Oncology最新文献

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.

Introduction: Research on esophageal squamous cell carcinoma (ESCC) in Asian American (AsA) populations frequently aggregates data, thereby overlooking the considerable diversity inherent within this demographic. The aim of this study was to investigate the variations in ESCC characteristics and clinical outcomes among AsA.

Methods: Patients diagnosed with ESCC were identified through the Surveillance, Epidemiology, and End Results (SEER) 17 database. The AsA cohort was categorized into specific subgroups: Chinese, Japanese, Filipino, Korean, Vietnamese, South Asian (Asian Indian or Pakistani), and other Asian. The Kaplan-Meier method was employed to estimate unadjusted overall survival (OS), while Cox proportional hazards models were utilized to assess adjusted OS.

Results: A total of 9,252 patients were included, with the cohort comprising 1,100 Asian, 2,135 Black, 951 Hispanic, and 5,066 White individuals. AsA patients demonstrated the highest unadjusted OS (p < 0.001). The Vietnamese subgroup exhibited the highest proportion of male patients at 92.1%. South Asian patients showed the highest unadjusted OS among the distinct Asian subgroups, with survival rates of 56% at 1 year (95% confidence interval [CI]: 49-64), 31% at 3 years (95% CI: 25-40), and 23% at 5 years (95% CI: 17-32). After adjusting, only Chinese and South Asian patients displayed significantly improved OS compared to the White reference group (p < 0.05).

Conclusion: Considerable disparities in ESCC characteristics and outcomes exist among AsA populations. Socioeconomic, genetic, and epigenetic factors may influence these differences. Further research is essential to clarify the mechanisms of this discrepancy.

Introduction: The objective of this study was to develop an automated method for segmenting spleen computed tomography (CT) images using a deep learning model. This approach is intended to address the limitations of manual segmentation, which is known to be susceptible to interobserver variability. Subsequently, a prediction model of gastric cancer (GC) lymph node metastasis was constructed in conjunction with radiomics and deep learning features, and a nomogram was generated to explore the clinical guiding significance.

Methods: This study enrolled 284 patients with pathologically confirmed GC from two centers. We employed a deep learning model, U-Mamba, to obtain fully automatic segmentation of the spleen CT images. Subsequently, radiomics features and deep learning features were extracted from the entire spleen CT images, and significant features were identified through dimensionality reduction. The clinical features, radiomic features, and deep learning features were organized and integrated, and five machine learning methods were employed to develop 15 predictive models. Ultimately, the model exhibiting superior performance was presented in the form of a nomogram.

Results: A total of 12 radiomics features, 17 deep learning features, and 2 clinical features were deemed valuable. The DRC model demonstrated superior discriminative capacity relative to other models. A nomogram was constructed based on the logistic clinical model to facilitate the usage and verification of the clinical model.

Conclusion: Radiomics and deep learning features derived from automated spleen segmentation to construct a nomogram demonstrate efficacy in predicting lymph node metastasis in GC. Concurrently, fully automated segmentation provides a novel and reproducible approach for radiomics research.

Introduction: Following resection for gastroesophageal cancer, patients may experience symptoms like reflux, anorexia, and weight loss that can significantly impact their quality of life (QoL). Patient-reported outcomes (PROs) are becoming more important for symptom monitoring. Nevertheless, there is limited knowledge on symptom management post-gastroesophageal cancer resection.

Methods: A single-center, randomized controlled trial was conducted on postoperative patients with gastroesophageal cancer. Participants were randomly assigned to the PRO group and usual care (the control group), with a 1:1 ratio. The PRO-based symptom management included symptom assessment, monitoring, and personalized interventions such as lifestyle guidance, nutritional support, and drug therapy. An electronic system was developed on the Research Electronic Data Capture (REDCap) platform to monitor and assess patients' symptoms, QoL, and provide diagnosis and treatment. The study focused on five key symptom events: anorexia, reflux, depression, nutritional risk, and underweight. In the PRO group, assessments were conducted every 3-4 weeks for a minimum of 16 weeks. Interventions for this group primarily involved counseling, patient education, and medication prescriptions based on individual symptoms. The control group's symptoms and QoL were assessed only at baseline and week 16. The primary outcome measure was the total number of symptoms at 16 weeks, with secondary outcomes including the incidence of symptoms at the same time point. QoL was also evaluated as part of the study.

