Cancer Investigation最新文献

Objective: The aim of this study is to assess the predictive and prognostic value of p16 in recurrent/metastatic HNSCC patients treated with molecular targeted agents (MTAs) or immune checkpoint inhibitors (ICIs).

Study design: The TRIUMPH trial (NCT03292250) was a multi-arm phase II umbrella trial using next-generation sequencing for patients with HNSCC. Patients were assigned to specific treatment arms including PIK3CA, EGFR/HER2, FGFR, CDK4/6 inhibitors, and ICI based on their genomic profiles. We performed post hoc analysis using 86 patients who had available p16 immunohistochemistry results. ORR, PFS, and OS were analyzed by p16 positivity.

Results: The p16 positivity rate was 33.7%. ORR was 20.7% for p16 (+) compared to 8.8% for p16 (-) patients (P = 0.072). Median PFS was 3.8 months for p16 (+) and 1.8 months for p16 (-) (P = 0.030). Median OS was 12.9 months for p16 (+) and 6.2 months for p16 (-) (P = 0.100).

Conclusion: Patients with p16 (+) showed longer PFS and OS compared to p16 (-) patients. This suggests that p16 has prognostic and predictive values in HNSCC patients who are treated with MTAs or ICIs.

Luminal B (HER2-) breast cancer is defined as ER- or PR-positive and HER2-negative meeting with PR ≤ 20%, or ER- or PR-positive and HER2-negative with high Ki-67 index, which has worse prognoses. The locally specified Ki-67 cutoff value has remained elusive in China. 4940 patients with ER- or PR-positive and HER2-negative operable breast cancer were recruited. The novel findings was that luminal B (HER2-) tumors showed poor DFS regardless of Ki-67 cutoff values (14, 20 or 30%), and luminal B (HER2-) subtype(PR ≤ 20% and high Ki-67 index) tumors showed inferior OS, DMFS, and BCSS. With Ki-67 cutoff value of 20%, it was optimized to distinguish prognostic differences.

Many Americans, especially emergency department (ED) patients, are not up to date with routine cancer screenings. This multi-center retrospective study assessed adherence to U.S. Preventive services task force guidelines for breast, colorectal, and lung cancer screenings among 198,210 patients across 11 Indiana EDs. Results showed 33.0% were screened for colorectal cancer, 55.4% of eligible females for breast cancer, and only 3.1% of eligible patients for lung cancer. These findings highlight persistently low screening rates in ED populations. Targeted interventions are needed to improve adherence and reduce disparities in cancer prevention among high-risk groups.

Immune checkpoint inhibitors (ICIs) are a novel and promising anti-cancer therapy. We conducted this systematic review to precisely quantify the occurrence and development for actue kidney injury(AKI) following ICIs treatment for cancer. We conducted a search of the PubMed, Embase, Web of Science, and Cochrane Library databases. Twenty-nine studies, comprising 24,953 cancer patients who received ICIs were finally eligible. The incidence of AKI was 16.2% (95%CI:12.8%-19.8%); the incidence of immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) was 3.1%(95%CI:2.4%-4%); the incidence of non-ICPi-AKI was 11.2%(95%CI:8.4%-14.3%), and the incidence of sustained AKI was 14.9%(95%CI:7.5%-24.3%). Patients who developed AKI (HR = 1.521(95%CI:1.208-1.916)) and ICPi-AKI (HR = 1.407(95%CI:1.059-1.869)) exhibited an elevated risk of all-cause mortality. An increased risk for AKI was observed with preexisting chronic kidney disease (CKD) and combined with other extrarenal immune-related adverse events (irAEs). The use of nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitor (PPI), diuretic, renin-angiotensin-aldosterone system (RAASi), antibiotics and fluidone was also significantly associated with incident AKI. Combined therapy had a greater impact on renal injury compared to monotherapy. Patients using ipilimumab were more prone to developing AKI, compared to those using nivoluma. CTLA4 (ref'PD-1) was associated with a higher likelihood of sustained AKI. The use of PDL-1(ref='PD-1) was linked to an increased susceptibility to ICPi-AKI. The occurrence of AKI was intricately linked to specific complications, the concomitant use of certain medications, and the specific regimen of ICIs. This deserves our attention.

The goal of this study was to look at the long-term survival outcomes and clinical characteristics of stage II/III locally advanced rectal cancer (LARC) patients who acquired pathological complete response (pCR) following neoadjuvant chemoradiotherapy (NCRT). The clinicopathological characteristics and treatment details of 277 LARC patients with pCR, relapse-free survival (RFS), overall survival (OS), and locoregional and systemic recurrence rates, were assessed. The 5-year RFS and OS rates were 85.6% and 90.9%. The rates of local and systemic recurrence were 3.6% and 7.9%. Our study confirmed the favorable results in survival in patients with LARC who achieved pCR.

