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Breast cancer neoadjuvant therapy outcome prediction based on clinical patient and tumor features: A cross-sectional study 基于临床患者和肿瘤特征的乳腺癌新辅助治疗结果预测：一项横断面研究
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-05-12 DOI: 10.1016/j.currproblcancer.2025.101220
Eva Brenner , Luka Bulić , Marija Milković-Periša

Introduction

Breast cancer is the most common malignant disease in the female population and one of the most common diseases in developed countries. Many factors which may impact the development and outcome of this complex disease have been investigated. The aim of this study was to analyze factors that affect neoadjuvant therapy outcomes and create an outcome prediction model based on these factors.

Materials and methods

Patient data was collected from all patients who underwent breast cancer neoadjuvant therapy at our clinical center from 2018 to 2022. Statistical analysis entailed the identification of patient and tumor features that are significantly associated with RCB index values, using Spearman’s correlation coefficient, the Mann-Whitney U-test, and the one-way ANOVA and Kruskal-Wallis test. Significant features were selected and used for the training of a machine-learning model based on the random forest algorithm.

Results

Regarding patient features, age, BMI, and previous history of malignant disease were found significantly associated with the RCB index. Significant tumor features included focality, nuclear grade, immunophenotype, positivity for estrogen receptors, progesterone receptors and HER-2, Ki-67 value, and presence of lymphovascular invasion. Based on these features, a predictive model was created with an accuracy of 80 % and ROC-AUC value of 0.83.

Conclusion

The discovered significant features are mostly in line with the published literature. While our predictive model yielded promising results, its training was limited by the number of patients and availability of data. Further research and the creation of more accurate predictive models might facilitate further personalization and improvement of breast cancer neoadjuvant treatment.
乳腺癌是女性人口中最常见的恶性疾病，也是发达国家最常见的疾病之一。许多可能影响这种复杂疾病的发展和结果的因素已经被研究。本研究的目的是分析影响新辅助治疗结果的因素，并基于这些因素建立结果预测模型。材料与方法收集2018 - 2022年在本临床中心接受乳腺癌新辅助治疗的所有患者的数据。统计分析包括识别与RCB指数值显著相关的患者和肿瘤特征，使用Spearman相关系数、Mann-Whitney u检验、单向方差分析和Kruskal-Wallis检验。选择有意义的特征并用于基于随机森林算法的机器学习模型的训练。结果患者的特征、年龄、BMI和既往恶性疾病史与RCB指数有显著相关性。肿瘤的显著特征包括病灶、核分级、免疫表型、雌激素受体、孕激素受体和HER-2阳性、Ki-67值以及有无淋巴血管浸润。基于这些特征，建立了预测模型，预测精度为80%，ROC-AUC值为0.83。结论发现的显著特征与已发表的文献基本一致。虽然我们的预测模型产生了有希望的结果，但其训练受到患者数量和数据可用性的限制。进一步的研究和建立更准确的预测模型可能有助于进一步个性化和改进乳腺癌新辅助治疗。
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引用次数: 0
Information for Readers 读者资讯
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-05-09 DOI: 10.1016/S0147-0272(25)00039-X
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引用次数: 0
Title Page 标题页
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-05-09 DOI: 10.1016/S0147-0272(25)00038-8
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引用次数: 0
Dosing immune-checkpoint inhibitors: Opportunities for the future 给药免疫检查点抑制剂：未来的机遇
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-05-07 DOI: 10.1016/j.currproblcancer.2025.101204
Won Jin Jeon , So Young Son , Faith Abodunrin , Anisha Khanna , Jyoti D Patel , Rajat Thawani
With recent breakthroughs in immunotherapy, particularly with the approval of immune checkpoint inhibitors for various cancer indications, patients now have a wider array of treatment options, even for those with metastatic disease. Still, the survival benefit of immune-checkpoint inhibitors is modest, and there is concern about drug toxicity. In addition, there is ongoing exploration into combination therapy involving immune-checkpoint inhibitors, which come at the risk of increased toxicity. Unfortunately, due to the cost of the currently approved doses and dosing intervals, many patients in the community in the United States and low- and middle-income countries lack access to these transformative therapies. Further, the observation of resistance to immune-checkpoint inhibitors and limitations of currently approved doses and dosing intervals warrants changes in current practice. This review paper discusses both model-based and clinical studies in the current literature. Strategies for improving access to immune-checkpoint inhibitors and expanding their utilization, including weight-based dosing instead of fixed dosing, dose and dose interval adjustments, development of biomarkers and scoring systems for personalization of immune-checkpoint inhibitors, and alternative trial design, are discussed.
随着最近免疫疗法的突破，特别是免疫检查点抑制剂被批准用于各种癌症适应症，患者现在有更广泛的治疗选择，即使是那些转移性疾病。尽管如此，免疫检查点抑制剂的生存益处是适度的，并且存在对药物毒性的担忧。此外，目前正在探索涉及免疫检查点抑制剂的联合治疗，这有增加毒性的风险。不幸的是，由于目前批准的剂量和给药间隔的成本，美国和中低收入国家社区的许多患者无法获得这些变革性疗法。此外，观察到免疫检查点抑制剂的耐药性以及目前批准的剂量和给药间隔的局限性，需要改变当前的做法。本文综述了目前文献中基于模型和临床的研究。本文讨论了改善免疫检查点抑制剂获取途径和扩大其使用的策略，包括以体重为基础给药而不是固定给药、剂量和剂量间隔调整、开发生物标志物和免疫检查点抑制剂个性化评分系统以及替代试验设计。
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引用次数: 0
Diagnostic accuracy of intraoperative frozen section in endometrial cancer: Correlation with final histopathology 术中冷冻切片诊断子宫内膜癌的准确性：与最终组织病理学的相关性
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-05-01 DOI: 10.1016/j.currproblcancer.2025.101207
Dipak Limbachiya, Ayush Heda, Mahan Gowda

