Cancer Investigation最新文献

Background: Human immunodeficiency virus is associated with the development of various aggressive non-Hodgkin B-cell lymphomas (NHL). Despite this, people living with HIV (PLWH) are often excluded from clinical trials. Here we analyze the change in clinical trial exclusion among PLWH resulting from multilateral advocacy efforts since 2017.

Methods: We identified all US-based clinical trials with the keyword "lymphoma" with start dates between January 01, 2014 and January 04, 2025 using the publicly available NIH Clinical Trial Database (https://www.clinicaltrials.gov/). All studies with aggressive B-cell NHL subtypes were included. Regression models were performed to analyze descriptive factors.

Results: 1,973 US-based clinical trials were captured, of which 945 met criteria for further analysis. PLWH were excluded from 59% pre-2018 versus 48% post-2018. After multivariate adjustment, NIH-funded trials (24% exclusion rate, p < 0.001), other funders (64% exclusion rate), and studies initiated post-2018 (48% exclusion rate, p < 0.001) were associated with inclusion, while CAR-T-related studies (62% exclusion rate, p < 0.05) were associated with exclusion.

Conclusions: Likely partly due to advocacy from ASCO, NCI, and NCCN, there was a significant decrease in exclusion among PLWH in US-based NHL clinical trials. Future research should analyze the safety and efficacy of immunotherapy in PLWH to foster inclusion and reduce stigma among physicians and researchers.

Although breast, cervical, endometrial, and ovarian cancers account for more than 43% of new cases in 2023 in Brazilian women, no national studies were found on the incidence, risk factors, and prevention of breast and gynecological neoplasms in lesbian women, causing the health needs of non-heterosexual women to go unnoticed by professionals. This study aims to identify and analyze the search for healthcare related to the prevention of breast/gynecological cancer among Brazilian lesbian cisgender women who have not had the disease. Seven lesbian women participated in this qualitative study. Semi-structured interviews were conducted and subsequently transcribed and analyzed following the reflexive thematic analysis approach and the theoretical framework of gender studies. Two thematic axes were constructed: gynecological appointments, which includes the subthemes follow-ups, types of exams, and struggles with the healthcare system, and meeting health professionals, which includes relationships with professionals, searching for professionals, discussing sexual orientation, and (un)preparedness. The participants in this study reported visiting a gynecologist at least once and doing preventive exams, although the frequency of these appointments varied for each woman. However, they highlighted that healthcare providers are not adequately prepared to address the needs of lesbian women and to talk about sexual orientation.

Accurate and timely diagnosis of t(9;22)-positive leukemias is vital to improving survival in pediatric patients. In low-resource settings, where healthcare disparities are exacerbated by limited resources, cost-effective and efficient diagnostic methods are essential for bridging these gaps and ensuring better outcomes. Among the diagnostic tools evaluated among 23 patients sample, RT-PCR demonstrated superior sensitivity (100%) and the shortest turnaround time (7 days), significantly outperforming FISH and karyotyping in both accuracy and timeliness. This capability of RT-PCR to provide reliable and rapid results enables earlier treatment initiation, which is critical in managing these aggressive leukemias. Simplified statistical reporting underscores RT-PCR's unmatched sensitivity, while FISH and karyotyping, though useful, showed moderate performance with longer delays. By adopting RT-PCR as the primary diagnostic tool in LMICs, healthcare systems can make faster and more accurate treatment decisions, reduce overall treatment costs by avoiding diagnostic delays, and ultimately improve survival rates in pediatric leukemia patients.

Apoptosis, or programmed cell death, is a fundamental biological process essential for maintaining tissue homeostasis. Dysregulation of apoptosis is implicated in a variety of diseases, including cancer, neurodegenerative disorders, and autoimmune conditions. This review provides an in-depth insight into the molecular mechanisms and signaling pathways that regulate apoptosis, highlighting both intrinsic and extrinsic pathways. Additionally, the review explains the tumor microenvironment's influence on apoptosis and its implications for cancer therapy resistance. Understanding the complex interplay between apoptotic signaling and cellular responses is crucial for developing targeted therapies that can effectively manage diseases associated with apoptosis dysregulation. The effects of conventional therapeutics and alternative substances with natural sources such as herbal compounds, alongside vitamins, minerals, and trace elements on cellular homeostasis and disease pathogenesis have been thoroughly investigated. Moreover, recent advances in therapeutic strategies aimed at modulating apoptosis are discussed, with a focus on novel interventions such as nutrition bio shield dietary supplement. These emerging approaches offer potential benefits beyond conventional treatments by selectively targeting apoptotic pathways to inhibit cancer progression and metastasis. By integrating insights from recent studies, this review aims to enhance our understanding of apoptosis and guide future research in developing innovative therapeutic approaches.

