The Lancet Regional Health: Western Pacific最新文献

{"title":"Chikungunya: a growing public health concern in the Western Pacific region","authors":"The Lancet Regional Health – Western Pacific","doi":"10.1016/j.lanwpc.2025.101733","DOIUrl":"10.1016/j.lanwpc.2025.101733","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101733"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving support for people with mental health problems in China: a cluster randomised controlled trial of culturally adapted Mental Health First Aid training","authors":"Nicola Reavley ,&nbsp;Amy J. Morgan ,&nbsp;Anthony F. Jorm ,&nbsp;Betty Kitchener ,&nbsp;Yan Wang ,&nbsp;Shurong Lu ,&nbsp;Wenjing Li ,&nbsp;Claire Kelly ,&nbsp;Brian Oldenburg ,&nbsp;Min Zhao ,&nbsp;Yanling He","doi":"10.1016/j.lanwpc.2025.101698","DOIUrl":"10.1016/j.lanwpc.2025.101698","url":null,"abstract":"<div><h3>Background</h3><div>Culturally appropriate interventions that teach members of the public to provide early help towards a person developing a mental health problem or in a mental health crisis may improve access to services, social support, and mental health outcomes. This is the first study to evaluate the effectiveness of culturally adapted Mental Health First Aid (MHFA) Training for China.</div></div><div><h3>Methods</h3><div>A two-arm wait-list pilot cluster randomised controlled trial (cRCT) was conducted in 3 settings in Shanghai (health services, workplaces and community settings). Intervention settings were paired according to type and one of each pair was randomly allocated to the intervention (MHFA Training for China) or the wait-list control group, with a 1:1 allocation. Participants were invited by the trial coordinators in each setting. They were asked to complete questionnaires at baseline (T1) and 1 month (T2) and 7 months after training (T3). Control group participants were asked to complete questionnaires at corresponding times. The primary outcome was participant intended actions (recommended or not recommended) towards a person experiencing a mental health problem or in a mental health crisis. Secondary outcomes included recognition of depression in a vignette; beliefs about the helpfulness of health professionals and interventions; helping actions; confidence in providing mental health first aid; and stigmatising attitudes.</div></div><div><h3>Findings</h3><div>Between April and May 2024, 6 clusters were recruited and randomised, with 3 in each of the intervention and control arms. Following exclusion of participants who did not provide data, 146 participants were included at baseline: 67 in the intervention group and 79 in the control group. For the primary outcome (recommended actions subscale), the intervention group showed a significantly larger improvement than the control group at T2 (8.19 [95% CI 4.05–12.34]; p &lt; 0.001) and T3 (3.08 [95% CI −1.02 to 7.18]; p = 0.034). Differences in changes in non-recommended actions were non-significant. At T2, significant differences favouring the intervention group were observed in confidence to provide support, perceiving the person as dangerous or unpredictable and in recognition of depression in a vignette. There were no significant differences in secondary outcomes at T3.</div></div><div><h3>Interpretation</h3><div>Delivering culturally adapted MHFA Training for China more widely could improve support for people experiencing mental health problems in the community.</div></div><div><h3>Funding</h3><div>This trial was supported the <span>National Health and Medical Research Council</span> under a <span>Global Alliance for Chronic Diseases</span> grant (<span><span>GNT1142395</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101698"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based versus facility-based services to improve hepatitis C screening in Cambodia: a cluster randomized controlled trial (ANRS 12384 Cam-C study)","authors":"Dyna Khuon ,&nbsp;Luis Sagaon-Teyssier ,&nbsp;Sansothy Neth ,&nbsp;Saly Saint ,&nbsp;Laurence Meyer ,&nbsp;Emilie Mosnier ,&nbsp;Diana Molino ,&nbsp;Chan Leakhena Phoeung ,&nbsp;Chhingsrean Chhay ,&nbsp;Kimeang Heang ,&nbsp;Sovatha Mam ,&nbsp;Jean-Charles Duclos-Vallée ,&nbsp;Olivier Ségéral ,&nbsp;Vonthanak Saphonn","doi":"10.1016/j.lanwpc.2025.101703","DOIUrl":"10.1016/j.lanwpc.2025.101703","url":null,"abstract":"<div><h3>Background</h3><div>The estimated prevalence of hepatitis C virus (HCV) infection among adults aged over 45 years in Cambodia is approximately 5%. The present study aimed assessing the effectiveness of a novel community-based strategy comprising HCV rapid testing (RDT) and dried blood spot (DBS) collection performed by community health workers (CHWs) in outreach contexts.