Technology in Cancer Research & Treatment最新文献

IntroductionCT-guided biopsy has good diagnostic accuracy, but adverse events such as pneumothorax are common. There are few reports on the safety and efficacy of CT-guided biopsy in the elderly.MethodsThis was a retrospective single-centre cohort study. Patients who underwent CT-guided lung biopsy between February 2017 and August 2024 were included. Patient background, disease background, examination status, and adverse events were ascertained. Elderly were defined as those aged 75 years and older. The primary outcome was the incidence of all adverse events, and the secondary outcomes were the incidence of pneumothorax and diagnostic accuracy. Categorical variables were compared by Chi-square test, and continuous variables by t-test. Multivariable analysis was performed by logistic regression analysis adjusted for age, sex, lung comorbidities, and radiological findings of target lesion.ResultsThere were significant differences between the two groups in ECOG-PS and the distance from the surface to pleura and target. In the primary outcome, any adverse events occurred in 207 patients (56.2%), with no significant difference between elderly (97/180, 53.9%) and non-elderly (110/188, 58.5%) patients (p = 0.401). Pneumothorax was the most common adverse event, occurring in 151 (41.0%) patients, with no significant difference between elderly (68/180, 37.8%) and non-elderly (83/188, 44.1%) (p = 0.244). On multivariate analysis, elderly (75years or older) was not clearly associated with the occurrence of all or severe adverse events, pneumothorax, and confirmed diagnosis. Location in the lower lung field and distant from the pleura were significantly associated with the incidence of all adverse event. In the secondary outcomes, emphysema or interstitial pneumonia, location in the lower lung field, and distant from the pleura were significantly associated with pneumothorax. There was no significant difference in the diagnostic accuracy disease between the elderly and non-elderly patients.ConclusionsThe incidence of adverse events and diagnostic accuracy of CT-guided biopsy are similar in elderly and non-elderly patients, and this method is useful even in elderly patients.Key pointThe safety and efficacy of CT-guided lung biopsy in elderly patients are equivalent to those in non-elderly patients.

IntroductionDespite the advent of anti-PD-1 immunotherapy as a promising treatment for HCC, there remains a significant gap in the comprehensive analysis of peripheral blood immunological markers that could predict treatment response. This study aims to identify peripheral blood immunological markers predictive of anti-PD-1 therapy response in HCC patients to improve clinical outcomes.MethodsWe retrospectively analyzed 69 HCC patients treated with anti-PD-1 therapy, divided into a training cohort (n = 30) and a validation cohort (n = 39). Clinical characteristics, hematological indices, cytokine levels, and serum PD-1 were assessed. Logistic regression and ROC curve analyses were performed to evaluate prognostic value, with bootstrap validation to assess model robustness. In addition, tumor samples from 6 patients underwent WES, and bioinformatic analyses were conducted to explore mutational profiles and their associations with immune infiltration as supportive mechanistic validation.ResultsThe IL-2/IL-10 ratio was significantly associated with tumor progression after adjustment for covariates (OR 2.918, 95% CI 1.191-7.150, p = 0.019) and achieved superior predictive performance (AUC 0.884, 95% CI 0.766-1.000) compared with conventional inflammation-based scores. Bootstrap validation confirmed model stability (corrected AUC ≈ 0.88), and external validation supported predictive value. Whole-exome sequencing revealed that mutations in genes such as FLT3, TET2, and IDH2 were commonly present in HCC. Immune infiltration analyses indicated that these mutations were associated with increased Treg and decreased Th1 infiltration, consistent with the clinical trend. Additional analyses of public transcriptomic datasets further supported these observations.ConclusionOur study reveals that a low IL-2/IL-10 ratio is significantly associated with adverse prognosis in HCC patients and may serve as a practical and biologically relevant biomarker for predicting the efficacy of anti-PD-1 therapy. Moreover, systematic evaluation of immune status could provide important guidance for predicting immunotherapy efficacy and supporting future clinical decision-making in HCC management.

