Journal of Chemotherapy最新文献

Cervical cancer remains a major global health burden, particularly in advanced and recurrent disease, where therapeutic options are limited. We conducted a systematic review of clinical studies evaluating nab-paclitaxel-based regimens in cervical cancer, following PRISMA 2020 guidelines. Literature published between 2015 and 2025 was identified across five databases, and risk of bias was assessed using the MINORS tool. Ten studies (five single-arm and five comparative; n = 417) were included. Nab-paclitaxel was administered in combination with chemotherapy, radiotherapy, or immunotherapy. Across single-arm studies, objective response rates ranged from 40% to 57%, with median progression-free survival of 4.5-9.1 months and overall survival of 8.9-16.6 months. Comparative studies suggested higher response rates with nab-paclitaxel-cisplatin regimens, particularly in neoadjuvant settings. Nab-paclitaxel-based combinations demonstrated generally manageable toxicity. However, interpretation is limited by study heterogeneity and the absence of randomized controlled trials.

Mpox is an emerging zoonosis that was first described in African animals, including monkeys, small rodents, and Gambian marsupial rats. It has since been identified as a sexually transmitted infection among humans. The disease is characterized by an incubation period ranging from 5 to 21 days, with the prodromal phase typically presenting nonspecific symptoms. The incubation period is followed by the development of the characteristic vesicular skin lesions that are the hallmarks of Mpox. Over the years, small outbreaks of Mpox have occurred regularly in Central and West Africa. In July 2022, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC), due to the rapid spread of the virus in non-endemic countries. On May 11, 2023, WHO declared the end of the Mpox emergency, considering a significant decline in reported cases. As of October 2024, the true impact of this infection on international public health remains unclear.

This study evaluated SARS-CoV-2 infection impacts on clinical characteristics, antibody levels, and immune responses in 100 malignant hematological tumor patients. Laboratory assessments included hematological, biochemical, and inflammatory markers. Multivariable analysis identified age (OR = 1.56, p = 0.004), chemotherapy cycles (OR = 1.86, p < 0.001), comorbidities (OR = 3.15, p = 0.015), WBC count (OR = 1.79, p = 0.016), CRP (OR = 2.07, p = 0.007), ferritin (OR = 1.22, p = 0.035), IL-6 (OR = 1.59, p = 0.001), IgG (OR = 2.28, p = 0.037), CD8+ T cells (OR = 2.97, p = 0.005), and NK cells (OR = 0.80, p = 0.019) as COVID-19 risk factors. COVID-19 patients showed significantly higher hospitalization (30.77% vs 10.42%, p = 0.007), ICU admission (23.08% vs 6.25%, p = 0.019), and lower 1-year survival (59.62% vs 87.50%, p = 0.002) versus controls. SARS-CoV-2 infection induces hematological/immune alterations and worsens clinical outcomes in hematological malignancy patients, emphasizing their heightened vulnerability.

Immune checkpoint inhibitors (ICIs) have shown promise in the treatment of gastric and oesophageal cancers (GEC). Despite their promising efficacy, ICIs have been associated with unique side effects known as immune-related adverse events (IRAEs). Several studies have shown improved treatment responses in patients with IRAEs compared to those without IRAEs in various cancer types such as melanoma and non-small cell lung cancer. We performed a single-institution retrospective study to characterize IRAE incidence and association with treatment response in advanced GEC. We identified 70 patients with GEC who received ICI therapy; 20 (29%) developed an IRAE of any magnitude. The most common were colitis (35%) hypothyroidism (25%) and pneumonitis (20%). Median PFS and OS were not statistically different between IRAE and nonIRAE groups (10.4 vs. 11.3 months p = 0.6 and 11.0 vs. 12.9 months p = 1.0, respectively). This is in contrast to studies in other cancer types that have suggested association between IRAE and improved outcomes.

To search for key drug resistance biomarkers and potential chemotherapeutic agents for combination therapy in melanoma patients. The common up-regulated differentially expressed genes were acquired from two cohort studies, GSE91061 and PRJEB23709. Univariate and multivariate Cox regression survival analyses were performed to screen for important prognostic biomarkers. A multi-gene panel including APP, ARHGAP42, GSTA4 and UCHL1, not only plays an important role in prognostic indicators, but also in predicting the probability of resistance to anti-PD-1 in patients with melanoma. Chemotherapy drug response models found five potential drugs, including all-trans retinoic acid, doxorubicin, etoposide, methotrexate and MG-132, were significantly associated with target genes in gene-panel. Molecular docking confirmed that potential drugs have good binding ability to target genes APP, GSTA4 and UCHL1, suggesting that the multi-gene panel is expected to provide assistance for drug resistance prediction and prognosis assessment and combination therapy in patients with anti-PD-1 resistant melanoma.

