Background: One in five people will eventually develop cancer, and one in eleven women will lose their lives to the disease. The main aim of this study is to determinants of survival time of women with breast cancer using appropriate Frailty models.
Methods: A study involving 632 Ethiopian women with breast cancer was conducted between 2018 and 2020, utilizing medical records from Felege-Hiwot Referral Hospital, the University of Gondar, and Dessie Referral Hospital. To compare survival, the Kaplan-Meier plot (s) and Log rank test were employed; to assess mean survival, one-way analysis of variance and the t test were utilized. The factors influencing women's survival times from breast cancer were identified using the parametric shared frailty model and the accelerated failure time model.
Results: The median time to die for breast cancer patients treated at FHRH, UoGCSH, and DRH was 14.91 months, 11.14 months, and 12.32 months, respectively. The parametric model of shared frailty fit those who were statistically significant in univariate analysis. The results showed that survival of women with breast cancer was significantly influenced by age, tumor size, comorbidity, nodal status, stage, histologic grade, and type of primary treatment initiated. When comparing mean survival times between hospitals, the results showed a significant difference; patients who were treated in FHRH live significantly longer than patients treated in UoGCSH and DRH, whereas patients treated in UoGCSH have comparatively lower survival. Women with stage IV and comorbidities have 22.4% and 27.1% shorter expected survival, respectively.
Conclusion: This finding suggests that improving the availability and accessibility of radiation therapy and surgery, eliminating disparities between hospitals, raising awareness of early signs and symptoms of breast cancer and encouraging women to seek clinical help, and highlighting women with comorbidities at diagnosis are important ways to increase survival time.
背景:每五个人中就有一人最终会罹患癌症,每十一名妇女中就有一人会因癌症而丧生。本研究的主要目的是利用适当的虚弱模型确定乳腺癌女性患者的生存时间:2018年至2020年期间,利用Felege-Hiwot转诊医院、贡德尔大学和Dessie转诊医院的医疗记录,开展了一项涉及632名埃塞俄比亚女性乳腺癌患者的研究。为比较存活率,采用了卡普兰-梅耶图(s)和对数秩检验;为评估平均存活率,采用了单因素方差分析和 t 检验。使用参数共享虚弱模型和加速失败时间模型确定了影响妇女乳腺癌生存时间的因素:结果:在FHRH、UoGCSH和DRH接受治疗的乳腺癌患者的中位死亡时间分别为14.91个月、11.14个月和12.32个月。共同虚弱参数模型符合单变量分析中具有统计学意义的患者。结果表明,年龄、肿瘤大小、合并症、结节状态、分期、组织学分级和初治类型对乳腺癌妇女的生存期有显著影响。在比较不同医院的平均生存时间时,结果显示出明显的差异;在弗吉尼亚赫尔辛基医院接受治疗的患者的生存时间明显长于在格拉斯哥大学附属加利福尼亚医院和格拉斯哥大学医学院附属加利福尼亚医院接受治疗的患者,而在格拉斯哥大学附属加利福尼亚医院接受治疗的患者的生存时间则相对较短。IV期和合并症妇女的预期生存期分别缩短了22.4%和27.1%:这一结果表明,改善放射治疗和手术的可用性和可及性、消除医院之间的差异、提高对乳腺癌早期症状和体征的认识并鼓励妇女寻求临床帮助,以及在诊断时重点关注有合并症的妇女,是延长生存时间的重要途径。
{"title":"Comparative Analysis of Women's Breast Cancer Survival Time at Three Selected Government Referral Hospitals in Ethiopia's Amhara Region Using Parametric Shared Frailty Models.","authors":"Seid Fentaw, Anteneh Asmare Godana, Dawit Abathun, Dessie Melese Chekole","doi":"10.2147/BCTT.S447684","DOIUrl":"10.2147/BCTT.S447684","url":null,"abstract":"<p><strong>Background: </strong>One in five people will eventually develop cancer, and one in eleven women will lose their lives to the disease. The main aim of this study is to determinants of survival time of women with breast cancer using appropriate Frailty models.</p><p><strong>Methods: </strong>A study involving 632 Ethiopian women with breast cancer was conducted between 2018 and 2020, utilizing medical records from Felege-Hiwot Referral Hospital, the University of Gondar, and Dessie Referral Hospital. To compare survival, the Kaplan-Meier plot (s) and Log rank test were employed; to assess mean survival, one-way analysis of variance and the <i>t</i> test were utilized. The factors influencing women's survival times from breast cancer were identified using the parametric shared frailty model and the accelerated failure time model.</p><p><strong>Results: </strong>The median time to die for breast cancer patients treated at FHRH, UoGCSH, and DRH was 14.91 months, 11.14 months, and 12.32 months, respectively. The parametric model of shared frailty fit those who were statistically significant in univariate analysis. The results showed that survival of women with breast cancer was significantly influenced by age, tumor size, comorbidity, nodal status, stage, histologic grade, and type of primary treatment initiated. When comparing mean survival times between hospitals, the results showed a significant difference; patients who were treated in FHRH live significantly longer than patients treated in UoGCSH and DRH, whereas patients treated in UoGCSH have comparatively lower survival. Women with stage IV and comorbidities have 22.4% and 27.1% shorter expected survival, respectively.</p><p><strong>Conclusion: </strong>This finding suggests that improving the availability and accessibility of radiation therapy and surgery, eliminating disparities between hospitals, raising awareness of early signs and symptoms of breast cancer and encouraging women to seek clinical help, and highlighting women with comorbidities at diagnosis are important ways to increase survival time.</p>","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Chen, Wen-Xia Li, Jia-Hua Wu, Geng-Hang Chen, Chun-Min Yang, Hai Lu, Xi Wang, Shu-sen Wang, Heng Huang, Li Cai, Li Zhao, Rou-Jun Peng, Ying Lin, Jun Tang, Jian Zeng, Le-hong Zhang, Y. Ke, Xian-Ming Wang, Xin-Mei Liu, An-Qin Zhang, Fei Xu, Xiwen Bi, Jiajia Huang, Ji-Bin Li, D. Pang, Cong Xue, Yan-Xia Shi, Zhenyu He, Huan-xin Lin, Xin An, W. Xia, Ye Cao, Yingwei Guo, R. Hong, Kui-Kui Jiang, Y. Zhong, Ge Zhang, P. Tienchaiananda, Masahiro Oikawa, Zhong-Yu Yuan, Qian-Jun Chen