Background: Suboptimal adherence to chemotherapy regimens remains a significant challenge in cancer management, adversely impacting treatment outcomes and quality of life. This study aimed to develop and evaluate a user-centric mobile app intervention to promote adherence and enhance quality of life among cancer patients undergoing chemotherapy.

Methodology: A quasi-experimental trial was conducted with 60 cancer patients undergoing chemotherapy, randomly assigned to an experimental group (n = 30) using the mobile app or a control group (n = 30) receiving standard care. Medication adherence was assessed using the Medication Adherence Measure Scale (MAMS), and quality of life was evaluated using the EORTC QLQ-C30 questionnaire at baseline and after one month of intervention.

Results: At baseline, no significant differences between the groups were observed in adherence levels or quality of life measures. However, after one month, the experimental group demonstrated a significant improvement in medication adherence (mean MAMS score increase from 3.03 to 4.88, p = 0.012) and better scores in physical, role, emotional, and cognitive functioning domains compared to the control group (p < 0.05).

Conclusion: The user-centric mobile app intervention showed potential efficacy in improving adherence to chemotherapy regimens and enhancing the specific quality of life domains among cancer patients.

Background: To describe family involvement in decision making for treatment in China.

Methods: A cross-sectional study was conducted with women diagnosed with breast cancer and their nominated family members.

Results: A total of 180 patients and their designated 180 family members participated. Most participants (>90%) thought that family should be involved in cancer TDM. Family members who were most engaged in TDM were more likely to be young, children of the patient, employed and first-degree relatives. The characteristics of breast cancer patients whose families made treatment decisions were as follows: the patient was older, the TNM stage was IV, and the level of education was relatively low. Most respondents stated that family involvement was helpful and did not hamper patient autonomy or complicate the cancer TDM process.

Conclusions: Patients and family caregivers expect and value family involvement in cancer TDM. Several factors influence the TDM process, including age, education level and cancer stage.

Practice: The TDM process heavily involves family members. This should be taken into consideration by medical staff during counseling to identify the best treatment.

Introduction: Breast Cancer (BC) is a leading cancer among women, influenced by genetic polymorphisms. This meta-analysis examines CYP2C19 (rs4244285) and ESR1 (rs2234693) polymorphisms and BC susceptibility.

Methodology: A PRISMA-guided search analyzed genotypic and allelic frequencies across six CYP2C19 and nine ESR1 studies, with quality assessed by the Newcastle-Ottawa Scale and Hardy-Weinberg Equilibrium, spanning diverse ethnic groups.

Results: Most models found no significant associations for CYP2C19 or ESR1. The GG genotype of CYP2C19 (rs4244285) showed a potential protective effect against BC.

Conclusion: Genetic variability impacts BC risk. CYP2C19 (rs4244285) may offer protective effects. Further research is needed for personalized treatments.

To prolong patients' survival has become a major topic in cancer research field. Albumin (Alb) to fibrinogen (Fib) ratio(AFR) or its reciprocal FAR, Fib to pre-albumin(PA) ratio(FPR) or its reciprocal PFR have been found significantly associated with survival of cancer patients and can be used as prognosis predictors for human cancers. Here, we summarized the emerging knowledge regarding the roles of AFR, FAR, FPR and/or PFR played in predicting prognosis for digestive system cancers.

To screen predictors of prognosis in NMIBC patients treated with RC and construct a predictive model that accurately assesses their overall survival (OS). 1129 patients screened from the SEER database were randomized in a 7:3 ratio into a training group (790) and a validation group (339). Univariate and multivariate Cox regression analyses screened for prognostic factors, the best predictive model was determined by AIC minimum, and variables were examined for multicollinearity. Based on the total score obtained from the column line graph and the X-Tile procedure to find the best cutoff point and create a risk classification system. Finally, the model was evaluated and validated by C-index, AUC, drawing calibration curves (1000 bootstrap resamples), and Decision curve analysis (DCA). In the training group, the C-index was 0.67, and the ROC curves showed AUCs of 0.655, 0.704, and 0.722 for 1-, 5-, and 10-year OS, respectively; in the validation group, the AUCs were 0.738, 0.694, and 0.705, respectively. Meanwhile, the predictive performance of the present model was superior to that of the TNM staging, pLNR, and N staging, which can be used as a basis for patient counseling, follow-up scheduling, and treatment choice The model can provide a basis for patient counseling, follow-up scheduling and treatment selection.