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Predictive Value of PERCIST for Locally Advanced Non-Small Cell Lung Cancer Treated with Preoperative Induction Therapy – A Multicenter Study in Japan PERCIST 对接受术前诱导治疗的局部晚期非小细胞肺癌的预测价值 - 日本一项多中心研究
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-30 DOI: 10.2147/cmar.s464265
Katsuhiko Shimizu, Masao Nakata, Shinsuke Saisho, Masayuki Inubushi, Norihito Okumura, Tomohiro Murakawa, Motohiro Yamashita, Hiroshige Nakamura, Yoshifumi Sano, Kazuhiko Kataoka, Shinichi Toyooka
Background: Induction therapy followed by surgery is recommended as an alternative treatment strategy for locally advanced non-small cell lung cancer (NSCLC). Patients who achieve pathologic response after induction therapy have better outcomes than non-responders; therefore, therapeutic response must be evaluated. Recently, new approaches for monitoring therapeutic responses, which are based on 18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET), have been developed. In this study, we evaluated the predictive value of Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST), which uses standardized uptake values corrected for lean body mass (SUL) and total lesion glycolysis (TLG).
Methods: A total of 130 patients in the Setouchi Lung Cancer Group who underwent FDG-PET imaging before and after induction therapy prior to a planned surgical resection for NSCLC between 2007 and 2016 were studied retrospectively. The pathologic responses of the primary lung tumors and metastatic lymph nodes were compared with their responses based on evaluation using PERCIST.
Results: Postoperative pathologic studies revealed pathologic complete response (pCR) in 42 (32.3%) patients. PERCIST was significantly correlated with pathologic response (p < 0.001). The sensitivity, specificity, and accuracy of PERCIST for predicting pCR were 16.7% (7/42), 88.6% (78/88), and 65.4% (85/130), respectively. Patients with pCR had significantly higher reduction rates in SULpeak for both primary lung tumors and metastatic lymph nodes and TLG for primary tumors than non-responders. In a multivariate Cox regression analysis, tumor site in upper lobes, reduction rate of TLG in primary tumor, and pathologic N0 were independent predictors of favorable recurrence-free survival (RFS).
Conclusion: Our study suggested that PERCIST, especially the rate of TLG reduction rate, are useful to predict the pathological response and prognosis after induction therapy. Although improvement is necessary, PERCIST can be a promising method of the post-induction status in lung cancer. Further research is needed to confirm our findings.

背景:对于局部晚期非小细胞肺癌(NSCLC),诱导治疗后手术是推荐的替代治疗策略。诱导治疗后获得病理反应的患者比无应答的患者有更好的预后;因此,必须对治疗反应进行评估。最近,基于 18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)的治疗反应监测新方法应运而生。在这项研究中,我们评估了实体瘤正电子发射断层扫描反应标准(PERCIST)的预测价值,该标准使用根据瘦体重(SUL)和总病变糖酵解(TLG)校正的标准化摄取值:2007年至2016年期间,濑户内肺癌研究组共对130名NSCLC患者在计划手术切除前接受诱导治疗前后进行了FDG-PET成像进行了回顾性研究。将原发肺肿瘤和转移淋巴结的病理反应与基于 PERCIST 评估的反应进行了比较:42例(32.3%)患者的术后病理检查显示病理完全反应(pCR)。PERCIST 与病理反应明显相关(p < 0.001)。PERCIST 预测 pCR 的敏感性、特异性和准确性分别为 16.7% (7/42)、88.6% (78/88) 和 65.4% (85/130)。与无应答患者相比,获得 pCR 的患者原发肺肿瘤和转移淋巴结的 SULpeak 降低率以及原发肿瘤的 TLG 降低率均明显较高。在多变量考克斯回归分析中,肿瘤部位位于上叶、原发肿瘤的TLG降低率和病理N0是良好无复发生存期(RFS)的独立预测因素:我们的研究表明,PERCIST,尤其是 TLG 减少率,有助于预测诱导治疗后的病理反应和预后。尽管还需要改进,但 PERCIST 可以作为肺癌诱导治疗后状况的一种有前途的方法。我们还需要进一步的研究来证实我们的发现。
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引用次数: 0
Focusing on the Immune Cells: Recent Advances in Immunotherapy for Biliary Tract Cancer 关注免疫细胞:胆道癌免疫疗法的最新进展
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-29 DOI: 10.2147/cmar.s474348
Luohang Ni, Jianing Xu, Quanpeng Li, Xianxiu Ge, Fei Wang, Xueting Deng, Lin Miao
Abstract: Biliary tract cancer (BTC) represents a challenging malignancy characterized by aggressive behavior, high relapse rates, and poor prognosis. In recent years, immunotherapy has revolutionized the treatment landscape for various cancers, but its efficacy in BTC remains limited. This article provides a comprehensive overview of the advances in preclinical and clinical studies of immunotherapy for BTC. We explore the potential of immune checkpoint inhibitors in reshaping the management of BTC. Despite disappointing results thus far, ongoing clinical trials are investigating the combination of immunotherapy with other treatment modalities. Furthermore, research on the tumor microenvironment has unveiled novel targets for immunotherapeutic interventions. By understanding the current state of immunotherapy in BTC and highlighting future directions, this article aims to fuel further exploration and ultimately improve patient outcomes in this challenging disease.

