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Partnership for Native American Cancer Prevention: Outreach Strategies and Evaluation 2019–2024 美洲原住民癌症预防伙伴关系：推广策略和评估2019-2024。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-12 DOI: 10.1002/cam4.71348

Nicolette I. Teufel-Shone, Kelly A. Laurila, Julie S. Armin, Carol Goldtooth, Francine C. Gachupin, Jacquanette R. Slowtalker, Janet R. Yellowhair, Ashley D. Lazaro, Eli BigThumb, Alexis K. Talayumptewa

Aim

The Outreach Core of the Partnership for Native American Cancer Prevention (NACP) in Arizona offers an overview of strategies designed to (1) provide cancer-related education in collaboration with Native Nations and (2) train researchers working with native American communities on tribal oversight of research activities and community-oriented dissemination.

Background

In the late 1990s, the National Institute of Health began to support an Outreach Core within its Center grants but provided limited guidance on expected activities and goals. NACP has been funded since 2002 and refunded to 2029. The NACP Outreach Core shares strategies implemented from 2019 to 2024. In this 5-year period, the NACP Outreach Core had four goals with the intention of increasing institutional and community capacity for cancer control activities: (1) Increase researcher, trainee and tribal communities' knowledge of native American cancer-related issues to enhance institutional and tribal capacity to design sustainable, relevant cancer research and prevention programs. (2) Provide training in research best practices when collaborating with tribal communities. (3) Facilitate community-based dissemination of NACP research results. (4) Collaborate with native American communities to develop and implement cancer-related informational activities to benefit native American communities.

Methods

Goal 1 employed 3 strategies: a speakers' series, regular contribution to a week-long workshop on genomics research in Indigenous communities and development of cancer research resources for Native Nations. Goal 2 involved contributions to a university workshop on native American research protections. Goal 3 was addressed with the development and implementation of community dissemination training for NACP-funded research teams. Goal 4 focused on building relationships, by responding to Native Nations' requests to present at community conferences and cancer awareness events.

Results

The Indigenous Cancer Prevention Speaker Series was implemented each quarter for 5 years. Through participation in the Summer Internship for INdigenous Peoples in Genomics, NACP provided education on the collection of biospecimens with Indigenous peoples. NACP developed and distributed cancer education resources to tribal health directors across Arizona. NACP designed and delivered virtually, in real time, the Community Dissemination and Application Training to 31 NACP

目的：亚利桑那州美洲原住民癌症预防伙伴关系（NACP）的外展核心概述了旨在(1)与土著民族合作提供与癌症相关的教育和(2)培训与美洲原住民社区合作的研究人员，以部落监督研究活动和面向社区的传播。背景：在20世纪90年代末，美国国立卫生研究院开始在其中心拨款范围内支持外展核心，但对预期活动和目标提供了有限的指导。NACP自2002年起获得资助，并退还至2029年。NACP外展核心分享了2019年至2024年实施的战略。在这5年期间，NACP外展核心有四个目标，旨在提高机构和社区在癌症控制活动方面的能力：(1)提高研究人员、学员和部落社区对美洲原住民癌症相关问题的了解，以提高机构和部落设计可持续的、相关的癌症研究和预防项目的能力。(2)在与部落社区合作时提供研究最佳实践方面的培训。(3)促进NACP研究成果在社区的传播。(4)与美洲原住民社区合作，开发和实施与癌症相关的信息活动，以造福美洲原住民社区。方法：目标1采用了3种策略：演讲者系列，定期为土著社区基因组学研究为期一周的研讨会做出贡献，以及为土著民族开发癌症研究资源。目标2涉及为一个关于保护美洲土著研究的大学讲习班提供捐款。目标3的解决办法是为国家艾滋病防治方案资助的研究小组制定和实施社区传播培训。目标4侧重于建立关系，响应土著民族出席社区会议和癌症宣传活动的要求。结果：原住民防癌讲座系列每季度进行一次，为期5年。通过参加土著人民基因组学暑期实习，该中心向土著人民提供了关于收集生物标本的教育。NACP开发并分发癌症教育资源给亚利桑那州的部落卫生主管。NACP为31名NACP资助的研究人员设计和提供了虚拟的、实时的社区传播和应用培训，并为研究团队提供了一对一的咨询。NACP与土著国家的服务提供者合作，开发了一个癌症对话播客系列，“照顾我们”，面向国内和国际听众。在5年多的时间里，NACP外展参与了20个社区活动，包括癌症市政厅、健康博览会、广播节目和癌症相关的跑步活动，接触了1400多名社区成员。结论：NACP外展核心的一系列策略为机构学者和部落社区提供了与癌症相关的信息，并与亚利桑那原住民保持了定期、互惠的沟通。这些活动的影响很难评估，而且仅限于达到的范围，即参与者的数量，或在线资源的“点击率”。这些指标表明NACP外展产品被使用，但没有跟踪影响。在设计推广策略时应考虑评估影响的能力。外展核心小组与美洲土著社区的定期联系有助于全国有色人种协进会与亚利桑那州土著民族的长期伙伴关系；社区与大学的关系对于确保外展活动的接受性和相关性至关重要。