Purpose Results from studies of extended capecitabine after the standard adjuvant chemotherapy in early stage triple-negative breast cancer (TNBC) were inconsistent, and only low-dose capecitabine from the SYSUCC-001 trial improved disease-free survival (DFS). Adjustment of the conventional adjuvant chemotherapy doses affect the prognosis and may affect the efficacy of subsequent treatments. This study investigated whether the survival benefit of the SYSUCC-001 trial was affected by dose adjustment of the standard adjuvant chemotherapy or not. Patients and Methods We reviewed the adjuvant chemotherapy regimens before the extended capecitabine in the SYSUCC-001 trial. Patients were classified into “consistent” (standard acceptable dose) and “inconsistent” (doses lower than acceptable dose) dose based on the minimum acceptable dose range in the landmark clinical trials. Cox proportional hazards model was used to investigate the impact of dose on the survival outcomes. Results All 434 patients in SYSUCC-001 trial were enrolled in this study. Most of patients administered the anthracycline-taxane regimen accounted for 88.94%. Among patients in the “inconsistent” dose, 60.8% and 47% received lower doses of anthracycline and taxane separately. In the observation group, the “inconsistent” dose of anthracycline and taxane did not affect DFS compared with the “consistent” dose. Moreover, in the capecitabine group, the “inconsistent” anthracycline dose did not affect DFS compared with the “consistent” dose. However, patients with “consistent” taxane doses benefited significantly from extended capecitabine (P=0.014). The sufficient dose of adjuvant taxane had a positive effect of extended capecitabine (hazard ratio [HR] 2.04; 95% confidence interval [CI] 1.02 to 4.06). Conclusion This study found the dose reduction of adjuvant taxane might negatively impact the efficacy of capecitabine. Therefore, the reduction of anthracycline dose over paclitaxel should be given priority during conventional adjuvant chemotherapy, if patients need dose reduction and plan for extended capecitabine.
{"title":"Does the Dose of Standard Adjuvant Chemotherapy Affect the Triple-negative Breast Cancer Benefit from Extended Capecitabine Metronomic Therapy? An Exploratory Analysis of the SYSUCC-001 Trial","authors":"Ying Chen, Wen-Xia Li, Jia-Hua Wu, Geng-Hang Chen, Chun-Min Yang, Hai Lu, Xi Wang, Shu-sen Wang, Heng Huang, Li Cai, Li Zhao, Rou-Jun Peng, Ying Lin, Jun Tang, Jian Zeng, Le-hong Zhang, Y. Ke, Xian-Ming Wang, Xin-Mei Liu, An-Qin Zhang, Fei Xu, Xiwen Bi, Jiajia Huang, Ji-Bin Li, D. Pang, Cong Xue, Yan-Xia Shi, Zhenyu He, Huan-xin Lin, Xin An, W. Xia, Ye Cao, Yingwei Guo, R. Hong, Kui-Kui Jiang, Y. Zhong, Ge Zhang, P. Tienchaiananda, Masahiro Oikawa, Zhong-Yu Yuan, Qian-Jun Chen","doi":"10.2147/BCTT.S447290","DOIUrl":"https://doi.org/10.2147/BCTT.S447290","url":null,"abstract":"Purpose Results from studies of extended capecitabine after the standard adjuvant chemotherapy in early stage triple-negative breast cancer (TNBC) were inconsistent, and only low-dose capecitabine from the SYSUCC-001 trial improved disease-free survival (DFS). Adjustment of the conventional adjuvant chemotherapy doses affect the prognosis and may affect the efficacy of subsequent treatments. This study investigated whether the survival benefit of the SYSUCC-001 trial was affected by dose adjustment of the standard adjuvant chemotherapy or not. Patients and Methods We reviewed the adjuvant chemotherapy regimens before the extended capecitabine in the SYSUCC-001 trial. Patients were classified into “consistent” (standard acceptable dose) and “inconsistent” (doses lower than acceptable dose) dose based on the minimum acceptable dose range in the landmark clinical trials. Cox proportional hazards model was used to investigate the impact of dose on the survival outcomes. Results All 434 patients in SYSUCC-001 trial were enrolled in this study. Most of patients administered the anthracycline-taxane regimen accounted for 88.94%. Among patients in the “inconsistent” dose, 60.8% and 47% received lower doses of anthracycline and taxane separately. In the observation group, the “inconsistent” dose of anthracycline and taxane did not affect DFS compared with the “consistent” dose. Moreover, in the capecitabine group, the “inconsistent” anthracycline dose did not affect DFS compared with the “consistent” dose. However, patients with “consistent” taxane doses benefited significantly from extended capecitabine (P=0.014). The sufficient dose of adjuvant taxane had a positive effect of extended capecitabine (hazard ratio [HR] 2.04; 95% confidence interval [CI] 1.02 to 4.06). Conclusion This study found the dose reduction of adjuvant taxane might negatively impact the efficacy of capecitabine. Therefore, the reduction of anthracycline dose over paclitaxel should be given priority during conventional adjuvant chemotherapy, if patients need dose reduction and plan for extended capecitabine.","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140709135","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}
Shen Ma, Ran Hao, Yi-Wei Lu, Hui-Po Wang, Jie Hu, Yi-Xin Qi