Keywords: biliary tract cancer, cancer immunotherapy, tumor microenvironment, immune checkpoint inhibitors, clinical trials
摘要:胆道癌(BTC)是一种具有挑战性的恶性肿瘤,其特点是侵袭性强、复发率高、预后差。近年来,免疫疗法彻底改变了各种癌症的治疗格局,但其对 BTC 的疗效仍然有限。本文全面概述了免疫疗法治疗 BTC 的临床前和临床研究进展。我们探讨了免疫检查点抑制剂在重塑 BTC 治疗中的潜力。尽管迄今为止的结果令人失望,但正在进行的临床试验正在研究免疫疗法与其他治疗方式的结合。此外,对肿瘤微环境的研究揭示了免疫治疗干预的新靶点。通过了解 BTC 免疫疗法的现状并强调未来的发展方向,本文旨在推动进一步的探索,并最终改善这种具有挑战性疾病的患者预后。 关键词:胆道癌;癌症免疫疗法;肿瘤微环境;免疫检查点抑制剂;临床试验
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引用次数: 0
Reference Ranges and Comparison of Pepsinogen by Chemiluminescence Immunoassay and Enzyme-Linked Immunosorbent Assay in Chinese Population 化学发光免疫分析法和酶联免疫吸附法测定中国人群胃蛋白酶原的参考范围及比较
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-29 DOI: 10.2147/cmar.s459568
Yuan Huang, Hong Yang, Rui Ding, Li Wang, Ji Li, Wenbo Li, Xuzhen Qin, Yingchun Xu, Jiaming Qian
<strong>Objective:</strong> Serum pepsinogen (PG) is a good indicator of atrophic changes in the gastric mucosa. Gastric mucosal atrophy is a high-risk factor for gastric cancer. Serological testing for PG combined with endoscopy can help to improve gastric cancer screening. In this study, we established the reference ranges of serum PG-I, PG-II, and the PG-I/II ratio (PGR) in the Chinese population by chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA). Besides, in the real world, doctors are often confused by the results of different testing platforms. Thus, a comparison of methods CLIA and ELISA was performed.<br/><strong>Methods:</strong> 2904 individuals were enrolled from six regions in China as part of the Chinese Adult Digestive Diseases Surveillance (2016) program. The individuals completed questionnaires and volunteered to undergo examinations, including gastroscopy, urea breath test, abdominal ultrasound examination and routine serologic tests. Serum was collected to measure PGs (including PG-I, PG-II and PGR) by CLIA and ELISA. Participants who were found obvious abnormalities or absent from the examinations were excluded. Ultimately, 747 healthy individuals were enrolled in this study. The Kolmogorov–Smirnov test was used to assess the distribution of variables. The Kruskal–Wallis <em>H</em> or Mann–Whitney <em>U</em>-tests were used to compare different sex, age, and geographical groups. The 95% reference ranges of PGs obtained by the two methods were established according to document CLSI-EP28-A3, with covariates of sex, age, and region. Spearman correlation analysis, linear regression analysis and allowable total error (ATE) zone analysis were utilized for comparing the two methods.<br/><strong>Results:</strong> On overall, the 95% reference ranges of PG-I, PG-II, and PGR measured by CLIA were 23.00– 110.64 ng/mL, 2.50– 19.13 ng/mL, and 3.87– 13.30, respectively. Meanwhile, the reference ranges of PG-I, PG-II, and PGR measured by ELISA were 36.93– 205.06 ng/mL, 1.65– 17.96 ng/mL, and 7.50– 33.60, respectively. Both PG-I and PG-II levels measured by the two platforms were found to be influenced by sex and age. PGR measured by CLIA was influenced by age but not by sex, while PGR measured by ELISA was not affected by either age or sex. Regional factors did not significantly impact the PG results, except for PG-I detected by ELISA. Ultimately, reference ranges for PGs were established based on age and sex stratification. Additionally, the Spearman correlation analysis revealed that the correlation coefficients for PG-I, PG-II, and PGR detected by the two methods were 0.899, 0.887, and 0.777, respectively, indicating a strong correlation between the two methods. The regression equation for the PG levels detected by two methods was obtained through linear regression analysis. The ATE analysis provided a visual depiction of the consistency between the two methods, clearly indicating the poor agreement betwe
