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Impact of Sequencing of Treatment Modalities on Survival in Nonmetastatic Hepatocellular Carcinoma. 治疗方式排序对非转移性肝细胞癌患者生存的影响。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 Epub Date: 2025-06-06 DOI: 10.1097/COC.0000000000001221
Bakr Alhayek, Firas Baidoun, Danny Hadidi, Muhamad A Moustafa, Omar Abdel-Rahman
<p><strong>Objectives: </strong>Hepatocellular carcinoma (HCC) is the most common type of liver malignancy and the third leading cause of cancer-related death in the world. Liver transplant is a cornerstone in treating nonmetastatic disease, but a significant portion of patients miss the opportunity of upfront liver transplant given the long waiting time for donor organs. Herein, we compare the survival outcomes between upfront liver transplant, liver transplant with bridge systemic therapy, and systemic therapy only.</p><p><strong>Methods: </strong>The National Cancer Database was queried for patients diagnosed with non-metastatic hepatocellular carcinoma (HCC) between 2004 and 2017. After including only patients with clinical N0 stage who received either systemic therapy alone, liver transplant alone or liver transplant with bridge systemic therapy, we split the cohort into 3 groups: systemic therapy only (including intra-arterial chemotherapy eg, TACE) group, upfront liver transplant group and liver transplant with bridge systemic therapy group. We evaluated overall survival (OS) among the three groups. We studied the OS using Kaplan-Meier estimates and multivariate Cox regression analyses to evaluate factors associated with overall survival (OS).</p><p><strong>Results: </strong>A total of 29,691 patients with nonmetastatic HCC were included for analysis, of which 25,122 (84.6%) were treated with systemic therapy only, 2513 (8.5%) were treated with bridge systemic therapy followed by liver transplant, and 2056 (6.9%) were treated with upfront liver transplant without systemic therapy bridge. We found that patients who were treated with bridge systemic therapy followed by liver transplant and patients who were treated with upfront liver transplant had a statistically significantly better OS compared to patients who were treated with systemic therapy only (mean OS was 101.9 mo and 98.2 vs. 39.4 mo, respectively, with P <0.001 for all). Whereas there was no significant difference in OS between patients who were treated with bridge systemic therapy followed by liver transplant and patients who were treated with upfront liver transplant (mean OS was 101.9 vs. 98.2 months, P =0.187). On multivariate analysis, factors associated with worse OS were older age (HR: 1.011; 95% CI: 1.010-1.013; P <0.001), Male sex (HR: 1.048; 95% CI: 1.014-1.084; P =0.006), White compared with African American race (HR: 1.055; 95% CI: 1.012-1.099; P =0.011), no insurance status (HR: 1.155; 95% CI: 1.079-1.237; P <0.001), clinical T4 stage compared with T0 stage (HR: 1.366; 95% CI: 1.257-1.483, P <0.001), and systemic therapy alone compared with upfront liver transplant and liver transplant with bridge systemic therapy (HR for upfront liver transplant and transplant with bridge systemic therapy vs. systemic therapy was 0.202; 95% CI: 0.184-0.223, and HR: 0.194, 95% CI: 0.178-0.212, respectively, with P <0.001 for all).</p><p><strong>Conclusions: </strong>Patients with nonm
目的:肝细胞癌(HCC)是最常见的肝脏恶性肿瘤类型,也是世界上癌症相关死亡的第三大原因。肝移植是治疗非转移性疾病的基石,但由于等待供体器官的时间过长,很大一部分患者错过了前期肝移植的机会。在此,我们比较了术前肝移植、肝移植联合过桥全身治疗和仅全身治疗的生存结果。方法:查询2004年至2017年期间诊断为非转移性肝细胞癌(HCC)的患者的国家癌症数据库。在仅纳入单纯接受全身治疗、单纯肝移植或肝移植联合过桥全身治疗的临床no期患者后,我们将队列分为3组:单纯接受全身治疗(包括动脉内化疗如TACE)组、前期肝移植组和肝移植联合过桥全身治疗组。我们评估了三组患者的总生存期(OS)。我们使用Kaplan-Meier估计和多变量Cox回归分析来评估与总生存期(OS)相关的因素。结果:共纳入29691例非转移性HCC患者,其中25122例(84.6%)仅接受全身治疗,2513例(8.5%)接受过桥全身治疗后肝移植,2056例(6.9%)接受前期肝移植,未接受过桥全身治疗。我们发现,与仅接受全身治疗的患者相比,接受桥式全身治疗后再进行肝移植的患者和接受前期肝移植的患者的OS有统计学意义上的显著改善(平均OS分别为101.9个月和98.2个月vs 39.4个月)。与仅接受全身治疗的患者相比,接受前期肝移植或肝移植联合过桥全身治疗的非转移性HCC患者的OS改善具有统计学意义。虽然我们的研究证实了肝移植对非转移性HCC患者的生存益处,但这些结果提高了在动脉内和/或全身治疗后进行肝移植的重要性,这些患者最初不符合条件或错过了前期肝移植的机会。
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引用次数: 0
Development and Validation of Palmitoylation-Related Genes in the Prognostic and Immunologic Characterization of Lung Adenocarcinoma. 棕榈酰化相关基因在肺腺癌预后和免疫学特性中的发展和验证。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 DOI: 10.1097/COC.0000000000001273
Pingjing Li, Yun Xiong

