Pub Date : 2024-10-21DOI: 10.1186/s12885-024-13034-7
Juliette Simon, Damien Reita, Eric Guerin, Benoit Lhermitte, Noelle Weingertner, François Lefebvre, Marie Karanian, Julien Masliah-Planchon, Veronique Lindner, Alina Onea, Sarah Jannier, Alexandra Salmon, Guillaume Bergthold, Florence Vincent, Marlène Deschuyter, Marie-Odile Barbaza, Natacha Entz-Werlé
Introduction: Faced to the growing development of collecting systematic molecular analyses in relapsed pediatric cancers to transform their targeted matched therapies, this study aimed to assess the clinical and therapeutic indications of systematic diagnostic genomic explorations performed in pediatric solid cancers to determine which type of screening and if it afford at relapse time an accurate targeted strategy.
Methods: A total of 280 patients less than 22 years, referred at the University Hospitals of Strasbourg for a newly diagnosed solid tumor from January 2015 to December 2021, were prospectively genomically investigated since diagnosis. Using 7 different molecular tests going from single-gene methods (IHC, FISH, RT-PCR, Sanger sequencing, droplet digital PCR) to largescale analyses (Next-Generation sequencing, RNAsequencing and FoundationOne®CDx), we explored retrospectively the molecular findings in those pediatric solid tumors (except hematolymphoid cancers) to improve diagnosis, prognosis assessment and relapse therapeutics.
Results: One hundred and ninety-eight patients (71%) underwent molecular biology (MB) at diagnosis. Thirty-eight different histologies were grouped into cerebral tumors (30%), sarcomas (26%, bone and soft tissues), various blastomas (27%), and other entities (17%). Over a median 40-month follow-up, the overall survival rate of patients was 85% and the relapse rate 28%. Of the 326 analyses carried out, 245 abnormalities (single nucleotide variations: 50%, fusions: 25%, copy number alteration: 20%) concerning 70 oncogenes were highlighted. The overall clinical impact rate was 84%. Broad-spectrum analyses had a higher therapeutic impact (57%) than the targeted analyses (28%). 75% of broad-spectrum tests found an actionable variant conducting 23% of patients to receive rapidly a matched targeted therapy since first relapse.
Conclusion: Our experience highlighted the clinical utility of molecular profiling of solid tumors as soon as at diagnosis in children to expect improving access to innovative agents at relapse.
{"title":"Clinical impact of large genomic explorations at diagnosis in 198 pediatric solid tumors: a monocentric study aiming practical feasibility of precision oncology.","authors":"Juliette Simon, Damien Reita, Eric Guerin, Benoit Lhermitte, Noelle Weingertner, François Lefebvre, Marie Karanian, Julien Masliah-Planchon, Veronique Lindner, Alina Onea, Sarah Jannier, Alexandra Salmon, Guillaume Bergthold, Florence Vincent, Marlène Deschuyter, Marie-Odile Barbaza, Natacha Entz-Werlé","doi":"10.1186/s12885-024-13034-7","DOIUrl":"10.1186/s12885-024-13034-7","url":null,"abstract":"<p><strong>Introduction: </strong>Faced to the growing development of collecting systematic molecular analyses in relapsed pediatric cancers to transform their targeted matched therapies, this study aimed to assess the clinical and therapeutic indications of systematic diagnostic genomic explorations performed in pediatric solid cancers to determine which type of screening and if it afford at relapse time an accurate targeted strategy.</p><p><strong>Methods: </strong>A total of 280 patients less than 22 years, referred at the University Hospitals of Strasbourg for a newly diagnosed solid tumor from January 2015 to December 2021, were prospectively genomically investigated since diagnosis. Using 7 different molecular tests going from single-gene methods (IHC, FISH, RT-PCR, Sanger sequencing, droplet digital PCR) to largescale analyses (Next-Generation sequencing, RNAsequencing and FoundationOne®CDx), we explored retrospectively the molecular findings in those pediatric solid tumors (except hematolymphoid cancers) to improve diagnosis, prognosis assessment and relapse therapeutics.</p><p><strong>Results: </strong>One hundred and ninety-eight patients (71%) underwent molecular biology (MB) at diagnosis. Thirty-eight different histologies were grouped into cerebral tumors (30%), sarcomas (26%, bone and soft tissues), various blastomas (27%), and other entities (17%). Over a median 40-month follow-up, the overall survival rate of patients was 85% and the relapse rate 28%. Of the 326 analyses carried out, 245 abnormalities (single nucleotide variations: 50%, fusions: 25%, copy number alteration: 20%) concerning 70 oncogenes were highlighted. The overall clinical impact rate was 84%. Broad-spectrum analyses had a higher therapeutic impact (57%) than the targeted analyses (28%). 75% of broad-spectrum tests found an actionable variant conducting 23% of patients to receive rapidly a matched targeted therapy since first relapse.</p><p><strong>Conclusion: </strong>Our experience highlighted the clinical utility of molecular profiling of solid tumors as soon as at diagnosis in children to expect improving access to innovative agents at relapse.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457964","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}
Pub Date : 2024-10-21DOI: 10.1186/s12885-024-13054-3
Samantha Batchelor, Belinda Lunnay, Sara Macdonald, Paul R Ward
Background: The increasing incidence of breast cancer and disease burden is a significant public health concern. While 30% of breast cancers could be prevented through addressing modifiable risk factors, misconceptions among women about breast cancer risks hamper primary prevention. In the absence of primary prevention, secondary prevention such as mammography increases the early detection of breast cancer and improves health outcomes. However, current population-level screening rates indicate secondary prevention is suboptimal. More effective public health efforts to improve breast cancer prevention are required. Given breast cancer is socially patterned, this work explores how social class impacts women's breast cancer prevention practices. This study uses the concepts of lay epidemiology and candidacy as a mechanism to understand women's breast cancer risk perspectives. It engages Bourdieu's relational social class theory to unpack how women's social, cultural, and structured life contexts shape these perspectives and their considerations regarding primary and secondary prevention.
