{"title":"Stratified prediction of HER2 status in breast cancer by integrating intratumoral and peritumoral radiomics from DCE-MRI.","authors":"Yang Gao, Jiangnian Gong, Yuanling Yang, Yingyi Luo, Weiyi Liu, Zisan Zeng","doi":"10.1186/s12885-026-15688-x","DOIUrl":"https://doi.org/10.1186/s12885-026-15688-x","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-13DOI: 10.1186/s12885-026-15704-0
Megan Sedeman, Claudia Christowitz, Louis de Jager, Anna-Mart Engelbrecht
{"title":"Correction to: Obese mammary tumour‑bearing mice are highly sensitive to doxorubicin‑induced hepatotoxicity.","authors":"Megan Sedeman, Claudia Christowitz, Louis de Jager, Anna-Mart Engelbrecht","doi":"10.1186/s12885-026-15704-0","DOIUrl":"10.1186/s12885-026-15704-0","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":"231"},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To identify symptom clusters (SCs) of nasopharyngeal carcinoma (NPC) patients during radiotherapy and examine the relative importance of specific symptoms in relation to quality of life (QoL).
Methods: This cross-sectional study recruited non-metastatic NPC patients undergoing radiotherapy at Sun Yat-sen University Cancer Center (August 23-24, 2023). Acute toxicities, malnutrition, and QoL were assessed using the patient-reported outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), modified Patient-Generated Subjective Global Assessment (mPG-SGA), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck 35 (EORTC QLQ-H&N35), respectively. Exploratory factor analysis and network analysis were used to identify SCs and characterize central and bridge symptoms. Multivariable logistic regression was conducted to explore factors associated with QoL.
Results: A total of 437 eligible patients (73.46% male; median [IQR] age, 47 [38-55]) were included. Most patients reported ≥ 5 acute toxicities (88.56%) and severe malnutrition (75.06%). Three SCs (corresponding central symptoms) were identified from 18 prevalent items of PRO-CTCAE: general SC (anxiety), head-neck SC (dysphagia), and gastrointestinal SC (nausea). Malnutrition showed high bridge connectivity across SCs. The network remained relatively stable across early and late radiotherapy phases. Among multiple variables examined, the head-neck SC showed the strongest association with poorer QoL (β = 1.805, P < 0.001).
Conclusions: NPC patients experience multiple co-occurring symptoms that organize into distinct clusters associated with QoL throughout radiotherapy. Dysphagia in head-neck SC and malnutrition deserve to be priorities for early management to relieve the global network burdens.
{"title":"Malnutrition-related symptom clusters and quality of life in nasopharyngeal carcinoma patients during radiotherapy: a network analysis.","authors":"Meng-Yu Hao, Feng-Yan Li, Su-Man Zhang, Yu-Xian Yang, Yu-Xi Xiong, Hang-Yu Wang, Yao Zhuang Chuah, Zi-Hang Chen, Ling-Xin Xu, Peng Sun, Jian Ji, Lecheng Jia, Hua Li, Yanfei Liu, Ying Sun, Jia-Wei Lv, Yan Li, Guan-Qun Zhou","doi":"10.1186/s12885-026-15694-z","DOIUrl":"https://doi.org/10.1186/s12885-026-15694-z","url":null,"abstract":"<p><strong>Background: </strong>To identify symptom clusters (SCs) of nasopharyngeal carcinoma (NPC) patients during radiotherapy and examine the relative importance of specific symptoms in relation to quality of life (QoL).</p><p><strong>Methods: </strong>This cross-sectional study recruited non-metastatic NPC patients undergoing radiotherapy at Sun Yat-sen University Cancer Center (August 23-24, 2023). Acute toxicities, malnutrition, and QoL were assessed using the patient-reported outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), modified Patient-Generated Subjective Global Assessment (mPG-SGA), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck 35 (EORTC QLQ-H&N35), respectively. Exploratory factor analysis and network analysis were used to identify SCs and characterize central and bridge symptoms. Multivariable logistic regression was conducted to explore factors associated with QoL.</p><p><strong>Results: </strong>A total of 437 eligible patients (73.46% male; median [IQR] age, 47 [38-55]) were included. Most patients reported ≥ 5 acute toxicities (88.56%) and severe malnutrition (75.06%). Three SCs (corresponding central symptoms) were identified from 18 prevalent items of PRO-CTCAE: general SC (anxiety), head-neck SC (dysphagia), and gastrointestinal SC (nausea). Malnutrition showed high bridge connectivity across SCs. The network remained relatively stable across early and late radiotherapy phases. Among multiple variables examined, the head-neck SC showed the strongest association with poorer QoL (β = 1.805, P < 0.001).</p><p><strong>Conclusions: </strong>NPC patients experience multiple co-occurring symptoms that organize into distinct clusters associated with QoL throughout radiotherapy. Dysphagia in head-neck SC and malnutrition deserve to be priorities for early management to relieve the global network burdens.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-13DOI: 10.1186/s12885-026-15594-2
