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The potential of hydrogel-free tumoroids in head and neck squamous cell carcinoma 头颈部鳞状细胞癌中无水凝胶肿瘤的潜力。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-22 DOI: 10.1002/cam4.70129
Michael Wong, Sarju Vasani, Omar Breik, Xi Zhang, Lizbeth Kenny, Chamindie Punyadeera

Background

Head and neck malignancy, and in particular squamous cell carcinoma (SCC), is responsible for a significant disease burden globally. The lack of an optimal in vitro model system to accurately recapitulate in vivo response to therapy in HNSCC remains a challenge. The development of patient-derived three-dimensional tumour cultures, or tumoroids, has enabled improved modelling of the tumour microenvironment through simulation of important characteristics such as tumour hypoxia, cell–cell interactions and nutrient diffusion characteristics.

Methods

We performed a comprehensive English-language literature review of current methods of tumoroid development utilising Matrigel and Cultrex Basement Membrane Extract 2 (key terms: tumour organoids, tumoroids, hydrogels, Matrigel, Cultrex, squamous cell carcinoma, head and neck)—two common proprietary murine-derived hydrogels containing extracellular matrix proteins. Nascent literature on the establishment of a novel hydrogel-free platform for tumoroid development as distinct from these existing methods was also explored.

Results

Whilst useful for facilitating cell-matrix interactions and providing a scaffold for three-dimensional cell growth and organisation, murine-derived cell matrix methods were noted to have notable limitations including temperature sensitivity and the medium forming a barrier to analysis of the supernatant. A novel hydrogel-free method of establishing in vitro tumoroid cultures has been subject to experimentation in colorectal but not head and neck malignancy. The absence of a hydrogel provides for the de novo synthesis of extracellular matrix native to the tumour and self-organisation of cells within this scaffold through the use of ultralow attachment plates. This model demonstrates similar structural and physiological properties to native tissue, whilst enabling more accurate biomimicry of the tumour microenvironment for drug testing.

Conclusions

In the absence of prior experimentation on a hydrogel-free method for establishing HNSCC tumoroids, and comparisons between hydrogel and hydrogel-free models, the future development of a comparative protocol encompassing recruitment, collection, processing and analysis represents a valuable opportunity.

背景:头颈部恶性肿瘤,尤其是鳞状细胞癌(SCC),在全球造成了巨大的疾病负担。缺乏一个最佳的体外模型系统来准确再现 HNSCC 的体内治疗反应仍然是一个挑战。通过模拟肿瘤缺氧、细胞间相互作用和营养物质扩散特性等重要特征,患者来源的三维肿瘤培养物(或称瘤体)的开发改善了肿瘤微环境的建模:我们对目前利用 Matrigel 和 Cultrex 基底膜提取物 2(关键术语:肿瘤器官组织、肿瘤组织、水凝胶、Matrigel、Cultrex、鳞状细胞癌、头颈部)--两种常见的含有细胞外基质蛋白的鼠源性专有水凝胶--进行肿瘤组织培育的方法进行了全面的英文文献综述。此外,还探讨了关于建立有别于这些现有方法的新型无水凝胶类瘤体发育平台的最新文献:结果:鼠源细胞基质方法虽然有助于促进细胞与基质之间的相互作用,并为三维细胞生长和组织提供支架,但也存在明显的局限性,包括温度敏感性和培养基对上清液分析形成障碍。一种建立体外类肿瘤培养的新型无水凝胶方法已在结直肠恶性肿瘤而非头颈部恶性肿瘤中进行了实验。由于没有水凝胶,因此可以从头合成肿瘤原生的细胞外基质,并通过使用超低附着板使细胞在支架内自组织。该模型具有与原生组织相似的结构和生理特性,同时还能更准确地模拟肿瘤微环境进行药物测试:结论:由于之前没有对建立 HNSCC 肿瘤细胞的无水凝胶方法进行实验,也没有对水凝胶模型和无水凝胶模型进行比较,因此未来制定包括招募、收集、处理和分析在内的比较方案是一个宝贵的机会。
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引用次数: 0
A prediction model based on deep learning and radiomics features of DWI for the assessment of microsatellite instability in endometrial cancer 基于深度学习和 DWI 放射组学特征的预测模型,用于评估子宫内膜癌的微卫星不稳定性。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-22 DOI: 10.1002/cam4.70046
Jing Wang, Pujiao Song, Meng Zhang, Wei Liu, Xi Zeng, Nanshan Chen, Yuxia Li, Minghua Wang

Background

To explore the efficacy of a prediction model based on diffusion-weighted imaging (DWI) features extracted from deep learning (DL) and radiomics combined with clinical parameters and apparent diffusion coefficient (ADC) values to identify microsatellite instability (MSI) in endometrial cancer (EC).

