Fernando Gálvez-Montosa, Giulia Peduzzi, José Manuel Sanchez-Maldonado, Rob ter Horst, Antonio J. Cabrera-Serrano, Manuel Gentiluomo, Angelica Macauda, Natalia Luque, Pelin Ünal, Francisco José García-Verdejo, Yang Li, José Antonio López López, Angelika Stein, H. Bas Bueno-de-Mesquita, Paolo Giorgio Arcidiacono, Dalila Luciola Zanette, Christoph Kahlert, Francesco Perri, Pavel Soucek, Renata Talar-Wojnarowska, George E. Theodoropoulos, Jakob R. Izbicki, Hussein Tamás, Hanneke Van Laarhoven, Gennaro Nappo, Maria Chiara Petrone, Martin Lovecek, Roel C. H. Vermeulen, Kestutis Adamonis, Fernando Jesus Reyes-Zurita, Bernd Holleczek, Jolanta Sumskiene, Beatrice Mohelníková-Duchoňová, Rita T. Lawlor, Raffaele Pezzilli, Mateus Nobrega Aoki, Claudio Pasquali, Vitalija Petrenkiene, Daniela Basso, Stefania Bunduc, Annalisa Comandatore, Hermann Brenner, Stefano Ermini, Giuseppe Vanella, Mara R. Goetz, Livia Archibugi, Maurizio Lucchesi, Faik Guntac Uzunoglu, Olivier Busch, Anna Caterina Milanetto, Marta Puzzono, Juozas Kupcinskas, Luca Morelli, Cosimo Sperti, Silvia Carrara, Gabriele Capurso, Casper H. J. van Eijck, Martin Oliverius, Susanne Roth, Francesca Tavano, Rudolf Kaaks, Andrea Szentesi, Ludmila Vodickova, Claudio Luchini, Ben Schöttker, Stefano Landi, Orsolya Dohan, Matteo Tacelli, William Greenhalf, Maria Gazouli, John P. Neoptolemos, Giulia Martina Cavestro, Ugo Boggi, Anna Latiano, Péter Hegyi, Laura Ginocchi, Mihai G. Netea, Pedro Sánchez-Rovira, Federico Canzian, Daniele Campa, Juan Sainz
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy-related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy-related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta-analysis of these populations identified, for the first time, the association of the BIDrs9604789 variant with an increased risk of developing the disease (ORMeta = 1.31, p = 9.67 × 10−6). We also confirmed the association of TP63rs1515496 and TP63rs35389543 variants with PDAC risk (OR = 0.89, p = 6.27 × 10−8 and OR = 1.16, p = 2.74 × 10−5). Although it is known that BID induces autophagy and TP63 promotes cell growth, cell motility and invasion, we also found that carriers of the TP63rs1515496G allele had increased numbers of FOXP3+ Helios+ T regulatory cells and CD45RA+ T regulatory cells (p = 7.67 × 10−4 and p = 1.56 × 10−3), but also decreased levels of CD4+ T regulatory cells (p = 7.86 × 10−4). These results were in agreement with research suggesting that the TP63rs1515496 variant alters binding sites for FOXA1 and CTCF, which are transcription factors involved in modulating specific subsets of regulatory T cells. In conclusion, this study identifies BID as new susceptibility locus for PDAC and confirms previous studies suggesting that the TP63 gene is involved in the development of PDAC. This study also suggests new pathogenic mechanisms of the TP63 locus in PDAC.
{"title":"Polymorphisms within autophagy-related genes as susceptibility biomarkers for pancreatic cancer: A meta-analysis of three large European cohorts and functional characterization","authors":"Fernando Gálvez-Montosa, Giulia Peduzzi, José Manuel Sanchez-Maldonado, Rob ter Horst, Antonio J. Cabrera-Serrano, Manuel Gentiluomo, Angelica Macauda, Natalia Luque, Pelin Ünal, Francisco José García-Verdejo, Yang Li, José Antonio López López, Angelika Stein, H. Bas Bueno-de-Mesquita, Paolo Giorgio Arcidiacono, Dalila Luciola Zanette, Christoph Kahlert, Francesco Perri, Pavel Soucek, Renata Talar-Wojnarowska, George E. Theodoropoulos, Jakob R. Izbicki, Hussein Tamás, Hanneke Van Laarhoven, Gennaro Nappo, Maria Chiara Petrone, Martin Lovecek, Roel C. H. Vermeulen, Kestutis Adamonis, Fernando Jesus Reyes-Zurita, Bernd Holleczek, Jolanta Sumskiene, Beatrice Mohelníková-Duchoňová, Rita T. Lawlor, Raffaele Pezzilli, Mateus Nobrega Aoki, Claudio Pasquali, Vitalija Petrenkiene, Daniela Basso, Stefania Bunduc, Annalisa Comandatore, Hermann Brenner, Stefano Ermini, Giuseppe Vanella, Mara R. Goetz, Livia Archibugi, Maurizio Lucchesi, Faik Guntac Uzunoglu, Olivier Busch, Anna Caterina Milanetto, Marta Puzzono, Juozas Kupcinskas, Luca Morelli, Cosimo Sperti, Silvia Carrara, Gabriele Capurso, Casper H. J. van Eijck, Martin Oliverius, Susanne Roth, Francesca Tavano, Rudolf