目的:血清胃蛋白酶原(PG血清胃蛋白酶原(PG)是胃黏膜萎缩性变化的良好指标。胃黏膜萎缩是胃癌的高危因素。血清胃蛋白酶原检测与内镜检查相结合有助于提高胃癌筛查率。本研究通过化学发光免疫分析法(CLIA)和酶联免疫吸附法(ELISA)确定了中国人群血清 PG-I、PG-II 和 PG-I/II 比值(PGR)的参考范围。此外,在现实世界中,医生经常会被不同检测平台的结果所迷惑。因此,我们对 CLIA 和 ELISA 方法进行了比较。方法:作为中国成人消化系统疾病监测(2016 年)项目的一部分,我们从中国六个地区招募了 2904 人。这些人填写了调查问卷并自愿接受检查,包括胃镜检查、尿素呼气试验、腹部超声检查和常规血清学检测。通过 CLIA 和 ELISA 采集血清以测定 PGs(包括 PG-I、PG-II 和 PGR)。发现明显异常或缺席检查的参与者被排除在外。最终,747 名健康人参加了这项研究。研究采用 Kolmogorov-Smirnov 检验来评估变量的分布。Kruskal-Wallis H 或 Mann-Whitney U 检验用于比较不同性别、年龄和地域的群体。根据 CLSI-EP28-A3 号文件确定了两种方法获得的 PG 的 95% 参考范围,并将性别、年龄和地区作为协变量。斯皮尔曼相关分析、线性回归分析和允许总误差(ATE)区分析被用于比较两种方法:总体而言,CLIA 法测得的 PG-I、PG-II 和 PGR 的 95% 参考范围分别为 23.00-110.64 纳克/毫升、2.50-19.13 纳克/毫升和 3.87-13.30。而用酶联免疫吸附法测得的 PG-I、PG-II 和 PGR 的参考范围分别为 36.93- 205.06 纳克/毫升、1.65- 17.96 纳克/毫升和 7.50- 33.60。两种平台测定的 PG-I 和 PG-II 水平均受性别和年龄的影响。CLIA 法测得的 PGR 受年龄影响,但不受性别影响,而 ELISA 法测得的 PGR 则不受年龄或性别影响。除 ELISA 检测到的 PG-I 外,地区因素对 PG 结果没有明显影响。最终,根据年龄和性别分层确定了 PG 的参考范围。此外,斯皮尔曼相关分析表明,两种方法检测到的 PG-I、PG-II 和 PGR 的相关系数分别为 0.899、0.887 和 0.777,表明两种方法之间有很强的相关性。通过线性回归分析得出了两种方法检测到的 PG 水平的回归方程。ATE 分析直观地描述了两种方法之间的一致性,清楚地表明它们之间的一致性很差:本研究通过严格、完整的入选标准确定了 PGs 的参考范围。此外,结果表明两种方法之间有很强的线性关系,但有明显的偏差,这对实验室解释很有价值。 关键词:胃蛋白酶原;参考范围;胃癌
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引用次数: 0
Combination Atezolizumab, Cobimetinib, and Vemurafenib as a Treatment Option in BRAF V600 Mutation–Positive Melanoma: Patient Selection and Perspectives 将阿特珠单抗、科比美替尼和维莫非尼联用作为 BRAF V600 突变阳性黑色素瘤的治疗方案:患者选择与展望
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-29 DOI: 10.2147/cmar.s325514
Michelle M Dugan, Matthew C Perez, Lilit Karapetyan, Jonathan S Zager
Abstract: The treatment landscape for advanced and metastatic melanoma has drastically changed in recent years, with the advent of novel therapeutic options such as immune checkpoint inhibitors and targeted therapies offering remarkable efficacy and significantly improved patient outcomes compared to traditional approaches. Approximately 50% of melanomas harbor activating BRAF mutations, with over 90% resulting in BRAF V600E. Tumors treated with BRAF inhibitor monotherapy have a high rate of developing resistance within six months. Combination therapy with MEK inhibitors helped to mitigate this treatment resistance and led to improved outcomes. Due to the up-regulation of PD-1/PD-L1 receptors in tumors treated with BRAF/MEK inhibitor therapy, further studies included a third combination agent, anti-PD-1/PD-L1 inhibitors. This triple combination therapy may have superior efficacy and a manageable safety profile when compared with single or double agent therapy regimens.

Plain Language Summary: Effective treatment of advanced and metastatic melanoma can be challenging. Newer treatment methods for patients with BRAF-mutated tumors include a combination of drugs with different complementary mechanisms. These drugs include BRAF-inhibitors, MEK-inhibitors, and PD-1/PD-L1 inhibitors. When these three medications are used in combination, patients may have better response rates and survival outcomes, when compared to using just one or two of these medications together. Toxicity rates are higher with a triple-medication regimen, so careful patient selection is important to consider.