Methods

This study included a cohort of 116 patients with EC, who were subsequently divided into training (n = 81) and test (n = 35) sets. From DWI, conventional radiomics features and convolutional neural network-based DL features were extracted. Random forest (RF) and logistic regression were adopted as classifiers. DL features, radiomics features, clinical variables, ADC values, and their combinations were applied to establish DL, radiomics, clinical, ADC, and combined models, respectively. The predictive performance was evaluated through the area under the receiver operating characteristic curve (AUC), total integrated discrimination index (IDI), net reclassification index (NRI), calibration curves, and decision curve analysis (DCA).

Results

The optimal predictive model, based on an RF classifier, comprised four DL features, three radiomics features, two clinical variables, and an ADC value. In the training and test sets, this model exhibited AUC values of 0.989 (95% CI: 0.935–1.000) and 0.885 (95% CI: 0.731–0.967), respectively, demonstrating different degrees of improvement compared with the clinical, DL, radiomics, and ADC models (AUC-training = 0.671, 0.873, 0.833, and 0.814, AUC-test = 0.685, 0.783, 0.708, and 0.713, respectively). The NRI and IDI analyses revealed that the combined model resulted in improved risk reclassification of the MSI status compared to the clinical, radiomics, DL, and ADC models. The calibration curves and DCA indicated good consistency and clinical utility of this model, respectively.

Conclusions

The predictive model based on DWI features extracted from DL and radiomics combined with clinical parameters and ADC values could effectively assess the MSI status in EC.

研究背景目的:探讨基于从深度学习(DL)和放射组学中提取的弥散加权成像(DWI)特征,结合临床参数和表观弥散系数(ADC)值的预测模型在识别子宫内膜癌(EC)微卫星不稳定性(MSI)方面的功效:这项研究包括116名子宫内膜癌患者,随后将他们分为训练组(81人)和测试组(35人)。从 DWI 中提取传统放射组学特征和基于卷积神经网络的 DL 特征。采用随机森林(RF)和逻辑回归作为分类器。应用 DL 特征、放射组学特征、临床变量、ADC 值及其组合分别建立了 DL、放射组学、临床、ADC 和组合模型。通过接收者操作特征曲线下面积(AUC)、总综合判别指数(IDI)、净再分类指数(NRI)、校准曲线和决策曲线分析(DCA)对预测性能进行评估:基于 RF 分类器的最佳预测模型由四个 DL 特征、三个放射组学特征、两个临床变量和一个 ADC 值组成。在训练集和测试集中,该模型的AUC值分别为0.989(95% CI:0.935-1.000)和0.885(95% CI:0.731-0.967),与临床、DL、放射组学和ADC模型相比有不同程度的提高(AUC-训练=0.671、0.873、0.833和0.814,AUC-测试=0.685、0.783、0.708和0.713)。NRI和IDI分析表明,与临床、放射组学、DL和ADC模型相比,联合模型提高了MSI状态的风险再分类能力。校准曲线和 DCA 分别表明该模型具有良好的一致性和临床实用性:基于从DL和放射组学提取的DWI特征的预测模型与临床参数和ADC值相结合,可有效评估EC的MSI状态。
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引用次数: 0
Efficacy and safety of PD-1 monoclonal antibody combined with interferon-alpha 1b and anlotinib hydrochloride as the second-line therapy in patients with unresectable advanced melanoma: A retrospective study PD-1单克隆抗体联合α-1b干扰素和盐酸安罗替尼作为不可切除的晚期黑色素瘤患者二线疗法的疗效和安全性:一项回顾性研究
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-21 DOI: 10.1002/cam4.70087
Bolun Zhao, Mengyu Zhang, Jingyi Tang, Daopei Zou, Fang Liu, Qiong Shi, Tianwen Gao, Chunying Li, Guannan Zhu

Background

Immune-checkpoint inhibitors are now used more commonly in combination than monotherapy as the first-line choice in patients with unresectable advanced melanoma. Nevertheless, for cases that progressed after the initial combination therapy, the subsequent regimen option can be very difficult. Herein, we reported the efficacy and safety of a triple combination regimen in Chinese unresectable advanced melanoma patients who had poor responses to the first-line immune therapy.

Methods

We reviewed the clinical profiles of patients diagnosed with stage IIIC-IV melanoma between June 1, 2020, and September 30, 2023. The patients who failed the prior immune therapies and received anti-PD-1 mono antibody plus interferon(IFN)-alpha 1b and anlotinib hydrochloride as the second-line therapy were enrolled in the retrospective analysis. Additionally, we examined the exhaustion of T-cells using mIHC staining in available tumor samples.

