Search results - PSJD

1

Satisfaction with life after radical treatment of cancer

100%

Nowicki A., Duba P., Lemanowicz M.

OncoReview

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2017

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vol. 7

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issue 4

192-198

EN

Introduction: Cancer treatment is multidisciplinary in its character and places a heavy burden on the patient. Quality of life is a concept that is closely related to the satisfaction with life. Cancer patients’ satisfaction with life, especially after recovery, is an increasingly examined indicator of treatment quality. Aim of the study: Evaluation of satisfaction with life in patients after radical cancer treatment. Material and methods: The study included 100 people, 81 women and 19 men of all ages, following radical treatment of various cancers. The study was conducted in 2016 at the Centre of Oncology in Bydgoszcz. The study used the Satisfaction with Life Scale (SWLS), adapted by Z. Juczyński, as well as a sociodemographic data questionnaire. Results: In general, cancer patients have an average level of satisfaction with life – the average score was 22.37 and 6.19 sten. The greatest satisfaction with life (average points) was reported for professionally active people – 22.67, patients between 41–50 years old – 23.5, patients with secondary education – 23.4, and patients with at least one child – 22.73, though the differences were not statistically significant. Additionally, patients 3–5 years after treatment declared a higher satisfaction with life – 23.05, as did patients without concomitant diseases – 22.77, though again the results were statistically non-significant. Conclusions: In general, patients after radical anti-cancer treatment have an average satisfaction with life, and in half of them satisfaction with life is high, regardless of the duration and type of cancer. Sociodemographic factors have no impact on the satisfaction with life scores.

2

Seizure as first manifestation of endocarditis in a patient with metastatic pancreatic adenocarcinoma: a case report

80%

Ciuffo Almeida M. P., Santos da Silva Costa I. B., Feres de Almeida M. C., Bittencourt Viana Cruz C. B., Itala Rizk S., Abrahão Hajjar L.

OncoReview

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2019

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vol. 9

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issue 4

92-95

EN

Nonbacterial thrombotic endocarditis is a potentially overlooked condition that involves the formation of sterile fibrin vegetations on heart valve leaflets in cancer patients. This condition can lead to valvular dysfunction, heart failure and systemic embolization. The pathogenesis depends on hypercoagulable states which are common in malignancy scenarios. Diagnosis requires the presence of valvular vegetations and the absence of infection.

3

Epidemiology of Cancer in Central and Eastern Europe Versus Western Europe and Poland

80%

Zatoński W., Didkowska J., Wojciechowska U.

Polish Journal of Surgery

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2009

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vol. 81

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issue 10

434-452

EN

The health transformation that took place after the Second World War in Europe was significantly delayed in the Central and Eastern European countries compared to countries of Northern Europe and United Kingdom. However, as death rates from cardiovascular disease have begun to fall since the 1990s, cancer has emerged as the most common cause of death among young and middle-aged adult women (20-64 years old) in the Central and Eastern European countries. In the coming decade it seems likely to be the leading cause of death among young and middle-aged adult men.The aim of the study was to compare the diversity in cancer risk, contrasting the "old" (EU-15) and the "new" Member States of European Union coming from Central and Eastern European (EU-10) and separately Poland.Material and methods. Data on deaths (1959-2002) in each country have been extracted from the World Health Organization database. Population data are from the Population Division of the Department of Economic and Social Affairs of the United Nations. Direct standardization has been undertaken using the World Standard Population.Results. The difference in life expectancy attributable to cancer for group 20-64 years of age is 0.68 of a year (16% of the total gap) among men and 0.35 of a year (24% of the total) among women. Trends in cancer over time differ significantly by gender, age group and time period in Central and Eastern Europe. The predicted mortality rate in Central and Eastern Europe in 2015 equates to 201/105 (95% CI 198.9-204) for men and 105.6/105 (95% CI 104.1-107.0) for women.Conclusions. In the Central and Eastern European countries deficiency of primary prevention is a main reason of poor health consciousness (consequences of smoking, fatty diet, low physical activity) and late introduction of poorly organized secondary prevention is responsible for worse survival of cancer patients, however tertiary prevention (therapy) is implemented in similar way as in Western Europe. Our analysis indicates that the greatest possibilities, but also the greatest unmet need, lie in primary and secondary prevention.

4

Cardiac amyloidosis: a hidden cause of cardiovascular complications in oncology practice

80%

Mladosievicova B., Poljak Z., El-Hassoun O., Roziakova L., Carter A.

