Yancen Pan, Chun-Pin Esther Chang, Randa Tao, Anees Daud, Jincheng Shen, Nathan D. Wong, Roch A. Nianogo, Jianyu Rao, Thomas Varghese, Zuo-Feng Zhang, Mia Hashibe
Background
There may be heterogeneity in lung cancer-related outcomes for individuals who are Asian, Native Hawaiian, and Pacific Islanders (ANHPI).
Objectives
The aims of this study were to investigate possible disparities in cardiovascular disease (CVD) risk between ANHPI and Non-Hispanic White (NHW) lung cancer survivors and evaluate potential CVD risk factors.
Methods
A total of 3920 ANHPI and 11,760 NHW lung cancer patients aged 66 years and older were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare registry from 1999 to 2017. Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident CVD, comparing ANHPI lung cancer patients and their race/ethnicity subgroups to NHW lung cancer patients.
Results
Compared to NHW lung cancer patients, ANHPI lung cancer patients had a lower risk of developing heart failure (HR, 0.64, 95% CI, 0.53–0.76) and ischemic heart disease (HR, 0.76, 95% CI, 0.60–0.95). Additionally, compared to Chinese lung cancer patients, Pacific Islander, South Asian, and Southeast Asian lung cancer patients had a higher risk of heart failure.
Conclusion
While ANHPI lung cancer patients had lower risks of heart failure and ischemic heart disease than NHW lung cancer patients, heterogeneity in risk was observed among ANHPI subgroups. Further research is needed to investigate the reasons for the higher risk of several CVDs among Pacific Islander, South Asian, and Southeast Asian lung cancer patients.
{"title":"Cardiovascular Disease Risk Among Older Asian, Native Hawaiian, Pacific Islanders Lung Cancer Survivors","authors":"Yancen Pan, Chun-Pin Esther Chang, Randa Tao, Anees Daud, Jincheng Shen, Nathan D. Wong, Roch A. Nianogo, Jianyu Rao, Thomas Varghese, Zuo-Feng Zhang, Mia Hashibe","doi":"10.1002/cam4.70702","DOIUrl":"https://doi.org/10.1002/cam4.70702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There may be heterogeneity in lung cancer-related outcomes for individuals who are Asian, Native Hawaiian, and Pacific Islanders (ANHPI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aims of this study were to investigate possible disparities in cardiovascular disease (CVD) risk between ANHPI and Non-Hispanic White (NHW) lung cancer survivors and evaluate potential CVD risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 3920 ANHPI and 11,760 NHW lung cancer patients aged 66 years and older were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare registry from 1999 to 2017. Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident CVD, comparing ANHPI lung cancer patients and their race/ethnicity subgroups to NHW lung cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to NHW lung cancer patients, ANHPI lung cancer patients had a lower risk of developing heart failure (HR, 0.64, 95% CI, 0.53–0.76) and ischemic heart disease (HR, 0.76, 95% CI, 0.60–0.95). Additionally, compared to Chinese lung cancer patients, Pacific Islander, South Asian, and Southeast Asian lung cancer patients had a higher risk of heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While ANHPI lung cancer patients had lower risks of heart failure and ischemic heart disease than NHW lung cancer patients, heterogeneity in risk was observed among ANHPI subgroups. Further research is needed to investigate the reasons for the higher risk of several CVDs among Pacific Islander, South Asian, and Southeast Asian lung cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Muscle-invasive urothelial carcinoma (MIUC) is a highly aggressive cancer associated with poor prognosis. Despite advancements in treatment, the optimal therapeutic approach remains unclear. Immune checkpoint inhibitors, when added to chemotherapy, have shown promise in improving patient outcomes.</p> </section> <section> <h3> Aims</h3> <p>This study aimed to evaluate the efficacy and safety of adjuvant tislelizumab combined with gemcitabine/cisplatin (Tisle+GC) compared to GC alone in patients with high-risk MIUC.</p> </section> <section> <h3> Materials & Methods</h3> <p>We conducted a retrospective analysis of 117 patients with histologically confirmed pT3/4 and pN+ MIUC treated at our center between October 2016 and March 2023. Eligible patients received either Tisle+GC or GC alone, excluding those with prior neoadjuvant therapy. We compared disease-free survival (DFS), overall survival (OS), and treatment-related adverse events (AEs) between the two groups using Cox proportional hazards models and Kaplan–Meier estimates.