Results

Fifty-five patients were included in this study. The median follow-up period was 13.6 months. The objective response rate evaluated by the investigators was 9.1%(1CR, 4PR). The disease control rate was 47.3%. The median overall survival was 17.6 months, and the median progression-free survival was 2.8 months. The adverse events rate of any grade was 100%. Grade 3 or 4 irAEs were observed in 29.1% of cases. Multiplex immunohistochemical staining revealed an increased trend of TIM3 expression on tumor-infiltrating T cells in patients without objective response.

Conclusion

PD-1 monoclonal antibody plus interferon-alpha 1b plus anlotinib showed acceptable tolerability and anticancer benefits in Chinese metastatic melanoma patients as a second-line therapy.

背景 目前,免疫检查点抑制剂作为不可切除的晚期黑色素瘤患者的一线选择,其联合疗法比单药疗法更为常用。然而,对于首次联合治疗后出现进展的病例,后续治疗方案的选择可能非常困难。在此,我们报告了三联疗法在中国不可切除的晚期黑色素瘤患者中的疗效和安全性,这些患者对一线免疫疗法反应不佳。 方法 我们回顾了 2020 年 6 月 1 日至 2023 年 9 月 30 日期间确诊的 IIIC-IV 期黑色素瘤患者的临床资料。回顾性分析中纳入了既往免疫疗法失败并接受抗PD-1单抗加干扰素(IFN)-α 1b和盐酸安罗替尼作为二线疗法的患者。此外,我们还使用 mIHC 染色法检测了现有肿瘤样本中 T 细胞的耗竭情况。 结果 本研究共纳入 55 例患者。中位随访时间为 13.6 个月。研究人员评估的客观反应率为 9.1%(1CR,4PR)。疾病控制率为 47.3%。中位总生存期为17.6个月,中位无进展生存期为2.8个月。任何级别的不良事件发生率均为100%。29.1%的病例出现了3级或4级虹膜不良反应。多重免疫组化染色显示,在无客观反应的患者中,肿瘤浸润T细胞上的TIM3表达呈上升趋势。 结论 PD-1单克隆抗体联合α-干扰素1b联合安罗替尼作为二线疗法,在中国转移性黑色素瘤患者中显示出可接受的耐受性和抗癌疗效。
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引用次数: 0
Predicting tumor mutation burden and VHL mutation from renal cancer pathology slides with self-supervised deep learning 用自我监督深度学习预测肾癌病理切片中的肿瘤突变负荷和VHL突变
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-21 DOI: 10.1002/cam4.70112
Qingyuan Zheng, Xinyu Wang, Rui Yang, Junjie Fan, Jingping Yuan, Xiuheng Liu, Lei Wang, Zhuoni Xiao, Zhiyuan Chen

Background

Tumor mutation burden (TMB) and VHL mutation play a crucial role in the management of patients with clear cell renal cell carcinoma (ccRCC), such as guiding adjuvant chemotherapy and improving clinical outcomes. However, the time-consuming and expensive high-throughput sequencing methods severely limit their clinical applicability. Predicting intratumoral heterogeneity poses significant challenges in biology and clinical settings. Our aimed to develop a self-supervised attention-based multiple instance learning (SSL-ABMIL) model to predict TMB and VHL mutation status from hematoxylin and eosin-stained histopathological images.

Methods

We obtained whole slide images (WSIs) and somatic mutation data of 350 ccRCC patients from The Cancer Genome Atlas for developing SSL-ABMIL model. In parallel, 163 ccRCC patients from Clinical Proteomic Tumor Analysis Consortium cohort was used as independent external validation set. We systematically compared three different models (Wang-ABMIL, Ciga-ABMIL, and ImageNet-MIL) for their ability to predict TMB and VHL alterations.

Results

We first identified two groups of populations with high- and low-TMB (cut-off point = 0.9). In two independent cohorts, the Wang-ABMIL model achieved the highest performance with decent generalization performance (AUROC = 0.83 ± 0.02 and 0.8 ± 0.04 in predicting TMB and VHL, respectively). Attention heatmaps revealed that the Wang-ABMIL model paid the highest attention to tumor regions in high-TMB patients, while in VHL mutation prediction, non-tumor regions were also assigned high attention, particularly the stromal regions infiltrated by lymphocytes.

Conclusions

Our results indicated that SSL-ABMIL can effectively extract histological features for predicting TMB and VHL mutation, demonstrating promising results in linking tumor morphology and molecular biology.

