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Evaluation of treatment strategies for patients with stage IIIA non-small cell lung cancer in the immunotherapy era.
Q3 Medicine Pub Date : 2024-11-28 DOI: 10.1016/j.ctarc.2024.100852
Amy Alabaster, Jeffrey B Velotta, Haley I Tupper, Mark S Walker, Yanina Natanzon

Background: Optimal treatment for patients with stage IIIA NSCLC is controversial. Growing evidence indicates surgery with adjuvant or neoadjuvant chemotherapy (SC) may be superior to non-surgical treatments. Direct comparisons have not been performed between SC and chemoradiation with immunotherapy (CRI) among patients diagnosed with stage IIIA NSCLC since consolidation immunotherapy was added to treatment guidelines.

Methods: This retrospective study compared surgical and systemic non-surgical treatments (except targeted therapy) among adults diagnosed with stage IIIA NSCLC 2017-2021. Data was from ConcertAI's curated EHR Patient360™ NSCLC real-world care product. Real-world progression-free survival (rwPFS) and overall survival (rwOS) were evaluated among patients treated with SC or CRI using Kaplan-Meier and Cox proportional hazard methods. Baseline differences were balanced using propensity score-derived inverse probability treatment weights (IPTW).

Results: Among 1718 eligible, the two main comparator groups (SC and CRI) had 431 (25%) and 576 (34%) patients; 711 patients received chemoradiation or monotherapy. A wide range of treatment strategies was observed across included oncology clinics (e.g., 0-67% clinic patients received surgery). IPTW-adjusted analyses showed reduced hazards in the SC group vs. CRI for rwPFS (HR 0.78, 95% CI: 0.63-0.97) and rwOS (HR 0.63, 95% CI: 0.49-0.82). SC was similarly beneficial for patients across nodal status groups and appeared especially beneficial for patients with resectable squamous-cell tumors.

Conclusion: Stage IIIA NSCLC treatment is highly variable. Real-world studies can provide valuable evidence to support surgery as a treatment option for stage IIIA patients, who currently may only be offered chemoradiation with or without immunotherapy.

{"title":"Evaluation of treatment strategies for patients with stage IIIA non-small cell lung cancer in the immunotherapy era.","authors":"Amy Alabaster, Jeffrey B Velotta, Haley I Tupper, Mark S Walker, Yanina Natanzon","doi":"10.1016/j.ctarc.2024.100852","DOIUrl":"https://doi.org/10.1016/j.ctarc.2024.100852","url":null,"abstract":"<p><strong>Background: </strong>Optimal treatment for patients with stage IIIA NSCLC is controversial. Growing evidence indicates surgery with adjuvant or neoadjuvant chemotherapy (SC) may be superior to non-surgical treatments. Direct comparisons have not been performed between SC and chemoradiation with immunotherapy (CRI) among patients diagnosed with stage IIIA NSCLC since consolidation immunotherapy was added to treatment guidelines.</p><p><strong>Methods: </strong>This retrospective study compared surgical and systemic non-surgical treatments (except targeted therapy) among adults diagnosed with stage IIIA NSCLC 2017-2021. Data was from ConcertAI's curated EHR Patient360™ NSCLC real-world care product. Real-world progression-free survival (rwPFS) and overall survival (rwOS) were evaluated among patients treated with SC or CRI using Kaplan-Meier and Cox proportional hazard methods. Baseline differences were balanced using propensity score-derived inverse probability treatment weights (IPTW).</p><p><strong>Results: </strong>Among 1718 eligible, the two main comparator groups (SC and CRI) had 431 (25%) and 576 (34%) patients; 711 patients received chemoradiation or monotherapy. A wide range of treatment strategies was observed across included oncology clinics (e.g., 0-67% clinic patients received surgery). IPTW-adjusted analyses showed reduced hazards in the SC group vs. CRI for rwPFS (HR 0.78, 95% CI: 0.63-0.97) and rwOS (HR 0.63, 95% CI: 0.49-0.82). SC was similarly beneficial for patients across nodal status groups and appeared especially beneficial for patients with resectable squamous-cell tumors.</p><p><strong>Conclusion: </strong>Stage IIIA NSCLC treatment is highly variable. Real-world studies can provide valuable evidence to support surgery as a treatment option for stage IIIA patients, who currently may only be offered chemoradiation with or without immunotherapy.</p>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"42 ","pages":"100852"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
En plaque meningioma of the temporal bone: A systematic review on the imaging and management of a rare tumor.
Q3 Medicine Pub Date : 2024-11-26 DOI: 10.1016/j.ctarc.2024.100854
Arianna Burato, Giuseppe Maruccio, Livio Presutti, Ignacio Javier Fernandez, Gabriele Molteni, Giulia Molinari