Objectives: Lung adenocarcinoma (LUAD), which is the most frequently diagnosed form of lung cancer, constitutes a major global health challenge due to its significant mortality rate. Palmitoylation, as a key post-translational modification of proteins, plays an important role in tumor progression. However, its influence on sculpting the tumor immune microenvironment (TME) and its subsequent impact on patient prognosis remains incompletely understood.

Methods: This study was based on the TCGA-LUAD and GSE72094 cohort data sets to explore the potential role of palmitoylation-related genes (PRGs) in LUAD. Through the integration of differential analysis, weighted gene coexpression network analysis (WGCNA), univariate Cox analysis and least absolute shrinkage and selection operator (LASSO) regression analysis, prognostic genes for LUAD were screened. Furthermore, the infiltration patterns of immune cells across different groups were assessed by applying the ssGSEA and CIBERSORT algorithms. To elucidate the potential biological processes mediated by PRGs in LUAD pathogenesis, GSEA, GO and KEGG enrichment analyses, were used. In addition, the consensus clustering method was utilized for identify molecular subtypes of LUAD.

Results: This study identified 5 PRGs as prognostic genes for LUAD and constructed a robust prognostic model. Immune infiltration analysis indicated that the level of immune cell infiltration in patients of the high-risk group was significantly lower. Further enrichment analysis showed that the upregulated differentially expressed genes (DEGs) in the high and low risk groups were related to the cytoskeleton, while the downregulated DEGs were related to lipid metabolism. In addition, this study successfully classified LUAD into 2 molecular subtypes with significant differences.

Conclusions: Our research delves into the intricate TME and molecular mechanisms of LUAD, providing new insights into the pathologic mechanism and treatment strategies of LUAD.

肺腺癌(LUAD)是最常诊断的肺癌形式,由于其高死亡率,构成了一项重大的全球健康挑战。棕榈酰化作为一种关键的蛋白翻译后修饰,在肿瘤进展中起着重要作用。然而,其对肿瘤免疫微环境(TME)的影响及其对患者预后的影响尚不完全清楚。方法:本研究基于TCGA-LUAD和GSE72094队列数据集,探讨棕榈酰化相关基因(PRGs)在LUAD中的潜在作用。通过整合差异分析、加权基因共表达网络分析(WGCNA)、单变量Cox分析和最小绝对收缩和选择算子(LASSO)回归分析,筛选LUAD预后基因。此外,应用ssGSEA和CIBERSORT算法评估不同组间免疫细胞的浸润模式。为了阐明PRGs在LUAD发病机制中介导的潜在生物学过程,我们使用了GSEA、GO和KEGG富集分析。此外,采用一致聚类方法鉴定LUAD的分子亚型。结果:本研究确定了5个PRGs作为LUAD的预后基因,并构建了稳健的预后模型。免疫浸润分析提示高危组患者免疫细胞浸润水平明显降低。进一步富集分析表明,高危组和低危组差异表达基因(DEGs)上调与细胞骨架相关,而下调的DEGs与脂质代谢相关。此外,本研究成功地将LUAD分为2个分子亚型,且差异显著。结论:我们的研究深入探讨了LUAD复杂的TME和分子机制,为LUAD的病理机制和治疗策略提供了新的见解。
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引用次数: 0
Incidence and Risk of Second Primary Malignancies After Treatment for Papillary Thyroid Cancer: A Single Institution Study. 甲状腺乳头状癌治疗后第二原发恶性肿瘤的发病率和风险:一项单机构研究。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 Epub Date: 2025-07-01 DOI: 10.1097/COC.0000000000001228
Katelyn R Ward, Heba Elassar, Jacquelyn Pastewski, Morta Lapkus, Diane Studzinski, Fionna Sun, Jordan Reilly, Peter Czako, Sapna Nagar

Objectives: Papillary thyroid cancer (PTC) patients develop nonthyroid second primary malignancy (SPM) at a rate higher than the general population. We aimed to investigate the incidence of SPM, demographic risk factors, and relationship with RAIT among PTC patients.

Methods: A retrospective review was performed of PTC patients who underwent thyroid surgery at a single institution from 1/2007 to 1/2011.

