Nutrition and Cancer-An International Journal最新文献

Background: Chemotherapy-induced anorexia and cachexia are significant challenges for patients with biliary tract cancer (BTC) and pancreatic ductal adenocarcinoma (PDAC). Megestrol acetate (MA), used to manage anorexia, has side effects and may trigger prescription cascades in cancer treatment. This study analyzed MA prescription trends and associated effects in BTC or PDAC patients.

Methods: MA prescription rates among BTC or PDAC patients were examined using data from the Health Insurance and Review Assessment Service database in Korea. We investigated thrombosis and anti-coagulant prescription rates during the same period.

Results: Analysis of 31,114 patients diagnosed with BTC or PDAC between 2009 and 2016 revealed significant increases in MA prescriptions: from 4.42% to 44.62% in BTC patients and from 7.56% to 63.15% in PDAC patients (p < 0.0001). In 2009, thrombosis was diagnosed in 5.58% of BTC patients and 6.83% of PDAC patients, rising to 7.62% and 12.47% by 2016. Anticoagulant prescriptions also increased, from 0.84% to 16.97% for BTC patients and from 2.37% to 15.96% for PDAC patients.

Conclusion: MA prescriptions for BTC or PDAC patients increased significantly over 8 years. Patients on long-term MA had higher anticoagulant prescription rates compared to those not on long-term MA.

Background: The global burden of digestive system tumors (e.g., hepatocellular carcinoma, gastric cancer, colorectal cancer) continues to rise, with low survival rates in advanced stages, necessitating etiology-based intervention strategies. Nutritional metabolic disorders are closely linked to tumor progression, but existing studies predominantly focus on correlational analyses, leaving causal relationships and molecular mechanisms poorly understood.

Objective: Integrating Mendelian randomization (MR), National Health and Nutrition Examination Survey (NHANES) epidemiological data, and transcriptomic data analysis, this study aims to elucidate the impact of nutritional status on digestive system tumors, identify key genes, develop prognostic models for precise nutritional interventions, and propose potential therapeutic directions.

Methods: Causal Inference: MR analysis using OpenGWAS data to assess causal associations between nutritional symptoms and digestive system tumor. Epidemiological Validation: Restricted cubic spline models analyzed nonlinear associations between nutritional status (Geriatric Nutritional Risk Index [GNRI]) and telomere length (DNAmTL) in NHANES 1999-2002 data (n = 2,532). Gender stratification and mediation effects tested nutritional pathways. Molecular Mechanism: Transcriptomic data from TCGA (CHOL, LIHC, COAD, etc.) identified malnutrition-related genes. Survival analysis, immune subtype classification (C1-C6), and tumor microenvironment scoring (ESTIMATE/RNAss) were integrated to build a Cox prognostic model. Machine learning (ML; Random Forest/Support Vector Machine) screened key genes. CellMiner database linked gene expression to drug sensitivity.

Results: Causal Association: MR confirmed significant causal effects of nutrition on digestive system tumor risk (P_IVW < 0.05). Gender Heterogeneity: Males exhibited accelerated telomere shortening at GNRI > 115 (β = -0.0123/unit, P = 0.035), while females showed no significant association. Dietary quality (Healthy Eating Index) directly protected telomeres (β = 0.069, P = 0.003), linked to seafood/plant protein (β = 0.066) and whole fruit intake (β = 0.067). Key Genes: ML identified ACTG2, MSX1, and COL7A1 as core drivers. Prognostic Model: A risk score model (ATP6V0A1*0.70 + TP63*0.37 + SLC7A7*0.49 + ARHGAP29*0.33 + CDH1*(-0.50)) distinguished high/low-risk groups (AUC = 0.977). Potentially Available Drugs: Zoledronate, LY-294002, and Everolimus may be potential choices for malnutrition digestive tract tumors.

Conclusion: This study systematically reveals multidimensional mechanisms linking malnutrition to digestive system tumor progression via genetic, molecular, and immune pathways. Key genes (ACTG2, MSX1, COL7A1) and gender-specific interventions offer novel strategies for precision on

Background: Children with acute lymphoblastic leukemia (ALL) have a higher risk of height deficit and obesity. Data on Chinese pediatric ALL patients treated on chemotherapy only are limited.