Background Distant metastasis remains the leading cause of death among patients with breast cancer (BRCA). The process of cancer metastasis involves multiple mechanisms, including compromised immune system. However, not all genes involved in immune function have been comprehensively identified. Methods Firstly 1623 BRCA samples, including transcriptome sequencing and clinical information, were acquired from Gene Expression Omnibus (GSE102818, GSE45255, GSE86166) and The Cancer Genome Atlas-BRCA (TCGA-BRCA) dataset. Subsequently, weighted gene co-expression network analysis (WGCNA) was performed using the GSE102818 dataset to identify the most relevant module to the metastasis of BRCA. Besides, ConsensusClusterPlus was applied to divide TCGA-BRCA patients into two subgroups (G1 and G2). In the meantime, the least absolute shrinkage and selection operator (LASSO) regression analysis was used to construct a metastasis-related immune genes (MRIGs)_score to predict the metastasis and progression of cancer. Importantly, the expression of vital genes was validated through reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC). Results The expression pattern of 76 MRIGs screened by WGCNA divided TCGA-BRCA patients into two subgroups (G1 and G2), and the prognosis of G1 group was worse. Also, G1 exhibited a higher mRNA expression level based on stemness index score and Tumor Immune Dysfunction and Exclusion score. In addition, higher MRIGs_score represented the higher probability of progression in BRCA patients. It was worth mentioning that the patients in the G1 group had a high MRIGs_score than those in the G2 group. Importantly, the results of RT-qPCR and IHC demonstrated that fasciculation and elongation protein zeta 1 (FEZ1) and insulin-like growth factor 2 receptor (IGF2R) were risk factors, while interleukin (IL)-1 receptor antagonist (IL1RN) was a protective factor. Conclusion Our study revealed a prognostic model composed of eight immune related genes that could predict the metastasis and progression of BRCA. Higher score represented higher metastasis probability. Besides, the consistency of key genes in BRCA tissue and bioinformatics analysis results from mRNA and protein levels was verified.
{"title":"Identification and Validation of Novel Metastasis-Related Immune Gene Signature in Breast Cancer","authors":"Shen Ma, Ran Hao, Yi-Wei Lu, Hui-Po Wang, Jie Hu, Yi-Xin Qi","doi":"10.2147/BCTT.S448642","DOIUrl":"https://doi.org/10.2147/BCTT.S448642","url":null,"abstract":"Background Distant metastasis remains the leading cause of death among patients with breast cancer (BRCA). The process of cancer metastasis involves multiple mechanisms, including compromised immune system. However, not all genes involved in immune function have been comprehensively identified. Methods Firstly 1623 BRCA samples, including transcriptome sequencing and clinical information, were acquired from Gene Expression Omnibus (GSE102818, GSE45255, GSE86166) and The Cancer Genome Atlas-BRCA (TCGA-BRCA) dataset. Subsequently, weighted gene co-expression network analysis (WGCNA) was performed using the GSE102818 dataset to identify the most relevant module to the metastasis of BRCA. Besides, ConsensusClusterPlus was applied to divide TCGA-BRCA patients into two subgroups (G1 and G2). In the meantime, the least absolute shrinkage and selection operator (LASSO) regression analysis was used to construct a metastasis-related immune genes (MRIGs)_score to predict the metastasis and progression of cancer. Importantly, the expression of vital genes was validated through reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC). Results The expression pattern of 76 MRIGs screened by WGCNA divided TCGA-BRCA patients into two subgroups (G1 and G2), and the prognosis of G1 group was worse. Also, G1 exhibited a higher mRNA expression level based on stemness index score and Tumor Immune Dysfunction and Exclusion score. In addition, higher MRIGs_score represented the higher probability of progression in BRCA patients. It was worth mentioning that the patients in the G1 group had a high MRIGs_score than those in the G2 group. Importantly, the results of RT-qPCR and IHC demonstrated that fasciculation and elongation protein zeta 1 (FEZ1) and insulin-like growth factor 2 receptor (IGF2R) were risk factors, while interleukin (IL)-1 receptor antagonist (IL1RN) was a protective factor. Conclusion Our study revealed a prognostic model composed of eight immune related genes that could predict the metastasis and progression of BRCA. Higher score represented higher metastasis probability. Besides, the consistency of key genes in BRCA tissue and bioinformatics analysis results from mRNA and protein levels was verified.","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775945","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}
We have read the paper written by Shuling Wang et al about Serum HER2 Level Predicts Therapeutic Efficacy and Prognosis in Advanced Breast Cancer Patients. 1 Serum HER2 has changed the treatment paradigm for half of patients with advanced breast cancer, and HER2 is currently defined as an expression immunohistochemistry without amplification via in-situ hybridization and therefore remains a clinical challenge in the treatment of breast cancer. 2 The introduction of antibody drug conjugates (ADCs) targeting HER2 offers a new treatment option for female breast cancer patients (FBC) who exhibit low HER2 levels; however, there is no evidence to show that low serum HER2 represents a new subtype of FBC; therefore, research is still needed to determine the impact of serum HER2 levels on breast cancer. 3 A study conducted by Shuling Wang et al analyzed sHER2 levels from 200 advanced breast cancer patients who received first or second-line treatment. Indicators of therapeutic efficacy and prognosis were objective response rate (ORR), disease control rate (DCR), and time to progression (TTP). 1 The indicator used is effective for the purposes of this study, however several other studies measure HER2 expression based on DNA, mRNA and protein tests which will most likely optimize HER2 testing with the aim of providing targeted therapy for patients who will benefit, while limiting exposure to treatment and toxicity, given that HER2 low breast cancer does not appear to represent a distinct breast cancer subtype then commonly used biomarkers and treatments should be
