Journal of the Egyptian National Cancer Institute最新文献

Background: Luminal breast cancer (LBC) is the most common subtype of breast cancer affecting women worldwide. Although luminal breast cancer typically has a better prognosis, it mostly responds poorly to neoadjuvant chemotherapy. Non-coding RNAs, especially long non-coding RNAs and microRNAs are crucial in regulating biological processes that contribute to breast cancer development. MALAT1, a long non-coding RNA, is pivotal in the progression of breast cancer. Epithelial-mesenchymal transition (EMT) is critical for cell movement during embryonic development. Clarifying this role could pave various avenues for developing innovative strategies for combating this subtype of malignancy. The present study aimed to investigate the expression profiles and clinical relevance of MALAT1 level and EMT-related miRNAs (miR-17-5p, miR-20a-5p, miR-93-5p, miR-135b-5p, and miR-146a-5p) alongside EMT markers (E-cadherin, N-cadherin, vimentin, fibronectin, twist, SNAI1, Slug, ZEB1, and ZEB2) in LBC patients.

Methods: Fresh tissues were collected from fifty patients and twenty noncancerous controls. Differential expression of the markers was evaluated using qRT-PCR assay. Spearman Rho test assessed the relationship between the expression levels. Linear regression test evaluated the correlation between the parameters and various clinico-pathological features.

Results: Our results revealed an overall upregulation of MALAT1 in breast cancer tissues although this increase did not reach statistical significance. Overexpression of miR-20a-5p, miR-135b, and ZEB2 was reported, whereas miR146a-5p, ZEB1 and Vimentin levels were suppressed. Correlation analysis demonstrated that miR-20a-5p was positively correlated with SNAI1, E-cadherin, N-cadherin and Slug also it was significantly associated with family history and tumor laterality.

Conclusions: Our findings suggest that miR-20a-5p plays an oncogenic role in luminal breast cancer by promoting EMT, while MALAT1 may contribute to disease progression through indirect regulatory mechanisms. Finally, MALAT1 and miR-20a-5p might serve as potential therapeutic and prognostic targets in LBC.

Background: Ovarian cancer remains the most lethal gynecological malignancy, necessitating precise diagnostic strategies to improve patient outcomes. This study aims to develop and evaluate machine learning models that utilize patient history, imaging, and blood test data to differentiate between benign and malignant ovarian tumors and predict the stage of malignant cases.

Methods: A total of 357 individuals diagnosed with ovarian tumors participated in the study. Among these, 139 tumors were identified as benign, 40 as borderline, and 178 as malignant. The analysis employed four machine learning classifiers support vector machine (SVM), random forest (RF), logistic regression (LR), and decision tree utilizing 39 features derived from blood tests, imaging, and the patient's background to generate diagnostic outcomes. The study focused on assessing the significance of these features in predicting malignancy and determining the stage of the disease.

Results: The RF algorithm demonstrated the highest accuracy, reaching 94% based on imaging and tumor markers, with an AUC of 0.9. Key features contributing to this success include Human Epididymis Protein 4 (HE4) and Cancer Antigen 125 (CA125). In terms of staging malignant tumors, the SVM exhibited lower error rates, particularly in predicting advanced-stage disease (AUC: 0.77). Notably, CA125 and the presence of ascites emerged as the most influential factors for accurately staging the disease.

Conclusion: The utilization of AI models proves effective in accurately classifying both malignant and benign ovarian tumors, showcasing promising advancements in diagnostic capabilities.

Multiple myeloma (MM) remains an incurable plasma cell malignancy despite advances with proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies. Bispecific antibodies (BsAbs) have emerged as a transformative, off-the-shelf immunotherapeutic strategy that redirects immune effector cells to eliminate malignant plasma cells. The recent FDA approvals of teclistamab, talquetamab, elranatamab and linvoseltamab have reshaped the therapeutic landscape of relapsed/refractory MM (RRMM), achieving overall response rates (ORR) exceeding 60% in heavily pretreated patients. Teclistamab, targeting BCMA, demonstrated an ORR of 63%, while talquetamab, targeting GPRC5D, achieved an ORR of 74%, even in patients previously treated with T-cell redirection therapies. Elranatamab and linvoseltamab further enriched this armamentarium with comparable efficacy and favorable safety profiles. In addition to these milestones, early-phase data from emerging trispecific antibodies, such as ISB 2001, show ORRs as high as 75% and deep responses, including stringent complete responses (sCR) and minimal residual disease (MRD) negativity. This review provides an integrated analysis of BsAbs in MM, encompassing mechanisms of action, clinical development, efficacy, safety profiles, and future directions. We synthesize the latest clinical trial data, explore strategies for overcoming resistance, and discuss ongoing efforts to optimize combination regimens and sequencing. By critically evaluating these advancements, we highlight the evolving role of BsAbs and trispecific antibodies in redefining treatment paradigms, with the ultimate goal of improving patient outcomes and advancing toward a potential cure for multiple myeloma.

