Novel trial designs: Master protocol trials.

Conventional trial designs are resource and time-intensive. To accelerate the process of testing new interventions, we now have several novel research trial designs. This article focuses on master protocol trials, which allow several therapies to be tested within a single larger trial.

Copper Imparts a New Therapeutic Property to Resveratrol by Generating ROS to Deactivate Cell-Free Chromatin.

Resveratrol, a bioactive phytoalexin, has been extensively studied as a pharmaceutical and nutraceutical candidate for the treatment of various diseases. Although its therapeutic effects have been largely attributed to its anti-oxidant properties, its underlying mechanisms and dose dependency are not well understood. Recent studies have shown that cell-free chromatin particles (cfChPs), which are released daily from billions of dying cells, can enter circulation and be internalized by healthy cells, wherein they trigger various damaging effects, including double-strand DNA breaks.

Deep Learning-Based Glioma Segmentation of 2D Intraoperative Ultrasound Images: A Multicenter Study Using the Brain Tumor Intraoperative Ultrasound Database (BraTioUS).

Intraoperative ultrasound (ioUS) provides real-time imaging during neurosurgical procedures, with advantages such as portability and cost-effectiveness. Accurate tumor segmentation has the potential to substantially enhance the interpretability of ioUS images; however, its implementation is limited by persistent challenges, including noise, artifacts, and anatomical variability. This study aims to develop a convolutional neural network (CNN) model for glioma segmentation in ioUS images via a multicenter dataset.

Primary Ovarian Angiosarcoma: Diagnostic Challenges and Conundrums.

Angiosarcoma is an extremely uncommon mesenchymal neoplasm overall and moreso in female genital organs such as the ovary. Diagnosing primary ovarian angiosarcoma remains challenging on clinical grounds due to the absence of specific clinical symptoms as well as on histopathological analysis especially in poorly differentiated subtypes due to non-specific and overlapping morphologic features. Misdiagnosis in such scenarios can be devastating as this tumor is clinically very aggressive.

Persistent Thrombocytopenia of an Unexplained Cause in a Patient With Metastatic Renal Cell Carcinoma: A Case Report.

Thrombocytopenia is a common complication in patients with solid tumors, particularly renal cell carcinoma (RCC), arising from mechanisms such as chemotherapy, direct tumor invasion, and paraneoplastic syndromes. Managing thrombocytopenia in advanced cancer presents significant challenges, often limiting therapeutic options and impacting patient outcomes. This case report describes a 62-year-old man with metastatic RCC complicated by persistent thrombocytopenia, unresponsive to both conventional treatments and novel therapies.

Simultaneous integrated boost intensity-modulated radiation therapy targeting clinically involved extramesorectal lymph nodes in locally advanced rectal cancer: A retrospective study.

Aim: Consensus is lacking regarding the management of extramesorectal lymph nodes (EMLN) in rectal cancer. Using simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT), we targeted involved EMLN and reserved lateral pelvic lymph nodal dissection (LPLND) for nonresponders. The primary aim of this work was to determine the proportion of patients who avoided LPLND and to establish the pathological EMLN positivity rate.

The Co-IMPACT Consortium: Integrating Prostate-specific Membrane Antigen Positron Emission Tomography and Radiotherapy in Prostate Cancer Care.

The Co-IMPACT consortium addresses knowledge gaps in prostate-specific membrane antigen positron emission tomography-guided radiotherapy for prostate cancer by establishing a global database (46 centres from 16 countries) to standardise and analyse data across four distinguished clinical scenarios. A collaborative model with the Advanced Prostate Cancer Consensus Conference aligns urgent clinical needs with actionable research insights.

Host Index and Gallbladder Cancer: An Emerging Prognostic Biomarker.

Background And Objectives: There is emerging evidence that host related variables predict outcomes in various cancers. The Host index (H-index) incorporates various host-related, blood-derived biomarkers (immunological and nutritional parameters) as a single mathematical formula. The aim of this study was to evaluate outcomes using the H-index as a prognostic marker in gallbladder cancer (GBC) patients undergoing curative resection.