{"title":"Serum HER2 Level Predicts Therapeutic Efficacy and Prognosis in Advanced Breast Cancer Patients [Letter]","authors":"Febie Syahruddin, Prihantono, Mirna Muis","doi":"10.2147/BCTT.S472589","DOIUrl":"https://doi.org/10.2147/BCTT.S472589","url":null,"abstract":"We have read the paper written by Shuling Wang et al about Serum HER2 Level Predicts Therapeutic Efficacy and Prognosis in Advanced Breast Cancer Patients. 1 Serum HER2 has changed the treatment paradigm for half of patients with advanced breast cancer, and HER2 is currently defined as an expression immunohistochemistry without amplification via in-situ hybridization and therefore remains a clinical challenge in the treatment of breast cancer. 2 The introduction of antibody drug conjugates (ADCs) targeting HER2 offers a new treatment option for female breast cancer patients (FBC) who exhibit low HER2 levels; however, there is no evidence to show that low serum HER2 represents a new subtype of FBC; therefore, research is still needed to determine the impact of serum HER2 levels on breast cancer. 3 A study conducted by Shuling Wang et al analyzed sHER2 levels from 200 advanced breast cancer patients who received first or second-line treatment. Indicators of therapeutic efficacy and prognosis were objective response rate (ORR), disease control rate (DCR), and time to progression (TTP). 1 The indicator used is effective for the purposes of this study, however several other studies measure HER2 expression based on DNA, mRNA and protein tests which will most likely optimize HER2 testing with the aim of providing targeted therapy for patients who will benefit, while limiting exposure to treatment and toxicity, given that HER2 low breast cancer does not appear to represent a distinct breast cancer subtype then commonly used biomarkers and treatments should be","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785062","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}
Abstract Endocrine therapy (ET) with a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) is currently the first-line standard treatment for most patients with hormone receptor-positive (HR+) and human epidermal growth receptor 2-negative (HER2-) metastatic or advanced breast cancer. However, the majority of tumors response to and eventually develop resistance to CDK4/6is. The mechanisms of resistance are poorly understood, and the optimal postprogression treatment regimens and their sequences continue to evolve in the rapidly changing treatment landscape. In this review, we generally summarize the mechanisms of resistance to CDK4/6is and ET, and describe the findings from clinical trials using small molecule inhibitors, antibody-drug conjugates and immunotherapy, providing insights into how these novel strategies may reverse treatment resistance, and discussing how some have not translated into clinical benefit. Finally, we provide rational treatment strategies based on the current emerging evidence.
摘要 使用细胞周期蛋白依赖性激酶4/6抑制剂(CDK4/6i)进行内分泌治疗(ET)是目前大多数激素受体阳性(HR+)和人类表皮生长受体2阴性(HER2-)转移性或晚期乳腺癌患者的一线标准治疗方法。然而,大多数肿瘤会对 CDK4/6is 产生反应并最终产生耐药性。耐药机制尚不清楚,最佳的进展后治疗方案及其顺序也在快速变化的治疗环境中不断发展。在这篇综述中,我们概括了 CDK4/6is 和 ET 的耐药机制,描述了使用小分子抑制剂、抗体药物共轭物和免疫疗法的临床试验结果,深入探讨了这些新策略如何逆转耐药性,并讨论了其中一些策略如何未能转化为临床获益。最后,我们将根据目前新出现的证据提供合理的治疗策略。
{"title":"Therapy for Hormone Receptor-Positive, Human Epidermal Growth Receptor 2-Negative Metastatic Breast Cancer Following Treatment Progression via CDK4/6 Inhibitors: A Literature Review","authors":"Meixi Ye, Hao Xu, Jinhuan Ding, Li Jiang","doi":"10.2147/BCTT.S438366","DOIUrl":"https://doi.org/10.2147/BCTT.S438366","url":null,"abstract":"Abstract Endocrine therapy (ET) with a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) is currently the first-line standard treatment for most patients with hormone receptor-positive (HR+) and human epidermal growth receptor 2-negative (HER2-) metastatic or advanced breast cancer. However, the majority of tumors response to and eventually develop resistance to CDK4/6is. The mechanisms of resistance are poorly understood, and the optimal postprogression treatment regimens and their sequences continue to evolve in the rapidly changing treatment landscape. In this review, we generally summarize the mechanisms of resistance to CDK4/6is and ET, and describe the findings from clinical trials using small molecule inhibitors, antibody-drug conjugates and immunotherapy, providing insights into how these novel strategies may reverse treatment resistance, and discussing how some have not translated into clinical benefit. Finally, we provide rational treatment strategies based on the current emerging evidence.","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756475","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}