Objective: To review the published cases of meningioma en plaque of the temporal bone (TB-MEP), to gather evidence on the clinical assessment and management of this rare entity.

Methods: Following PRISMA statement recommendations, 383 abstracts were screened independently by two authors. Inclusion criteria were articles of human patients affected by TB-MEP; English or Italian language; availability of the abstract articles unrelated to TB-MEP, guidelines and systematic reviews were excluded. Only full-text articles reporting the diagnostic work-up and the management of the TB-MEP were considered for analysis.

Results: A total of 12 articles were included, for a total of 25 patients with a mean age of 52 years (range: 31-71). The average time elapsed between the onset of symptoms and the actual diagnosis of TB-MEP was 36.5 months (range: 2-120). In most cases, the pathology presented with hearing loss (80 %), often accompanied by effusive otitis media (52 %), aural fullness (32 %), and tinnitus (32 %). The main Computed Tomography (CT) findings were hyperostosis (76 %), hairy appearance of bony margins (16 %), involvement of the mastoid and middle ear (48 %). Magnetic Resonance Imaging (MRI) revealed dural enhancement (28 %), temporal hyperostosis (20 %), a clearly enhancing extra-axial mass (28 %), compression of the surrounding vasculo-nervous structures (8 %) and the possible involvement of the temporal lobe (8 %). Forty percent of patients underwent various medical and surgical treatment before reaching the diagnosis. Forty-four percent of patients were sent to definitive surgical treatment, 44 % to follow-up while 8 % received radiotherapy.

Conclusions: Meningioma en plaque (MEP) is a rare tumour, particularly when it originates within the temporal bone. Appropriate imaging in patients complaining of audiological sign and symptoms is mandatory to avoid diagnostic delays, avoid inappropriate surgical procedures, and adopt the appropriate treatment.

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引用次数: 0
Characterization of genomic profiling of Mexican women with breast cancer using EndoPredict.
Q3 Medicine Pub Date : 2024-11-26 DOI: 10.1016/j.ctarc.2024.100851
Diana Carolina Correa Sandoval, Jose Luis Guzman Murguia, Diego Alberto Guajardo Nieto

Purpose: In the context of rising breast cancer incidence and mortality rates in Mexico, our study delves into the genomic landscape of Mexican women diagnosed with stage I-III breast cancer.

Methods: Employing the EndoPredict test for genomic analysis, our retrospective, cross-sectional study explores correlations between genomic expression and immunohistochemistry (IHC).

Results: Among 50 female patients, risk stratification by IHC revealed 50 % as high risk and 50 % as low risk, with notable clinical and histological distinctions between the two groups. High-risk samples exhibited larger tumors, higher histological grades, and more positive lymph nodes. Immunohistochemistry results displayed a moderate concordance (kappa Cohen´s 0.48) with the EndoPredict test, emphasizing its clinical reliability over IHC.

Conclusions: The study advocates for the integration of genomic tools, particularly the EndoPredict test, in the management of breast cancer in Mexican women for enhanced precision in treatment decisions. Our findings contribute valuable insights to the evolving landscape of breast cancer diagnosis and management in the Mexican population.