Methods: In this qualitative study 43 Australian midlife women (aged 45-64 years), were interviewed to explore their understandings of breast cancer risks, how they perceived their own risk, and how this shaped their prevention behaviours. A theory-informed thematic analysis applying Bourdieu's concepts of habitus, capital, and fields to understand how women's social class positions shapes risk perspectives and prevention practices was conducted.
Results: This social class analysis showed differences in how women engage in breast cancer discourse, consider risks, and participate in breast cancer prevention. Middle-class women prioritise health promoting practices and were more likely than working-class and affluent women to attend mammography screening. Working-class women experience structural factors, like low income, stress and difficult life circumstances, which hamper primary prevention practices and for some screening is not considered or prioritised, and their decisions not to screen are less active. Affluent women often do not consider themselves at-risk due to their healthier 'lifestyles. 'They suggest that this, and their knowledge of screening benefits and harms allows them to make informed decisions not to screen.
Conclusions: Women interpret and understand breast cancer risks differently and enact prevention practices within the parameters afforded by their social class positions. These findings are useful to inform improved public health approaches regarding both modifiable breast cancer risks and increasing mammography screening. To improve equity in breast cancer prevention efforts, such approaches must respond to limitations based on social class and address structural factors that impact prevention practices.
背景:乳腺癌发病率和疾病负担的不断增加是一个重大的公共卫生问题。虽然 30% 的乳腺癌可以通过改变风险因素来预防,但妇女对乳腺癌风险的误解阻碍了一级预防。在缺乏一级预防的情况下,乳房 X 射线照相术等二级预防可提高乳腺癌的早期发现率,改善健康状况。然而,目前的人口筛查率表明二级预防并不理想。需要更有效的公共卫生工作来改善乳腺癌的预防。鉴于乳腺癌是一种社会模式,本研究探讨了社会阶层如何影响女性的乳腺癌预防实践。本研究将非专业流行病学和候选资格的概念作为了解妇女乳腺癌风险观点的机制。它采用布迪厄的社会阶层关系理论,来解读女性的社会、文化和结构化生活背景是如何形成这些观点以及她们对一级和二级预防的考虑的:在这项定性研究中,对 43 名澳大利亚中年女性(45-64 岁)进行了访谈,以探讨她们对乳腺癌风险的理解、她们如何看待自身的风险以及这种风险如何影响她们的预防行为。研究人员运用布尔迪厄的惯性、资本和领域概念进行了主题分析,以了解妇女的社会阶层地位如何影响她们的风险观点和预防行为:这项社会阶层分析表明,妇女在参与乳腺癌讨论、考虑风险和参与乳腺癌预防的方式上存在差异。中产阶级妇女优先考虑促进健康的做法,与工薪阶层妇女和富裕妇女相比,她们更有可能参加乳房 X 射线照相筛查。工薪阶层妇女经历的结构性因素,如低收入、压力和艰难的生活环境,阻碍了初级预防措施的实施,对一些妇女来说,筛查没有被考虑或被列为优先事项,她们决定不做筛查的积极性也较低。富裕的妇女往往不认为自己有风险,因为她们的'生活方式'更健康。她们认为,这一点以及她们对筛查利弊的了解使她们能够在知情的情况下做出不做筛查的决定:女性对乳腺癌风险有不同的解释和理解,并在其社会阶层所提供的参数范围内采取预防措施。这些发现有助于改进有关可改变的乳腺癌风险和增加乳房 X 线照相筛查的公共卫生方法。为了提高乳腺癌预防工作的公平性,这些方法必须应对基于社会阶层的限制,并解决影响预防实践的结构性因素。
{"title":"How social class shapes breast cancer risk perspectives and prevention practices of Australian midlife women: a qualitative study using the concept of 'breast cancer candidacy'.","authors":"Samantha Batchelor, Belinda Lunnay, Sara Macdonald, Paul R Ward","doi":"10.1186/s12885-024-13054-3","DOIUrl":"10.1186/s12885-024-13054-3","url":null,"abstract":"<p><strong>Background: </strong>The increasing incidence of breast cancer and disease burden is a significant public health concern. While 30% of breast cancers could be prevented through addressing modifiable risk factors, misconceptions among women about breast cancer risks hamper primary prevention. In the absence of primary prevention, secondary prevention such as mammography increases the early detection of breast cancer and improves health outcomes. However, current population-level screening rates indicate secondary prevention is suboptimal. More effective public health efforts to improve breast cancer prevention are required. Given breast cancer is socially patterned, this work explores how social class impacts women's breast cancer prevention practices. This study uses the concepts of lay epidemiology and candidacy as a mechanism to understand women's breast cancer risk perspectives. It engages Bourdieu's relational social class theory to unpack how women's social, cultural, and structured life contexts shape these perspectives and their considerations regarding primary and secondary prevention.</p><p><strong>Methods: </strong>In this qualitative study 43 Australian midlife women (aged 45-64 years), were interviewed to explore their understandings of breast cancer risks, how they perceived their own risk, and how this shaped their prevention behaviours. A theory-informed thematic analysis applying Bourdieu's concepts of habitus, capital, and fields to understand how women's social class positions shapes risk perspectives and prevention practices was conducted.</p><p><strong>Results: </strong>This social class analysis showed differences in how women engage in breast cancer discourse, consider risks, and participate in breast cancer prevention. Middle-class women prioritise health promoting practices and were more likely than working-class and affluent women to attend mammography screening. Working-class women experience structural factors, like low income, stress and difficult life circumstances, which hamper primary prevention practices and for some screening is not considered or prioritised, and their decisions not to screen are less active. Affluent women often do not consider themselves at-risk due to their healthier 'lifestyles. 'They suggest that this, and their knowledge of screening benefits and harms allows them to make informed decisions not to screen.</p><p><strong>Conclusions: </strong>Women interpret and understand breast cancer risks differently and enact prevention practices within the parameters afforded by their social class positions. These findings are useful to inform improved public health approaches regarding both modifiable breast cancer risks and increasing mammography screening. To improve equity in breast cancer prevention efforts, such approaches must respond to limitations based on social class and address structural factors that impact prevention practices.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457983","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}
Pub Date : 2024-10-21DOI: 10.1186/s12885-024-13058-z
Danxue Huang, Su Li, Yang Bai, Yan Wang
Background: Currently, several randomized controlled trials (RCTs) have been conducted to investigate the efficacy of combining immune checkpoint inhibitors (ICIs) with chemotherapy as a first-line treatment for advanced or recurrent endometrial cancer; however, the optimal treatment strategy remains undetermined.