Background The purpose of this study was to investigate the therapeutic efficacy and prognosis of serum HER2 (sHER2) in patients with advanced breast cancer. Methods We analyzed the sHER2 levels of 200 patients with advanced breast cancer receiving first or second line treatment, the tissue HER2 (tHER2) level was also analyzed. Indicators of therapeutic efficacy and prognosis were objective response rate (ORR), disease control rate (DCR), and time to progression (TTP). Results The baseline sHER2 level was high in 132 patients and low in 68 patients. The high level of sHER2 is correlated with molecular subtype (p=0.016), visceral metastasis (p<0.001), liver metastasis (p<0.001), tissue HER-2 (tHER2) (p=0.001), and, among tHER2-low tumors (59 patients), the baseline sHER2 high level was associated with a higher proportion of brain metastasis. The ORR of patients with baseline sHER2 high level is higher than those with baseline sHER2 low level (p=0.026). The TTP of patients with baseline sHER2 low level is longer than the patients with baseline sHER2 high level (p=0.024). For patients with baseline sHER2 high level, a significant decrease in sHER2 after two cycles of treatment indicates higher ORR, DCR, and an extension of TTP. After multiple cycles of treatment, for patients with tHER-2 positive and baseline sHER2 high level, the DCR in the sHER2 decrease in the negative group was higher than that in the continuous positive group (p=0.037). Patients with a rapid decline type of sHER2 dynamic change curve had higher ORR and prolonged TTP compared with patients with other types of sHER2 dynamic change curve. There is no correlation between OS and sHER2 levels. Conclusion Our study showed that patients with advanced breast cancer had a high level of sHER2 at recurrence, regardless of whether they are tHER2 positive or negative. Dynamic detection of sHER2 can help predict therapeutic efficacy and prognosis, regardless of whether tHER-2 is positive or negative.
{"title":"Serum HER2 Level Predicts Therapeutic Efficacy and Prognosis in Advanced Breast Cancer Patients","authors":"Shuling Wang, Yuqin Chen, Weidong Li, Chun-fang Hao, Li Zhang, Wei-peng Zhao, Yehui Shi, Zhongsheng Tong","doi":"10.2147/BCTT.S449510","DOIUrl":"https://doi.org/10.2147/BCTT.S449510","url":null,"abstract":"Background The purpose of this study was to investigate the therapeutic efficacy and prognosis of serum HER2 (sHER2) in patients with advanced breast cancer. Methods We analyzed the sHER2 levels of 200 patients with advanced breast cancer receiving first or second line treatment, the tissue HER2 (tHER2) level was also analyzed. Indicators of therapeutic efficacy and prognosis were objective response rate (ORR), disease control rate (DCR), and time to progression (TTP). Results The baseline sHER2 level was high in 132 patients and low in 68 patients. The high level of sHER2 is correlated with molecular subtype (p=0.016), visceral metastasis (p<0.001), liver metastasis (p<0.001), tissue HER-2 (tHER2) (p=0.001), and, among tHER2-low tumors (59 patients), the baseline sHER2 high level was associated with a higher proportion of brain metastasis. The ORR of patients with baseline sHER2 high level is higher than those with baseline sHER2 low level (p=0.026). The TTP of patients with baseline sHER2 low level is longer than the patients with baseline sHER2 high level (p=0.024). For patients with baseline sHER2 high level, a significant decrease in sHER2 after two cycles of treatment indicates higher ORR, DCR, and an extension of TTP. After multiple cycles of treatment, for patients with tHER-2 positive and baseline sHER2 high level, the DCR in the sHER2 decrease in the negative group was higher than that in the continuous positive group (p=0.037). Patients with a rapid decline type of sHER2 dynamic change curve had higher ORR and prolonged TTP compared with patients with other types of sHER2 dynamic change curve. There is no correlation between OS and sHER2 levels. Conclusion Our study showed that patients with advanced breast cancer had a high level of sHER2 at recurrence, regardless of whether they are tHER2 positive or negative. Dynamic detection of sHER2 can help predict therapeutic efficacy and prognosis, regardless of whether tHER-2 is positive or negative.","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771294","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}
Pub Date : 2024-03-28eCollection Date: 2024-01-01DOI: 10.2147/BCTT.S450682
Katleen Nobbe, Melanie Erices-Leclercq, Frank Foerster, Robert Förster, Stephan E Baldus, Christian Rudlowski, Lars Schröder, Sabine Lubig
Purpose: The introduction of HER2-targeting antibody drug conjugates (ADCs) offers new treatment options for female breast cancer patients (FBC) expressing low levels of HER2 (HER2 low). No evidence was found that HER2 low describes a new FBC subtype. There is a lack of studies determining the impact of HER2 low in male breast cancer (MBC). In this study, we evaluate the prevalence of HER2 low in primary MBC and correlate the results with patient characteristics.
Patients and methods: In this study, histological specimens were obtained from 120 male patients diagnosed and treated for primary invasive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz, and Zwickau, Germany. HER2 immunostaining and in situ hybridization were performed by central pathology and evaluated based on the ASCO/CAP guidelines. The correlation of expression of HER2 low with tumor biological characteristics and patient outcomes was investigated.