Purpose

Accurate intraoperative assessment of tumor characteristics for endometrial cancer, including histological type, grade, and depth of myometrial invasion (MI), is essential for determining the extent of surgery, particularly lymphadenectomy. This study aims to evaluate the concordance between intra-operative frozen section analysis (IFS) and final histopathology (FH) in endometrial cancer cases.

Methods

This retrospective analysis included 100 patients who underwent laparoscopic staging surgery for endometrial carcinoma between March 2018 and September 2024. Data on histological type, tumor grade, MI, lymph node involvement, and cervical/adnexal metastases were extracted from medical records. The diagnostic accuracy of IFS was assessed by comparing findings with FH. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa (κ) statistics were used to determine agreement levels.

Results

IFS demonstrated high concordance with FH for malignancy detection (97%, κ = 0.56). Sensitivity, specificity, PPV, and NPV were 96.9%, 100%, 100%, and 40%, respectively. Tumor grading agreement was 78.2% (κ = 0.67), with the highest accuracy in Grade 3 tumors (sensitivity 85.0%, specificity 98.3%). MI assessment showed strong agreement (κ = 0.851) with 93.7% overall accuracy. Lymph node evaluation by IFS exhibited excellent agreement (κ = 0.942), with 98.3% accuracy.

Conclusion

IFS is a reliable tool for intraoperative decision-making in endometrial cancer, particularly for malignancy detection, MI assessment, and lymph node evaluation. However, moderate concordance in tumor grading suggests caution in surgical decision-making based solely on IFS results. Future research should focus on optimizing frozen section protocols to improve diagnostic accuracy and streamline intraoperative management.
目的术中准确评估子宫内膜癌的肿瘤特征，包括组织学类型、分级和子宫肌层浸润（MI）的深度，对于确定手术的范围，特别是淋巴结切除术的范围至关重要。本研究旨在评估子宫内膜癌患者术中冷冻切片分析（IFS）与最终组织病理学（FH）的一致性。方法回顾性分析2018年3月至2024年9月期间接受腹腔镜子宫内膜癌分期手术的100例患者。从医疗记录中提取组织学类型、肿瘤分级、心肌梗死、淋巴结受累和宫颈/附件转移的数据。通过比较IFS与FH的诊断结果来评估IFS的诊断准确性。采用敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和Cohen’s kappa （κ）统计来确定一致性水平。结果fs与FH在恶性肿瘤检测中的一致性较高（97%,κ = 0.56）。敏感性、特异性、PPV和NPV分别为96.9%、100%、100%和40%。肿瘤分级一致性为78.2% (κ = 0.67)，其中3级肿瘤准确率最高（敏感性85.0%，特异性98.3%）。MI评估显示高度一致（κ = 0.851），总准确率为93.7%。IFS对淋巴结的评价具有良好的一致性（κ = 0.942），准确率为98.3%。结论ifs是子宫内膜癌术中决策的可靠工具，尤其适用于恶性肿瘤检测、心肌梗死评估和淋巴结评估。然而，肿瘤分级的中度一致性表明，仅根据IFS结果进行手术决策时要谨慎。未来的研究应侧重于优化冷冻切片方案，以提高诊断准确性和简化术中管理。
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引用次数: 0
hsa_circ_0008285: Circular RNA with potential as a biomarker in ovarian cancer hsa_circ_0008285：环状RNA可能作为卵巢癌的生物标志物
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-04-26 DOI: 10.1016/j.currproblcancer.2025.101208
Khadijeh Elmizadeh , Ensiyeh Bahadoran , Zahra Mortezaei , Sahar Moghbelinejad
Liquid biopsy has emerged as a non-invasive cancer diagnosis and prognosis tool. Circular RNAs (circRNAs) have become promising biomarkers due to their stability and regulatory roles in cancer biology. This study aimed to evaluate the potential of hsa_circ_0008285 as a diagnostic biomarker for ovarian cancer (OC). 102 paired cancer and adjacent normal tissue samples, along with plasma from 98 OC patients, 42 polycystic ovary syndrome (PCO) patients, 35 endometriosis patients, and 93 healthy donors, were analyzed. Differentially expressed circRNAs were identified using Illumina HiSeq 2000 high-throughput sequencing in OC tissue samples (n = 4). Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to validate the expression of hsa_circ_0008285. Diagnostic efficacy and sensitivity were assessed using receiver operating characteristic (ROC) analysis. High-throughput sequencing identified hsa_circ_0008285 as the most significantly upregulated circRNA (P = 0.000012). qRT-PCR results confirmed increased expression of hsa_circ_0008285 in OC tissues and plasma compared to healthy controls (P < 0.0001). ROC analysis demonstrated an area under the curve (AUC) of 0.74 (95 % CI: 0.6567–0.8306, P < 0.0001), indicating moderate diagnostic potential. Notably, the combined detection of hsa_circ_0008285 and CA_125 improved diagnostic specificity and sensitivity. Correlation analysis revealed that hsa_circ_0008285 upregulation was associated with tumor size, differentiation, and T stage. These findings suggest that hsa_circ_0008285 holds promise as a non-invasive biomarker for the diagnosis of OC, with potential applications in clinical practice.
液体活检已成为一种非侵入性的癌症诊断和预后工具。环状rna （circRNAs）由于其稳定性和在癌症生物学中的调节作用而成为有前途的生物标志物。本研究旨在评估hsa_circ_0008285作为卵巢癌（OC）诊断生物标志物的潜力。本研究分析了98例卵巢癌患者、42例多囊卵巢综合征（PCO）患者、35例子宫内膜异位症患者和93例健康供体的102例配对肿瘤和邻近正常组织样本，以及血浆。采用Illumina HiSeq 2000高通量测序技术在OC组织样本中鉴定差异表达的circRNAs （n = 4）。采用定量实时聚合酶链反应（qRT-PCR）验证hsa_circ_0008285的表达。采用受试者工作特征（ROC）分析评估诊断效果和敏感性。高通量测序发现hsa_circ_0008285是表达上调最显著的circRNA （P = 0.000012）。qRT-PCR结果证实，与健康对照组相比，hsa_circ_0008285在OC组织和血浆中的表达增加(P <；0.0001)。ROC分析显示曲线下面积为0.74 (95% CI: 0.6567-0.8306, P <；0.0001)，表明诊断潜力中等。值得注意的是，hsa_circ_0008285和CA_125联合检测提高了诊断的特异性和敏感性。相关分析显示，hsa_circ_0008285表达上调与肿瘤大小、分化和T分期相关。这些发现表明，hsa_circ_0008285有望作为一种非侵入性的OC诊断生物标志物，在临床实践中具有潜在的应用前景。
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引用次数: 0
Replication stress response and radioresistance in lung cancer: Mechanistic insights and advanced therapeutic approaches 肺癌的复制应激反应和放射耐药：机制见解和先进的治疗方法
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-04-22 DOI: 10.1016/j.currproblcancer.2025.101206
Moumita Kundu , Ankita Dey , Sanjukta Dasgupta
Lung cancer, the leading cause of cancer mortality globally, comprises mainly non-small cell lung cancer and small cell lung cancer. Its pathogenesis involves genetic mutations, environmental exposures, chronic inflammation, and tumor microenvironment interactions. Critical genes like TP53, RB1, KRAS, and EGFR often mutate, driving uncontrolled cell growth. Radiation therapy, a primary treatment, faces challenges with radioresistance due to DNA repair mechanisms and replication stress responses. Emerging therapeutic strategies target DNA repair pathways, cell cycle checkpoints, and immune responses to enhance radiosensitivity and counteract resistance. Promising approaches include PARP inhibitors, CDK inhibitors, EGFR blockers, and immunotherapies combined with radiation. Advances in understanding these mechanisms are crucial for developing targeted therapies to improve lung cancer patient outcomes. The present review focuses on elucidating the intricate mechanisms of lung cancer pathogenesis and radioresistance, while highlighting novel therapeutic strategies designed to overcome these challenges and improve treatment efficacy.
肺癌是全球癌症死亡的主要原因，主要包括非小细胞肺癌和小细胞肺癌。其发病机制涉及基因突变、环境暴露、慢性炎症和肿瘤微环境相互作用。关键基因如TP53、RB1、KRAS和EGFR经常发生突变，导致不受控制的细胞生长。放射治疗作为一种主要的治疗方法，由于DNA修复机制和复制应激反应，面临着放射耐药的挑战。新兴的治疗策略以DNA修复途径、细胞周期检查点和免疫反应为目标，以增强放射敏感性和抵抗耐药性。有希望的方法包括PARP抑制剂、CDK抑制剂、EGFR阻滞剂和放射联合免疫疗法。了解这些机制的进展对于开发靶向治疗以改善肺癌患者的预后至关重要。本文的重点是阐明肺癌的发病机制和放射耐药的复杂机制，同时强调新的治疗策略，旨在克服这些挑战，提高治疗效果。
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引用次数: 0
Updated perspectives on visceral pleural invasion in non-small cell lung cancer: A propensity score-matched analysis of the SEER database 非小细胞肺癌内脏胸膜浸润的最新观点：SEER数据库的倾向评分匹配分析
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-04-18 DOI: 10.1016/j.currproblcancer.2025.101205
Jingxin Liu , Yibing Wang , Xianwei Zhou , Meijin Reng , Ziyue Xiang , Ruimin Chang , Wen Hao , Xitai Sun , Yang Yang