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引用次数: 0

Chemobrain and Cancer Survivorship: A Scoping Review of the Literature 化学脑与癌症存活：文献综述。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-12 DOI: 10.1002/cam4.71383

Michael J. Rovito, Khushi M. Chauhan, Humnah Baig

<div> <section> <h3> Background</h3> <p>Cancer-related cognitive impairment (CRCI), commonly known as chemobrain, is characterized by deficits in memory, processing speed, and executive function. While traditionally linked to chemotherapy, emerging evidence suggests that hormone and radiation therapies may also contribute. Despite its high prevalence, CRCI remains underrecognized in oncology research and clinical practice, limiting the development of targeted interventions. Estimates suggest that up to 75% of cancer patients experience cognitive impairment during treatment, with approximately 35% reporting persistent symptoms months or even years post-treatment. However, much of the existing literature has focused on breast cancer, leaving a critical gap in understanding CRCI in other cancer populations.</p> </section> <section> <h3> Aims</h3> <p>This scoping review systematically analyzed research on CRCI across various malignancies, excluding breast cancer, to provide a broader perspective.</p> </section> <section> <h3> Materials & Methods</h3> <p>A comprehensive literature search identified 29 studies examining cognitive impairment in patients with colorectal, testicular, lung, prostate, and hematological cancers.</p> </section> <section> <h3> Results</h3> <p>Findings suggest that the severity and duration of cognitive decline vary depending on cancer type and treatment modality, with some therapies inducing transient symptoms and others contributing to prolonged deficits. Existing cognitive assessment tools, such as the Mini-Mental State Examination (MMSE), often lack the sensitivity to detect subtle neurocognitive changes, highlighting the need for more precise diagnostic measures. Methodological challenges, including small sample sizes and reliance on self-reported cognitive symptoms, further hinder the characterization of CRCI in non-breast cancer populations.</p> </section> <section> <h3> Discussion</h3> <p>Given the increasing recognition of CRCI across diverse malignancies, future research should prioritize longitudinal studies, advanced neuroimaging techniques, and targeted interventions to mitigate cognitive impairment. A more comprehensive understanding of CRCI in various cancer populations is essential for refining clinical guidelines, improving cognitive assessments, and enhancing survivorship care.</p> </section> <section> <h3> Conclusion</h3>

背景：癌症相关认知障碍（CRCI），通常被称为化学脑，其特征是记忆、处理速度和执行功能的缺陷。虽然传统上与化疗有关，但新出现的证据表明，激素和放射疗法也可能起作用。尽管CRCI的发病率很高，但在肿瘤研究和临床实践中仍未得到充分认识，限制了靶向干预措施的发展。估计表明，高达75%的癌症患者在治疗期间出现认知障碍，约35%的患者在治疗后数月甚至数年报告持续症状。然而，现有的许多文献都集中在乳腺癌上，在了解其他癌症人群的CRCI方面留下了一个关键的空白。目的：本综述系统分析了各种恶性肿瘤（不包括乳腺癌）的CRCI研究，以提供更广阔的视角。材料与方法：综合文献检索确定了29项研究，研究结直肠癌、睾丸癌、肺癌、前列腺癌和血液癌患者的认知障碍。结果：研究结果表明，认知能力下降的严重程度和持续时间因癌症类型和治疗方式而异，一些治疗方法会引起短暂的症状，而另一些则会导致长期的缺陷。现有的认知评估工具，如迷你精神状态检查（MMSE），往往缺乏检测细微神经认知变化的敏感性，这突出了对更精确诊断措施的需求。方法学上的挑战，包括小样本量和依赖自我报告的认知症状，进一步阻碍了对非乳腺癌人群中CRCI的表征。讨论：鉴于CRCI在不同恶性肿瘤中的认识日益提高，未来的研究应优先考虑纵向研究、先进的神经影像学技术和有针对性的干预措施，以减轻认知障碍。更全面地了解不同癌症人群的CRCI对于完善临床指南、改善认知评估和加强生存护理至关重要。结论：扩大乳腺癌以外的研究将有助于优化支持性护理策略，改善癌症相关认知功能障碍患者的生活质量。

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引用次数: 0

Cytokine–Cytokine Receptor Interaction and Endocytosis are Common Pathways for Symptom Burden and Sickness Behavior Symptoms in Oncology Patients Undergoing Chemotherapy 细胞因子-细胞因子受体相互作用和内吞作用是肿瘤化疗患者症状负担和疾病行为症状的共同途径。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-11 DOI: 10.1002/cam4.71328

Carolyn S. Harris, Kord M. Kober, Joosun Shin, Lisa Morse, Kate R. Oppegaard, Steven Paul, Marilyn J. Hammer, Jon D. Levine, Yvette P. Conley, Christine A. Miaskowski

Background

Inflammation is associated with sickness behavior symptoms in patients receiving chemotherapy. However, its impact on symptom burden (i.e., higher number of concurrent symptoms) requires evaluation. Study purposes were to evaluate for differentially perturbed immune and/or inflammatory pathways between outpatients receiving chemotherapy with Low (i.e., 0–8) versus High (i.e., 16–38) symptom burden and identify common immune and/or inflammatory pathways among symptom burden and single sickness behavior symptoms.

