Cancer Management and Research最新文献

Purpose: Complementary and alternative medicine (CAM) is widely used by cancer patients, yet regional data from Qassim, Saudi Arabia, are lacking. This study assessed the prevalence, patterns, motivations, and predictors of CAM use among cancer patients in the region.

Methods: A cross-sectional survey was conducted at Prince Faisal Cancer Center, Qassim, between February and August 2025. Eligible adults with confirmed cancer completed a culturally adapted version of the International CAM Questionnaire. CAM modalities were classified using the NCCIH/SIO framework. Descriptive statistics summarized prevalence, types, motivations, disclosure, benefits, harms, and costs. Predictors were assessed using chi-square tests and logistic regression.

Results: Among 258 participants (mean age 51.6 ± 15.1 years; 57.4% female), 145 (56.2%) reported CAM use. Most described CAM as complementary (91.0%), with 6.2% as alternative, and 2.8% as integrative. Common modalities included spiritual/faith-based (91.0%; Qur'an recitation, 74.3%; Zamzam water, 72.2%), biologically based (66.7%; olive oil, 41.7%; honey, 34.7%), and traditional remedies (53.5%; camel milk, 22.2%; camel urine, 13.9%). The main motivation was belief in a cure (91.0%). Perceived benefits were reported by 58.6% (most often improved mood, 33.8%); adverse effects were rare (6.9%) and mild. Only 23.4% disclosed CAM use to physicians, and 7.6% delayed conventional therapy. Female sex (aOR 2.29, 95% CI 1.04-5.01) and higher education (aOR 2.48, 95% CI 1.12-5.18) independently predicted CAM use.

Conclusion: CAM use was highly prevalent among cancer patients in Qassim, with faith-based and traditional practices most common. Curative expectations were widespread, but disclosure to physicians was low, creating a critical communication gap. Addressing this gap requires proactive, culturally sensitive physician-patient dialogue and integration of safe, evidence-based supportive practices into cancer care.

Purpose: Next-generation sequencing (NGS) has transformed molecular diagnostics and precision oncology by enabling broad genomic profiling and informed treatment selection for non-small cell lung cancer (NSCLC). However, adoption in Southeast Asia remains limited, particularly in public healthcare settings. This study aimed to assess the landscape of NGS testing for NSCLC in Malaysia, identify barriers, and explore strategies clinicians use to improve patient access.

Patients and methods: A descriptive, cross-sectional survey comprising 18 questions was distributed to clinical oncologists and respiratory physicians across Malaysia over an eight-week period. The survey collected data on clinical experience with NGS, testing practices, perceived barriers, and access strategies. Descriptive statistics were used for analysis, and associations between healthcare sectors (public vs private) and NGS usage frequency were evaluated using the Chi-square test.

Results: Seventy-one clinicians participated - 67.6% clinical oncologists and 32.4% respiratory physicians. Private hospitals had the highest NGS uptake (38.5% testing all NSCLC patients), with the lowest in Ministry of Health (MoH) institutions (8.3%) (p<0.0001). Among oncologists, 45.8% used NGS for all or nearly all patients. For respiratory physicians, 35.3%, mainly from MoH, used it most of the time. NGS results were more frequently available in private referrals. Most private clinicians (84.6%) rated NGS accessibility as excellent. Key barriers included cost of testing and therapies, limited availability, long turnaround times, insufficient tissue, and unclear guidelines. Strategies to improve access included industry-subsidized programs, insurance coverage, and clinical trial enrolment.

Conclusion: NGS adoption for NSCLC in Malaysia varies significantly across healthcare settings. Public hospitals face substantial barriers, particularly related to cost and access to testing and therapies. Addressing these challenges will require coordinated efforts across policy, infrastructure, clinician training, and public-private partnerships. This study offers key insights into the Malaysian NGS landscape and supports broader access to precision oncology.

Introduction: Women diagnosed with cancer often undergo aggressive chemotherapy that can impair fertility and lead to long-term ovarian damage, significantly affecting their quality of life. Cyclophosphamide (CPA), a chemotherapeutic agent known for its gonadotoxic effects, has been shown to reduce ovarian follicle reserves, thereby contributing to the development of primary ovarian insufficiency in both humans and animal models. This study sought to identify the molecules and intracellular signaling pathways associated with CPA's effects on ovarian tissue of rats bearing mammary tumors.

Methods: To address the objective of the study, transcriptomic (RNA-Seq) and proteomic (2D-DIGE/MS) methodologies were applied. The study was conducted on rats with N-methyl-N-nitrosourea (MNU)-induced mammary neoplasia, randomly assigned to control or cyclophosphamide (CPA)-treated groups. CPA was administered intraperitoneally (50 mg/kg on day 3, then 10 mg/kg weekly until day 31). Animals were euthanized on day 34, and ovaries were collected for RNA-Seq and 2D-DIGE/MS analyses.