</p> </section> <section> <h3> Results</h3> <p>The Tisle+GC group showed significantly longer median DFS (19.08 vs. 9.06 months, HR = 0.114, <i>p</i> < 0.001) and OS (20.07 vs. 10.63 months, HR = 0.083, <i>p</i> = 0.026) compared to the GC group. Nerve tract invasion was identified as a significant predictor of poor outcomes (HR = 22.1, <i>p</i> = 0.003). Both groups experienced manageable grade 1–2 immune-related AEs, with pruritus being the most common, followed by liver function abnormalities and thyroid disturbances. Nonhematologic toxicities in the Tisle+GC group included elevated aspartate aminotransferase and hyponatremia, while the GC group mainly reported vomiting. No treatment-related fatalities occurred.</p> </section> <section> <h3> Discussion</h3> <p>The addition of tislelizumab to GC chemotherapy significantly improved both DFS and OS in high-risk MIUC patients. The safety profile was manageable, with immune-related AEs being predictable and not life-threatening. The findings support the potential of Tisle+GC as an effective adjuvant therapy.</p> </section> <section> <h3> Conclusion</h3> <p>Tisle+GC is a promising adjuvant treatment for high-risk MIUC, offering improved survival outcomes with a manageable safety profile. Further prospective studies are needed to confir
{"title":"Clinical Effectiveness of Tislelizumab With Gemcitabine/Cisplatin Versus Gemcitabine/Cisplatin Alone as Adjuvant Therapy for High-Risk Muscle-Invasive Urothelial Carcinoma: A Real-World Study","authors":"Yanjun Wang, Kaihua Zhong, Xingliang Tan, Qianghua Zhou, Lijuan Jiang, Kai Yao, Zhiming Wu","doi":"10.1002/cam4.70661","DOIUrl":"https://doi.org/10.1002/cam4.70661","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle-invasive urothelial carcinoma (MIUC) is a highly aggressive cancer associated with poor prognosis. Despite advancements in treatment, the optimal therapeutic approach remains unclear. Immune checkpoint inhibitors, when added to chemotherapy, have shown promise in improving patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the efficacy and safety of adjuvant tislelizumab combined with gemcitabine/cisplatin (Tisle+GC) compared to GC alone in patients with high-risk MIUC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of 117 patients with histologically confirmed pT3/4 and pN+ MIUC treated at our center between October 2016 and March 2023. Eligible patients received either Tisle+GC or GC alone, excluding those with prior neoadjuvant therapy. We compared disease-free survival (DFS), overall survival (OS), and treatment-related adverse events (AEs) between the two groups using Cox proportional hazards models and Kaplan–Meier estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Tisle+GC group showed significantly longer median DFS (19.08 vs. 9.06 months, HR = 0.114, <i>p</i> < 0.001) and OS (20.07 vs. 10.63 months, HR = 0.083, <i>p</i> = 0.026) compared to the GC group. Nerve tract invasion was identified as a significant predictor of poor outcomes (HR = 22.1, <i>p</i> = 0.003). Both groups experienced manageable grade 1–2 immune-related AEs, with pruritus being the most common, followed by liver function abnormalities and thyroid disturbances. Nonhematologic toxicities in the Tisle+GC group included elevated aspartate aminotransferase and hyponatremia, while the GC group mainly reported vomiting. No treatment-related fatalities occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The addition of tislelizumab to GC chemotherapy significantly improved both DFS and OS in high-risk MIUC patients. The safety profile was manageable, with immune-related AEs being predictable and not life-threatening. The findings support the potential of Tisle+GC as an effective adjuvant therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tisle+GC is a promising adjuvant treatment for high-risk MIUC, offering improved survival outcomes with a manageable safety profile. Further prospective studies are needed to confir","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arthur W. Cowman, Kristel Lourdault, Douglas Hanes, Jessica Weiss, Sean Nassoiy, Melanie Goldfarb, Richard Essner
Background
There remains significant variability in the surgical management of thick melanoma patients with clinically node-negative disease. We evaluated factors influencing overall survival (OS) in these patients, focusing on the surgical management of the primary tumor and nodal basin.
Methods
Using the National Cancer Database, we identified 7647 patients diagnosed between 2012 and 2017 with thick melanoma (> 4 mm, T4) and clinically node-negative disease. 4332 patients had complete data and met all inclusion criteria. These patients were stratified into three groups based on nodal assessment: sentinel lymph node biopsy (SLNB), elective lymphadenectomy (ELND), or no nodal evaluation (NNE). OS was compared using Kaplan–Meier analyses and multivariable Cox proportional hazard regression.
