Cancer Management and Research最新文献

Purpose: We retrospectively analyzed the effect of Bevacizumab (BEV) on recurrent high-grade glioma (rHGG) and examined the relationship between dose and efficacy.

Methods: A total of 182 patients with rHGG were included in this study. Patients were divided into a non-BEV group and a BEV group according to the treatment they received, and the BEV group was further divided into a low-dose group and a high-dose group based on the dose. Depending on the number of groups and the characteristics of numerical variables, t-test, ANOVA, or rank-sum test were selected. Categorical variables were compared using the chi-squared test.

Results: Progression-free survival (PFS) was lower in the non-BEV group compared to the BEV group, while overall survival (OS) was not different between the two groups. There was no difference in PFS and OS between low-dose group and high-dose group. Notably, we found that patients with longer PFS and OS were more likely to be from the BEV group. In addition, differences in Karnofsky Performance Score (KPS), steroid dose, and brain edema were observed in the non-BEV, low-dose, and high-dose groups from 3 to 12 months after treatment.

Conclusion: BEV can improve PFS in patients with rHGG, although its impact on OS is limited. There was no difference in the efficacy of different doses of BEV on rHGG. Interestingly, patients with longer PFS and OS were more likely to be from the BEV group. Based on these findings, long-term low-dose BEV appears to be an effective treatment option for rHGG.

The disparity in access to essential cancer medicines between less and more affluent countries is a major source of inequities in access to cancer care. In May 2022, the Union for International Cancer Control (UICC) launched a new initiative, the Access to Oncology Medicines Coalition (ATOM Coalition), bringing together over 40 organisations from the private and civil society sectors to cooperate and combine resources to address key barriers of access to cancer medicines in low- and lower-middle income countries. While the ATOM Coalition is engaged in global efforts to make cancer medicines more accessible, the initiative also includes a country-level support programme to enhance coordinated locally-led action and accelerate access. This is supported by a transparent governance and organisational structure as well as a working framework with governments and other key stakeholders to assess the current capacity and develop tailored responses that can lift and/or relax some of the identified barriers through joint collaborations with ATOM Coalition partners.

Introduction: Hepatocellular carcinoma (HCC), a prevalent and aggressive form of cancer, poses significant challenges due to its limited therapeutic options. This study aims to leverage multi-omics data from liver cancer to identify potential therapeutic targets for HCC.

Methods: We employed an integrative approach by analyzing various omics datasets related to liver cancer. Through comprehensive data mining and analysis, we identified key genes that are significantly associated with HCC. To gain insights into their biological roles and underlying mechanisms, we constructed gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway networks. Specifically, we focused on genes that exhibited high expression levels in HCC and were correlated with poor patient prognosis. Among these, CDK1 and DLGAP5 emerged as promising candidates and were further investigated for their potential involvement in tumor immune cell infiltration and HCC progression.

Results: Our analysis revealed that CDK1 and DLGAP5 are highly expressed in HCC tissues compared to normal liver tissues, and their elevated expression is associated with unfavorable clinical outcomes. Furthermore, through GO and KEGG pathway analyses, we found that these genes are implicated in critical biological processes and signaling pathways relevant to HCC pathogenesis. Notably, CDK1 and DLGAP5 were shown to be associated with tumor immune cell infiltration, suggesting their potential role in modulating the tumor microenvironment and promoting HCC progression.

Discussion: These findings provide valuable insights into the development of novel therapeutic approaches for HCC.

Autologous chimeric antigen receptor-modified T-cell therapy (CAR-T) has revolutionized treatment paradigms across multiple lymphoid malignancies, including relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). The introduction of the CD19-directed CAR-T product brexucabtagene autoleucel (brexu-cel; Tecartus) in October 2021 made this treatment approach available for the first time for adults with R/R B-ALL, a historically challenging clinical entity to treat. In this review, we will discuss the pivotal clinical trial data from the ZUMA-3 study that led to the US Food and Drug Administration (FDA) approval of brexu-cel, including clinical outcomes and key toxicity data (most importantly, the incidence and severity of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome). Additionally, we will compare and contrast these data from the ZUMA-3 study with "real-world" data from examinations of patient outcomes with brexu-cel as an FDA-approved therapy in R/R B-ALL, and discuss practical considerations with brexu-cel use in the clinic, including the role of consolidative allografting for patients post-brexu-cel. We finish by discussing future directions for CAR-T use in R/R B-ALL with the anticipated introduction of a new CD19-directed CAR-T product - obecabtagene autoleucel - in the near future.

Background: To analyze the risk factors of cervical lymph node metastasis (LNM) of thyroid papillary carcinoma (PTC) and construct the prediction model.

Methods: Clinical data of 1105 patients with pathologically confirmed PTC in our hospital from February 2019 to May 2024 were retrospectively analyzed, and randomly divided into a training set and validation set according to the proportion of 7:3. With cervical central LNM (CLNM) and lateral LNM (LLNM) as outcome variables respectively, ultrasound characteristics were analyzed and C-TIRADS scores were performed Combined with the general situation of the patient, preoperative serum thyroglobulin (Tg) level, BRAFV600E (hereinafter referred to as BRAF) gene mutation and other characteristics of the patient, analysis was conducted to determine the independent risk factors for cervical CLNM and LLNM of PTC, and establish Nomogram prediction models. The test data set is used to validate the model. The area under the ROC curve (AUC) and the decision curve analysis (DCA) were used to evaluate the prediction efficiency of the model.

