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Introduction: Pandemic COVID-19 is an unexpected challenge for the oncological community, indicating potential detrimental effects on cancer patients. Our aim was to summarize the converging key points providing a general guidance in order to support decision making, pertaining to the oncologic care in the middle of a global outbreak. Methods: We did an international online search in twenty five countries that have managed a surge in cancer patient numbers. We collected the recommendations from thirty one medical oncology societies. Results: By synthesizing guidelines for a) oncology service delivery adjustments, b) general and specific treatment adaptations, and c) discrepancies from guidelines comparison, we present a clinical synopsis with the forty more crucial statements. A Covid-19 risk stratification base was also created in order to obtain a quick, objective patient assessment and a risk-benefit evaluation on a case-by-case basis. Conclusions: In an attempt to face these complex needs and due to limited understanding of COVID-19, a variability of recommendations based on general epidemiological and infectious disease principles rather than definite cancer-related evidence has evolved. Additionally, the absence of an effective treatment or vaccine requires the development of cancer management guidance, capitalizing on comprehensive COVID-19 oncology experience globally.

Background: CTCs are a promising alternative for metastatic tissue biopsies for use in precision medicine approaches. We investigated to what extent the molecular characteristics of circulat

The molecular characterization of circulating tumor cells (CTCs) is a promising tool for the repeated and non-invasive evaluation of predictive and prognostic factors. Challenges associated with CTC characterization using the only FDA approved method for CTC enumeration, the CellSearch technique, include the presence of an excess of leukocytes in CTC-enriched blood fractions. Here we aimed to identify colorectal tumor-specific gene expression levels in the blood of patients with and without detectable CTCs according to CellSearch criteria. Materials and methods: Blood of 30 healthy donors (HDs) and 142 metastatic colorectal cancer (mCRC) patients was subjected to CellSearch CTC enumeration and isolation. In all samples, 95 mRNAs were measured by reverse transcriptase quantitative PCR (RT-qPCR). HD blood samples and patient samples with three or more CTCs were compared to identify CTC-specific mRNAs. Patient samples without detectable CTCs were separately analyzed. Results: Thirty-four CTC-specific mRNAs were higher expressed in patients with ≥3 CTCs compared with HDs (Mann-Whitney U-test P<0.05). Among patients without detectable CTCs, a HD-unlike subgroup was identified which could be distinguished from HDs by the expression of epithelial genes such as KRT19, KRT20 and AGR2. Also, in an independent patient set, a similar HD-unlike group could be identified among the patients without detectable CTCs according to the CellSearch system. Conclusion: Extensive molecular characterization of colorectal CTCs is feasible and a subgroup of patients without detectable CTCs according to CellSearch criteria bears circulating tumor load, which may have clinical consequences. This CTC-specific gene panel for mCRC patients may enable the exploration of CTC characterization as a novel means to further individualize cancer treatment.

The transition to air-breathing by formerly aquatic species has occurred repeatedly and independently in fish, crabs and other animal phyla, but the proximate drivers of this key innovation remain a long-standing puzzle in evolutionary biology. Most studies attribute the onset of air-breathing to the repeated occurrence of aquatic hypoxia; however, this hypothesis leaves the current geographical distribution of the 300 genera of air-breathing crabs unexplained. Here, we show that their occurrence is mainly related to high environmental temperatures in the tropics. We also demonstrate in an amphibious crab that the reduced cost of oxygen supply in air extends aerobic performance to higher temperatures and thus widens the animal's thermal niche. These findings suggest that high water temperature as a driver consistently explains the numerous times air-breathing has evolved. The data also indicate a central role for oxygen- and capacity-limited thermal tolerance not only in shaping sensitivity to current climate change but also in underpinning the climate-dependent evolution of animals, in this case the evolution of air-breathing.

Het rapport Waardevol – Indicatoren voor valorisatie biedt kennisinstellingen, wetenschapsfinanciers en kennisgebruikers een gemeenschappelijk kader voor valorisatie. De methode werkt met valorisatiekaarten waarmee betrokken organisaties systematisch kunnen monitoren hoe groot de valorisatie-inspanningen zijn, wat de opbrengsten zijn en welke mogelijkheden voor verbetering er zijn. Het gebruik van valorisatiekaarten zal helpen om het inzicht te vergroten in wat publieke kennisinstellingen, wetenschapsfinanciers en bedrijfsleven nu al doen aan valorisatie., Het rapport Waardevol – Indicatoren voor valorisatie biedt kennisinstellingen, wetenschapsfinanciers en kennisgebruikers een gemeenschappelijk kader voor valorisatie. De methode werkt met valorisatiekaarten waarmee betrokken organisaties systematisch kunnen monitoren hoe groot de valorisatie-inspanningen zijn, wat de opbrengsten zijn en welke mogelijkheden voor verbetering er zijn. Het gebruik van valorisatiekaarten zal helpen om het inzicht te vergroten in wat publieke kennisinstellingen, wetenschapsfinanciers en bedrijfsleven nu al doen aan valorisatie.