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引用次数: 0
Clinical and pathological differences between early- and late-onset colorectal cancer and determinants of one-year all-cause mortality among advanced-stage patients: a retrospective cohort study in Medellín, Colombia 早期和晚期结直肠癌的临床和病理差异以及晚期患者一年全因死亡率的决定因素:哥伦比亚麦德林的一项回顾性队列研究
Q3 Medicine Pub Date : 2024-02-15 DOI: 10.1016/j.ctarc.2024.100797
Álvaro Esteban Ruiz Grajales , Manuela María Orozco Puerta , Senshuang Zheng , Geertruida H. de Bock , Juan Camilo Correa Cote , Esteban Castrillón Martínez

Objective

To identify the differences between early- (EOCRC) and late-onset colorectal cancer (LOCRC), and to evaluate the determinants of one-year all-cause mortality among advanced-stage patients.

Methods

A retrospective cohort study was carried out. CRC patients ≥ 18 years old were included. Chi-Square test was applied to compare both groups. Uni- and multivariate regressions were performed to evaluate the determinants of one-year all-cause mortality in all advanced-stage patients regardless of age of onset.

Results

A total of 416 patients were enrolled; 53.1 % were female. Ninety cases (21.6 %) had EOCRC and 326 (78.4 %) had LOCRC. EOCRC cases were predominantly sporadic (88.9 %). Histology of carcinoma other than adenocarcinoma (p = 0.044) and rectum tumors (p = 0.039) were more prevalent in EOCRC. LOCRC patients were more likely to have smoking history (p < 0.001) and right colon tumors (p = 0.039). Alcohol consumption history (odds ratio [OR]: 3.375, 95 %CI: 1.022–11.150) and stage IV (OR: 12.632, 95 %CI: 3.506–45.513) were associated with higher one-year all-cause mortality among advanced-stage patients, the opposite was noted with left colon tumors (OR: 0.045, 95 %CI: 0.003–0.588).

Conclusion

EOCRC was predominantly sporadic and had more cases of uncommon histological subtypes and rectal tumors. LOCRC was characterized by a higher prevalence of smoking history. Multivariate regression revealed an association between higher one-year all-cause mortality and alcohol consumption history and stage IV in advanced-stage patients. CRC exhibited differences based on age of onset. The evaluated factors associated with CRC mortality provide valuable insights for healthcare professionals, emphasizing the importance of adequate clinical assessment and early CRC diagnosis.

目的 找出早期(EOCRC)和晚期(LOCRC)结直肠癌之间的差异,并评估晚期患者一年全因死亡率的决定因素。 方法 开展一项回顾性队列研究。研究纳入了年龄≥ 18 岁的 CRC 患者。采用 Chi-Square 检验对两组患者进行比较。结果共纳入 416 例患者,其中 53.1% 为女性。其中 90 例(21.6%)为 EOCRC,326 例(78.4%)为 LOCRC。EOCRC病例主要为散发性(88.9%)。除腺癌(p = 0.044)和直肠肿瘤(p = 0.039)以外的其他组织学癌在 EOCRC 中更为常见。LOCRC患者更有可能有吸烟史(p < 0.001)和右侧结肠肿瘤(p = 0.039)。在晚期患者中,饮酒史(几率比 [OR]:3.375,95 %CI:1.022-11.150)和 IV 期(OR:12.632,95 %CI:3.506-45.513)与较高的一年全因死亡率相关,而左结肠肿瘤则相反(OR:0.结论EOCRC 以散发性为主,不常见的组织学亚型和直肠肿瘤病例较多。LOCRC的特点是吸烟史发生率较高。多变量回归显示,晚期患者较高的一年全因死亡率与饮酒史和 IV 期之间存在关联。根据发病年龄的不同,CRC 也存在差异。所评估的与 CRC 死亡率相关的因素为医护人员提供了宝贵的见解,强调了充分的临床评估和早期诊断 CRC 的重要性。
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引用次数: 0
Invited commentary on “The impact of bleomycin deficit on survival in Hodgkin's lymphoma patients: A retrospective study” 关于 "博来霉素不足对霍奇金淋巴瘤患者生存期的影响:回顾性研究 "的特约评论。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100806

