Adenoid cystic carcinoma (ACC) is primarily found in the salivary glands and rarely at other organs but never reported as liver primary. This is a very rare case of primary ACC of the liver which was not resectable and managed with chemotherapy and targeted therapy. The patient progressed on imatinib (c-kit positive) while responded to chemotherapy and gefitinib (epidermal growth factor receptor mutation absent).

Background: The WHO 2016 molecular classification corroborating with the histology has given more significant diagnostic objectivity to the diagnosis of brain tumors and it is more reliable for instituting therapy as the heterogeneity and observer subjectivity are bypassed with the addition of isocitrate dehydrogenase, ATRX, and 1p19q, and other molecular markers. Aim: Our aim is to review the histopathology of diagnosed brain tumors and correlate with immunohistochemical (IHC) findings to note for any disparity to reform the diagnosis in order to benefit the patient and report to the clinician if any treatment change is to be considered. Materials and Methods: This article is based on studies of screening and diagnostic test. A total of 150 brain tumors were retrospectively analyzed. Age, gender, and the tumor histological type and grade were systematically recorded. We compared our histopathological diagnosis before the introduction of the WHO 2016 molecular classification of central nervous system tumors and later after the relevant IHC and fluorescence in situ hybridization studies. Statistical Analysis: The statistical analysis was done by using Statistical Package for Social Sciences version recent for Windows. Results: Out of the total 150 brain tumor patients, 65 were males and 45 were females. About 37 were glial and the rest were in other categories. Conclusions: The molecular diagnosis that substantiated with the histomorphology is more objective and beneficial in the treatment of the patients.

Breast cancer is a heterogeneous disease. Liquid biopsy is a novel diagnostic tool and may provide answers to many questions related to unevenness in prognosis and ultimate outcome. Different technologies for CTC isolation, enrichment, detection, and characterization are under evaluation. Various clinical trials and meta-analysis have been conducted to define the role of CTC in early and metastatic breast cancer. CTCs are superior to other serum markers for prognostication. Their role as predictive marker remains elusive.

Cancer has become an important public health issue in India as ICMR in its latest report on cancer status (summarized in Figure 1), has projected that the total number of new cases would be around 14.5 lakhs in 2016 and the figure is likely to reach 17.3 lakhs by the year 2020. Molecular oncology, a multidisciplinary specialty involving extensive use of genomics, computational biology, and tumor imaging, is the “backbone technology” for the management of the disease. In the modern day India, the growing significance of molecular genetics and cytogenetics in diagnosis as well as management of various cancers has also led to expansion of genetic diagnostic and counseling services. However, skewed geographical distribution, lack of awareness about the disease, symptoms, and diagnostic practices further augments the challenge of treating cancers in India. Lack of adequate infrastructure and absence of mass screening programs are key barriers to timely and accurate diagnosis in India. Key themes that may help in effective management of cancer include cost-effective, early diagnosis and screening; national planning based on robust and granular cancer registry; public-private partnerships to decentralize cancer care delivery and nurture centers of excellence.

Purpose: Angiogenesis is a necessary step in tumor growth and metastasis. Vascular endothelial growth factor (VEGF-c) is a major mediator of breast cancer angiogenesis. Therefore, we investigated the association of polymorphism in the VEGF-c gene with breast cancer risk and prognostic characteristics of the tumors in a case-control study. Experimental Design: We examined one polymorphism in the VEGF-c gene (+936C/T) in 75 breast cancer cases and 75 control from Kanpur, Uttar Pradesh, India and adjacent areas together with geographically selected controls. Results: None of the polymorphism or any haplotype was significantly associated with either breast cancers. Our study suggests that the +936C/T polymorphism is unlikely to be associated with breast cancer. We also analyzed the cases for genotypes or haplotypes that associated with tumor characteristics. The genotypes and haplotypes were not related with other tumor characteristics such as regional or distant metastasis, stage at diagnosis, or dietary history. Conclusions: Although none of the polymorphisms studied in the VEGF-c gene was found to influence susceptibility to breast cancer significantly, some of the VEGF-c genotypes and haplotypes may influence tumor growth through an altered expression of VEGF-c and tumor angiogenesis.

Letter to Editor

Letter to Editor

Non-small-cell lung cancer (NSCLC) accounts for 80–85% of all lung cancer cases. The majority of patients present with advanced disease. Adenocarcinoma of the lung forms one of the major histopathological subtypes of metastatic NSCLC. A 70-year-old male was diagnosed with adenocarcinoma right lung with clinical staging of cT2 N0 M0 in 2012. Patient was treated with adjuvant chemotherapy with 4 cycles of vinorelbine and cisplatin followed by image guided radiation therapy that was completed in November 2012. The patient was started on gefitinib in Jan 2014 till January 2015 due to recurrence and progression and was subsequently switched to erlotinib as the gefitinib was becoming ineffective. However, the patient developed toxicity leading to diarrhea, and the patient had to discontinue erlotinib. In view of poor general condition of the patient (ECOG performance status 4), and progression post gefitinib and erlotinib he was deemed unfit for chemotherapy and it was decided to start the patient on afatinib 40 mg once a day in July 2015, to which the patient responded. The patient showed significant improvement on afatinib. The response though partial and incomplete was substantial and further improvement was very much expected unfortunately the patient succumbed to a lower respiratory tract infection in November 2015.