Kaaks, Andrea Szentesi, Ludmila Vodickova, Claudio Luchini, Ben Schöttker, Stefano Landi, Orsolya Dohan, Matteo Tacelli, William Greenhalf, Maria Gazouli, John P. Neoptolemos, Giulia Martina Cavestro, Ugo Boggi, Anna Latiano, Péter Hegyi, Laura Ginocchi, Mihai G. Netea, Pedro Sánchez-Rovira, Federico Canzian, Daniele Campa, Juan Sainz","doi":"10.1002/ijc.35196","DOIUrl":"10.1002/ijc.35196","url":null,"abstract":"<p>Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy-related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy-related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta-analysis of these populations identified, for the first time, the association of the <i>BID</i><sub>rs9604789</sub> variant with an increased risk of developing the disease (OR<sub>Meta</sub> = 1.31, <i>p</i> = 9.67 × 10<sup>−6</sup>). We also confirmed the association of <i>TP63</i><sub>rs1515496</sub> and <i>TP63</i><sub>rs35389543</sub> variants with PDAC risk (OR = 0.89, <i>p</i> = 6.27 × 10<sup>−8</sup> and OR = 1.16, <i>p</i> = 2.74 × 10<sup>−5</sup>). Although it is known that <i>BID</i> induces autophagy and <i>TP63</i> promotes cell growth, cell motility and invasion, we also found that carriers of the <i>TP63</i><sub>rs1515496G</sub> allele had increased numbers of FOXP3+ Helios+ T regulatory cells and CD45RA+ T regulatory cells (<i>p</i> = 7.67 × 10<sup>−4</sup> and <i>p</i> = 1.56 × 10<sup>−3</sup>), but also decreased levels of CD4+ T regulatory cells (<i>p</i> = 7.86 × 10<sup>−4</sup>). These results were in agreement with research suggesting that the <i>TP63</i><sub>rs1515496</sub> variant alters binding sites for FOXA1 and CTCF, which are transcription factors involved in modulating specific subsets of regulatory T cells. In conclusion, this study identifies <i>BID</i> as new susceptibility locus for PDAC and confirms previous studies suggesting that the <i>TP63</i> gene is involved in the development of PDAC. This study also suggests new pathogenic mechanisms of the <i>TP63</i> locus in PDAC.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"156 2","pages":"339-352"},"PeriodicalIF":5.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ijc.35196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337952","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}
Anja Oštrbenk Valenčak, Kelsi R Kroon, Danijela Fabjan, Jana Mlakar, Katja Seme, Johannes Berkhof, Mario Poljak
Molecular testing for human papillomaviruses (HPV) is gradually replacing cytology in cervical cancer screening. In this longitudinal population-based cohort study, 4140 women 20 to 64 years old attending organized screening were tested at baseline by five different screening methods and followed for 9 years. To assess long-term safety, the cumulative risks of CIN2+/CIN3+ were estimated after a negative baseline result obtained by conventional cytology and four clinically validated HPV assays: Hybrid Capture 2 (hc2), RealTime High Risk HPV assay (RealTime), cobas 4800 HPV Test (cobas_4800), and Alinity m HR HPV (Alinity). HPV-negative women at baseline had a substantially lower risk for CIN2+ compared to those with normal baseline cytology: 0.84% (95% CI, 0.46-1.22), 0.90% (95% CI, 0.51-1.29), 0.78% (95% CI, 0.42-1.15), and 0.75% (95% CI, 0.39-1.11) for hc2, RealTime, cobas_4800, and Alinity, respectively, compared to 2.46% (95% CI, 1.88-3.03) for cytology. No differences were observed between HPV assays in longitudinal sensitivity (range: 86.21%-90.36%) and negative predictive values (range: 99.54%-99.70%) for CIN2+ in women ≥30 years, but were significantly different from cytology (p < .05). The 9-year cumulative risk of CIN2+ differed significantly between HPV genotypes, reaching 32.1% (95% CI, 14.5-46.1) for HPV16, 24.9% (95% CI, 4.7-40.8) for HPV18/45, 27.2% (95% CI, 14.6-37.8) for HPV31/33/35/52/58, and 8.1% (95% CI, 0.0-16.7) for HPV39/51/56/59. Four clinically validated HPV assays showed comparable safety and better assurance against precancerous lesions than cytology, but some important differences were identified in the performance characteristics of HPV assays impacting the referral rate. Information about the HPV genotype is valuable for guiding further clinical action in HPV-based screening programs.