Background

Visceral pleural invasion (VPI), including PL1 (the tumor invades beyond the elastic layer) and PL2 (the tumor extends to the surface of the visceral pleura), plays a crucial role in staging Non-Small Cell Lung Cancer (NSCLC). However, there is a growing debate concerning the prognostic significance of PL1 and PL2. This study, therefore, conducted the analysis of the prognostic differences between PL1 and PL2 to inform more precise staging and treatment strategies.

Methods

Altogether, 12,223 resected T1-3N0M0 NSCLC patients from 2010 to 2015 were enrolled. Utilizing propensity score matching (PSM) and Kaplan-Meier survival analysis, this study explored the prognosis of patients under different settings of VPI and the impact of various treatments. Finally, a machine learning model was constructed to accurately predict the 5-year survival probability.

Results

For tumors ≤ 50 mm, PL1 did not confer a survival disadvantage compared to PL0 (the tumor within the elastic layer of the visceral pleura), whereas PL2 did. Notably, patients with tumor sizes 31–50 mm and PL2 have a similar poor prognosis to patients with tumor sizes of 51–70 mm and PL0. Further survival analysis showed that lobectomy offered better outcomes than sublobectomy. Moreover, patients in this study did not benefit from postoperative radiotherapy or chemotherapy. A model with high efficacy in predicting the 5-year survival probability was developed eventually.

Conclusion

These data support the viewpoint that staging patients with tumor ≤ 30 mm and PL1 as T1. Those with 31–50 mm tumors and PL2, exhibiting a similar poor prognosis to patients with T3 and PL0, warrant a T3 classification. Apart from optimizing the TNM staging system, machine learning could also play a significant role in prognostic prediction.
内脏胸膜浸润（VPI），包括PL1（肿瘤侵入弹性层外）和PL2（肿瘤延伸到内脏胸膜表面），在非小细胞肺癌（NSCLC）的分期中起着至关重要的作用。然而，关于PL1和PL2的预后意义的争论越来越多。因此，本研究对PL1和PL2的预后差异进行了分析，以提供更精确的分期和治疗策略。方法共纳入2010 - 2015年12223例T1-3N0M0 NSCLC患者。本研究利用倾向评分匹配（PSM）和Kaplan-Meier生存分析，探讨不同VPI设置下患者的预后以及不同治疗方法的影响。最后，构建机器学习模型，准确预测5年生存率。结果对于≤50 mm的肿瘤，与PL0（内脏胸膜弹性层内的肿瘤）相比，PL1不会导致生存劣势，而PL2则会。值得注意的是，肿瘤大小为31-50 mm和PL2的患者与肿瘤大小为51-70 mm和PL0的患者预后相似。进一步的生存分析表明，肺叶切除术比肺叶亚切除术的预后更好。此外，本研究中的患者没有从术后放疗或化疗中获益。最终建立了一个预测5年生存率的高效模型。结论支持肿瘤≤30mm、PL1分期为T1的观点。那些31-50 mm肿瘤和PL2，表现出与T3和PL0患者相似的不良预后，需要T3分类。除了优化TNM分期系统外，机器学习还可以在预后预测中发挥重要作用。