Marcin Kubeczko, Anna Polakiewicz-Gilowska, Katarzyna Świderska, Marta Mianowska-Malec, Aleksandra Leśniak, Barbarba Łanoszka, Konstanty Chomik, Barbara Grandys, Natalya Lisovska, Grzegorz Woźniak, Tomasz Latusek, Ewa Stobiecka, Jakub Simek, Bartłomiej Pyciński, Barbara Bobek-Billewicz, Ewa Chmielik, Michał Jarząb
{"title":"Deciphering the role of Ki67: prognostic insights in advanced breast cancer therapy with Cyclin-dependent kinase 4/6 inhibitors.","authors":"Marcin Kubeczko, Anna Polakiewicz-Gilowska, Katarzyna Świderska, Marta Mianowska-Malec, Aleksandra Leśniak, Barbarba Łanoszka, Konstanty Chomik, Barbara Grandys, Natalya Lisovska, Grzegorz Woźniak, Tomasz Latusek, Ewa Stobiecka, Jakub Simek, Bartłomiej Pyciński, Barbara Bobek-Billewicz, Ewa Chmielik, Michał Jarząb","doi":"10.1186/s12885-026-15594-2","DOIUrl":"https://doi.org/10.1186/s12885-026-15594-2","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-13DOI: 10.1186/s12885-026-15721-z
Ilker Nihat Ökten, Tuba Baydaş, Sinan Koca, Mukaddes Feyza Baltacı, Filiz Özen, İbrahim Çil, Metin Eser, Adnan Gündoğdu, Merve Aktaş, Osman Cem Yılmaz
<p><strong>Background: </strong>Germline testing for BRCA1 and BRCA2 has become integral to the management of breast cancer, with pathogenic variants strongly influencing surgical decision-making. However, the increasing detection of variants of uncertain significance (VUS) presents a major clinical challenge, as their implications for cancer risk and treatment remain unclear. This study aimed to evaluate real-world surgical management patterns among breast cancer patients carrying pathogenic BRCA1/2 variants or VUS, with a particular focus on determinants of final bilateral mastectomy.</p><p><strong>Methods: </strong>This multicenter retrospective study included female breast cancer patients who underwent germline BRCA1/2 testing across three institutions in Türkiye between 2017 and 2025. Patients carrying pathogenic variants or VUS were identified and reclassified according to American College of Medical Genetics and Genomics (ACMG) criteria. Clinicopathological characteristics and surgical outcomes were compared between pathogenic and VUS groups. Final bilateral mastectomy was defined as either primary bilateral mastectomy or unilateral mastectomy followed by completion contralateral mastectomy. Multivariable logistic regression was performed to identify factors independently associated with final bilateral mastectomy, including a separate exploratory analysis restricted to VUS carriers.</p><p><strong>Results: </strong>A total of 203 patients with abnormal BRCA results were included, comprising 107 pathogenic variant carriers and 96 VUS carriers. Patients with pathogenic BRCA variants were significantly younger at diagnosis and more frequently had triple-negative tumors. Final bilateral mastectomy was markedly more common among pathogenic variant carriers than VUS carriers (67% vs. 12%, p < 0.001). In multivariable analysis, pathogenic BRCA status remained independently associated with final bilateral mastectomy (adjusted OR 10.38, 95% CI 3.98-27.10; p < 0.001), while increasing age was also independently associated. Among VUS carriers, no clinicopathological variable-including molecular subtype, tumor size, Ki-67 index, family history, or BRCA1 versus BRCA2 VUS-was significantly associated with final bilateral mastectomy in univariate analyses. In exploratory multivariable modeling, younger age at diagnosis emerged as the only independent factor associated with surgical choice (adjusted OR per year 1.09, 95% CI 1.01-1.17; p = 0.027).</p><p><strong>Conclusion: </strong>While pathogenic BRCA1/2 variants are strongly associated with bilateral mastectomy in breast cancer patients, surgical decision-making among VUS carriers appears largely independent of tumor biology or genetic subtype and is primarily influenced by age. These findings highlight substantial heterogeneity and potential overtreatment in the management of BRCA VUS carriers, underscoring the need for improved genetic counseling and standardized approaches to mitigate the impact of g
