Cancer pathogenesis and therapy最新文献

Background

On average, 5–10% of patients are diagnosed with metastatic breast cancer (MBC) at the initial diagnosis. This study aimed to develop a nomogram to predict the overall survival (OS) in these patients.

Methods

The nomogram was based on a retrospective study of 9435 patients with de novo MBC from the Surveillance, Epidemiology, and End Results (SEER) database. The predictive accuracy and discriminative ability of the nomogram were determined using the concordance index (C-index), area under the time-dependent receiver operating characteristic curve (AUC), and calibration curve. Decision curve analysis (DCA) was employed to evaluate the benefits and advantages of our new predicting model over the 8th edition of the American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) staging system. The results were validated in a retrospective study of 103 patients with de novo MBC from January 2013 to June 2022 at an institution in northwest China.

Results

Multivariate analysis of the primary cohort revealed that independent factors for survival were age at diagnosis, pathological type, histological grade, T stage, N stage, molecular subtype, bone metastasis, brain metastasis, liver metastasis, lung metastasis, surgery, chemotherapy, and radiotherapy. The nomogram achieved a C-index of 0.688 (95% confidence interval [CI], 0.682–0.694) in the training cohort and 0.875 (95% CI, 0.816–0.934) in the validation cohort. The AUC of the nomograms indicated good specificity and sensitivity in the training and validation cohorts, respectively. Calibration curves showed favorable consistency between the predicted and actual survival probabilities. Additionally, the DCA curve produced higher net gains than by the AJCC-TNM staging system. Finally, risk stratification can accurately identify groups of patients with de novo MBC at different risk levels.

Conclusions

The nomogram showed favorable predictive and discriminative abilities for OS in patients with de novo MBC. Other populations from different countries or prospective studies are needed to further validate the nomogram.

Tumor lysis syndrome (TLS) remains a debilitating cause of hospitalization and death in patients with cancer and is a significant challenge for healthcare providers despite advancements in its management. This umbrella review analyzed the results of meta-analyses on the use of rasburicase in the treatment of patients with cancer. A literature search was performed of five databases (PubMed, Google Scholar, Cochrane Library, Scopus, Global Index Medicus, and ScienceDirect) for articles with full texts available online. A measurement tool to assess systematic reviews 2 (AMSTAR 2) was used to assess the quality of the included studies, and Review Manager software was used to conduct all statistical analyses. The systematic search identified eight relevant meta-analyses, with primary analyses including outcome data that analyzed mortality, renal failure, and comparisons with allopurinol. The pooled data showed that rasburicase effectively reduced TLS development and serum uric acid levels in children and adults with malignancies. Most outcomes did not differ significantly compared with those of allopurinol. Future trials should focus on the cost-effectiveness of rasburicase compared to that of allopurinol while including high-, intermediate-, and low-risk patients. Rasburicase is safe and effective for managing patients with TLS. However, recent large-scale meta-analyses have reported conflicting results. Most meta-analyses were graded as low to critically low as per AMSTAR 2. The analysis revealed that the benefit of rasburicase did not differ significantly from that of allopurinol, which has higher cost-effectiveness and fewer side effects.

Background

Shan Zha (Hawthorn or Crataegus) is a traditional Chinese medicine (TCM) most commonly used for the treatment of hyperlipidemia. Gastrointestinal cancer is closely correlated with blood lipid levels. This study illustrates the potential anticancer effects of Shan Zha on gastrointestinal tumors based on network pharmacology and molecular docking.

Methods

Hawthorn's bioactive ingredients and drug targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine version 2.0 (TCMIP v2.0), and Herbal Ingredients' Targets Platform (HIT 2.0) databases. Validated disease targets of gastrointestinal cancer were obtained from the Therapeutic Targets Database (TTD) and HIT 2.0 databases. Protein–protein interaction analysis of intersecting genes was performed using the Search Tool for the Retrieval of Interacting Genes (STRING) database. The functions of these genes were further analyzed by performing gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Molecular docking verification was performed using Molecular Operating Environment (MOE) software.

Results

Four main bioactive components were identified in Shan Zha. A total of 271 potential drug targets were identified, and 393 gastrointestinal-tumor targets were obtained. Through protein interaction analysis of intersecting targets, the main components of Shan Zha were found to interact more closely with proteins such as tumor protein p53 (TP53), AKT serine/threonine kinase 1 (AKT1), JUN proto-oncogene (JUN), interleukin 6 (IL6), epidermal growth factor receptor (EGFR), and vascular endothelial growth factor A (VEGFA). KEGG pathway enrichment analysis showed a total of 127 pathways, mainly involving pathways in multiple types of cancer, the Phosphatidylinositol 3-kinase-Akt (PI3K-Akt) signaling pathway, and EGFR tyrosine kinase inhibitor resistance. Combined with The Cancer Genome Atlas (TCGA) differential analysis, key targets, including TP53, cyclin D1 (CCND1), EGFR, and VEGFA, were screened. Molecular docking results showed that quercetin and kaempferol had the good binding potential for TP53, CCND1, EGFR, and VEGFA.

Conclusion

These findings suggest that Shan Zha exerts its effects on gastrointestinal cancers through a multitarget, multi-component, and a multi-pathway mechanism.

Metastatic pheochromocytoma/paraganglioma (MPP) is a rare endocrine tumor that originates from extra-adrenal chromaffin cells such as the paraganglia cells of sympathetic and parasympathetic nerves. It usually causes multiple solid tumors and exhibits strong aggressiveness with poor prognosis, with a reported 5-year survival rate of less than 50%. Cases of brain and retroperitoneal metastases at the initial diagnosis have not yet been reported. We report a 41-year-old male patient initially diagnosed with MPP in the brain and retroperitoneum who underwent multi-disciplinary collaborative surgery and simultaneous removal of two tumors at our center. Postoperative pathology revealed infiltrative growth of a skull base tumor. The patient chose to receive the tyrosine kinase inhibitor sunitinib as a targeted treatment. A 3-month follow-up after surgery showed that the patient recovered well without signs of metastasis or recurrence. We present multi-disciplinary surgery under similar circumstances for enhanced treatment and postoperative management. The patient demonstrates a favorable prognosis during postoperative follow-up, indicating that simultaneous multidisciplinary surgery may offer greater benefits for MPP patients.

In recent years, there has been continuous improvement in the treatment and diagnosis of cancer, which has led to a significant improvement in the survival rate of cancer patients. Treatments that include chemotherapy, radiotherapy, surgery, or combined therapy have several side effects that may lead to premature ovarian insufficiency in females or substantial male germ cell loss. Reproductive biologists recommend that all patients who are diagnosed with a malignant tumor must undergo a consultation for fertility protection and preservation. In this review, we discuss the background knowledge, methods, and options for fertility preservation and how these new strategies help oncologists, surgeons, pediatricians, and hematologists, conserve fertility and be aware of the concepts, methods, and importance of fertility guards. This review may aid in the advancement of novel personalized methods for fertility preservation according to patients’ conditions.