Future oncology最新文献

This review explores the complexities of treatment intensification in metastatic hormone-sensitive prostate cancer (mHSPC), emphasizing the limitations of using disease volume and metastatic timing as sole prognostic factors. Current algorithms focus on clinical factors like ECOG, comorbidities, and patient preferences, yet lack biomarkers for more individualized therapy. By examining prognostic indicators - clinical, analytical, pathological, molecular, and imaging - this article highlights the importance of a personalized approach. Multimodal strategies and predictive biomarkers are proposed to optimize therapy selection between doublet and triplet regimens, ultimately improving patient outcomes. Future trials incorporating emerging biomarkers may provide the basis for precision treatment in mHSPC, shifting management beyond conventional classifications.

Clinical trial registration: www.clinicaltrials.gov identifier is NCT06607302.

Triple-negative breast cancer (TNBC) presents a formidable global health challenge, marked by its aggressive behavior and significant treatment resistance. This subtype, devoid of estrogen, progesterone, and HER2 receptors, largely relies on breast cancer stem cells (BCSCs) for its progression, metastasis, and recurrence. BCSCs, characterized by their self-renewal capacity and resistance to conventional therapies, exploit key surface markers and critical signaling pathways like Wnt, Hedgehog, Notch, TGF-β, PI3K/AKT/mTOR and Hippo-YAP/TAZ to thrive. Their adaptability is underscored by mechanisms including drug efflux and enhanced DNA repair, contributing to poor prognosis and high recurrence rates. The tumor microenvironment (TME) further facilitates BCSC survival through complex interactions with stromal and immune cells. Emerging therapeutic strategies targeting BCSCs - ranging from immunotherapy and nanoparticle-based drug delivery systems to gene-editing technologies - aim to disrupt these resistant cells. Additionally, innovative approaches focusing on exosome-mediated signaling and metabolic reprogramming show promise in overcoming chemoresistance. By elucidating the distinct characteristics of BCSCs and their role in TNBC, researchers are paving the way for novel treatments that may effectively eradicate these resilient cells, mitigate metastasis, and ultimately improve patient outcomes. This review highlights the urgent need for targeted strategies that address the unique biology of BCSCs in the pursuit of more effective therapeutic interventions for TNBC.

Background: We herein retrospectively analyzed the clinicopathologic features from a large cohort of GAS patients to provide real-world evidence for optimizing the diagnosis and treatment.

Research design and methods: One hundred and fifty-seven GAS patients from three hospitals were recruited for analysis. We extracted clinical and pathologic information from patient medical records and performed regular follow-up. Logistic regression and Kaplan - Meier analyses were conducted to identify the prognostic factors.

Results: 31.2% exhibited stage I tumor, and 11.5%, 33.1%, and 24.2% manifested tumors at stages II, III, and IV, respectively. For the entire group, the median progression-free survival (PFS) and overall survival (OS) were 22 and 33 months, respectively. Multivariate analysis showed tumor stage and ovarian metastasis were predictors for PFS; and that ovarian metastasis and small tumor diameter were independent prognostic factors for OS. We determined an abnormal elevation of tumor abnormal protein (TAP) in 76% GAS patients, which could serve as a sensitive marker for tumor recurrence/metastasis.

Conclusions: We demonstrated that ovarian metastasis and FIGO stage (including tumor diameter) were independent prognostic predictors for GAS patients. Moreover, we were the first to report that TAP constituted a potent marker for GAS surveillance, thus warranting further investigation.

Aim: Multiple myeloma (MM) is a hematological malignancy associated with poor health-related quality of life (HRQoL). Safe and effective treatments for MM are limited. There is a need for real-world data to improve understanding of treatment patterns and sequencing in routine clinical practice in Japan. This study evaluated disease burden, treatment patterns, treatment sequencing, and reasons for treatment selection in patients with MM in Japan.

Methods: This analysis used survey data of hematologists or hemato-oncologists and their adult patients with MM who received active treatment in a real-world setting in Japan between September 2022 and May 2023. Treatment and retreatment patterns and data from several validated patient reported outcome tools were analyzed. Formal sample size calculations were not applicable.

Results: Fifty-one physicians provided data for 309 patients, of whom 52 completed a quality-of-life survey (median [interquartile range] overall health status by EQ-5D-3L questionnaire: 0.7 [0.6-1.0]). Of 309 patients, most (77%) of the first-line cohort received a lenalidomide-based therapy. Lenalidomide retreatment was common in patients with relapsed/refractory MM (80%).

Conclusion: Poor HRQoL and high retreatment rates indicate a need for new therapy options in patients with MM in Japan. These findings may guide healthcare policies and clinical practice in Japan.

Aim: Describe real-world epidemiology, treatment patterns, health care resource utilization, and costs of locally advanced or metastatic urothelial carcinoma (la/mUC) in France.

Patients & methods: Retrospective study including all adults with la/mUC diagnosis during January 2017 to December 2020 in the PMSI database.

Results: Annual prevalence and incidence ranged from 36.4 to 38.9 and 16.4 to 18.5 cases per 100,000 people, respectively. Of the 25,314 patients with incident la/mUC, 37.6% did not receive first-line systemic treatment. Of the 14,656 patients who started first-line systemic treatment, 66.6%, 22.5%, and 10.9% received 1, 2, and 3 lines of therapy, respectively. Annual per-patient costs in second-/third-line setting ranged from €8803 to €16,012.

Conclusion: The substantial disease burden of la/mUC in France highlights the unmet need for new therapies.