World journal of clinical oncology最新文献

Serological screening, endoscopic imaging, morphological visual verification of precancerous gastric diseases and changes in the gastric mucosa are the main stages of early detection, accurate diagnosis and preventive treatment of gastric precancer. Laboratory - serological, endoscopic and histological diagnostics are carried out by medical laboratory technicians, endoscopists, and histologists. Human factors have a very large share of subjectivity. Endoscopists and histologists are guided by the descriptive principle when formulating imaging conclusions. Diagnostic reports from doctors often result in contradictory and mutually exclusive conclusions. Erroneous results of diagnosticians and clinicians have fatal consequences, such as late diagnosis of gastric cancer and high mortality of patients. Effective population serological screening is only possible with the use of machine processing of laboratory test results. Currently, it is possible to replace subjective imprecise description of endoscopic and histological images by a diagnostician with objective, highly sensitive and highly specific visual recognition using convolutional neural networks with deep machine learning. There are many machine learning models to use. All machine learning models have predictive capabilities. Based on predictive models, it is necessary to identify the risk levels of gastric cancer in patients with a very high probability.

Background: Multiple primary cancers refer to the presence of two or more distinct malignant tumors in a single individual, either simultaneously or sequentially. The synchronous occurrence of cholangiocarcinoma (CCA) and cervical squamous cell carcinoma (SCC) is extremely rare. This case highlights the diagnostic challenges and significance of a multidisciplinary team in managing complex malignancies involving both the hepatobiliary and gynecologic systems. The 8^th edition of the American Joint Committee on Cancer staging system was as follows: T1aN0M0 intrahepatic CCA; the 2018 edition of the International Federation of Gynecology and Obstetrics staging system was stage IB1 cervical SCC.

Case summary: A 74-year-old postmenopausal woman (Karnofsky performance status = 80) presented with a one-day history of vaginal bleeding. Cross-sectional imaging (contrast-enhanced computed tomography, liver magnetic resonance imaging, and positron emission tomography/computed tomography) first demonstrated a single 3-cm lesion in liver segment V and a hypermetabolic cervical mass. Subsequent ultrasound-guided liver biopsy confirmed CCA, whereas cervical biopsy revealed SCC. After multidisciplinary discussion, the patient underwent laparoscopic liver resection. Pelvic external-beam radiotherapy was delivered at 45 grays in 25 fractions (6-megavolt photons) over 5 weeks, followed by high-dose-rate ¹⁹²Ir intracavitary brachytherapy, at 35 grays in 7 fractions (International Commission on Radiation Units and Measurements A-point). She received eight cycles of systemic therapy with lenvatinib, capecitabine, and camrelizumab. Over a 12-month follow-up, she remained disease-free with no signs of recurrence or metastasis.

Conclusion: Multidisciplinary management offers a promising strategy for treating synchronous complex malignancies with individualized treatment plans.

The increasing incidence of melanoma poses significant challenges for conventional treatment approaches, plagued by drug resistance and adverse side effects. Natural marine-derived compounds have gained prominence in melanoma research for their unique bioactivities and diversity. This review delves into the therapeutic potential of these compounds in melanoma treatment, emphasizing their distinctive advantages such as multi-target mechanisms and immune modulation, which distinguish them from traditional therapies. Additionally, we discuss the challenges in translating these agents into clinical applications, including formulation stability, bioavailability, and regulatory hurdles. Recent advancements in preclinical models such as organoids and completed clinical trials further support the exploration of marine-derived compounds in melanoma management. By consolidating current research, this review underscores the potential of these agents to enhance treatment efficacy and foster new therapeutic strategies.

Gastric cancer (GC) remains a leading cause of cancer mortality. While the extent of nodal involvement is a well-known prognostic factor, the specific entity of swollen lymph node metastasis (SLNM), bulky nodal tumor deposits detectable radiologically or pathologically, has received little attention in staging. Recent data from a study by Cui et al demonstrated that SLNM is an independent predictor of very poor survival in GC. Through robust data and rigorous propensity-matched analyses, SLNM emerged not merely as an anatomical finding but as an independent predictor of poor prognosis, even among patients undergoing curative resection. As precision oncology advances, the findings by Cui et al urge a fundamental rethinking of how SLNM is incorporated into clinical decision-making for GC management. In this editorial, we critically examine the prognostic significance of SLNM, challenge its omission from traditional staging frameworks, and advocate for its formal integration into preoperative risk stratification and treatment planning. Recognizing SLNM at diagnosis could unlock intensified neoadjuvant therapy strategies and optimize outcomes for a historically high-risk patient subgroup.

