Oncology最新文献

The success of modern chemotherapy in overall survival of patients with advanced stages of osteosarcoma and soft tissue sarcoma has reached a plateau. Therefore a deeper understanding of molecular mechanisms behind deregulated apoptosis in sarcoma is essential for the cure of patients with advanced stages of osteosarcoma and soft tissue sarcoma. Lifeguard (LFG) is a member of the Bax Inhibitor-1 (BI-1) protein family and has anti-apoptotic effects by inhibiting Fas-mediated cell death signaling. Although LFG has been proven to be expressed in several breast cancer tissues, the expression and function of LFG regarding apoptosis in different subtypes of sarcoma remains unclear. In the present study, the expression of LFG in osteosarcoma (50 samples), chondrosarcoma (28 samples) and soft tissue sarcoma (total 55 samples) with different tumor stages for each sarcoma subtype were analyzed. For each subtype, clinical TNM-classification and pathological grading were determined and compared to healthy corresponding tissues. Soft tissue sarcoma subtypes included liposarcoma, dermatofibrosarcoma, angiosarcoma, leiomyosarcoma, malignant schwannoma and synovial cell sarcoma. In this study, significantly higher expressions of anti-apoptotic LFG protein in osteosarcoma, chondrosarcoma and many different subtypes of soft tissue sarcoma were found, compared to corresponding healthy tissues. More importantly a positive correlation between LFG expression and tumor stage for osteosarcoma and chondrosarcoma was found. In conclusion, LFG protein might play an important role in inhibition of Fas-mediated apoptosis in osteosarcoma cells, with possible potential for targeted tumor therapy in osteosarcoma.

In the article "Prognostic Factors in Pleural Mesothelioma Patients Receiving First-Line Chemotherapy: Establishing the PLECH Baseline Risk Score" [Oncology. 2025;103:1088-1096; https://doi.org/10.1159/000543637] by Guijosa et al., the following is being corrected.In Table 1, the percentages for lymphocytes (>1.46 vs. ≤1.46) were inadvertently inverted. The correct values are 54.6% and 45.4%, respectively.In addition, a citation mismatch occurred, affecting only reference 39. The correct reference 39 is:39. Feng Y, Xiong Y, Qiao T, Li X, Jia L, Han Y. Lactate dehydrogenase A: A key player in carcinogenesis and potential target in cancer therapy. Cancer Med. 2018;7:6124-36. https://doi.org/10.1002/cam4.1820The original article has been updated to reflect this.

Introduction: Atezolizumab-bevacizumab (AB) and durvalumab-tremelimumab (DT) combination therapies are widely used for the treatment of unresectable hepatocellular carcinoma (u-HCC). However, the optimal predictors of the therapeutic response remain unclear. Interferon-γ-induced protein-10 (IP-10) levels are considered potential biomarkers in immunotherapy for u-HCC and other cancers. To our knowledge, this study is the first to analyze the relationship between blood IP-10 levels and therapeutic response in patients with u-HCC receiving AB or DT.

Methods: This retrospective cohort included 106 patients who received immunotherapy for u-HCC. In these patients, IP-10 levels were quantified through enzyme-linked immunosorbent assay using stored plasma samples at baseline and after induction, and the ratio of postinduction to baseline IP-10 levels was calculated.

Results: The initial therapeutic responses were partial response (PR), stable disease (SD), and progressive disease (PD) rates of 42%, 28%, and 30%, respectively. The best responses were complete response (CR), PR, SD, and PD of 3%, 43%, 26%, and 28%, respectively. Baseline IP-10 levels in the PR group as the initial therapeutic response were higher than those in the SD/PD group (p = 0.0067). Using receiver operating characteristic curve analysis, patients with a baseline IP-10 level >150 pg/mL showed a higher response rate than those with not high levels (62% vs. 26%, p < 0.001). Moreover, the non-PD group, showing the best response, exhibited a lower IP-10 ratio before response evaluation than the PD group (p = 0.015). Achieving an IP-10 ratio <1 was independently associated with longer progression-free survival (hazard ratio 1.9, p = 0.022).

Conclusion: IP-10 levels may be useful predictors of therapeutic response in patients receiving AB or DT therapy. .

Introduction: Nivolumab combined with chemotherapy has been approved as the first-line treatment for HER2-negative, unresectable, advanced, or recurrent gastric cancer. Patients aged ≥ 75 years more often have impaired organ function and comorbidities that increase the risk of adverse events, including immune-related adverse events, than younger patients, potentially limiting the continuation of treatment. In this multicenter study, we aimed to evaluate the safety and efficacy of first-line nivolumab chemotherapy in older patients.