This retrospective study aimed to explore the efficacy and safety of oral isavuconazole in treating invasive pulmonary aspergillosis (IPA). Among 31 enrolled patients, 21 survived and 10 died by the 42-days follow-up. The mean hospitalization duration was 21.81 ± 8.03 days, with isavuconazole administered for a mean of 25.10 ± 12.87 days. Survivors received isavuconazole for significantly longer period than non-survivors (28.62 vs 17.70 days, P = 0.025). The time to initiation of isavuconazole was significantly shorter in survivors compared to non-survivors (7.86 vs 14.4 days, P = 0.013). Early initiation of treatment was significantly associated with a shorter hospital stay (16.33 vs 25.83 days, P < 0.001). No significant adverse effects were observed in laboratory parameters, and no patients discontinued treatment due to side effects. These findings suggest that early oral administration of isavuconazole may reduce mortality rates and shorten hospitalization duration in patients with IPA. The treatment demonstrated a favourable safety profile, with minimal adverse reactions.

Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) are the recommended front-line therapy for treatment-naïve patients with advanced stage EGFR mutated Non-Small Cell Lung Cancer (NSCLC), with better tolerance and outcomes compared to chemotherapy. However, patients inevitably develop resistance to EGFR-TKI. The extent of progression free survival depends on intrinsic or acquired on-target/off-target mechanisms of EGFR-TKI resistance. Overcoming these acquired rearrangements remains challenging in modern precision medicine. In case of disease progression during treatment with an EGFR-TKI, rebiopsy is recommended to search for a potential resistance mechanism. However, the therapeutic potential of these resistance mechanisms represents an unmet need in thoracic oncology. Case Presentation: We present a case of a 78-year-old woman with stage IVB EGFR-mutated NSCLC in whom an acquired RET Gene Fusion was identified as the EGFR-independent resistance mechanism. Additionally, a combined therapy of Osimertinib and Selpercatinib showed a durable oncological response with 14 months of progression free survival in the absence of adverse events. Conclusion: Addition of Selpercatinib to Osimertinib in an EGFR-mutated NSCLC patient with an acquired RET fusion was well tolerated and created a clinical benefit. Further prospective investigation into these novel combination strategies is needed as resistance mechanisms could serve as possible targets for new therapy approaches.

Doxorubicin (DOX) and lapatinib (LAP) have been reported to cause liver toxicity. The roles of mitochondrial and cellular responses in DOX and LAP mediated-hepatotoxicity have not been investigated with or without quercetin (QUE) in HepG2 cells sensitive to mitochondrial damage (high-glucose or galactose media) in addition to in silico studies. Our results revealed that cytosolic pathways might play role a in DOX-induced cytotoxicity rather than mitochondria. QUE exacerbated DOX-induced ATP depletion in both environments. Our data also indicated that cytosolic and mitochondrial pathways might play a role in LAP-induced cytotoxicity. Incubating QUE with LAP increased ATP levels in high-glucose media. Therefore, QUE might have protective effect against LAP-induced cytotoxicity resulting from cytosolic pathways. The findings from in vitro experiments that QUE increased DOX or LAP-induced mitochondrial dysfunction were confirmed by the results from in silico studies indicating that QUE incubated with LAP or DOX might increase mitochondrial dysfunction.

As a systematic review, this study addresses a gap in the literature by evaluating both the short-term and long-term outcomes of breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The purpose of the current study was to evaluate NAC's impact on breast cancer patients' surgical outcomes. We performed a comprehensive search of international databases, including PubMed, Scopus, Embase, and Science Direct, covering studies from 2000 to 2023, using carefully selected keywords. Our search strategy aimed to capture a wide variety of relevant studies. To ensure a structured and unbiased selection, we followed PRISMA guidelines throughout the process. We concentrated on identifying studies that reported on short-term outcomes, like surgical complications (e.g., operation time, blood loss), as well as long-term outcomes, including overall survival, tumor size reduction, metastasis rates, breast conservation surgery, and recurrence rates. The findings highlighted the benefits of NAC in terms of lower recurrence and metastasis rates. The results also emphasized the significance of considering tumor characteristics and nodal involvement for prognostication in this patient population. The findings of this study will contribute to a better understanding of the impact of NAC on surgical outcomes in breast cancer patients, providing valuable insights for treatment planning and optimizing patient care.

Although recent advancements in cancer treatment have significantly improved survival rates, they have also raised concerns regarding severe adverse effects, including cardiotoxicity. We conducted a prospective study at Dayanand Medical College and Hospital, Ludhiana to assess chemotherapy-related cardiac dysfunction in newly diagnosed, histologically confirmed breast cancer cases. Among 97 breast cancer patients undergoing chemotherapy, 13 (13.4%) developed left ventricular dysfunction (LVD), predominantly in younger patients with left-sided breast involvement (64.9%). A significant association was found between estrogen receptor (ER) positivity and LVD risk (P = 0.03), with 15.4% of LVD patients also being hypertensive. The incidence of LVD was notably high at 38.5% among patients receiving trastuzumab, while cumulative doses of doxorubicin and cyclophosphamide did not show significant correlation with LVD. Recovery was promising, with 76.9% of affected patients demonstrating significant improvement post-treatment. These findings highlight the need for continuous cardiac monitoring and personalized treatment strategies to mitigate LVD risk.