Results: Of 528 patients, 40 (7.6%) were diagnosed with SPM (SPM+) over a median follow-up of 9.3 years. The standardized incidence ratio was 1.3 using demographic-adjusted SEER data. Median time to SPM diagnosis was 4.0 years (IQR 2.0, 6.7). Breast cancer was the most common SPM, occurring in 12 patients (30%). RAIT use and RAIT dose were not associated with SPM. There was no significant association between SPM and mortality (6.3% SPM+ vs. 3.1% SPM-, P =0.300). Older age (median 56.5 vs. 49.0 y, P =0.004), prior personal history of cancer (22.5% vs. 11.3%, P =0.036), and family history of cancer (70.0% vs. 42.8%, P <0.001) were associated with SPM+, but none were identified as independent risk factors.

Conclusions: This study did not find any association between SPM and RAIT in PTC patients. Factors other than RAIT, such as age and personal or family history of cancer were associated with SPM risk in PTC patients.

目的:甲状腺乳头状癌(PTC)患者发生非甲状腺第二原发性恶性肿瘤(SPM)的比率高于一般人群。我们的目的是调查PTC患者中SPM的发生率、人口统计学危险因素以及与RAIT的关系。方法:回顾性分析2007年1月至2011年1月在同一医院接受甲状腺手术的PTC患者。结果:在528例患者中,40例(7.6%)被诊断为SPM (SPM+),中位随访时间为9.3年。采用人口统计学校正的SEER数据,标准化发病率为1.3。到SPM诊断的中位时间为4.0年(IQR 2.0, 6.7)。乳腺癌是最常见的SPM,发生在12例患者中(30%)。RAIT的使用和剂量与SPM无关。SPM与死亡率之间无显著相关性(6.3% SPM+ vs 3.1% SPM-, P=0.300)。年龄(中位数56.5比49.0岁,P=0.004)、既往个人癌症史(22.5%比11.3%,P=0.036)和癌症家族史(70.0%比42.8%)。结论:本研究未发现PTC患者SPM和RAIT之间存在任何关联。除RAIT外的其他因素,如年龄、个人或家族癌症史与PTC患者的SPM风险相关。
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引用次数: 0
Targeting Tumor-Induced Immune Disorder: A New Frontier in Cancer Immunotherapy. 靶向肿瘤诱导的免疫紊乱:肿瘤免疫治疗的新前沿。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 DOI: 10.1097/COC.0000000000001270
Lingbing Zhang, Xun Zhu
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引用次数: 0
Quantification of Postdiagnosis Cancer Patient Navigation. 癌症患者诊断后导航的量化。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 Epub Date: 2025-06-17 DOI: 10.1097/COC.0000000000001225
Sarojini Posani, Ursula J Burnette, Shearwood McClelland

Objectives: Patient navigation is a key component in achieving optimal cancer care outcomes. While a vast amount of literature suggests its clear benefits in cancer care, limited objective data exists regarding navigation metrics, specifically the number of navigator-patient contacts and time spent with patients. This study attempts to attain findings from the published literature to better understand navigation metrics to achieve optimal cancer care outcomes.

Methods: A systematic PubMed search was performed in April 2025 focusing on cancer patient navigation, with the term "patient navigation or navigator in postdiagnosis cancer care-contact metrics." Important metrics analysed were the median number of navigator-patient contacts, the median time spent per patient, the most common barriers addressed, and their respective improved outcomes. These metrics were then compared with results from the ongoing Phase I Navigator-Assisted Hypofractionation (NAVAH) trial (clinicaltrials.gov, NCT05978232).

Results: A total of 7 peer-reviewed studies met the inclusion criteria. The number of patient-navigator contacts widely ranged from 1 to 119; the average being 13.4 (∼0.3 times/mo, compared with 2 times/mo in NAVAH). The median time spent per patient varied from 40 minutes to over 10 hours (compared with 20 mins/encounter in NAVAH). The most commonly discussed topic was financial assistance, which is consistent with NAVAH findings. Improved outcomes were significantly reduced treatment interruption days and securing early specialist appointments.

Conclusions: As previously published data depicted wide variability, it highlights the need for standardized data collection and reporting practices, as such quantitative data can facilitate the evolution of patient navigation in achieving improved cancer care outcomes.