Methods

Prior to their second or third cycle of chemotherapy, oncology outpatients reported the occurrence of 38 symptoms using the Memorial Symptom Assessment Scale and provided a peripheral blood sample. Using previously identified symptom cutpoints, patients with Low versus High symptom burden were evaluated. Transcriptome-wide gene expression was quantified using RNA-sequencing (n = 213; RNA-seq sample) or microarray (n = 207; microarray sample) technologies. Pathway impact analyses (PIA) were performed and signaling pathways were defined with the Kyoto Encyclopedia of Genes and Genomes database. Fisher's combined probability test was used to identify perturbed pathways between the Low and High symptom burden groups across both samples (false discovery rate < 0.005).

Results

For the RNA-seq sample, 159 patients had High and 54 patients had Low symptom burden. For the microarray sample, 135 patients had High and 72 patients had Low symptom burden. Of the 40 pathways that were perturbed between the Low and High symptom burden groups, 10 were involved in immune or inflammatory processes. Cytokine–cytokine receptor interaction and endocytosis pathways were the common pathways identified across this study and PIAs of single sickness behavior symptoms.

Conclusions

This study is the first to identify differentially perturbed immune and inflammatory signaling pathways that were associated with symptom burden in oncology patients receiving chemotherapy. Evaluation of interventions targeted at the cytokine–cytokine receptor interaction and endocytosis pathways may decrease the burden associated with single and multiple occurring symptoms.

背景：炎症与化疗患者的疾病行为症状相关。然而，其对症状负担的影响（即并发症状数量增加）需要评估。研究目的是评估低（即0-8）和高（即16-38）症状负担的门诊化疗患者的免疫和/或炎症途径的差异，并确定症状负担和单一疾病行为症状之间共同的免疫和/或炎症途径。方法：肿瘤门诊患者在第二或第三周期化疗前，使用记忆症状评估量表报告38种症状的发生，并提供外周血样本。使用先前确定的症状切点，评估低与高症状负担的患者。使用rna测序（n = 213； RNA-seq样本）或微阵列（n = 207；微阵列样本）技术定量转录组基因表达。进行通路影响分析（PIA），并使用京都基因和基因组百科全书数据库定义信号通路。使用Fisher联合概率检验在两个样本中识别低和高症状负担组之间的扰动通路（错误发现率）结果：对于RNA-seq样本，159例患者具有高症状负担，54例患者具有低症状负担。对于微阵列样本，135例患者有高症状负担，72例患者有低症状负担。在低症状负担组和高症状负担组之间的40条通路中，有10条与免疫或炎症过程有关。细胞因子-细胞因子受体相互作用和内吞作用途径是本研究中发现的共同途径，也是单一疾病行为症状的pia。结论：本研究首次确定了与接受化疗的肿瘤患者症状负担相关的免疫和炎症信号通路的差异紊乱。评估针对细胞因子-细胞因子受体相互作用和内吞作用途径的干预措施可能会减轻与单次和多次出现症状相关的负担。

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引用次数: 0

Impact of Travel Burden on Timeliness of Care and Overall Survival for Breast Cancer: A National Cancer Database Analysis 旅行负担对乳腺癌护理及时性和总体生存率的影响：一项国家癌症数据库分析。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-10 DOI: 10.1002/cam4.71354

Yongzhe Wang, Christine M. Quinones, Elizabeth Gonzalez, Preeti Farmah, Hans F. Schoellhammer, Lorena Gonzalez, Nikita Shah, Katharine Schulz-Costello, Jennifer Tseng, Veronica C. Jones

Introduction

Timely treatment initiation is critical to clinical outcomes in breast cancer (BC). While social determinants of health are established drivers of disparities in the timeliness of care (ToC), the impact of travel burden remains less defined. This study evaluates associations between travel burden, ToC, and overall survival (OS) in a nationally representative BC cohort.

Methods

We analyzed 283,166 BC patients from the National Cancer Database (2004–2021) with documented great circle distance (GCD), categorized as ≤ 10, 10.1–20.0, and > 20 miles. Associations between GCD and ToC—defined as time from diagnosis to first treatment and categorized as < 8, 8–12, and > 12 weeks—were assessed using negative binomial models, and associations with OS were evaluated using Cox models.

Results

Compared to patients with GCD < 10 miles, patients with GCD > 20 miles experienced delays in ToC when diagnosed with early-stage disease, especially when undergoing surgery as first treatment (RR: 1.05, 95% CI: 1.04–1.06). Compared to treatment within 8 weeks of diagnosis, treatment initiation > 12 weeks had 24% higher mortality (HR: 1.24, 95% CI: 1.14–1.35), especially among patients receiving surgery (HR: 1.31, 95% CI: 1.19–1.43) and chemotherapy (HR: 1.30, 95% CI: 1.18–1.43). Even surgery within 8–12 weeks carried an elevated risk (HR: 1.09, 95% CI: 1.02–1.16). Metropolitan patients with GCD > 20 miles had a 12% lower mortality (HR: 0.88, 95% CI: 0.81–0.96) than those ≤ 10 miles away; no such differences were observed in urban or rural groups.