{"title":"Clinically validated HPV assays offer comparable long-term safety in primary cervical cancer screening: A 9-year follow-up of a population-based screening cohort.","authors":"Anja Oštrbenk Valenčak, Kelsi R Kroon, Danijela Fabjan, Jana Mlakar, Katja Seme, Johannes Berkhof, Mario Poljak","doi":"10.1002/ijc.35200","DOIUrl":"10.1002/ijc.35200","url":null,"abstract":"<p><p>Molecular testing for human papillomaviruses (HPV) is gradually replacing cytology in cervical cancer screening. In this longitudinal population-based cohort study, 4140 women 20 to 64 years old attending organized screening were tested at baseline by five different screening methods and followed for 9 years. To assess long-term safety, the cumulative risks of CIN2+/CIN3+ were estimated after a negative baseline result obtained by conventional cytology and four clinically validated HPV assays: Hybrid Capture 2 (hc2), RealTime High Risk HPV assay (RealTime), cobas 4800 HPV Test (cobas_4800), and Alinity m HR HPV (Alinity). HPV-negative women at baseline had a substantially lower risk for CIN2+ compared to those with normal baseline cytology: 0.84% (95% CI, 0.46-1.22), 0.90% (95% CI, 0.51-1.29), 0.78% (95% CI, 0.42-1.15), and 0.75% (95% CI, 0.39-1.11) for hc2, RealTime, cobas_4800, and Alinity, respectively, compared to 2.46% (95% CI, 1.88-3.03) for cytology. No differences were observed between HPV assays in longitudinal sensitivity (range: 86.21%-90.36%) and negative predictive values (range: 99.54%-99.70%) for CIN2+ in women ≥30 years, but were significantly different from cytology (p < .05). The 9-year cumulative risk of CIN2+ differed significantly between HPV genotypes, reaching 32.1% (95% CI, 14.5-46.1) for HPV16, 24.9% (95% CI, 4.7-40.8) for HPV18/45, 27.2% (95% CI, 14.6-37.8) for HPV31/33/35/52/58, and 8.1% (95% CI, 0.0-16.7) for HPV39/51/56/59. Four clinically validated HPV assays showed comparable safety and better assurance against precancerous lesions than cytology, but some important differences were identified in the performance characteristics of HPV assays impacting the referral rate. Information about the HPV genotype is valuable for guiding further clinical action in HPV-based screening programs.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victoria Damerell, Niels Klaassen-Dekker, Stefanie Brezina, Jennifer Ose, Arve Ulvik, Eline H van Roekel, Andreana N Holowatyj, Andreas Baierl, Jürgen Böhm, Martijn J L Bours, Hermann Brenner, Johannes H W de Wilt, William M Grady, Nina Habermann, Michael Hoffmeister, Pekka Keski-Rahkonen, Tengda Lin, Peter Schirmacher, Petra Schrotz-King, Alexis B Ulrich, Fränzel J B van Duijnhoven, Christy A Warby, David Shibata, Adetunji T Toriola, Jane C Figueiredo, Erin M Siegel, Christopher I Li, Andrea Gsur, Ellen Kampman, Martin Schneider, Per M Ueland, Matty P Weijenberg, Cornelia M Ulrich, Dieuwertje E Kok, Biljana Gigic
Alterations within the tryptophan-kynurenine metabolic pathway have been linked to the etiology of colorectal cancer (CRC), but the relevance of this pathway for prognostic outcomes in CRC patients needs further elucidation. Therefore, we investigated associations between circulating concentrations of tryptophan-kynurenine pathway metabolites and all-cause mortality among CRC patients. This study utilizes data from 2102 stage I-III CRC patients participating in six prospective cohorts involved in the international FOCUS Consortium. Preoperative circulating concentrations of tryptophan, kynurenine, kynurenic acid (KA), 3-hydroxykynurenine (HK), xanthurenic acid (XA), 3-hydroxyanthranilic acid (HAA), anthranilic acid (AA), picolinic acid (PA), and quinolinic acid (QA) were measured by liquid chromatography-tandem mass spectrometry. Using Cox proportional hazards regression, we examined associations of above-mentioned metabolites with all-cause mortality, adjusted for potential confounders. During a median follow-up of 3.2 years (interquartile range: 2.2-4.9), 290 patients (13.8%) deceased. Higher blood concentrations of tryptophan, XA, and PA were associated with a lower risk of all-cause mortality (per doubling in concentrations: tryptophan: HR = 0.56; 95%CI:0.41,0.76, XA: HR = 0.74; 95%CI:0.64,0.85, PA: HR = 0.76; 95%CI:0.64,0.92), while higher concentrations of HK and QA were associated with an increased risk of death (per doubling in concentrations: HK: HR = 1.80; 95%CI:1.47,2.21, QA: HR = 1.31; 95%CI:1.05,1.63). A higher kynurenine-to-tryptophan ratio, a marker of cell-mediated immune activation, was associated with an increased risk of death (per doubling: HR = 2.07; 95%CI:1.52,2.83). In conclusion, tryptophan-kynurenine pathway metabolites may be prognostic markers of survival in CRC patients.
{"title":"Circulating tryptophan-kynurenine pathway metabolites are associated with all-cause mortality among patients with stage I-III colorectal cancer.","authors":"Victoria Damerell, Niels Klaassen-Dekker, Stefanie Brezina, Jennifer Ose, Arve Ulvik, Eline H van Roekel, Andreana N Holowatyj, Andreas Baierl, Jürgen Böhm, Martijn J L Bours, Hermann Brenner, Johannes H W de Wilt, William M Grady, Nina Habermann, Michael Hoffmeister, Pekka Keski-Rahkonen, Tengda Lin, Peter Schirmacher, Petra Schrotz-King, Alexis B Ulrich, Fränzel J B van Duijnhoven, Christy A Warby, David Shibata, Adetunji T Toriola, Jane C Figueiredo, Erin M Siegel, Christopher I Li, Andrea Gsur, Ellen Kampman, Martin Schneider, Per M Ueland, Matty P Weijenberg, Cornelia M Ulrich, Dieuwertje E Kok, Biljana Gigic","doi":"10.1002/ijc.35183","DOIUrl":"10.1002/ijc.35183","url":null,"abstract":"<p><p>Alterations within the tryptophan-kynurenine metabolic pathway have been linked to the etiology of