目的:患者导航是实现最佳癌症治疗结果的关键组成部分。虽然大量的文献表明它在癌症治疗中有明显的好处,但关于导航指标的客观数据有限,特别是导航员与患者接触的数量和与患者相处的时间。本研究试图从已发表的文献中获得研究结果,以更好地理解导航指标,以实现最佳的癌症治疗结果。方法:在2025年4月进行了一次系统的PubMed检索,重点是癌症患者导航,术语为“诊断后癌症护理接触指标中的患者导航或导航”。分析的重要指标包括导航员与患者接触的中位数、每位患者花费的中位数时间、解决的最常见障碍以及各自改善的结果。然后将这些指标与正在进行的I期导航辅助分割(NAVAH)试验的结果进行比较(clinicaltrials.gov, NCT05978232)。结果:共有7项同行评议研究符合纳入标准。患者导航员接触人数从1到119人不等;平均为13.4次(~ 0.3次/月,而NAVAH为2次/月)。每位患者的中位时间从40分钟到10小时以上不等(相比之下,NAVAH患者为20分钟/次)。最常讨论的话题是经济援助,这与NAVAH的调查结果一致。改善的结果显著减少了治疗中断天数,并确保了早期的专家预约。结论:由于先前发表的数据描述了广泛的可变性,它强调了标准化数据收集和报告实践的必要性,因为这种定量数据可以促进患者导航的演变,以实现改善的癌症治疗结果。
{"title":"Quantification of Postdiagnosis Cancer Patient Navigation.","authors":"Sarojini Posani, Ursula J Burnette, Shearwood McClelland","doi":"10.1097/COC.0000000000001225","DOIUrl":"10.1097/COC.0000000000001225","url":null,"abstract":"<p><strong>Objectives: </strong>Patient navigation is a key component in achieving optimal cancer care outcomes. While a vast amount of literature suggests its clear benefits in cancer care, limited objective data exists regarding navigation metrics, specifically the number of navigator-patient contacts and time spent with patients. This study attempts to attain findings from the published literature to better understand navigation metrics to achieve optimal cancer care outcomes.</p><p><strong>Methods: </strong>A systematic PubMed search was performed in April 2025 focusing on cancer patient navigation, with the term \"patient navigation or navigator in postdiagnosis cancer care-contact metrics.\" Important metrics analysed were the median number of navigator-patient contacts, the median time spent per patient, the most common barriers addressed, and their respective improved outcomes. These metrics were then compared with results from the ongoing Phase I Navigator-Assisted Hypofractionation (NAVAH) trial (clinicaltrials.gov, NCT05978232).</p><p><strong>Results: </strong>A total of 7 peer-reviewed studies met the inclusion criteria. The number of patient-navigator contacts widely ranged from 1 to 119; the average being 13.4 (∼0.3 times/mo, compared with 2 times/mo in NAVAH). The median time spent per patient varied from 40 minutes to over 10 hours (compared with 20 mins/encounter in NAVAH). The most commonly discussed topic was financial assistance, which is consistent with NAVAH findings. Improved outcomes were significantly reduced treatment interruption days and securing early specialist appointments.</p><p><strong>Conclusions: </strong>As previously published data depicted wide variability, it highlights the need for standardized data collection and reporting practices, as such quantitative data can facilitate the evolution of patient navigation in achieving improved cancer care outcomes.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"610-613"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancements in Cutaneous T-Cell Lymphoma Treatment: Unveiling Novel Therapeutic Avenues and Clinical Implications. 皮肤t细胞淋巴瘤的治疗进展:揭示新的治疗途径和临床意义。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-12-01 Epub Date: 2025-07-10 DOI: 10.1097/COC.0000000000001230
Zaheer Qureshi, Abdur Jamil, Fatima Hameed, Navkirat Kahlon

Objectives: The non-Hodgkin lymphoma class known as cutaneous T-cell lymphomas (CTCLs) is uncommon and diverse, mainly affecting the skin. The prognosis is dismal, and despite recent breakthroughs, few treatment options are available for advanced-stage disease. This narrative review outlines the current state of care for CTCLs, emphasizing innovative immunotherapies, targeted medicines, combination approaches, and epigenetic modifiers.

Methods: This paper was conducted to summarize the newer approaches to treating CTCL, with a literature search spanning PubMed, Science Direct, and Cochrane databases that identified articles reporting emerging treatments. Selected articles were categorized into sections to summarize pertinent results in a narrative report.

Results: Extracorporeal photopheresis with mogamulizumab, a monoclonal antibody targeting CCR4, has shown promise in treating skin and blood involvement while maintaining a good safety record. Additional treatments that have been highlighted include the antibody-drug combination brentuximab vedotin, which targets CD30; checkpoint inhibitors like pembrolizumab and durvalumab; and new medicines, including CD47 inhibitor TTI-621, IL-2/IL-9/IL-15 signaling inhibitor BNZ-1, pegylated interferon alpha-2a, and anti-KIR3DL2 antibody IPH4102. Even though the early clinical trial results for these novel treatments have been positive, more extensive research is required to determine the safety and efficacy of the treatments.

Conclusions: This review emphasizes the necessity for ongoing research and individualized treatment plans while highlighting the promise of these cutting-edge techniques to enhance outcomes for patients with advanced CTCL.

