Publications by authors named "Rafal Suwinski"

Objectives: The aim of this study was to compare pathological response rates after preoperative hyperfractionated radiotherapy with co-administration of chemotherapy based on 5FU (HART-CT) versus preoperative hyperfractionated radiotherapy (HART) in patients with resectable rectal cancer.

Methods: Patients with T2/N+ or T3/any N rectal cancer were randomized either to HART twice a day (28 fractions of 1.5 Gy) to total dose 42 Gy or to HART-CT.

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Background And Purpose: Osteopontin is a known marker for tumour hypoxia with relevance for the outcome of radiotherapy. We analysed the plasma concentration of OPN in prostate cancer patients receiving RT with or without ADT to evaluate OPN as a potential marker of treatment response.

Materials And Methods: Between 2012 and 2014, 274 patients with prostate cancer qualifying for RT were enrolled to the study.

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Background: The efficacy of immunotherapy for brain metastases from small cell lung cancer (SCLC) is relatively low, and the tumor microenvironment of SCLC brain metastases is still unknown. Therefore, we investigated the distribution of tumor-infiltrating lymphocytes (TILs) and the expression of programmed cell death-ligand 1 (PD-L1) in patients with brain metastases from SCLC to explore the tumor microenvironment of SCLC brain metastases.

Methods: A retrospective analysis was performed on 12 surgical specimens of brain metastases from patients with SCLC treated in the Department of Neurosurgery of The First Affiliated Hospital of Anhui Medical University from June 2017 to June 2022.

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Purpose: External beam radiotherapy (EBRT) with or without brachytherapy boost (BTB) has not been compared in prospective studies using guideline-recommended radiation dose and recommended androgen-deprivation therapy (ADT). In this multicenter retrospective analysis, we compared modern-day EBRT with BTB in terms of biochemical control (BC) for intermediate-risk (IR) and high-risk (HR) prostate cancer.

Methods: Patients were treated for primary IR or HR prostate cancer during 1999-2019 at three high-volume centers.

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Osteopontin (OPN)-CD44 signaling plays an important role in promoting tumor progression and metastasis. In cancer, OPN and CD44 overexpression is a marker of aggressive disease and poor prognosis, and correlates with therapy resistance. In this study, we aimed to evaluate the association of single nucleotide polymorphisms (SNPs) in the and genes with clinical outcomes in 307 non-small cell lung cancer (NSCLC) patients treated with radiotherapy or chemoradiotherapy.

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Article Synopsis
  • Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer, with a median survival of 2-3 years for stage III patients, highlighting the challenges of early detection and treatment decision-making.
  • A study analyzed PET/CT images of 115 NSCLC patients to extract radiomic features from primary tumors, aiming to stratify patients based on their risk of developing metastasis.
  • Results showed moderate success in classifying metastasis-free survival, with an accuracy of 0.73, and a stronger risk prediction using a Cox regression model, achieving a C-index score of 0.84, indicating that imaging features can effectively aid in assessing metastasis risk.
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Background: Tumor local and distant relapse recurrence after radiotherapy (RT) is one of the critical factors leading to poor prognosis. The effective antitumor effects of RT are dependent upon the participation of innate and adaptive components of the immune system. C5a/C5aR1 signaling can regulate antitumor immune effect in the tumor microenvironment (TME).

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Pembrolizumab and nivolumab (anty-PD-1 antibody) are commonly used for the treatment of melanoma patients. However, their efficacy and safety have never been directly compared, leaving little guidance for clinicians to select the best therapy. The study included patients with inoperable or metastatic melanoma treated in first line with anti-PD-1 immunotherapy (nivolumab or pembrolizumab).

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Article Synopsis
  • This study investigates the survival benefits of combining external beam radiotherapy (EBRT) with brachytherapy boost (BTB) for patients with intermediate- to high-risk prostate cancer, aiming to provide real-world data on survival outcomes.
  • Data was gathered from 1,641 patients treated between 2003 and 2014, analyzing overall survival, freedom from distant metastases, and metastases-free survival using statistical models.
  • Results showed that patients receiving BTB had significantly better overall survival and reduced rates of metastases compared to those treated with EBRT alone, indicating BTB's effectiveness in improving treatment outcomes for prostate cancer.
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Background: Combined treatment with BRAFi and/or MEK inhibitors (MEKi) improves outcomes in advanced melanoma patients in comparison with monotherapy.

Objective: We aim to report real-world treatment efficacy and safety of vemurafenib (V) and vemurafenib + cobimetinib (V + C) from 10 years of practice.

Patients And Methods: A total of 275 consecutive patients with unresectable or metastatic BRAF mutated melanoma started first-line V or V + C treatment between 1 October 2013 and 31 December 2020.

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Background: Implementation of anal squamous cell carcinoma (ASCC) treatment modifications requires reliable patient risk stratification. The circulating tumor-related human papillomavirus type 16 (ctHPV16) may play a role in predicting survival or assessing treatment response.

Methods: The study included 62 ASCC patients treated with chemoradiotherapy.

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Background: Radiotherapy (RT) may enhance the systemic antitumor reaction to immunotherapy (IT). Currently, the effect of RT in stage IV non-small cell lung cancer (NSCLC) patients treated with IT is uncertain. This study aimed to confirm the role of RT in these patients.