背景 肿瘤突变负荷(TMB)和VHL突变在透明细胞肾细胞癌(ccRCC)患者的治疗中起着至关重要的作用,如指导辅助化疗和改善临床预后。然而,耗时且昂贵的高通量测序方法严重限制了其临床适用性。在生物学和临床环境中,预测肿瘤内异质性是一项重大挑战。我们旨在开发一种基于注意力的自监督多实例学习(SSL-ABMIL)模型,从苏木精和伊红染色的组织病理学图像中预测TMB和VHL突变状态。 方法 我们从《癌症基因组图谱》(The Cancer Genome Atlas)中获得了350名ccRCC患者的全切片图像(WSI)和体细胞突变数据,用于开发SSL-ABMIL模型。同时,临床肿瘤蛋白质组分析联盟队列中的 163 例 ccRCC 患者也被用作独立的外部验证集。我们系统地比较了三种不同模型(Wang-ABMIL、Ciga-ABMIL 和 ImageNet-MIL)预测 TMB 和 VHL 改变的能力。 结果 我们首先确定了高TMB和低TMB的两组人群(截断点 = 0.9)。在两个独立队列中,Wang-ABMIL 模型的性能最高,泛化性能也不错(预测 TMB 和 VHL 的 AUROC 分别为 0.83 ± 0.02 和 0.8 ± 0.04)。注意力热图显示,Wang-ABMIL 模型对高 TMB 患者的肿瘤区域关注度最高,而在 VHL 突变预测中,非肿瘤区域也受到高度关注,尤其是淋巴细胞浸润的基质区域。 结论 我们的研究结果表明,SSL-ABMIL 能有效提取组织学特征来预测 TMB 和 VHL 突变,在将肿瘤形态学与分子生物学联系起来方面取得了可喜的成果。
{"title":"Predicting tumor mutation burden and VHL mutation from renal cancer pathology slides with self-supervised deep learning","authors":"Qingyuan Zheng,&nbsp;Xinyu Wang,&nbsp;Rui Yang,&nbsp;Junjie Fan,&nbsp;Jingping Yuan,&nbsp;Xiuheng Liu,&nbsp;Lei Wang,&nbsp;Zhuoni Xiao,&nbsp;Zhiyuan Chen","doi":"10.1002/cam4.70112","DOIUrl":"https://doi.org/10.1002/cam4.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tumor mutation burden (TMB) and VHL mutation play a crucial role in the management of patients with clear cell renal cell carcinoma (ccRCC), such as guiding adjuvant chemotherapy and improving clinical outcomes. However, the time-consuming and expensive high-throughput sequencing methods severely limit their clinical applicability. Predicting intratumoral heterogeneity poses significant challenges in biology and clinical settings. Our aimed to develop a self-supervised attention-based multiple instance learning (SSL-ABMIL) model to predict TMB and VHL mutation status from hematoxylin and eosin-stained histopathological images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We obtained whole slide images (WSIs) and somatic mutation data of 350 ccRCC patients from The Cancer Genome Atlas for developing SSL-ABMIL model. In parallel, 163 ccRCC patients from Clinical Proteomic Tumor Analysis Consortium cohort was used as independent external validation set. We systematically compared three different models (Wang-ABMIL, Ciga-ABMIL, and ImageNet-MIL) for their ability to predict TMB and VHL alterations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We first identified two groups of populations with high- and low-TMB (cut-off point = 0.9). In two independent cohorts, the Wang-ABMIL model achieved the highest performance with decent generalization performance (AUROC = 0.83 ± 0.02 and 0.8 ± 0.04 in predicting TMB and VHL, respectively). Attention heatmaps revealed that the Wang-ABMIL model paid the highest attention to tumor regions in high-TMB patients, while in VHL mutation prediction, non-tumor regions were also assigned high attention, particularly the stromal regions infiltrated by lymphocytes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicated that SSL-ABMIL can effectively extract histological features for predicting TMB and VHL mutation, demonstrating promising results in linking tumor morphology and molecular biology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142013660","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
The efficacy of cognitive behavioral therapy for mental health and quality of life among individuals diagnosed with cancer: A systematic review and meta-analysis 认知行为疗法对确诊癌症患者的心理健康和生活质量的疗效:系统回顾与荟萃分析。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-21 DOI: 10.1002/cam4.70063
Alexander T. Dils, Kathryn O'Keefe, Nada Dakka, Michelle Azar, Meiyan Chen, Anao Zhang

Objective

It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta-analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy.

Methods

In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression (for moderator analysis).

Results

Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294–0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population.

Conclusions

CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention-related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer.