Keywords: BRAF inhibitor, MEK inhibitor, metastatic melanoma, BRAF-mutant melanoma, combination BRAF therapy, triple therapy
摘要:近年来,随着免疫检查点抑制剂和靶向疗法等新型治疗方案的出现,晚期和转移性黑色素瘤的治疗形势发生了巨大变化,与传统方法相比,这些治疗方案疗效显著,患者预后明显改善。约 50% 的黑色素瘤携带活化 BRAF 基因突变,其中 90% 以上是 BRAF V600E 基因突变。接受 BRAF 抑制剂单药治疗的肿瘤在 6 个月内产生耐药性的比例很高。与 MEK 抑制剂联合治疗有助于缓解这种耐药性,并改善治疗效果。由于在接受 BRAF/MEK 抑制剂治疗的肿瘤中,PD-1/PD-L1 受体上调,进一步的研究纳入了第三种联合用药--抗 PD-1/PD-L1 抑制剂。与单药或双药治疗方案相比,这种三联疗法可能具有更优越的疗效和可控的安全性。白话摘要:有效治疗晚期和转移性黑色素瘤是一项挑战。针对BRAF突变肿瘤患者的新治疗方法包括具有不同互补机制的药物组合。这些药物包括BRAF抑制剂、MEK抑制剂和PD-1/PD-L1抑制剂。与只同时使用其中一种或两种药物相比,这三种药物联合使用时,患者的反应率和生存率可能会更高。三联用药方案的毒性率较高,因此必须考虑谨慎选择患者:BRAF抑制剂 MEK抑制剂 转移性黑色素瘤 BRAF突变黑色素瘤 BRAF联合疗法 三联疗法
{"title":"Combination Atezolizumab, Cobimetinib, and Vemurafenib as a Treatment Option in BRAF V600 Mutation–Positive Melanoma: Patient Selection and Perspectives","authors":"Michelle M Dugan, Matthew C Perez, Lilit Karapetyan, Jonathan S Zager","doi":"10.2147/cmar.s325514","DOIUrl":"https://doi.org/10.2147/cmar.s325514","url":null,"abstract":"<strong>Abstract:</strong> The treatment landscape for advanced and metastatic melanoma has drastically changed in recent years, with the advent of novel therapeutic options such as immune checkpoint inhibitors and targeted therapies offering remarkable efficacy and significantly improved patient outcomes compared to traditional approaches. Approximately 50% of melanomas harbor activating BRAF mutations, with over 90% resulting in BRAF V600E. Tumors treated with BRAF inhibitor monotherapy have a high rate of developing resistance within six months. Combination therapy with MEK inhibitors helped to mitigate this treatment resistance and led to improved outcomes. Due to the up-regulation of PD-1/PD-L1 receptors in tumors treated with BRAF/MEK inhibitor therapy, further studies included a third combination agent, anti-PD-1/PD-L1 inhibitors. This triple combination therapy may have superior efficacy and a manageable safety profile when compared with single or double agent therapy regimens.<br/><br/><strong>Plain Language Summary:</strong> Effective treatment of advanced and metastatic melanoma can be challenging. Newer treatment methods for patients with BRAF-mutated tumors include a combination of drugs with different complementary mechanisms. These drugs include BRAF-inhibitors, MEK-inhibitors, and PD-1/PD-L1 inhibitors. When these three medications are used in combination, patients may have better response rates and survival outcomes, when compared to using just one or two of these medications together. Toxicity rates are higher with a triple-medication regimen, so careful patient selection is important to consider.<br/><br/><strong>Keywords:</strong> BRAF inhibitor, MEK inhibitor, metastatic melanoma, BRAF-mutant melanoma, combination BRAF therapy, triple therapy<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"170 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141867362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Astragalus membranaceus: A Review of Its Antitumor Effects on Non-Small Cell Lung Cancer 黄芪:黄芪对非小细胞肺癌的抗肿瘤作用综述
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-25 DOI: 10.2147/cmar.s466633
Zhenyu Li, Jimin Liu, Haishan Cui, Wenlong Qi, Yangyang Tong, Tan Wang
Abstract: The rising global morbidity and mortality rates of non-small cell lung cancer (NSCLC) underscore the urgent need for more effective treatments. Current therapeutic modalities—including surgery, radiotherapy, chemotherapy, and targeted therapy—face several limitations. Recently, Astragalus membranaceus, a traditional Chinese medicine (TCM), has captured significant attention due to its broad pharmacological properties, such as immune regulation, anti-inflammatory effects, and the modulation of reactive oxygen species (ROS) and enzyme activities. This review delivers a comprehensive summary of the most recent advancements and ongoing applications of Astragalus membranaceus in NSCLC treatment, underlining its potential for integration into existing treatment protocols. It also highlights essential areas for future research, including the elucidation of its molecular mechanisms, optimization of dosage and administration, and evaluation of its efficacy and safety alongside standard therapies, all of which could potentially improve therapeutic outcomes for NSCLC patients.

Keywords: non-small cell lung cancer, Astragalus membranaceus, antitumor activity, immunoregulation, cisplatin
摘要:非小细胞肺癌(NSCLC)在全球的发病率和死亡率不断上升,突出表明迫切需要更有效的治疗方法。目前的治疗方法--包括手术、放疗、化疗和靶向治疗--面临着一些局限性。最近,传统中药黄芪因其广泛的药理特性,如免疫调节、抗炎作用、调节活性氧(ROS)和酶活性等,引起了广泛关注。本综述全面总结了膜荚黄芪在治疗 NSCLC 方面的最新进展和持续应用,强调了其融入现有治疗方案的潜力。它还强调了未来研究的重要领域,包括阐明其分子机制、优化剂量和给药以及评估其与标准疗法并用的疗效和安全性,所有这些都有可能改善 NSCLC 患者的治疗效果。
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引用次数: 0
Retinol Binding Protein 4 Serves as a Potential Tumor Biomarker and Promotes Malignant Behavior in Gastric Cancer 视黄醇结合蛋白 4 是一种潜在的肿瘤生物标记物,可促进胃癌的恶性行为
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-24 DOI: 10.2147/cmar.s480337
Yantao Yu, Chenkai Zhang, Qiannan Sun, Shantanu Baral, Jianyue Ding, Fanyu Zhao, Qing Yao, Shuyang Gao, Bin Liu, Daorong Wang
Background: Gastric cancer (GC) is a highly phenotypically heterogeneous disease and is caused by a combination of factors. Retinol binding protein 4 (RBP4) is a member of a family of lipid transport proteins that are involved in the transport of substances between cells and play a crucial role in a variety of cancers. However, the expression and role of RBP4 in GC remain unknown.