</div></div><div><h3>Methods</h3><div>ANRS 12384 Cam-C is a parallel arm cluster randomized controlled trial conducted in the Siem Reap and Kampong Cham provinces of Cambodia between April 2022 and September 2023. Four geographical areas in each province were randomized into two arms to compare HCV RDT and DBS collection provided in homes by community health workers (i.e., community-based strategy) with facility-based HCV RDT and whole blood collection provided by healthcare workers in health centers (i.e., facility-based strategy). The primary outcome was combined testing uptake, defined as the proportion of participants who were actually tested for HCV using RDT or RDT/RNA if positive out of all those who participated in the study. Mixed effects logistic models were used to estimate the effect of the community-based strategy. The study is registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT03992313</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Among the 7692 participants who initially enrolled in the study, 5590 (72.7%) actually went on to have HCV RDT or HCV RDT/RNA screening (i.e., combined testing uptake). Combined testing uptake in the community-based (2990 participants) and facility-based (2600 participants) arms was 78.1% and 67.3%, respectively (p &lt; 0.001). Positive HCV RDT was found for 57 (2.2%) including 39 (1.5%) with detectable HCV RNA among participants in the facility-based arm. In the community-based arm, 37 (1.2%) had positive HCV RDT including 32 (1.1%) with detectable HCV RNA. Treatment uptake concerned 36 participants (out of 39 with positive HCV RDT) and 30 (out of 32) in the facility-based and community-based arms, respectively. The odds of combined testing uptake in the community-based strategy were 2.18 (95% CI [1.28–3.73], p = 0.004) times higher than in the facility-based strategy.</div></div><div><h3>Interpretation</h3><div>Combined testing uptake (HCV RDT or HCV RDT/RNA) was higher for the community-based strategy than for the facility-based strategy. The involvement of community health workers improved first contact with HCV services and uptake. Integrating this trial's community-based screening strategy into the national Cambodian HCV program could improve its effectiveness as part of the country's broader goal of eliminating HCV by 2030.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>ANRS</span> MIE (ANRS 12384).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101703"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to A multicentre, prospective, double-blind study comparing the accuracy of autoantibody diagnostic assays in myasthenia gravis: the SCREAM study Lancet Reg Health West Pac (2023) 38: 100846","authors":"Zhiguo Li ,&nbsp;Chao Zhang ,&nbsp;Ting Chang ,&nbsp;Xinghu Zhang ,&nbsp;Huan Yang ,&nbsp;Feng Gao ,&nbsp;Jinzhou Feng ,&nbsp;Hongbo Liu ,&nbsp;Sheng Chen ,&nbsp;Lihua Wang ,&nbsp;Chunsheng Yang ,&nbsp;Huining Li ,&nbsp;Yuesong Pan ,&nbsp;Jacqueline Palace ,&nbsp;Fu-Dong Shi","doi":"10.1016/j.lanwpc.2025.101665","DOIUrl":"10.1016/j.lanwpc.2025.101665","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101665"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of cancer associated with residential exposure to asbestos insulation: updated evidence","authors":"Hsei Di Law ,&nbsp;Mark Clements ,&nbsp;Nina Lazarevic ,&nbsp;Kayla Smurthwaite ,&nbsp;Susan Trevenar ,&nbsp;Leah Newman ,&nbsp;Elizabeth Chalker ,&nbsp;Martyn D. Kirk ,&nbsp;Rosemary J. Korda","doi":"10.1016/j.lanwpc.2025.101699","DOIUrl":"10.1016/j.lanwpc.2025.101699","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101699"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing patterns of education, marriage and fertility in Chinese adolescents: a systematic synthesis of national and subnational population data from 1990 to 2020","authors":"Dongmei Luo ,&nbsp;Xiaojin Yan ,&nbsp;Tianyu Huang ,&nbsp;Jiajia Dang ,&nbsp;Shan Cai ,&nbsp;Yi Song ,&nbsp;Susan M. Sawyer","doi":"10.1016/j.lanwpc.2025.101706","DOIUrl":"10.1016/j.lanwpc.2025.101706","url":null,"abstract":"<div><h3>Background</h3><div>Secondary education, and early marriage and childbirth are major determinants of health and wellbeing. We aimed to describe the long-term trends and inequalities of these three indicators in Chinese adolescents over three decades of dramatic social and economic change.