colorectal cancer (CRC), but the relevance of this pathway for prognostic outcomes in CRC patients needs further elucidation. Therefore, we investigated associations between circulating concentrations of tryptophan-kynurenine pathway metabolites and all-cause mortality among CRC patients. This study utilizes data from 2102 stage I-III CRC patients participating in six prospective cohorts involved in the international FOCUS Consortium. Preoperative circulating concentrations of tryptophan, kynurenine, kynurenic acid (KA), 3-hydroxykynurenine (HK), xanthurenic acid (XA), 3-hydroxyanthranilic acid (HAA), anthranilic acid (AA), picolinic acid (PA), and quinolinic acid (QA) were measured by liquid chromatography-tandem mass spectrometry. Using Cox proportional hazards regression, we examined associations of above-mentioned metabolites with all-cause mortality, adjusted for potential confounders. During a median follow-up of 3.2 years (interquartile range: 2.2-4.9), 290 patients (13.8%) deceased. Higher blood concentrations of tryptophan, XA, and PA were associated with a lower risk of all-cause mortality (per doubling in concentrations: tryptophan: HR = 0.56; 95%CI:0.41,0.76, XA: HR = 0.74; 95%CI:0.64,0.85, PA: HR = 0.76; 95%CI:0.64,0.92), while higher concentrations of HK and QA were associated with an increased risk of death (per doubling in concentrations: HK: HR = 1.80; 95%CI:1.47,2.21, QA: HR = 1.31; 95%CI:1.05,1.63). A higher kynurenine-to-tryptophan ratio, a marker of cell-mediated immune activation, was associated with an increased risk of death (per doubling: HR = 2.07; 95%CI:1.52,2.83). In conclusion, tryptophan-kynurenine pathway metabolites may be prognostic markers of survival in CRC patients.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Approximately one-third of advanced renal cell carcinoma (RCC) patients develop osteolytic bone metastases, leading to skeletal complications. In this review, we first provide a comprehensive perspective of seminal studies on bone metastasis of RCC describing the main molecular modulators and growth factor signaling pathways most important for the RCC-stimulated osteoclast-mediated bone destruction. We next focus on newer developments revealing with in-depth details, the bidirectional interplay between renal cancer cells and the immune and stromal microenvironment that can through epigenetic reprogramming, profoundly affect the behaviors of transformed cells. Understanding their mechanistic interactions is of paramount importance for advancing both fundamental and translational research. These new investigations into the landscape of RCC-bone metastasis offer novel insights and identify potential avenues for future therapeutic interventions.
{"title":"New players in the landscape of renal cell carcinoma bone metastasis and therapeutic opportunities.","authors":"Beatrice Cesana, Claude Cochet, Odile Filhol","doi":"10.1002/ijc.35181","DOIUrl":"https://doi.org/10.1002/ijc.35181","url":null,"abstract":"<p><p>Approximately one-third of advanced renal cell carcinoma (RCC) patients develop osteolytic bone metastases, leading to skeletal complications. In this review, we first provide a comprehensive perspective of seminal studies on bone metastasis of RCC describing the main molecular modulators and growth factor signaling pathways most important for the RCC-stimulated osteoclast-mediated bone destruction. We next focus on newer developments revealing with in-depth details, the bidirectional interplay between renal cancer cells and the immune and stromal microenvironment that can through epigenetic reprogramming, profoundly affect the behaviors of transformed cells. Understanding their mechanistic interactions is of paramount importance for advancing both fundamental and translational research. These new investigations into the landscape of RCC-bone metastasis offer novel insights and identify potential avenues for future therapeutic interventions.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jian-Guo Chen, Thomas W Kensler, Jian Zhu, Yuan-Rong Zhu, Jin-Bing Wang, Jian-Hua Lu, Alvaro Muñoz, John D Groopman
Liver cancer causes upwards of 1 million cancer deaths annually and is projected to rise by at least 55% over the next 15 years. Two of the major risk factors contributing to liver cancer have been well documented by multiple epidemiologic studies and the hepatitis B virus (HBV) and aflatoxin show a synergy that increases by more than 8-fold the risk of liver cancer relative to HBV alone. Using the population-based cancer registry established by the Qidong Liver Cancer Institute in 1972 and aflatoxin-specific biomarkers, we document that reduction of aflatoxin exposure has likely contributed to a nearly 70% decline in age-standardized liver cancer incidence over the past 30 years despite an unchanging prevalence of HBV infection in cases. A natural experiment of economic reform in the 1980s drove a rapid switch from consumption of heavily contaminated corn to minimally, if any, contaminated rice and subsequent dietary diversity. Aflatoxin consumption appears to accelerate the time to liver cancer diagnosis; lowering exposure to this carcinogen adds years of life before a cancer diagnosis. Thus, in 1990 the median age of diagnosis was 48 years, while increasing to 67 years by 2021. These findings have important translational public health implications since up to 5 billion people worldwide might be routinely exposed to dietary aflatoxin, especially in societies using corn as the staple food. Interventions against aflatoxin are an achievable outcome leading to a reduction in liver cancer incidence and years of delay of its nearly always fatal diagnosis.
