Cancer Control最新文献

IntroductionNucleophosmin 1 (NPM1), FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD), and de novo methyl transferase 3 A (DNMT3A) triple-mutated acute myeloid leukemia (AML) represents a distinct entity with poor outcomes.MethodsWe explored the gene mutation spectrum and clinical characteristics of 165 AML patients retrospectively, particularly comparing patients with NPM1/FLT3-ITD/DNMT3A triple-mutations and those without.ResultsOur results demonstrated significantly elevated white blood cell counts (P < 0.001), bone marrow blast percentages (P = 0.037), and platelet counts (P = 0.007) in the triple-mutated cohort (6.7%) compared to the non-triple-mutated patients. Furthermore, all triple-mutated cases were classified as the M4/M5 subtype of the French-American-British classification (P = 0.017). Although no significant difference in complete remission rates was observed between the groups after initial treatment, the median overall survival for triple-mutated AML patients was only 4 months. Using the Gene Expression Omnibus (GEO) database and bioinformatics, we compared AML^{NPM1mutFLT3-ITDmutDNMT3Amut} and AML^{NPM1mutFLT3-ITDmutDNMT3Awt}. A total of 246 AML patients from the GEO dataset were included to evaluate the expression profiles of differentially expressed genes. The guanine nucleotide-binding protein subunit γ 4 (GNG4) was differentially expressed between AML^{NPM1mutFLT3-ITDmutDNMT3Amut} and AML^{NPM1mutFLT3-ITDmutDNMT3Awt}, which had the most adjacent nodes among hub genes. The prognostic value of GNG4 was further validated in AML patient samples through qRT-PCR.ConclusionClinical validation indicated a substantial downregulation of GNG4 in AML^{NPM1mutFLT3-ITDmutDNMT3Amut} compared to AML^{NPM1mutFLT3-ITDmutDNMT3Awt} patients. Thus, GNG4 may play a role in the low survival rate of AML^{NPM1mutFLT3-ITDmutDNMT3Amut} patients, offering novel insights into the prognosis, therapeutic targets, and prognostic evaluation of AML.

Breast cancer remains a critical public health challenge in low- and middle-income countries (LMICs), where late-stage diagnoses, limited access to care, and fragmented survivorship support exacerbate disparities in outcomes. This manuscript examines the systemic barriers to delivering women-centric breast cancer care in LMICs, including geographic and socioeconomic inequities, underfunded prevention efforts, and gaps in policy implementation. Building on a proposed roadmap for reform, we advocate for culturally adaptive strategies, community co-creation, and investment in scalable care models. By prioritizing women's unique needs and fostering multisectoral collaboration, LMICs can transform breast cancer care from survival-focused to empowerment-driven, even amid resource constraints.

This editorial introduces the "Cancer Control" Special Collection featuring 14 peer-reviewed diverse studies from diverse geographical regions and thematic areas, including screening, HPV vaccination, cancer literacy, genetic and molecular innovations, and culturally tailored interventions. This collection highlights disparities in access, uptake, and awareness across populations emphasizing the urgent need for evidence-based strategies. It calls for integrated approaches in prevention, health education, policy reform, and technological advancements to reduce the global cancer burden, which continues to rise, especially in low- and middle-income countries.

IntroductionColorectal cancer (CRC) is the third most common cancer worldwide and a significant public health threat with far-reaching societal implications. The currently available CRC therapeutic strategies have limitations, thus requiring the development of new strategies. Coxsackievirus B3 (CVB3) exhibits strong oncolytic activity in CRC, although its mechanism of action remains unclear. This study aimed to investigate whether the induction of ferroptosis is a promising treatment strategy for CRC and whether CVB3 could activate ferroptosis during infection.MethodsIn vitro and in vivo experiments were conducted to evaluate whether CVB3 infection activates the ferroptosis pathway by upregulating miR-214-3p to suppress glutathione peroxidase 4 (GPX4) expression. Dual-luciferase assays and rescue experiments were performed to confirm this regulatory mechanism. Clinical CRC tissues and colon cancer xenograft models were used to demonstrate the mediating role of the miR-214-3p/GPX4 axis in the interaction between viral replication and ferroptosis.ResultsCVB3 demonstrated oncolytic virus properties by selectively lysing tumor cells. The in vitro and in vivo experiments confirmed that CVB3 activates the ferroptosis pathway by upregulating miR-214-3p to suppress GPX4 expression, thereby promoting viral replication and tumor regression. Antagonizing miR-214-3p reversed this process.ConclusionmiR-214-3p expression was upregulated during CVB3 infection of CRC tissues and cells, activating the ferroptosis pathway and promoting tumor cell death.