Methods: A comprehensive search of online databases was conducted to identify RCTs published until December 31, 2023. Network meta-analysis was performed to evaluate PFS, OS, TRAEs, irAEs, and the ranking of different treatment regimens.
Results: A total of 2702 patients from five RCTs (six reports) were included in the analysis. The combination therapy of ICIs significantly prolonged PFS (HR = 0.69, 95%CI 0.63-0.76, p < 0.0001) and OS (HR = 0.73, 95%CI 0.63-0.85, p < 0.0001) in the overall population. Among the different ICIs combinations evaluated, Durva-Olap-CP exhibited superior efficacy for both PFS and OS outcomes. In the pMMR population, both Durva-Olap-CP and Pembro-CP significantly reduced the risk of disease progression or death compared to Avelu-CP and Atezo-CP treatments; however, no significant differences were observed among various ICI combination therapies in patients with dMMR. In the dMMR population, Dostar-CP demonstrates a 42.2% probability of achieving first rank in terms of PFS, whereas in the pMMR population, Pembro-CP exhibits a 60% likelihood of securing the top position. Importantly, the toxicity associated with ICIs combination therapy was manageable and well-tolerated.
Conclusions: The combination of ICIs and chemotherapy as first-line treatment for advanced or recurrent endometrial cancer has demonstrated superior survival outcomes compared to chemotherapy alone. Durva-Olap-CP exhibited the most favorable PFS and OS benefits in the overall population. In patients with dMMR, Dostar-CP showed the greatest improvement in PFS, while Pembro-CP demonstrated the most pronounced PFS benefit in patients with pMMR.
{"title":"Efficacy and safety of immune checkpoint inhibitors for advanced or recurrent endometrial cancer: a systematic review and network meta-analysis.","authors":"Danxue Huang, Su Li, Yang Bai, Yan Wang","doi":"10.1186/s12885-024-13058-z","DOIUrl":"10.1186/s12885-024-13058-z","url":null,"abstract":"<p><strong>Background: </strong>Currently, several randomized controlled trials (RCTs) have been conducted to investigate the efficacy of combining immune checkpoint inhibitors (ICIs) with chemotherapy as a first-line treatment for advanced or recurrent endometrial cancer; however, the optimal treatment strategy remains undetermined.</p><p><strong>Methods: </strong>A comprehensive search of online databases was conducted to identify RCTs published until December 31, 2023. Network meta-analysis was performed to evaluate PFS, OS, TRAEs, irAEs, and the ranking of different treatment regimens.</p><p><strong>Results: </strong>A total of 2702 patients from five RCTs (six reports) were included in the analysis. The combination therapy of ICIs significantly prolonged PFS (HR = 0.69, 95%CI 0.63-0.76, p < 0.0001) and OS (HR = 0.73, 95%CI 0.63-0.85, p < 0.0001) in the overall population. Among the different ICIs combinations evaluated, Durva-Olap-CP exhibited superior efficacy for both PFS and OS outcomes. In the pMMR population, both Durva-Olap-CP and Pembro-CP significantly reduced the risk of disease progression or death compared to Avelu-CP and Atezo-CP treatments; however, no significant differences were observed among various ICI combination therapies in patients with dMMR. In the dMMR population, Dostar-CP demonstrates a 42.2% probability of achieving first rank in terms of PFS, whereas in the pMMR population, Pembro-CP exhibits a 60% likelihood of securing the top position. Importantly, the toxicity associated with ICIs combination therapy was manageable and well-tolerated.</p><p><strong>Conclusions: </strong>The combination of ICIs and chemotherapy as first-line treatment for advanced or recurrent endometrial cancer has demonstrated superior survival outcomes compared to chemotherapy alone. Durva-Olap-CP exhibited the most favorable PFS and OS benefits in the overall population. In patients with dMMR, Dostar-CP showed the greatest improvement in PFS, while Pembro-CP demonstrated the most pronounced PFS benefit in patients with pMMR.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457977","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}
Pub Date : 2024-10-21DOI: 10.1186/s12885-024-13049-0
Rachida Hachache, Ali Yahyaouy, Jamal Riffi, Hamid Tairi, Soukayna Abibou, Mohammed El Adoui, Mohammed Benjelloun
Purpose: Despite suffering from the same disease, each patient exhibits a distinct microbiological profile and variable reactivity to prescribed treatments. Most doctors typically use a standardized treatment approach for all patients suffering from a specific disease. Consequently, the challenge lies in the effectiveness of this standardized treatment and in adapting it to each individual patient. Personalized medicine is an emerging field in which doctors use diagnostic tests to identify the most effective medical treatments for each patient. Prognosis, disease monitoring, and treatment planning rely on manual, error-prone methods. Artificial intelligence (AI) uses predictive techniques capable of automating prognostic and monitoring processes, thus reducing the error rate associated with conventional methods.