Methods: Changes in z scores for height and body mass index (BMI) from the diagnosis to 2 years after the initial of treatment were analyzed in 805 ALL patients diagnosed at Children's Hospital of Zhejiang University School of Medicine.

Results: A significant reduction in height z-scores and increase in BMI z-scores were documented during treatment (p < 0.001), the most pronounced changes observed in the first three months. Catch-up growth was noted after nine months. Children in middle-high-aged group showed the most significant decline in height z-scores after 24 months (p < 0.05). High-risk patients exhibited lower height z-scores at 9 and 12 months (p < 0.01). Children under 9 years or in non-high-risk group showed greater BMI z-scores increase during treatment (p < 0.05). There were no significant differences by gender.

Conclusion: Chemotherapy leads to height deficit and BMI increase in pediatric ALL patients. Height deficit is more pronounced in children aged 8-13 years, BMI increases are more significant in younger children. High-risk patients are more prone to lower height and smaller BMI increases.

The association between nutritional status and the risk of radiation pneumonitis (RP) in patients with thoracic cancer undergoing radiotherapy remains unclear and warrants further investigation. General clinical data between January 2021 and June 2024 were retrospectively analyzed. RP was diagnosed and graded according to the Common Terminology Criteria for Adverse Events (version 5), with symptomatic RP defined as grade ≥2. Predictive factors for RP were identified using least absolute shrinkage and selection operator and multivariate logistic regression analyses, followed by the development of a nomogram. The predictive performance of the nomogram was evaluated using the area under the curve (AUC) of receiver operating characteristic, calibration curve, and decision curve analysis. Controlling Nutritional Status (CONUT) scores and V₅ were identified as independent predictors of symptomatic RP and incorporated into the predictive model. The nomogram demonstrated excellent predictive capability (AUC: 0.851; 95% confidence interval: 0.801-0.902), with good accuracy and clinical application utility. Nutritional status is associated with the development of symptomatic RP. The pre-radiotherapy CONUT score can serve as a predictor of symptomatic RP, and its incorporation into the CONUT-V₅ model achieves better discriminative capacity. Improving nutritional status may be a simple way to prevent the development of symptomatic RP.

The purpose of the study is to determine if artificial intelligence (AI) models could provide dietary recommendations to manage chemotherapy-induced nutritional symptoms in breast cancer (BC) patients that are on comparable levels with the American Cancer Society, National Cancer Institute and World Cancer Research Fund guidelines which were used as evidence-based recommendation. The AI models-ChatGPT, ChatGPT 4.0, Gemini, Gemini Advanced, Copilot, and Copilot Pro-were evaluated based on their adherence to the guidelines. Specific queries were posed to each model, and the generated responses were rated by two experienced dietitians using a 5-point likert scale. Gemini provided the most adherent recommendations for metallic taste in mouth, while Gemini Advanced excelled in managing dehydration. ChatGPT and Gemini Advanced were the most effective in addressing heartburn, and Copilot Pro consistently showed the lowest performance across most symptoms. Overall, ChatGPT 4.0 attained the highest total score, followed by Copilot and Gemini, indicating a general trend where certain models were better suited for specific symptoms. Various AI models (e.g. ChatGPT 4.0) show potential in addressing certain chemotherapy-induced symptoms, but they do not consistently align with evidence-based recommendations. Improvement of AI models is necessary for their adherence to evidence-based recommendations.

Folate, a water-soluble B vitamin crucial for DNA synthesis and repair, is internalized by cells through specific folate receptors (FRs), which are frequently overexpressed in various types of cancers. In this comprehensive study, we conducted a review of the literature from Google Scholar, PubMed, and Science Direct, focusing on research published between 1980 and 2024 to evaluate folate-targeted therapeutic strategies in oncology. Our study design involved a rigorous review of both preclinical and clinical research, emphasizing strategies such as folate-drug conjugates, antibody-drug conjugates, and folate-targeted nanoparticles. Key findings indicate that targeting FRs in cancers such as ovarian, breast, cervical, renal, and colorectal enhances drug delivery specificity to tumors, increases therapeutic efficacy, and decreases systemic toxicity compared to traditional chemotherapy. Several clinical trials reported improved progression-free survival and overall response rates among patients receiving folate-targeted therapies. In conclusion, our review highlights the significant potential of folate-targeted strategies in advancing precision oncology while these approaches provide substantial benefits in terms of efficacy and safety, further research is essential to refine drug design and expand clinical applications. Such initiatives will facilitate the development of more personalized cancer treatment protocols that maximize therapeutic outcomes while minimizing adverse effects.