BackgroundColorectal cancer (CRC) predominantly affects older adults, whose treatment outcomes may be influenced by baseline health-related quality of life (HRQoL). This study aimed to identify predictors of poor preoperative HRQoL in older patients undergoing CRC surgery and to stratify them into risk groups.MethodsWe retrospectively analyzed data on patients aged ≥65 years who underwent radical CRC surgery at a single medical center in Taiwan (2016-2018). Preoperative HRQoL was assessed using the EORTC QLQ-ELD14 questionnaire and a comprehensive geriatric assessment. Patients were stratified into high or low HRQoL groups based on the median QLQ-ELD14 sum score. Logistic regression identified independent predictors of poor HRQoL, and recursive partitioning analysis (RPA) was applied for risk stratification.ResultsAmong the 179 patients, the most distressing HRQoL domains were Burden of Disease, Maintaining Purpose, and Worries about Others. Independent predictors of poor HRQoL included female sex (adjusted odds ratio [OR] = 2.41, P = 0.029), frailty (adjusted OR = 1.53, P = 0.042), poor Eastern Cooperative Oncology Group (ECOG) performance status (adjusted OR = 2.19, P = 0.008), and lower educational attainment (adjusted OR = 0.23, P = 0.019). RPA identified five patient subgroups with distinct risk levels; frail female had the highest risk (71.4%), while fit patients with college education or higher had the lowest (9.5%).ConclusionFrailty, functional status, sex, and education level are key determinants of preoperative HRQoL in older patients with CRC. The RPA provides a simple tool to identify high-risk patients, allowing targeted preoperative interventions to optimize care and enhance surgical outcomes.

ObjectivesThis study aims to evaluate the perceived impact of extreme weather events from 2017 - 2024 on delivery of radiotherapy in Puerto Rico (PR), including effects on radiation oncologists, medical physicists, clinical staff, and patients. A secondary objective is to identify resources and strategies that may strengthen resiliency and support continuity of care in radiation oncology clinics located in weather-vulnerable regions.MethodsWe developed a comprehensive online cross-sectional survey to evaluate clinic emergency preparedness and the impact of extreme weather events on radiation oncology clinic stakeholders in PR. Potential participants were identified through the American Society for Radiation Oncology (ASTRO) membership directory and were invited to participate via email and direct outreach.ResultsFourteen radiation oncologists and four medical physicists were invited to participate, with a response rate of 56% (n = 10), representing 71.4% of radiation oncology clinics in PR. Among respondents, 90% reported clinical disruptions due to extreme weather events from 2017 to 2024. The most commonly reported impacts were property damage (90%), communication failures between providers, patients and staff (90%), power outages (80%), and school and/or childcare closures (80%). A majority (90%) supported developing comprehensive supportive resources, including professional society resources, to enhance disaster preparedness and operational resiliency.ConclusionRadiation oncology providers in PR reported significant disruptions in care delivery from extreme weather events and identified a need for strong resiliency measures. Institutional policy, coupled with targeted support from professional societies, may reduce lapses in treatment, safeguard vulnerable patients - particularly those with complex treatment plans - and improve continuity of care and outcomes in weather-prone regions.