In recent years, many new anti-cancer agents have been developed and introduced into clinical care. While these new agents have led to substantial gains in response rates and life expectancies, they have also increased the need for tools to select those patients benefitting from said therapies. Once patients develop metastatic disease, treatment is aimed at improving quality of life and prolonging life expectancy, but is always a trade-off against the side-effects that are inevitably associated with anti-tumor therapy, underscoring the need to select only those patients who are likely to respond to a particular drug. However, there is still an unmet need for such an array of reliable predictive factors, a need that can be met by designing studies in which patient subgroups are defined and stratified based on rational, biology-driven but feasible tumor characteristics. An increasing number of studies is being designed in which, for example, only patients with a specific gain-of-function mutation are subjected to a monoclonal antibody therapy aimed at the activated pathway this gene is involved in. While substantial progress is being made with this approach, patient selection has thus far been far from perfect. Even a powerful predictor such as a KRAS mutation for EGFR-inhibiting therapy results in a response in just 20% of patients who are deemed sensitive based on their KRAS wild-type status. One of the reasons for the disappointing performance of predictive factors could be the fact that they are most often based on primary tumor characteristics, while at the time of metastatic disease, a patients’ prognosis is determined by their metastatic tumor load and its biological phenotype. Through processes such as clonal selection and the inherent genomic instability of the tumor or as a consequence of therapy pressure, metastatic tumor cells can differ substantially and vitally from primary tumor cells. Analysis of metastatic tissue would thus probably be better indicati

Summary: Circulating tumor cells (CTCs) have rapidly developed as important cancer biomarkers after their enumeration proved to be prognostic in metastatic breast, colorectal and prostate cancer, and their rise or decline after the first cycle of therapy showed to predict therapy response. Besides mere counting, CTCs can be isolated and subsequently analyzed using various molecular applications, including miRNA expression analysis. Recently, miRNA expression profiling in primary tumors has yielded promising results. However, establishing miRNA expression in the circulation likely has advantages over determination in primary tumor tissue, further augmenting the potential applications of miRNA determination in oncology. Additionally to CTC-associated miRNAs, free circulating miRNAs have been identified in whole blood, plasma and serum. Since determination of miRNAs in peripheral blood, either cell-free or CTC-associated, is expected to become important in oncology, especially when linked to and interpreted together with epithelial CTCs, this review focuses on measuring miRNAs in the circulation of cancer patients.

Het rapport Waardevol – Indicatoren voor valorisatie biedt kennisinstellingen, wetenschapsfinanciers en kennisgebruikers een gemeenschappelijk kader voor valorisatie. De methode werkt met valorisatiekaarten waarmee betrokken organisaties systematisch kunnen monitoren hoe groot de valorisatie-inspanningen zijn, wat de opbrengsten zijn en welke mogelijkheden voor verbetering er zijn. Het gebruik van valorisatiekaarten zal helpen om het inzicht te vergroten in wat publieke kennisinstellingen, wetenschapsfinanciers en bedrijfsleven nu al doen aan valorisatie., Het rapport Waardevol – Indicatoren voor valorisatie biedt kennisinstellingen, wetenschapsfinanciers en kennisgebruikers een gemeenschappelijk kader voor valorisatie. De methode werkt met valorisatiekaarten waarmee betrokken organisaties systematisch kunnen monitoren hoe groot de valorisatie-inspanningen zijn, wat de opbrengsten zijn en welke mogelijkheden voor verbetering er zijn. Het gebruik van valorisatiekaarten zal helpen om het inzicht te vergroten in wat publieke kennisinstellingen, wetenschapsfinanciers en bedrijfsleven nu al doen aan valorisatie.

Contains fulltext : 71123.pdf (publisher's version ) (Closed access), BACKGROUND: Pregnancy in women with congenital aortic stenosis (AS) is associated with increased cardiac complications. Data on non-cardiac complications are limited, and this information is crucial for prenatal counselling and perinatal care. The aim of this study was to present the maternal and perinatal outcome of pregnancy in women with congenital AS. METHODS: By review of the Dutch CONCOR national registry and a local Belgian tertiary care centre database, 35 women with congenital AS with a history of completed pregnancy before aortic valve replacement were enrolled in this study. Medical history and maternal and perinatal outcome were determined. RESULTS: Thirty-five women had 58 pregnancies resulting in 53 successful pregnancies, three miscarriages, and two abortions. The most serious cardiac complications were heart failure (n=2, 3.8%) and atrial arrhythmia (n=3, 5.7%). Although cardiac complications were present (9.4%), obstetric (22.6%) and perinatal (24.5%) complications were observed more often. A total of six pregnancies (11.3%) were complicated by hypertension-related disorders, including one case of eclampsia. Furthermore, 7 premature births (13.2%) and 7 small-for-gestational-age births (13.2%) were encountered. Pregnancy in women with severe AS was characterized by an increased incidence of heart failure and premature labour, and shorter pregnancy duration. Older women (>30 years) were at increased risk of perinatal events (odds ratio 4.38, 95% confidence interval 1.02 to 18.81). CONCLUSIONS: Pregnancy is generally well tolerated in women with congenital AS. Importantly, an excess of obstetric and perinatal complications was found, requiring more meticulous attention.