目的:被称为皮肤t细胞淋巴瘤(CTCLs)的非霍奇金淋巴瘤类型罕见且多样,主要影响皮肤。预后是令人沮丧的,尽管最近取得了突破,但很少有治疗方案可用于晚期疾病。这篇叙述性综述概述了ctcl的护理现状,强调创新的免疫疗法,靶向药物,联合方法和表观遗传修饰剂。方法:本文通过PubMed、Science Direct和Cochrane数据库的文献检索,总结了治疗CTCL的新方法。选定的文章被分成几节,以在叙述报告中总结相关的结果。结果:mogamulizumab是一种靶向CCR4的单克隆抗体,在治疗皮肤和血液受损伤方面显示出良好的前景,同时保持良好的安全性记录。其他被强调的治疗方法包括靶向CD30的抗体-药物联合brentuximab vedotin;检查点抑制剂如pembrolizumab和durvalumab;新药物,包括CD47抑制剂TTI-621、IL-2/IL-9/IL-15信号抑制剂BNZ-1、聚乙二醇化干扰素α -2a、抗kir3dl2抗体IPH4102。尽管这些新疗法的早期临床试验结果是积极的,但还需要更广泛的研究来确定这些疗法的安全性和有效性。结论:本综述强调了持续研究和个性化治疗计划的必要性,同时强调了这些尖端技术对提高晚期CTCL患者预后的承诺。
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引用次数: 0
Risk Model Based On Neutrophil-Related Genes Constructs to Assess Prognosis and Immune Landscape in Diffuse Large B-Cell Lymphoma. 基于中性粒细胞相关基因构建的风险模型评估弥漫性大b细胞淋巴瘤的预后和免疫景观。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-11-28 DOI: 10.1097/COC.0000000000001272
Xinfang Gao, Xinguo Luo, Hongwei Ye, Shanshan Hu, Fangquan Yu, Panpan Xu, Fangjing Shi, Li Huang

Objectives: Diffuse large B-cell lymphoma (DLBCL), the most common type of non-Hodgkin lymphoma, represents a highly heterogeneous cancer. Neutrophils, as the core effector cells of intrinsic immunity, play an important role in regulating the tumor microenvironment (TME) due to their functional complexity. This study aimed to assess the prognostic significance of neutrophil-related genes (NRGs) in DLBCL and their association with the TME.

Methods: Transcriptomic data and clinical information of DLBCL patients were retrieved from TCGA and GEO databases. Characterized genes were screened by LASSO, random forest, and XGBoost algorithm. A prognostic model was constructed by multivariate Cox regression analysis, and the predictive efficacy of the accuracy of the model was assessed through receiver operating characteristic (ROC) curves and Kaplan-Meier (K-M) survival analysis. Subsequently, immune cell infiltration, gene enrichment, tumor mutation burden (TMB), and drug sensitivity were analyzed across different risk groups. Finally, consensus clustering was used to identify molecular subtypes of DLBCL, and immune cell activity and immune function differences among these subtypes were compared through immune infiltration analysis.

Results: A risk stratification model established based on NRGs (TGFB2, LAMA4, GGH, F5, CD163, RasGRP4, ANXA2, S100A4, and PTEN) significantly differentiated the survival prognosis of patients in the high and low-risk groups. The low-risk group was found to have elevated immunoreactivity and a higher ESTIMATE composite score, according to immune infiltration analysis. Enrichment analysis revealed that the high risk exhibited upregulation of cell cycle regulation, DNA repair and chromosome dynamics pathways, while the low risk group exhibited extracellular matrix remodeling and activation of cytokine signaling pathways.

Conclusions: The NRG-based risk model can effectively predict the survival outcomes and immune profiles of DLBCL patients, offering a novel perspective on the link between NRGs and DLBCL.

目的:弥漫性大b细胞淋巴瘤(DLBCL)是最常见的非霍奇金淋巴瘤,是一种高度异质性的肿瘤。中性粒细胞作为内在免疫的核心效应细胞,由于其功能的复杂性,在调节肿瘤微环境(tumor microenvironment, TME)中发挥着重要作用。本研究旨在评估中性粒细胞相关基因(NRGs)在DLBCL中的预后意义及其与TME的相关性。方法:从TCGA和GEO数据库中检索DLBCL患者的转录组学数据和临床信息。采用LASSO、随机森林和XGBoost算法筛选特征基因。采用多变量Cox回归分析构建预后模型,并通过受试者工作特征(ROC)曲线和Kaplan-Meier (K-M)生存分析评估模型准确性的预测效果。随后,对不同风险组的免疫细胞浸润、基因富集、肿瘤突变负荷(tumor mutation burden, TMB)和药物敏感性进行分析。最后,采用共识聚类法鉴定DLBCL分子亚型,并通过免疫浸润分析比较各亚型间免疫细胞活性和免疫功能的差异。结果:基于NRGs (TGFB2、LAMA4、GGH、F5、CD163、RasGRP4、ANXA2、S100A4、PTEN)建立的风险分层模型对高危组和低危组患者的生存预后有明显的区分。根据免疫浸润分析,发现低风险组具有较高的免疫反应性和较高的ESTIMATE综合评分。富集分析显示,高风险组细胞周期调控、DNA修复和染色体动力学通路上调,而低风险组细胞外基质重塑和细胞因子信号通路激活。结论:基于nrg的风险模型可以有效预测DLBCL患者的生存结局和免疫特征,为nrg与DLBCL之间的联系提供了新的视角。
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引用次数: 0
The Role of Lactate Metabolism in Tumors: From Metabolic Byproduct to Signaling Molecule. 乳酸代谢在肿瘤中的作用:从代谢副产物到信号分子。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-11-26 DOI: 10.1097/COC.0000000000001276
Zhenghui Tian, Kexin Zhang, Sufang Sheng, Chengxia Kan, Fang Han, Xiaodong Sun

