide in patients with recurrent epithelial ovarian cancer.

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Angiopoietin-2 (Ang-2) has been implicated in the development of several types of cancer, including lung malignancy. In the present study, we examined the impact of Ang-2 serum concentration on the development, dissemination, and 5-year overall survival of NSCLC and SCLC. A total of 99 patients with lung cancer were tested.

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Background: Germline BRCA1/2 mutations are identified in 13-15% of ovarian cancers, while an additional 5-7% of ovarian cancers harbor somatic BRCA1/2 mutations. Beyond these mutations, germline or somatic aberrations in genes of the homologous recombination (HR) pathway such as may confer an HR deficiency in up to 50% of ovarian tumors. Next-generation sequencing (NGS) is a high-throughput massive parallel sequencing method that enables the simultaneous detection of several mutations in entire genomes.

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