M. Manickavasagam

Sri Ramachandra Institute of Higher Education and Research

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Co-Authors

Christopher John

Sri Ramachandra Institute of Higher Education and Research

Solomon F.D. Paul

Sri Ramachandra Institute of Higher Education and Research

Aparna R. Bitla

Sri Venkateswara Institute of Medical Sciences

Mutheeswaraiah Yootla

Sri Venkateswara Institute of Medical Sciences

Sowmica Devabhaktuni

Sri Ramachandra Institute of Higher Education and Research

Nalini Ganesan

Sri Ramachandra Institute of Higher Education and Research

Ravichandran Ambalathandi

Sri Ramachandra Institute of Higher Education and Research

Lakshmi Amancharla Yadagiri

Sri Venkateswara Institute of Medical Sciences

Narendra Hulikal

Sri Venkateswara Institute of Medical Sciences

Mayakannan Manikandan

Indiana University – Purdue University Indianapolis

Cooperative Institutions

Sri Ramachandra Institute of Higher Education and Research

Sri Venkateswara Institute of Medical Sciences

Sri Ramachandra Medical Centre

Christian Medical College & Hospital

Christian Medical College

Creative Commons

University of Madras

SRM Institute of Science and Technology

All India Institute of Medical Sciences

Kasturba Medical College, Manipal

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Common Symptoms Experienced by Cancer Patients Undergoing Chemotherapy

International Journal of Current Research and Review (2021)

Uppu Praveen M. Manickavasagam Sirala Jagadeesh Nalini

Introduction: Chemotherapy is one of the most commonly used treatments of choice for cancer and it leads to certain side effects.The oncology care team needs to identify the symptoms experienced by cancer patients who are under chemotherapy to resolve these side effects.Objective: To identify the most common side effects experienced by cancer patients undergoing chemotherapy. Methods:A cross-sectional survey is carried out in the Medical Oncology Outpatient department and Chemotherapy Units of Sri Ramachandra Hospital, Sri Ramachandra Institute of Higher Education, and Research (DU), Chennai, India, from February to March 2020.A convenient sampling technique was used to recruit a total of 150 cancer patients.Data collection was done through personal interviews and a review of their medical records.Approximately 15-20 minutes was required to obtain data from each participant.Results: Most (31%) of them had breast cancer, 21% of them had gynaecological tract cancer, around 20% of them had digestive tract cancer.Fatigue was the most (48%) commonly reported symptom, followed by vomiting (36%) and pain (29.3%).Other symptoms like itching, oral mucositis, urinary problems, dyspnoea were experienced by the cancer patients under chemotherapy. Conclusion:This study will help the oncology care team to understand the most common symptoms experienced by cancer patients who underwent chemotherapy.Identification and management of these symptoms will help the cancer patients to have adherence to the treatment.

Cancer Chemotherapy

10.31782/ijcrr.2021.132016

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Tele Oncology Consultation During the Covid-19 Pandemic: SingleCenter Analysis

British Journal of Cancer Research (2020)

Jovita Ada Daniel Sowmica Devabhaktuni Ravichandran Ambalathandi M. Manickavasagam Sathish Kumar

Background: COVID-19 has posed a lot of changes in the medical management of various fields.With the advent of Tele Oncology to combat the lag in treatment for the cancer patients to keep their disease at bay, may eventually be a practice transforming style of management getting in order the line of care for the patients in need.Methods: This is a retrospective study in the Medical Oncology Department at Sri Ramachandra Institute of Higher Education and Research Center from March 23rd to September 30th, 2020.Data was collected from documented records of tele consultations, landline calls, mobile calls, SMS (short message service) and What's app consultations and emails.Results: There has been a definite reduction in the outpatient consultations in 2020 compared to 2019; however the number of tele-consultations through the different means has increased.Out of 746 consultations, 347 (46.5%) were through Tele consultations, 142 (19%) through what's app, followed by mobile calls 78(10.4%).Others were made through Landline calls 75 (10%), SMS 71 (9.5%) and Emails 33 (4.4%).Conclusion: Something that makes Tele-oncology interesting is that the physicians and the patients both are new to it.Like any new modality Telemedicine does face teething issues which can be overcome with proper systemization and incorporation of protocols.Hence, larger studies are needed to validate this modality as an integral part extension of health care services, in order to increase the standard of care.