Methods: This paper conducts an analysis of current literature, encompassing the period from January 2015 to 2023, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Results: In assessing 25 pertinent studies concerning predicting neoadjuvant treatment (NAT) response in breast cancer (BC) patients, the studies explored various imaging modalities (Magnetic Resonance Imaging, Ultrasound, etc.), evaluating results based on accuracy, sensitivity, and area under the curve. Additionally, the technologies employed, such as machine learning (ML), deep learning (DL), statistics, and hybrid models, were scrutinized. The presentation of datasets used for predicting complete pathological response (PCR) was also considered.
Conclusion: This paper seeks to unveil crucial insights into the application of AI techniques in personalized oncology, particularly in the monitoring and prediction of responses to NAT for BC patients. Finally, the authors suggest avenues for future research into AI-based monitoring systems.
目的:尽管患的是同一种疾病,但每位患者的微生物学特征各不相同,对处方治疗的反应也不尽相同。大多数医生通常对所有特定疾病患者采用标准化治疗方法。因此,这种标准化治疗方法的有效性以及如何根据每个病人的具体情况进行调整就成了难题。个性化医疗是一个新兴领域,医生通过诊断测试为每位患者确定最有效的治疗方法。预后判断、疾病监测和治疗计划都依赖于人工和容易出错的方法。人工智能(AI)使用的预测技术能够使预后和监测过程自动化,从而降低与传统方法相关的错误率:本文根据系统综述和荟萃分析的首选报告项目(PRISMA),对2015年1月至2023年期间的现有文献进行了分析:在评估25项关于预测乳腺癌(BC)患者新辅助治疗(NAT)反应的相关研究时,这些研究探讨了各种成像模式(磁共振成像、超声波等),并根据准确性、灵敏度和曲线下面积对结果进行了评估。此外,还仔细研究了所采用的技术,如机器学习(ML)、深度学习(DL)、统计学和混合模型。还考虑了用于预测完全病理反应(PCR)的数据集的展示:本文旨在揭示人工智能技术在个性化肿瘤学中应用的重要见解,尤其是在监测和预测 BC 患者对 NAT 的反应方面。最后,作者为基于人工智能的监测系统的未来研究提出了建议。
{"title":"Advancing personalized oncology: a systematic review on the integration of artificial intelligence in monitoring neoadjuvant treatment for breast cancer patients.","authors":"Rachida Hachache, Ali Yahyaouy, Jamal Riffi, Hamid Tairi, Soukayna Abibou, Mohammed El Adoui, Mohammed Benjelloun","doi":"10.1186/s12885-024-13049-0","DOIUrl":"10.1186/s12885-024-13049-0","url":null,"abstract":"<p><strong>Purpose: </strong>Despite suffering from the same disease, each patient exhibits a distinct microbiological profile and variable reactivity to prescribed treatments. Most doctors typically use a standardized treatment approach for all patients suffering from a specific disease. Consequently, the challenge lies in the effectiveness of this standardized treatment and in adapting it to each individual patient. Personalized medicine is an emerging field in which doctors use diagnostic tests to identify the most effective medical treatments for each patient. Prognosis, disease monitoring, and treatment planning rely on manual, error-prone methods. Artificial intelligence (AI) uses predictive techniques capable of automating prognostic and monitoring processes, thus reducing the error rate associated with conventional methods.</p><p><strong>Methods: </strong>This paper conducts an analysis of current literature, encompassing the period from January 2015 to 2023, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).</p><p><strong>Results: </strong>In assessing 25 pertinent studies concerning predicting neoadjuvant treatment (NAT) response in breast cancer (BC) patients, the studies explored various imaging modalities (Magnetic Resonance Imaging, Ultrasound, etc.), evaluating results based on accuracy, sensitivity, and area under the curve. Additionally, the technologies employed, such as machine learning (ML), deep learning (DL), statistics, and hybrid models, were scrutinized. The presentation of datasets used for predicting complete pathological response (PCR) was also considered.</p><p><strong>Conclusion: </strong>This paper seeks to unveil crucial insights into the application of AI techniques in personalized oncology, particularly in the monitoring and prediction of responses to NAT for BC patients. Finally, the authors suggest avenues for future research into AI-based monitoring systems.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457960","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: Docetaxel (DOC) and ramucirumab (RAM) is one of the most effective regimens for advanced non-small cell lung cancer (NSCLC) treatment. In our previous study, baseline anemia was identified as a preventive factor against the development of severe adverse effects during the first treatment cycle. It was hypothesized that anemia directly promotes tumor angiogenesis, leading to the elevation of RAM efficacy with increased DOC delivery to tumors, while reducing DOC delivery to other organs, potentially mitigating severe adverse effects. If this hypothesis is correct, patients with baseline anemia may have better clinical outcomes than those with normal hemoglobin levels. In this study, we aimed to investigate the effect of baseline anemia on the efficacy of DOC + RAM in treating advanced NSCLC in a real-word setting.
