Expert Review of Anticancer Therapy最新文献

Background: For patients with de novo stage IV breast cancer (BC), the conditions under which the primary tumor resection (PTR) may offer benefit remain unclear.

Methods: The SEER database provides treatment data for patients with de novo stage IV BC. We screened cases of metastatic BC diagnosed from 2010 to 2015, with primary endpoints of overall survival (OS) and cancer-specific survival (CSS).

Results: 9252 patients with stage IV de novo BC were enrolled. For OS, median survival time (MST) was 38 months with systematic treatment (ST) compared to 52 months with ST plus PTR (p < 0.001). For CSS, MST was 38 months for ST versus 54 months for ST plus PTR (p < 0.001). The results of the Cox proportional hazards regression analysis regarding PTR, for OS: bone metastasis (aHR 0.664, 95%CI 0.583-0.756, p < 0.001); liver-lung metastasis (aHR 0.528, 95%CI 0.327-0.853, p = 0.009). For CSS: bone metastasis (aHR 0.655, 95%CI 0.571-0.751, p < 0.001); liver-lung metastasis (aHR 0.549, 95%CI 0.336-0.889, p = 0.017). Kaplan-Meier analysis indicated that in patients with bone metastases and liver-lung metastases, PTR could improve survival outcomes.

Conclusion: Liver-lung metastases and bone metastases in patients with de novo stage IV BC could enhance both OS and CSS through PTR.

Introduction: Ovarian cancer contributed to 13,270 patient deaths in the United States during 2023 and is considered the most aggressive gynecologic malignancy. While surgery, chemotherapy and targeted medications have improved ovarian cancer patient outcomes, novel therapies that further bolster treatment efficacy without compromising toxicity represent an unmet clinical need.

Areas covered: In the current review, we assessed the reported studies involving statin use and ovarian cancer outcomes; a preponderance of the evidence indicated that statins confer a survival benefit in ovarian cancer, especially for patients who underwent treatment post-diagnosis and for a prolonged interval.

Expert opinion: The evidence involving a potential survival benefit from statin use in ovarian cancer remains controversial, especially with hydrophilic statins (e.g. pravastatin). While statin users may exhibit better ovarian cancer survival outcomes than non-statin users, additional research should evaluate the putative clinical benefits of statins in ovarian cancer via randomized controlled trials.

Background: We aimed to develop a nomogram to predict abnormal follow-up results of co-testing for cytology and human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) patients after conization.

Research design and methods: Two hundred sixty-three patients initially diagnosed as CIN2+ were recruited. Data on immunohistochemical (IHC) staining scores, along with demographic and clinical information were collected. Using least absolute shrinkage and selection operator (LASSO) regression analysis, variables were identified for inclusion. A predict model and nomogram were developed through multi-factor logistic regression. The goodness-of-fit test was applied across different cohorts to construct the calibration curve of the model, and the predictive effect was evaluated by the receiver operating characteristic curve. Decision curve analysis was performed to determine the net benefit.

Results: Five predictor variables, including protein expression score, vaginal infection, HPV coinfection, and cone height were screened and plotted as a nomogram. The calibration curves showed a good fit. The area under the curve of the model was 0.835 for the training cohort and 0.728 for the internal test cohort. The decision curve analysis indicated that the nomogram provides significant net advantages for clinical use.

Conclusion: A practical nomogram predict model was developed to predict abnormal follow-up outcomes in CINs after conization.

Background: The role of 21-gene recurrence score (RS) testing on chemotherapy decision-making and survival outcomes for T3N0 luminal breast cancer (BC) remains unclear. This study aimed to investigate the effect of RS testing in chemotherapy selection and prognosis in these patients.

Research design and methods: Patients diagnosed with T3N0 luminal BC were included from the Surveillance, Epidemiology, and End Results Oncotype database. The likelihood of undergoing chemotherapy was analyzed using the chi-square test and binomial logistic regression. Survival analysis used Kaplan-Meier method and multivariate Cox proportional hazards models.

Results: Of the 3186 patients, 852 (26.7%) underwent RS testing. Those who had RS testing demonstrated a lower probability of chemotherapy receipt than those without RS testing (27.0% vs. 47.5%, p < 0.001). Higher RS correlated with increased the probabilities of chemotherapy receipt. The probabilities of chemotherapy for low-risk, intermediate-risk, and high-risk were 9.8%, 26.7%, and 60.6%, respectively (p < 0.001). RS testing independently improved breast cancer-specific survival (p < 0.001) and overall survival (p < 0.001). In the high-risk cohort, chemotherapy administration was associated with improved overall survival than those who did not (p = 0.038).

Conclusions: Our study highlights the significant role of RS testing in guiding treatment decisions and improving survival outcomes for patients with T3N0 luminal BC.