Metastatic urothelial carcinoma (mUC) is a challenging malignancy with historically limited treatment options. Advances in understanding its biology have enabled the development of innovative therapies, including immune checkpoint inhibitors and antibody-drug conjugates (ADCs). ADCs, such as enfortumab vedotin, sacituzumab govitecan, and trastuzumab deruxtecan, represent transformative advancements, offering targeted delivery of cytotoxic agents. This review highlights the evolving role of ADCs in mUC, examining their mechanisms, clinical efficacy, patient selection criteria, genetic insights, and future directions in personalized treatment strategies.

Gliomas are the most common primary tumors of the central nervous system; among them, glioblastoma multiforme stands out as the most aggressive and lethal subtype, characterized by high therapeutic resistance and frequent recurrences. Glioblastoma's complex pathology is driven by biological and molecular factors that compromise conventional therapies, including blood-brain and blood-tumor barriers, angiogenesis, immune evasion, and aberrant signaling pathways, along with genetic drivers of drug resistance. In cancer therapy, mesoporous silica nanoparticles (MSNs) have shown promise as nanocarriers thanks to the unique attributes of their mesostructure, including large surfaces, uniform pore sizes, high loading efficiency, and flexibility of chemical modifications. Several studies have proposed MSNs to address a number of challenges facing drug delivery in gliomas, including limited penetration across the blood-brain barrier, non-specific biodistribution, and systemic adverse reactions. Moreover, MSNs can be functionalized with tumor-targeting ligands so that cancer cells are selectively taken up, while they can also release therapeutic agents in response to internal and external stimuli, enabling controlled drug delivery within tumor microenvironments. Herein, we review the integration of the MSN-based delivery approach with advances in molecular oncology to improve clinical outcomes for glioma therapeutics, while highlighting the concerns around their limited clinical translation and potential toxicity.

Neoadjuvant treatment is being extensively evaluated in pancreatic ductal adenocarcinoma (PDAC). This interest is appropriate given the dismal long-term prognosis for most patients who undergo upfront surgery. Despite prospective, retrospective and randomized trials supporting the role of neoadjuvant therapy in general for PDAC, the long-term benefit specifically for patients with resectable PDAC remains unclear. The phase III PREOPANC trial showed an improvement in overall survival in borderline resectable PDAC with neoadjuvant gemcitabine-based chemoradiation compared to upfront surgery alone, however, no such benefit was observed in the resectable cohort. Notably, three randomized trials (PANACHE01-PRODIGE 48, NORPACT-1, and PREOPANC-2) failed to show a clear improvement in overall survival with a neoadjuvant approach. The ongoing NeoFOL-R, PREOPANC-3, and the Alliance A021806 will help clarify the role of neoadjuvant therapy in resectable PDAC. In this minireview article we summarize the data surrounding neoadjuvant therapy in resectable pancreatic cancer and discuss future considerations of trials in this subgroup.

Immuno-positron emission tomography (immuno-PET) is an innovative medical imaging technique that combines antibodies (Abs) or other immune-targeting molecules with positron-emitting radionuclides. By targeting antigens that are highly expressed in hematologic malignancies, immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection. Additionally, it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies. Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods, especially for detecting minimal residual disease and guiding adaptive therapeutic interventions. In Ab-based immuno-PET, positron-emitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs. Recent studies have highlighted the advantages of long-lived radionuclides, such as ⁸⁹Zr, which exhibit low positron energy and enable high sensitivity and resolution, making them particularly effective for tumor visualization and characterization. This review explores the current applications, recent advancements, and potential of immuno-PET for hematologic malignancies, emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.

Neuroendocrine tumors are a rare cancer, with those arising in gastric tissue even less commonly. With increasing recognition through endoscopy, these tumors are diagnosed in more patients each year. As a rare and growing entity, our understanding of these tumors, the way we characterize them, and treatment are changing rapidly. Thus, we sought to provide an updated review of pathology and management, highlighting the latest guidelines and evidence for surgical treatment. Much of the general treatment paradigm is from consensus guidelines put forth by the European Neuroendocrine Tumor Society and the North American Neuroendocrine Tumor Society; however, future research is needed to help guide further surgical decision-making around intermediate grade and intermediate size type III tumors, as well as systemic therapies in the perioperative and nonoperative settings for high-grade tumors.