Frontiers in Oncology最新文献

Head and neck squamous cell carcinoma (HNSCC) remains a prevalent epithelial malignancy. Immune-checkpoint inhibitors have reshaped first-line therapy for recurrent/metastatic disease; yet durable benefit is confined to a subset, reflecting myeloid-centric mechanisms-SPP1⁺ TAM barriers, cDC1/IL-12 insufficiency, and CXCL8-CXCR1/2-driven neutrophil trafficking-distinct from, and complementary to, classical lymphoid exhaustion. In this review we summarize advances from single-cell RNA and ATAC profiling and spatial transcriptomics that resolve macrophage, dendritic-cell and neutrophil programs, and appraise translational opportunities spanning myeloid reprogramming, innate-adaptive combinations and spatial biomarkers. We also discuss enduring challenges-including HPV-status heterogeneity, limited assay standardization and a scarcity of predictive metrics-that temper implementation. By integrating myeloid-informed readouts (e.g., SPP1-TAM burden, cDC1 competency, serum IL-8) with PD-1-based regimens, EGFR-directed antibodies and myeloid checkpoints (CD47-SIRPα, PI3Kγ, CXCR1/2), emerging strategies aim to restore antigen presentation, improve lymphocyte trafficking and remodel tumor-stroma interfaces. Our synthesis provides an appraisal of the evolving landscape of myeloid-informed precision immuno-oncology in HNSCC and outlines pragmatic standards and avenues for clinical translation. We hope these insights will assist researchers and clinicians as they endeavor to implement more effective, individualized regimens.

Metastatic mucinous adenocarcinoma arising from a tailgut cyst is an ultra-rare cancer. Literature on the chemosensitivity and radiosensitivity of this cancer is lacking, and treatment is extrapolated from rectal cancer management. We are reporting, for the first time, the case of a patient with metastatic tailgut cyst adenocarcinoma who derived 1.5 years of clinical benefit from treatment with gemcitabine, selected as a result of transcriptomic analysis of her circulating tumor cells using an in vitro assay. The cancer was refractory to regimens extrapolated from rectal cancer management (capecitabine with oxaliplatin, and irinotecan). Pelvic recurrence and osseous metastases were clearly radiosensitive. Tumor molecular profile showed microsatellite stable cancer with KRAS p.G13D and TP53 p.C176W mutations.

Background: Donafenib is an approved multikinase inhibitor for hepatocellular carcinoma (HCC). However, cutaneous toxicity-particularly hand-foot skin reaction (HFSR)-may necessitate treatment interruption and compromise therapeutic continuity.

Case presentation: A 58-year-old man with HCC on a cirrhotic background developed abrupt onset of intensely painful plantar erythema with overlying desquamation 10-11 days after initiating donafenib. The lesions rapidly progressed, leading to impaired ambulation and were consistent with CTCAE grade 3 HFSR.

Management and outcome: Donafenib was immediately discontinued, and the patient received short-term symptomatic management, resulting in prompt improvement of the acral lesions. He was subsequently transitioned to lenvatinib, which was well tolerated without recurrence of high-grade skin toxicity. The patient maintained clinical stability and was able to continue systemic anticancer therapy.

Conclusion: This case highlights the importance of early detection and accurate grading of HFSR, timely treatment interruption, and mechanism-informed switching to an alternative tyrosine kinase inhibitor such as lenvatinib. It also underscores key differences in toxicity profiles between donafenib-associated with VEGFR/RAF-related cutaneous injury-and lenvatinib, which is more commonly linked to hypertension, diarrhea, and appetite or weight changes.

[This corrects the article DOI: 10.3389/fonc.2025.1671896.].

Background: This study aims to evaluate the diagnostic efficacy of ¹⁸F-FDG PET-CT imaging and enhanced abdominal CT scans for the preoperative detection of lymph node metastasis in liver cancer.

Methods: We sought to compare the diagnostic performance of 18F-FDG PET-CT with that of CT and to determine the optimal predictive thresholds for lymph node metastasis, based on the maximum standardized uptake value (SUVmax) and the nodal short-axis diameter.