Lactate, once viewed as a metabolic by-product of glycolysis, is now recognized as a central regulator in cancer biology. Accumulating evidence reveals that lactate actively participates in tumor progression by functioning as a metabolic fuel, signaling mediator, epigenetic modifier, and immune modulator. Tumor cells exhibit elevated glycolytic flux through the Warburg effect, producing large quantities of lactate through LDHA and exporting it through MCTs, which acidifies the tumor microenvironment and drives metabolic symbiosis, angiogenesis, and immune evasion. Lactate also stabilizes HIF-1α and activates the receptor GPR81, triggering signaling pathways that promote proliferation, invasion, and immune checkpoint expression. Epigenetically, lactate regulates histone acetylation and lactylation, modulating gene expression and supporting adaptive transcriptional programs. Immune suppression is reinforced through direct inhibition of effector T and NK cells and expansion of Tregs and MDSCs. Given its multifaceted role, lactate metabolism has emerged as a promising therapeutic target. Inhibitors of LDHA, MCT1/4, and GPR81 are under active development and show synergistic potential with immunotherapy and chemoradiotherapy. This review summarizes current advances in lactate biology and therapeutic strategies, highlighting the need for personalized approaches that consider tumor-specific lactate dependencies and signaling contexts.

乳酸,曾经被认为是糖酵解的代谢副产物,现在被认为是癌症生物学的中心调节因子。越来越多的证据表明,乳酸盐作为代谢燃料、信号介质、表观遗传调节剂和免疫调节剂积极参与肿瘤的进展。肿瘤细胞通过Warburg效应表现出糖酵解通量升高,通过LDHA产生大量乳酸并通过mct输出,从而使肿瘤微环境酸化,促进代谢共生、血管生成和免疫逃逸。乳酸还能稳定HIF-1α并激活受体GPR81,触发促进增殖、侵袭和免疫检查点表达的信号通路。表观遗传学上,乳酸调节组蛋白乙酰化和乳酸化,调节基因表达和支持适应性转录程序。免疫抑制通过直接抑制效应T和NK细胞以及扩增treg和MDSCs而加强。鉴于其多方面的作用,乳酸代谢已成为一个有希望的治疗靶点。LDHA、MCT1/4和GPR81抑制剂正在积极开发中,并显示出与免疫治疗和放化疗的协同潜力。这篇综述总结了乳酸生物学和治疗策略的最新进展,强调了考虑肿瘤特异性乳酸依赖性和信号环境的个性化方法的必要性。
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引用次数: 0
Contributing Factors to Delay of Adjuvant Postsurgical Radiation for Malignant Brain Tumors: A Single Institution Experience in a Rural State. 影响恶性脑肿瘤术后辅助放疗延迟的因素:一个农村州的单一机构经验。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-11-20 DOI: 10.1097/COC.0000000000001266
Grace Guzman, Ghassan Makhoul, Sahana Bettadapura, William J Shelton, Sean G Young, Pearman D Parker, Sanjay Maraboyina, Jing Jin, Ruofei Du, Analiz Rodriguez

Objectives: Malignant tumors of the central nervous system (CNS) are associated with high morbidity and mortality, requiring prompt and coordinated multidisciplinary care. Although adjuvant radiotherapy (RT) is a standard component of treatment that improves survival, delays in initiating RT remain common and may negatively impact patient outcomes. This study investigates patient-related factors contributing to delayed adjuvant RT in individuals with high-grade gliomas (HGGs) and brain metastases (BMs) treated at a tertiary care center in Arkansas.

Methods: Electronic medical records (EMR) were retrospectively reviewed for patients diagnosed with HGGs and BMs who sought medical treatment at the University of Arkansas for Medical Sciences (UAMS) from 2019 to 2022. Statistical analysis included evaluation of the association of sociodemographic and clinical variables with radiotherapy status, using multivariable logistic regression and survival analysis.

