Ciência e terapia do câncer

Introduction: Experts dealing with the treatment of cancer in children believe that the COVID-19 pandemic could pose a serious global challenge
to the delivery of affordable and equitable treatment to children with cancer. In this paper we report our experience in the management of children
with cancer in these COVID-19 times.
Patients and Methods: Out-patient case records, in-patient case records, imaging pictures of all children with cancer attending our hospital were
retrieved and analyzed.
Results: Our study period extended from Dec 2019 until the end of April 2020. During this period, it was observed that the number of children
attending the outpatient department, undergoing day-care procedures including chemotherapy, as well as children undergoing surgery progressively
declined due to COVID-19 associated lockdown. Efforts were made to help the children and their families to gain easy access to treatment.
Conclusion: COVID-19 has disrupted the world and has caused widespread anxiety among families of children with cancer. The medical fraternity
with active help from all agencies should work out measures to reduce these difficulties faced by children and their families to provide the means
to ensure the continuity of curative treatments and palliative care as effectively as possible.

Triple Negative Breast Cancer (TNBC) is a particular subtype of breast cancer accounting for 15% to 20% of all breast cancer. It is defined on
immunohistochemistry (IHC) by negative estrogen receptor (ER) and progesterone receptors (PR) and negative human epidermal growth factor
receptor 2 (HER2) and characterized by aggressive nature, distinct metastatic patterns, lack of targeted therapies and poor outcomes. Cytotoxic
chemotherapy was the mainstay of treatment for long decades and the development of new treatments for selected patients was complicated
because of the heterogeneity of TNBC. The good understanding of molecular and genomic mechanisms of TNBC has allowed the development
of new targeted therapies more efficient. Although the heterogeneity of genetic alterations in TNBCs based on the ethnicity and the age, BRCA
mutations are found in around 20% to 25% of patients and especially in those of the basal-like immune-phenotype. Thus, targeting the defects
in the DNA repair pathway becomes a promising field of research for this selected category of TNBC patients. Poly (ADP-ribose) polymerase
(PARP) inhibitors exploit this DNA defects through synthetic lethality and therefore represent a promising treatment especially in BRCA1/ BRCA2
mutation carriers. These findings have finally allowed bringing personalized treatment to this orphan disease. In this work we tried to explain the
rationale and mechanisms of targeting the immune system in TNBC, to report the results from recent clinical trials that put immunotherapy as a
new standard of care in TNBC.