Results: The analysis shows that male, age < 55 years old, tumor diameter ≥ 1 cm, capsular invasion, positive serum thyroglobulin (Tg), BRAF gene mutation type and C-TIRADS score are independent risk factors for cervical CLNM in PTC (P < 0.05). Tumor diameter ≥ 1 cm, capsular invasion, tumor located at the upper pole and presence of CLNM are independent risk factors for LLNM in PTC. Based on the above risk factors, Nomogram prediction models for CLNM and LLNM are constructed respectively. The AUC of the CLNM prediction model is 91.5%. LLNM model is 96.1%.

Conclusion: Ultrasound indicators, C-TIRADS score combined with BRAF gene status, Tg and clinical indicators of patients have important value in predicting cervical CLNM and LLNM in PTC. The Nomogram prediction models constructed based on the above indicators can effectively predict the risk of LNM in PTC.

Purpose: The objective of this study was to compare the clinical outcomes of stereotactic body radiation therapy (SBRT) in elderly patients aged 65 or older with clinical stage I-II non-small-cell lung cancer (NSCLC), specifically examining the differences between centrally located lung tumors and peripherally located lung tumors.

Methods: From April 2009 to January 2020, a total of 136 patients with 136 tumors (65 central, 71 peripheral; NSCLC) at an early stage (T1-3N0M0) were treated with SBRT at a single institution. Central/peripheral location was assessed retrospectively on planning CT scans. A propensity score matching analysis was utilized to compare the two groups. In addition, the prognosis and related toxicity were compared between the two study arms.

Results: A total of 33 central tumors and 33 peripheral tumors were matched and analyzed. The results showed no significant differences in overall survival (OS) and progression-free survival (PFS) between the two groups. The 2-year OS was 71.88% (95% CI, 57.87%-89.27%) in the central lung cancer group, while it was 93.94% (95% CI, 86.14%-100.00%) in the peripheral lung cancer group (P=0.462). The 2-year PFS was 43.75% in the central lung cancer group, while it was 78.79% in the peripheral lung cancer group (P=0.279). Further subgroup analysis indicated that the location of peripheral tumor have a positive impact on OS in patients with adenocarcinoma. The occurrence of local failure, regional failure, or distant failure was comparable between central and peripheral tumors. There was no statistically significant difference in toxicity between the central and the peripheral tumor groups.

Conclusion: The outcomes of SBRT for central tumors versus peripheral lung tumors in elderly patients with early-stage NSCLC were similar. SBRT demonstrated a similar level of safety in terms of toxicity for both central and peripheral lung tumors.

Purpose: Resilience has been suggested as an important predictor of both physical and mental health-related quality of life in breast cancer patients. However, it is unclear why resilient women handle their diagnosis better, not only mentally, but also physically. The aim of this study was to investigate paths between resilience, physical activity, and mental, physical, and global health-related quality of life in breast cancer patients.

Patients and methods: Structural equation modeling was conducted to evaluate the proposed structural paths using a sample of 638 women with newly diagnosed breast cancer patients from Sweden.

Results: Resilience was directly associated with physical activity and mental health-related quality of life. It was indirectly associated with physical functioning, through mental health-related quality of life and physical activity. Resilience was also indirectly associated with global quality of life, through mental health-related quality of life.

Conclusion: Mental health support and encouraging physical activity may be especially relevant to enhance all aspects of health-related quality of life early in the breast cancer process. Results should be replicated longitudinally.

Purpose: The aim of this study was to explore the immune subtypes of endometrial cancer (EC) and its characteristics by immunogenes from the perspective of multidimensional genomics (multi-omics).

Patients and methods: Immune subtypes were carried out using an unsupervised non-negative matrix factorization clustering (NMF) method and their characteristics were analysed. Key genes were identified using random forest analysis. A predictive model for immune subtypes and their clinical prognosis were constructed. The relationship between immune subtypes and molecular subtypes was investigated.

Results: Two immune subtypes C1 and C2 were available. C2 patients were younger, less graded, had significantly higher immune cell infiltration, immune checkpoint expression, tumor neoantigens, tumor mutation load than C1 (P<005). S100A9, CD3D, CD3E, HLA-DRB1 and IL2RB were the key genes with significant survival outcomes. S100A9 expression was lower in C2 than C1, and IL2RB, HLA-DRB1, CD3E and CD3D expression was higher than C1 (P<0.05). The predictive accuracy of five key genes for immune subtypes was good, with a Receiver operating characteristic of 0.941. The incidence of TP53abn type in C2 was significantly lower than that of C1, and the incidence of POLE type was significantly higher than that of C1 (P<0.0001).

Conclusion: EC can be divided into two immune subtypes based on immunogenes. Low expression of S100A9 and high expression of IL2RB, HLA-DRB1, CD3E, and CD3D suggest sensitivity to immunotherapy and a good prognosis.

Introduction: Incidental Enhancement Lesions (IELs) complicate patient management but may be detected through multiparameter MRI including dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) and synthetic magnetic resonance imaging (syMRI). The multiparameter MRI model gave greater objectivity to avoid unnecessary biopsy.

Case presentation: A 60 year-old woman had a history of occasional right breast pain and a mass was identified in the right breast. A thickening in the upper quadrant of the right outer breast was found during physical examination but no mass was palpable. Breast dynamic contrast enhancement MRI and synthetic MRI were performed prior to ultrasound-guided biopsy of the right breast lesion. Resection of the right breast lesion and sentinel lymph node was performed 2 days later. Chronic inflammation, locally invasive ductal carcinoma and high-grade ductal carcinoma in situ were found by pathological examination.

Discussion: Differentiation between benign and malignant breast IELs was facilitated by use of a multiparameter MRI model with DCE-MRI and syMRI, giving greater objectivity in differentiating between benign and malignant lesions.