{"title":"Profound primary prevention of liver cancer following a natural experiment in China: A 50-year perspective and public health implications.","authors":"Jian-Guo Chen, Thomas W Kensler, Jian Zhu, Yuan-Rong Zhu, Jin-Bing Wang, Jian-Hua Lu, Alvaro Muñoz, John D Groopman","doi":"10.1002/ijc.35198","DOIUrl":"https://doi.org/10.1002/ijc.35198","url":null,"abstract":"<p><p>Liver cancer causes upwards of 1 million cancer deaths annually and is projected to rise by at least 55% over the next 15 years. Two of the major risk factors contributing to liver cancer have been well documented by multiple epidemiologic studies and the hepatitis B virus (HBV) and aflatoxin show a synergy that increases by more than 8-fold the risk of liver cancer relative to HBV alone. Using the population-based cancer registry established by the Qidong Liver Cancer Institute in 1972 and aflatoxin-specific biomarkers, we document that reduction of aflatoxin exposure has likely contributed to a nearly 70% decline in age-standardized liver cancer incidence over the past 30 years despite an unchanging prevalence of HBV infection in cases. A natural experiment of economic reform in the 1980s drove a rapid switch from consumption of heavily contaminated corn to minimally, if any, contaminated rice and subsequent dietary diversity. Aflatoxin consumption appears to accelerate the time to liver cancer diagnosis; lowering exposure to this carcinogen adds years of life before a cancer diagnosis. Thus, in 1990 the median age of diagnosis was 48 years, while increasing to 67 years by 2021. These findings have important translational public health implications since up to 5 billion people worldwide might be routinely exposed to dietary aflatoxin, especially in societies using corn as the staple food. Interventions against aflatoxin are an achievable outcome leading to a reduction in liver cancer incidence and years of delay of its nearly always fatal diagnosis.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tamoxifen (TAM), a selective estrogen receptor (ER) modulator, has received approval for use in patients with breast cancer (BC) exhibiting positive ER expression. Given the widespread clinical use of TAM, a comprehensive real-world study of its adverse events (AEs) is warranted. The database for analysis, sourced from the Food and Drug Administration Adverse Event Reporting System (FAERS), covers the period from the first quarter of 2014 to the third quarter of 2023. A disproportionality analysis was conducted to quantify the correlation between TAM and AEs. Subgroup analyses were performed to identify differences between BC AEs in males and females receiving TAM, aiming to assess the risk factors of male BC AEs. Total 4890 reports indicated BC, with 91 and 4190 specifically linked to AEs in male and female patients with BC, respectively. Male-specific AE was libido decreased (reporting odds ratio [ROR]: 43.33), and female-specific AE was uterine disease, including sarcoma uterus (ROR: 519.51), endometrial cancer (ROR: 131.26), uterine polyp (ROR: 40.83), endometriosis (ROR: 11.39), among others. A notably higher risk of AEs in male patients with BC was observed in individuals aged >65 years (χ2 = 20.83, p < .001). Male patients with BC had a relatively higher risk of hospitalization (χ2 = 4.83, p = .03) and a lower risk of deaths (χ2 = 5.32, p = .02). Theses finding may assist healthcare professionals in recognizing the TAM-associated AEs and understanding gender differences, potentially improving safety in clinical applications.
他莫昔芬(TAM)是一种选择性雌激素受体(ER)调节剂,已获准用于ER阳性表达的乳腺癌(BC)患者。鉴于他莫昔芬在临床上的广泛应用,有必要对其不良事件(AEs)进行全面的真实世界研究。用于分析的数据库来自美国食品和药物管理局不良事件报告系统(FAERS),时间跨度为2014年第一季度至2023年第三季度。进行了比例失调分析,以量化 TAM 与 AE 之间的相关性。还进行了亚组分析,以确定男性和女性接受 TAM 治疗的 BC AEs 之间的差异,目的是评估男性 BC AEs 的风险因素。共有4890份报告指出了BC,其中91份和4190份分别与男性和女性BC患者的AE有关。男性特异性 AE 为性欲减退(报告几率比 [ROR]:43.33),女性特异性 AE 为子宫疾病,包括子宫肉瘤(ROR:519.51)、子宫内膜癌(ROR:131.26)、子宫息肉(ROR:40.83)、子宫内膜异位症(ROR:11.39)等。观察发现,年龄大于 65 岁的男性 BC 患者发生 AEs 的风险明显较高(χ2 = 20.83,P 2 = 4.83,P = .03),而死亡风险较低(χ2 = 5.32,P = .02)。这些发现可能有助于医护人员识别 TAM 相关的 AEs 并了解性别差异,从而提高临床应用的安全性。
{"title":"Postmarketing adverse events of tamoxifen in male and female patients with breast cancer.","authors":"Chengjie Ke, Maohua Chen, Li Lin, Yaping Huang","doi":"10.1002/ijc.35193","DOIUrl":"https://doi.org/10.1002/ijc.35193","url":null,"abstract":"<p><p>Tamoxifen (TAM), a selective estrogen receptor (ER) modulator, has received approval for use in patients with breast cancer (BC) exhibiting positive ER expression. Given the widespread clinical use of TAM, a comprehensive real-world study of its adverse events (AEs) is warranted. The database for analysis, sourced from the Food and Drug Administration Adverse Event Reporting System (FAERS), covers the period from the first quarter of 2014 to the third quarter of 2023. A disproportionality analysis was conducted to quantify the correlation between TAM and AEs. Subgroup analyses were performed to identify differences between BC AEs in males and females receiving TAM, aiming to assess the risk factors of male BC AEs. Total 4890 reports indicated BC, with 91 and 4190 specifically linked to AEs in male and female patients with BC, respectively. Male-specific AE was libido decreased (reporting odds ratio [ROR]: 43.33), and female-specific AE was uterine disease, including sarcoma uterus (ROR: 519.51), endometrial cancer (ROR: 131.26), uterine polyp (ROR: 40.83), endometriosis (ROR: 11.39), among others. A notably higher risk of AEs in male patients with BC was observed in individuals aged >65 years (χ<sup>2</sup> = 20.83, p < .001). Male patients with BC had a relatively higher risk of hospitalization (χ<sup>2</sup> = 4.83, p = .03) and a lower risk of deaths (χ<sup>2</sup> = 5.32, p = .02). Theses finding may assist healthcare professionals in recognizing the TAM-associated AEs and understanding gender differences, potentially improving safety in clinical applications.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentine Poissonnet, Emmanuelle Uro-Coste, Emilien Chabrillac, Anouchka Modesto, Caroline Even, Nicolas Fakhry, Renaud Garrel, Olivier Malard, Florian Chatelet, Charles Dupin, Franck Jegoux, Philippe Schultz, Dorian Culié, Robin Baudouin, Diane Evrard, Pierre Ransy, Sylvain Morinière, Haitham Mirghani, François Mouawad, Christian Righini, Suzy Duflo, Jean-Paul Marie, Florence Jourdan-Soulier, Sarah Atallah, Esteban Brenet, Chloé Bertolus, Philippe Ceruse, Lionel Ramin, Xavier Dufour, Duc Trung Nguyen, Vianney Bastit, Bertille Segier, Sébastien Vergez