Methods: In this study, we explored the expression, prognostic significance, immune microenvironment, drug responsiveness and function of associated signaling pathways of RBP4 in GC using web-based bioinformatics tools. Immunohistochemistry and real-time quantitative PCR were utilized to analyze the tissue and cell expression levels of RBP4. CCK-8, colony formation, EDU incorporation, wound healing and transwell assays were applied to demonstrate the effect of RBP4 on GC cell function. Flow cytometric detection of apoptosis after RBP4 knockdown. Nude mice xenograft model elucidates the role of RBP4 for GC in vivo. Related proteins of the RAS signaling pathway were analyzed by employing Western blot assays.
Results: RBP4 is highly expressed in GC. RBP4 is closely associated with patient survival and sensitivity to a wide range of antitumor agents. Knockdown of RBP4 promoted apoptosis and inhibited cell proliferation, invasion and migration. RBP4 promotes GC tumorigenesis in vivo. Finally, RBP4 modulates the RAS/RAF/ERK axis.
Conclusion: RBP4 may promote gastric carcinogenesis and development through the RAS/RAF/ERK axis and is expected to be a novel target for GC treatment.

背景:胃癌(GC)是一种表型高度异质性的疾病,由多种因素引起。视黄醇结合蛋白 4(RBP4)是脂质转运蛋白家族中的一员,参与细胞间的物质转运,在多种癌症中起着至关重要的作用。然而,RBP4在GC中的表达和作用仍然未知:在这项研究中,我们利用基于网络的生物信息学工具探讨了 RBP4 在 GC 中的表达、预后意义、免疫微环境、药物反应性和相关信号通路的功能。免疫组化和实时定量 PCR 分析了 RBP4 在组织和细胞中的表达水平。应用 CCK-8、菌落形成、EDU掺入、伤口愈合和透孔试验来证明 RBP4 对 GC 细胞功能的影响。流式细胞术检测 RBP4 敲除后的细胞凋亡。裸鼠异种移植模型阐明了 RBP4 在体内对 GC 的作用。通过Western印迹法分析了RAS信号通路的相关蛋白:结果:RBP4在GC中高表达。RBP4与患者的存活率和对多种抗肿瘤药物的敏感性密切相关。敲除 RBP4 可促进细胞凋亡,抑制细胞增殖、侵袭和迁移。RBP4 在体内促进 GC 肿瘤的发生。最后,RBP4调节RAS/RAF/ERK轴:结论:RBP4 可通过 RAS/RAF/ERK 轴促进胃癌的发生和发展,有望成为治疗 GC 的新靶点。
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引用次数: 0
Investigation of the Effectiveness of Prostate Biopsy Density in Predicting Prostate Cancer Under Cognitive and Systematic Biopsy in Multi-Parametric Magnetic Resonance Imaging (mpMRI) 前列腺活检密度在多参数磁共振成像(mpMRI)认知性和系统性活检中预测前列腺癌的有效性研究
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-24 DOI: 10.2147/cmar.s476636
Jiajin Feng, Keming Chen, Haifu Tian, Al-qaisi Mohammed Abdulkarem, Yunshang Tuo, Xuehao Wang, Bincheng Huang, Yu Gao, Zhiyong Lv, Rui He, Guangyong Li
Objective: To explore the effectiveness of prostate biopsy density in predicting prostate cancer under cognitive and systematic biopsy mode in multi-parametric magnetic resonance imaging (mpMRI).
Methods: A retrospective analysis was conducted on clinical data of 204 patients who were suspected of having prostate cancer with prostate-specific antigen (PSA) levels less than 50 ng mL− 1 and underwent cognitive and systematic biopsy through the perineal approach in our hospital from 2022 to 2023. Univariate and multivariate logistic regression analyses were used to evaluate the odds ratios of prostate biopsy density and relevant clinical indicators. Logistic regression analysis was performed to establish a predictive model combining indicators with predictive value. The predictive value of each indicator and the new model was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC).
Results: The detection rate of prostate cancer in the study population was 32.35%. Multivariate analysis showed that age, PSAD, PI-RADS 2.1 score, and prostate biopsy density were independent predictors of prostate cancer. The ROC curve analysis revealed an AUC of 0.707 (95% CI 0.625– 0.790) for biopsy density, with a cutoff value of approximately 0.22 needle mL− 1. The best predictive model consisted of age, PSAD, PI-RADS 2.1 score, and biopsy density, with an AUC of 0.857.
Conclusion: Biopsy density is associated with the detection of prostate cancer, with a critical value of 0.22 needle mL− 1. Combining biopsy density with other clinical indicators can significantly improve the ability to predict prostate cancer and avoid unnecessary prostate biopsy cores.