{"title":"Updated perspectives on visceral pleural invasion in non-small cell lung cancer: A propensity score-matched analysis of the SEER database","authors":"Jingxin Liu ,&nbsp;Yibing Wang ,&nbsp;Xianwei Zhou ,&nbsp;Meijin Reng ,&nbsp;Ziyue Xiang ,&nbsp;Ruimin Chang ,&nbsp;Wen Hao ,&nbsp;Xitai Sun ,&nbsp;Yang Yang","doi":"10.1016/j.currproblcancer.2025.101205","DOIUrl":"10.1016/j.currproblcancer.2025.101205","url":null,"abstract":"<div><h3>Background</h3><div>Visceral pleural invasion (VPI), including PL1 (the tumor invades beyond the elastic layer) and PL2 (the tumor extends to the surface of the visceral pleura), plays a crucial role in staging Non-Small Cell Lung Cancer (NSCLC). However, there is a growing debate concerning the prognostic significance of PL1 and PL2. This study, therefore, conducted the analysis of the prognostic differences between PL1 and PL2 to inform more precise staging and treatment strategies.</div></div><div><h3>Methods</h3><div>Altogether, 12,223 resected T1-3N0M0 NSCLC patients from 2010 to 2015 were enrolled. Utilizing propensity score matching (PSM) and Kaplan-Meier survival analysis, this study explored the prognosis of patients under different settings of VPI and the impact of various treatments. Finally, a machine learning model was constructed to accurately predict the 5-year survival probability.</div></div><div><h3>Results</h3><div>For tumors ≤ 50 mm, PL1 did not confer a survival disadvantage compared to PL0 (the tumor within the elastic layer of the visceral pleura), whereas PL2 did. Notably, patients with tumor sizes 31–50 mm and PL2 have a similar poor prognosis to patients with tumor sizes of 51–70 mm and PL0. Further survival analysis showed that lobectomy offered better outcomes than sublobectomy. Moreover, patients in this study did not benefit from postoperative radiotherapy or chemotherapy. A model with high efficacy in predicting the 5-year survival probability was developed eventually.</div></div><div><h3>Conclusion</h3><div>These data support the viewpoint that staging patients with tumor ≤ 30 mm and PL1 as T1. Those with 31–50 mm tumors and PL2, exhibiting a similar poor prognosis to patients with T3 and PL0, warrant a T3 classification. Apart from optimizing the TNM staging system, machine learning could also play a significant role in prognostic prediction.</div></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"56 ","pages":"Article 101205"},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843685","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
Efficacy of atezolizumab, bevacizumab, carboplatin, and paclitaxel for epidermal growth factor receptor mutation-positive advanced non-small cell lung cancer after tyrosine kinase inhibitor failure 阿特唑单抗、贝伐单抗、卡铂和紫杉醇治疗酪氨酸激酶抑制剂失效后表皮生长因子受体突变阳性的晚期非小细胞肺癌的疗效
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-04-04 DOI: 10.1016/j.currproblcancer.2025.101200
Yoh Yamaguchi , Yuki Shinno , Ken Masuda , Ryo Ariyasu , Kaname Nosaki , Taiki Hakozaki , Takaaki Tokito , Shogo Nomura , Makoto Nishio , Koichi Goto , Yukio Hosomi , Koichi Azuma , Yuichiro Ohe