OncoReview

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2014

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vol. 4

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issue 4

A137-A143

EN

Amyloidosis is rare, but known cause of heart failure, cardiomyopathy, coronary artery disease, disorders of cardiac conduction system and valvular damage. Disease often remains undetected until it reaches an advanced stage. Currently, we distinguish several types of amyloidosis. Cardiac amyloidosis may be caused by cancer, chronic inflammation, genetic factors and by aging related processes. Overproduction of amyloidogenic proteins by tumor cells has a key role in the pathogenesis of immunoglobulin light chain amyloidosis. Cardiovascular complications in patients with amyloidosis can be induced by insoluble deposits of misfolded proteins or by direct toxic effects of amyloidogenic molecules on cardiomyocytes and endothelial cells. In this review we focus mainly on pathophysiological mechanisms of cardiac amyloidosis, classification of cardiac amyloidosis types and their cardiovascular manifestations.

5

New integrative PDT method of cancer treatment by means of laser, magnetic therapy and herbal ferromagnetics

80%

Arakelyan H. S.

OncoReview

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2014

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vol. 4

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issue 4

A171-A174

EN

Integrative photodynamic therapy (IPDT) of tumors consists of combined use of different curable factors that extremely increase the effectiveness of IPDT. The leading curable effect of PDT is determined by developing of aggressive photochemical reactions in the tumor. The main destructive factor of these reactions is the generation of free radicals that kill tumor’s cells. For PDT efficacy increasing it is necessary to solve the following problems and assure: easiness of production or synthesis; accumulation high selectivity regarding tumor tissue; low toxicity in light and darkness; singled oxygen generation high quant output; promptly elimination from the organism after the treatment procedure; good absorption in spectral intervals most transparent for tissues (red and infrared intervals); optimal interconversion between quant output and fluorescence quant output. PDT effectiveness may be significantly increased by means of: increasing of photosentisizer selectivity and accumulation in tumor tissue; increasing of tumor tissue photochemical destruction caused by photosensitizer. Realization of integrative PDT using Cyber Laser may increase tumor therapy effectiveness to 94–96% and at the same time will establish a new direction in PDT.

6

Assessment of nutritional status of patients with cancer who are qualified for home enteral nutrition – a retrospective analysis

80%

Kaźmierczak-Siedlecka K., Folwarski M., Jankowska B., Spychalski P., Szafrański W., Baran M., Makarewicz W., Bryl E.

European Journal of Translational and Clinical Medicine

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2020

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vol. 3

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issue 1

16-23

EN

Background: Patients with cancer are at risk of malnutrition. The aim of this study is to assess the nutritional status of patients with cancer who are qualified for home enteral nutrition. Secondary aim is to compare the nutritional status of patients with gastric cancer and with esophageal cancer. Material and methods: Retrospective analysis of medical documentation of 84 participants with cancer who were qualified for home enteral nutrition in Nutritional Counselling Center Copernicus in Gdansk in 2009-2015 was performed. Assessment of nutritional status included body mass index, the level of total protein and albumin in blood serum, total lymphocyte count, and Nutritional Risk Score 2002 method. Results: Patients with gastric cancer most often presented albumin deficiency in comparison with patients with esophageal cancer (p=0.02). The low level of total lymphocyte count in 1mm3 of peripheral blood was observed in 47.6% participants. All the patients qualified for home enteral nutrition received at least 3 points in NRS 2002 method and most often 5 points (40.4%). Conclusions: All patients required nutritional treatment. Notwithstanding, the nutritional status of patients varied. Hypoalbuminemia was observed more often in patients with gastric cancer in comparison with patients with esophageal cancer.

7

Percutaneous retrieval of a fractured portacath fragment in two patients undergoing long-term chemotherapy

80%

Norwa J., Darocha S., Dobosiewicz A., Koteja A., Pietrasik A., Pietura R., Torbicki A., Szmit S., Kurzyna M.

OncoReview

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2016

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vol. 6

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issue 2

A57-61

EN

The paper discusses two clinical cases of cancer patients undergoing chemotherapy, in whom fractured and displaced tips of portacath catheters were revealed based on plain chest imaging. In the first case, the portacath fragment migrated to the left pulmonary artery, with the missing catheter tip revealed during the procedure of port removal due to its occlusion, with no other prior clinical symptoms. In the second case, the catheter broke off at the level of its entry into the subclavian vein, and migrated into the right cardiac ventricle, which was accompanied by mild pain and oedema in the subclavicular region. Both patients underwent successful procedures of percutaneous foreign body retrieval with the use of endovascular snares. The procedures were performed via femoral vein access, with no complications.