Keywords: prostate biopsy, multi-parametric magnetic resonance imaging, biopsy density, cognitive fusion, cancer prediction
目的探讨前列腺活检密度在多参数磁共振成像(mpMRI)认知和系统活检模式下预测前列腺癌的有效性:对2022年至2023年期间在我院接受会阴部认知性和系统性活检的204例前列腺特异性抗原(PSA)水平低于50 ng mL- 1的前列腺癌疑似患者的临床数据进行回顾性分析。采用单变量和多变量逻辑回归分析评估前列腺活检密度与相关临床指标的几率比。通过逻辑回归分析,结合具有预测价值的指标建立预测模型。使用接收者操作特征曲线(ROC)和曲线下面积(AUC)评估了各指标和新模型的预测价值:研究人群的前列腺癌检出率为 32.35%。多变量分析显示,年龄、PSAD、PI-RADS 2.1 评分和前列腺活检密度是前列腺癌的独立预测因素。ROC 曲线分析显示,活检密度的 AUC 为 0.707(95% CI 0.625-0.790),临界值约为 0.22 针 mL-1。最佳预测模型由年龄、PSAD、PI-RADS 2.1 评分和活检密度组成,AUC 为 0.857:活检密度与前列腺癌的检测相关,临界值为 0.22 针 mL-1。关键词:前列腺活检;多参数磁共振成像;活检密度;认知融合;癌症预测
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引用次数: 0
An Assessment of Cryopreserved Semen and Testicular Tissue Collected Before and After Cancer Treatment Initiation 对癌症治疗开始前后采集的冷冻精液和睾丸组织进行评估
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-24 DOI: 10.2147/cmar.s460960
Marta Julia Fernández-González, Anne-Catherine Radauer-Plank, Anja Borgmann-Staudt, Waldemar Geiger, Irena Goranova, Stephanie Klco-Brosius, Bernhard Ralla, Cornelia Stelzer, Ina Wilkemeyer, Magdalena Balcerek
Purpose: This retrospective cohort study assessed semen and testicular tissue quality from adult and adolescent cancer patients who had samples cryopreserved in the Cryobank of Charité-Universitätsmedizin before and/or after cancer treatment.
Methods and Materials: Medical and cryopreservation data for all samples stored between 03/2004 and 05/2019 were collected retrospectively.
Results: We included information on 601 samples cryopreserved from 506 cancer patients for whom oncologic treatment data were available. The majority of the samples were cryopreserved prior to cancer treatment (460/600, 77%, median 5 days before treatment). Semen quality had a predisposed reduction in those collected from adolescents with testicular and/or hematological malignancies. Analyses of the 140 (23%) samples cryopreserved after treatment initiation (median of 84 days) revealed decreased median concentration and motility following high gonadotoxic-risk treatment. Rate of oligoasthenozoospermia was comparable in samples collected prior to treatment with those provided during follow-up spermiograms within 1 year after treatment initiation (45.5% vs 45.5%). However, an increase was seen in samples collected 1– 2 (9.1% to 90.9%) and 2– 3 (50.0% to 100.0%) years after treatment initiation.
Conclusion: Cancer diagnosis and treatment may impair spermatogenesis; therefore, patient counseling prior to cancer treatment by an oncologist and/or fertility specialist is crucial.

Keywords: cancer, fertility preservation, adolescent, men
目的:这项回顾性队列研究评估了在癌症治疗前和/或治疗后将样本冷冻保存在Charité-Universitätsmedizin冷冻库的成年和青少年癌症患者的精液和睾丸组织质量:回顾性收集了 2004 年 3 月至 2019 年 5 月期间储存的所有样本的医学和冷冻保存数据:结果:我们纳入了从 506 名癌症患者冷冻保存的 601 份样本的信息,这些患者均有肿瘤治疗数据。大多数样本是在癌症治疗前冷冻保存的(460/600,77%,中位数为治疗前 5 天)。从患有睾丸和/或血液恶性肿瘤的青少年中采集的精液样本,其质量容易下降。对开始治疗后(中位数为 84 天)冷冻保存的 140 份样本(23%)进行分析后发现,高性腺毒性风险治疗后,样本的中位数浓度和运动能力均有所下降。在治疗前采集的样本中,少精症发生率与治疗开始后一年内随访精子图中提供的样本相当(45.5% vs 45.5%)。然而,在开始治疗后1-2年(9.1%至90.9%)和2-3年(50.0%至100.0%)采集的样本中,无精子症的比例有所上升:癌症的诊断和治疗可能会影响精子的生成;因此,在癌症治疗前由肿瘤专家和/或生育专家对患者进行咨询至关重要。
{"title":"An Assessment of Cryopreserved Semen and Testicular Tissue Collected Before and After Cancer Treatment Initiation","authors":"Marta Julia Fernández-González, Anne-Catherine Radauer-Plank, Anja Borgmann-Staudt, Waldemar Geiger, Irena Goranova, Stephanie Klco-Brosius, Bernhard Ralla, Cornelia Stelzer, Ina Wilkemeyer, Magdalena Balcerek","doi":"10.2147/cmar.s460960","DOIUrl":"https://doi.org/10.2147/cmar.s460960","url":null,"abstract":"<strong>Purpose:</strong> This retrospective cohort study assessed semen and testicular tissue quality from adult and adolescent cancer patients who had samples cryopreserved in the Cryobank of Charité-Universitätsmedizin before and/or after cancer treatment.<br/><strong>Methods and Materials:</strong> Medical and cryopreservation data for all samples stored between 03/2004 and 05/2019 were collected retrospectively.