Journal of Chemotherapy最新文献

The increasing prevalence of multidrug-resistant (MDR) Pseudomonas aeruginosa infections poses a major challenge in clinical settings, particularly when antibiotic therapy fails and surgical source control is not feasible. Bacteriophage therapy (BT) has emerged as a promising alternative, offering a targeted approach to combat persistent infections. Recent advancements in phage isolation, purification and genomic characterization have facilitated their use in compassionate treatment cases. Studies suggest that phage-antibiotic synergy can enhance bacterial eradication while potentially mitigating resistance development. However, challenges remain regarding optimal dosing strategies, host immune responses and regulatory approval pathways. This review examines the current state of BT for P. aeruginosa infections, its mechanisms of action, clinical applications and future directions for integrating phage-based treatments into infectious disease management.

In a real-world setting, this study evaluated clinical parameters and outcomes with the administration of eribulin in heavily pre-treated Indian metastatic breast cancer (MBC) patients using electronic medical records. Among 145 patients, 46.2% were oestrogen/progesterone receptor-positive, 15.9% had HER2-overexpression, and 46.2% had triple-negative breast cancer (TNBC). Eribulin was administered as a 2nd, 3rd, 4th, and ≥5th line chemotherapy in 11.7%, 18.6%, 30.3%, and 39.3% patients, respectively. Grade ≥3 neutropenia occurred in 26.2% of patients. After six cycles, 1.8% had complete response, 17.5% partial response, 17.5% stable disease, and 57.9% experienced disease progression. The overall response rate was 7.6%. Median progression-free survival and overall survival were 3.9 and 11.6 months, respectively. Overall, the study shows low response rate with manageable toxicity. The findings highlight the need for further focused studies comparing eribulin with existing chemotherapies, especially in the Indian patients with disease heterogeneity and unique genetic makeup.

Castleman disease (CD) and immunoglobulin G4-related disease (IgG4-RD) are rare systemic immune-mediated disorders that share similar clinical manifestations and overlapping pathological features. We present a case of insidious idiopathic multicentric CD (iMCD) with elevated serum IgG4 levels, characterized by a persistent dry cough and widespread lymphadenopathy. A 38-year-old male patient exhibited persistent dry cough, generalized lymphadenopathy, and fatigue. An inguinal lymph node biopsy showed plasma cell-type MCD characteristics, such as atrophic lymphoid follicles and significant plasma cell infiltration. Immunohistochemical staining revealed positivity for IgG, CD38, and CD138, with over 50 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of 40%, confirming the diagnosis of the idiopathic plasmacytic lymphadenopathy (IPL) subtype of multicentric Castleman disease (iMCD-IPL). After receiving a siltuximab-based regimen followed by radiotherapy, the patient achieved a notable partial remission. We present a case illustrating the significant efficacy of siltuximab-based therapy in iMCD-IPL, resembling IgG4-related disease.

The use of immune checkpoint inhibitors (ICIs) has offered new hope for patients with malignant tumours; however, it is essential to acknowledge their potential toxic side effects. Among these, ICIs-associated arthritis (IA) is not uncommon but non-specific and lacks diagnostic criteria. In this case, a patient with advanced colon cancer developed IA following treatment with Toripalimab. Notably, the condition improved after the administration of steroids, and the tumour remains well-controlled. This case report significantly contributes to enhancing clinicians' understanding of IA.

BRAF inhibitors (BRAFi) and MEK inhibitors (MEKi) are approved in the U.S. to be given in combination or as single agents to treat patients with BRAF V600E/K-positive solid and histiocytic neoplasms. During postmarketing safety surveillance, we identified cases of photosensitivity with BRAFi (dabrafenib, encorafenib) and MEKi (trametinib, binimetinib) and evaluated this finding further using data from the Food and Drug Administration's Adverse Event Reporting System, the literature, and the drug manufacturers. We identified 72 cases of photosensitivity with BRAFi/MEKi with a median time to onset of 60 days. Cases described erythema, pruritis, blistering, pain, and swelling. Based on a temporal relationship; positive dechallenge after BRAFi/MEKi discontinuation, interruption, or dose reduction; and positive rechallenge with drug re-exposure, findings from our case series suggest a causal association between BRAFi/MEKi and photosensitivity, and this is further supported by pre-market, non-clinical testing results.

This research aimed to assess the effectiveness of daratumumab in the treatment of relapsed and refractory multiple myeloma (RRMM) within a real - world setting. We conducted a retrospective analysis of the clinical features and treatment outcomes of patients diagnosed with RRMM at the Union Hospital of Fujian Medical University from 2018 to 2024. The study cohort consisted of 62 patients, with a median age of 62 years. 80.6% of patients received one line therapy before administration of daratumumab. The median follow - up duration was 16.1 (1.9 - 69.6) months, and the median number of daratumumab treatment cycles was 7.5 (1 - 72) courses. Among the 56 evaluable cases, the overall response rate (ORR) was 89.3%, which included 11 cases (19.6%) attaining a stringent complete response (sCR) and 13 cases (23.2%) achieving a complete response (CR). The median progression free survival (PFS) of the entire cohort was 25.2 months. The 1 - year and 3 - year PFS rates were 75.2% and 25.4% respectively. The median overall survival (OS) was 42.7 months. The 1 - year and 3 - year OS rates were 84.2% and 62.8% respectively. Multivariate analysis indicated that poor performance status was independent unfavorable prognostic factors for PFS and OS. In conclusions, an early daratumumab - based treatment regimen has demonstrated promising therapeutic potential for treating RRMM and warrants further validation and exploration in future clinical practice.