Background

Non-small cell lung cancer (NSCLC) with driver mutations, notably epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase, shows reduced sensitivity to immune checkpoint inhibitors. A subgroup analysis of the IMpower150 data on patients resistant to EGFR tyrosine kinase inhibitors (EGFR-TKI) before enrollment demonstrated prolonged progression-free survival (PFS) with atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) over bevacizumab, carboplatin, and paclitaxel. However, due to the exploratory nature and small sample size, the efficacy of ABCP post-EGFR-TKI failure is still debated. We evaluated ABCP therapy against other platinum-based regimens without immune checkpoint inhibitors in terms of effectiveness and toxicity.

Methods

Data from patients with advanced or recurrent NSCLC harboring EGFR-sensitizing mutations treated with platinum-based chemotherapy or ABCP at five Japanese hospitals were retrospectively analyzed. Propensity score matching compared efficacy outcomes, including overall response rate (ORR), PFS, and OS.

Results

Of 183 EGFR mutation carriers, 33 underwent ABCP therapy, while 150 received platinum-based chemotherapy. Following propensity score matching, 32 and 74 patients were analyzed. In the ABCP group, median PFS and OS were 6.8 and 16.7 months compared to 5.8 and 25.7 months with platinum-based chemotherapy, showing no significant differences in PFS (p = 0.46) and OS (p = 0.85). In liver metastases, ABCP yielded a median PFS of 9.9 versus 6.1 months and an ORR of 62.5 % versus 35.7 % relative to platinum-based chemotherapy, without statistical significance (PFS p = 0.16; ORR p = 0.70).