<br/><strong>Results:</strong> We included information on 601 samples cryopreserved from 506 cancer patients for whom oncologic treatment data were available. The majority of the samples were cryopreserved prior to cancer treatment (460/600, 77%, median 5 days before treatment). Semen quality had a predisposed reduction in those collected from adolescents with testicular and/or hematological malignancies. Analyses of the 140 (23%) samples cryopreserved after treatment initiation (median of 84 days) revealed decreased median concentration and motility following high gonadotoxic-risk treatment. Rate of oligoasthenozoospermia was comparable in samples collected prior to treatment with those provided during follow-up spermiograms within 1 year after treatment initiation (45.5% vs 45.5%). However, an increase was seen in samples collected 1– 2 (9.1% to 90.9%) and 2– 3 (50.0% to 100.0%) years after treatment initiation.<br/><strong>Conclusion:</strong> Cancer diagnosis and treatment may impair spermatogenesis; therefore, patient counseling prior to cancer treatment by an oncologist and/or fertility specialist is crucial.<br/><br/><strong>Keywords:</strong> cancer, fertility preservation, adolescent, men<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"23 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combination Therapy with Immune Checkpoint Inhibitors and Histone Deacetylase Inhibitors or Alkylating Agents 免疫检查点抑制剂与组蛋白去乙酰化酶抑制剂或烷基化药物的联合疗法
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-22 DOI: 10.2147/cmar.s464245
Markus Joerger, Kira-Lee Koster, Tomas Janik, Floris A de Jong
<strong>Purpose:</strong> Immune checkpoint inhibitors (CPIs) have been widely adopted in a number of early and advanced malignancies. Histone deacetylase inhibitors (HDACis) and alkylating agents (AAs) have been suggested to potentiate the actions of CPIs on tumor cells. We conducted a comprehensive literature review to explore the potential synergistic activity between CPIs, AAs, and HDACis.<br/><strong>Patients and Methods:</strong> Clinical and non-clinical studies describing outcomes in patients with cancer receiving CPIs and either concomitant or sequential (pre- or post-CPI) AAs or HDACis were identified in PubMed using pre-defined search strings. Manual searches of key oncology congresses were similarly performed. All relevant articles and abstracts were manually screened for relevance, classified according to the specific anticancer agents used (CPIs, AAs, or HDACis), tumor entity, and whether treatment was concomitant or sequential.<br/><strong>Results:</strong> Overall, 227 unique clinical studies across a range of tumor types, both solid tumors and hematological malignancies, were identified. One hundred and fifty-nine publications on Phase I and II clinical studies together with 41 publications on Phase III studies were examined. The most commonly investigated tumor types were melanoma, triple-negative breast cancer, non-small cell lung cancer, and Hodgkin lymphoma. The randomized clinical studies identified, all of which reported on the combination of a CPI with an AA, demonstrated superior outcomes in the combination arm compared with CPI or AA monotherapy. Similarly, combination therapy with CPIs and HDACis demonstrated promising activity.<br/><strong>Conclusion:</strong> Sequential or concomitant administration of a CPI with an AA or an HDACi may improve outcomes for patients with a range of tumor types. There is a rationale to support further investigation into the potential for synergy between CPIs, alkylating agents and/or HDACis in both the non-clinical and clinical settings.<br/><br/><strong>Plain Language Summary:</strong> People being treated for cancer will often receive more than one drug at a time, and the concept of combining cancer drugs is frequently investigated as a potential opportunity to improve outcomes for patients. We reviewed the published literature for clinical trials and work undertaken in laboratories to explore whether combining targeted agents that stop cancer cells from multiplying (known as checkpoint inhibitors) with traditional chemotherapy that kills cancer cells could be a useful approach. We looked at evidence in publications where checkpoint inhibitors were used at the same time as chemotherapy, or given immediately before or after chemotherapy. The most important evidence came from clinical trials where outcomes for patients receiving combinations of treatment were directly compared with those from patients receiving a single treatment. These studies showed superior outcomes for patients who w