目的:长期以来,认知行为疗法(CBT)对改善普通人群的心理健康(MH)和生活质量(QoL)有着积极的影响,但对其对癌症幸存者影响的调查仍然有限,尤其是对 QoL 结果的调查。本荟萃分析旨在研究 CBT 与对照组相比对癌症患者心理健康和 QoL 结果的影响。本研究将对照组定义为标准疗法、候补对照组和积极/替代疗法:共收集了 154 项临床试验,样本量达 1627 人。以心理健康和 QoL 为重点的分析排除了 29 项临床试验,最终分析了 132 项临床试验(和 1030 个效应大小)。利用 R 统计软件(4.2.2 版)和 robumeta 软件包完成分析,其中包括仅截距元回归的稳健方差估计(RVE)和单变量元回归(用于调节因子分析):在 132 项临床试验和 1030 个效应大小估计中,我们发现 CBT 可适度改善癌症患者的心理健康和 QoL d = 0.388,95% CI 0.294-0.483,p 结论:CBT 在统计学上可改善癌症患者的心理健康和 QoL:据统计,CBT 可改善癌症患者的心理健康和 QoL 心理社会参数,对年轻患者的疗效更好。当肿瘤学家考虑将 CBT 作为癌症患者的心理治疗干预时,应考虑重要的临床和干预相关因素,即年龄和分娩。
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引用次数: 0
Multidisciplinary care meeting practices across diverse international settings 在不同国际环境下的多学科护理会议实践。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-21 DOI: 10.1002/cam4.70136
Alisha R. Pershad, Dylan Graetz, Mai An Le, Heather Forrest, Miriam Gonzalez-Guzman, Paola Friedrich

Purpose

Multidisciplinary care (MDC) meetings improve the quality of cancer care by providing a space for interdisciplinary communication. The Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool assesses MDC meetings as part of the Service Integration module. We aimed to evaluate the characteristics of MDC meetings at institutions that completed PrOFILE.

Methods

From 2019 to 2021, 112 institutions from 23 countries collected data by utilizing the abbreviated version of PrOFILE. Within a secondary data analysis, we descriptively analyzed the characteristics of MDC meetings stratified by income level.

Results

Participating institutions were located in low-income countries (LICs) (n = 6), lower-middle-income countries (LMICs) (n = 34), upper-middle-income countries (UMICs) (n = 55), and high-income countries (HICs) (n = 17). Of the 112 participating facilities, 79% reported having MDC meetings. The existence of an MDC varied with income, with 50% of LICs and 100% of HICs hosting MDCs. The frequency of MDC meetings also differed, with 100% of MDCs in LICs occurring weekly, while 53% of MDCs in HICs occurred monthly. Specialties regularly represented at MDC meetings across all participating institutions were hematology/oncology (93%), pathology (52%), radiology (60%), general surgery (57%), and radiation oncology (51%). All MDC meetings in LICs reported representation from these specialties. Availability of test results and discussion of new cases did not vary with income. Residual disparities were identified for the following characteristics: discussion of new and interesting cases, inclusion of patient preferences, and ability to meet urgently.

Conclusions

The existence and components of a functional MDC meeting may vary between countries' income levels. Variation in certain components, such as access to tests, may be due to differences in resource distribution, but other factors such as inclusion of patient preferences and ability to meet urgently can be optimized in all settings to foster high-quality teamwork and communication.

目的:多学科护理(MDC)会议为跨学科交流提供了空间,从而提高了癌症护理的质量。儿科肿瘤机构综合地方评估(PrOFILE)工具将多学科会议作为服务整合模块的一部分进行评估。我们旨在评估完成 PrOFILE 的机构中 MDC 会议的特点:从 2019 年到 2021 年,来自 23 个国家的 112 家机构利用 PrOFILE 的缩略版收集了数据。在二次数据分析中,我们按收入水平对MDC会议的特点进行了描述性分析:参与机构分别位于低收入国家(LICs)(6 个)、中低收入国家(LMICs)(34 个)、中高收入国家(UMICs)(55 个)和高收入国家(HICs)(17 个)。在 112 个参与机构中,79% 的机构报告称已召开了 MDC 会议。多指标类集调查中心的存在因收入而异,50%的低收入国家和 100%的高收入国家设有多指标类集调查中心。MDC 会议的频率也不尽相同,在低收入国家,100% 的 MDC 会议每周举行一次,而在高收入国家,53% 的 MDC 会议每月举行一次。在所有参与机构中,定期参加 MDC 会议的专科有血液学/肿瘤学(93%)、病理学(52%)、放射学(60%)、普通外科(57%)和放射肿瘤学(51%)。LICs 的所有 MDC 会议都有这些专科的代表参加。检验结果的提供和新病例的讨论并不因收入而异。以下特点仍存在差异:新病例和有趣病例的讨论、纳入患者偏好以及紧急会议的能力:结论:不同国家的收入水平不同,功能性 MDC 会议的存在和组成部分也可能不同。结论:在不同收入水平的国家,功能性 MDC 会议的存在和构成要素可能有所不同。某些构成要素的差异(如获得检查的机会)可能是由于资源分配的差异造成的,但其他因素(如纳入患者偏好和紧急会议的能力)可以在所有环境中进行优化,以促进高质量的团队合作和沟通。
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引用次数: 0
Correction to Cervicovaginal specimen biomarkers for early detection of ovarian and endometrial cancer: A review 更正:用于早期检测卵巢癌和子宫内膜癌的宫颈阴道标本生物标记物:综述。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-20 DOI: 10.1002/cam4.70107