Results
In the cohort, 2851 (65.8%) had a SLNB, 799 (18.4%) had an ELND, and 682 (15.7%) had NNE. OS significantly decreased for each millimeter of increasing Breslow thickness. Ulceration, lymphovascular invasion, and tumor-positive SLN (+SLN) were associated with worse OS (all p < 0.001). The size of surgical margins was not significantly associated with OS. Five-year OS of patients with SLNB was 67.1% ± 1.2% compared to 57.9% ± 2.3% with ELND and 46.8% ± 2.5% with NNE (p < 0.001). Among +SLN patients, a complete lymph node dissection (CLND) was performed in 400 (62.3%) but was not associated with improved OS (p = 0.67) when compared to the nodal observation group.
Conclusion
Our results suggest that increasing Breslow thickness and nodal assessment provide important prognostic information regarding OS for thick melanoma patients, which emphasizes the importance of SLNB for staging and confirm the lack of benefit of CLND after +SLN in thick melanoma. The size of surgical margins did not affect OS.
{"title":"Surgical Management of Thick Primary Cutaneous Melanoma in the US","authors":"Arthur W. Cowman, Kristel Lourdault, Douglas Hanes, Jessica Weiss, Sean Nassoiy, Melanie Goldfarb, Richard Essner","doi":"10.1002/cam4.70578","DOIUrl":"https://doi.org/10.1002/cam4.70578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There remains significant variability in the surgical management of thick melanoma patients with clinically node-negative disease. We evaluated factors influencing overall survival (OS) in these patients, focusing on the surgical management of the primary tumor and nodal basin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the National Cancer Database, we identified 7647 patients diagnosed between 2012 and 2017 with thick melanoma (> 4 mm, T4) and clinically node-negative disease. 4332 patients had complete data and met all inclusion criteria. These patients were stratified into three groups based on nodal assessment: sentinel lymph node biopsy (SLNB), elective lymphadenectomy (ELND), or no nodal evaluation (NNE). OS was compared using Kaplan–Meier analyses and multivariable Cox proportional hazard regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the cohort, 2851 (65.8%) had a SLNB, 799 (18.4%) had an ELND, and 682 (15.7%) had NNE. OS significantly decreased for each millimeter of increasing Breslow thickness. Ulceration, lymphovascular invasion, and tumor-positive SLN (+SLN) were associated with worse OS (all <i>p</i> < 0.001). The size of surgical margins was not significantly associated with OS. Five-year OS of patients with SLNB was 67.1% ± 1.2% compared to 57.9% ± 2.3% with ELND and 46.8% ± 2.5% with NNE (<i>p</i> < 0.001). Among +SLN patients, a complete lymph node dissection (CLND) was performed in 400 (62.3%) but was not associated with improved OS (<i>p</i> = 0.67) when compared to the nodal observation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results suggest that increasing Breslow thickness and nodal assessment provide important prognostic information regarding OS for thick melanoma patients, which emphasizes the importance of SLNB for staging and confirm the lack of benefit of CLND after +SLN in thick melanoma. The size of surgical margins did not affect OS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deana M. Williams, Chaya M. Pflugeisen, Khadijah Ameen, Toby K. Chen, Sheree Cooks, Bernadette C. Ray, Melissa Foster, De Phillips, Lizbeth Sanchez, Keywanna Hardiman, Cynthia Smith, Jennifer Slim
Introduction
Racially and ethnically diverse populations are disproportionately burdened with and more likely to die from cancer than White populations but remain persistently underrepresented in cancer clinical trials. Thus, the safety and efficacy assessments of novel therapies may not apply to all populations, and guidelines are developed using trials that inadequately reflect our population. This study aims to explore healthcare experiences, cancer clinical trial perceptions, and solutions for bridging gaps in cancer clinical trials among communities of color.
Methods
We held a series of five focus groups with 23 survivors and caregivers of color. These sessions explored perspectives around cancer care and research, clinical trials recruitment and messaging, and priorities around addressing the current insufficiency in representation in cancer research.
Results
Our focus group data was analyzed using an inductive thematic approach. Four themes were present including (1) high motivation to participate in cancer trials and desire for better outreach and education within communities of color; (2) examples of just care as a model for improving access to clinical trials; (3) manifestations of power and inequity in healthcare inhibiting opportunities for clinical trial participation; and (4) the need for trust-building at the healthcare, community, and interpersonal levels.
Conclusion
Our findings demonstrate that people of color strongly desire clinical trial options and discussions during cancer care, and trust-building is foundational to opening pathways to research participation. We offer concrete steps for increasing racial justice in cancer clinical trials that serve as a point of reflection and guidance for healthcare professionals, researchers, and clinical trials teams.