The article “The impact of bleomycin deficit on survival in Hodgkin's lymphoma patients: A retrospective study” have presented the experience of AVD chemotherapy regimen in newly diagnosed Hodgkin's lymphoma (HL) in a single center in Brazil. Though being a small retrospective study, results from this study have provided the medical community a real-world data on HL in Brazil. ABVD has remained the standard of care for patients of newly diagnosed HL both in early and advance stages. Newer targeted molecules have also come for use in novel combinations with existing drugs. However, in a situation of temporary scarcity of bleomycin due to lack of supply during 2017 in Brazil led to use of incomplete ABVD regimen without bleomycin, i.e. AVD for HL. However, Soldi et al. utilized the opportunity to retrospectively study if the omission of bleomycin leads to subnormal treatment or unwarranted effects.

博来霉素不足对霍奇金淋巴瘤患者生存期的影响:回顾性研究 "一文介绍了巴西一家中心在新诊断的霍奇金淋巴瘤(HL)患者中采用AVD化疗方案的经验。虽然这只是一项小型回顾性研究,但研究结果为医学界提供了巴西霍奇金淋巴瘤的真实数据。无论是早期还是晚期,ABVD 仍是新诊断 HL 患者的标准治疗方法。新的靶向分子也开始与现有药物进行新的联合应用。然而,2017年巴西由于博莱霉素供应不足而出现暂时性短缺,导致使用不含博莱霉素的不完全ABVD方案,即AVD治疗HL。不过,Soldi等人利用这一机会回顾性研究了博莱霉素的缺失是否会导致治疗效果不正常或产生不必要的影响。
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引用次数: 0
Sarcopenia in gastric cancer and its impact on early postoperative outcome 胃癌患者的肌肉疏松症及其对术后早期预后的影响
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100829
Mira Sudam Wagh , Arun K. Balan , Arun Peter Mathew , C.A. Rakesh , Jagath Krishna , K. Chandramohan , Madhu Muralee

Background

Sarcopenia, defined as progressive and generalised loss of skeletal muscle mass, quality, and strength, is considered as a poor prognostic factor in cancer. Outcomes in oncology mainly focus on survival related to disease and treatment. Other factors affecting the end result get less attention. This study was conducted with the aim to determine presence of sarcopenia in operable gastric cancer, factors positively correlating with presence of sarcopenia and its impact on early postoperative outcomes.

Methodology

This is a prospective study conducted from January 2020 to December 2021 in a tertiary care cancer hospital. All patients with adenocarcinoma stomach planned for curative intent surgery were assessed for sarcopenia by measuring hand grip strength(HGS) and skeletal muscle index(SMI). Comparison was made between patient and tumour related factors in patients with and without sarcopenia and impact of sarcopenia on early postoperative outcome was assessed.

Results

74 patients were assessed for sarcopenia. 32 (43.2 %) were patients diagnosed with sarcopenia. Advanced age(p = 0.040), low BMI (p < 0.001), gastric outlet obstruction (p = 0.020) and urgent surgery (p = 0.002) positively correlated with sarcopenia. Curative resection was done in 68(91.89 %) patients and these patients were evaluated for early postoperative outcomes. 18 (26.5 %) patients had complications of Clavien Dindo grade 3 or above. Sarcopenia was not significantly associated with major postoperative complications(p = 0.857).

Conclusion

Sarcopenia, though associated with a substantial proportion of patients with gastric cancer, does not significantly affect early postoperative complications in a high volume oncology centre .