Methods: Patients with advanced NSCLC receiving DOC + RAM (n = 72) were retrospectively assessed. They were categorized into a control group with normal baseline hemoglobin levels and an anemia group with baseline anemia. The primary endpoint was progression-free survival (PFS) evaluation.
Results: Patients in the anemia group had a significantly shorter PFS than that of patients in the control group (median PFS: 3.2 and 6.2 months; 95% confidence interval [CI]: 2.2-4.8 and 4.3-9.9 months, respectively;P = 0.008). In addition, the disease control rate in the anemia group was 65.8%, which was significantly lower than that in the control group (93.6%; P = 0.007). Overall survival tended to be shorter in patients with anemia than in controls, although the difference was not statistically significant (P = 0.07). Multivariate Cox hazard analysis suggested that baseline anemia was a singular risk factor for poor PFS (adjusted hazard ratio 1.84, 95% CI 1.08-3.13; P = 0.02). The incidence of severe adverse effects did not differ between the two groups.
Conclusions: This study suggests that the PFS of patients with anemia treated with DOC + RAM for advanced NSCLC is shorter than that of those without the symptoms.
{"title":"Effect of baseline anemia on the efficacy of docetaxel and ramucirumab for advanced non-small cell lung cancer treatment.","authors":"Yoshitaka Saito, Yoh Takekuma, Jun Sakakibara-Konishi, Yasushi Shimizu, Ichiro Kinoshita, Mitsuru Sugawara","doi":"10.1186/s12885-024-13070-3","DOIUrl":"10.1186/s12885-024-13070-3","url":null,"abstract":"<p><strong>Background: </strong>Docetaxel (DOC) and ramucirumab (RAM) is one of the most effective regimens for advanced non-small cell lung cancer (NSCLC) treatment. In our previous study, baseline anemia was identified as a preventive factor against the development of severe adverse effects during the first treatment cycle. It was hypothesized that anemia directly promotes tumor angiogenesis, leading to the elevation of RAM efficacy with increased DOC delivery to tumors, while reducing DOC delivery to other organs, potentially mitigating severe adverse effects. If this hypothesis is correct, patients with baseline anemia may have better clinical outcomes than those with normal hemoglobin levels. In this study, we aimed to investigate the effect of baseline anemia on the efficacy of DOC + RAM in treating advanced NSCLC in a real-word setting.</p><p><strong>Methods: </strong>Patients with advanced NSCLC receiving DOC + RAM (n = 72) were retrospectively assessed. They were categorized into a control group with normal baseline hemoglobin levels and an anemia group with baseline anemia. The primary endpoint was progression-free survival (PFS) evaluation.</p><p><strong>Results: </strong>Patients in the anemia group had a significantly shorter PFS than that of patients in the control group (median PFS: 3.2 and 6.2 months; 95% confidence interval [CI]: 2.2-4.8 and 4.3-9.9 months, respectively;P = 0.008). In addition, the disease control rate in the anemia group was 65.8%, which was significantly lower than that in the control group (93.6%; P = 0.007). Overall survival tended to be shorter in patients with anemia than in controls, although the difference was not statistically significant (P = 0.07). Multivariate Cox hazard analysis suggested that baseline anemia was a singular risk factor for poor PFS (adjusted hazard ratio 1.84, 95% CI 1.08-3.13; P = 0.02). The incidence of severe adverse effects did not differ between the two groups.</p><p><strong>Conclusions: </strong>This study suggests that the PFS of patients with anemia treated with DOC + RAM for advanced NSCLC is shorter than that of those without the symptoms.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457976","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: Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality.
Objective: The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024.
Method: This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables.
Result: The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012-4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562-6.650), history of STD (OR = 2.59, 95% CI: 1.694-4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312-5.316), high perceived severity (OR = 2.603, 95% CI: 2.203-3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331-8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102-5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851-5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619-5.375).
Conclusion: Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.
{"title":"Applying the Health Belief Model to cervical cancer screening uptake among women in Ethiopia: a systematic review and meta-analysis.","authors":"Amlaku Nigusie Yirsaw, Mitiku Tefera, Eyob Ketema Bogale, Tadele Fentabel Anagaw, Misganaw Guadie Tiruneh, Eneyew Talie Fenta, Destaw Endeshaw, Ousman Adal, Abiyu Abadi Tareke, Lijalem Jemberu, Eyob Getachew, Asnake Gashaw Belayneh, Getnet Alemu Andarge, Kedir Seid, Gebeyehu Lakew","doi":"10.1186/s12885-024-13055-2","DOIUrl":"10.1186/s12885-024-13055-2","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality.</p><p><strong>Objective: </strong>The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024.</p><p><strong>Method: </strong>This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as \"Cervical cancer screening\", \"uptake\", \"utilization\", \"factors\", \"barriers\", and \"Ethiopia\" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables.</p><p><strong>Result: </strong>The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012-4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562-6.650), history of STD (OR = 2.59, 95% CI: 1.694-4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312-5.316), high perceived severity (OR = 2.603, 95% CI: 2.203-3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331-8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102-5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851-5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619-5.375).</p><p><strong>Conclusion: </strong>Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457961","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: Exploration of novel combination mode of pyrotinib and chemotherapy for heavily pretreated HER2-positive metastatic breast cancer (MBC) and how to balance survival benefits and compliance are still urgent problems in clinical practice. The current single-arm prospective phase II study aimed to evaluate the efficacy and safety of pyrotinib in combination with metronomic oral etoposide in heavily pretreated HER2-positive MBC.