Cancer-associated fibroblasts (CAFs) are pivotal regulators of the tumor microenvironment (TME), driving malignancy through extracellular matrix remodeling, paracrine and metabolic crosstalk, angiogenesis, fibrosis, and immune suppression. Emerging single-cell and spatial multi-omics have revealed CAF heterogeneity and plasticity, with subtypes such as myofibroblastic, inflammatory, antigen-presenting, and metabolic CAFs exerting context-dependent functions that can either promote or restrain tumor growth. This duality cautions against indiscriminate stromal ablation and highlights the need for precision strategies. CAFs also mediate resistance to chemotherapy, radiotherapy, targeted agents, and immunotherapy by creating physical and biochemical barriers and fostering immune exclusion. Therapeutic approaches span depletion strategies, pathway inhibitors, and stromal reprogramming using vitamin D receptor agonists, retinoids, and epigenetic modulators, often in combination with immunotherapies. However, CAF plasticity and the lack of exclusive markers remain major challenges. This review positions CAFs as dynamic regulators of cancer hallmarks and argues for a paradigm shift toward precision stromal oncology, where the trajectory from CAF depletion to CAF reprogramming and CAF-guided combinatorial therapies reshapes cancer treatment itself.

Background: Intermediate-risk (IR) neuroblastoma represents a biologically and clinically diverse group of tumors. This study evaluates the feasibility of surgical excision and identifies prognostic factors that influence survival in IR-neuroblastoma patients, particularly those with suboptimal responses to induction chemotherapy.

Methods: We conducted a retrospective analysis of 50 pediatric patients diagnosed with IR-neuroblastoma at a tertiary cancer center between 2007 and 2016. Treatment responses, surgical outcomes, and survival data were assessed. Prognostic variables were evaluated using univariable and multivariable models.

Results: After four cycles of induction chemotherapy, 26% of patients showed an objective response, increasing to 62% by treatment completion. Surgical resection was performed in 70% of patients, with a higher proportion among non-responders. Initial response to induction chemotherapy was a significant independent predictor of surgical feasibility (p = 0.022) and final disease status (p = 0.026). Five-year overall survival (OS) was 84%, and event-free survival (EFS) was 72%. Surgical resection significantly improved end-of-treatment disease status in slow-responder patients but did not independently affect OS or EFS.

Conclusion: Moderate-intensity chemotherapy with or without surgery provides acceptable survival outcomes in IR-neuroblastoma. An early favorable response to induction therapy may justify avoiding surgery, while surgical resection remains critical for slow-responder patients.

Purpose: Paclitaxel chemotherapy is known to induce peripheral neuropathy, significantly impacting patients' daily activities. Effective interventions to alleviate these symptoms are crucial for improving patient quality of life. The objective was to investigate the effects of gradient pressure therapy on symptoms of paclitaxel-induced peripheral neuropathy and daily activities.

Methods: Eighty patients with breast cancer receiving a 125-mg/m² paclitaxel chemotherapy regimen at a class III hospital in Tangshan from October 2022 to October 2023 were randomly divided into a control group (n = 40) and an intervention group (n = 40). The control group received routine treatment and health guidance, whereas the intervention group received additional II-level hand and foot gradient pressure therapy. Chemotherapy-induced peripheral neuropathy (CIPN) symptoms and activities of daily living (ADL) impact scores were compared after the second, fourth, and sixth chemotherapy cycles and at the 3-month follow-up.

Results: No significant differences were found in CIPN symptoms and ADL impact scores between the groups after the second chemotherapy cycle (P > 0.05). However, after the fourth cycle, the intervention group showed significant improvements in nine items: hand numbness, foot numbness, discomfort in fingers/hands or toes/feet, walking, exercise, sleep, sexual activity, chores, and enjoyment of life (P < 0.05). At the sixth cycle and at the 3-month follow-up, additional improvements were noted in cold sensitivity and total scores (P < 0.05).

Conclusion: Gradient pressure therapy effectively reduces symptoms of paclitaxel-induced peripheral neuropathy, improving patients' daily activities. This intervention is recommended for clinical promotion and application.