Pandemic

2019-20 coronavirus outbreak

10.31488/bjcr.157

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Herbal supplement usage among cancer patients

Journal of Cancer Research and Therapeutics (2020)

T. Kanimozhi Hindu Kalluru Yuvaraj Maheshvari Y. Gulab Khushnidha M. Kumaravel

Herbal supplements (HS) are one of the most commonly used complementary and alternative medicines in cancer. Reduced therapeutic efficacy of prescription anticancer agents through unwarranted herb-drug interactions is a major efficacy/safety concern. In view of the rising cancer prevalence in India along with a high degree of reliance and cultural acceptability in favor of traditional medicine drugs, prevalence data exclusively of HS usage during cancer treatment are of considerable epidemiological significance.This questionnaire-based prospective observational study aimed at estimating the prevalence of HS among cancer patients during treatment at our tertiary care medical center. Taken on a population of 220 patients within a period of 9 months, data were generated by a customized validated questionnaire and the same processed by IBM SPSS Statistics for Windows, version XXIV, Armonk, NY: IBM Corp. Differences between HS use and nonuse with respect to demographic, disease, and treatment characteristics were assessed by Chi-square test. For examining the latter variables as possible predictors of HS usage, they were entered into bivariate logistic regression with odds ratio and confidence intervals calculated for each.Out of 220 patients, 57 (26%) were HS users and 163 (74%) were nonusers. Majority of the users (42.1%) were on self-prepared folklore herbal medicine postdiagnosis of cancer (57.9%), the most common reason cited being symptom palliation (35.1%) on the advice of friends and family (64.9%). Fear of disapproval was the most common reason cited (68.4%) for not disclosing HS usage to the physician.Chemotherapy and unemployment are predictors of HS usage, and there is a significant association between occupation status and HS usage. This first study on HS prevalence among South Indian population proposes the need for a more robust evidence base for understanding all aspects of HS use in cancer.

10.4103/jcrt.jcrt_612_18

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Association between CYP17A1, CYP19A1, and HSD17B1 Gene Polymorphisms in Hormone Synthesis pathway with Ovarian Cancer Risk

Authorea (Authorea) (2020)

Gowtham Kumar G Andrea Mary Francis Solomon F.D. Paul Chirag Molia M. Manickavasagam

Objective: To investigate the polymorphisms of genes in the steroidogenesis pathway to understand the etiological mechanisms to OC risk in the South Indian population Design: Case-Control Study Setting and Sample: Ovarian cancer cases (200) and healthy individuals (200) from the South Indian population. Methods: All the cases and controls were genotyped for SNPs by using allelic discrimination assay. Main outcome measures: Genetic distribution of SNPs of Steroidogenesis pathway genes in the South Indian population. Results: The observed results for rs743752, the homozygous CC genotype revealed significant association (OR; 1.68; 95%CI, 1.25-2.26; p =<0.05) and the dominant model, recessive model and additive model showed a significant association with an OR of 1.62; 95%CI, 1.09 – 2.42; p = 0.015, OR of 0.29, 95%CI, 0.14 – 0.60; p = <0.001 and OR of 1.68, 95%CI, 1.25 – 2.26); p = <0.001 respectively in cases and controls for OC risk. In rs10046, the heterozygous CT genotype (OR; 1.61; 95%CI 1.06 – 2.43; p = 0.023), the dominant (OR; 1.65; 95%CI, 1.11 – 2.45; p = 0.012) and the additive (OR; 1.46; 95%CI, 1.07 - 1.98; p = 0.015) models were found to be statistically significant. There was no significant association between rs605059 genotypes with ovarian cancer risk. Conclusions: To conclude, results indicated that the polymorphisms of CYP17A1 (rs743572) and CYP19A1 (rs10046) genes are associated with increased risk of ovarian cancer risk in South Indian population.