Methods: HER2-positive MBC patients previously treated with trastuzumab were enrolled to receive oral pyrotinib 400 mg per day and metronomic oral etoposide 50 mg per day d1-21 every 28 days, until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), clinical benefit rate (CBR), overall survival (OS), and safety.
Results: 22 patients were enrolled with a median of 4 prior treatment regimens for MBC. During the follow-up of 20 evaluable patients, the median PFS was 9.0 months (95% CI, 7.6-10.4 months), and the median OS was 27.0 months (95%CI, 20.9-33.1 months). The ORR was 30% (6/20), the DCR was 80% (16/20), and the CBR was 65% (13/20). The most common grade 3 adverse events (AEs) included nausea (15%), vomiting (15%), diarrhea (5%), anemia (5%), and peripheral neuropathy (5%). No grade 4 or lethal AEs were observed.
Conclusion: The combination of pyrotinib with metronomic oral etoposide has achieved promising clinical benefits in heavily pretreated HER2-positive MBC, with acceptable and manageable toxicity.
Trial registration: Registry number: NCT03923179. Registered April 18, 2019.
{"title":"Pyrotinib combined with metronomic etoposide in heavily pretreated HER2-positive metastatic breast cancer: a single-arm, phase II study.","authors":"Jiaxuan Liu, Maiyue He, Mingxia Jiang, Shihan Zhou, Mengqi Zhang, Yiqun Li, Shanshan Chen, Ruigang Cai, Hongnan Mo, Bo Lan, Fei Ma, Binghe Xu, Qiao Li","doi":"10.1186/s12885-024-13041-8","DOIUrl":"https://doi.org/10.1186/s12885-024-13041-8","url":null,"abstract":"<p><strong>Background: </strong>Exploration of novel combination mode of pyrotinib and chemotherapy for heavily pretreated HER2-positive metastatic breast cancer (MBC) and how to balance survival benefits and compliance are still urgent problems in clinical practice. The current single-arm prospective phase II study aimed to evaluate the efficacy and safety of pyrotinib in combination with metronomic oral etoposide in heavily pretreated HER2-positive MBC.</p><p><strong>Methods: </strong>HER2-positive MBC patients previously treated with trastuzumab were enrolled to receive oral pyrotinib 400 mg per day and metronomic oral etoposide 50 mg per day d1-21 every 28 days, until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), clinical benefit rate (CBR), overall survival (OS), and safety.</p><p><strong>Results: </strong>22 patients were enrolled with a median of 4 prior treatment regimens for MBC. During the follow-up of 20 evaluable patients, the median PFS was 9.0 months (95% CI, 7.6-10.4 months), and the median OS was 27.0 months (95%CI, 20.9-33.1 months). The ORR was 30% (6/20), the DCR was 80% (16/20), and the CBR was 65% (13/20). The most common grade 3 adverse events (AEs) included nausea (15%), vomiting (15%), diarrhea (5%), anemia (5%), and peripheral neuropathy (5%). No grade 4 or lethal AEs were observed.</p><p><strong>Conclusion: </strong>The combination of pyrotinib with metronomic oral etoposide has achieved promising clinical benefits in heavily pretreated HER2-positive MBC, with acceptable and manageable toxicity.</p><p><strong>Trial registration: </strong>Registry number: NCT03923179. Registered April 18, 2019.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457989","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: Gastric cancer is a significant global malignancy with poor prognosis. Although the emergence of immune checkpoint inhibitors (ICIs) prolonged the duration of survival, resistance and progression are inevitable. We aim to evaluate the effectiveness of programmed death-1 (PD-1) inhibitors in immunotherapy beyond progression (IBP).
Method: We divided the advanced gastric cancer patients who received two lines immunotherapy into same regimen group (with same PD-1 inhibitor regime after IBP) and different regimen group (with different PD-1 inhibitor regime after IBP). Statistical analysis conducted to compare patient characteristics and evaluate survival differences between groups.
Result: The clinical outcome analysis showed that the same PD-1 inhibitor regime seemed to exhibit a higher disease control rate (DCR) (51.8% vs. 29.2%, P = 0.062), significantly prolonged progression-free survival 2 (PFS2) (162 vs. 75 days, P = 0.001) and overall survival (OS) (312 vs. 166 days, P = 0.022) when compared with those of cross line. In the multivariate analysis, when using different regimen group as reference, the same regimen group was found to be independently associated with improved PFS2 [hazard ratio (HR) = 0.467, 95% confidence interval (CI): 0.267-0.816, P = 0.008] and OS (HR = 0.508, 95%CI: 0.278-0.927, P = 0.027).
Conclusion: Continuation of the same type of PD-1 inhibitor regime in IBP shows clinical benefits and represents a promising therapeutic approach.