8

Acute coronary syndromes in oncology: conservative or invasive strategies? Case study and literature review

80%

Wilk M., Walaszkowska-Czyż A., Rak A., Piłka M., Szmit S.

OncoReview

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2018

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vol. 8

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issue 1

5-10

EN

We present the case of a 70-year-old male patient with metastatic and castration-resistant prostate cancer as well as advanced bladder cancer, who suffered a non-ST-elevation myocardial infarction (NSTEMI). The cause of ischemia was critical left main stem stenosis, and right coronary artery stenosis. Initially, the patient was qualified for conservative treatment, but due to the intensifying symptoms of myocardial ischemia, it was decided that a hemodynamic intervention was necessary. Two drug-eluting stents were implanted, leading to clinical improvement. Following the treatment, the patient was considered as a candidate for further anti-cancer therapy. Unfortunately, due to the bladder cancer progression, anaemia and haemorrhage, his clinical condition exacerbated, and the patient died about 1 month from the cardiac intervention. Apart from the case description, the paper includes a review of literature on the treatment of acute coronary syndromes without ST-segment elevation in cancer patients.

9

Isolation of low-molecular albumins of 2S fraction from soybean (Glycine max (L.) Merrill)

80%

Galbas M., Porzucek F., Woźniak A., Słomski R., Selwet M.

Acta Biochimica Polonica

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2013

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vol. 60

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issue 1

107-110

EN

Numerous studies have shown that consumption of soybean products decrease the risk of cancers in humans. Experiments at the molecular level have demonstrated that in most cases proteins and peptides are responsible for the anticancer properties of soybeen. Special attention should be paid to lunasin - a peptide described for the first time 16 years ago. Due to its structure it causes i.a., inhibition of cancer cell proliferation. A novel procedure for the isolation and purification of low-molecular-mass 2S soybean albumin protein is described in the present paper. A fraction of four peptides one of them corresponding to molecular mass and isoelectric point characteristic for lunasin. The obtained peptides decreased on the rate of HeLa cell proliferation.

10

Sleep quality during hospitalization in critically ill cancer patients in Sri Lanka

80%

Sandamali P., Vithana N. J., Lakmali I. G., Madhushani J. I., Rasadari V., Perera C. H., Dharmarathna N. D., Jayamaha A. R.

Critical Care Innovations

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2022

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vol. 5

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issue 4

18-28

EN

INTRODUCTION: : Sleep is vital for physical, psychological, emotional, and cognitive well-being. Cancer becomes life-threatening once it affects major organs and their ability to function. Sleep disturbance is one of the most common complaints in patients with cancer which interferes with the symptom burden, coping ability, and treatment effectiveness. Current study aimed to assess sleep quality and its associated factors among critically ill cancer patients who were admitted to the Apeksha Hospital, Sri Lanka. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted among 384 patients with cancer, who were admitted to Apeksha Hospital. Pretested interviewer-administered questionnaire was used for data collection. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Sleep quality was classified as good (Global PSQI score ≤5) and poor (Global PSQI score >5). The data were analyzed using descriptive statistics and associations between categorical variables were assessed by performing a Chi-square test. IBM SPSS Version 26 was used as the analytical tool. RESULTS: Of 384 patients with cancer, 58.9% (n=226) were females. Most of the patients (78.4%, n=301) were adults (25-64 years), and 63.0% (n=242) were married. Breast cancers (20.1%), blood cancers (19.3%), and ovarian cancers [13.8%) were the most common cancers reported by the study participants. The mean Global PSQI score was 10.27±3.48 (range 3-20) and 95.3% of the participants were categorized as having poor sleep quality. Age (p=0.002), income (p=0.050), engaging in leisure time activities (p=0.036), social media use (p=0.022), and fatigue (p=0.012), and level of pain (p<0.001) were significantly associated with the sleep quality of patients with cancer. CONCLUSIONS: Poor sleep quality is highly prevalent among patients with cancer and evidence-based interventions should be implemented to improve sleep quality.