Background: Paclitaxel is a widely used chemotherapeutic agent for the treatment of breast cancer. While peripheral neuropathy is a well-recognized dose-limiting toxicity of paclitaxel, cranial nerve involvement remains exceptionally rare. We report a case of unilateral facial nerve palsy in a breast cancer patient receiving standard-dose paclitaxel therapy, highlighting the diagnostic challenges in distinguishing drug-induced neurotoxicity from other aetiologies.

Case report: A 43-year-old woman with metastatic breast cancer developed left facial nerve paralysis after 12 months of weekly paclitaxel treatment (80 mg/m²). Contrast-enhanced cranial Magnetic Resonance Imaging (MRI) demonstrated bilateral cranial nerve VII enhancement, creating diagnostic uncertainty between leptomeningeal metastasis, paclitaxel-induced neuritis, and idiopathic Bell's palsy. Paclitaxel was discontinued, and corticosteroid therapy was initiated. Clinical and radiological improvement at follow-up strongly supported a drug-related aetiology.

Conclusion: This case illustrates the diagnostic complexity of facial nerve palsy in cancer patients receiving neurotoxic chemotherapy. The overlapping clinical and radiological features between drug-induced cranial neurotoxicity, leptomeningeal disease, and idiopathic causes present significant diagnostic challenges. Clinicians should maintain a high degree of suspicion for rare chemotherapy-related cranial neuropathies while pursuing comprehensive differential diagnosis, including infectious aetiologies and metastatic disease.

This retrospective study evaluated the clinical efficacy of camrelizumab combined with transarterial chemoembolization (TACE) in 120 hepatocellular carcinoma (HCC) patients with liver cirrhosis. Based on the intervention received, patients were categorized into an observation group (OG) (n = 60, underwent camrelizumab combined with TACE interventional therapy) and a control group (CG) (n = 60, underwent camrelizumab monotherapy). The OG showed significantly higher objective response (66.67% vs. 46.67%) and disease control rates (91.67% vs. 80.00%), improved immune function (elevated CD3⁺, CD4⁺, CD4⁺/CD8⁺), better liver function (reduced TB and ALT), and reduced tumor markers (AFP, CEA) compared to the CG. One-year follow-up revealed prolonged overall survival rate and progression-free survival, along with better quality-of-life scores in the OG. These findings suggest that camrelizumab combined with TACE demonstrates definitive short-term efficacy, improved immune and liver function, better survival outcomes, and favorable safety in HCC patients with liver cirrhosis, supporting its clinical value.

This study is the first to investigate the therapeutic potential of a mono/combination treatment with the selective phase III BCR::ABL1 tyrosine kinase inhibitor (TKI) asciminib (ABL001) and the c-MET inhibitor tivantinib (ARQ197) in hematopoietic stem cells (HSCs) and leukaemia stem cells (LSCs) in terms of cytotoxicity, apoptosis, target gene expression profiles, and bioinformatics in vitro. In silico studies were also performed for various tivantinib and asciminib derivatives. Asciminib and tivantinib exhibited significant antileukaemic effects, with tivantinib showing the strongest apoptotic impact in LSCs and asciminib in HSCs. Although their combination exhibited an additive effect on LSCs, enabling dose reduction and potentially minimizing side effects; the treatment succeeded in promoting apoptosis as effectively as tivatinib monotherapy. Gene expression analysis showed increased pro-apoptotic and tumour suppressor markers, whereas decreased oncogenes' expressions following mono/combined treatment in LSCs. Molecular docking showed that a new analogue of tivantinib (compound-1) and CHEMBL5274046 are promising c-MET and ABL1 inhibitors, respectively. The findings highlight the antileukaemic potential of initially tivantinib and asciminib in LSCs. Despite an additive effect, combination therapy allowed dose reduction, giving rise to a potential decrease in side effects. Targeting c-MET, alone or in combination with BCR::ABL1 inhibition, presents a compelling strategy for eradicating LSCs, which underpin resistance and relapse in CML therapy - thus marking a crucial advancement in the pursuit of more effective treatment paradigms. In silico studies indicated that various tivantinib and asciminib analogues could also have potential therapeutic effects as c-MET and ABL1 inhibitors for future anti-leukaemia research.

This study explored the efficacy of fruquintinib monotherapy versus fruquintinib combined with immune checkpoint inhibitors in the treatment of advanced proficient mismatch repair/microsatellite stable-type colorectal cancer. We retrospectively collected data from patients (n=75) diagnosed with advanced colorectal cancer at our hospital from January 2020 to December 2022 who chose to receive fruquintinib monotherapy or combine it with immune checkpoint inhibitors for treatment. The primary endpoint was progression-free survival (PFS) and overall survival (OS). As of July 1, 2023, the median PFS for the fruquintinib monotherapy group and combination therapy was 3.9 months and 7.9 months , respectively (P = 0.142). The median OS in the monotherapy group and combination therapy was 10.3 months and 10.0 months, respectively (P = 0.942). However, as compared with the monotherapy group, the combination therapy group showed a trend for a prolonged duration of PFS, and it may have good application potential.