Conclusion

Travel burden influences BC ToC and OS through geographic, clinical, and facility factors, underscoring the need for tailored interventions that address local care capacity, patient demographics, and disease profiles.

及时开始治疗对乳腺癌（BC）的临床结果至关重要。虽然健康的社会决定因素是医疗及时性差异的既定驱动因素，但旅行负担的影响仍然不太明确。本研究在一个具有全国代表性的BC队列中评估了旅行负担、ToC和总生存（OS）之间的关系。方法：我们分析了来自国家癌症数据库（2004-2021）的283,166例BC患者，记录了大圆距离（GCD），分类为≤10,10.1-20.0和bbb20英里。使用负二项模型评估GCD和toc（从诊断到首次治疗的时间，分类为12周）之间的关联，使用Cox模型评估与OS的关联。结果：与GCD患者相比，20英里的患者在诊断为早期疾病时ToC延迟，特别是在首次接受手术治疗时（RR: 1.05, 95% CI: 1.04-1.06）。与诊断后8周内治疗相比，开始治疗前12周的死亡率高出24% (HR: 1.24, 95% CI: 1.14-1.35)，尤其是接受手术（HR: 1.31, 95% CI: 1.19-1.43）和化疗（HR: 1.30, 95% CI: 1.18-1.43）的患者。即使在8-12周内进行手术，风险也会增加（HR: 1.09, 95% CI: 1.02-1.16）。与距离≤10英里的患者相比，距离≤20英里的大都市患者死亡率低12% (HR: 0.88, 95% CI: 0.81-0.96)；在城市和农村人群中没有观察到这种差异。结论：旅行负担通过地理、临床和设施因素影响BC ToC和OS，强调需要针对当地护理能力、患者人口统计和疾病概况进行量身定制的干预措施。

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引用次数: 0

Artificial Intelligence Chatbots and Their Responses to Most Searched Spanish Cancer Questions 人工智能聊天机器人及其对最热门西班牙癌症问题的回答。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-10 DOI: 10.1002/cam4.71364

En Cheng, Jesus D. Anampa, Carolina Bernabe-Ramirez, Juan Lin, Xiaonan Xue, Carmen R. Isasi, Alyson B. Moadel-Robblee, Edward Chu

Background

Artificial intelligence (AI) chatbots perform well in answering English cancer questions. For Spanish, their performance is unknown and may differ by free vs. paywall versions.

Methods

We evaluated the quality (range: 1–5 points), actionability (range: 0–100%), and readability (range: 1–13 grades) of six popular AI chatbots in responding to the 15 most searched Spanish questions regarding breast, prostate, and colon cancer.

Results

The quality of overall AI chatbot responses was good (mean [95% CI]: 3.5 [3.4–3.6] points), while the actionability was low (mean [95% CI]: 35.6% [30.8%–40.3%]). The readability was high-school-level (mean [95% CI]: 9.2 [8.8–9.6] grades), not concordant with the American Medical Association recommendation (≤ 6th grade). The quality, actionability, and readability did not differ by free and paywall versions (p > 0.05).

Conclusion

Our findings suggested AI chatbots may generate good-quality responses to Spanish cancer questions, regardless of free or paywall versions. However, further improvement in actionability and readability is needed to benefit Spanish-speaking patients.

背景：人工智能（AI）聊天机器人在回答英语癌症问题方面表现出色。对于西班牙语，他们的表现是未知的，并且可能因免费和付费版本而有所不同。方法：我们评估了六个流行的人工智能聊天机器人的质量（范围：1-5分）、可操作性（范围：0-100%）和可读性（范围：1-13分），以回答有关乳腺癌、前列腺癌和结肠癌的15个搜索最多的西班牙语问题。结果：人工智能聊天机器人的整体响应质量良好（平均[95% CI]: 3.5[3.4-3.6]点），而可操作性较低（平均[95% CI]: 35.6%[30.8%-40.3%]）。可读性为高中水平（平均[95% CI]: 9.2[8.8-9.6]年级），不符合美国医学协会推荐（≤6年级）。免费版和付费版的质量、可操作性和可读性没有差异（p < 0.05）。结论：我们的研究结果表明，无论是免费版本还是付费版本，人工智能聊天机器人都可能对西班牙癌症问题产生高质量的回答。然而，需要进一步改善可操作性和可读性，以使讲西班牙语的患者受益。

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引用次数: 0

Survival Prediction in Middle-Aged and Elderly Patients With Burkitt Lymphoma: A Comprehensive Nomogram Approach Based on SEER Data 中老年伯基特淋巴瘤患者的生存预测：基于SEER数据的综合Nomogram方法

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-10 DOI: 10.1002/cam4.71334

Xia Cao, Duanzong Zhang, Jichang Gong, Xin Yang, Jiqiong He, Yaqiong Li, Hongjiang Pu

Background

Burkitt lymphoma (BL) in middle-aged and elderly populations presents unique prognostic challenges due to distinct biological behaviors and therapeutic vulnerabilities. Current prognostic tools inadequately address age-specific survival determinants in this understudied cohort.