Results: Out of all cases, four patients (3.3%) showed HER2 positivity (3+), 39 (32.5%) patients were classified as HER2 low, 7 (5.8%) were HER2 2+ (no amplification), 32 (26.7%) were HER2 1+, and 77 (64.2%) were classified as HER2 zero. Out of 77 HER2 zero cases, 47 tumors (61.0%) showed incomplete staining, with <10% of tumor cells classified as HER2 ultralow. No statistical correlation between HER2 low and tumor biological characteristics and patients' survival was found.
Conclusion: Our findings show a notable, albeit lower, prevalence of HER2 low expression in primary MBC. However, tumors expressing HER2 low do not show specific tumor biological features to define a new breast cancer subtype in MBC. Our results suggest that a significant number of MBC patients could benefit from ADCs, as shown in FBC. Further studies are required to better understand HER2 low breast cancer, both generally and in MBC.
{"title":"HER2 Low Expression in Primary Male Breast Cancer.","authors":"Katleen Nobbe, Melanie Erices-Leclercq, Frank Foerster, Robert Förster, Stephan E Baldus, Christian Rudlowski, Lars Schröder, Sabine Lubig","doi":"10.2147/BCTT.S450682","DOIUrl":"10.2147/BCTT.S450682","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of HER2-targeting antibody drug conjugates (ADCs) offers new treatment options for female breast cancer patients (FBC) expressing low levels of HER2 (HER2 low). No evidence was found that HER2 low describes a new FBC subtype. There is a lack of studies determining the impact of HER2 low in male breast cancer (MBC). In this study, we evaluate the prevalence of HER2 low in primary MBC and correlate the results with patient characteristics.</p><p><strong>Patients and methods: </strong>In this study, histological specimens were obtained from 120 male patients diagnosed and treated for primary invasive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz, and Zwickau, Germany. HER2 immunostaining and in situ hybridization were performed by central pathology and evaluated based on the ASCO/CAP guidelines. The correlation of expression of HER2 low with tumor biological characteristics and patient outcomes was investigated.</p><p><strong>Results: </strong>Out of all cases, four patients (3.3%) showed HER2 positivity (3+), 39 (32.5%) patients were classified as HER2 low, 7 (5.8%) were HER2 2+ (no amplification), 32 (26.7%) were HER2 1+, and 77 (64.2%) were classified as HER2 zero. Out of 77 HER2 zero cases, 47 tumors (61.0%) showed incomplete staining, with <10% of tumor cells classified as HER2 ultralow. No statistical correlation between HER2 low and tumor biological characteristics and patients' survival was found.</p><p><strong>Conclusion: </strong>Our findings show a notable, albeit lower, prevalence of HER2 low expression in primary MBC. However, tumors expressing HER2 low do not show specific tumor biological features to define a new breast cancer subtype in MBC. Our results suggest that a significant number of MBC patients could benefit from ADCs, as shown in FBC. Further studies are required to better understand HER2 low breast cancer, both generally and in MBC.</p>","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28eCollection Date: 2024-01-01DOI: 10.2147/BCTT.S441368
Michelle Marie Ubowski, Ryan VanSice, Morgan Marriott, Matthew J Yacobucci, Lipika Chablani
Introduction: The study focuses on evaluating the immune responses generated by a novel microparticulate murine breast cancer vaccine.
Methods: The methodology included the use of a co-culture model of dendritic cells (DCs), and T-cells to evaluate the immunotherapeutic responses generated by the vaccine.
Results: The study observed that the dendritic cells expressed significantly higher levels of MHC I, MHC II, CD 40, and CD 80 cell surface markers in the presence of the vaccine microparticles than the controls (p<0.05). This response was potentiated in the presence of an adjuvant, Poly (I:C). The study also demonstrated that the vaccine microparticles do not elicit inflammatory (TNF-alpha, IFN-gamma, IL-2, and IL-12) or immunosuppressive (IL-10) cytokine production when compared to the control.
Discussion: In conclusion, the study established the role of DCs in stimulating the cancer vaccine's adaptive immune responses.
简介:本研究的重点是评估新型微粒子小鼠乳腺癌疫苗产生的免疫反应:研究重点是评估一种新型微粒子小鼠乳腺癌疫苗产生的免疫反应:方法:使用树突状细胞(DC)和 T 细胞的共培养模型来评估疫苗产生的免疫治疗反应:结果:研究观察到,树突状细胞在疫苗微颗粒存在的情况下表达的 MHC I、MHC II、CD 40 和 CD 80 细胞表面标记物水平明显高于对照组(p 讨论:总之,这项研究确定了直流电在刺激癌症疫苗适应性免疫反应中的作用。
{"title":"Amplifying Immune Responses: Microparticulate Vaccine Approach Against Breast Cancer.","authors":"Michelle Marie Ubowski, Ryan VanSice, Morgan Marriott, Matthew J Yacobucci, Lipika Chablani","doi":"10.2147/BCTT.S441368","DOIUrl":"10.2147/BCTT.S441368","url":null,"abstract":"<p><strong>Introduction: </strong>The study focuses on evaluating the immune responses generated by a novel microparticulate murine breast cancer vaccine.</p><p><strong>Methods: </strong>The methodology included the use of a co-culture model of dendritic cells (DCs), and T-cells to evaluate the immunotherapeutic responses generated by the vaccine.</p><p><strong>Results: </strong>The study observed that the dendritic cells expressed significantly higher levels of MHC I, MHC II, CD 40, and CD 80 cell surface markers in the presence of the vaccine microparticles than the controls (p<0.05). This response was potentiated in the presence of an adjuvant, Poly (I:C). The study also demonstrated that the vaccine microparticles do not elicit inflammatory (TNF-alpha, IFN-gamma, IL-2, and IL-12) or immunosuppressive (IL-10) cytokine production when compared to the control.</p><p><strong>Discussion: </strong>In conclusion, the study established the role of DCs in stimulating the cancer vaccine's adaptive immune responses.</p>","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-15eCollection Date: 2024-01-01DOI: 10.2147/BCTT.S445753
Nelson Rangel, Iris Lorena Sánchez, Duván Sebastián Valbuena, Milena Rondón-Lagos
Purpose: The therapeutic decision for the management of breast cancer (BC) patients is based on the evaluation of prognostic factors alongside clinical and pathological parameters. Despite the use of standard biomarkers, response and resistance to therapy represent a challenge for clinicians. Among the new potential biomarkers for BC the ZNF217 gene have gained importance in recent years. However, while associations between ZNF217 gene copy number and clinicopathological characteristics have been established, its correlation with treatment response remains unclear.