Kwinten KJJ, Lemain VA, de Hullu JA, Leenders WPJ, Steenbeek MP, van Altena AM, Pijnenborg JMA Cervicovaginal specimen biomarkers for early detection of ovarian and endometrial cancer: a review. Cancer Med. 2024;13:e70000. doi:10.1002/cam4.70000

We apologize for this error.

Kwinten KJJ、Lemain VA、de Hullu JA、Leenders WPJ、Steenbeek MP、van Altena AM、Pijnenborg JMA 用于早期检测卵巢癌和子宫内膜癌的宫颈阴道标本生物标记物:综述。Cancer Med.2024;13:e70000。DOI:10.1002/cam4.70000我们对此错误深表歉意。
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引用次数: 0
Development and validation of a nomogram model for predicting venous thromboembolism risk in lung cancer patients treated with immune checkpoint inhibitors: A cohort study in China 用于预测接受免疫检查点抑制剂治疗的肺癌患者静脉血栓栓塞风险的提名图模型的开发与验证:中国队列研究。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-20 DOI: 10.1002/cam4.70115
Guanzhong Liang, Zuhai Hu, Qianjie Xu, Guixue Wang, Ying Wang, Xiaosheng Li, Wei Zhang, Haike Lei

Objective

Venous thromboembolism (VTE) poses a significant threat to lung cancer patients, particularly those receiving treatment with immune checkpoint inhibitors (ICIs). We aimed to develop and validate a nomogram model for predicting the occurrence of VTE in lung cancer patients undergoing ICI therapy.

Methods

The data for this retrospective cohort study was collected from cancer patients admitted to Chongqing University Cancer Hospital for ICI treatment between 2019 and 2022. The research data is divided into training and validation sets using a 7:3 ratio. Univariate and multivariate analyses were employed to identify risk factors for VTE. Based on these analyses, along with clinical expertise, a nomogram model was crafted. The model's predictive accuracy was assessed through receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis, clinical impact curve, and other relevant metrics.

Results

The initial univariate analysis pinpointed 13 potential risk factors for VTE. The subsequent stepwise multivariate regression analysis identified age, Karnofsky performance status, chemotherapy, targeted, platelet count, lactate dehydrogenase, monoamine oxidase, D-dimer, fibrinogen, and white blood cell count as significant predictors of VTE. These 10 variables were the foundation for a predictive model, illustrated by a clear and intuitive nomogram. The model's discriminative ability was demonstrated by the ROC curve, which showed an area under the curve of 0.815 (95% CI 0.772–0.858) for the training set, and 0.753 (95% CI 0.672–0.835) for the validation set. The model's accuracy was further supported by Brier scores of 0.068 and 0.080 for the training and validation sets, respectively, indicating a strong correlation with actual outcomes.

Conclusion

We have successfully established and validated a nomogram model for predicting VTE risk in lung cancer patients treated with ICIs.