目的:免疫检查点抑制剂(CPIs)已被广泛用于一些早期和晚期恶性肿瘤。有人认为组蛋白去乙酰化酶抑制剂(HDACis)和烷化剂(AAs)能增强CPIs对肿瘤细胞的作用。我们进行了全面的文献综述,以探索 CPIs、AAs 和 HDACis 之间潜在的协同活性:使用预先定义的搜索字符串,在 PubMed 上查找描述癌症患者接受 CPIs 和同时或先后(CPI 之前或之后)接受 AAs 或 HDACis 治疗的临床和非临床研究。对主要肿瘤学大会也进行了类似的人工检索。人工筛选所有相关文章和摘要的相关性,并根据使用的特定抗癌药物(CPI、AA 或 HDACis)、肿瘤实体以及治疗是同时进行还是连续进行进行进行分类:总体而言,共发现了 227 项独特的临床研究,涉及多种肿瘤类型,包括实体瘤和血液恶性肿瘤。其中 159 篇发表于 I 期和 II 期临床研究,41 篇发表于 III 期研究。最常研究的肿瘤类型是黑色素瘤、三阴性乳腺癌、非小细胞肺癌和霍奇金淋巴瘤。已确定的随机临床研究均报告了 CPI 与 AA 的联合治疗,结果显示联合治疗组的疗效优于 CPI 或 AA 单药治疗组。同样,CPI 与 HDACis 的联合疗法也显示出良好的活性:结论:CPI 与 AA 或 HDACi 相继或同时给药可改善各种肿瘤类型患者的预后。有理由支持在非临床和临床环境中进一步研究 CPIs、烷化剂和/或 HDACis 之间的潜在协同作用。我们回顾了已发表的临床试验文献和实验室工作,以探讨将阻止癌细胞繁殖的靶向药物(称为检查点抑制剂)与杀死癌细胞的传统化疗相结合是否是一种有用的方法。我们研究了在化疗的同时使用检查点抑制剂或在化疗前后立即使用检查点抑制剂的出版物中的证据。最重要的证据来自临床试验,在这些试验中,接受联合治疗的患者的疗效与接受单一治疗的患者的疗效进行了直接比较。这些研究显示,与接受单一疗法的患者相比,接受联合抗癌药物治疗的患者疗效更佳。我们还发现有证据表明,加入另一类抗癌药物(组蛋白去乙酰化酶抑制剂)可能会使肿瘤对检查点抑制剂敏感。这些发现为研究烷化剂和/或组蛋白去乙酰化酶抑制剂与检查点抑制剂联合应用提供了理论依据。 关键词:组蛋白去乙酰化酶抑制剂;检查点抑制剂;烷化剂;协同作用;血液恶性肿瘤;实体瘤
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引用次数: 0
Real-World Treatment Patterns and Outcomes of Cemiplimab in Patients with Advanced Cutaneous Squamous Cell Carcinoma Treated in US Oncology Practices 在美国肿瘤医院接受治疗的晚期皮肤鳞状细胞癌患者中使用西米普利单抗的实际治疗模式和结果
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-18 DOI: 10.2147/cmar.s445910
Wenzhen Ge, Ning Wu, Chieh-I Chen, Timothy J Inocencio, Patrick R LaFontaine, Frank Seebach, Matthew Fury, James Harnett, Emily S Ruiz
Background: Prior to the Food and Drug Administration approval of cemiplimab in 2018, the median overall survival (OS) for adult patients with advanced CSCC receiving systemic therapy was approximately 8 to 15 months. Limited real-world data are available on cemiplimab for this indication in the US.
Patients and Methods: This retrospective cohort study included US patients with advanced CSCC initiating cemiplimab monotherapy in a real-world database (2018– 2021). A clinical trial–like sub-cohort was identified using select criteria. Time to treatment discontinuation (TTD), time to next treatment (TTNT), and OS were estimated using Kaplan–Meier methods. Cox proportional hazard models were used to examine prognostic factors associated with OS in the main cohort.
Results: The main cohort included 622 patients (n = 240 in the trial-like cohort). In the main cohort, the median age was 78 years, 77.8% were male, 21.4% were immunocompromised/immunosuppressed, and 63.8% had metastatic CSCC. Median (95% CI) TTD and TTNT were 8.0 (6.6– 9.0) months and 16.4 (13.3– 21.0) months, respectively, in the main cohort. Median (95% CI) OS was 24.8 (21.8– 29.1) months in the main cohort (not reached in the trial-like cohort). In multivariable analyses, age < 60 years (hazard ratio [HR], 0.37), Eastern Cooperative Oncology Group performance status < 3– 4 (HR range, 0.13– 0.57), and primary CSCC location in the head and neck only versus extremities only (HR, 0.59) were associated with better OS. Similar OS was observed between patients who had immunosuppressing/immunocompromising conditions and those without.
Conclusion: These findings confirm the effectiveness of cemiplimab among a heterogenous, real-world advanced CSCC patient population and substantiate the efficacy of cemiplimab observed in clinical trials.

背景:在2018年食品药品管理局批准使用cemiplimab之前,接受全身治疗的晚期CSCC成年患者的中位总生存期(OS)约为8至15个月。关于cemiplimab在美国用于该适应症的真实世界数据有限:这项回顾性队列研究纳入了真实世界数据库(2018-2021 年)中开始接受 cemiplimab 单药治疗的美国晚期 CSCC 患者。通过选择标准确定了一个类似临床试验的子队列。采用Kaplan-Meier方法估算了治疗中止时间(TTD)、下次治疗时间(TTNT)和OS。采用 Cox 比例危险模型检查与主队列中 OS 相关的预后因素:主要队列包括 622 名患者(试验类队列中的人数为 240 人)。主队列的中位年龄为 78 岁,77.8% 为男性,21.4% 为免疫功能低下/免疫抑制患者,63.8% 为转移性 CSCC 患者。主要队列的中位(95% CI)TTD和TTNT分别为8.0(6.6- 9.0)个月和16.4(13.3- 21.0)个月。主要队列的中位(95% CI)OS 为 24.8(21.8- 29.1)个月(试验样队列未达到)。在多变量分析中,年龄为60岁(危险比[HR],0.37)、东部合作肿瘤学组表现状态为3-4(HR范围为0.13-0.57)、原发CSCC位置仅在头颈部而非四肢(HR,0.59)与较好的OS相关。免疫抑制/免疫功能低下患者与无免疫抑制/免疫功能低下患者的OS相似:这些研究结果证实了cemiplimab在异质性、真实世界的晚期CSCC患者群体中的有效性,并证实了临床试验中观察到的cemiplimab的疗效。
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Cancer Management and Research
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