</div></div><div><h3>Methods</h3><div>Using data from Chinese population censuses and 1% population sample surveys from 1990 to 2020 (the most recent survey), we calculated the senior secondary school participation rate in 20–24-year-olds, the ever-married rate in 15–19-year-olds, and the age-specific fertility rate in 15–19 year-old females, by urban-rural location and province.</div></div><div><h3>Findings</h3><div>In urban areas, the secondary school participation rate substantially increased, from 34.7% in 1990 to 82.4% in 2020 for females and from 38.7% to 77.0% for males. The participation rate in rural areas also greatly increased, from 5.0% in 1990 to 55.7% in 2020 for females and from 9.1% to 51.0% for males, but remained markedly lower than in urban areas at all time points. The ever-married rate decreased dramatically from 1990 to 2005, rebounded between 2005 and 2015, and then dropped so that the rate in 2020 was at a level comparable to that in 2005 (0.7% [95% CI 0.7–0.7] for urban females, 2.2% [2.1–2.2] for rural females, 0.2% [0.2–0.2] for urban males, and 0.5% [0.5–0.5] for rural males). In urban areas, the fertility rate decreased from 10.1 per 1000 in 1990 to 2.4 (2.3–2.4) per 1000 in 2000, but then largely stabilised between 2000 and 2020. For rural adolescents, the fertility rate also decreased dramatically from 25.9 per 1000 in 1990 to 8.5 (8.2–8.8) per 1000 in 2005. The fertility rate rebounded to 15.4 (14.9–15.9) per 1000 in 2015 and decreased to 12.5 (12.3–12.7) in 2020 in rural areas. These three indicators greatly varied by province in 2020, with more negative patterns in western provinces.</div></div><div><h3>Interpretation</h3><div>China has seen dramatic changes in adolescent education, and early marriage and fertility over the past three decades but large inequities persist between urban-rural areas and by province. Government investments are needed to promote education in rural areas and western regions to promote more equitable health, development and wellbeing in Chinese adolescents.</div></div><div><h3>Funding</h3><div><span>National Nature Science Foundation of China</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101706"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-life NO2 exposure and sleep disturbances in preschool children: a study from 551 cities across China","authors":"Yuanxin Lin ,&nbsp;Yang Shen ,&nbsp;Xia Meng ,&nbsp;Haidong Kan ,&nbsp;Jing Cai ,&nbsp;Jing Hua","doi":"10.1016/j.lanwpc.2025.101701","DOIUrl":"10.1016/j.lanwpc.2025.101701","url":null,"abstract":"<div><h3>Background</h3><div>Ambient nitrogen dioxide (NO₂) has been linked to sleep disturbances in adults, yet its impact on pediatric populations remains understudied.</div></div><div><h3>Methods</h3><div>A total of 112,471 children aged 3–7 years from the Chinese National Cohort of Motor Development were enrolled. Sleep quality was assessed using the Children's Sleep Habits Questionnaire (CSHQ), while NO₂ exposure at home addresses was estimated through a satellite-based spatiotemporal model. Linear mixed-effect models and generalized estimating equations were employed to quantify the associations of NO₂ exposure with CSHQ scores and sleep disturbances, with the adjustment for demographics, meteorological parameters.</div></div><div><h3>Findings</h3><div>Early-life NO₂ exposure was associated with higher CSHQ scores and increased risk of sleep disturbances. Per 10 μg/m³ increase in NO₂ exposure during 0–3 years and the entire pregnancy was associated with 0.23 (95% confidence interval [CI]: 0.12–0.33) and 0.18 (95% CI: 0.09–0.27) increases in CSHQ score, respectively, indicating poorer sleep quality. A 10 μg/m³ increase in NO₂ exposure from ages 0–3 years and during the pregnancy was associated with a 1.1% (relative risk [RR] = 1.011, 95% CI: 1.004–1.018) and 1.0% (RR = 1.010, 95% CI: 1.004–1.016) higher risk of sleep disturbances, respectively. Higher NO₂ exposure was linked to greater likelihood of sleep onset delay, sleep-disordered breathing, and daytime sleepiness. The association appeared more pronounced among children exclusively breastfed &lt;6 months (RR = 1.018, 95% CI: 1.001–1.034) compared with those breastfed ≥6 months (RR = 1.009, 95% CI: 1.001–1.018).