Cancer Medicine最新文献

Objective

Utilizing data from the National Health Insurance Sharing Service database, this study explored significant risk factors for pancreatic cancer in a cohort of 1,120,377 South Korean individuals over a 10-year period (2009–2019).

Methods

Propensity score matching was employed to ensure comparability between 3535 pancreatic cancer patients and a control group with a common cold diagnosis. The study analyzed various lifestyle factors and biochemical markers, including smoking status, alcohol consumption, fasting blood glucose (FBS) levels, liver enzyme levels, and Charlson comorbidity index (CCI) scores.

Results

The findings revealed that current smoking, frequent alcohol consumption, and elevated levels of FBS and liver enzymes were associated with an increased risk of pancreatic cancer. Conversely, engaging in high-intensity exercise (≥ 20 min, twice weekly) was correlated with a 20% reduction in pancreatic cancer risk (p < 0.05). Additionally, optimal thresholds for total cholesterol (179.50 mg/dL), GGT (29.50 U/L), low-density lipoprotein cholesterol (104.50 mg/dL), and CCI score (2.50) were identified, which may facilitate early diagnosis and intervention.

Conclusions

These findings underscore the importance of modifiable lifestyle factors in managing pancreatic cancer risk and highlight the potential of personalized, evidence-based interventions—such as high-intensity exercise programs—in improving prevention and treatment outcomes.

Background

Cervical cancer remains a major global health threat for women, primarily driven by human papillomavirus (HPV) infection. While HPV vaccination serves as the cornerstone of prevention, disparities in vaccine accessibility persist across low-income countries. Secondary prevention through screening faces challenges in public engagement, often leading to late-stage diagnoses. Recent advancements in novel anti-HPV drugs offer expanded opportunities for cervical cancer management.

Aim

This review examines emerging anti-HPV therapeutics to provide insights into innovative strategies for cervical cancer prevention and treatment.

Methods

We conducted a systematic analysis of published studies investigating anti-HPV agents, focusing on their molecular mechanisms and clinical efficacy in cervical cancer prevention.

Results & Conclusions

Multiple promising anti-HPV agents have been identified, including 3-hydroxyphthalic anhydride-modified bovine β-lactoglobulin (3HP-β-LG), carrageenan, defensins, and 25-hydroxycholesterol (25HC). These compounds exert antiviral effects through distinct mechanisms: 3HP-β-LG competitively inhibits viral attachment, carrageenan blocks HPV entry via heparan sulfate mimicry, defensins inhibit the dissociation of viral capsid, and 25HC activates cholesterol-mediated antiviral pathways. They have demonstrated strong inhibitory effects on HPV infection, making them novel therapeutic candidates for the prevention and treatment of cervical cancer.

Background

Osimertinib is the standard therapy for patients with chemotherapy-naive advanced non-small-cell lung cancer (NSCLC) harbouring sensitising epidermal growth factor receptor (EGFR) mutations. However, some patients treated with osimertinib experience progressive disease (PD). Therefore, this study aimed to explore mechanisms underlying osimertinib resistance, focusing on early PD (within 6 months).

Methods

This multicentre prospective observational study enrolled patients with advanced NSCLC receiving osimertinib as the first-line anti-cancer therapy. Mutations in cancer-associated genes were analysed using next-generation sequencing of circulating tumour DNA samples collected before osimertinib treatment and on detection of PD.

Findings

Between May 2019 and January 2021, 188 patients were enrolled, of whom 125 (66%) were women and 96 (51%) had EGFR exon 19 deletion mutations. In this interim analysis, 78 patients experienced PD and 36 experienced early PD. Compared with patients without early PD, those with early PD were more likely to test positive for EGFR-activating mutations at baseline (86.1% vs. 63.4%, p = 0.009) and had significantly more co-occurring gene mutations in addition to EGFR mutations (2.89 ± 1.49 vs. 1.97 ± 1.37, p = 0.002). In three patients with early PD, one patient each had a germline BRCA1, BRCA2 and BRINP3 mutation.

Conclusion

EGFR mutations in ctDNA and multiple co-occurring gene mutations at baseline are associated with poor outcomes and early PD. Plasma-based serial comprehensive gene profiling could help predict and identify patients who are unlikely to benefit from osimertinib treatment.

Trial Registration: Japanese Register of Clinical Trials JRCT: registration number: jRCTs031180051

Background

High neighborhood deprivation is linked to increased cancer and overall mortality. Prior studies demonstrated higher inflammation in people from high deprivation areas. The area deprivation index (ADI) is a composite measure of income, education, employment, and housing, which quantifies neighborhood deprivation. We used the All of Us dataset to test whether inflammation, measured via c-reactive protein (CRP), albumin, and the neutrophil-to-lymphocyte ratio (NLR), differs by ADI in cancer survivors.

Methods

Our sample included individuals with a history of lung, breast, prostate, and colorectal cancer, filtered for the presence of the inflammatory biomarkers. We used quartiles of ADI based on 3-digit zip code and biomarkers from electronic health records. We estimated the association between ADI and inflammation using adjusted logistic regression (n = 690 for CRP; n = 4242 for albumin; n = 5183 for NLR).