Results: Between April 2021 and May 2022, a total of 124 patients were divided into two groups: 60 in the PRO group and 64 in the control group. The PRO group exhibited notably fewer overall symptoms at the 16-week mark compared to the control group (1.20 ± 1.16 vs. 2.50 ± 1.47), along with a lower prevalence of nutritional risk (63.3% vs. 81.3%), anorexia (18.3% vs. 60.9%), reflux (13.3% vs. 57.8%), and depression (5.0% vs. 20.3%). The QoL scores were markedly higher in the PRO group. Furthermore, the PRO group displayed lower nutritional status, reflux, and depression scale trends, as well as higher anorexia trends when compared to the control group.

Conclusions: PRO-based symptom management led to superior symptom control and enhanced QoL in postoperative gastroesophageal cancer patients when compared to standard care.

Introduction: Maximum tumor diameter (MTD) is one of the key aggressiveness features of hepatocellular carcinoma (HCC). However, the clinical associations and causes of large size HCC are not well understood. The aim was to compare small and large MTD (≤/>6 cm) HCCs with respect to clinical associations.

Methods: MTD ≤/> 6 cm HCCs were compared by clinical characteristics and analyzed through logistical regression models, as well as Cox proportional hazard models for death, on clinical parameters.

Results: Patients with larger HCCs had more portal vein thrombosis (PVT) and tumor multifocality, higher AST, ALKP and GGT levels and lower albumin levels. A logistic regression model of MTD (≤/>6 cm) showed the highest risk for PVT and platelet-lymphocyte ratio (PLR) >150, while albumin and female gender were protective. The combination of male gender, PLR >150, plus PVT had an odds ratio of 12.124. In Cox proportional hazard models, the highest hazard ratio for death was for PVT, and only albumin was significantly protective. PVT plus low albumin had a hazard ratio of 4.254.

Conclusion: PVT, albumin, PLR, and gender were significant for ≤/>6 cm MTD. PVT and albumin were significant for survival.

Introduction: The incidence of multiple myeloma (MM) in the USA has been increasing over the past decades with persistent demographic disparities. Social determinants of health (SDOH) were found to affect health outcomes among certain diseases. However, there were limited data on the impact of SDOH on the MM mortality rates. Our study aimed to investigate the association between the SDOH and MM mortality rates from 2016 to 2020.

Methods: County-level data from the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (CDC/ATSDR SVI) were correlated with MM mortality rates from the CDC WONDER database. Counties were categorized into four quartiles based on SVI scores: SVI-Q1 (lowest vulnerability) to SVI-Q4 (highest vulnerability). Age-adjusted mortality rates (AAMRs) per 100,000 individuals for patients aged 25 years and above were analyzed. The rate ratio (RR) was measured by calculating the ratio of the AAMRs in SVI-Q4 to SVI-Q1.

Results: Between 2016 and 2020, 61,307 MM-related deaths occurred, with 20,390 in SVI-Q4 versus 8,498 in SVI-Q1. Overall, AAMR was higher in SVI-Q4 (4.90; 95% CI, 4.83-4.97) than in SVI-Q1 (4.66; 95% CI, 4.56-4.76), though the RR was not significant (1.05; 95% CI, 0.81-1.36). Higher SVI was not significantly associated with higher AAMR among males (RR: 1.03; 95% CI, 0.73-1.45) or females (RR: 1.10; 95% CI, 0.75-1.62). Among the younger patients (25-64 years old) and the older patients (65 years old and above), increasing SVI was not associated with higher AAMR (RR: 1.27 [95% CI, 0.69-2.34] and 1.01 [95% CI, 0.76-1.34], respectively). SVI was also not significantly associated with higher AAMR in the rural populations (1.07 [95% CI, 0.60-1.92]). Across racial groups - American Indians, Asians, African Americans, Hispanics, and Whites - SVI was not significantly associated with AAMR differences. Similarly, no significant differences were observed when stratified by census regions (Northeast, Midwest, South, and West).

Conclusion: African Americans had higher AAMRs from MM compared to other racial groups. However, SVI scores were not significantly associated with MM mortality disparities. These findings suggest that SVI alone is insufficient to determine mortality disparities in MM. Future research should explore more specific indicators to identify at-risk populations and address mortality inequities in MM.