CYP17A1

genetic model

Etiology

Genetic Association

10.22541/au.159853880.08354364

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The association between CYP17A1, CYP19A1, and HSD17B1 gene polymorphisms of estrogen synthesis pathway and ovarian cancer predisposition

Meta Gene (2021)

Gunjan Kumar Solomon F.D. Paul Chirag Molia M. Manickavasagam R Ramya

CYP17A1

International HapMap Project

Genetic Association

10.1016/j.mgene.2021.100985

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Association of single nucleotide polymorphisms of adiponectin and leptin genes with breast cancer

Molecular Biology Reports (2019)

Sarvari Geriki Aparna R. Bitla P Srinivasarao Narendra Hulikal Mutheeswaraiah Yootla

10.1007/s11033-019-05070-5

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Clinicopathologic significance of HER2 expression in gastric cancer: A retrospective study in Indian population.

Journal of Clinical Oncology (2013)

Sudheer Reddy Kataru Venkata Sampath Vankamamidi Amit Kumar Chowhan M. Manickavasagam K. Radhakrishna

e15143 Background: Gastric cancer is the second most common cause of cancer related death worldwide. HER2 expression is an important biomarker for identifying patients who could respond to targeted therapy. The purpose of this study was to evaluate the frequency of HER2 expression and its clinicopathological significance in Indian population with gastric cancer. Methods: In this retrospective study, clinicopathological details and formalin fixed embedded tissue from patients with gastric and gastro-esophageal junction Adenocarcinoma of all stages from August 2009 to January 2012 were collected. HER2 status in the tissue was evaluated by the validated methods. IHC (Immunohistochemistry) scores of 3+ were considered positive, 2+ equivocal, 1+ and 0 negative for HER2. Equivocal staining was further evaluated with FISH (Fluorescence In-situ Hybridization) testing. The significance of HER2 expression was correlated with epidemiological, clinical, pathological and biochemical parameters using Pearson’s test. Progression free survivals (PFS) were compared using Log Rank test (Mantel-Cox). Kaplan-Meier curves were determined for PFS. SPSS version 17.0 was used for statistical analysis. Results: We studied 135 patients, of which IHC for HER2 was 3+ in 8.8%, 2+ in 10.4%, 1+ in 8.9% and zero in 71.9%. Among HER2 equivocal samples (n=14), FISH showed HER2 gene amplification in 14.2%. HER2 status was negative in 89.6% and positive in 10.4%.HER2 status significantly correlated with stage (p=0.03), smoking status (p=0.022) and not correlated with Age, Gender, Site, Lauren’s classification, Albumin, Hemoglobin. HER2 negative patients have better PFS (13.1 versus 7.1 months; p=0.005) and the levels of HER2 expression significantly influenced the PFS (p=0.006).Median PFS in patients with 3+, 2+, 1+ and zero IHC scores were 8.2, 8.8, 9.3, and 14.2 months respectively. Conclusions: The frequency of HER2 expression in gastric cancer in Indian population is comparable to the published data. HER2 in Gastric cancer serves as a prognostic marker.

Clinical Significance

10.1200/jco.2013.31.15_suppl.e15143

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Discovery of Substituted 2-oxoquinolinylthiazolidin-4-one Analogues as Potential EGFRK Inhibitors in Lung Cancer Treatment

Drug Research (2024)

Soniya Naik V Soumya Shivlingrao Mamledesai M. Manickavasagam Prafulla B. Choudhari