Background: The research on the associations between tissue inhibitors of metalloproteinase-1 (TIMP1) expression and the clinicopathological characteristics and prognosis of patients with gastric cancer (GC) have resulted in contradictory findings. Exploring the associations between TIMP1 and clinicopathological parameters and the prognosis of GC patients is essential.

Methods: We searched the literature in the databases according to the inclusion and exclusion criteria. Hazard ratios (HRs), odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to evaluate the relationships between TIMP1 expression and the clinicopathological parameters and prognosis of GC patients.

Results: Nine studies with 1,200 GC patients were included. Our results indicated that TIMP1 expression was not related to sex, age, TNM stage, depth of invasion, lymph node metastasis, or tumor size in GC patients. However, TIMP1 expression was associated with the differentiation of GC. Furthermore, TIMP1 expression was associated with poor prognosis in GC patients.

Conclusion: TIMP1 expression was related to tumor differentiation and poor prognosis but not sex, age, TNM stage, depth of invasion, lymph node metastasis or tumor size.

Introduction: Childhood cancers as a group affect around 1 in 500 children but each individual diagnosis is a rare disease. While research largely focuses on improving cure rates, the management of side effects of treatment are high priority for clinicians, families and children and young people.

Areas covered: The prevention and efficient management of infectious complications, oral mucositis, nausea and vomiting and graft-vs-host disease illustrated with examples of implementation research, translation of engineering to care, advances in statistical methodologies, and traditional bench-to-patient development. The reviews draw from existing systematic reviews and well conducted clinical practice guidelines.

Expert opinion: The four areas are driven from patient and family priorities. Some of the problems outlined are ready for proven interventions, others require us to develop new technologies. Advancement needs us to make the best use of new methods of applied health research and clinical trial methodologies. Some of the greatest challenges may be those we're not fully aware of, as new therapies move from their use in adult oncological practice into children. This will need us to continue our collaborative, multi-professional, multi-disciplinary and eclectic approach.

Introduction: Myelodysplastic syndromes/neoplasms (MDS) are a heterogeneous group of hematologic malignancies that are stratified into high-risk (HR-MDS) and low-risk (LR-MDS) categories. Until recently, LR-MDS has been typically managed by supportive measures and erythropoiesis-stimulating agents (ESAs); whereas management of HR-MDS typically included hypomethylating agents and allogeneic hematopoietic stem cell transplant. However, the limited rates and durations of response observed with these interventions prompted the search for targeted therapies to improve the outcomes among patients with MDS.

Areas covered: Here, we review the current landscape of targeted therapies in MDS. These include pyruvate kinase and hypoxia-inducible factor (HIF) activators; TGF-beta, telomerase, BCL2 and isocitrate dehydrogenase (IDH) inhibitors; as well as novel approaches targeting inflammation, pyroptosis, immune evasion, and RNA splicing machinery.

Expert opinion: This review highlights the progress and challenges in MDS treatment. Despite some promising results, many therapies remain in early development or have faced setbacks, emphasizing the need for a more comprehensive understanding of the disease's pathobiology. Continued research into targeted therapies, homogenous clinical trial designs, as well as increased incorporation of molecular prognostic tools and artificial intelligence into trial design are essential for developing effective treatments for MDS and improving patient outcomes.

Areas covered: Here we describe novel agents, their mechanism(s) of action, preclinical results, and ongoing clinical trials in HNSCC.

Expert opinion: Established therapeutic targets in HNSCC include EGFR (cetuximab) and PD-1 (pembrolizumab and nivolumab). Despite the detection of many other possible targets in HNSCC cell lines and patient tumors, no other therapies have successfully advanced to date. Identification of predictive biomarkers may guide the use of targeted agents and combination therapies. Clinical trials supported by strong preclinical data in relevant models are more likely to advance treatment options.

Introduction: Cancer constitutes the greatest public health threat to humans, as its incidence and mortality rates continue to increase worldwide. With the development of medical physics, more practitioners focus on the direct and indirect anti-tumor effects of physical factors. Infrared radiation (INR) is currently the most rapidly developing physical therapy method for tumors and has become a favored target for many oncologists and researchers owing to its advantages of high efficiency, low toxicity, and strong feasibility.

Areas covered: This work provides a comprehensive collection of the latest information on INR anti-tumor research, drawing from public medical databases (PubMed, Web of Science, Embase, and Clinical Trials) from the last 10 years (2014 to 2024), and encompassing both basic and clinical research in oncology and physics. This article reviews the application of INR in tumor hyperthermia, summarizes and analyzes the practical value of INR for tumor treatment, and discusses future development trends to provide valuable assistance for the subsequent development of oncology.

Expert opinion: Currently, INR has continuously accumulated excellent data in the field of tumor hyperthermia, bringing practical survival benefits to patients with cancer, and playing an important role in basic and clinical cancer research.