背景:肌肉疏松症是指骨骼肌质量、质量和力量的进行性和普遍性丧失,被认为是癌症的不良预后因素。肿瘤学的结果主要集中在与疾病和治疗相关的存活率上。而影响最终结果的其他因素则较少受到关注。本研究旨在确定可手术胃癌患者是否存在肌肉疏松症、与肌肉疏松症存在正相关的因素及其对术后早期预后的影响:这是一项前瞻性研究,于 2020 年 1 月至 2021 年 12 月在一家三级癌症医院进行。通过测量手部握力(HGS)和骨骼肌指数(SMI),对所有计划进行根治性手术的胃腺癌患者进行肌肉疏松症评估。比较有无肌肉疏松症患者的患者和肿瘤相关因素,并评估肌肉疏松症对术后早期预后的影响:74名患者接受了肌肉疏松症评估。结果:74 名患者接受了肌肉疏松症评估,其中 32 人(43.2%)被确诊为肌肉疏松症患者。高龄(p = 0.040)、低体重指数(p < 0.001)、胃出口梗阻(p = 0.020)和紧急手术(p = 0.002)与肌肉疏松症呈正相关。68例(91.89%)患者接受了根治性切除术,并对这些患者的术后早期效果进行了评估。有 18 名患者(26.5%)出现了 Clavien Dindo 3 级或以上的并发症。肌肉疏松症与主要术后并发症无明显关联(P = 0.857):尽管相当一部分胃癌患者都患有肌肉疏松症,但这并不会明显影响大手术量肿瘤中心的早期术后并发症。
{"title":"Sarcopenia in gastric cancer and its impact on early postoperative outcome","authors":"Mira Sudam Wagh ,&nbsp;Arun K. Balan ,&nbsp;Arun Peter Mathew ,&nbsp;C.A. Rakesh ,&nbsp;Jagath Krishna ,&nbsp;K. Chandramohan ,&nbsp;Madhu Muralee","doi":"10.1016/j.ctarc.2024.100829","DOIUrl":"10.1016/j.ctarc.2024.100829","url":null,"abstract":"<div><h3>Background</h3><p>Sarcopenia, defined as progressive and generalised loss of skeletal muscle mass, quality, and strength, is considered as a poor prognostic factor in cancer. Outcomes in oncology mainly focus on survival related to disease and treatment. Other factors affecting the end result get less attention. This study was conducted with the aim to determine presence of sarcopenia in operable gastric cancer, factors positively correlating with presence of sarcopenia and its impact on early postoperative outcomes.</p></div><div><h3>Methodology</h3><p>This is a prospective study conducted from January 2020 to December 2021 in a tertiary care cancer hospital. All patients with adenocarcinoma stomach planned for curative intent surgery were assessed for sarcopenia by measuring hand grip strength(HGS) and skeletal muscle index(SMI). Comparison was made between patient and tumour related factors in patients with and without sarcopenia and impact of sarcopenia on early postoperative outcome was assessed.</p></div><div><h3>Results</h3><p>74 patients were assessed for sarcopenia. 32 (43.2 %) were patients diagnosed with sarcopenia. Advanced age(<em>p</em> = 0.040), low BMI (<em>p</em> &lt; 0.001), gastric outlet obstruction (<em>p</em> = 0.020) and urgent surgery (<em>p</em> = 0.002) positively correlated with sarcopenia. Curative resection was done in 68(91.89 %) patients and these patients were evaluated for early postoperative outcomes. 18 (26.5 %) patients had complications of Clavien Dindo grade 3 or above. Sarcopenia was not significantly associated with major postoperative complications(<em>p</em> = 0.857).</p></div><div><h3>Conclusion</h3><p>Sarcopenia, though associated with a substantial proportion of patients with gastric cancer, does not significantly affect early postoperative complications in a high volume oncology centre .</p></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"40 ","pages":"Article 100829"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468294224000418/pdfft?md5=2072b55a4a18ef912b997cd606da6570&pid=1-s2.0-S2468294224000418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low to intermediate grade lung neuroendocrine tumours. A single centre real world experience 中低度肺神经内分泌肿瘤。单个中心的实际经验。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100846
Jacqueline Martin , Mohammad Alrehaili , Horia Marginean , Rachel Goodwin , Paul Wheatley-Price