Abstract Purpose Cancer is the second leading cause of death globally and is responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer and the chemotherapeutic drugs available have high toxicity and have reported side effects hence, there is a need for the synthesis of novel drugs in the treatment of cancer. Methods The current research work dealt with the synthesis of a series of 3-(3-acetyl-2-oxoquinolin-1-(2H)-yl-2-(substitutedphenyl)thiazolidin-4-one (Va-j) derivatives and evaluation of their in-vitro anticancer activity. All the synthesized compounds were satisfactorily characterized by IR and NMR data. Compounds were further evaluated for their in-vitro anticancer activity against A-549 (lung cancer) cell lines. The in-vitro anticancer activity was based upon the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay method. Results The synthesized compounds exhibited satisfactory anticancer properties against the A-549 cell line. The compound (Vh) showed the highest potency amongst the tested derivatives against the A-549 cell line with IC50 values of 100 µg/ml respectively and was also found to be more potent than Imatinib (150 µg/ml) which was used as a standard drug. Molecular docking studies of the titled compounds (Va-j) were carried out using AutoDock Vina/PyRx software. The synthesized compounds exhibited well-conserved hydrogen bonds with one or more amino acid residues in the active pocket of the EGFRK tyrosine kinase domain (PDB 1m17). Conclusion Among all the synthesized analogues, the binding affinity of the compound (Vh) was found to be higher than other synthesized derivatives and a molecular dynamics simulation study explored the stability of the docked complex system.

Docking (animal)

MTT assay

IC50

10.1055/a-2305-2789

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Assessment of serum microRNA-21 and miRNA-205 as diagnostic markers for stage I and II breast cancer in Indian population

Indian Journal of Cancer (2023)

Kanchi Rama Aparna R. Bitla Narendra Hulikal Mutheeswaraiah Yootla Lakshmi Amancharla Yadagiri

Background: Current markers (carcinoembryonic antigen [CEA] and carbohydrate antigen 15-3 [CA15-3]) lack sensitivity in diagnosis of breast cancer. The aberrantly expressed circulating miRNAs were shown as diagnostic markers in breast cancer. However, there are very few studies from the Indian population. We studied the diagnostic utility of miRNA-21, miRNA-155 and miRNA-205 compared to CEA and CA15-3 in stage I and II breast cancer patients. Materials and Methods: Sixty newly diagnosed women with stage I/II breast cancer and 20 healthy controls were recruited. Expression of circulating miRNAs was studied using reverse transcription-polymerase chain reaction, whereas CEA and CA 15-3 were analyzed by enzyme-linked immunosorbent assay. Results: miRNA-21 and miRNA-155 were upregulated, miRNA-205 down-regulated ( P < 0.05) and serum CEA and CA15-3 levels increased in breast cancer patients ( P < 0.001). Receiver operating characteristic curve analysis showed significant area under curve (AUC) for all markers (0.656 to 0.993; P = 0.015 to <0.001) validating their diagnostic potential. Unlike CEA and CA15-3, miRNAs retained their sensitivity even at higher cut-offs (95% CI of mean). Logistic regression analysis showed significant association between disease and marker positivity for miRNA-21 and miRNA-205 but not for miRNA-155. Combining CA15-3 with miRNAs did not improve their diagnostic performance. However, combining CEA with either miRNA-21 (AUC = 0.742; P < 0.001 versus AUC = 0.656; P = 0.018) or miRNA-205 (AUC = 0.733; P < 0.001 versus AUC = 0.700; P < 0.001) increased its diagnostic performance. Conclusion: Our study shows miRNA-21 and miRNA-205, are useful as diagnostic markers for breast cancer in the Indian population and combination of these miRNAs with CEA but not with CA 15-3 improved their diagnostic performance.

10.4103/ijc.ijc_187_20

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Rarest of the rare-male triple negative breast cancer

Journal of Dr NTR University of Health Sciences (2022)

RaviC Ambalathandi Haneesha Polavarapu R Bhaskar Reddy Archana B. Balasubramanian M. Manickavasagam

Breast cancer in males is rare. Luminal A is the predominant subtype in male breast cancer. Clinical data on triple negative breast cancer in male patients is sparse. This case report will add to the literature on male breast cancers. This is a rare case of a 60-year-old male patient who was diagnosed to have locally advanced breast cancer of triple negative (basal-like) subtype. He received eight cycles of neoadjuvant chemotherapy. He later underwent modified radical mastectomy followed by adjuvant radiotherapy and 6 months of adjuvant capecitabine. He is on regular follow-up for the past 3 years.

Male Breast Cancer

Triple-negative breast cancer

Modified Radical Mastectomy

Adjuvant Chemotherapy

Adjuvant radiotherapy

Radical mastectomy

10.4103/jdrntruhs.jdrntruhs_17_21

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