Methods: We retrospectively analyzed data from 103 patients treated with first-line nivolumab combination chemotherapy for unresectable, advanced, or recurrent gastric cancer at 12 institutions between November 2021 and January 2023. The participants were divided into groups A (<75 years, n=67) and B (≥75 years, n=36).

Results: The mean age was 63.9 years in Group A and 78.6 years in Group B. Body weight was significantly lower in Group B (p=0.041), and performance status 0-1 and hypertension were more prevalent in Group B (both p<0.01). Chemotherapy regimens and incidence of grade ≥3 immune-related adverse events were similar between the groups. The median overall survival was 15.2 months in Group A and was not reached in group B; this difference was not significant (p=0.689).

Conclusions: First-line chemotherapy with nivolumab is safe and effective in patients aged ≥75 years with a good performance status, as in younger patients, suggesting that it is a valid treatment option for the former subgroup.

Introduction: The prognosis of chronic myeloid leukemia (CML) has been revolutionized in recent decades with tyrosine kinase inhibitors (TKIs). Yet, comorbidities that require anticoagulation therapy pose a challenge in CML management because of the scarcity of evidence on the optimal drug combinations. This systematic review (SR) aims to summarize the efficacy and safety considerations for the concomitant use of anticoagulants with different TKIs in CML and investigate their potential drug interactions.

Methods: A comprehensive search strategy was used, employing Medical Subject Headings (MeSH) and free text terms across databases including PubMed (via OVID), Medline (via OVID), Embase (via OVID), and Web of Science. Members of the research team independently screened the titles and abstracts for eligibility based on predefined inclusion and exclusion criteria. Data extraction was then performed using a standardized form to record the studies' characteristics, the TKIs and anticoagulants used, and the outcomes related to safety. Two reviewers independently assessed study quality using Critical Appraisal Skills Program (CASP) checklists and the Joanna Briggs Institute (JBI) tool for case reports.

Results: The search yielded 406 studies, of which 13 met the inclusion criteria for reporting real-world safety data in adults receiving TKIs with anticoagulants. Overall, the combinations of TKIs with anticoagulants like ponatinib with apixaban and imatinib with warfarin had no major bleeding complications. The pharmacokinetic findings suggested some interaction variability, particularly between nilotinib and warfarin, but overall, anticoagulant use appeared safe in the studied populations across various indications for anticoagulation.

Conclusion: This is the first systematic review that addresses a critical gap in the literature by systematically evaluating the safety profiles of various TKIs in combination with different anticoagulants. The findings from cohort studies highlighted the feasibility of concomitant use of anticoagulants and TKIs in CML patients, with close monitoring of potential adverse events and drug interactions. PROSPERO registration number: CRD42024528737.

Background: Neratinib is a potent tyrosine kinase inhibitor with activity against HER2-positive breast cancer (HER2+). The ExteNET study demonstrated a significant invasive disease-free survival benefit of neratinib in hormone receptor-positive (HR+) HER2+ breast cancer following trastuzumab-based adjuvant therapy. However, ExteNET was conducted before the use of pertuzumab or adjuvant trastuzumab emtansine (T-DM1). We evaluated clinical characteristics of patients prescribed neratinib in current practice.

Methods: We retrospectively reviewed patients with HR+ HER2+ breast cancer eligible for neratinib at our institution from 2017-2024. Clinical and treatment information was extracted from the electronic medical record. High-risk status was defined using traditional high-risk HR+ breast cancer features and literature supporting high Ki-67 and tumor grade as predictors of recurrence. Chi-square and t-tests were used for analysis.

Results: Among 107 eligible patients, 67 were offered neratinib and 40 were not. High-risk disease was significantly more prevalent in patients offered neratinib (p<0.01). Residual disease and progression rates did not differ significantly between groups.

Conclusion: High-risk clinical features significantly influenced neratinib prescribing. Residual disease did not appear to impact prescribing decisions. These findings suggest biologic risk criteria may serve as practical guidelines for adjuvant neratinib use.

Introduction: This study aimed to compare the effectiveness outcomes of Child-Pugh class A patients with unresectable hepatocellular carcinoma (HCC) treated with first-line atezolizumab-bevacizumab and lenvatinib.

Methods: This retrospective study included patients with Child-Pugh A unresectable HCC who were administered first-line treatment with either atezolizumab-bevacizumab (n = 368) or lenvatinib (n = 229) at Asan Medical Center (Seoul, Korea). Effectiveness outcomes were analyzed along with the inverse probability treatment weighting (IPTW) analysis to adjust for potential confounders.