Patients and methods: This study aimed to evaluate the ZNF217 gene copy number and establish its associations with treatment response in estrogen receptor positive (ERα+) and ERα negative (ERα-) BC cell lines. In addition, a validation of the relationship between ZNF217 gene copy number and its prognostic value was performed using datasets of BC patients retrieved from the cBioPortal public database.
Results: Our data show that in ERα+ cells, ZNF217 gene copy number increase (amplification), while cell proliferation decreases in response to standard drug treatments. In contrast, both ZNF217 gene copy number (gain) and cell proliferation increases in response to standard drug treatments in ERα- cells. The results obtained align with findings from the cBioPortal database analysis, demonstrating that ERα+/HER2- low proliferation patients, exhibiting ZNF217 gene amplification or gain, have a significantly higher survival probability after treatment, compared to ERα-/HER2- and HER2+ patients.
Conclusion: Our results suggest that in ERα+ BC cells, ZNF217 gene amplification could be indicative of a favorable response, while in ERα- BC cells, ZNF217 gene gain could be postulated as a potential predictor of treatment resistance. A broader understanding of the role of ZNF217 gene in treatment response, together with prospective studies in BC patients, could contribute to confirming our data, as well as optimizing existing treatments and exploring novel approaches to improve overall cancer treatment outcomes.
目的:乳腺癌(BC)患者的治疗决策基于对预后因素以及临床和病理参数的评估。尽管使用了标准生物标志物,但治疗反应和耐药性仍是临床医生面临的挑战。近年来,ZNF217 基因已成为治疗乳腺癌的新的潜在生物标志物。然而,虽然ZNF217基因拷贝数与临床病理特征之间的关系已经确定,但其与治疗反应的相关性仍不清楚:本研究旨在评估雌激素受体阳性(ERα+)和ERα阴性(ERα-)BC细胞系的ZNF217基因拷贝数,并确定其与治疗反应的相关性。此外,我们还利用从 cBioPortal 公共数据库中检索到的 BC 患者数据集验证了 ZNF217 基因拷贝数与其预后价值之间的关系:结果:我们的数据显示,在ERα+细胞中,ZNF217基因拷贝数增加(扩增),而细胞增殖在标准药物治疗下减少。相反,在ERα-细胞中,ZNF217基因拷贝数(增殖)和细胞增殖在标准药物治疗下都会增加。研究结果与cBioPortal数据库的分析结果一致,表明与ERα-/HER2和HER2+患者相比,出现ZNF217基因扩增或增益的ERα+/HER2-低增殖患者治疗后的生存概率明显更高:我们的研究结果表明,在ERα+ BC细胞中,ZNF217基因扩增可能预示着有利的反应,而在ERα- BC细胞中,ZNF217基因增殖可能被认为是耐药性的潜在预测因素。更广泛地了解ZNF217基因在治疗反应中的作用,并对BC患者进行前瞻性研究,将有助于证实我们的数据,并优化现有的治疗方法,探索新的方法来改善癌症的整体治疗效果。
{"title":"<i>ZNF217</i> Gene Copy Number as a Marker of Response to Standard Therapy Drugs According to ERα Status in Breast Cancer.","authors":"Nelson Rangel, Iris Lorena Sánchez, Duván Sebastián Valbuena, Milena Rondón-Lagos","doi":"10.2147/BCTT.S445753","DOIUrl":"https://doi.org/10.2147/BCTT.S445753","url":null,"abstract":"<p><strong>Purpose: </strong>The therapeutic decision for the management of breast cancer (BC) patients is based on the evaluation of prognostic factors alongside clinical and pathological parameters. Despite the use of standard biomarkers, response and resistance to therapy represent a challenge for clinicians. Among the new potential biomarkers for BC the <i>ZNF217</i> gene have gained importance in recent years. However, while associations between <i>ZNF217</i> gene copy number and clinicopathological characteristics have been established, its correlation with treatment response remains unclear.</p><p><strong>Patients and methods: </strong>This study aimed to evaluate the <i>ZNF217</i> gene copy number and establish its associations with treatment response in estrogen receptor positive (ERα+) and ERα negative (ERα-) BC cell lines. In addition, a validation of the relationship between <i>ZNF217</i> gene copy number and its prognostic value was performed using datasets of BC patients retrieved from the cBioPortal public database.</p><p><strong>Results: </strong>Our data show that in ERα+ cells, <i>ZNF217</i> gene copy number increase (amplification), while cell proliferation decreases in response to standard drug treatments. In contrast, both <i>ZNF217</i> gene copy number (gain) and cell proliferation increases in response to standard drug treatments in ERα- cells. The results obtained align with findings from the cBioPortal database analysis, demonstrating that ERα+/HER2- low proliferation patients, exhibiting <i>ZNF217</i> gene amplification or gain, have a significantly higher survival probability after treatment, compared to ERα-/HER2- and HER2+ patients.</p><p><strong>Conclusion: </strong>Our results suggest that in ERα+ BC cells, <i>ZNF217</i> gene amplification could be indicative of a favorable response, while in ERα- BC cells, <i>ZNF217</i> gene gain could be postulated as a potential predictor of treatment resistance. A broader understanding of the role of <i>ZNF217</i> gene in treatment response, together with prospective studies in BC patients, could contribute to confirming our data, as well as optimizing existing treatments and exploring novel approaches to improve overall cancer treatment outcomes.</p>","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10950081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-08eCollection Date: 2024-01-01DOI: 10.2147/BCTT.S451617
Qin Ma, Yao-Bang Liu, Tong She, Xin-Lan Liu
Objective: This study determined the cut-off value of Ki-67 expression and discussed the interaction between Ki-67 and histological grade, further explored the prognostic role of Ki-67 in hormone receptor-positive and human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer;.