NIRADS-based case assessment of post-treatment head and neck cancer and its clinical correlation: A validation study.

Introduction: The neck imaging reporting and data system (NIRADS) lexicon is aimed at surveillance of head and neck cancer during post-treatment follow-up using either a CECT or PET-CT scan. These recommendations standardize management, reduce interobserver variability, and standardizes scientific communication.

Objectives: The primary aim of this study was to validate the correlation between the NI-RADS category and disease status on clinical follow-up and histopathological analysis.

Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA).

Purpose: Head and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world.

Learning curve and proficiency assessment for gynecological brachytherapy amongst radiation oncology trainees in India: Results from a prospective study.

Purpose: The quality of cervical cancer intracavitary brachytherapy (ICBT) depends on the training and experience of the radiation oncologist (RO). The present study was performed to establish primary learning curve for ICBT.

Materials And Methods: Forty-three skill parameters were identified for performing ICBT and were included for Brachytherapy Proficiency Assessment and Scoring System (Brachy-PASS) questionnaire.

Unravelling Eribulin's role in metastatic breast cancer: evaluating benefits for both triple negative and non-triple negative patients in real-world scenarios in resource-constrained settings.

Background: Metastatic breast cancer (MBC) patients have numerous options for treatment. However, it is essential to consider treatments with favorable toxicity profiles and convenient modes of administration. Eribulin has shown effectiveness in aggressive MBC, but there is a lack of sufficient real-world data specific to Indian patients.

Cholangioblastic Cholangiocarcinoma (NIPBL::NACC1 cholangiocarcinoma): Expanded Morphologic Spectrum and Further Genetic Characterization.

The cholangioblastic variant of intrahepatic cholangiocarcinoma is a distinctive neoplasm that typically affects young women without underlying liver disease. Morphologically, it demonstrates solid, trabecular, and tubulocystic architecture, biphasic small cell-large cell cytology, and immunoreactivity for inhibin, neuroendocrine markers, and biliary but not hepatocellular markers. In 2021, our group identified a characteristic NIPBL::NACC1 gene fusion in cholangioblastic cholangiocarcinoma, and since then ~20 genetically confirmed cases have been reported in the literature.

Access to timely cancer treatment initiation in India: extent, determinants and trends.

Background: Treatment delays are significantly associated with advanced stage, poor response to treatment, increased mortality risk, poor health outcomes, increased healthcare expenditures among cancer patients. However, factors associated with these delays have not yet been robustly evaluated. In order to bridge this gap, we determined the delayed time to treatment initiation (TTI) among cancer patients in India, ascertained its determinants, and assessed the trends of delayed TTI.

Structure-Activity Relationship of Ciprofloxacin towards S-Spike Protein of SARS-CoV-2: Synthesis and Evaluation.

The recent outbreak of the coronavirus (COVID-19) pandemic, caused by the SARS-CoV-2 virus, has posed serious threats to global health systems. Although several directions have been put by the WHO for effective treatment, use of antibiotics, particularly ciprofloxacin, in suspected and acquired Covid-19 patients has raised an even more serious concern of antibiotic resistance. Ciprofloxacin has been reported to inhibit entry of SARS-CoV-2 into the host cells via interacting with the spike (S) protein.

Tele-Manipulative Neuro-Registration in Robot assisted Neurosurgery.

This paper deals with neuro-registration using tele-manipulation (Master-Slave Manipulation) to facilitate tele-surgery and enhance the overall accuracy and reach of the robot-assisted neurosurgery. Accurate Neuro-registration is important as the success of the surgical procedure highly depends on it. A 6-degree-of-freedom Parallel Kinematic Mechanism (6D-PKM) master-slave robot in tele-manipulation mode is utilized for both neuro-registration and neurosurgery.

Radiation Safety Assessment of 177Lu-DOTATATE Intra-arterial Peptide Receptor Therapy (PRRT).

Objective: Lu-DOTATATE peptide receptor therapy (PRRT) is an established treatment for patients suffering from neuroendocrine tumors. In the last few years, intra-arterial PRRT is being considered for patients having liver metastatic disease predominantly. The aim of our study is to measure the radiation doses received by the treating intervention radiologists involved in intra-arterial PRRT treatment using Lu-DOTATATE.