IntroductionOsteosarcoma (OS) is a highly aggressive primary bone malignancy with poor prognosis. Histone modifications play crucial roles in tumor progression, but their systematic investigation in OS remains unexplored.MethodsThis study integrated single-cell RNA sequencing data and large-scale clinical information to systematically analyze the spatial heterogeneity of histone modifications in OS and their clinical significance. We employed Seurat for single-cell data analysis, CellChat for cell-cell communication network analysis, and LASSO Cox regression to construct a prognostic model. Additionally, we conducted functional enrichment analysis, immune characteristics analysis, and drug sensitivity prediction.ResultsWe identified five major cell types in the OS microenvironment and discovered significant differences in histone modification levels among different cell types, with osteosarcoma cells and endothelial cells exhibiting higher modification levels. Cell-cell communication network analysis revealed the importance of signaling pathways such as SPP1, CypA, MIF, IGFBP, and VEGF in OS. Based on nine histone modification-related genes, we constructed an efficient prognostic model (AUC values of 0.713, 0.845, and 0.888 for 1-, 3-, and 5-year predictions, respectively), which was validated in an external cohort (AUC = 0.808). Immune microenvironment analysis showed significantly higher proportions of CD8+ T cells and Treg cells in the low-risk group. Drug sensitivity analysis revealed that the low-risk group was more sensitive to Imatinib, Rapamycin, and Sunitinib, while the high-risk group was more sensitive to MAPK pathway inhibitors.ConclusionThis study systematically revealed the spatial heterogeneity of histone modifications in OS and their clinical significance for the first time, proposing an "epigenetic-immune" regulatory network hypothesis and developing a histone modification-based prognostic model. Our proposed "epigenetic-guided personalized medication strategy" provides new insights for precision treatment of OS, potentially significantly improving patient prognosis.

Colorectal cancer (CRC) remains a formidable global health challenge, with the majority of patients exhibiting microsatellite stable (MSS) and proficient mismatch repair (pMMR) tumors that are largely unresponsive to immune checkpoint inhibitors (ICIs). The management of MSS/pMMR CRC remains a clinical challenge due to the intrinsic resistance to ICIs. The innovative strategy of combining cetuximab, an EGFR-targeting monoclonal antibody with immunomodulatory properties, offers a promising strategy to enhance the immunotherapeutic response in MSS/pMMR CRC. This combination therapy is rooted in the complementary therapeutic mechanisms of cetuximab and ICIs, which may synergistically improve overall response rates and durability of response. Although some preclinical and clinical data have suggested additional promising results, there are still some challenges and questions that need to be addressed. Further large-scale, randomized, phase III clinical trials are required to confirm the efficacy and safety of this combination therapy. The ongoing clinical trials evaluating the safety and efficacy of cetuximab-ICI combinations are eagerly anticipated to pave the way for a new era in personalized immunotherapy for MSS/pMMR CRC.

This review summarizes the intricate relationship between the microbiome and cancer initiation and development. Microbiome alterations impact metabolic pathways, immune responses, and gene expression, which can accelerate or mitigate cancer progression. We examine how dysbiosis affects tumor growth, metastasis, and treatment resistance. Additionally, we discuss the potential of microbiome-targeted therapies, such as probiotics and fecal microbiota transplants, to modulate cancer metabolism. These interventions offer the possibility of reversing or controlling cancer progression, enhancing the efficacy of traditional treatments like chemotherapy and immunotherapy. Despite promising developments, challenges remain in identifying key microbial species and pathways and validating microbiome-targeted therapies through large-scale clinical trials. Nonetheless, the intersection of microbiome research and cancer initiation and development presents an exciting frontier for innovative therapies. This review offers a fresh perspective on cancer initiation and development by integrating microbiome insights, highlighting the potential for interdisciplinary research to enhance our understanding of cancer progression and treatment strategies.

IntroductionMultiple targets with varying distances are common in radiotherapy. Reducing treatment time in the plan design helps minimize patient movement and discomfort during the treatment process. This retrospective study aimed to investigate the impact of varying intertarget distances (ITDs) on the dosimetric differences and delivery efficiency of two single-isocenter techniques.MethodsITDs for 15 patients with dual-site vertebral metastases undergoing volume-modulated arc therapy (VMAT) were modified using Matlab 2019a. Distances of 2, 4, 6, 8, and 10 cm were considered. The VMAT plans were designed with a prescription dose of 40 Gy/20f on Infinity Linac and Monaco 5.40.01. Single-isocenter with jaw tracking (VMAT1) and fixed jaw (VMAT2) were compared in terms of dosimetry and delivery efficiency under different ITDs.ResultsResults showed that both VMAT plans exhibited dosimetric parameters meeting clinical requirements. The conformity index (CI) of VMAT1 plans was smaller than that of VMAT2 at ITD = 4, 6, and 8 cm (P = 0.007, 0.020, and 0.039, respectively), with no significant differences in other planning target volume dosimetry parameters. In terms of delivery efficiency, the treatment time of VMAT1 increased significantly when ITD > 2 cm compared with that at ITD = 2 cm (P = 0.000). Conversely, VMAT2 exhibited no significant change in treatment time at different ITDs (P = 0.073). For ITD = 2 cm, the treatment time of VMAT1 was shorter than that of VMAT2, with a median difference of 77 s. For ITD > 2 cm, the treatment time of VMAT2 was shorter than that of VMAT1, with a median difference ranging from 65 s to 121 s.ConclusionThe experimental results showed that the single-isocenter with jaw tracking is recommended in the planning design when ITDs are less than 2 cm. However, for ITDs greater than 2 cm, the single-isocenter with fixed jaw demonstrates high delivery efficiency.5075.