PL

WSTĘP: Sen jest niezbędny dla dobrego samopoczucia fizycznego, psychicznego, emocjonalnego i poznawczego. Rak staje się zagrożeniem dla życia, gdy atakuje główne narządy i ich zdolność do funkcjonowania. Zaburzenia snu są jedną z najczęstszych dolegliwości u pacjentów z chorobą nowotworową, która zaburza nasilenie objawów, zdolność radzenia sobie i skuteczność leczenia. Obecne badanie miało na celu ocenę jakości snu i związanych z nim czynników wśród krytycznie chorych pacjentów z rakiem, którzy zostali przyjęci do szpitala Apeksha na Sri Lance. MATERIAŁ I METODY: Przeprowadzono opisowe badanie przekrojowe wśród 384 pacjentów z chorobą nowotworową przyjętych do szpitala Apeksha. Do zbierania danych wykorzystano wstępnie przetestowany kwestionariusz administrowany przez ankietera. Jakość snu oceniono za pomocą Pittsburgh Sleep Quality Index (PSQI). Jakość snu została sklasyfikowana jako dobra (globalny wynik PSQI ≤5) i zła (globalny wynik PSQI >5). Dane analizowano za pomocą statystyk opisowych, a powiązania między zmiennymi kategorycznymi oceniano za pomocą testu chi-kwadrat. Jako narzędzie analityczne wykorzystano IBM SPSS wersja 26. WYNIKI: Spośród 384 pacjentów z chorobą nowotworową 58,9% (n=226) stanowiły kobiety. Większość pacjentów (78,4%, n=301) to osoby dorosłe (25-64 lata), a 63,0% (n=242) było w związku małżeńskim. Raki piersi (20,1%), krwi (19,3%) i jajników (13,8%) były najczęstszymi nowotworami zgłaszanymi przez uczestników badania. Średni wynik Global PSQI wyniósł 10,27 ± 3,48 (zakres 3-20), a 95,3% uczestników zostało sklasyfikowanych jako osoby o złej jakości snu. Wiek (p=0,002), dochód (p=0,050), aktywność w czasie wolnym (p=0,036), korzystanie z mediów społecznościowych (p=0,022) i zmęczenie (p=0,012) oraz poziom bólu (p<0,001) ) były istotnie związane z jakością snu pacjentów z rakiem. WNIOSKI: Niska jakość snu jest bardzo powszechna wśród pacjentów z chorobą nowotworową i należy wdrożyć interwencje oparte na dowodach w celu poprawy jakości snu.

11

Improving cancer outcomes through better cancer data in Poland

80%

Gralinska M., Nawrocki S.

OncoReview

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2013

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vol. 3

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issue 3

177-190

EN

Based on NFZ published aggregate data, the public spending on cancer care in Poland was 6.3 billion PLN in 2011 (or approximately 10% of total public health spending). Poland is one of the few large countries in the world that has two centralised and public data sources for cancer, namely the National Cancer Registry (NCR, pol. Krajowy Rejestr Nowotworów – KRN) and activity expenditure database run by the National Health Fund (NFZ, pol. Narodowy Fundusz Zdrowia). We show in our article that having a population-based registry and a complete treatment/clinical care dataset is a necessary condition to have a useful cancer strategy data set that can in turn lead to evidence based health policies in the area of cancer. Lack of audited and publicly available cancer data means that a coherent cancer strategy, assessing service provision and cost effectiveness of treatments and monitoring outcomes is, in our opinion, currently not possible in Poland. We postulate that Poland should create a task force to create cancer data strategy based on NCIN (National Cancer Intelligence Network) in the UK or Cancer Australia.

12

Application of kinesiology taping for pain management in oncologic patients

80%

Amarowicz J., Warzecha M.

Advances in Rehabilitation

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2020

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vol. 34

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issue 2

32-41

EN

Rehabilitation of patients with a diagnosed cancer poses a major challenge for physiotherapists (PT) due to the limited number of methods which may be used on every stage of cancer treatment (including convalescence). Kinesiology Taping (KT) is one of the few available options that enable pain and oedema reduction. Limited number of studies with significantly varied study methods makes it difficult to draw clear conclusions on the legitimacy of KT use. Aim of the review was to analyse available studies on the KT use in pain management and associated discomfort reported by cancer patients. Six papers met the criteria for the review and were included in the detailed pooled analysis (2 clinical studies and 4 case studies). Analysis emphasized papers describing analgesic effect of KT. On the basis of available studies, it proved to be beneficial for oncology patients (breast cancer, lung cancer, multiple myeloma). Additionally, studies reported an increased ability to carry out daily activities, decreased ‘psychological suffering’ and lower fatigue which directly resulted in the improvement of the quality of life (QoL) – a main goal of palliative care. The number of studies that evaluate the effectiveness of KT in pain reduction in oncology patients is scarce. Since KT has minor adverse effects it is recommended to be used as an adjunct analgesic therapy. Review supports the effectiveness of KT for pain management in oncologic patients. In order to confirm the efficacy of KT use in cancer patients, a greater number of randomized clinical trials, covering larger study groups, is required with special emphasis on malignant neoplasms.