Introduction: Multidisciplinary treatments for advanced rectal cancer are diverse. Neoadjuvant chemoradiation therapy (nCRT) is a total neoadjuvant therapy treatment option. Some studies have reported that tumor-infiltrating lymphocytes (TILs) and inflammatory blood factors (neutrophil-lymphocyte ratio [NLR], platelet-lymphocyte ratio [PLR], and systemic immune inflammatory index [SII]) are predictors of nCRT efficacy. However, the relationship between changes in TILs and inflammatory blood factors during nCRT and the resulting tumor regression grade (TRG) remains unclear. In this study, we investigated whether changes in TILs and inflammatory blood factors during nCRT were related to TRG.

Methods: We retrospectively studied 196 patients with rectal cancer who underwent curative resection after nCRT for advanced rectal cancer. Immunohistochemical staining of lymphocyte surface markers, including CD3, CD4, and CD8, was performed on biopsy specimens before and during nCRT. Inflammatory blood factors were assessed using blood samples collected before treatment and 7 days after the initiation of nCRT.

Results: Changes in CD4 levels were related to TRG. NLR, and SII during nCRT were associated with TRG. TRG tended to be better in patients with values below the cutoff. The NLR during nCRT and changes in NLR, PLR, and SII were associated with the tumor shrinkage rate. Changes in PLR were related to TRG. There was no relationship between TIL, peripheral blood changes, and recurrence rate.

Conclusion: It was suggested that changes in CD4+ TILs immediately after treatment initiation and changes in inflammatory blood factors during treatment may be useful for predicting the reduction rate and TRG. These changes begin early during treatment and may be useful in predicting efficacy.

Introduction: Antihistamines (AHs) have beneficial effects as adjuvant anticancer agent in several preclinical and observational studies. We aimed to evaluate the effect of AHs on stage IV lung cancer patients.

Methods: We used data from the Cancer Registry Database provided by the Cancer Center of Kaohsiung Veterans General Hospital to investigate whether AH use is associated with improved survival among patients with stage IV lung cancer. We analyzed AHs use across various patient subgroups, including sex, age, comorbidities, co-medications, smoking status, histologic type, treatment modality, and survival time. The primary endpoint was overall survival (OS).

Results: A total of 1,886 lung cancer patients were enrolled. Of them, 41 (2.1%) patients were AH users, 1,845 (97.8%) were AH nonusers before lung cancer diagnosis, and 594 (31.6%) patients were AH users, 1,292 (68.4%) were AH nonusers after lung cancer diagnosis. AH users were more to have comorbidities with hypertension (p < 0.001), diabetes mellitus (p < 0.001), allergic disease (p < 0.001), chronic obstructive pulmonary disease (p = 0.002), co-medications with targeted therapy (p < 0.001), and nonaspirin NSAID (p < 0.001). Pre-diagnostic AH users did not show improved survival outcomes. Post-diagnostic AH users tend to have a better OS among patients with a survival period of more than 90 days (median, 28.4 months and 15.1 months, respectively; HR: 0.49; 95% confidence interval: 0.43-0.55).

Conclusion: AHs use was associated with improved OS in patients with stage IV lung cancer. Further prospective studies are needed to better elucidate the role of AHs in the treatment of lung cancer.

The article "Post-Progression Treatments after Palbociclib plus Endocrine Therapy in HR+/HER2- Metastatic Breast Cancer Patients: What Is the Better Choice?" [Oncology 2021; https://doi.org/10.1159/000521252] by Alessandra Fabi, Mariangela Ciccarese, Sinome Scagnoli, Michelangelo Russillo, Francesco Schettini, Giuseppe Buono, Vito Lorusso, Katia Cannita, Grazia Arpino, Simonetta Stani, Michela Palleschi, Rosalba Rossello, Giuseppina Sarobba, Agnese Fabbri, Marianna Giampaglia, Patrizia Pellegrini, Vincenzo Adamo, Francesca Morelli, Vittoria Barberi, Gianluigi Ferretti, Giovanna Catania, Simona Pisegna, Francesco Cognetti and Diana Giannarelli has been retracted by the Publisher and the Editor.After peer review, the accepted, unedited manuscript was published online as Early View. The authors did not respond to our requests and communication regarding the production process of their article despite extensive attempts at contact. As the article has not been approved by the authors for publication, we cannot publish the final version. To avoid confusion for readers we are retracting the Early View accepted, unedited manuscript.The authors did not respond to correspondence about the retraction.