Cancer Control最新文献

IntroductionS100 calcium-binding protein A2 (S100A2) is associated with various tumors. However, its expression profile, clinical relevance, and prognostic value in hepatocellular carcinoma (HCC) remain unclear; therefore, this study assessed S100A2 expression levels in HCC and adjacent normal tissues.MethodsTo investigate the role of S100A2 in HCC, RNA sequencing and DNA methylation data were obtained from The Cancer Genome Atlas (TCGA)-Liver Hepatocellular Carcinoma (LIHC) cohort comprising 374 tumor and 50 normal liver tissues. A retrospective cohort of 216 HCC patients was also evaluated for correlations between S100A2 expression and clinicopathological characteristics. In a subset of 62 paired tumor and adjacent normal tissues, S100A2 protein and mRNA levels were assessed by immunohistochemistry (IHC) and quantitative RT-PCR. Finally, the relationship between S100A2 overexpression and clinicopathological variables was examined using the Cox proportional hazards regression model.ResultsAnalysis of the TCGA-LIHC dataset revealed a marked elevation in S100A2 expression in tumor tissues compared to normal liver tissues. Consistently, DNA methylation analysis showed hypomethylation of several S100A2-associated CpG sites in liver hepatocellular carcinoma, suggesting a potential epigenetic mechanism for its upregulation. Correlation analysis demonstrated that increased S100A2 expression was associated with advanced histological grade, lymph node metastasis, serum alpha-fetoprotein level, microvascular invasion, tyrosine kinase inhibitor level, concurrent treatment, and higher Tumor, Node, Metastasis stage. Univariate analysis showed that elevated S100A2 levels were associated with significantly poorer recurrence-free survival (RFS) and overall survival (OS). Moreover, multivariate analysis identified S100A2 as an independent prognostic indicator for both RFS and OS. Kaplan-Meier survival curves also confirmed that patients with high S100A2 protein levels had significantly worse 5-year OS and RFS rates.ConclusionThese findings indicate that S100A2 overexpression is associated with poor prognosis in patients with HCC, highlighting its potential utility as a diagnostic biomarker.

IntroductionCancer clinical trials do not always represent the real-world cancer population, as older adults and marginalized racial groups are often underrepresented. This study assessed patterns of enrollment of underrepresented patients and how trial and site factors may influence enrollment.MethodsThis retrospective, pooled cross-sectional study used de-identified data from ECOG-ACRIN (EA)-sponsored breast cancer therapeutic clinical trials from 2002-2020. Patient- and trial-level data were extracted from EA trials and ClinicalTrials.gov. Site-level data were from de-identified Landscape Assessment surveys voluntarily completed by National Cancer Institute Community Oncology Research Program sites. Outcomes included the proportions of underrepresented patients enrolled on a trial. Fractional regression models evaluated associations between trial-level factors and enrollment proportions of underrepresented patients using adjusted means and 95% confidence intervals (CI). Weighted Kappa (Kw) statistics and corresponding 95% CI estimated the level of agreement between patient populations served by sites versus enrolled on a trial.ResultsOf 9,015 patients enrolled across 12 trials, 18% were aged ≥65 years old, 12% were Black, 15% were Medicare beneficiaries, and 15% were rural residents (unadjusted enrollment). Adjusted mean proportion enrollment of underrepresented patients was similar to unadjusted results. Over half of trials were randomized and 92% of studies had two or more drugs in the protocol, yet these did not appear to influence mean enrollment of underrepresented groups. Moderate levels of agreement were found between Black patients served versus enrolled (Kw 0.64; 95% CI 0.50-0.78), and low or no agreement for Medicare beneficiaries and patients aged ≥65 (Kw 0.18, 0.05-0.31; Kw 0.02, -0.06-0.11; respectively).ConclusionsEA-sponsored breast trials continue to enroll few individuals from underrepresented backgrounds. Trial design had a minimal impact on enrollment and patient populations sites served did not typically match the patients enrolled on trials. More research is needed to engage sites and test strategies for enrolling underrepresented patients.

IntroductionThe purpose of this study was to use a Virtual Community Engagement Studio (V-CES) model to develop and refine short message service (SMS) content in English and Spanish related to dietary quality, physical activity, and sleep hygiene intended for individuals with cancer and their caregivers.MethodsCommunity expert stakeholders participated in an English or Spanish V-CES and provide actionable feedback on the content and delivery of 180 previously developed SMS messages.ResultsParticipants were nine stakeholders representative of the Southern Arizona cancer care community (eg, survivors, caregivers, healthcare providers, community health workers). SMS as a health promotion intervention strategy in context of cancer survivorship was viewed as accessible and appropriate. Actionable feedback from the V-CES included using positive affirmations, incorporating motivational strategies, using relatable language, and emphasizing evidence. Spanish language SMS should consider regional context during translation. Stakeholders recommended that two SMS be sent daily to dyads between 8:00 am and 7:00 pm, at relevant times for each behavior.ConclusionFuture research will test the SMS for feasibility and acceptability among survivor-caregiver dyads. The V-CES model is an innovative approach for developing and refining dyadic health behavior interventions and may be beneficial for future research to engage communities.