背景:胃癌是一种严重的全球性恶性肿瘤,预后较差。虽然免疫检查点抑制剂(ICIs)的出现延长了患者的生存期,但耐药和进展是不可避免的。我们旨在评估程序性死亡-1(PD-1)抑制剂在进展期后免疫治疗(IBP)中的有效性:方法:我们将接受两线免疫治疗的晚期胃癌患者分为相同方案组(IBP后使用相同的PD-1抑制剂方案)和不同方案组(IBP后使用不同的PD-1抑制剂方案)。统计分析比较了患者特征,并评估了组间生存率差异:临床结果分析表明,与交叉方案相比,相同的PD-1抑制剂方案似乎表现出更高的疾病控制率(DCR)(51.8% vs. 29.2%,P = 0.062),显著延长无进展生存期2(PFS2)(162天 vs. 75天,P = 0.001)和总生存期(OS)(312天 vs. 166天,P = 0.022)。在多变量分析中,以不同方案组为参照,发现相同方案组与PFS2[危险比(HR)=0.467,95%置信区间(CI):0.267-0.816,P=0.008]和OS(HR=0.508,95%CI:0.278-0.927,P=0.027)的改善独立相关:结论:IBP患者继续使用同一种PD-1抑制剂可获得临床疗效,是一种很有前景的治疗方法。
{"title":"Continuation of same programmed death-1 inhibitor regime beyond progression is a novel option for advanced gastric cancer.","authors":"Jiasong Li, Fang Ding, Shasha Zhang, Yuanyuan Jia, Tianhang Zhang, Siqi Wang, Qingyi Liu, Zhanjun Guo","doi":"10.1186/s12885-024-13063-2","DOIUrl":"10.1186/s12885-024-13063-2","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is a significant global malignancy with poor prognosis. Although the emergence of immune checkpoint inhibitors (ICIs) prolonged the duration of survival, resistance and progression are inevitable. We aim to evaluate the effectiveness of programmed death-1 (PD-1) inhibitors in immunotherapy beyond progression (IBP).</p><p><strong>Method: </strong>We divided the advanced gastric cancer patients who received two lines immunotherapy into same regimen group (with same PD-1 inhibitor regime after IBP) and different regimen group (with different PD-1 inhibitor regime after IBP). Statistical analysis conducted to compare patient characteristics and evaluate survival differences between groups.</p><p><strong>Result: </strong>The clinical outcome analysis showed that the same PD-1 inhibitor regime seemed to exhibit a higher disease control rate (DCR) (51.8% vs. 29.2%, P = 0.062), significantly prolonged progression-free survival 2 (PFS2) (162 vs. 75 days, P = 0.001) and overall survival (OS) (312 vs. 166 days, P = 0.022) when compared with those of cross line. In the multivariate analysis, when using different regimen group as reference, the same regimen group was found to be independently associated with improved PFS2 [hazard ratio (HR) = 0.467, 95% confidence interval (CI): 0.267-0.816, P = 0.008] and OS (HR = 0.508, 95%CI: 0.278-0.927, P = 0.027).</p><p><strong>Conclusion: </strong>Continuation of the same type of PD-1 inhibitor regime in IBP shows clinical benefits and represents a promising therapeutic approach.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457972","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}
Pub Date : 2024-10-18DOI: 10.1186/s12885-024-13052-5
Manlu Cui, Juan Fu, Qiuyun Li
Background: Neoadjuvant targeted therapy has shown that improve pathologic complete response and facilitate breast-conserving surgery, but the difference between single-agent treatment or dual-HER2 blockade to the conversion of breast-conserving surgery has not been well described.
Methods: Via the systematic literature search of PubMed, Web of Science and Cochrane Library databases, 5 eligible studies used to perform this meta-analysis, which was carried out using RevMan version 5.4.
Results: A total of 1306 patients from five randomized controlled trials were included in the analysis, revealing a significant increase in the conversion rate to breast-conserving surgery with neoadjuvant targeted therapy (OR 0.30, 95% CI 0.15-0.57; p = 0.0003). The odds ratio (OR) for single-agent treatment compared to dual-HER2 blockade was 1.04 (95% CI 0.73-1.48; p = 0.82). For pathological complete response (pCR), the OR for single-HER2 blockade versus dual-HER2 blockade was 0.43 (95% CI 0.34-0.55; p = 0.01), and for clinical response, it was 0.81 (95% CI 0.59-1.10; p = 0.17). The OR for serious adverse events between single-HER2 and dual-HER2 blockade was 0.72 (95% CI 0.55-0.95; p = 0.02). The risk ratio (RR) for pCR and the shift from mastectomy to BCS was 1.16 (95% CI 0.78-1.72; p = 0.47), while for clinical response and the shift from mastectomy to BCS, it was 2.40 (95% CI 1.44-4.01; p = 0.0008).
Conclusion: Neoadjuvant targeted treatment obviously promote the actual implementation rate of breast-conserving surgery, nevertheless, there was no statistically significant increase in single-agent treatment versus dual-HER2 blockade.