{"title":"Promoting Racial Justice in Cancer Clinical Trials: Community Engaged Solutions for Bridging Gaps","authors":"Deana M. Williams, Chaya M. Pflugeisen, Khadijah Ameen, Toby K. Chen, Sheree Cooks, Bernadette C. Ray, Melissa Foster, De Phillips, Lizbeth Sanchez, Keywanna Hardiman, Cynthia Smith, Jennifer Slim","doi":"10.1002/cam4.70690","DOIUrl":"https://doi.org/10.1002/cam4.70690","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Racially and ethnically diverse populations are disproportionately burdened with and more likely to die from cancer than White populations but remain persistently underrepresented in cancer clinical trials. Thus, the safety and efficacy assessments of novel therapies may not apply to all populations, and guidelines are developed using trials that inadequately reflect our population. This study aims to explore healthcare experiences, cancer clinical trial perceptions, and solutions for bridging gaps in cancer clinical trials among communities of color.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We held a series of five focus groups with 23 survivors and caregivers of color. These sessions explored perspectives around cancer care and research, clinical trials recruitment and messaging, and priorities around addressing the current insufficiency in representation in cancer research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our focus group data was analyzed using an inductive thematic approach. Four themes were present including (1) high motivation to participate in cancer trials and desire for better outreach and education within communities of color; (2) examples of just care as a model for improving access to clinical trials; (3) manifestations of power and inequity in healthcare inhibiting opportunities for clinical trial participation; and (4) the need for trust-building at the healthcare, community, and interpersonal levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrate that people of color strongly desire clinical trial options and discussions during cancer care, and trust-building is foundational to opening pathways to research participation. We offer concrete steps for increasing racial justice in cancer clinical trials that serve as a point of reflection and guidance for healthcare professionals, researchers, and clinical trials teams.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian cancer (OC) is the most lethal gynecological malignancy and a major global health concern, often diagnosed at advanced stages with poor survival rates. Despite advancements in treatment, resistance to standard chemotherapy remains a critical challenge with limited treatment options available. In recent years, the role of metabolic reprogramming in OC has emerged as a key factor driving tumor progression, therapy resistance, and poor clinical outcomes.
Methods
This review explores the intricate connections between metabolic syndrome, enhanced glycolysis, and altered lipid metabolism within OC cells, which fuel the aggressive nature of the disease. We discuss how metabolic pathways are rewired in OC to support uncontrolled cell proliferation, survival under hypoxic conditions, and evasion of cell death mechanisms, positioning metabolic alterations as central to disease progression. The review also highlights the potential of repurposed metabolic-targeting drugs, such as metformin and statins, which have shown promise in preclinical studies for their ability to disrupt these altered metabolic pathways.
Conclusion
Drug repurposing offers a promising strategy to overcome chemoresistance and improve patient outcomes. Future research should focus on unraveling the complex metabolic networks in OC to develop innovative, targeted therapies that can enhance treatment efficacy and patient survival.
{"title":"Navigating Metabolic Challenges in Ovarian Cancer: Insights and Innovations in Drug Repurposing","authors":"Sara Mikhael, Georges Daoud","doi":"10.1002/cam4.70681","DOIUrl":"https://doi.org/10.1002/cam4.70681","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian cancer (OC) is the most lethal gynecological malignancy and a major global health concern, often diagnosed at advanced stages with poor survival rates. Despite advancements in treatment, resistance to standard chemotherapy remains a critical challenge with limited treatment options available. In recent years, the role of metabolic reprogramming in OC has emerged as a key factor driving tumor progression, therapy resistance, and poor clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review explores the intricate connections between metabolic syndrome, enhanced glycolysis, and altered lipid metabolism within OC cells, which fuel the aggressive nature of the disease. We discuss how metabolic pathways are rewired in OC to support uncontrolled cell proliferation, survival under hypoxic conditions, and evasion of cell death mechanisms, positioning metabolic alterations as central to disease progression. The review also highlights the potential of repurposed metabolic-targeting drugs, such as metformin and statins, which have shown promise in preclinical studies for their ability to disrupt these altered metabolic pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Drug repurposing offers a promising strategy to overcome chemoresistance and improve patient outcomes. Future research should focus on unraveling the complex metabolic networks in OC to develop innovative, targeted therapies that can enhance treatment efficacy and patient survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to develop a non-invasive, preoperative predictive model for Ki-67 expression in HCC patients using enhanced computed tomography (CT) and clinical indicators to improve patient outcomes.