13

Gelsolin in human colon adenocarcinoma cells with different metastatic potential

80%

Litwin M., Mazur A., Nowak D., Mannherz H., Malicka-Błaszkiewicz M.

Acta Biochimica Polonica

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2009

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vol. 56

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issue 4

739-743

EN

Gelsolin, one of a major actin-binding proteins, is involved in the regulation of actin cytoskeleton organization by its severing and capping activity towards actin filaments. Human colon adenocarcinoma cell line LS180 and its selected variants of different metastatic potential were used to check for a correlation between gelsolin level, its subcellular localization and the invasive capacity of cells. Based on immunoblotting experiments, a decreased level of gelsolin was detected in the most invasive 5W subline when compared to the parental cell line LS180. The intracellular distribution of actin filaments and gelsolin in colon adenocarcinoma cells was examined by confocal microscopy. In the 5W subline, unlike in the other examined cells, gelsolin was colocalized with filamentous actin at the cell periphery. In summary, in human colon adenocarcinoma cells, gelsolin level and its subcellular distribution seem to correlate with their metastatic potential.

14

Transcatheter aortic valve replacement in a patient with renal cell carcinoma. A case report

80%

Almeida M. P. C., González T. B., Santos da Silva Costa I. B., Itala Rizk S., Assunção B. M. B. L., Barbosa Ribeiro H., Abrahão Hajjar L.

OncoReview

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2020

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vol. 10

|

issue 1

5-7

EN

The transcatheter aortic valve replacement (TAVR) is an important therapy for symptomatic patients with severe aortic stenosis who have an intermediate or high surgical risk. The profile of patients eligible for this therapy as first choice has changed over the last few years, with increasing indication even for patients who do not have surgical high risk. Severely ill and frail patients, elderly or patients with multiple clinical comorbidities, such as cancer might be considered for TAVR.

15

Kinin-generating cellular model obtained from human glioblastoma cell line U-373

80%

Guevara-Lora I., Blonska B., Faussner A., Kozik A.

Acta Biochimica Polonica

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2013

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vol. 60

|

issue 3

299-305

EN

Kinins, a group of important pro-inflammatory peptides, are abundantly found in tissues and biological fluids of cancer patients. Bradykinin, the major representative of kinins, induces vascular permeability and, in consequence, promotes tumor expansion. Additionally, the kinin-induced inflammatory responses, especially those mediated by kinin metabolites without the C-terminal arginine residue, lead to enhanced tumor growth. The present study aimed at analyzing the ability of the human glioblastoma cell line U-373, derived from a malignant tumor, to produce kinin peptides. The proteins involved in kinin generation, i.e., the kininogens and the kallikreins, were shown to be expressed in these cells. Moreover, tumor necrosis factor α, a proinflammatory cytokine that mediates tumorigenesis, was found to enhance the expression of enzymes associated with kinin production. The strong binding of kininogen to the cell surface and the enzymatic degradation of this protein by cells suggest the activation of kinin-generating systems. Indeed, glioblastoma cells, pre-treated with tumor necrosis factor α, released kinin peptides from exogenous kininogen. The expression of kinin receptors in these cells was also shown to increase under the influence of this cytokine. Our results suggest that the human glioblastoma cell line U-373 constitutes a good cellular model that can be helpful in cancer research focused on kinin-induced inflammation. Furthermore, our findings can contribute to new approaches in cancer treatment with the use of kinin receptor antagonists and inhibitors of kinin production.

16

Stimuli responsive polymeric nanoparticles in regulated drug delivery for cancer

80%

Yadav D., Suri S., Chaudhary A., Hemant, Beg M., Garg V., Asif M., Ahmad A.