Results: Our sample included 219 patients diagnosed with HGGs or BMs who were treated at UAMS. Out of the 219 patients, 72.1% (n=158) patients received adjuvant RT treatment. In this group, 102 patients underwent timely RT treatment while 53 received delayed treatment. The timing of radiation was not available for 3 patients. Our analysis revealed an association between the Charlson Comorbidities Index (CCI) and RT timing status, suggesting a higher probability of receiving late RT with a higher CCI score (P=0.048). In addition, patients who received delayed RT also had a significantly longer interval between surgery and RT treatment compared with patients with timed adjuvant RT (P<0.0001 for both).

Conclusions: We found that patients with a higher CCI score suggested an increased probability of experiencing delayed RT.

目的:中枢神经系统(CNS)恶性肿瘤具有高发病率和死亡率,需要及时和协调的多学科治疗。虽然辅助放疗(RT)是提高生存率的标准治疗组成部分,但延迟开始RT仍然很常见,并可能对患者的预后产生负面影响。本研究调查了在阿肯色州三级保健中心接受治疗的高级别胶质瘤(HGGs)和脑转移瘤(BMs)患者延迟辅助RT治疗的患者相关因素。方法:回顾性分析2019年至2022年在阿肯色大学医学科学学院(UAMS)就诊的hgg和脑转移患者的电子病历(EMR)。统计分析包括评估社会人口学和临床变量与放疗状态的关系,采用多变量logistic回归和生存分析。结果:我们的样本包括219名在UAMS治疗的诊断为hgg或脑转移的患者。在219例患者中,72.1% (n=158)患者接受了辅助RT治疗。本组102例患者及时接受RT治疗,53例患者延迟接受RT治疗。3例患者放疗时间不详。我们的分析揭示了Charlson合并症指数(CCI)与RT时间状态之间的关联,表明CCI评分越高,接受晚期RT的可能性越大(P=0.048)。此外,与接受定时辅助RT的患者相比,接受延迟RT的患者手术和RT治疗之间的间隔时间也明显更长(结论:我们发现CCI评分较高的患者经历延迟RT的可能性增加。
{"title":"Contributing Factors to Delay of Adjuvant Postsurgical Radiation for Malignant Brain Tumors: A Single Institution Experience in a Rural State.","authors":"Grace Guzman, Ghassan Makhoul, Sahana Bettadapura, William J Shelton, Sean G Young, Pearman D Parker, Sanjay Maraboyina, Jing Jin, Ruofei Du, Analiz Rodriguez","doi":"10.1097/COC.0000000000001266","DOIUrl":"https://doi.org/10.1097/COC.0000000000001266","url":null,"abstract":"<p><strong>Objectives: </strong>Malignant tumors of the central nervous system (CNS) are associated with high morbidity and mortality, requiring prompt and coordinated multidisciplinary care. Although adjuvant radiotherapy (RT) is a standard component of treatment that improves survival, delays in initiating RT remain common and may negatively impact patient outcomes. This study investigates patient-related factors contributing to delayed adjuvant RT in individuals with high-grade gliomas (HGGs) and brain metastases (BMs) treated at a tertiary care center in Arkansas.</p><p><strong>Methods: </strong>Electronic medical records (EMR) were retrospectively reviewed for patients diagnosed with HGGs and BMs who sought medical treatment at the University of Arkansas for Medical Sciences (UAMS) from 2019 to 2022. Statistical analysis included evaluation of the association of sociodemographic and clinical variables with radiotherapy status, using multivariable logistic regression and survival analysis.</p><p><strong>Results: </strong>Our sample included 219 patients diagnosed with HGGs or BMs who were treated at UAMS. Out of the 219 patients, 72.1% (n=158) patients received adjuvant RT treatment. In this group, 102 patients underwent timely RT treatment while 53 received delayed treatment. The timing of radiation was not available for 3 patients. Our analysis revealed an association between the Charlson Comorbidities Index (CCI) and RT timing status, suggesting a higher probability of receiving late RT with a higher CCI score (P=0.048). In addition, patients who received delayed RT also had a significantly longer interval between surgery and RT treatment compared with patients with timed adjuvant RT (P<0.0001 for both).</p><p><strong>Conclusions: </strong>We found that patients with a higher CCI score suggested an increased probability of experiencing delayed RT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic Value of Multiparameter Biomarkers in Pleural Effusion of Patients With Non-small Cell Lung Cancer for Predicting Survival Outcomes: A Prospective Cohort Study. 非小细胞肺癌患者胸腔积液中多参数生物标志物预测生存结局的预后价值:一项前瞻性队列研究。
IF 1.8 4区 医学 Q4 ONCOLOGY Pub Date : 2025-11-19 DOI: 10.1097/COC.0000000000001269
Dan Yang, Bao-Hong Cui, Hui-Yan Wang, Zhi-Ran Zhang, Ming-Yan Zhang

Objective: Pleural effusion is a frequent and clinically significant complication in patients with non-small cell lung cancer (NSCLC), frequently causing debilitating respiratory symptoms, most notably dyspnea. The development of MPE is strongly correlated with unfavorable prognosis in NSCLC patients. This study aims to evaluate the prognostic value of multiparameter biomarkers (including CA125, CEA, CYFRA21-1, NSE, and LDH) in patients with NSCLC complicated by pleural effusion.