Materials and methods: We assessed the Ki-67 expression of 956 patients with HR+/HER2 breast cancer diagnosed in the General Hospital of Ningxia Medical University from 2015 to 2019 by immunohistochemistry (IHC), The disease-free survival (DFS) was defined as the time from postoperative to the first local recurrence, distant metastasis or death of the disease. The follow-up by means of inpatient or outpatient medical records and telephone.
Results: 22.5% was used as the cut-off for low/high Ki-67 expression in HR+/HER2- breast cancer. Compared with the value of 14%, which is commonly used in clinic at present, the consistency of the two values is moderate (Kappa = 0.484, P<0.001). The expression of Ki-67 was increased with the grade. (Median: G1:10%; G2:20%; G3:40%. Mean: G1:13%; G2:23%; G3:39%, P <0.001). Survival analysis was based on all patients for a median of 51 months (24-89 months), 63 cases had recurrence or metastasis during the follow-up, which 21 cases had low expression of Ki-67 and 42 cases had high expression. The patients with Ki-67 ≥ 22.5% had a 2.969 higher risk of early recurrence and metastasis than the patients with Ki-67 < 22.5%. There were 4 cases of local recurrence, 7 cases of regional lymph node metastasis, and 52 cases of distant metastasis in all patients, the common distant metastases were bone, liver, and lung, and rare metastases were adrenal gland, bone marrow, and pericardium.
Conclusion: In HR+/HER2- breast cancer, patients with Ki-67 > 22.5% have a worse prognosis and are more likely to have early recurrence and metastasis.
{"title":"The Role of Ki-67 in HR+/HER2- Breast Cancer: A Real-World Study of 956 Patients.","authors":"Qin Ma, Yao-Bang Liu, Tong She, Xin-Lan Liu","doi":"10.2147/BCTT.S451617","DOIUrl":"10.2147/BCTT.S451617","url":null,"abstract":"<p><strong>Objective: </strong>This study determined the cut-off value of Ki-67 expression and discussed the interaction between Ki-67 and histological grade, further explored the prognostic role of Ki-67 in hormone receptor-positive and human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer;.</p><p><strong>Materials and methods: </strong>We assessed the Ki-67 expression of 956 patients with HR+/HER2 breast cancer diagnosed in the General Hospital of Ningxia Medical University from 2015 to 2019 by immunohistochemistry (IHC), The disease-free survival (DFS) was defined as the time from postoperative to the first local recurrence, distant metastasis or death of the disease. The follow-up by means of inpatient or outpatient medical records and telephone.</p><p><strong>Results: </strong>22.5% was used as the cut-off for low/high Ki-67 expression in HR+/HER2- breast cancer. Compared with the value of 14%, which is commonly used in clinic at present, the consistency of the two values is moderate (Kappa = 0.484, <i>P</i><0.001). The expression of Ki-67 was increased with the grade. (Median: G1:10%; G2:20%; G3:40%. Mean: G1:13%; G2:23%; G3:39%, <i>P</i> <0.001). Survival analysis was based on all patients for a median of 51 months (24-89 months), 63 cases had recurrence or metastasis during the follow-up, which 21 cases had low expression of Ki-67 and 42 cases had high expression. The patients with Ki-67 ≥ 22.5% had a 2.969 higher risk of early recurrence and metastasis than the patients with Ki-67 < 22.5%. There were 4 cases of local recurrence, 7 cases of regional lymph node metastasis, and 52 cases of distant metastasis in all patients, the common distant metastases were bone, liver, and lung, and rare metastases were adrenal gland, bone marrow, and pericardium.</p><p><strong>Conclusion: </strong>In HR+/HER2- breast cancer, patients with Ki-67 > 22.5% have a worse prognosis and are more likely to have early recurrence and metastasis.</p>","PeriodicalId":9106,"journal":{"name":"Breast Cancer : Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}