Methods

This study used the Surveillance, Epidemiology, and End Results (SEER) data from patients diagnosed with BL between 2000 and 2020, aged 45 years and older. Through univariate and multivariate Cox regression analyses, we identified independent prognostic factors affecting overall survival (OS) and cancer-specific survival (CSS). Finally, nomograms were constructed, and the models were evaluated across three dimensions.

Results

Multivariate analysis results indicated that factors such as age, race, Ann Arbor stage, and chemotherapy were independently associated with OS, while age, Ann Arbor stage, radiotherapy, chemotherapy, and number of tumor masses were independently associated with CSS. The nomogram model effectively predicted the 1-, 3-, and 5-year probabilities of OS and CSS. The results from receiver operating characteristic curves, calibration curves, and decision curve analysis in the training and validation groups confirmed that the risk prediction nomogram could accurately predict the survival of BL patients.

Conclusion

The nomogram model constructed in this study provides a personalized survival prediction tool for BL patients, effectively distinguishing the survival probabilities of different risk groups. This research offers new insights for risk stratification and treatment management of middle-aged and elderly BL patients.

背景：中老年人群中的伯基特淋巴瘤（BL）由于其独特的生物学行为和治疗脆弱性，呈现出独特的预后挑战。目前的预后工具不能充分解决这一研究不足的队列中年龄特异性生存决定因素。方法：本研究使用了2000年至2020年间诊断为BL的45岁及以上患者的监测、流行病学和最终结果（SEER）数据。通过单因素和多因素Cox回归分析，我们确定了影响总生存期（OS）和癌症特异性生存期（CSS）的独立预后因素。最后，构建了模态图，并对模型进行了三维评价。结果：多因素分析结果显示，年龄、种族、Ann Arbor分期、化疗等因素与OS独立相关，年龄、Ann Arbor分期、放疗、化疗、肿瘤肿块数与CSS独立相关。nomogram模型能有效预测OS和CSS的1、3、5年概率。训练组和验证组的受试者工作特征曲线、校准曲线和决策曲线分析结果证实，风险预测nomogram可以准确预测BL患者的生存期。结论：本研究构建的nomogram模型为BL患者提供了一种个性化的生存预测工具，有效区分了不同风险群体的生存概率。本研究为中老年BL患者的风险分层和治疗管理提供了新的见解。

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引用次数: 0

A Novel Nomogram to Predict Pathological Complete Response in Breast Cancer Patients and Identify Candidates Who Might Omit Surgery: A Large Cohort Study 一种新的Nomogram预测乳腺癌患者的病理完全缓解并确定可能省略手术的候选人：一项大型队列研究

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-08 DOI: 10.1002/cam4.71372

Kaining Ye, Xuehong Liao, Weiping Yang, Jianming Weng, Yongliang Dai, Xiliang Chen, Yongjian Liu, Kaixin Du

Purpose

To establish and validate a nomogram for predicting pathological complete response (pCR) after neoadjuvant therapy (NAT) in breast cancer (BC) patients, aiming to identify subgroups potentially suitable for non-surgical management.

Methods

Between 2010 and 2015, 4402 BC patients (3037 surgery, 1365 non-surgery) were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, with external validation in 339 BC patients from our hospital. Logistic regression identified pCR predictors and a nomogram model was constructed. Propensity score matching (PSM) was applied to minimize the effect of the imbalance of the prognostic factors between the surgery group and the non-surgery group.

Results

Univariable and multivariable analyses revealed that age, marital status, T stage, N stage, differentiation grade, hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status and chemotherapy were significant predictors of pCR in the surgery group (all p < 0.05). The area under the receiver operating characteristic curve (AUC) for predicting pCR was 0.756 (95% CI: 0.736–0.776), 0.717 (95% CI: 0.681–0.754), and 0.744 (95% CI: 0.687–0.800) in the training, internal validation, and external validation sets, respectively. Non-surgery patients were stratified into high (> 375), medium (162.5–375), and low (< 162.5) nomogram score groups, with 5-year OS rates of 70.7%, 49.2%, and 29.2% (p < 0.05). After PSM, 358 pairs of patients were included to compare 5-year OS between the surgery group and the non-surgery group, and the results showed that the 5-year OS of patients stratified by high-score group, medium-score group and low-score group between the surgery group and the non-surgery group were 85.4% vs. 72.8%, 78.3% vs. 59.8% and 79.3% vs. 20.0% (all p < 0.05).

Conclusion

We successfully established a nomogram for pCR in BC patients. Based on this predictive model, patients with higher scores may represent potential candidates for non-surgical therapeutic approaches, warranting further investigation in future studies.

