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Prostate-specific antigen doubling time and response to cabazitaxel in a hormone-resistant metastatic prostate cancer patient

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The Journal of Biomedical Research 2015年第5期29卷 420-422页

作者： marwan ghosn Alain Dagher Fadi El-Karak Hematology-Oncology Department Faculty of MedicineSaint-Joseph University

We report a case of metastatic castration-resistant prostate cancer, who received prior treatment with docetaxel and was then given cabazitaxel as salvage therapy. The patient was monitored by prostate-specific antigen doubling time and prostate-specific antigen absolute value. The prostate-specific antigen doubling time was found to be a good response predictor in the patient.

关键词： prostate-specific antigen doubling time prostate cancer cabazitaxel docetaxel

Immunotherapies in sarcoma:Updates and future perspectives

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World Journal of Clinical Oncology 2017年第2期8卷 145-150页

作者： marwan ghosn Elie El Rassy Hampig Raphael Kourie Department of Oncology Hotel Dieu de France University HospitalFaculty of MedicineSaint Joseph University

Sarcomas are malignant tumors that are characterized by a wide diversity of subtypes with various cytogenetic profiles. Despite major treatment breakthroughs, standard treatment modalities combining chemotherapy, radiotherapy, and surgery failed to improve overall survival. Therefore, high expectations are foreseen with immunotherapy upon its maturation and better understanding of its mechanism of action. This paper presents a targeted review of the published data and ongoing clinical trials in immunotherapies of sarcomas, mainly adoptive cell therapies, cancer vaccines and immune checkpoint inhibitors.

关键词： Adoptive cell therapy Cancer vaccines Immunotherapy Immune checkpoint inhibitors Sarcoma

Is metastatic pancreatic cancer an untargetable malignancy?

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World Journal of Gastrointestinal Oncology 2016年第3期8卷 297-304页

作者： Hampig Raphael Kourie Joseph Gharios Fadi Elkarak Joelle Antoun marwan ghosn Department of Oncology Faculty of Medicine Saint Joseph University

Metastatic pancreatic cancer(MPC) is one of the most aggressive malignancies, known to be chemo-resistant and have been recently considered resistant to some targeted therapies(TT). Erlotinib combined to gemcitabine is the only targeted therapy that showed an overall survival benefit in MPC. New targets and therapeutic approaches, based on new-TT, are actually being evaluated in MPC going from immunotherapy, epigenetics, tumor suppressor gene and oncogenes to stromal matrix regulators. We aim in this paper to present the major causes rendering MPC an untargetable malignancy and to focus on the new therapeutic modalities based on TT in MPC.

关键词： Pancreatic cancer Tumor suppressor genes Targeted therapies Immunotherapy Epigenetics

Road map for pain management in pancreatic cancer: A review

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World Journal of Gastrointestinal Oncology 2016年第8期8卷 599-606页

作者： Marie José Lahoud Hampig Raphael Kourie Joelle Antoun Lana El Osta marwan ghosn Department of Anesthesiology and Critical Care Faculty of Medicine Saint Joseph University Department of Oncology Faculty of Medicine Saint Joseph University

Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief.

关键词： Pain management Interventional Medical Treatment Pancreatic cancer

Dilemma of first line regimens in metastatic pancreatic adenocarcinoma

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World Journal of Gastroenterology 2016年第46期22卷 10124-10130页

作者： marwan ghosn Tony Ibrahim Tarek Assi Elie El Rassy Hampig Raphael Kourie Joseph Kattan Department of Oncology Faculty of Medicine Saint Joseph University

Pancreatic cancer is one of the deadliest cancers,ranking fourth among cancer-related deaths. Despite all the major molecular advances and treatment breakthroughs, mainly targeted therapies, the cornerstone treatment of metastatic pancreatic cancer(m PC) remains cytotoxic chemotherapy. In 2016, more than 40 years after the introduction of gemcitabine in the management of m PC, the best choice for first-line treatment has not yet been fully elucidated. Two main strategies have been adopted to enhance treatment efficacy. The first strategy is based on combining non-cross resistant drugs, while the second option includes the development of newer generations of chemotherapy. More recently, two new regimens, FOLFIRINOX and gemcitabine/nab-paclitaxel(GNP), have both been shown to improve overall survival in comparison with gemcitabine alone, at the cost of increased toxicity. Therefore, the best choice for first line therapy is a matter of debate. For some authors, FOLFIRINOX should be the first choice in patients with an Eastern Cooperative Oncology Group score(0-1) given its lower hazard ratio. However, others do not share this opinion. In this paper, we review the main comparison points between FOLFIRINOX and GNP. We analyze the two pivotal trials to determine the similarities and differences in study design. In addition, we compare the toxicity profile of the two regimens as well as the impact on quality of life. Finally, we present studies revealing real life experiences and review the advantages and disadvantages of possible second-line therapies including their cost effectiveness.