Methods
This retrospective study analyzed 595 post-curative hepatectomy HCC patients. Patients were categorized into high (> 20%) and low (≤ 20%) Ki-67 expression groups based on cellular proliferation levels. Radiomic features were extracted from enhanced CT scans and combined with clinical parameters to develop a predictive model for Ki-67 expression.
Results
Key clinical factors impacting Ki-67 expression in HCC included alpha-fetoprotein (AFP), non-smooth tumor margin, ill-defined pseudo-capsule, and peritumoral star node. From 1441 initially extracted radiomic features, 16 key features were selected using Lasso regression. These features were used to develop a radiomics model, which, when combined with clinical data, yielded an integrated predictive model with high accuracy. The combined model achieved an area under the curve (AUC) of 0.854 in the training group and 0.839 in the validation group. A nomogram based on this model was constructed, and its predictive accuracy was validated through calibration curves and decision curve analysis. A risk scorecard model was also constructed as a practical tool for clinicians to assess the risk level of high Ki-67 expression, facilitating personalized treatment planning. Survival analysis demonstrated significant differences in 3-year overall survival (OS) and progression-free survival (PFS) rates between patients with high and low Ki-67 expression, indicating the model's strong prognostic capability.
Conclusions
This study successfully developed a comprehensive model that integrates radiomic and clinical data for the preoperative prediction of Ki-67 expression in HCC patients.
{"title":"Imaging-Based Prediction of Ki-67 Expression in Hepatocellular Carcinoma: A Retrospective Study","authors":"Chiyu Cai, Liancai Wang, Lianyuan Tao, Hengli Zhu, Yongnian Ren, Deyu Li, Dongxiao Li","doi":"10.1002/cam4.70562","DOIUrl":"https://doi.org/10.1002/cam4.70562","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to develop a non-invasive, preoperative predictive model for Ki-67 expression in HCC patients using enhanced computed tomography (CT) and clinical indicators to improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 595 post-curative hepatectomy HCC patients. Patients were categorized into high (> 20%) and low (≤ 20%) Ki-67 expression groups based on cellular proliferation levels. Radiomic features were extracted from enhanced CT scans and combined with clinical parameters to develop a predictive model for Ki-67 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key clinical factors impacting Ki-67 expression in HCC included alpha-fetoprotein (AFP), non-smooth tumor margin, ill-defined pseudo-capsule, and peritumoral star node. From 1441 initially extracted radiomic features, 16 key features were selected using Lasso regression. These features were used to develop a radiomics model, which, when combined with clinical data, yielded an integrated predictive model with high accuracy. The combined model achieved an area under the curve (AUC) of 0.854 in the training group and 0.839 in the validation group. A nomogram based on this model was constructed, and its predictive accuracy was validated through calibration curves and decision curve analysis. A risk scorecard model was also constructed as a practical tool for clinicians to assess the risk level of high Ki-67 expression, facilitating personalized treatment planning. Survival analysis demonstrated significant differences in 3-year overall survival (OS) and progression-free survival (PFS) rates between patients with high and low Ki-67 expression, indicating the model's strong prognostic capability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study successfully developed a comprehensive model that integrates radiomic and clinical data for the preoperative prediction of Ki-67 expression in HCC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Do Hee Kim, Yejin Kim, Jun Su Park, Sang Gyu Lee, Hyuk-Jae Chang, Tae Hyun Kim
Introduction
Cancer remains one of the leading causes of mortality and financial distress worldwide. In South Korea, the government introduced a benefit extension system in 2013 aimed at mitigating the financial strain associated with cancer treatment. However, cancer patients continue to bear significant out-of-pocket (OOP) expenses. This study aims to quantify the incremental healthcare utilization and OOP expenditures incurred by cancer patients in South Korea.
Methods
Utilizing data from the 2019 Korean Health Panel (KHP), we assessed cancer-related healthcare utilization and OOP expenditures. A generalized linear regression model, adjusted for demographic and socioeconomic variables, was employed. Healthcare utilization was measured by hospital admissions, outpatient visits, and emergency room (ER) visits, while OOP expenditures encompassed services including both covered and not covered by the National Health Insurance (NHI) system.
Results
Cancer patients experienced 0.39 more hospitalizations, 4.91 additional outpatient visits, and 0.11 more ER visits annually compared to non-cancer patients. Their incremental OOP expenses amounted to $482.8 per year, with $340.2 attributable to inpatient services. Notable variations in healthcare utilization and expenditures were observed across different cancer types.
Discussion
Despite the implementation of the benefit extension system, cancer patients continue to face considerable OOP expenses, particularly for inpatient care. With cancer incidence expected to rise, there is a pressing need for more comprehensive healthcare policies that alleviate the financial burden and prioritize cost-effective treatments for cancer patients.