Tumor immune escape is a major challenge in cancer treatment, and targeted immune escape therapy has become a key strategy for cancer treatment. As an important deubiquitinating enzyme, ubiquitin-specific protease 10 (USP10) participates in the process of tumor development by adjusting the balance between ubiquitination and deubiquitination of substrate proteins. Recently, USP10 has been shown to be closely related to tumor immune escape, where it serves to reduce the immunogenicity of tumor cells by stabilizing immune checkpoints and promotes tumor immune escape. In this review, we focus on the structural and functional characteristics of USP10 and elaborate on the biological function of USP10 in the occurrence and development of tumors, as well as its role in immune escape, including the regulation of immune checkpoints and the effect on immune cells in the immune microenvironment. It is possible to improve the efficacy of traditional cancer therapies by appropriately regulating the expression of USP10. The aim of this review is to provide a reference for further understanding the mechanism of tumor immune escape and the development of new tumor treatment methods.

For older adults with cancer, communication is among the most critical aspects of care. This commentary examines two communication timepoints that may confer disproportionate clinical impact: the initial consultation and major change points, such as progression, hospitalization, or functional decline. We argue that a validating and clear communication style-offering clear recommendations while honoring patient values-anchors trust and improves outcomes. The initial consultation should focus as much on understanding the person as the pathology, incorporating functional status, caregiver capacity, and treatment priorities. Evidence from the Mohile COACH trial demonstrates that geriatric assessment can enrich these conversations and ensure vulnerabilities shape the care plan. While electronic health record (EHR)-supported prompts may strengthen communication, their applicability varies across settings, and such tools require contextual adaptation. At major change points, structured approaches such as best case/worst case framing, agenda setting, and teach-back provide reliability and clarity. Beyond the clinician, learning electronic health records (EHRs) can flag inflection points, nudge best practices, and embed documentation of goals into routine workflows. Framing communication as a measurable intervention-one that is trainable, auditable, and supported by systems-offers a path toward oncology care that is not only evidence-based but also values-based, particularly for older adults, while avoiding mechanistic, tick-box use of communication tools that could undermine authenticity.

BackgroundDiffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma and a leading cause of cancer-related mortality worldwide. Evidence on long-term survival and prognostic determinants remains limited, particularly among people living with HIV. This study evaluated survival outcomes and predictors of mortality among adults with DLBCL in Northwest Ethiopia.MethodsWe conducted a multicenter retrospective cohort study of consecutively enrolled adults with newly histologically confirmed DLBCL diagnosed between August 1, 2020, and July 31, 2025, at three referral hospitals in Northwest Ethiopia. Patients were followed from diagnosis until death, loss to follow-up, or study end. Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazard regression was used to identify independent predictors of mortality. Subgroup analyses were performed depending on HIV status. Statistical significance was set at P ≤0.05.ResultsA total of 175 patients with DLBCL were included, of whom 31 (17.7%) were HIV-positive. The median survival time was 36 months (IQR: 21-49). The estimated 5-year OS was 25%. Advanced disease (stage IV; AHR = 2.7, 95% CI: 1.1-6.5), HIV-positive status (AHR = 2.3, 95% CI: 1.1-5.0), elevated serum lactate dehydrogenase (LDH) (≥2× upper limit of normal; AHR = 2.2, 95% CI: 1.0-4.9), and delayed initiation of chemotherapy (≥2 months; AHR = 2.6, 95% CI: 1.2-5.8) were independently associated with increased mortality. Among HIV-positive patients, neutropenic fever was the sole independent predictor of death (AHR = 4.3, 95% CI: 1.1-17.4).ConclusionsSurvival among patients with DLBCL in Northwest Ethiopia remains poor, particularly among those presenting with advanced disease, those living with HIV, those that have delayed treatment initiation, and those that have elevated serum LDH - all these parameters were independently associated with increased mortality. Strengthening diagnostic capacity, ensuring equitable access to immunochemotherapy, integrating HIV-oncology services, and prioritizing early treatment initiation are essential to improving outcome.