关键词：评论变形胰腺的癌症 FOLFIRINOX Gemcitabine/nab-paclitaxel 枢轴的试用

Where does chemotherapy stands in the treatment of ampullary carcinoma? A review of literature

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World Journal of Gastrointestinal Oncology 2016年第10期8卷 745-750页

作者： marwan ghosn Hampig Raphael Kourie Elie El Rassy Fady Ghassan Haddad Colette Hanna Fadi El Karak Dolly Nasr Department of Oncology Faculty of MedicineSaint Joseph University Department of Oncology Jules Bordet InstituteFree University of Brussels (ULB) Department of Radiation Oncology Faculty of MedicineSaint Joseph University

Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancers.Few papers have studied the AC as an independent entity and yet succombs to several limitations.These studies were retrospective single institutional experiences with limited sample sizes recruited over a long period of time.Unlike metastatic ACs where chemotherapy is the only recommended option,localized AC once excised may be approached by either chemotherapy alone or concomitant chemoradiation therapy.In this review,we report the overall survival and recurrence factors of more than 1000 patients from all the studies treating exclusively ACs.We also review the medical treatment of this tumor and conclude to the necessity of multi-institutional randomized controlled studies for AC exclusively.

关键词： Ampullary 癌症预示的因素治疗评论新奇治疗

Gastrointestinal cancers in the era of theranostics: Updates and future perspectives

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World Journal of Gastroenterology 2015年第28期21卷 8473-8477页

作者： marwan ghosn Hampig Raphael Kourie Samer Tabchi Hematology-Oncology Department Faculty of Medicine Saint Joseph University

Theranostics are one of the practical aspects of personalized medicine.This concept was designed to describe a material combining diagnosis,treatment and follow up of a disease.It evolved and included molecular targeting and nanotechnologies that incorporate both diagnosis and therapeutics.In this editorial,we are presenting briefly the concept and evolution of theranostics,highlighting many applications of theranostics in daily practice and discussing future perspectives and aspects of this model in gastrointestincal cancers.

关键词： Theranostics Gastrointestinal cancer Nanoparticles Nanotheranostics Molecular targeting

Metastatic gastric cancer treatment: Second line and beyond

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World Journal of Gastroenterology 2016年第11期22卷 3069-3077页

作者： marwan ghosn Samer Tabchi Hampig Raphael Kourie Mustapha Tehfe Hematology-Oncology Department Faculty of MedicineSaint Joseph University Department of Medical Oncology Centre Hospitalier de l'Université de Montréal

Advanced gastric cancer(a GC), not amenable to curative surgery, is still a burdensome illness tormenting afflicted patients and their healthcare providers. Whereas combination chemotherapy has been shown to improve survival and tumor related symptoms in the frontline setting, second-line therapy(SLT) is subject to much debate in the scientific community, mainly because of the debilitating effects of GC, which would impede the administration of cytotoxic therapy. Recent data has provided sufficient evidence for the safe use of SLT in patients with an adequate performance status. Taxanes, Irinotecan and even some Fluoropyrimidine analogs were found to provide a survival advantage in this subset of patients. Most importantly, quality of life measures were also improved through the use of adequate therapy. Even more pertinent were the findings involving antiangiogenic agents, which would add measurable improvements without significantly jeopardizing the patients' well-being. Further lines of therapy are cause for much more debate nowadays, but specific targeted agents have shown considerable promise in this context. We herein review noteworthy published data involving the use of additional lines of the therapy after failure of standard frontline therapies in patients with a GC.

关键词： Advanced gastric cancer Treatment Second-line Cytotoxic Targeted therapy

Anal cancer treatment:Current status and future perspectives

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World Journal of Gastroenterology 2015年第8期21卷 2294-2302页

作者： marwan ghosn Hampig Raphael Kourie Pamela Abdayem Joelle Antoun Dolly Nasr Hematology-Oncology Department Faculty Of Medicine Saint Joseph University

Anal cancers(AC)are relatively rare tumors.Their incidence is increasing,particularly among men who have sex with other men due to widespread infection by human papilloma virus.The majority of anal cancers are squamous cell carcinomas,and they are treated according to stage.In local and locally advanced AC,concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil(5-FU)is the current best treatment,while metastatic AC,chemotherapy with 5-FU and cisplatin remains the gold standard.There are no indications for induction or maintenance therapies in locally advanced tumors.Many novel strategies,such as targeted therapies,vaccination,immunotherapy and photodynamic therapy are in clinical trials for the treatment of AC,with promising results in some indications.

关键词： Anal cancer Optimum treatment Updates Guidelines N