背景：BRCA1和BRCA2的生殖系检测已经成为乳腺癌治疗不可或缺的一部分，致病变异强烈影响手术决策。然而，越来越多的不确定意义变异（VUS）的检测提出了一个重大的临床挑战，因为它们对癌症风险和治疗的影响尚不清楚。本研究旨在评估携带致病性BRCA1/2变异或VUS的乳腺癌患者的实际手术管理模式，特别关注最终双侧乳房切除术的决定因素。方法：这项多中心回顾性研究纳入了2017年至2025年间在泰国三家机构接受生殖系BRCA1/2检测的女性乳腺癌患者。根据美国医学遗传学和基因组学学院（ACMG）的标准，对携带致病变异或VUS的患者进行鉴定和重新分类。比较致病性组和VUS组的临床病理特征和手术结果。最终双侧乳房切除术定义为原发性双侧乳房切除术或单侧乳房切除术，然后完成对侧乳房切除术。采用多变量逻辑回归来确定与最终双侧乳房切除术独立相关的因素，包括单独的探索性分析，仅限于VUS携带者。结果：共纳入203例BRCA结果异常患者，其中致病性变异携带者107例，VUS携带者96例。具有致病性BRCA变异的患者在诊断时明显更年轻，并且更经常患有三阴性肿瘤。最终双侧乳房切除术在致病性变异携带者中比在VUS携带者中更常见（67% vs 12%）。结论：虽然致病性BRCA1/2变异与乳腺癌患者的双侧乳房切除术密切相关，但VUS携带者的手术决策似乎在很大程度上与肿瘤生物学或遗传亚型无关，主要受年龄影响。这些研究结果强调了BRCA VUS携带者管理中的巨大异质性和潜在的过度治疗，强调了改进遗传咨询和标准化方法的必要性，以减轻遗传不确定性对临床决策的影响。
{"title":"Breast cancer surgery in the era of genetic uncertainty: real-world outcomes in BRCA1/2 pathogenic variants and variants of uncertain significance.","authors":"Ilker Nihat Ökten, Tuba Baydaş, Sinan Koca, Mukaddes Feyza Baltacı, Filiz Özen, İbrahim Çil, Metin Eser, Adnan Gündoğdu, Merve Aktaş, Osman Cem Yılmaz","doi":"10.1186/s12885-026-15721-z","DOIUrl":"https://doi.org/10.1186/s12885-026-15721-z","url":null,"abstract":"<p><strong>Background: </strong>Germline testing for BRCA1 and BRCA2 has become integral to the management of breast cancer, with pathogenic variants strongly influencing surgical decision-making. However, the increasing detection of variants of uncertain significance (VUS) presents a major clinical challenge, as their implications for cancer risk and treatment remain unclear. This study aimed to evaluate real-world surgical management patterns among breast cancer patients carrying pathogenic BRCA1/2 variants or VUS, with a particular focus on determinants of final bilateral mastectomy.</p><p><strong>Methods: </strong>This multicenter retrospective study included female breast cancer patients who underwent germline BRCA1/2 testing across three institutions in Türkiye between 2017 and 2025. Patients carrying pathogenic variants or VUS were identified and reclassified according to American College of Medical Genetics and Genomics (ACMG) criteria. Clinicopathological characteristics and surgical outcomes were compared between pathogenic and VUS groups. Final bilateral mastectomy was defined as either primary bilateral mastectomy or unilateral mastectomy followed by completion contralateral mastectomy. Multivariable logistic regression was performed to identify factors independently associated with final bilateral mastectomy, including a separate exploratory analysis restricted to VUS carriers.</p><p><strong>Results: </strong>A total of 203 patients with abnormal BRCA results were included, comprising 107 pathogenic variant carriers and 96 VUS carriers. Patients with pathogenic BRCA variants were significantly younger at diagnosis and more frequently had triple-negative tumors. Final bilateral mastectomy was markedly more common among pathogenic variant carriers than VUS carriers (67% vs. 12%, p < 0.001). In multivariable analysis, pathogenic BRCA status remained independently associated with final bilateral mastectomy (adjusted OR 10.38, 95% CI 3.98-27.10; p < 0.001), while increasing age was also independently associated. Among VUS carriers, no clinicopathological variable-including molecular subtype, tumor size, Ki-67 index, family history, or BRCA1 versus BRCA2 VUS-was significantly associated with final bilateral mastectomy in univariate analyses. In exploratory multivariable modeling, younger age at diagnosis emerged as the only independent factor associated with surgical choice (adjusted OR per year 1.09, 95% CI 1.01-1.17; p = 0.027).</p><p><strong>Conclusion: </strong>While pathogenic BRCA1/2 variants are strongly associated with bilateral mastectomy in breast cancer patients, surgical decision-making among VUS carriers appears largely independent of tumor biology or genetic subtype and is primarily influenced by age. These findings highlight substantial heterogeneity and potential overtreatment in the management of BRCA VUS carriers, underscoring the need for improved genetic counseling and standardized approaches to mitigate the impact of g","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Checkpoint inhibitor pneumonitis (CIP) is an uncommon but clinically severe adverse event that can seriously compromise the quality of life and can be potentially life-threatening in lung cancer patients receiving immune checkpoint inhibitors (ICI). However, there is still a lack of effective predictive models to predict the occurrence of CIP. The aim of this study was to develop a novel scoring system for predicting the risk of CIP based on a nomogram model.