IntroductionClinical practice organizations have developed evidence-based guidelines to structure oncofertility care delivery and mitigate fertility impairment after cancer. However, fertility care remains a leading unmet need for adolescents and young adults (AYAs) with cancer, and implementation of guidelines in practice is poorly understood. This study aims to identify intervention opportunities to improve the delivery of guideline-concordant oncofertility counseling for AYAs with cancer from the perspectives of oncologists.MethodsOncologists who treat AYAs with cancer at risk for infertility at an NCI-designated Comprehensive Cancer Center in California were recruited to participate in a virtual, semi-structured qualitative interview. Opportunities for interventions were identified following a thematic analysis.ResultsData/thematic saturation was achieved through 12 interviews with oncologists (66.7% female, 41.7% White and 41.7% Asian, in practice for an average of 14.3 years). To increase delivery of guideline-concordant oncofertility counseling for AYAs with cancer, oncologists reported opportunities for: (1) enhancements to electronic care systems (e.g., reminders to discuss fertility with young patients, automatic referrals for fertility-related care, expedited oncofertility consults); (2) dedicated personnel and time (e.g., appointing a specific person to discuss fertility, allocating dedicated time to discuss fertility); and (3) oncologist education (e.g., related to financial considerations, fertility preservation, availability of oncofertility-related resources within the care setting, patient preferences and experiences).DiscussionThis study identified oncologists' perspectives on opportunities for interventions to improve guideline-concordant oncofertility counseling for AYAs with cancer, providing actionable insights into targets for change across both provider- and system-level domains. Notably, identified interventions depend upon institutional commitments to prioritize oncofertility. Without systemic efforts to improve care, oncofertility will likely remain a prominent unmet need for AYAs with cancer.

IntroductionThe long-acting somatostatin analogues (LA-SSAs) octreotide LAR (OCT) and lanreotide (LAN) improve progression-free survival (PFS) in gastrointestinal neuroendocrine tumors (NETs), however, no head-to-head comparison exists. We compared treatment patterns and efficacy in a small bowel and pancreatic NET population-based cohort from British Columbia, Canada.MethodsWe identified 321 patients receiving either LAN or OCT for retrospective chart review. These somatostatin analogs were evaluated for impact on progression-free and overall survival.ResultsAge, sex, ECOG, and primary site did not differ by treatment, however, LAN was more commonly used in higher grade tumors (P = 0.019). PFS was longer for patients receiving LAN than OCT (Hazard Ratio (HR) 0.60, 95% CI 0.40-0.89, P = 0.011). Similarly, overall survival (OS) was longer for patients receiving LAN than OCT (HR 0.45, 95% CI 0.28-0.73, P = 0.016). Sensitivity analysis among patients diagnosed after both agents were reimbursed showed similar results for PFS (HR 0.50, 95% CI 0.28-0.90, P = 0.018). There was similar dose escalation with LAN vs OCT (OR: 0.80, CI 0.38-1.77, P = 0.70), with 29.4% of patients in the LAN group requiring LA-SSA dose escalation compared to 34.3% in the OCT group. There was numerically less short acting octreotide use in the LAN group (P = 0.087), with none of these patients requiring short acting octreotide, compared to 8.7% of the OCT group.ConclusionLAN was associated with longer time to cancer progression, as well as less use of short acting rescue octreotide in our population-based cohort. However, given the retrospective design and reimbursement-era differences, these findings should be interpreted cautiously and warrant confirmation in prospective or head-to-head studies.

IntroductionEarly-onset colorectal cancer (EOCRC) is increasing worldwide, with Serbia showing a similar incidence compared to global trends. Precise mutation genotyping has gained importance following the recent approval of KRAS-specific inhibitors. Although KRAS, NRAS, and BRAF testing is routinely performed in Serbia, specific mutation subtypes in EOCRC patients have not yet been published. This retrospective cohort study aimed to investigate temporal trends in EOCRC incidence in Serbia and characterize the mutational profile of KRAS, NRAS, and BRAF in EOCRC patients.MethodsNational cancer registry data from 2016 to 2022 were analyzed to assess EOCRC incidence trends. Molecular testing for KRAS, NRAS, and BRAF was performed on 681, 420, and 67 EOCRC patients, respectively, using qPCR-based diagnostic assays, complemented by Sanger sequencing on 54 cases to characterize KRAS exon 2 and BRAF V600E mutations.ResultsRegistry data revealed a consistent upward trend in EOCRC incidence, especially in the 45-49 years' age group. In the qPCR-tested cohort, KRAS mutations were detected in 44.3% (302/681), NRAS in 6.4% (27/420), and BRAF in 8.9% (6/67). In the sequenced subset, KRAS mutations were found in 20.4%, including G12D (36.4%), G13D (27.3%), G12 C (18.1%), and G12S/G12 V (9.1%) variants. BRAF V600E was detected in 3.7%.ConclusionsWe report a rise in EOCRC in Serbia, especially in ages 45-49, and recommend policy makers to lower the screening age to 45. We present the first detailed molecular profile of Serbian EOCRC and recommend that policy makers implement routine KRAS variant testing and ensure access to KRAS G12C-targeted therapies to improve personalized care.