Methods: In this prospective cohort study, we included 119 patients diagnosed with NSCLC and pleural effusion. We systematically assessed the levels of these biomarkers in pleural effusion and their relationship with overall survival. Univariate and multivariate Cox regression analyses were used to explore the association between these biomarkers and patient prognosis.

Results: The study found that levels of CA125, CYFRA21-1, and LDH in pleural effusion were significantly correlated with overall survival, with higher levels associated with shorter survival times. In addition, as the volume of pleural effusion increased, the levels of these biomarkers also significantly rose. Multivariate Cox regression analysis indicated that age, larger pleural effusion volume, and elevated levels of CA125, CYFRA21-1, and LDH were independent risk factors for overall survival.

Conclusion: The findings of this study suggest that CA125, CYFRA21-1, and LDH in pleural effusion may be potential biomarkers for assessing prognosis in patients with NSCLC and pleural effusion. While these results offer valuable insights into their potential role in clinical practice, further validation through larger, multicenter studies is needed to confirm their prognostic significance.

目的:胸腔积液是非小细胞肺癌(NSCLC)患者常见且具有临床意义的并发症,常引起衰弱的呼吸系统症状,最显著的是呼吸困难。在非小细胞肺癌患者中,MPE的发生与不良预后密切相关。本研究旨在评估多参数生物标志物(包括CA125、CEA、CYFRA21-1、NSE和LDH)在NSCLC合并胸腔积液患者中的预后价值。方法:在这项前瞻性队列研究中,我们纳入了119例诊断为非小细胞肺癌和胸腔积液的患者。我们系统地评估了这些生物标志物在胸腔积液中的水平及其与总生存率的关系。采用单因素和多因素Cox回归分析探讨这些生物标志物与患者预后之间的关系。结果:研究发现胸腔积液中CA125、CYFRA21-1、LDH水平与总生存期显著相关,水平越高,生存期越短。此外,随着胸腔积液量的增加,这些生物标志物的水平也显著升高。多因素Cox回归分析显示,年龄、胸腔积液较大、CA125、CYFRA21-1、LDH水平升高是影响总生存率的独立危险因素。结论:本研究结果提示胸腔积液CA125、CYFRA21-1和LDH可能是评估非小细胞肺癌合并胸腔积液患者预后的潜在生物标志物。虽然这些结果为其在临床实践中的潜在作用提供了有价值的见解,但需要通过更大规模的多中心研究进一步验证以确认其预后意义。
{"title":"Prognostic Value of Multiparameter Biomarkers in Pleural Effusion of Patients With Non-small Cell Lung Cancer for Predicting Survival Outcomes: A Prospective Cohort Study.","authors":"Dan Yang, Bao-Hong Cui, Hui-Yan Wang, Zhi-Ran Zhang, Ming-Yan Zhang","doi":"10.1097/COC.0000000000001269","DOIUrl":"10.1097/COC.0000000000001269","url":null,"abstract":"<p><strong>Objective: </strong>Pleural effusion is a frequent and clinically significant complication in patients with non-small cell lung cancer (NSCLC), frequently causing debilitating respiratory symptoms, most notably dyspnea. The development of MPE is strongly correlated with unfavorable prognosis in NSCLC patients. This study aims to evaluate the prognostic value of multiparameter biomarkers (including CA125, CEA, CYFRA21-1, NSE, and LDH) in patients with NSCLC complicated by pleural effusion.</p><p><strong>Methods: </strong>In this prospective cohort study, we included 119 patients diagnosed with NSCLC and pleural effusion. We systematically assessed the levels of these biomarkers in pleural effusion and their relationship with overall survival. Univariate and multivariate Cox regression analyses were used to explore the association between these biomarkers and patient prognosis.</p><p><strong>Results: </strong>The study found that levels of CA125, CYFRA21-1, and LDH in pleural effusion were significantly correlated with overall survival, with higher levels associated with shorter survival times. In addition, as the volume of pleural effusion increased, the levels of these biomarkers also significantly rose. Multivariate Cox regression analysis indicated that age, larger pleural effusion volume, and elevated levels of CA125, CYFRA21-1, and LDH were independent risk factors for overall survival.</p><p><strong>Conclusion: </strong>The findings of this study suggest that CA125, CYFRA21-1, and LDH in pleural effusion may be potential biomarkers for assessing prognosis in patients with NSCLC and pleural effusion. While these results offer valuable insights into their potential role in clinical practice, further validation through larger, multicenter studies is needed to confirm their prognostic significance.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Clinical Oncology-Cancer Clinical Trials
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