Results

The sample had a mean age of 66.2 ± 10.1 years, 63.0% were female, and 86.8% were White. Mean CRP (11.5 ± 17.5 mg/L) and NLR (3.6 ± 2.2) indicated moderate to high inflammation. In the fully adjusted model, there were 2.04 (95% CI:1.02, 4.11) and 2.17 higher odds (95% CI:1.16, 4.13) of elevated CRP when comparing quartile 4 and quartile 3, respectively, to the lowest ADI quartile. Regression models were not significant for albumin or NLR.

Conclusion

Area deprivation is associated with CRP, a marker of stress that may lead to a higher risk of chronic diseases among cancer survivors. Future studies using a sample of cancer survivors with a wider range of ADI may help to strengthen this association.

Background

Currently, there are no clinically predictive models that can prognosticate the response of rectal cancers to Contact X-ray brachytherapy (CXB). This review aims to critically evaluate existing models that have attempted to predict the response of rectal cancer to external beam radiotherapy, with the objective of laying the foundation for the development of a CXB-specific prediction model.

Methods

A random-effects meta-analysis was employed to calculate pooled estimates of the discriminative ability of published models. Using the Prediction Model Risk Of Bias Assessment Tool (PROBAST), each model was evaluated for its risk of bias and applicability. Additionally, the frequency of commonly utilised predictive factors was documented.

Results

Twelve papers discussed fifteen models based on pre-treatment factors. Models predicting response based on the Tumour regression grade (TRG) classified responders as patients who achieved a complete response or near complete response and achieved a pooled AUC of 0.82 (95% CI 0.74–0.89). Models that predicted pathologic complete response (pCR) had a pooled AUC of 0.76 (95% CI 0.71–0.82). The most utilised predictive parameters were age, tumour grade and T stage. However, these models were prone to significant risk of bias and had limited applicability to the general population.

Conclusions

Although the existing models were statistically robust, they lacked broad applicability. This was primarily due to a lack of external validation, which limits their clinical utility. A future CXB-specific model should prioritise dedicated data collection based on pre-calculated sample size and include the predictive factors identified in this review.

Background

Digestive system malignancies are a major global health burden, and the role of fatty acid binding protein 5 (FABP5) in these tumors remains controversial.

Aims

This meta-analysis aimed to evaluate the correlation between FABP5 expression and clinicopathological features, as well as survival outcomes in digestive system malignancies.

Materials and Methods

Data from 11 studies (1207 patients) retrieved from PubMed, Embase, Cochrane Library, CNKI, and WanFang were analyzed.

Results

FABP5 overexpression was associated with poorer overall survival (OS), larger tumor size, advanced UICC stage, and increased risk of vascular invasion and lymph node metastasis. Notably, FABP5 overexpression is particularly associated with poorer OS in the subgroup of digestive tract malignancies and larger tumor sizes in the subgroup of Chinese patients.

Discussion

Cellular experiments demonstrated that FABP5 overexpression enhances proliferation, migration, and invasion in hepatocellular carcinoma (Huh7) and gastric cancer (HGC-27) cell lines, while FABP5 knockdown reduces these effects. Mechanistically, FABP5 may drive tumor progression through PPARβ/δ signaling, epithelial-mesenchymal transition induction, angiogenesis regulation, and potential effects on fatty acid metabolism and hypoxia-related pathways.

Conclusion

FABP5 overexpression correlates with adverse clinicopathological features and prognosis in digestive system malignancies, suggesting its potential as a biomarker for these tumors. Further research is warranted.

Background

The microsatellite status (dMMR vs. pMMR) in colorectal cancer can serve as a guiding factor for patient prognosis and treatment, where dMMR status indicates a better prognosis and often obviates the need for adjuvant chemotherapy (ACT). Conversely, a higher lymph node ratio (LNR) is associated with a poorer prognosis. This study aims to elucidate the prognostic significance of LNR and MMR status in relation to ACT in stages II and III colorectal cancer.

Methods

A total of 1946 patients who underwent radical resection for colorectal cancer and were pathologically staged as II and III from three medical centers between 2012 and 2019 were selected. Among them, 1104 patients were included after MMR status was tested and postoperative chemotherapy was administered, along with other clinical information. MMR (mismatch repair) status was determined via pathological immunohistochemistry (IHC), and LNR was calculated. Patients were divided into three groups based on the LNR value and subjected to Kaplan–Meier and Cox regression analysis to assess the impact of MMR, LNR, and ACT on overall survival (OS) and disease-free survival (DFS).

Results

A total of 6.47% of stage II and III colorectal cancers were detected as dMMR. Significant differences in OS and DFS between dMMR and pMMR patients were observed when the LNR ranged from 0.03 to 0.31, with pMMR patients showing a better prognosis. Stratified analysis with ACT revealed that postoperative chemotherapy did not affect the prognosis within the dMMR patient group. However, compared to the pMMR group, dMMR patients experienced significantly adverse effects on prognosis after receiving postoperative chemotherapy (p < 0.05). This result was more pronounced in the stratified analysis based on LNR (0.03–0.31) (p < 0.01).

Conclusions

Integrating LNR based on the microsatellite status of colorectal tumors provides comprehensive prognostic predictions, enhancing postoperative prognostic considerations for tumor patients. Additionally, our study suggests that patients with stage II and III colorectal cancer with dMMR status do not require any adjuvant chemotherapy postoperatively.