Results: The diagnostic efficacy of ¹⁸F-FDG PET-CT, including sensitivity, specificity, and accuracy, was significantly higher than that of CT, with statistically significant differences (P < 0.05). Both the short diameter of lymph nodes and the SUVmax in the lymph node metastasis group were both greater than those in the non-metastasis group, with statistically significant differences (P < 0.05). The CT parameter of lymph node short diameter and the 18F-FDG PET-CT parameter of SUVmax were identified as independent predictors of lymph node metastasis in liver cancer and demonstrated a significant positive correlation (P < 0.001). The area under the receiver operating characteristic curve (ROC) for combined detection was 0.938, with a sensitivity of 92.3%, specificity of 85.3%, and accuracy of 88.3% for diagnosing regional lymph node metastasis in liver cancer. The efficacy of combined detection for diagnosing regional lymph node metastasis in liver cancer was superior to that of individual tests (P < 0.05), providing valuable clinical guidance for staging, treatment, and prognosis of liver cancer.

Conclusion: The application of the optimal threshold values can further enhance the diagnostic accuracy of ¹⁸F-FDG PET-CT in detecting regional lymph node metastasis. The proposed criteria for lymph node metastasis were an SUVmax greater than 2.25 or a short diameter exceeding 8.5 mm. This information may assist in the formulation and optimisation of treatment plans for patients with liver cancer.

Background: The relationship between air pollution and lung cancer has attracted considerable attention from researchers worldwide. To systematically assess the scholarly landscape and pinpoint research fronts, this study employs bibliometric analysis to delineate global trends, collaborative networks, and key publications within this field.

Methods: Publications from 1990 to 2025 were extracted from Web of Science Core Collection and Scopus databases. Bibliometric tools including VOSViewer, Citespace, and Bibliometrix R were used to examine trends, key contributors, research themes, and prominent journals.

Results: Among 4,238 publications, citation rates rose significantly. China produced the most publications, with leading institutions such as Harvard University and the Chinese Academy of Sciences. Key researchers included Lan Q, Rothman N, and Vermeulen R. Major journals were Environmental Health Perspectives and Atmospheric Environment. Frequently used keywords like "Lung Cancer" and "Particulate Matter" indicate core themes, while emerging terms such as "Covid-19" and "Machine Learning" reflect evolving interests.

Conclusion: Fine particulate matter is an established environmental risk factor for lung cancer, and research on polycyclic aromatic hydrocarbons and asbestos remains active. The field has shifted from exposure assessment to mechanistic investigations focusing on oxidative stress, gene expression, and machine learning applications, defining key future research directions.

Background: According to the 2021 WHO classification of tumors of the central nervous system, isocitrate dehydrogenase (IDH) status serve an independent prognostic biomarker and is closely associated with tumor diagnosis and treatment response. At present, the determination of IDH status still relies on invasive surgical procedures.

Method: A total of 345 patients with pathologically confirmed gliomas diagnosed at the First Affiliated Hospital of Xi'an Jiaotong University between October 2019 and October 2024 were retrospectively included, comprising 148 (42.9%) IDH-wild and 197 (57.1%) IDH-mutant. An additional 495 glioma patients were obtained from the public TCIA dataset. Patients were randomly split into training, validation, and test cohorts 6:2:2. A Hierarchical Attention-Based Multiple Instance Learning (HAB-MIL) framework was developed, integrating auxiliary positional encoding into feature maps to capture spatially specific information and generate refined 3D lesion representations. Model performance was evaluated using five-fold cross-validation, with receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, and specificity as assessment metrics.

Result: HAB-MIL achieved competitive performance, with AUCs of 0.917 and 0.892 on the glioma datasets from TCIA and the First Affiliated Hospital of Xi'an Jiaotong University. Additionally, our work achieves results that are comparable to the state-of-the-art methods in TCIA dataset and demonstrates that multiple instance learning has great potential for IDH prediction.

Conclusion: The proposed HAB-MIL achieved IDH classification based on conventional preoperative MRI images, eliminating the need for pixel-level annotations and significantly reducing the annotation burden for doctors.