</div></div><div><h3>Interpretation</h3><div>Early-life exposure to NO₂ is associated with poorer sleep quality in preschool-aged children, highlighting the importance of mitigating air pollution exposure during critical developmental periods to support healthy sleep and child development.</div></div><div><h3>Funding</h3><div><span>Ministry of Science and Technology of the People's Republic of China</span>, <span>National Natural Science Foundation of China</span>, and <span>Shanghai Municipal Health Commission</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101701"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models and global health equity: a roadmap for equitable adoption in LMICs","authors":"Haichao Chen ,&nbsp;Dian Zeng ,&nbsp;Yiming Qin ,&nbsp;Zeyue Fan ,&nbsp;Faye Ng Yu Ci ,&nbsp;David C. Klonoff ,&nbsp;John S. Ji ,&nbsp;Shuyang Zhang ,&nbsp;Kwesi Nyan Amissah-Arthur ,&nbsp;Michelle María Jiménez de Tavárez ,&nbsp;Saleha Masood ,&nbsp;Phuoc Van Le ,&nbsp;Pearse A. Keane ,&nbsp;Bin Sheng ,&nbsp;Tien Yin Wong ,&nbsp;Yih Chung Tham","doi":"10.1016/j.lanwpc.2025.101707","DOIUrl":"10.1016/j.lanwpc.2025.101707","url":null,"abstract":"<div><div>Large language models (LLMs) have been proposed to address global health inequity by providing accessible and high-quality health care, particularly in low- and middle-income countries (LMICs). However, despite the early enthusiasm following the release of GPT, development and deployment of LLMs have remained heavily concentrated in high-income countries (HIC), raising concerns that such technology may worsen existing health disparities instead of alleviating them. The most recent LLMs, which include features such as lower cost, and open-source framework, show promise in rebalancing LLMs' benefits worldwide. In this viewpoint, we examine the current challenges and imbalance in LLM deployment across global regions, identify the key barriers to adoption in LMICs, assess current LLMs' advances and the new opportunities they bring to global health equity. We also propose a five-dimensional roadmap—focusing on people, products, platforms, processes, and policies—to advance LLMs' equitable adoption in LMIC and improve inclusive progress in global health.</div></div><div><h3>Funding</h3><div><span>National Key R&amp;D Program</span> (Grant No: <span><span>2022YFC2502800</span></span>); <span>National Natural Science Fund of China</span> (Grant No: <span><span>82388101</span></span>); <span>Beijing Natural Science Foundation</span> (Grant No: <span><span>IS23096</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101707"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidrug-resistant tuberculosis household contact screening and management by community healthcare workers in Mongolia: a prospective implementation study","authors":"Bazarragchaa Tsogt ,&nbsp;Tsegmed Sambuu ,&nbsp;Yanjindulam Purevsuren ,&nbsp;Sergelen Munkhbaatar ,&nbsp;Purevsuren Batsuren ,&nbsp;Oyun-Erdene Khandaa ,&nbsp;Narantsetseg Doyod ,&nbsp;Nasanjargal Byambaa ,&nbsp;Norovrenchin Tsogtgerel ,&nbsp;Gregory J. Fox ,&nbsp;Stephen M. Graham","doi":"10.1016/j.lanwpc.2025.101704","DOIUrl":"10.1016/j.lanwpc.2025.101704","url":null,"abstract":"<div><h3>Background</h3><div>Mongolia is a high burden country for multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB). The implementation of systematic household TB contact investigation has been very limited despite policy recommendations. We implemented a community-based approach to MDR/RR-TB contact screening and management.