Polish Journal of Chemical Technology

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2012

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vol. 14

|

issue 1

57-64

EN

Stimuli-responsive drug delivery system is a concept in which a drug is delivered at a suitable rate in response to stimuli. States of diseases may cause an alteration in some parameters of the body (e.g. in tumors) and the onset and offset of the drug delivery can be done by using this as a stimuli or a "trigger". Stimuli-responsive ("intellectual" or "sharp") resources and molecules show abrupt property changes in response to miniature changes in external stimuli such as pH, temperature etc. For regulated drug delivery, environmental stimuli such as pH and temperature, which undertake phase transition in polymer system, have been investigated. Thermally-responsive polymers can be tuned to a preferred temperature variety by copolymerization with a hydrophilic co-monomer or a hydrophobic co-monomer. Hydrophilic co-monomers increase the LCST while hydrophobic co-monomers decrease the LCST. The stimuli responsive polymer for regulated drug delivery can contain a polymer and copolymers having equilibrium of hydrophilic and hydrophobic groups. A number of these polymers have been investigated extensively and some success in drug delivery with them has been achieved, such as polymers and copolymers of N-isopropylacrylamide, PLGA, and PLA, HEMA etc. Thus this review is designed for stimuli pH and temperature responsive polymeric nanoparticles, which would be helpful to treat various cronic diseases such as cancer and others, for scientists in the field of the regulated drug delivery system.

17

Should a diagnosis of cancer impact the anticoagulant therapy in patients with recurrent thromboembolic disease?

80%

Wieteska M., Kurzyna M., Szmit S., Torbicki A.

OncoReview

|

2015

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vol. 5

|

issue 2

A62-66

EN

Venous thromboembolism often coexists with cancer, deteriorating patient prognosis. The diagnosis of cancer in patients who suffer from venous thromboembolism may lead to changes in the anticoagulant therapy administered. We present a case report involving a 72-year-old patient with recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension in whom the diagnosis of colorectal cancer resulted in the need for modification of the anticoagulant therapy. Oral anticoagulant was replaced with low molecular weight heparin and an inferior vena cava filter was implanted due to active bleeding from the anus, high perioperative risk of bleeding, which caused the need for a temporary interruption of anticoagulant therapy.

18

Variable order 3D models of bone remodelling

80%

Valério D., Neto J., Vinga S.

Bulletin of the Polish Academy of Sciences: Technical Sciences

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2019

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issue 3

19

Design of vascular endothelium-specific drug-targeting strategies for the treatment of cancer.

80%

Molema G.

Acta Biochimica Polonica

|

2005

|

vol. 52

|

issue 2

301-310

EN

Tumor endothelial cells are actively involved in the neovascularization processes that accompany tumor growth. Their easy accessibility for systemically applied therapeutics makes them interesting targets for therapeutic intervention. Especially for drug targeting-based therapeutics that often consist of macromolecular moieties, the tumor endothelium is considered a much better target than the tumor cells located behind the vascular wall barrier. In this review, the general principles underlying the development and choices in the development of vascular drug-targeting strategies are discussed. An overview of target epitopes identified in the past two decades is followed by a summary of those strategies that directly or indirectly induced tumor blood flow blockade in vivo. The demonstrated therapeutic success in pre-clinical animal models in debulking large tumor masses and inhibiting tumor outgrowth warrant further development of these therapeutic approaches. Yet, more effort should be put in studies in which the efficacy of different effector activities aimed at the same target, of one effector activity aimed at different targets, and of multiple target strategies are be compared. Combining these data with proper inventories on the molecular basis of tumor endothelial heterogeneity in general will make possible the development of tumor vascular drug-targeting strategies towards clinical application.

20

Tumors and the danger model.

80%

Kowalczyk D. W.

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vol. 49

|

issue 2

295-302

EN

This article reviews the evidence for the danger model in the context of immune response to tumors and the insufficiency of the immune system to eliminate tumor growth. Despite their potential immunogenicity tumors do not induce significant immune responses which could destroy malignant cells. According to the danger model, the immune surveillance system fails to detect tumor antigens because transformed cells do not send any danger signals which could activate dendritic cells and initiate an immune response. Instead, tumor cells or antigen presenting cells turn off the responding T cells and induce tolerance. The studies reviewed herein based on model tumor antigens, recombinant viral vectors and detection of tumor specific T cells by MHC/peptide tetramers underscore the critical role of tumor antigen presentation and the context in which it occurs. They indicate that antigen presentation only by activated but not by cancer or resting dendritic cells is necessary for the induction of immune responses to tumor antigens. It becomes apparent that the inability of dendritic cells to become activated provides a biological niche for tumor escape from immune destruction and seems to be a principal mechanism for the failure of tumor immune surveillance.

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