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The prognostic value of inflammatory indices, such as the absolute monocyte count (AMC), has been a subject of interest in recent prostate cancer (PCa) studies, while hemoglobin concentration (HGB) has been recognized as a survival factor in castration-resistant metastatic prostate cancer, but its value remains unclear in localized diseases. The aim of this study was to test the prognostic value of these two simple and inexpensive biomarkers for survival and was based on a cohort of 1016 patients treated with primary radiotherapy and androgen deprivation therapy for localized or locally advanced intermediate- or high-risk PCa. Complete survival data were available for all cases and were based on the National Cancer Registry, with a median observation time of 120 months (Interquartile Range (IQR) 80.

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Article Synopsis
  • Lung cancer, particularly non-small cell lung cancer (NSCLC), is the top cause of cancer-related deaths globally, and advancements in radiotherapy and new therapies are enhancing treatment options beyond just palliative care.
  • A group of international radiotherapy experts worked together to develop evidence-based recommendations for the use of radiotherapy in patients with metastatic NSCLC, focusing on personalized patient management.
  • Radiotherapy can provide quick symptom relief and improve survival rates when used correctly, especially for patients with fewer metastases or brain metastases; however, further research is needed to determine the best treatment combinations and strategies.
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Introduction: The availability and non-invasiveness of circulating cell-free DNA (cfDNA) opens up new possibilities for real-time serial testing. The relationship between cfDNA concentration, clinical factors and suitability for monitoring was analyzed in patients with newly diagnosed anal squamous cell carcinoma (ASCC).

Material And Methods: Blood samples were collected at several points during and after treatment.

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(1) Background: BRAFi/MEKi are usually offered as a first line treatment for patients requiring rapid response; with elevated lactate dehydrogenase (LDH) activity, large tumor burden, and with brain metastases. The efficacy of second line therapies after BRAFi/MEKI failure is now well defined. (2) Methods: Patients treated with first line target BRAFi/MEKi therapy (vemurafenib plus cobimetinib, dabrafenib plus trametinib or encorafenib plus binimetinib); and for the second line treatment immunotherapy with programmed cell death 1 (PD-1) checkpoint inhibitors (nivolumab or pembrolizumab) with at least one cycle of second line were analyzed for survival and prognostic biomarkers.

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Background: Currently, limited data on targeted therapy and immunotherapy sequencing in patients with -mutant melanoma is available. Targeted therapy and immunotherapy are expected to be comparable in terms of overall survival (OS) when used as second-line therapies; therefore, understanding the characteristics of patients who completed sequential treatment is needed.

Methods: The primary objective of this study was to analyze the efficacy of BRAFi/MEKi activity as second-line therapy in patients with advanced melanoma.

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  • Malignant pleural mesothelioma (MPM) is an aggressive cancer linked to asbestos exposure, with first-line treatment typically involving pemetrexed and platinum-based therapies, though nearly all patients experience disease progression.
  • A study analyzed 57 patients treated at two oncological institutions in Poland to evaluate the effectiveness of first and second-line therapies, focusing on progression-free survival (PFS), overall survival (OS), and overall response rate (ORR).
  • Results showed that first-line therapy yielded a median PFS of 7.6 months and OS of 14 months, while second-line therapy had a lower median PFS of 3.7 months and OS of 7.2 months, highlighting the challenges in treatment efficacy
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Background: The primary aim of this study was to investigate the prognostic value of peripheral blood lymphocyte subsets in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs).

Methods: From 2018 to 2019, 82 patients diagnosed with stage IIIB-IV NSCLC at Zhejiang Cancer Hospital were recruited for this study. Peripheral blood lymphocyte subsets of NSCLC patients were analyzed using flow cytometry before and after ICI treatment.

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Article Synopsis
  • * Researchers used Ion AmpliSeq HD Technology to evaluate tumor and liquid biopsy samples from 14 patients, finding high agreement (91%) in detecting the BRAF mutation across different sample types.
  • * Although 17 pathogenic variants across 14 genes were identified, the study noted that the correlation of non-BRAF mutations was lower (28%), highlighting both the advantages and challenges of using liquid biopsies for genetic profiling in cancer treatment.
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It was commonly assumed in the past that blood-brain barrier could efficiently prohibit penetration of large peptide molecules, such as monoclonal antibodies, including programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors. This belief has been recently revised by studies that demonstrate the presence of functional lymphatic vessels lining the dural sinuses. Furthermore, the activated circulating T cells have been shown to cross the blood-brain barrier.

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For non-small cell lung cancer (NSCLC), radiotherapy (RT) and platinum-based chemotherapy (CHT) are among the main treatment options. On the other hand, radioresistance and cytotoxic drug resistance are common causes of failure. The epidermal growth factor receptor (EGFR) plays an important role in radioresponse and therapy resistance.

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Background: The relationship between immune related adverse events (irAEs) and efficacy is not definitively proven, and data on the relationship between irAE and treatment efficacy are contradictory.

Material And Methods: Five hundred ninety-three consecutive patients with unresectable or metastatic melanoma treated in the first line with anti-PD-1 (nivolumab or pembrolizumab) between January 2016 and December 2019 were enrolled in the study.

Results: Statistically significant differences were demonstrated between the group of patients without and with irAE in median OS and PFS ( < .

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Prophylactic cranial irradiation (PCI) has well established place in therapy for patients with limited-disease small cell lung cancer who responded to treatment. The data from randomized trials document that PCI reduces brain metastases rate from approximately 60% to 30%, and increases 3-year overall survival by approximately 5%. Currently, the dose of 25 Gy in 10 fractions is considered as standard.

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Background: Randomised, controlled trials and meta-analyses have shown the survival benefit of concomitant chemoradiotherapy or hyperfractionated radiotherapy in the treatment of locally advanced head and neck cancer. However, the relative efficacy of these treatments is unknown. We aimed to determine whether one treatment was superior to the other.

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