目的建立并验证预测乳腺癌（BC）患者新辅助治疗（NAT）后病理完全缓解（pCR）的nomogram，旨在确定适合非手术治疗的亚群。方法2010 - 2015年，从监测、流行病学和最终结果（SEER）数据库中提取4402例BC患者（3037例手术，1365例非手术），并对我院339例BC患者进行外部验证。Logistic回归分析了pCR预测因子，并建立了正态图模型。采用倾向评分匹配（PSM）来最小化手术组与非手术组预后因素不平衡的影响。结果单变量和多变量分析显示，年龄、婚姻状况、T分期、N分期、分化分级、激素受体（HR）状态、人表皮生长因子受体2 （HER2）状态和化疗是手术组pCR的显著预测因子（p < 0.05）。在训练集、内部验证集和外部验证集，预测pCR的受试者工作特征曲线下面积（AUC）分别为0.756 （95% CI: 0.736-0.776）、0.717 （95% CI: 0.681-0.754）和0.744 （95% CI: 0.687-0.800）。非手术患者分为高（> 375）、中（< 375）、低（< 162.5） nomogram评分组，5年OS率分别为70.7%、49.2%、29.2% （p < 0.05）。PSM后纳入358对患者，比较手术组与非手术组的5年OS，结果显示手术组与非手术组按高、中、低评分分组患者的5年OS分别为85.4% vs. 72.8%、78.3% vs. 59.8%、79.3% vs. 20.0%（均p <； 0.05）。结论我们成功地建立了BC患者的pCR图。基于该预测模型，得分较高的患者可能代表非手术治疗方法的潜在候选人，值得在未来的研究中进一步研究。

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引用次数: 0

Cervical Adenocarcinoma: What's Special About the Long-Term Reproductive and Oncological Outcomes of Fertility-Sparing Radical Trachelectomy in It? 宫颈腺癌：保留生育能力的根治性气管切除术的长期生殖和肿瘤预后有何特殊之处？

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-08 DOI: 10.1002/cam4.71366

Jingwen Gan, Dongyan Cao, Huimei Zhou, Mei Yu, Tao Wang, Ying Zhang, Ninghai Cheng, Peng Peng, Jiaxin Yang, Huifang Huang, Keng Shen

Objective

To present reproductive and oncological outcomes of radical trachelectomy (RT) in patients with cervical adenocarcinomas (AC).

Methods

This retrospective study included 51 patients with cervical AC who underwent RT at Peking Union Medical Hospital from January 1, 2005 to June 1, 2023.

Results

Five patients (9.8%) experienced cervical stenosis following RT, which likely occurred in cases of abdominal RT (50%) and virginal prophylactic cerclage (33.33%) and those without copper T intrauterine devices during RT (20%). In total, 30 patients (58.82%) attempted to conceive, and 11 (36.67%) succeeded. Five patients (45.45%) achieved pregnancy with fertility assistance. The mean surgery–pregnancy interval was 27 months (range, 17–118). Two preterm and two full-term births were achieved. With a median follow-up of 50 months (range, 7–238), seven patients (13.73%) experienced recurrence and three (5.88%) died. Six of seven patients relapsed beyond the residual cervix. The cancer recurrence rate (CRR) was 5.88% for patients with pre-cervical conization and 17.65% for those with biopsy (p = 0.250); 11.63% had human papillomavirus-associated (HPVA) disease and 25% had non-HPVA (NHPVA) (p = 0.313). The cancer death rate (CDR) was 4.65% with HPVA and 12.50% with NHPVA (p = 0.386); 13.63% had the endogenous type and 0 had the exogenous type (p = 0.04). Chemotherapy in patients with risk factors resulted in better CRR and CDR than in those without (5.88% vs. 17.65%, 0% vs. 8.82%). The cumulative 5-year recurrence-free survival (RFS) and overall survival rates were 82.03% and 94.39%, respectively.

Conclusion

RT in patients with AC led to an acceptable pregnancy rate but a higher CRR and lower 5-year RFS. Careful patient selection for RT, combined with adjuvant chemotherapy when indicated, is crucial to optimize the balance between reproductive and oncological outcomes in AC.

目的探讨宫颈腺癌根治性气管切除术（RT）的生殖及肿瘤预后。方法回顾性分析2005年1月1日至2023年6月1日在北京协和医院行放射治疗的51例宫颈AC患者。结果5例（9.8%）患者在放疗后出现颈椎狭窄，主要发生在腹部放疗（50%）、单纯预防性环扎（33.33%）和放疗时未使用铜T宫内节育器的患者（20%）。共30例（58.82%）尝试妊娠，11例（36.67%）成功。5例患者（45.45%）在辅助生育下成功妊娠。平均手术-妊娠间隔为27个月（范围17-118）。2例早产和2例足月分娩。中位随访50个月（范围7-238），7例（13.73%）复发，3例（5.88%）死亡。7个病人中有6个在残余子宫颈以外复发。宫颈前锥切患者的肿瘤复发率（CRR）为5.88%，活检患者的肿瘤复发率（CRR）为17.65% (p = 0.250)；11.63%患有人乳头瘤病毒相关疾病（HPVA）， 25%患有非HPVA (NHPVA) （p = 0.313）。HPVA组肿瘤死亡率（CDR）为4.65%，NHPVA组为12.50% (p = 0.386)；内源型为13.63%，外源型为0 （p = 0.04）。有危险因素患者化疗后的CRR和CDR均优于无危险因素患者（5.88% vs. 17.65%, 0% vs. 8.82%）。累计5年无复发生存率（RFS）和总生存率分别为82.03%和94.39%。结论AC患者接受RT治疗妊娠率可接受，但CRR较高，5年RFS较低。仔细选择患者进行放疗，并在需要时结合辅助化疗，对于优化生殖和肿瘤预后之间的平衡至关重要。