</div></div><div><h3>Methods</h3><div>We conducted a prospective implementation study in the nine districts of Ulaanbaatar and 10 other provinces. Community health workers (CHWs) were trained to identify and screen household contacts of patients with confirmed pulmonary MDR/RR-TB. Initial screening included symptom assessment for all with chest radiography for adult contacts or tuberculin skin test (TST) for child or young adolescent contacts (&lt;15 years). Follow-up visits to households were conducted quarterly for 12 months. Six months of daily levofloxacin (6Lfx) was offered to eligible contacts, i.e. &lt;15 years, TST-positive and without disease.</div></div><div><h3>Findings</h3><div>Of 99 people with pulmonary MDR/RR-TB, 349 household contacts were identified and 347 (99.4%) were screened by CHWs at initial home-based visit. Contact screening coverage remained high (&gt;98%) for each quarterly visit up to 12 months of follow-up. TB was diagnosed in 17 contacts (4.9%); ten from initial screen, seven from follow-up screen and 12 (71%) were children or adolescents. Four contacts were diagnosed with bacteriologically confirmed MDR/RR-TB and two died. 6Lfx was initiated in 15 (43%) of 35 eligible contacts who all completed therapy without interruption.</div></div><div><h3>Interpretation</h3><div>A decentralized model for the screening and management of MDR/RR-TB contacts implemented by trained CHWs has wider potential for increasing TB detection and prevention in Mongolia and the region.</div></div><div><h3>Funding</h3><div><span>John Burge Trust</span> and <span>National Health and Medical Research Council</span>, Australia.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101704"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant chidamide combined with chemotherapy in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer (MUKDEN 05): a multicentre, single-arm, phase 2 trial","authors":"Jinqi Xue ,&nbsp;Huilian Shan ,&nbsp;Fang Qiu ,&nbsp;Nan Niu ,&nbsp;Guanglei Chen ,&nbsp;Qianshi Xu ,&nbsp;Xi Gu ,&nbsp;Fei Xing ,&nbsp;Yongqing Xu ,&nbsp;Xinyu Zheng ,&nbsp;Guijin He ,&nbsp;Hong Xu ,&nbsp;Hao Zhang ,&nbsp;Dong Song ,&nbsp;Ye Han ,&nbsp;Meiyue Tang ,&nbsp;Shuo Cao ,&nbsp;Yang Song ,&nbsp;Ran Zheng ,&nbsp;Yafei Zhao ,&nbsp;Caigang Liu","doi":"10.1016/j.lanwpc.2025.101700","DOIUrl":"10.1016/j.lanwpc.2025.101700","url":null,"abstract":"<div><h3>Background</h3><div>Existing neoadjuvant therapies for hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) breast cancer have not achieved optimal clinical outcomes, thus prompting the investigation of novel treatment strategies. Given the emerging significance of HDAC inhibitors in the management of advanced breast cancer, this study investigated the efficacy and safety of chidamide plus chemotherapy as neoadjuvant therapy for patients with HR+/HER2− breast cancer.</div></div><div><h3>Methods</h3><div>This single arm, open-label, multicentre, phase 2 trial was conducted at three hospitals in China. Patients aged 18–75 years who had treatment-naïve, stage II–III HR+/HER2− breast cancer with an Eastern Cooperative Oncology Group performance status of 0–1 were enrolled. Patients received oral chidamide at a dose of 20 mg on days 1, 4, 8, and 11 of each 21-day cycle. The chemotherapy regimen consisted of four cycles of epirubicin (90 mg/m²) and cyclophosphamide (600 mg/m²) administered every three weeks, followed by four cycles of docetaxel (100 mg/m²) administered every three weeks. The primary endpoint was the rate of residual cancer burden (RCB) 0–I. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT05400993</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>Between May 23, 2022 and July 6, 2023, a total of 54 female patients (median age: 50 years [range, 26–75]) were recruited. The RCB 0–I rate was 35.2% (19 of 54, 95% confidence interval [CI], 22.7%–49.4%). The most frequent grade 3 or 4 adverse events were decreased neutrophil count (70%) and decreased white blood cell (67%). No treatment-related deaths occurred.</div></div><div><h3>Interpretation</h3><div>The combination of chidamide and chemotherapy shows the potential to be an alternative neoadjuvant therapy option for patients with HR+/HER2− breast cancer.</div></div><div><h3>Funding</h3><div><span>Shenyang Municipal Science and Technology Program</span> (Grant No. <span><span>22-321-32-18</span></span>), Shenzhen Chipscreen Biosciences Co., Ltd.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101700"},"PeriodicalIF":8.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}