Conclusion
This study underscores the substantial economic impact of cancer on South Korean patients. Expanding the benefit extension system and promoting cost-effective care strategies are critical to easing the growing financial pressures on cancer patients.
{"title":"Assessing the Economic Impact of Cancer Care: A Study on Out-of-Pocket Expenditures and Utilization in South Korea","authors":"Do Hee Kim, Yejin Kim, Jun Su Park, Sang Gyu Lee, Hyuk-Jae Chang, Tae Hyun Kim","doi":"10.1002/cam4.70593","DOIUrl":"https://doi.org/10.1002/cam4.70593","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cancer remains one of the leading causes of mortality and financial distress worldwide. In South Korea, the government introduced a benefit extension system in 2013 aimed at mitigating the financial strain associated with cancer treatment. However, cancer patients continue to bear significant out-of-pocket (OOP) expenses. This study aims to quantify the incremental healthcare utilization and OOP expenditures incurred by cancer patients in South Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing data from the 2019 Korean Health Panel (KHP), we assessed cancer-related healthcare utilization and OOP expenditures. A generalized linear regression model, adjusted for demographic and socioeconomic variables, was employed. Healthcare utilization was measured by hospital admissions, outpatient visits, and emergency room (ER) visits, while OOP expenditures encompassed services including both covered and not covered by the National Health Insurance (NHI) system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cancer patients experienced 0.39 more hospitalizations, 4.91 additional outpatient visits, and 0.11 more ER visits annually compared to non-cancer patients. Their incremental OOP expenses amounted to $482.8 per year, with $340.2 attributable to inpatient services. Notable variations in healthcare utilization and expenditures were observed across different cancer types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Despite the implementation of the benefit extension system, cancer patients continue to face considerable OOP expenses, particularly for inpatient care. With cancer incidence expected to rise, there is a pressing need for more comprehensive healthcare policies that alleviate the financial burden and prioritize cost-effective treatments for cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the substantial economic impact of cancer on South Korean patients. Expanding the benefit extension system and promoting cost-effective care strategies are critical to easing the growing financial pressures on cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niall J. O'Sullivan, Fariba Tohidinezhad, Hugo C. Temperley, Mirac Ajredini, Bedirye Koyuncu Sokmen, Rumeysa Atabey, Leyla Ozer, Erman Aytac, Alison Corr, Alberto Traverso, James F. Meaney, Michael E. Kelly
Introduction
Local recurrence and distant metastasis remain a concern in advanced rectal cancer, with up to 10% and 20%–30% of patients suffering local and distal progression, respectively. Radiomics refers to a novel technology that extracts and analyses quantitative imaging features from images, which can be subsequently used to develop and test clinical models predictive of outcomes. We aim to develop and test an MRI-based radiomics nomogram predictive of disease recurrence in patients with T4 rectal cancer.
Methods
We conducted a multi-institutional retrospective analysis of 55 patients with T4 rectal cancer treated with neoadjuvant chemoradiotherapy followed by exenterative surgery. Radiomic features were extracted from pre-treatment T2-weighted MRI scans and used to construct predictive models. The top-performing radiomic signatures were identified, and internal validation with 1000 bootstrap samples was performed to calculate optimism-corrected performance measures.
Results
Two radiomic signatures were identified as strong predictors of post-operative disease recurrence. The best-performing model achieved an optimism-corrected AUC of 0.75, demonstrating good discriminative ability. Calibration plots showed a satisfactory fit of the predictions to the actual rates, and decision curve analyses confirmed the positive net benefit of the models.
Conclusion
The MRI-based radiomics nomogram provides a promising tool for predicting disease recurrence in T4 rectal cancer patients post-exenteration. This model could improve risk stratification and guide more personalized treatment strategies. Further studies with larger cohorts and external validation are needed to confirm these findings and enhance the model's generalizability.