Methods: We retrospectively screened patients with lung cancer who received ICI treatment at our hospital. The independent risk factors of CIP were identified by the univariable and multivariable analysis of the COX hazard regression model and were integrated to develop a nomogram predictive model. The receiver operating characteristic (ROC) curve, the concordance index (C- index), and the calibration curve were used to evaluate the discrimination and prediction accuracy of the model. The clinical utility of the model was evaluated by decision curve analysis (DCA).
Results: A total of 2,082 cancer patients were included in the analysis. In the final multivariate Cox regression analysis identified that sex, body mass index (BMI), chemotherapy, radiotherapy, C-reactive protein (CRP), CD4/CD8, white blood cell (WBC), ALB/GLB, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-platelet ratio (NPR), platelet-to-albumin ratio (PAR), and CRP-to-lymphocyte ratio (CLR) were the independent predictive factors for CIP. Based on these risk factors, a predictive nomogram model was constructed. The C-index for the nomogram model in predicting the probability of CIP at 1 year, 1.5 years, and 2 years was 0.704, 0.718, and 0.725, respectively. The average C-index (SD) was 0.712 (0.004), and the average AUC (SD) was 0.733 (0.005), calculated through 100 iterations of 10-fold cross-validation. The calibration curves demonstrated good concordance, and the DCA indicated that the model had good clinical utility.
Conclusions: The nomogram was accurate in predicting the occurrence of CIP in patients with lung cancer. This study provides a reference for screening CIP high-risk patients and for individualized treatment strategies.
{"title":"Nomogram-based prediction of checkpoint inhibitor pneumonitis in lung cancer patients.","authors":"Dan Tao, Haike Lei, Lisi Sun, Lulu Wang, Wei Zhou, Ying Wang, Yongzhong Wu","doi":"10.1186/s12885-026-15729-5","DOIUrl":"https://doi.org/10.1186/s12885-026-15729-5","url":null,"abstract":"<p><strong>Background: </strong>Checkpoint inhibitor pneumonitis (CIP) is an uncommon but clinically severe adverse event that can seriously compromise the quality of life and can be potentially life-threatening in lung cancer patients receiving immune checkpoint inhibitors (ICI). However, there is still a lack of effective predictive models to predict the occurrence of CIP. The aim of this study was to develop a novel scoring system for predicting the risk of CIP based on a nomogram model.</p><p><strong>Methods: </strong>We retrospectively screened patients with lung cancer who received ICI treatment at our hospital. The independent risk factors of CIP were identified by the univariable and multivariable analysis of the COX hazard regression model and were integrated to develop a nomogram predictive model. The receiver operating characteristic (ROC) curve, the concordance index (C- index), and the calibration curve were used to evaluate the discrimination and prediction accuracy of the model. The clinical utility of the model was evaluated by decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 2,082 cancer patients were included in the analysis. In the final multivariate Cox regression analysis identified that sex, body mass index (BMI), chemotherapy, radiotherapy, C-reactive protein (CRP), CD4/CD8, white blood cell (WBC), ALB/GLB, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-platelet ratio (NPR), platelet-to-albumin ratio (PAR), and CRP-to-lymphocyte ratio (CLR) were the independent predictive factors for CIP. Based on these risk factors, a predictive nomogram model was constructed. The C-index for the nomogram model in predicting the probability of CIP at 1 year, 1.5 years, and 2 years was 0.704, 0.718, and 0.725, respectively. The average C-index (SD) was 0.712 (0.004), and the average AUC (SD) was 0.733 (0.005), calculated through 100 iterations of 10-fold cross-validation. The calibration curves demonstrated good concordance, and the DCA indicated that the model had good clinical utility.</p><p><strong>Conclusions: </strong>The nomogram was accurate in predicting the occurrence of CIP in patients with lung cancer. This study provides a reference for screening CIP high-risk patients and for individualized treatment strategies.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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