Trastuzumab deruxtecan (T-DXd or DS-8201) is a novel antibody-drug conjugate (ADC) targeting HER2 that has shown significant efficacy in advanced breast cancer. However, data on its use in elderly patients with hormone receptor-positive (HR+)/HER2-low disease complicated by malignant pleural effusion are scarce. We report the case of a 75-year-old woman with HR+/HER2-low (HER2 2+/FISH- at diagnosis, HER2-0 at recurrence) advanced breast cancer who developed multiple lymph node metastases and a large pleural effusion after progression on endocrine therapy plus a CDK4/6 inhibitor. She received trastuzumab deruxtecan as salvage therapy, initially at a reduced dose of 4.4 mg/kg because of frailty, followed by escalation to the standard 5.4 mg/kg dose after good tolerability. Several cycles were administered at extended intervals due to financial constraints. T-DXd therapy resulted in near-complete resolution of the pleural effusion, marked shrinkage of nodal disease, improvement of upper limb edema and respiratory symptoms, and sustained declines in serum tumor markers. Progression-free survival on T-DXd reached 16 months, while overall survival from T-DXd initiation was 18 months. Treatment-related adverse events were limited to mild myelosuppression and gastrointestinal discomfort, without interstitial lung disease. This case suggests that dose-adjusted T-DXd can achieve durable disease control with acceptable safety in a frail elderly patient with HR+/HER2-low breast cancer and pleural effusion, adding to the growing real-world evidence supporting the use of HER2-directed ADCs beyond traditional HER2-positive populations.

Background: Ovarian cancer (OC) remains a lethal gynecologic cancer marked by substantially reduced 5-year survival probabilities. Elevated BMI (≥25 kg/m²) constitutes a progressively recognized OC risk determinant mediated by chronic inflammatory states and metabolic pathway perturbations. Leveraging GBD 2021 repositories, this investigation quantified high BMI-attributable ovarian cancer burden trajectories among reproductive-age women (WCBA, 15-49 years) worldwide.

Methods: Leveraging GBD 2021 repositories, we evaluated worldwide OC burden mediated by elevated BMI across women of childbearing age (WCBA) during 1990-2021. Evaluated metrics comprised deaths, DALYs, YLDs, YLLs, and ASR (EAPC-based trend analysis). ARIMA and Exponential Smoothing models generated 2050 burden projections.

Results: From 1990 to 2021, the global burden of OC attributable to high BMI increased significantly. In 2021, there were 17,344 deaths (95% UI: 4,141-30,810) and 477,248 DALYs (95% UI: 113,449-840,002) among WCBA. The ASMR rose from 0.32 (95% UI: 0.07-0.61) to 0.38 (95% UI: 0.09-0.67) per 100,000 (EAPC: 1.03, 95% CI: 0.85-1.21). The ASDR increased from 8.72 (95% UI: 1.78-16.41) to 10.56 (95% UI: 2.50-18.57) per 100,000 (EAPC: 1.09, 95% CI: 0.93-1.25). The burden peaked in the 45-49 age group, with 995 deaths and 44,223 DALYs. High SDI regions had the highest ASMR (0.57, 95% UI: 0.14-1.01) and ASDR (15.13, 95% UI: 3.79-26.82). Projections indicate a continued increase in the OC burden attributable to high BMI by 2050, with the ASMR reaching 0.43 (95% HDI: 0.40-0.46) and the ASDR reaching 12.28 (95% HDI: 11.58-12.98).

Conclusion: This study highlights the escalating global burden of OC attributable to high BMI among WCBA, particularly in high SDI regions. This investigation delineates progressively intensifying worldwide OC burden mediated by elevated BMI in WCBA, disproportionately affecting high SDI territories.

This report describes a case of lung adenocarcinoma harboring an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion, high programmed death-ligand 1 (PD-L1) expression, and a Bcl-2-like protein 11 (BIM) deletion polymorphism. The patient was initially treated with alectinib, but experienced rapid disease progression. After repeat genetic testing, therapy was switched to lorlatinib, which again resulted in early progression. Subsequently, treatment with ivonescimab combined with chemotherapy achieved a favorable clinical response. To our knowledge, this is the first reported case of ivonescimab use in such a patient. This case offers a potential reference for the management of ALK fusion-positive lung adenocarcinoma resistant to ALK tyrosine kinase inhibitors (ALK-TKIs).