Results: Our results demonstrated that the crucial mechanism of CPA action during follicular depletion in the ovary may be linked to CPA-induced immune cell responses. Moreover, we found that CPA may trigger apoptosis or ferroptosis of follicular cells, ultimately leading to ovarian dysfunction.

Conclusion: The obtained results highlight the importance of mechanisms contributing to ovarian toxicity from cancer chemotherapy, paving the way for developing targeted strategies for ovarian protection. Further functional experiments are needed to identify substances that could effectively preserve the fertility of female cancer survivors.

Purpose: Papillary thyroid microcarcinoma (PTMC, ≤1 cm) has risen sharply in incidence, comprising nearly half of papillary thyroid carcinoma cases. This study assessed clinical features and risk factors for multifocality, nodal metastasis, and recurrence to inform treatment and risk stratification.

Patients and methods: We retrospectively analyzed 418 patients diagnosed with PTMC at Chang Gung Memorial Hospital between 2005 and 2015. Patients with incomplete data, initial distant metastasis, or lost to follow-up were excluded. Clinical, pathological, and treatment data were reviewed. Risk factors were identified using multivariate logistic regression analysis. Sensitivity analysis was performed on the total thyroidectomy subgroup to address potential selection bias. The study was IRB-approved and informed consent was waived due to its retrospective nature.

Results: Among 418 patients (75 males, 343 females; median age 47 years), the median tumor size was 6.0 mm. Multifocal PTMC occurred in 32.1% of patients and was significantly associated with larger tumor size (p < 0.001) and lymphovascular invasion (p < 0.001). Cervical lymph node metastasis was observed in 11.5% of patients and was linked to male sex (OR: 3.27, p = 0.006), non-incidental findings (OR: 8.38, p < 0.001), multifocality (OR: 3.13, p = 0.047), and lymphovascular invasion (OR: 709.01, p < 0.001). Sixteen patients (3.8%) experienced recurrence, which was significantly associated with prior lymph node metastasis (OR: 6.24, p = 0.011). The overall survival rate was 97.6%.

Conclusion: PTMC is usually indolent, but male gender, non-incidental findings, multifocality, and lymphovascular invasion indicate higher risk. These mainly histopathological factors can guide management and are particularly relevant when evaluating alternatives such as radiofrequency ablation.

Radioactive ¹²⁵I seed implantation, a minimally invasive and targeted local therapy, is particularly suitable for elderly patients who are ineligible for conventional treatments. Meanwhile, PD-1 inhibitors, as a major focus of current research, have become an essential component of systemic therapy for non-small cell lung cancer. This case report describes a 72-year-old male patient with advanced non-small cell lung cancer(NSCLC) whose disease progressed despite multiple lines of chemotherapy and radiotherapy. Due to the onset of hemoptysis, he underwent combined treatment with radioactive ¹²⁵I seeds and a PD-1 inhibitor. Postoperatively, his hemoptysis resolved completely, and notably, the patient achieved a progression-free survival of 40 months, demonstrating sustained clinical benefit. These findings suggest that the combination of ¹²⁵I seed implantation and PD-1 inhibitors may exert a synergistic antitumor effect, offering a promising therapeutic strategy for elderly patients with advanced NSCLC.

Vitamin D (VD) has been the focus of extensive clinical research, yet conclusions regarding its biological roles remain inconsistent. VD exerts its functions through the vitamin D receptor (VDR), a nuclear transcription factor that regulates the expression of VD3-responsive target genes. Notably, divergent findings across studies have been reported regarding VDR expression patterns and functional roles, underscoring the complexity of VDR in cancer biology. Whether this complexity interferes with VD's biological activity-thereby contributing to the variable impacts of VD3 on cancer prevention and treatment-remains unclear. This review systematically addresses: (1) the association between VDR expression (assessed by immunohistochemistry) and cancer prognosis; (2) the roles and mechanisms of VDR in cancer; (3) the multi-level regulatory networks governing VDR expression and activity; and (4) the translational implications of VDR in cancer therapy. Elucidating the precise roles and mechanisms of VDR is critical for optimizing cancer treatment strategies and resolving conflicting clinical evidence.

Objective: Neoadjuvant chemotherapy (NAC) in hormone-positive operable breast cancer supports breast-conserving surgery, axillary dissection, and survival. However, the pathological complete response (pCR) rates to NAC in hormone-positive breast cancer remain low. Identifying the predictive parameters for pathological response prior to NAC is crucial. In this study, we investigated clinical, pathological, inflammatory, and metabolic parameters that could predict NAC response and survival.

Material and methods: A retrospective study was conducted on 120 patients with hormone-positive breast cancer. Clinical and pathological stages of patients who underwent surgery following NAC were used to calculate the CPS score (clinical stage score + pathological stage score). The Kruskal Wallis test was employed to compare clinical, pathological, and laboratory parameters with the CPS score. The Bonferroni test was applied for post-hoc analysis. Categorical variables were compared using the Pearson Chi-Square test or Fisher's exact test.