目的:静脉血栓栓塞症(VTE)对肺癌患者,尤其是接受免疫检查点抑制剂(ICIs)治疗的患者构成重大威胁。我们旨在开发并验证一种提名图模型,用于预测接受 ICI 治疗的肺癌患者 VTE 的发生率:这项回顾性队列研究的数据来自2019年至2022年期间重庆大学附属肿瘤医院收治的接受ICI治疗的癌症患者。研究数据按 7:3 的比例分为训练集和验证集。采用单变量和多变量分析来确定 VTE 的风险因素。在这些分析的基础上,结合临床专业知识,建立了一个提名图模型。该模型的预测准确性通过接收者操作特征曲线(ROC)、校准曲线、决策曲线分析、临床影响曲线和其他相关指标进行评估:结果:最初的单变量分析确定了 13 个潜在的 VTE 危险因素。随后的逐步多变量回归分析发现,年龄、卡诺夫斯基表现状态、化疗、靶向治疗、血小板计数、乳酸脱氢酶、单胺氧化酶、D-二聚体、纤维蛋白原和白细胞计数是 VTE 的重要预测因素。这 10 个变量是建立预测模型的基础,并通过清晰直观的提名图加以说明。该模型的判别能力通过 ROC 曲线得到证明,训练集的曲线下面积为 0.815(95% CI 0.772-0.858),验证集的曲线下面积为 0.753(95% CI 0.672-0.835)。训练集和验证集的布赖尔评分分别为 0.068 和 0.080,进一步证明了模型的准确性,表明模型与实际结果密切相关:我们成功地建立并验证了一个预测肺癌患者接受 ICIs 治疗后 VTE 风险的提名图模型。
{"title":"Development and validation of a nomogram model for predicting venous thromboembolism risk in lung cancer patients treated with immune checkpoint inhibitors: A cohort study in China","authors":"Guanzhong Liang,&nbsp;Zuhai Hu,&nbsp;Qianjie Xu,&nbsp;Guixue Wang,&nbsp;Ying Wang,&nbsp;Xiaosheng Li,&nbsp;Wei Zhang,&nbsp;Haike Lei","doi":"10.1002/cam4.70115","DOIUrl":"10.1002/cam4.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Venous thromboembolism (VTE) poses a significant threat to lung cancer patients, particularly those receiving treatment with immune checkpoint inhibitors (ICIs). We aimed to develop and validate a nomogram model for predicting the occurrence of VTE in lung cancer patients undergoing ICI therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data for this retrospective cohort study was collected from cancer patients admitted to Chongqing University Cancer Hospital for ICI treatment between 2019 and 2022. The research data is divided into training and validation sets using a 7:3 ratio. Univariate and multivariate analyses were employed to identify risk factors for VTE. Based on these analyses, along with clinical expertise, a nomogram model was crafted. The model's predictive accuracy was assessed through receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis, clinical impact curve, and other relevant metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The initial univariate analysis pinpointed 13 potential risk factors for VTE. The subsequent stepwise multivariate regression analysis identified age, Karnofsky performance status, chemotherapy, targeted, platelet count, lactate dehydrogenase, monoamine oxidase, D-dimer, fibrinogen, and white blood cell count as significant predictors of VTE. These 10 variables were the foundation for a predictive model, illustrated by a clear and intuitive nomogram. The model's discriminative ability was demonstrated by the ROC curve, which showed an area under the curve of 0.815 (95% CI 0.772–0.858) for the training set, and 0.753 (95% CI 0.672–0.835) for the validation set. The model's accuracy was further supported by Brier scores of 0.068 and 0.080 for the training and validation sets, respectively, indicating a strong correlation with actual outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We have successfully established and validated a nomogram model for predicting VTE risk in lung cancer patients treated with ICIs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003180","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
Diagnosis, treatment, and prognosis of adult pancreatoblastoma 成人胰母细胞瘤的诊断、治疗和预后。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-20 DOI: 10.1002/cam4.70132
Jiaqian Yuan, Yong Guo, Yan Li

Background

Pancreatoblastoma (PB) is one of the rare malignant tumors that typically occurs in children. Cases of PB in adults are highly unusual. This disease often presents with subtle symptoms and lacks characteristic clinical manifestations, leading to diagnostic challenges.

Objective

This study integrates the relevant literature on adult PB, conducting data analysis on clinical features, laboratory and imaging results, pathological characteristics, and treatments according to inclusion and exclusion criteria. Kaplan–Meier univariate analysis and Log-rank tests are employed to analyze survival data from adult PB follow-up, exploring factors influencing prognosis.

Results

A total of 65 articles were included, encompassing 103 cases of adult PB. The average age of PB patients was 41.78 years (range 19–81 years), and the male-to-female ratio was 1.06:1. Patients frequently presented with abdominal pain as the initial symptom. Laboratory results lacked specificity and imaging findings often presented as large, well-defined masses. PB exhibited distinctive pathological features, including squamous corpuscles (n = 76, 89.41%) and acinar differentiation (n = 34, 40%), with frequent positive expression of Trypsin, Chymotrypsin, and AACT (Alpha-1-Antichymotrypsin). APC (Adenomatous Polyposis Coli) gene mutation was the most common molecular alteration in adult PB. During the follow-up period, 43.59% of patients died (range 3 days to 348 months). The primary factors affecting prognosis were the presence of metastasis (χ2 = 3.996, p = 0.046) and incomplete surgical resection (χ2 = 5.586, p = 0.018), with mean survival times of 48 months and 27 months, respectively.