Salivary carcinomas of minor salivary glands are very infrequent tumors. When located in the tongue, the therapeutic strategy may comprise upfront surgery, which may be debilitating, and/or (chemo-)radiotherapy. The aim of this study was to identify the prognostic factors of salivary carcinomas of the tongue in a population-based cohort. This retrospective multicentric study, based on the “Réseau d'Expertise Français sur les Cancers ORL Rares” (REFCOR), included all the patients with a salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018. Dubious slides were reviewed by REFCOR expert pathologists to ensure diagnostic accuracy. Treatment was performed in accordance with national REFCOR recommendations. From 28 centers, 103 patients were included in this study. Median age at diagnosis was 63 years, and 60.2% were female. Tumors were adenoid cystic carcinomas (41.7%), mucoepidermoid carcinomas (30.1%), and other adenocarcinomas (28.2%). Primary treatment was surgical for 61.2% of them. Five-year overall survival (OS) and event-free survival (EFS) rates were 84.7% and 38.6%, respectively. In multivariable analysis, EFS was significantly worse in case of nonsurgical treatment, alcohol consumption, and glossotonsillar sulcus involvement. N-positive status was the only significant prognostic factor for OS in multivariable analysis. Salivary carcinomas of the tongue represent a heterogeneous group of rare tumors, with a high risk of recurrence. In this national cohort, surgery was associated with better EFS and N-status was the main independent prognostic factor for OS.
{"title":"Malignant salivary gland tumors of the tongue: A multicenter REFCOR study","authors":"Valentine Poissonnet, Emmanuelle Uro-Coste, Emilien Chabrillac, Anouchka Modesto, Caroline Even, Nicolas Fakhry, Renaud Garrel, Olivier Malard, Florian Chatelet, Charles Dupin, Franck Jegoux, Philippe Schultz, Dorian Culié, Robin Baudouin, Diane Evrard, Pierre Ransy, Sylvain Morinière, Haitham Mirghani, François Mouawad, Christian Righini, Suzy Duflo, Jean-Paul Marie, Florence Jourdan-Soulier, Sarah Atallah, Esteban Brenet, Chloé Bertolus, Philippe Ceruse, Lionel Ramin, Xavier Dufour, Duc Trung Nguyen, Vianney Bastit, Bertille Segier, Sébastien Vergez","doi":"10.1002/ijc.35167","DOIUrl":"10.1002/ijc.35167","url":null,"abstract":"<p>Salivary carcinomas of minor salivary glands are very infrequent tumors. When located in the tongue, the therapeutic strategy may comprise upfront surgery, which may be debilitating, and/or (chemo-)radiotherapy. The aim of this study was to identify the prognostic factors of salivary carcinomas of the tongue in a population-based cohort. This retrospective multicentric study, based on the “Réseau d'Expertise Français sur les Cancers ORL Rares” (REFCOR), included all the patients with a salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018. Dubious slides were reviewed by REFCOR expert pathologists to ensure diagnostic accuracy. Treatment was performed in accordance with national REFCOR recommendations. From 28 centers, 103 patients were included in this study. Median age at diagnosis was 63 years, and 60.2% were female. Tumors were adenoid cystic carcinomas (41.7%), mucoepidermoid carcinomas (30.1%), and other adenocarcinomas (28.2%). Primary treatment was surgical for 61.2% of them. Five-year overall survival (OS) and event-free survival (EFS) rates were 84.7% and 38.6%, respectively. In multivariable analysis, EFS was significantly worse in case of nonsurgical treatment, alcohol consumption, and glossotonsillar sulcus involvement. N-positive status was the only significant prognostic factor for OS in multivariable analysis. Salivary carcinomas of the tongue represent a heterogeneous group of rare tumors, with a high risk of recurrence. In this national cohort, surgery was associated with better EFS and N-status was the main independent prognostic factor for OS.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"156 2","pages":"310-321"},"PeriodicalIF":5.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maxime Turuban, Hans Kromhout, Javier Vila, Miquel Vallbona-Vistós, Frank De Vocht, Isabelle Baldi, Lesley Richardson, Geza Benke, Daniel Krewski, Marie-Elise Parent, Siegal Sadetzki, Brigitte Schlehofer, Joachim Schüz, Jack Siemiatycki, Martie van Tongeren, Alistair Woodward, Elisabeth Cardis, Michelle C Turner
Radiofrequency electromagnetic fields (RF-EMF, 100 kHz to 300 GHz) are classified by IARC as possibly carcinogenic to humans (Group 2B). This study evaluates the potential association between occupational RF-EMF exposure and brain tumor risk, utilizing for the first time, a RF-EMF job-exposure matrix (RF-JEM) developed in the multi-country INTEROCC case-control study. Cumulative and time-weighted average (TWA) occupational RF-EMF exposures were estimated for study participants based on lifetime job histories linked to the RF-JEM using three different methods: (1) by considering RF-EMF intensity among all exposed jobs, (2) by considering RF-EMF intensity among jobs with an exposure prevalence ≥ the median exposure prevalence of all exposed jobs, and (3) by considering RF-EMF intensity of jobs of participants who reported RF-EMF source use. Stratified conditional logistic regression models were used, considering various lag periods and exposure time windows defined a priori. Generally, no clear associations were found for glioma or meningioma risk. However, some statistically significant positive associations were observed including in the highest exposure categories for glioma for cumulative and TWA exposure in the 1- to 4-year time window for electric fields (E) in the first JEM application method (odds ratios [ORs] = 1.36, 95% confidence interval [95% CI] 1.08, 1.72 and 1.27, 95% CI 1.01, 1.59, respectively), as well as for meningioma for cumulative exposure in the 5- to 9-year time window for electric fields (E) in the third JEM application method (OR = 2.30, 95% CI 1.11, 4.78). We did not identify convincing associations between occupational RF-EMF exposure and risk of glioma or meningioma.