{"title":"Multi-Institutional MR-Derived Radiomics to Predict Post-Exenteration Disease Recurrence in Patients With T4 Rectal Cancer","authors":"Niall J. O'Sullivan, Fariba Tohidinezhad, Hugo C. Temperley, Mirac Ajredini, Bedirye Koyuncu Sokmen, Rumeysa Atabey, Leyla Ozer, Erman Aytac, Alison Corr, Alberto Traverso, James F. Meaney, Michael E. Kelly","doi":"10.1002/cam4.70699","DOIUrl":"https://doi.org/10.1002/cam4.70699","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Local recurrence and distant metastasis remain a concern in advanced rectal cancer, with up to 10% and 20%–30% of patients suffering local and distal progression, respectively. Radiomics refers to a novel technology that extracts and analyses quantitative imaging features from images, which can be subsequently used to develop and test clinical models predictive of outcomes. We aim to develop and test an MRI-based radiomics nomogram predictive of disease recurrence in patients with T4 rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multi-institutional retrospective analysis of 55 patients with T4 rectal cancer treated with neoadjuvant chemoradiotherapy followed by exenterative surgery. Radiomic features were extracted from pre-treatment T2-weighted MRI scans and used to construct predictive models. The top-performing radiomic signatures were identified, and internal validation with 1000 bootstrap samples was performed to calculate optimism-corrected performance measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two radiomic signatures were identified as strong predictors of post-operative disease recurrence. The best-performing model achieved an optimism-corrected AUC of 0.75, demonstrating good discriminative ability. Calibration plots showed a satisfactory fit of the predictions to the actual rates, and decision curve analyses confirmed the positive net benefit of the models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MRI-based radiomics nomogram provides a promising tool for predicting disease recurrence in T4 rectal cancer patients post-exenteration. This model could improve risk stratification and guide more personalized treatment strategies. Further studies with larger cohorts and external validation are needed to confirm these findings and enhance the model's generalizability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Senwei Jiang, Minjuan Ye, Jing Wan, Qingjian Ye, Suli Qiu, Yuebo Yang, Xiaomao Li
Background
Previously, anti-CTLA4 and anti-PD-1/PD-L1 immunotherapies have shown limited efficacy in MSI-H/MMR-D endometrial cancer, leading to poor clinical outcomes. The gelsolin superfamily, which includes GSN, SCIN, VILL, VIL1, CAPG, AVIL, SVIL, and FLII, plays crucial roles in cell motility and gene regulation.
Aims
The objective of this study is to explore the potential therapeutic and prognostic implications of the gelsolin superfamily in EC.
Materials & Methods
Data from TCGA, GEPIA, THPA, UALCAN, and Kaplan–Meier plotter databases were analyzed to investigate the expression and clinical relevance of gelsolin superfamily members. Co-expression networks of the gelsolin superfamily were assessed using LinkedOmics, GeneMANIA, and NetworkAnalyst. The relationship between gelsolin superfamily and immune cell infiltration was investigated using TIMER, ImmuCellAI, and GEPIA.
Results
We found that high expressions of CAPG, AVIL, and SVIL were associated with poor prognosis, while high expressions of GSN and FLII were linked to better outcomes in EC. Functional enrichment analysis indicated the involvement of gelsolin superfamily members in pathways related to estrogen response, MYC targets, epithelial–mesenchymal transition, TGF beta signaling, MTORC1 signaling, oxidative phosphorylation, inflammatory response, and IL6-JAK-STAT3 signaling. Furthermore, gelsolin superfamily members demonstrated strong correlations with the levels of monocytes, natural killer T, naive CD4+ T, follicular helper T, and central memory T in EC. In vitro studies showed that silencing CAPG and FLII could inhibit proliferation and metastasis in endometrial cancer cell lines.
Conclusion
These findings indicate the significant association of gelsolin superfamily members with prognosis and immunological status in endometrial cancer.