Results: Hepatitis B virus infection was the most common cause of HCC. With median follow-up duration of 11.9 for atezolizumab-bevacizumab and 20.9 months for the lenvatinib groups, patients treated with atezolizumab-bevacizumab exhibited superior progression-free survival (PFS) and overall survival (OS) than those treated with lenvatinib (median PFS 6.3 vs. 4.9 months, p = 0.031; and median OS 18.5 vs. 11.3 months, p < 0.001). After IPTW adjustment, atezolizumab-bevacizumab remained associated with favorable OS (median OS of 17.9 vs. 12.3 months, p = 0.010). Treatment with atezolizumab-bevacizumab was an independent factor of OS in both the entire and IPTW-adjusted cohorts. For patients with a viral etiology, the atezolizumab-bevacizumab group exhibited significantly longer OS than the lenvatinib group in both entire and IPTW-adjusted cohorts (p < 0.001 and p = 0.006, respectively). Conversely, both groups showed comparable OS among those with a nonviral etiology (p = 0.656 and p = 0.616, respectively).

Conclusions: Atezolizumab-bevacizumab showed superior OS compared to lenvatinib in Asian patients with unresectable HCC.

Introduction: In the ninth edition of the TNM staging system, the new nodal involvement (N) subcategories to N2 for single-station involvement (N2a) and multiple-station involvement (N2b) have been adopted. Although there are significant differences in survival rates for each group of pN categories in the ninth edition, it can be assumed that survival rates in pN1 and pN2a are relatively similar.

Methods: We retrospectively evaluated the utility of the new category by number of stations such as none, single station, and multiple station for pN in 1,000 NSCLC patients treated by pulmonary resection.

Result: Survival rates were significantly different among none, single station, and multiple station (5-year RFS: none: 79.6%, single station: 47.3%, multiple station: 24.2%, all groups, p < 0.01; 8-year OS: none: 78.7%, single station: 65.2%, multiple station: 33.6%, all groups, p < 0.01). There were significant differences among each group categorized by number of pN station in multivariate analysis for RFS (none vs. single station: p < 0.01, none vs. multiple station: p < 0.01, single station vs. multiple station: p < 0.01). There were significant differences among each group categorized by number of pN station in multivariate analysis for OS (none vs. single station: p = 0.04, none vs. multiple station: p < 0.01, single station vs. multiple station: p < 0.01).

Conclusion: There were significant differences among none, single station, and multiple station in each survival curve and in multivariate analysis for both RFS and OS. This category by number of pN station without dependence of location for lymph nodal involvement might be the new classification of lymph node involvement.

Background: Noncoding RNAs (ncRNAs), including microRNAs, lncRNAs, and circRNAs, play essential roles in physiological and pathological processes, including cancer, where they act as drivers or suppressors. Aberrant ncRNA expression in tumors has been linked to tumor promotion or suppression, making them potential cancer biomarkers. Pyroptosis, a newly discovered form of programmed cell death, is characterized by cell swelling, membrane rupture, and inflammation, offering a novel strategy for tumor elimination.

Summary: Pyroptosis can activate anti-tumor immunity, while ncRNAs regulate pyroptosis pathways, influencing tumorigenesis through diverse mechanisms. However, the role of ncRNAs in pyroptosis, including potential initiators and their impact on tumor resistance, immunity, and cancer progression, remains unclear. The specific role of circRNAs in pyroptosis also requires further exploration.

Key messages: This article explores the role of ncRNAs in pyroptosis, with a particular focus on ncRNA-mediated mechanisms, and highlights their potential as diagnostic and prognostic markers in cancer.

Introduction: Age has been reported as a risk factor for chemotherapy-induced nausea and vomiting. However, few reports have described risk factors for nausea and vomiting with carboplatin (CBDCA). This study investigated whether the incidence of CBDCA-induced nausea and vomiting differs with age, using 70 years as the cutoff.

Methods: Patients who underwent CBDCA for lung cancer at the Cancer Institute Hospital of Japanese Foundation for Cancer Research between November 2020 and October 2023 were included in this retrospective study. The age cutoff was set at 70 years, with the complete response (CR; no vomiting/retching and no rescue medication) rate during the observation period as the endpoint.

Results: Of the 198 patients included in the analysis, 114 (57.6%) were ≥70 years old. The CR rate was 36.9% for patients <70 years old and 61.4% for patients ≥70 years old (p = 0.001). In univariate analyses, age <70 years, female sex, no drinking history, no smoking history, and higher CBDCA dose were associated with non-CR. In multivariate analysis, age <70 years, no drinking history, and higher CBDCA dose were associated with non-CR.

Conclusion: Age <70 years, no drinking history, and higher CBDCA dose were identified as risk factors for CBDCA-induced nausea and vomiting.