{"title":"Occupational exposure to radiofrequency electromagnetic fields and brain tumor risk: Application of the INTEROCC job-exposure matrix.","authors":"Maxime Turuban, Hans Kromhout, Javier Vila, Miquel Vallbona-Vistós, Frank De Vocht, Isabelle Baldi, Lesley Richardson, Geza Benke, Daniel Krewski, Marie-Elise Parent, Siegal Sadetzki, Brigitte Schlehofer, Joachim Schüz, Jack Siemiatycki, Martie van Tongeren, Alistair Woodward, Elisabeth Cardis, Michelle C Turner","doi":"10.1002/ijc.35182","DOIUrl":"https://doi.org/10.1002/ijc.35182","url":null,"abstract":"<p><p>Radiofrequency electromagnetic fields (RF-EMF, 100 kHz to 300 GHz) are classified by IARC as possibly carcinogenic to humans (Group 2B). This study evaluates the potential association between occupational RF-EMF exposure and brain tumor risk, utilizing for the first time, a RF-EMF job-exposure matrix (RF-JEM) developed in the multi-country INTEROCC case-control study. Cumulative and time-weighted average (TWA) occupational RF-EMF exposures were estimated for study participants based on lifetime job histories linked to the RF-JEM using three different methods: (1) by considering RF-EMF intensity among all exposed jobs, (2) by considering RF-EMF intensity among jobs with an exposure prevalence ≥ the median exposure prevalence of all exposed jobs, and (3) by considering RF-EMF intensity of jobs of participants who reported RF-EMF source use. Stratified conditional logistic regression models were used, considering various lag periods and exposure time windows defined a priori. Generally, no clear associations were found for glioma or meningioma risk. However, some statistically significant positive associations were observed including in the highest exposure categories for glioma for cumulative and TWA exposure in the 1- to 4-year time window for electric fields (E) in the first JEM application method (odds ratios [ORs] = 1.36, 95% confidence interval [95% CI] 1.08, 1.72 and 1.27, 95% CI 1.01, 1.59, respectively), as well as for meningioma for cumulative exposure in the 5- to 9-year time window for electric fields (E) in the third JEM application method (OR = 2.30, 95% CI 1.11, 4.78). We did not identify convincing associations between occupational RF-EMF exposure and risk of glioma or meningioma.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
André Pfob, Irina Surovtsova, Daria B Kokh, Joerg Heil, Maggie Banys-Paluchowski, Philipp Morakis
We aimed to evaluate the role of adjuvant chemotherapy and loco-regional therapy for stage IA (pT1, pN0) triple-negative breast cancer (TNBC) in a real-world setting. We identified patients with pT1, pN0 TNBC diagnosed between 2009 and 2021 within the Baden-Württemberg cancer registry (BWCR), Germany. Overall survival (OS) was assessed using Kaplan-Meier statistics and multivariate Cox regression models (adjusted for age, use of chemotherapy, local therapy (breast conserving therapy [breast conserving surgery + radiotherapy] vs. mastectomy), and tumor histologic subtype). A total of 1231 patients with a median follow-up of 45.9 months were identified: 1.0% (12 of 1231) with pT1mi stage, 9.5% (117 of 1231) with pT1a, 23.7% (292 of 1231) with pT1b, and 65.8% (810 of 1231) with pT1c. Multivariate Cox regression analysis revealed no significant influence for the use of chemotherapy on OS in pT1b patients (HR 0.90, 95% CI 0.43-1.90). For pT1c patients with Grade 1-2 tumors, the use of chemotherapy was not significantly associated OS (HR 1.01, 95% CI 0.48-2.11) but breast conserving therapy was associated with improved OS (HR 0.41, 95% CI 0.18-0.93). For pT1c patients with Grade 3 tumors, the use of chemotherapy (HR 0.51, 95% CI 0.33-0.78) as well as breast conserving therapy (HR 0.42, 95% CI 0.23-0.76) was associated with OS. This data suggests that OS in stage IA TNBC is strongly influenced by local therapy rather than the use of chemotherapy, except for pT1c patients with Grade 3 tumors. Larger studies with longer-term follow-up are welcomed to fully inform this discussion.