{"title":"Cervical Adenocarcinoma: What's Special About the Long-Term Reproductive and Oncological Outcomes of Fertility-Sparing Radical Trachelectomy in It?","authors":"Jingwen Gan, Dongyan Cao, Huimei Zhou, Mei Yu, Tao Wang, Ying Zhang, Ninghai Cheng, Peng Peng, Jiaxin Yang, Huifang Huang, Keng Shen","doi":"10.1002/cam4.71366","DOIUrl":"https://doi.org/10.1002/cam4.71366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To present reproductive and oncological outcomes of radical trachelectomy (RT) in patients with cervical adenocarcinomas (AC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 51 patients with cervical AC who underwent RT at Peking Union Medical Hospital from January 1, 2005 to June 1, 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients (9.8%) experienced cervical stenosis following RT, which likely occurred in cases of abdominal RT (50%) and virginal prophylactic cerclage (33.33%) and those without copper T intrauterine devices during RT (20%). In total, 30 patients (58.82%) attempted to conceive, and 11 (36.67%) succeeded. Five patients (45.45%) achieved pregnancy with fertility assistance. The mean surgery–pregnancy interval was 27 months (range, 17–118). Two preterm and two full-term births were achieved. With a median follow-up of 50 months (range, 7–238), seven patients (13.73%) experienced recurrence and three (5.88%) died. Six of seven patients relapsed beyond the residual cervix. The cancer recurrence rate (CRR) was 5.88% for patients with pre-cervical conization and 17.65% for those with biopsy (<i>p</i> = 0.250); 11.63% had human papillomavirus-associated (HPVA) disease and 25% had non-HPVA (NHPVA) (<i>p</i> = 0.313). The cancer death rate (CDR) was 4.65% with HPVA and 12.50% with NHPVA (<i>p</i> = 0.386); 13.63% had the endogenous type and 0 had the exogenous type (<i>p</i> = 0.04). Chemotherapy in patients with risk factors resulted in better CRR and CDR than in those without (5.88% vs. 17.65%, 0% vs. 8.82%). The cumulative 5-year recurrence-free survival (RFS) and overall survival rates were 82.03% and 94.39%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RT in patients with AC led to an acceptable pregnancy rate but a higher CRR and lower 5-year RFS. Careful patient selection for RT, combined with adjuvant chemotherapy when indicated, is crucial to optimize the balance between reproductive and oncological outcomes in AC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 21","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469820","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}

引用次数: 0

A Real-World Pharmacovigilance Study of Fruquintinib Based on the FDA Adverse Event Reporting System (FAERS) Database 基于FDA不良事件报告系统（FAERS）数据库的fruquininib药物警戒研究

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-07 DOI: 10.1002/cam4.71352

Yajing Xu, Dongchen Wang, Yuyan Xu

Background

Fruquintinib is a highly selective small-molecule inhibitor that targets vascular endothelial growth factor receptors and is approved for the treatment of metastatic colorectal cancer. Given its increasing clinical adoption, a comprehensive pharmacovigilance evaluation of the adverse events (AEs) is warranted.

Methods

We conducted an analysis of fruquintinib-related AEs by mining the FDA Adverse Event Reporting System (FAERS) database, covering the period from the fourth quarter of 2023 to the first quarter of 2025. The regulatory characterization of the AEs was based on the system organ class (SOC) and preferred term (PT) of the Medical Dictionary for Regulatory Activities (MedDRA). We employed four disproportionality analysis methods, including the reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma Poisson shrinker (MGPS), and Bayesian confidence propagation neural network (BCPNN). Furthermore, Weibull distribution modeling was employed to characterize the temporal risk patterns of adverse reactions.

Results

Among 1632 reports in which fruquintinib was flagged as the primary suspect drug, 78 PTs met the criteria of all four algorithms. In addition to known AEs listed on the drug label, the analysis also identified previously unrecognized AEs, encompassing large intestinal obstruction, dehydration, peripheral neuropathy, renal-limited thrombotic microangiopathy, and posterior reversible encephalopathy syndrome. The median onset time of fruquintinib-associated AEs was 18 days, with 66.16% of cases occurring within the first month of treatment.

Conclusion

This pharmacovigilance study aligned with established clinical observations. Additionally, novel AEs associated with fruquintinib therapy were detected, offering valuable evidence to enhance clinical surveillance strategies and risk assessment protocols.