Results: There was no statistically significant association between the CPS score and age (p=0.106), estrogen receptor positivity (p=0.331), grade (p=0.100), Ki67 (p=0.247), and chemotherapy received (p=0.720). While pCR was statistically significant in univariate analysis (p=0.001), it did not reach statistical significance in the multivariate model (p=0.258). Axillary pathological response (ypN) had a statistically significant correlation with the CPS score (p=0.003). There was no statistically significant association between the CPS score and leukocyte, lymphocyte, neutrophil, or platelet counts, glucose levels, NLR, PNI, or SII values (p > 0.05).

Conclusion: ypN was associated with the CPS score in predicting survival following NAC in hormone-positive breast cancer. No statistically significant association was observed between inflammatory or metabolic parameters and the CPS score. Further validation in larger studies is warranted.

Background: Prostate cancer (PC) is a common malignant tumor. Although androgen deprivation therapy (ADT) drugs are widely used in the treatment of PC, to date, clinical research on ADT drugs has not provided a clear overview of the existing treatment regimens. The purpose of this study is to use scoring review to sort out relevant research, present relevant research evidence, and identify recommended guidance for selecting therapeutic strategies.

Methods: PubMed, Embase and Cochrane Library databases were searched for literature published until September 2025. Statistical analysis was conducted on the main characteristics of the included studies, with a primary focus on changes in the medication regimens of the four ADT drugs identified in clinical studies.

Results: Ultimately, 160 literatures with 126 randomized controlled trials (RCTs) were included in the analysis. There were 52, 67, ten, and 16 studies evaluating leuprorelin, goserelin, triptorelin, and degarelix, respectively. The main medication regimens for ADT drugs included monotherapy and combination therapy with first generation anti-androgen drugs, novel hormonal drugs, and other treatments. In RCTs that evaluated leuprorelin and goserelin, numerous studies involved all four medication regimens. However, due to the relatively late regulatory approval of triptorelin and degarelix, these were mainly studied as monotherapy. There were only six studies from China.

Conclusion: Although numerous studies have evaluated the efficacy of ADT drugs for the treatment of PC, there is still a paucity of high-quality research across multiple domains. Furthermore, there is a relative lack of in-depth research involving Chinese patients.

Background: Epithelial ovarian cancer (EOC) remains highly lethal due to late-stage diagnosis and chemoresistance, necessitating strategies to enhance conventional therapies like doxorubicin (DOX) while mitigating toxicity. This study evaluated morin, a flavonoid, as an adjunct to DOX in chemoresistant EOC models.

Methods: In vitro, DOX-resistant OVCAR-3-DR, OVCAR-3, and A2780 cells were treated with DOX, morin, or their combination. Synergy was assessed via MTT and apoptosis assays, alongside autophagy and cell cycle markers. In vivo, OVCAR-3-DR xenograft mice were divided into Sham, DOX (5 mg/kg), morin (15 and 30 mg/Kg), and combination groups. Tumor volume, apoptosis (BCL-2, caspase-3/9), autophagy (LC3, ATG5, Beclin-1), cell cycle regulators (Cyclin A2/D1), and oxidative stress (SOD, CAT, GPx, GR, GSH, MDA) were analyzed.

Results: Findings demonstrated significant synergistic cytotoxicity, with a combination index (CI) of 0.72, and enhanced apoptosis. Combination therapy suppressed Cyclin A2/D1, upregulated autophagy markers (, and reduced oxidative stress. In vivo, DOX+Morin30 reduced tumor volume synergistically (p<0.001) without systemic toxicity (stable body weight).

Conclusion: Morin synergizes with DOX by modulating apoptosis, autophagy, cell cycle, and oxidative stress, overcoming chemoresistance while reducing toxicity. These findings position morin as a promising, orally bioavailable adjunct worthy of further clinical investigation for optimizing DOX therapy in refractory EOC.

Purpose: This review analyzes the factors influencing mucosal administration of opioids, the methods of administration, clinical applications, pharmacokinetic parameters, and considerations.

Summary: Inclusion criteria for this review includes English literature from 1984 to the present, with the primary literature search conducted on PubMed. The findings indicate that mucosal administration of opioids offers a non-invasive and rapidly effective treatment option for chronic and breakthrough pain in terminal cancer patients, which is crucial for improving their quality of life. Specifically, rectal administration provides long-lasting analgesia but is slow-acting and has variable bioavailability. Oral administration is more patient-friendly and has higher bioavailability than rectal administration, though some of the drug may be swallowed. Nasal administration is well-tolerated, has higher bioavailability than the rectal and buccal routes, and acts quickly, but its effects are short-lived and the long-term impact on the nasal mucosa remains unclear.

Conclusion: Current research shows that mucosal opioid administration can relieve pain in advanced cancer patients, but each route has pros and cons. Choosing the appropriate method and medication based on the patient's condition is crucial. Further research on integrating these routes to optimize pain management for terminal patients is needed.