Optimizing Low-Dose [18F]FDG-PET/CT Scans: Ensuring Quality Amid Radiotracer Availability Challenges - Insights from a Peripheral Tertiary Care Center.

Background: The introduction of positron emission tomography/computed tomography (PET/CT) has significantly advanced medical imaging. In oncology, F-fluorodeoxyglucose (F-FDG) PET/CT is particularly crucial for staging, evaluating treatment response, monitoring follow-up, and planning radiotherapy. However, in resource limiting hospitals, the availability of fluorine-labeled F-FDG limits optimal scan acquisition.

GFR Estimation and Correlation for Oncology Patients by Two Methods, Gates Method and Dual Time Point Plasma Sampling Method.

Background: With the increasing number of oncology cases and a parallel surge in chemotherapeutic drugs for treatment, the treating physicians conducts nephrotoxicity evaluation to provide a personalized dosing strategy. Of the various tests available, glomerular filtration rate (GFR) under gamma camera with help of Gates method has gained importance, being a good index of overall kidney functions. In addition to this, there has been an alternate and old method for GFR estimation: plasma sampling.

Time-efficient HPLC Validation Methodology for the Qualitative Analysis of 68Ga PSMA-11 in Routine Clinical Usage under Isocratic Method.

Background: Prostate-specific membrane antigen (PSMA) has shown to be a promising agent for prostate cancer imaging under PET-CT. With the automation in radiolabeling with 68Ga, using iTG 68Ge/68Ga generator, it has helped introduce various new diagnostic agents and achieve good manufacturing practices (GMP) simultaneously. However, before any radiopharmaceutical is put into clinical usage, it should always be checked for its radiochemical purity and other quality parameters before injecting in the patient.

Comparative analysis of EGFR mutations in circulating tumor DNA and primary tumor tissues from lung cancer patients using BEAMing PCR.

In this study, we measured human epidermal growth factor receptor (EGFR) mutations in both tissue and circulating tumor DNA (ctDNA) by using beads, emulsions, amplifications and magnetic polymerase chain reaction (BEAMing PCR). Noninvasive mutation detection by assessing circulating tumor DNA (ctDNA) offers many advantages over tumor biopsy. One hundred non-small cell lung cancer (NSCLC) patients were enrolled, and both preoperative plasma samples and formalin-fixed and paraffin-embedded (FFPE) samples were collected for the study.

The Hemodynamic Management and Postoperative Outcomes After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Prospective Observational Study.

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has become standard treatment for peritoneal cancers and metastases, significantly enhancing survival rates. This study evaluated the relationship between tumor burden, hemodynamic management, and postoperative outcomes after CRS-HIPEC. This study included 203 patients undergoing CRS-HIPEC.

Challenges in the Management of Hemorrhagic Shock in Patients with Bombay Blood Group in the ICU: What the H?

Bhosale SJ, Joshi M, Dhakane P, Ojha S, Kulkarni AP. Challenges in the Management of Hemorrhagic Shock in Patients with Bombay Blood Group in the ICU: What the H? Indian J Crit Care Med 2024;28(12):1185-1186.

Ewing's sarcoma of the head and neck: differential diagnosis, treatment and outcomes.

Purpose Of Review: Ewing's sarcoma is a small round-cell tumour typically arising in the bones, and only rarely affecting soft tissues. These are rarely seen in the head and neck comprising 1-9% of all cases, making management of these tumours a challenge. This review aims to review the current literature to update the current diagnostic and treatment options in head and neck Ewing's sarcoma.

A prospective study on diagnostic accuracy of technology-enabled early detection of oral cancer and epidemiology of tobacco and other substances use in rural India.

Background: Lip and oral cavity cancer is leading cause of cancer mortality among Indian men. This study evaluated diagnostic accuracy of mobile health (mHealth) enabled screening for early detection of oral premalignant lesions or oral cancer (OPML/OC). It also described epidemiology of tobacco and other substance use and associated oral lesions in rural northern India.