Conclusions

PB in adults is an invasive tumor. The key to distinguishing PB from other pancreatic tumors lies in recognizing its unique pathological feature, the squamous corpuscles. Timely and complete surgical resection is the preferred treatment following diagnosis. Patients with incomplete resection or the presence of lymph nodes or (and) distant metastases have a poor prognosis.

背景:胰母细胞瘤(PB)是罕见的恶性肿瘤之一,通常发生在儿童身上。成人胰母细胞瘤病例非常罕见。这种疾病通常症状不明显,缺乏特征性临床表现,因此诊断困难:本研究整合了有关成人 PB 的相关文献,根据纳入和排除标准对临床特征、实验室和影像学结果、病理特征和治疗方法进行了数据分析。采用Kaplan-Meier单变量分析和Log-rank检验分析成人PB随访生存数据,探讨影响预后的因素:结果:共纳入 65 篇文章,涵盖 103 例成人 PB。PB患者的平均年龄为41.78岁(19-81岁),男女比例为1.06:1。患者常以腹痛为首发症状。实验室检查结果缺乏特异性,影像学检查结果通常表现为界限清楚的大肿块。PB表现出明显的病理特征,包括鳞状细胞(76例,89.41%)和针状分化(34例,40%),胰蛋白酶、糜蛋白酶和AACT(α-1-抗糜蛋白酶)常呈阳性表达。APC(腺瘤性息肉病大肠杆菌)基因突变是成人 PB 中最常见的分子改变。在随访期间,43.59%的患者死亡(3天至348个月)。影响预后的主要因素是出现转移(χ2 = 3.996,P = 0.046)和手术切除不彻底(χ2 = 5.586,P = 0.018),平均生存时间分别为48个月和27个月:结论:成人PB是一种侵袭性肿瘤。将胰腺癌与其他胰腺肿瘤区分开来的关键在于识别其独特的病理特征--鳞状上皮细胞。确诊后,及时、彻底的手术切除是首选治疗方法。切除不彻底或存在淋巴结或(和)远处转移的患者预后较差。
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引用次数: 0
WNT5A is a putative epi-driver of prostate cancer metastasis to the bone WNT5A 是前列腺癌骨转移的假定外驱动因素。
IF 2.9 2区 医学 Q2 ONCOLOGY Pub Date : 2024-08-20 DOI: 10.1002/cam4.70122
Emma J. Wilkinson, Kelsie Raspin, Roslyn C. Malley, Shaun Donovan, Louise M. Nott, Adele F. Holloway, Joanne L. Dickinson

Background

Current diagnostic tools are unable to distinguish low-grade indolent prostate cancer (PrCa) from that with a propensity to become metastatic and/or lethal. Recent evidence suggests that reprogramming of the transcriptome may drive the metastatic phenotype, and that this reprogramming is controlled, at least in part, by epigenetic changes to the DNA of cancer cells, including methylation. These changes, referred to as ‘epigenetic drivers,’ have previously been associated with cancer cell survival.

Methods

Here, using Illumina Methylation EPIC array data of paired primary PrCa and metastatic bone samples, we identified WNT5A as a putative epi-driver of PrCa metastasis to the bone, which was further validated in vitro.

Results

Significantly higher WNT5A methylation was observed in primary PrCa samples and 22Rv1 cells compared to metastatic bone samples and PC-3 cells. This higher methylation was associated with significantly lower WNT5A gene expression.

Conclusion

Given the limited effective therapies available for metastatic cancer sufferers, particularly those whose disease has metastasised to the bone, WNT5A presents as a potential putative target for therapy.

背景:目前的诊断工具无法区分低度懒散性前列腺癌(PrCa)和有转移和/或致死倾向的前列腺癌。最近的证据表明,转录组的重编程可能会驱动转移表型,而这种重编程至少部分受控于癌细胞 DNA 的表观遗传变化,包括甲基化。这些变化被称为 "表观遗传驱动因素",以前与癌细胞的存活有关。方法:在此,我们利用Illumina甲基化EPIC阵列对原发性PrCa和转移性骨样本的数据,确定了WNT5A是PrCa向骨转移的假定表观驱动因素,并在体外进行了进一步验证:结果:与骨转移样本和 PC-3 细胞相比,在原发性 PrCa 样本和 22Rv1 细胞中观察到的 WNT5A 甲基化程度明显更高。结果:与转移性骨样本和 PC-3 细胞相比,在原发性 PrCa 样本和 22Rv1 细胞中观察到了显著较高的 WNT5A 甲基化水平,这种较高的甲基化水平与较低的 WNT5A 基因表达有关:鉴于对转移性癌症患者,尤其是疾病已转移至骨骼的患者的有效疗法有限,WNT5A 成为了一个潜在的治疗靶点。
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引用次数: 0
期刊
Cancer Medicine
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