The prediction of brain cancer occurrence and risk assessment of brain hemorrhage using a hybrid deep learning (DL) technique is a critical area of research in medical imaging analysis. One prominent challenge in this field is the accurate identification and classification of brain tumors and hemorrhages, which can significantly impact patient prognosis and treatment planning. The objectives of the study address the prediction of brain cancer occurrence and the assessment of risk levels associated with both brain cancers due to brain hemorrhage. A diverse dataset of brain MRI and CT scan images. Utilize Unsymmetrical Trimmed Median Filter with Optics Clustering for noise removal while preserving edges and details. The Chan-Vese segmentation process for refined segmentation. Brain cancer detection using Multi-Head Self-Attention Dilated Convolution Neural Network (MH-SA-DCNN) with Efficient Net Model. Brain cancer detection using MH-SA-DCNN with Efficient Net Model. This trains the algorithm to predict cancerous regions in brain images. Further, implement a Graph-Based Deep Neural Network Model (G-DNN) to capture spatial relationships and risk factors from brain images. Cox regression model to estimate cancer risk over time and fine-tune and optimize the model's parameters and features using the Osprey optimization algorithm (OPA).

Recent research has underscored the pivotal role of chronic inflammation in cancer development. Investigations have elucidated key molecular mechanisms underpinning inflammation-related cancer. Extrinsic pathway, driven by inflammatory conditions and intrinsic pathway, propelled by genetic events, emerged as critical links between inflammation and carcinogenesis. The persistent inflammation exacerbates genomic instability, providing a mechanistic link between inflammation and cancer. Targeting crucial inflammatory pathways such as NFκB, JAK-STAT, MAPK/ERK, PI3K/AKT, Wnt and TGF-β, holds promise for advancing cancer treatment modalities. Hence, understanding the key signalling pathways will highlight the intricate interplay between inflammation and cancer recognizing it as a potential target for interventions.

Objective: The ExPRO (External factors influencing patient reported outcomes of patients with malignant diseases) study explored associations between QoL data and environmental factors on the day of questionnaire completion: mean temperature, sunshine hours, season, and lunar phase.

Methods: We undertook a cross-sectional analysis of baseline data in the prospective cohort study at two cancer centers in eastern Germany. From December 2020 to December 2021, cancer patients completed the EORTC QLQ-C30 questionnaire upon admission. Statistical analysis was performed to explore associations between QoL data and environmental factors, including temperature, sunshine hours, season, and lunar phases.

Results: We received 5040 responses (54% male). QoL scores were highest at 25-30 °C and lowest at 5-10 °C (mean 61.3 vs. 52.6, p <0.001). Insomnia was highest at ≤0 °C and lowest at 25-30 °C (mean 39.3 vs. 29.5, p <0.001). QoL was highest with 8 hours of sunshine and lowest with 0 hours (mean 56.9 vs. 50.9, p = 0.003).

Conclusion: Higher temperatures, more sunshine, and summer seasons are associated with higher QoL in cancer patients, while lower temperatures and reduced sunlight are associated with poorer QoL. These findings highlight the need to consider environmental factors in PRO assessments.

Objective: Cancer patients frequently report sleep problems. The Pittsburgh Sleep Quality Index (PSQI) is a 19-item instrument for assessing sleep problems. The main objective of this study was to analyze the usefulness of the PSQI in oncological research.

Methods: A sample of 1,733 cancer patients with mixed diagnoses were included. In addition to the PSQI, the following questionnaires were adopted: the Insomnia Severity Index (ISI), the Jenkins Sleep Scale (JSS) and the sleep scale of the EORTC QLQ-SURV100.

Results: The internal consistency of the PSQI was α = 0.79. Of the PSQI subscales, the subjective sleep quality correlated most strongly with the other sleep instruments (r between 0.68 and 0.77). In total, 69.2% of the sample were poor sleepers; the effect size of the difference between the PSQI total scores of the patients and a general population sample was d = 0.83. Female patients experienced more sleep problems than male patients (d = -0.49), and younger patients (<60 years) reported more sleep problems than older patients (≥60 years) (d = 0.21).

Conclusions: The PSQI can be recommended for use in clinical practice since its sub-dimensions provide detailed information on the sleep situation of cancer patients.

Despite a biologically established causative role of viral hepatitis (VH), i.e. HBV and HCV infections, on intrahepatic cholangiocarcinoma (ICC), only few large Western cohorts exploring the association between VH and ICC development are available. The prognostic significance of VH in ICC is debated, and no data are available regarding a predictive role for standard first-line CT (CT1), consisting of gemcitabine +/- platinoids. VH-positivity definition is often clinically incomplete and inconsistent among studies. Five different VH conditions, based on laboratory and anamnestic data, were investigated in a multicentric retrospective cohort of advanced ICC cases. Depending on the specific VH condition considered, 139-194 of 472 ICC cases could be categorized according to the presence of the mentioned VH conditions. VH prevalence ranged from 9.3 to 25.3%. No VH condition showed an impact on survival, although a non-significant worse outcome was observed for some HBV-related conditions. HCV-related conditions were associated to lower pre-CT1 biomarkers of inflammation, markedly higher disease control, and numerically longer time-to-progression with CT1. No benefit on time-to-progression was demonstrated for the addition of platinoids to gemcitabine in VH-positive patients (HR 0.77, CI_95% 0.41-1.45), at least in HBV-related cases. These findings are clinically relevant and deserve further investigation.