背景:新辅助靶向治疗可改善病理完全反应并促进保乳手术,但单药治疗或双HER2阻断对保乳手术转换的影响尚未得到很好的描述:方法:通过对PubMed、Web of Science和Cochrane Library数据库进行系统文献检索,采用RevMan 5.4版对5项符合条件的研究进行荟萃分析:结果表明,新辅助靶向治疗可显著提高保乳手术的转化率(OR 0.30,95% CI 0.15-0.57;P = 0.0003)。与双HER2阻断相比,单药治疗的几率比(OR)为1.04(95% CI 0.73-1.48;P = 0.82)。就病理完全反应(pCR)而言,单HER2阻断与双HER2阻断的OR值为0.43(95% CI 0.34-0.55;p = 0.01),就临床反应而言,OR值为0.81(95% CI 0.59-1.10;p = 0.17)。单HER2和双HER2阻断疗法发生严重不良事件的OR为0.72(95% CI 0.55-0.95;P = 0.02)。pCR和从乳房切除术转为BCS的风险比(RR)为1.16 (95% CI 0.78-1.72; p = 0.47),而临床反应和从乳房切除术转为BCS的风险比(RR)为2.40 (95% CI 1.44-4.01; p = 0.0008):结论:新辅助靶向治疗明显提高了保乳手术的实际实施率,然而,单药治疗与双HER2阻断相比,并没有统计学意义上的显著提高。
{"title":"Comparison of neoadjuvant single-agent treatment and dual-HER2 blockade for breast-conserving surgery conversion in HER2-positive breast cancer: a meta-analysis.","authors":"Manlu Cui, Juan Fu, Qiuyun Li","doi":"10.1186/s12885-024-13052-5","DOIUrl":"10.1186/s12885-024-13052-5","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant targeted therapy has shown that improve pathologic complete response and facilitate breast-conserving surgery, but the difference between single-agent treatment or dual-HER2 blockade to the conversion of breast-conserving surgery has not been well described.</p><p><strong>Methods: </strong>Via the systematic literature search of PubMed, Web of Science and Cochrane Library databases, 5 eligible studies used to perform this meta-analysis, which was carried out using RevMan version 5.4.</p><p><strong>Results: </strong>A total of 1306 patients from five randomized controlled trials were included in the analysis, revealing a significant increase in the conversion rate to breast-conserving surgery with neoadjuvant targeted therapy (OR 0.30, 95% CI 0.15-0.57; p = 0.0003). The odds ratio (OR) for single-agent treatment compared to dual-HER2 blockade was 1.04 (95% CI 0.73-1.48; p = 0.82). For pathological complete response (pCR), the OR for single-HER2 blockade versus dual-HER2 blockade was 0.43 (95% CI 0.34-0.55; p = 0.01), and for clinical response, it was 0.81 (95% CI 0.59-1.10; p = 0.17). The OR for serious adverse events between single-HER2 and dual-HER2 blockade was 0.72 (95% CI 0.55-0.95; p = 0.02). The risk ratio (RR) for pCR and the shift from mastectomy to BCS was 1.16 (95% CI 0.78-1.72; p = 0.47), while for clinical response and the shift from mastectomy to BCS, it was 2.40 (95% CI 1.44-4.01; p = 0.0008).</p><p><strong>Conclusion: </strong>Neoadjuvant targeted treatment obviously promote the actual implementation rate of breast-conserving surgery, nevertheless, there was no statistically significant increase in single-agent treatment versus dual-HER2 blockade.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457966","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: We developed a Rare Cell Sorter (RCS) for collecting single cell including circulating tumor cells (CTCs). This single-institution pilot study evaluated the ability of this device to detect tumor-like cells in patients with lung cancer and confirmed their genuineness based on the epidermal growth factor receptor (EGFR) mutation concordance with tissue samples.
Methods: This study included patients treated for lung cancer from September 2021 to August 2022 in University of Tsukuba Hospital. Peripheral blood samples were obtained before surgery or during periodic medical checks for patients treated with drugs. We used the RCS to capture cells based on size. The cells were stained, and the Hoechst-positive, CD45-negative, and epithelial celladhesion molecule (EpCAM)- positive cells were defined as CTCs, were collected. The presumptive CTCs were counted and tested using digital droplet polymerase chain reaction for EGFR mutations and compared with the tissue EGFR status to check concordance.
Results: Eighteen patients were included in this study and CTCs were detected in 6 patients (33%). The CTCs from three patients showed EGFR mutation, and the EGFR mutation status of CTCs concorded with that of tissue samples in 83% of the cases (5/6). Only one CTC showed a different status from the tissue, and the concordance rate of EGFR status between CTCs and the tissue was 96% (24/25).
Conclusion: The ability of the RCS to detect CTCs in patients with lung cancer was demonstrated based on the concordance of EGFR status in this pilot study. This novel hybrid method of CTC recovery using the RCS has the potential to recover a wide range of CTCs regardless of EpCAM. Further validation through a large-scale study is needed.
{"title":"Detection of circulating tumor cells in patients with lung cancer using a rare cell sorter: a pilot study.","authors":"Kazuto Sugai, Tomoko Mori, Turan Bilal, Atsuko Furukawa, Yasuharu Sekine, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Hideo Ichimura, Taisuke Masuda, Fumihito Arai, Yukio Sato, Satoshi Matsusaka","doi":"10.1186/s12885-024-12945-9","DOIUrl":"https://doi.org/10.1186/s12885-024-12945-9","url":null,"abstract":"<p><strong>Background: </strong>We developed a Rare Cell Sorter (RCS) for collecting single cell including circulating tumor cells (CTCs). This single-institution pilot study evaluated the ability of this device to detect tumor-like cells in patients with lung cancer and confirmed their genuineness based on the epidermal growth factor receptor (EGFR) mutation concordance with tissue samples.</p><p><strong>Methods: </strong>This study included patients treated for lung cancer from September 2021 to August 2022 in University of Tsukuba Hospital. Peripheral blood samples were obtained before surgery or during periodic medical checks for patients treated with drugs. We used the RCS to capture cells based on size. The cells were stained, and the Hoechst-positive, CD45-negative, and epithelial celladhesion molecule (EpCAM)- positive cells were defined as CTCs, were collected. The presumptive CTCs were counted and tested using digital droplet polymerase chain reaction for EGFR mutations and compared with the tissue EGFR status to check concordance.</p><p><strong>Results: </strong>Eighteen patients were included in this study and CTCs were detected in 6 patients (33%). The CTCs from three patients showed EGFR mutation, and the EGFR mutation status of CTCs concorded with that of tissue samples in 83% of the cases (5/6). Only one CTC showed a different status from the tissue, and the concordance rate of EGFR status between CTCs and the tissue was 96% (24/25).</p><p><strong>Conclusion: </strong>The ability of the RCS to detect CTCs in patients with lung cancer was demonstrated based on the concordance of EGFR status in this pilot study. This novel hybrid method of CTC recovery using the RCS has the potential to recover a wide range of CTCs regardless of EpCAM. Further validation through a large-scale study is needed.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457973","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}