Breast cancer is one of the most common malignancies, with a 10-year survival rate for early non-metastatic stages of over 80%. However, recurrence or relapse may occur decades after completing therapy, and cancer survivors have also a risk of secondary neoplasia especially due to radiation therapy. This case highlights the challenges of an accurate diagnosis and appropriate treatment in patients with second primary cancer and uncommon metastasis.

Paraneoplastic syndromes of the nervous system are rare disorders, strongly linked with lung cancer. This report aims to explore the challenges in the diagnosis and treatment of a patient with early-stage small cell lung cancer and neurological manifestations as initial clinical symptoms.

Pregnancy is a risk factor for developing a severe, complicated form of COVID-19. Medical reports have revealed that pregnancy increases three times the risk of ICU admission and 1.7 times the risk of death in patients with COVID-19. The crossing of the placenta by the antibodies generated through vaccination offer a level of protection that should not be ignored. We aimed to comparatively analyze the levels of SARS-CoV-2 IgG and IgM antibodies in pregnant women who have had this infection during pregnancy or have undergone a complete vaccination cycle during pregnancy, as well as antibody levels in newborns. The inclusion criterion was history of SARS-CoV-2 infection during pregnancy or COVID-19 complete vaccination. For each case the peri-partum values of IgG and IgM SARSCoV- 2 antibodies were analyzed in the same laboratory along with those of their newborns. The vaccination rate in our study group was about 6%. All cases had a significant value of protective IgG SARS-CoV-2 antibodies and the level of protective antibodies of the newborns closely followed maternal values. From the cases with SARS-CoV-2 infection during pregnancy, only 16.6% had a protective level of antibodies and 75% of the newborns from these cases had protective levels of IgG SARS-CoV-2 antibodies. Our results clearly plead in favor of vaccination in pregnancy
which provides significant benefits for both mothers and infants.

Multigene assays were developed to guide treatment in early-stage breast cancer and to evaluate the benefit of adjuvant chemotherapy. Patients with invasive breast carcinoma, either T1 or T2, N0 or N1 (one to three positive lymph nodes), with no invaded surgical margins (R0), positive for hormone receptors and negative for Her2 receptor derive benefit from these tests. The Food and Drug Administration (FDA) validated the use of the following tests: OncotypeDX (a 21 gene test), Mammaprint (70 ARN messenger genes), Predictor Analysis of Microarray 50-PAM50 (50 genes) also known as Prosigna and Endopredict (12 genes). These gene expression signatures have been increasingly used to evaluate the prognosis (such as Endopredict- that can predict outcomes more accurately than ki67 values in early-stage breast cancer) or the benefit of adjuvant chemotherapy (such as Oncotype DX). For the moment only two assays, the 70-gene signature (MammaPrint) and the 21-gene Recurrence Score (RS) assay (Oncotype DX), are supported by prospective randomized phase 3 trials. However, all multigene assays are important tools in the identification of low-risk, breast cancer patients, for whom chemotherapy could be avoided.

In the last decade, huge efforts have been made to optimize and personalize oncological treatment. Many novel therapies and better combinations of older ones have been implemented. Even if novelty is always exciting, one has take into consideration that the way a drug is administered is as important as the drug itself. The present review focuses on how the administration of several cancer drugs can minimize the toxicity they induce. It stresses that if enough importance is given to this aspect, patients can tolerate effective doses of treatment with better outcomes and have better quality of life. [...]