Investigator
Polytechnic University Of Timioara
The Role of Initial Neutropenia and Neutrophil Dynamics in Personalizing Chemotherapy for Platinum-Resistant Ovarian Cancer
Background and Objectives: Platinum-resistant ovarian cancer (PROC) is associated with limited treatment options and poor outcomes, with median progression-free survival (PFS) and overall survival (OS) remaining suboptimal. Neutropenia, a common chemotherapy-related toxicity, has shown potential as a predictive biomarker for treatment efficacy in several malignancies, including ovarian cancer. However, its role as a prognostic marker, particularly baseline neutropenia, remains underexplored. This study aimed to evaluate the prognostic and predictive value of initial neutropenia and neutrophil dynamics in PROC patients undergoing chemotherapy. Materials and Methods: A retrospective cohort study was conducted on 250 PROC patients treated between 2018 and 2022 at the OncoHelp Medical Center, Timișoara, Romania. Patients were stratified into two groups based on baseline absolute neutrophil count (ANC), as those with initial neutropenia (ANC < 2000/mm3) and without initial neutropenia (ANC ≥ 2000/mm3). Clinical outcomes, including tumor response, PFS, and OS, were assessed using RECIST 1.1 criteria. Hematological toxicities and neutrophil dynamics across three chemotherapy cycles were analyzed. Results: Patients with baseline neutropenia demonstrated significantly higher tumor response rates (47.05% vs. 27.27%; p = 0.002), longer median PFS (8.2 vs. 6.3 months; p = 0.008), and extended median OS (14.5 vs. 11.2 months; p = 0.002). Hematological toxicities, including Grade ≥3 neutropenia and febrile neutropenia, were more frequent in the neutropenic group (p < 0.001). Baseline ANC thresholds effectively predicted clinical outcomes, with an AUC of 0.79 for OS. Conclusions: Baseline neutropenia is a significant prognostic marker in PROC, correlating with improved tumor response and survival outcomes despite increased hematological toxicities. These findings support incorporating baseline ANC into treatment personalization strategies for PROC.
Evaluating the Cost-Effectiveness of Cervical Cancer Screening and Treatment in Western Romania
Background and Objectives: As a leading European country in terms of cervical cancer incidence and mortality, there has been a pressing need for Romania to upgrade its cervical cancer management. The criteria set by the International Federation of Gynecology and Obstetrics indicate that different treatments should have a similar trend concerning progression-free survival and overall survival at all the various stages of cervical cancer. This study aimed to assess the cost-effectiveness (CE) of the primary treatment plans related to the survival rate for cervical cancer screening in the western part of Romania and provide some recommendations. Materials and Methods: Descriptive statistics and a correlation model were used to examine costs. AI models have been developed to forecast the CE of different treatments using the above-mentioned studies on overall survival rates and treatment-related toxicity rates for five years. The costs of cervical cancer treatment were sourced from the public health department, the oncology clinic in the western region of Romania, and the County Hospital available for each stage. Results: Treatment expenses vary by cancer stage, with a significant increase from stages IA/IB to IIA, stabilizing between IIA and IIIC (about €7800–€8300), followed by a steep decline in IVA and a more pronounced decrease in IVB and in situ. The results highlight certain treatment combinations and their costs, indicating that the highest costs (exceeding €8000) are linked to multimodal treatments, which encompass surgery, chemotherapy, radiotherapy, and brachytherapy. Conclusions: Advanced cancer stages (IIA–IIIC) entail the highest treatment costs due to intricate, multimodal therapy, whereas early stages (IA, IB, in situ) and late terminal stages (IVB) are linked to considerably reduced treatment costs.