This study examines the effects of a dietary and physical activity intervention on body composition and metabolic parameters in Moroccan women with breast cancer. Conducted as a pilot cohort study, 37 women with breast cancer were recruited between 2017 and 2019 at the Hassan II Regional Hospital Center and the Agadir Regional Oncology Center. Participants completed a 12-month nutrition and physical activity intervention. The mean age was 47.92 ± 8.56 years. At the end of the intervention, participants experienced a mean weight loss of 11%, resulting in a significant reduction in normal weight and obesity rates from 35.14% and 32.43% to 57% and 5%, respectively (p < 0.05). Waist and hip circumferences were reduced by 10%, and there were significant reductions in body fat and visceral fat. Improvements were also seen in metabolic markers, with significant reductions in total cholesterol, LDL-C, blood glucose and HbA1c levels (p < 0.05). Lean mass was preserved and HDL-C showed a significant increase (p < 0.001).

This study aimed to evaluate the relationship between the consumption of different dietary fatty acids and the risk of bladder cancer. A quantitative analysis was conducted using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included 101,731 participants. The Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for bladder cancer risk in relation to dietary fatty acid intake. During a median follow-up of 11.3 years, 861 bladder cancer cases were identified. After fully adjusting for potential confounders in a multivariate Cox regression model, no significant association was found between dietary fatty acid consumption and bladder cancer risk. Subgroup analysis revealed significant interactions with gender (p < 0.001) and smoking status (p < 0.001). Gender-specific analysis showed that a higher intake of monounsaturated fatty acids (MUFAs) was linked to a reduced risk of bladder cancer in females (HR: 0.62; 95% CI: 0.39-0.99, P-trend = 0.028). However, restricted cubic spline analysis revealed no linear relationship between MUFA intake and bladder cancer risk in the overall group or gender-specific subgroups. The association between dietary fatty acids and bladder cancer risk is influenced by factors like gender and smoking status. In females, moderate MUFA intake may reduce bladder cancer risk, but higher intake does not provide additional benefits.

Background: Ovarian cancer is a lethal female cancer with a rising incidence that is often diagnosed late due to a lack of symptoms, affecting survival and quality of life. Studies suggest that dietary factors, especially the levels of branched-chain amino acids such as valine, may influence its development. While valine is essential for metabolism, its specific role in ovarian cancer remains unclear, necessitating further research.

Methods: This study aimed to elucidate the causal relationship between valine and OC through a bidirectional Mendelian randomization (MR) approach. Data were sourced from the IEU OpenGWAS project, encompassing genome-wide association statistics for valine (N = 115,048) and OC (Ncase = 1,218, Ncontrol = 198,523) among European participants. Independent genetic variants associated with each phenotype at genome-wide significance were employed as instrumental variables (IVs). The primary analysis utilized the inverse variance weighted (IVW) method for two-sample MR analysis. MR‒Egger regression was applied to adjust for potential pleiotropy, whereas the weighted median method provided robust causal estimates under the assumption of valid IVs. Sensitivity analyses, including leave-one-out (LOO) analysis, heterogeneity tests, and horizontal pleiotropy assessments, were conducted to ensure the robustness of the findings.

Results: The results revealed a significant causal relationship between valine and OC, identifying valine as a risk factor for OC (p = 0.043, 95% CI = 1.00008-1.00491, OR = 1.00249) in the forward MR analysis. Sensitivity analyses confirmed the absence of heterogeneity (Q_p value >0.05) and horizontal pleiotropy (p > 0.05), and LOO analysis validated the stability of the results. Conversely, reverse MR analysis revealed no causal effect of OC on valine levels (p = 0.875, 95% CI = 0.34125-2.51495, OR = 1.08528).

Conclusions: These findings reveal a causal link between high valine levels and an increased OC risk. This research highlights the monitoring of valine levels as a preventive strategy and the significance of valine metabolism in OC. Future studies are needed to investigate the mechanisms and interventions for reducing risk, offering insights for clinical practice and public health initiatives in OC prevention.