Immunotherapy has emerged as a pivotal advancement in oncological therapeutics, representing a paradigm shift from conventional treatment modalities including surgery, radiotherapy, and chemotherapy. This innovative approach demonstrates considerable clinical potential through its capacity to enhance systemic anti-tumor responses via active or passive immunomodulation. Compared to traditional therapies, immunotherapy offers distinct advantages such as broad applicability, rapid therapeutic onset, and reduced adverse effects. However, critical challenges persist in clinical implementation, particularly concerning treatment safety and efficacy optimization. Current limitations, including drug off-target effects and biological delivery barriers, frequently result in suboptimal therapeutic outcomes and severe complications such as autoimmune disorders and nonspecific inflammation. Recently advancements in drug delivery systems (DDS) present transformative solutions to these challenges. Sophisticated DDS platforms enable precise spatiotemporal delivery of tumor antigens, immunotherapeutic agents, and immunostimulatory molecules, thereby achieving targeted modulation of diverse immune cell populations. This technological innovation not only enhances therapeutic efficacy but also significantly mitigates adverse reactions, while facilitating synergistic combinations with conventional cancer treatments. In this review, we outline the application of new drug delivery platforms in major malignancies (including but not limited to melanoma, non-small cell lung cancer, hormone receptor-positive breast cancer, and hepatocellular carcinoma). We further propose evidence-based optimization strategies for next-generation delivery platforms, aiming to bridge the gap between preclinical development and clinical implementation in cancer immunotherapy.

AimsThis review aims to synthesize the existing literature on palliative radiotherapy (RT) delivered in two daily fractions for patients with advanced cancer, focusing on its impact on symptom alleviation, treatment tolerance, and the implications for clinical practice and future research.MethodsAn international team conducted this narrative review, adhering to SANRA guidelines. Studies published in English on palliative RT delivered in two daily fractions were selected without date restrictions. The literature search, using a combination of specific key terms, led to a comprehensive examination of relevant studies. Data on study objectives, treatment approaches, palliative effectiveness, and toxicity were extracted and qualitatively analyzed.ResultsThe review included 29 publications, showing consistent efficacy in symptom reduction (63.0%-100% palliative response rate) and general tolerability across various cancer types. These studies highlighted the potential radiobiological advantages and practicality of accelerated multi-fractionated regimens, which provide rapid tumor response with reduced late toxicity risks. Furthermore, the logistical benefits of such treatments, including shorter hospital stays and minimized travel requirements, were noted as particularly valuable during challenging times such as recent pandemics.ConclusionsThe evidence supports the integration of evidence-based, accelerated-hypofractionated RT into palliative care strategies, ensuring effective symptom management with minimal patient burden. Future research should focus on comparative studies on single versus multiple-cycle treatments, optimal intervals between treatment cycles, and the integration of advanced RT techniques.

IntroductionRenal cancer, particularly Kidney Renal Clear Cell Carcinoma (KIRC), remains a major clinical challenge due to its aggressive nature and poor prognosis. Identifying reliable biomarkers for tumor progression and survival is critical for improving patient outcomes. This study aimed to investigate the role of Centromere Protein F (CENPF) as a potential prognostic biomarker for renal cancer.MethodData from the TCGA database, including Kidney Chromophobe (KICH), Kidney Renal Papillary Cell Carcinoma (KIRP), and KIRC, were analyzed to identify differentially expressed genes. Molecular Complex Detection (MCODE) was used to identify significant gene modules among upregulated genes, and univariate Cox regression analyses assessed the prognostic value of hub genes. Retrospective qPCR was conducted on tissue and plasma samples from KIRC patients to validate findings. Single-cell sequencing data from the GSE159115 dataset were analyzed, and the CIBERSORT algorithm was applied to evaluate the composition of tumor immune infiltrating cells (TIICs).ResultsCENPF was identified as a hub gene significantly upregulated in renal cancer subtypes, with overexpression linked to worse survival outcomes in KIRC patients. Retrospective qPCR confirmed high CENPF expression was associated with poorer prognosis. Single-cell sequencing revealed that CENPF is predominantly expressed in T-cell clusters. TIIC analysis showed a negative correlation between CENPF and resting mast cells, but positive correlations with follicular helper T-cells and memory-activated CD4T-cells. Prognostic analysis indicated that high follicular helper T-cell expression predicted poorer survival, while high plasma cell expression correlated with better outcomes.ConclusionCENPF plays a critical role in tumor progression and the modulation of the tumor immune microenvironment in KIRC. These findings suggest that CENPF could serve as a valuable prognostic biomarker and potential target for therapeutic intervention in renal cancer.