我们旨在评估辅助化疗和局部区域治疗在真实世界中对IA期(pT1,pN0)三阴性乳腺癌(TNBC)的作用。我们在德国巴登-符腾堡州癌症登记处(BWCR)确定了 2009 年至 2021 年期间确诊的 pT1、pN0 TNBC 患者。采用卡普兰-梅耶统计法和多变量考克斯回归模型(根据年龄、化疗使用情况、局部治疗(保乳疗法[保乳手术+放疗]与乳房切除术)和肿瘤组织学亚型进行调整)评估总生存期(OS)。共确定了 1231 名患者,中位随访时间为 45.9 个月:1.0%(1231 例中的 12 例)为 pT1mi 期,9.5%(1231 例中的 117 例)为 pT1a 期,23.7%(1231 例中的 292 例)为 pT1b 期,65.8%(1231 例中的 810 例)为 pT1c 期。多变量考克斯回归分析显示,化疗对pT1b患者的OS无明显影响(HR 0.90,95% CI 0.43-1.90)。对于1-2级肿瘤的pT1c患者,化疗的使用与OS无明显关系(HR 1.01,95% CI 0.48-2.11),但保乳治疗与OS的改善有关(HR 0.41,95% CI 0.18-0.93)。对于 3 级肿瘤的 pT1c 患者,化疗(HR 0.51,95% CI 0.33-0.78)和保乳治疗(HR 0.42,95% CI 0.23-0.76)与 OS 相关。这些数据表明,IA期TNBC的OS主要受局部治疗而非化疗的影响,但患有3级肿瘤的pT1c患者除外。欢迎进行更大规模、更长期的随访研究,以便为这一讨论提供更充分的信息。
{"title":"Use of chemotherapy and loco-regional therapy in stage IA triple-negative breast cancer and their association with oncologic outcomes: A cancer registry study.","authors":"André Pfob, Irina Surovtsova, Daria B Kokh, Joerg Heil, Maggie Banys-Paluchowski, Philipp Morakis","doi":"10.1002/ijc.35189","DOIUrl":"https://doi.org/10.1002/ijc.35189","url":null,"abstract":"<p><p>We aimed to evaluate the role of adjuvant chemotherapy and loco-regional therapy for stage IA (pT1, pN0) triple-negative breast cancer (TNBC) in a real-world setting. We identified patients with pT1, pN0 TNBC diagnosed between 2009 and 2021 within the Baden-Württemberg cancer registry (BWCR), Germany. Overall survival (OS) was assessed using Kaplan-Meier statistics and multivariate Cox regression models (adjusted for age, use of chemotherapy, local therapy (breast conserving therapy [breast conserving surgery + radiotherapy] vs. mastectomy), and tumor histologic subtype). A total of 1231 patients with a median follow-up of 45.9 months were identified: 1.0% (12 of 1231) with pT1mi stage, 9.5% (117 of 1231) with pT1a, 23.7% (292 of 1231) with pT1b, and 65.8% (810 of 1231) with pT1c. Multivariate Cox regression analysis revealed no significant influence for the use of chemotherapy on OS in pT1b patients (HR 0.90, 95% CI 0.43-1.90). For pT1c patients with Grade 1-2 tumors, the use of chemotherapy was not significantly associated OS (HR 1.01, 95% CI 0.48-2.11) but breast conserving therapy was associated with improved OS (HR 0.41, 95% CI 0.18-0.93). For pT1c patients with Grade 3 tumors, the use of chemotherapy (HR 0.51, 95% CI 0.33-0.78) as well as breast conserving therapy (HR 0.42, 95% CI 0.23-0.76) was associated with OS. This data suggests that OS in stage IA TNBC is strongly influenced by local therapy rather than the use of chemotherapy, except for pT1c patients with Grade 3 tumors. Larger studies with longer-term follow-up are welcomed to fully inform this discussion.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shen‐Han Lee, Alan Soo‐Beng Khoo, John R. Griffiths, Norhafiza Mat Lazim
The Epstein–Barr virus (EBV), the first identified human tumour virus, infects over 95% of the individuals globally and has the potential to induce different types of cancers. It is increasingly recognised that EBV infection not only alters cellular metabolism, contributing to neoplastic transformation, but also utilises several non‐cell autonomous mechanisms to shape the metabolic milieu in the tumour microenvironment (TME) and its constituent stromal and immune cells. In this review, we explore how EBV modulates metabolism to shape the interactions between cancer cells, stromal cells, and immune cells within a hypoxic and acidic TME. We highlight how metabolites resulting from EBV infection act as paracrine factors to regulate the TME, and how targeting them can disrupt barriers to immunotherapy.
{"title":"Metabolic regulation of the tumour and its microenvironment: The role of Epstein–Barr virus","authors":"Shen‐Han Lee, Alan Soo‐Beng Khoo, John R. Griffiths, Norhafiza Mat Lazim","doi":"10.1002/ijc.35192","DOIUrl":"https://doi.org/10.1002/ijc.35192","url":null,"abstract":"The Epstein–Barr virus (EBV), the first identified human tumour virus, infects over 95% of the individuals globally and has the potential to induce different types of cancers. It is increasingly recognised that EBV infection not only alters cellular metabolism, contributing to neoplastic transformation, but also utilises several non‐cell autonomous mechanisms to shape the metabolic milieu in the tumour microenvironment (TME) and its constituent stromal and immune cells. In this review, we explore how EBV modulates metabolism to shape the interactions between cancer cells, stromal cells, and immune cells within a hypoxic and acidic TME. We highlight how metabolites resulting from EBV infection act as paracrine factors to regulate the TME, and how targeting them can disrupt barriers to immunotherapy.","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"13 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}