背景：fruquininib是一种靶向血管内皮生长因子受体的高选择性小分子抑制剂，已被批准用于治疗转移性结直肠癌。鉴于其越来越多的临床应用，有必要对不良事件（ae）进行全面的药物警戒评估。方法：通过挖掘FDA不良事件报告系统（FAERS）数据库，对2023年第四季度至2025年第一季度的fruquintinib相关ae进行分析。ae的调节特征是基于系统器官类别（SOC）和调节活动医学词典（MedDRA）的首选术语（PT）。我们采用了四种歧化分析方法，包括报告优势比（ROR）、比例报告比（PRR）、多条目伽玛泊松收缩器（MGPS）和贝叶斯置信传播神经网络（BCPNN）。此外，采用威布尔分布模型表征不良反应的时间风险模式。结果：在1632例fruquininib被标记为主要可疑药物的报告中，78例PTs符合所有四种算法的标准。除了药物标签上列出的已知不良事件外，该分析还确定了以前未被识别的不良事件，包括大肠阻塞、脱水、周围神经病变、肾限制性血栓性微血管病和后可逆脑病综合征。氟喹替尼相关ae的中位发病时间为18天，66.16%的病例发生在治疗的第一个月内。结论：该药物警戒研究与已建立的临床观察结果一致。此外，还发现了与fruquininib治疗相关的新型不良事件，为加强临床监测策略和风险评估方案提供了有价值的证据。

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引用次数: 0

Recent Advancements in Known and Emerging Risk Factors of Hepatocellular Carcinoma 肝细胞癌已知和新兴危险因素的最新进展。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2025-11-07 DOI: 10.1002/cam4.71330

Muhammad Masroor Hussain, Bi Feng, Ju-Mei Wang, Ao-Qiang Zhai, Fu-yu Li, Hai-jie Hu

Background

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and a leading cause of cancer-related deaths worldwide. Despite advancements in antiviral therapies for hepatitis B (HBV) and hepatitis C (HCV), HCC incidence continues to rise due to metabolic dysfunction-associated steatotic liver disease (MASLD), obesity, type 2 diabetes mellitus (T2DM), and emerging environmental and genetic risk factors. Understanding the evolving landscape of HCC pathogenesis is crucial for improved prevention and treatment strategies.

Objective

This review consolidates recent insights into established and emerging HCC risk factors, highlighting epidemiological trends, molecular mechanisms, and global disparities. It also explores novel therapeutic and preventive strategies aimed at reducing HCC burden and improving patient outcomes.

Methods

A systematic literature review was conducted, incorporating epidemiological studies, molecular research, and clinical trials on HCC risk factors. The interplay between viral hepatitis, metabolic syndrome, environmental toxins, and gut-liver axis dysregulation was analyzed to provide a comprehensive understanding of HCC development.

Results

While HBV and HCV remain significant drivers of HCC, metabolic risk factors—including MASLD, obesity, insulin resistance, and T2DM—are increasingly prevalent, particularly in Western populations. Environmental exposures such as aflatoxins, alcohol, smoking, and air pollution further exacerbate disease progression. Gut microbiota dysbiosis has also emerged as a key modulator of hepatic carcinogenesis. Advances in precision medicine, including tyrosine kinase inhibitors (sorafenib, lenvatinib), immune checkpoint inhibitors (nivolumab, pembrolizumab), and gut microbiota-targeted therapies, are transforming HCC management. Early detection is improving through biomarker-driven surveillance and AI-enhanced imaging techniques.

Conclusion

The shifting epidemiology of HCC necessitates a multidisciplinary approach to prevention, early detection, and treatment. Integrating genomic profiling, biomarker-based risk stratification, and equitable healthcare access will be critical to reducing the global burden of HCC.

背景：肝细胞癌（HCC）是最常见的原发性肝脏恶性肿瘤，也是全球癌症相关死亡的主要原因。尽管乙型肝炎（HBV）和丙型肝炎（HCV）的抗病毒治疗取得了进展，但由于代谢功能障碍相关的脂肪变性肝病（MASLD）、肥胖、2型糖尿病（T2DM）以及新出现的环境和遗传风险因素，HCC发病率继续上升。了解HCC发病机制的演变对改善预防和治疗策略至关重要。目的：本综述整合了最近对已确定和新出现的HCC危险因素的见解，强调了流行病学趋势、分子机制和全球差异。它还探讨了旨在减轻HCC负担和改善患者预后的新的治疗和预防策略。方法：进行系统的文献综述，结合流行病学研究、分子研究和HCC危险因素的临床试验。分析了病毒性肝炎、代谢综合征、环境毒素和肠肝轴失调之间的相互作用，以提供对HCC发展的全面了解。结果：虽然HBV和HCV仍然是HCC的重要驱动因素，但代谢危险因素——包括MASLD、肥胖、胰岛素抵抗和t2dm——越来越普遍，特别是在西方人群中。黄曲霉毒素、酒精、吸烟和空气污染等环境暴露会进一步加剧疾病进展。肠道菌群失调也是肝癌发生的关键调节因素。精准医学的进步，包括酪氨酸激酶抑制剂（索拉非尼、lenvatinib）、免疫检查点抑制剂（nivolumab、pembrolizumab）和肠道微生物靶向治疗，正在改变HCC的管理。通过生物标志物驱动的监测和人工智能增强的成像技术，早期检测正在得到改善。结论：HCC的流行病学变化需要多学科的预防、早期发现和治疗。整合基因组分析、基于生物标志物的风险分层和公平的医疗保健可及性对于减轻全球HCC负担至关重要。

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