{"title":"Significance of Gelsolin Superfamily Genes in Diagnosis, Prognosis and Immune Microenvironment Regulation for Endometrial Cancer","authors":"Senwei Jiang, Minjuan Ye, Jing Wan, Qingjian Ye, Suli Qiu, Yuebo Yang, Xiaomao Li","doi":"10.1002/cam4.70584","DOIUrl":"https://doi.org/10.1002/cam4.70584","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previously, anti-CTLA4 and anti-PD-1/PD-L1 immunotherapies have shown limited efficacy in MSI-H/MMR-D endometrial cancer, leading to poor clinical outcomes. The gelsolin superfamily, which includes <i>GSN</i>, <i>SCIN</i>, <i>VILL</i>, <i>VIL1</i>, <i>CAPG</i>, <i>AVIL</i>, <i>SVIL</i>, and <i>FLII</i>, plays crucial roles in cell motility and gene regulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The objective of this study is to explore the potential therapeutic and prognostic implications of the gelsolin superfamily in EC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>Data from TCGA, GEPIA, THPA, UALCAN, and Kaplan–Meier plotter databases were analyzed to investigate the expression and clinical relevance of gelsolin superfamily members. Co-expression networks of the gelsolin superfamily were assessed using LinkedOmics, GeneMANIA, and NetworkAnalyst. The relationship between gelsolin superfamily and immune cell infiltration was investigated using TIMER, ImmuCellAI, and GEPIA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that high expressions of <i>CAPG</i>, <i>AVIL</i>, and <i>SVIL</i> were associated with poor prognosis, while high expressions of <i>GSN</i> and <i>FLII</i> were linked to better outcomes in EC. Functional enrichment analysis indicated the involvement of gelsolin superfamily members in pathways related to estrogen response, MYC targets, epithelial–mesenchymal transition, TGF beta signaling, MTORC1 signaling, oxidative phosphorylation, inflammatory response, and IL6-JAK-STAT3 signaling. Furthermore, gelsolin superfamily members demonstrated strong correlations with the levels of monocytes, natural killer T, naive CD4+ T, follicular helper T, and central memory T in EC. In vitro studies showed that silencing CAPG and FLII could inhibit proliferation and metastasis in endometrial cancer cell lines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings indicate the significant association of gelsolin superfamily members with prognosis and immunological status in endometrial cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with triple negative breast cancer (TNBC) who have a poor response to neoadjuvant chemotherapy (NAC) have worse survival and new treatment strategies need to be developed. TNBC is considered a subtype in which the cyclic GMP-AMP synthase (cGAS) is linked to the stimulator of interferon genes (STING) pathway, an innate immune response that recognizes cytosolic nucleic acid components, is activated when DNA damage occurs, and is attracting attention as a new therapeutic target.
Methods
Patients with TNBC who underwent surgery following NAC and for whom pre- and post-treatment tissue specimens were available were enrolled in this study. To examine the association of STING expression with immune profiles and prognosis, STING, cGAS, CD8, and programmed cell death ligand 1 (PD-L1) expressions in tumor cells (TCs) and immune cells (ICs), and tumor infiltrating lymphocytes (TILs) were assessed using immunohistochemistry of specimens obtained at pre-treatment and at surgery.
Results
Ninety-one cases were eligible, of which 68 cases were evaluable and included in the analysis. The high STING expression at baseline was marginally correlated with TILs, but not with CD8+ cells or PD-L1 expression. Patients with sustained high expression of STING before and after NAC had a significantly poorer prognosis than that of others for distant recurrence-free survival and breast cancer-specific survival independent of nodal status, lymphatic invasion and therapeutic effects (p = 0.024 and 0.014, respectively).
Conclusion
TNBCs with sustained high STING expression following NAC demonstrated a poor prognosis and will be a target for new treatment strategies.
{"title":"Prognostic Impact of Stimulator of Interferon Genes Expression in Triple Negative Breast Cancer","authors":"Tetsuyo Maeda, Makiko Ono, Tomo Osako, Tomohiro Chiba, Satoko Baba, Asumi Iesato, Yukinori Ozaki, Yuka Inoue, Natsue Uehiro, Yoko Takahashi, Takayuki Kobayashi, Takahiro Kogawa, Tomohiko Ohta, Shigehisa Kitano, Takayuki Ueno, Shinji Ohno","doi":"10.1002/cam4.70666","DOIUrl":"https://doi.org/10.1002/cam4.70666","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with triple negative breast cancer (TNBC) who have a poor response to neoadjuvant chemotherapy (NAC) have worse survival and new treatment strategies need to be developed. TNBC is considered a subtype in which the cyclic GMP-AMP synthase (cGAS) is linked to the stimulator of interferon genes (STING) pathway, an innate immune response that recognizes cytosolic nucleic acid components, is activated when DNA damage occurs, and is attracting attention as a new therapeutic target.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with TNBC who underwent surgery following NAC and for whom pre- and post-treatment tissue specimens were available were enrolled in this study. To examine the association of STING expression with immune profiles and prognosis, STING, cGAS, CD8, and programmed cell death ligand 1 (PD-L1) expressions in tumor cells (TCs) and immune cells (ICs), and tumor infiltrating lymphocytes (TILs) were assessed using immunohistochemistry of specimens obtained at pre-treatment and at surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-one cases were eligible, of which 68 cases were evaluable and included in the analysis. The high STING expression at baseline was marginally correlated with TILs, but not with CD8<sup>+</sup> cells or PD-L1 expression. Patients with sustained high expression of STING before and after NAC had a significantly poorer prognosis than that of others for distant recurrence-free survival and breast cancer-specific survival independent of nodal status, lymphatic invasion and therapeutic effects (<i>p</i> = 0.024 and 0.014, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TNBCs with sustained high STING expression following NAC demonstrated a poor prognosis and will be a target for new treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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