IntroductionFinancial hardship during cancer treatment is common in privatised healthcare systems and has been extensively studied in cancer survivorship groups. The experience of financial concerns by people living with advanced, incurable cancer has been less frequently explored. This paper sought to describe the proportion of patients experiencing financial worry longitudinally, in a cohort with advanced colorectal cancer, in a publicly funded healthcare system.MethodsThis secondary analysis of a prospective, observational cohort study 'Palliative Care Early and Systematic (PaCES)' project, analysed data from 131 patients with advanced colorectal cancer, from Alberta's two tertiary cancer centres, treated between January 2018 - December 2020. Rates of self-reported financial concerns were obtained from the Canadian Problem Checklist, completed monthly for 10 months and 3 monthly thereafter.ResultsFifty-seven patients (43%) affirmed at least once that they had worried about their finances in the preceding month. Of those who reported they had "noˮ financial concerns at enrolment, 41 (35%) subsequently answered "yesˮ. The proportion of patients experiencing financial worry at any given time point fluctuated but the mean proportion was 18%. Multivariable analysis confirmed younger age (<65) was associated with more financial worry (P-value <0.01).ConclusionFinancial worry is a common and often recurrent concern for patients with advanced colorectal cancer, particularly for younger patients. Serial screening is important to detect persisting or de novo worry.

IntroductionWe aimed to investigate the predictive value of body fat composition parameters obtained using computed tomography (CT) for preoperative occult peritoneal metastasis (OPM) in gastric cancer.MethodsWe adopted a single-center case-control design and retrospectively analyzed data from 115 patients with gastric cancer who underwent laparoscopic exploration or radical gastrectomy at our hospital between October 2020 and March 2024. Patients were divided into OPM-positive (n = 35) and OPM-negative (n = 80) groups. The visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area, and mean attenuation of CT images at the central level of the L3 lumbar spine were measured using the sliceOmatic software, and the clinical and imaging characteristics of the patients were analyzed.ResultsSignificant differences were present in the VAT area, VAT/SAT area, mean attenuation of SAT, mean attenuation of VAT, VAT area of different N stages, and lesion sites between the OPM-positive and OPM-negative groups (P < 0.05). Results of a multifactor logistic regression analysis showed that the VAT/SAT area ratio and VAT mean attenuation were independent risk factors for OPM in gastric cancer (P < 0.05). The AUC of the clinical-imaging model in predicting gastric cancer OPM was 0.92 (95% confidence interval, 0.86-0.97). A VAT/SAT area of 1.04 (specificity: 54%, sensitivity: 86%) and a VAT mean attenuation of -83.60 Hounsfield unit (HU) (specificity: 99%, sensitivity:34%) were used as optimal cutoff values for identifying the occurrence of OPM in gastric cancer.ConclusionVAT/SAT area ratio and mean VAT attenuation in body fat composition are potential auxiliary parameters for predicting OPM in gastric cancer.

IntroductionPatients with cancer may overestimate their ability to adhere to oral anticancer treatments (OAT) which may significantly reduce adherence rates. However, only few studies have investigated the specific role of personality traits and cognitive distortions in the definition of the adherence trajectory in the cancer field.MethodsThis study is nested in the Pfizer project (65080791), and it is a secondary, observational analysis of prospectively collected data from a randomized controlled trial (RCT). To avoid potential bias from comparing measurements across different time points, we limited the evaluation of associations among variables to the baseline data. 94 metastatic breast cancer (MBC) patients (mean age 56.8) receiving OAT for MBC have been enrolled. Each participant filled a set of measures assessing personality (Big Five), adherence (AAI-28 and MMAS-8) (© 2006 Donald E Morisky), and optimistic bias (VAS), and Quality of Life (EORTC QLQ-C30 and EORTC QLQ-BR23).ResultsA discrepancy between self-oriented and other-oriented evaluation of the capacity to take the therapy in the doses, frequencies, and times prescribed was observed (P < 0.001). A negative association between adherence rate and the self-perception of treatment adherence was identified (P < 0.001). Further, conscientiousness correlated positively with the perception of risk to their own health (P = 0.034), and negative association between extraversion and self-perception of treatment adherence (P = 0.05) and between agreeableness and self-perception of treatment adherence have been observed (P = 0.029).ConclusionsOur findings suggest that optimistic bias and personality may contribute to shaping adherence in MBC patients. Personality traits influence adherence both directly, by increasing the perception of health risks, and indirectly, by influencing coping strategies and emotion regulation. MBC patients having an OB may underestimate the important side effects and physical comorbidities, as well as difficulties in the daily management and adjustment of therapy due to disease progression.