Conclusion

Compared with platinum-based chemotherapy, ABCP did not improve effectiveness in patients with EGFR-mutated NSCLC after EGFR-TKI failure.
具有驱动突变的非小细胞肺癌（NSCLC），特别是表皮生长因子受体（EGFR）或间变性淋巴瘤激酶，对免疫检查点抑制剂的敏感性降低。IMpower150在入组前对EGFR酪氨酸激酶抑制剂（EGFR- tki）耐药患者的亚组分析显示，阿特唑单抗、贝伐单抗、卡铂和紫杉醇（ABCP）治疗比贝伐单抗、卡铂和紫杉醇治疗的无进展生存期（PFS）更长。然而，由于探索性和小样本量，egfr - tki失败后ABCP的疗效仍存在争议。我们在有效性和毒性方面评估了ABCP治疗与其他无免疫检查点抑制剂的基于铂的方案的疗效。方法回顾性分析日本5家医院接受含铂化疗或ABCP治疗的egfr致敏突变晚期或复发性NSCLC患者的数据。倾向评分匹配比较了疗效结果，包括总有效率（ORR）、PFS和OS。结果183例EGFR突变携带者中，33例接受ABCP治疗，150例接受铂类化疗。根据倾向评分匹配，对32例和74例患者进行分析。在ABCP组中，中位PFS和OS分别为6.8和16.7个月，而铂基化疗组的中位PFS和OS分别为5.8和25.7个月，PFS （p = 0.46）和OS （p = 0.85）无显著差异。在肝转移中，相对于铂基化疗，ABCP的中位PFS为9.9个月vs 6.1个月，ORR为62.5% vs 35.7%，无统计学意义(PFS p = 0.16；ORR p = 0.70)。结论与铂基化疗相比，ABCP对EGFR-TKI失败后egfr -突变的NSCLC患者的疗效没有提高。
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引用次数: 0
Efficacy and Safety of triplet versus doublet regimens in patients with multiple myeloma: A systematic review and meta-analysis 多发性骨髓瘤患者三联与双联治疗方案的疗效和安全性：一项系统回顾和荟萃分析
IF 2.5 4区 医学 Q3 ONCOLOGY
Current Problems in Cancer
Pub Date : 2025-04-03 DOI: 10.1016/j.currproblcancer.2025.101202
Zilu Meng , Hanxue Zheng , Yanhong Li , Jun Bai , Liansheng Zhang , Lijuan Li

Background

The efficacy and safety of various therapies for multiple myeloma (MM) remain a subject of ongoing debate, with inconsistent findings. This meta-analysis aimed to compare the efficacy and safety of triplet versus doublet regimens in the management of MM. This study followed the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 statement, with our protocol duly registered in PROSPERO (CRD42024527903).

Methods

An exhaustive literature search was performed across four databases, PubMed, EMBASE, Web of Science, and Cochrane Library, from their commencement to March 5, 2024. Data on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and grade ≥ 3 AEs were synthesized using either random-effects or fixed-effects models.

Results

This analysis considered 29 studies, which cover approximately 11,230 MM patients in total. Triplet regimens were found to yield better PFS and OS for MM patients as compared to the doublet regimens. Although the incidence of serious AEs was higher under the triplet regimens, with pooled RRs of grade ≥ 3 AEs reaching 1.13. Besides, subgroup analysis demonstrated that patients with relapsed/refractory multiple myeloma (RRMM) tended to have better PFS and OS under triple therapy, in contrast to newly diagnosed multiple myeloma (NDMM) and older adults, who experienced little to no significant impact.

Conclusions

Triplet regimens demonstrate superior PFS and OS compared to doublet regimens in MM patients, but also have a higher likelihood of causing AEs of grade 3 or 4.
各种治疗多发性骨髓瘤（MM）的疗效和安全性仍然是一个持续争论的主题，研究结果不一致。本荟萃分析旨在比较三联和双联治疗方案在MM治疗中的疗效和安全性。本研究遵循系统评价和荟萃分析首选报告项目（PRISMA） 2020声明中所描述的指南，我们的方案已在PROSPERO （CRD42024527903）正式注册。方法对PubMed、EMBASE、Web of Science、Cochrane Library 4个数据库进行全面的文献检索，检索时间从数据库启动到2024年3月5日。总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）、不良事件（ae）和≥3级ae的数据采用随机效应或固定效应模型合成。本分析纳入了29项研究，共涉及约11,230例MM患者。与双重方案相比，三重方案对MM患者产生更好的PFS和OS。虽然在三组方案下严重ae的发生率更高，≥3级ae的合并rr达到1.13。此外，亚组分析显示，与新诊断的多发性骨髓瘤（NDMM）和老年人相比，复发/难治性多发性骨髓瘤（RRMM）患者在三联治疗下往往有更好的PFS和OS，而新诊断的多发性骨髓瘤（NDMM）患者几乎没有显著影响。结论在MM患者中，三联体方案的PFS和OS优于双联体方案，但也有更高的可能性导致3级或4级ae。
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引用次数: 0
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