Introduction

Lung neuroendocrine tumours (LNETs) are a rare heterogenous group of tumours whose incidence has been increasing. We investigated the diagnosis, treatment, and survival patterns of patients with low to intermediate grade LNETs.

Methods

A retrospective chart review of patients with low to intermediate grade LNETs, treated at a Canadian tertiary-level cancer centre was performed.

Results

We identified 59 patients. Most were G1or G2 and well or moderately differentiated. Forty-seven patients presented with local or locally advanced disease, of which 57.4 % received curative intent surgery. The rest were treated with definitive radiation, radical chemoradiation with platinum and etoposide, palliative chemotherapy with doxorubicin, or supportive care. The five-year overall survival (OS) for those treated surgically was 83 % versus 44 % in the non-surgical group. Metastatic disease was seen in 24/59 patients, with a five-year OS in patients with stage IV disease of 39 %. Of those with advanced or unresectable disease (n = 32), 21 received palliative systemic treatment with up to three lines of therapy. First-line treatment was most commonly chemotherapy with platinum/etoposide combination or somatostatin analogue therapy. Second-line treatment involved chemotherapy or targeted everolimus. PRRT was used once as a first-line and once as second-line therapy. Third-line included lanreotide or chemotherapy with capecitabine/temozolomide combination.

Conclusion

Overall, patients with surgically resectable disease had a good five-year OS. However, inoperable or more advanced disease was associated with a poorer OS. Despite many treatment options, the sequence of treatments is poorly established. This highlights the need for further development and dissemination of evidence-based guidelines for LNET patients.
简介肺神经内分泌肿瘤(LNETs)是一种罕见的异质性肿瘤,其发病率呈上升趋势。我们对中低级别 LNET 患者的诊断、治疗和生存模式进行了调查:我们对在加拿大一家三级癌症中心接受治疗的中低级别 LNET 患者进行了回顾性病历审查:结果:我们发现了 59 名患者。大多数为 G1 或 G2,分化良好或中度。47名患者出现局部或局部晚期疾病,其中57.4%接受了根治性手术。其余患者接受了确定性放射治疗、铂类和依托泊苷根治性化疗、多柔比星姑息化疗或支持治疗。手术治疗组的五年总生存率(OS)为 83%,而非手术治疗组为 44%。24/59例患者出现了转移性疾病,IV期患者的五年生存率为39%。在晚期或无法切除的患者(32 人)中,21 人接受了多达三种疗法的姑息性全身治疗。一线治疗最常见的是铂/依托泊苷联合化疗或体生长抑素类似物疗法。二线治疗包括化疗或靶向依维莫司。PRRT作为一线疗法和二线疗法各使用过一次。三线治疗包括兰瑞肽或卡培他滨/替莫唑胺联合化疗:总的来说,可手术切除的患者五年的OS良好。结论:总体而言,可手术切除的患者的五年生存率较高,但无法手术或病情较晚的患者的生存率较低。尽管治疗方案很多,但治疗顺序还不太确定。这凸显了为LNET患者进一步制定和传播循证指南的必要性。
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引用次数: 0
Gastric cancer—Epidemiology, modifiable and non-modifiable risk factors, challenges and opportunities: An updated review 胃癌--流行病学、可改变和不可改变的风险因素、挑战和机遇:最新综述。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100845
Tajul Islam Mamun , Sabrina Younus , Md. Hashibur Rahman
Gastric cancer represents a significant global health challenge due to its high mortality and incidence rates, particularly in Eastern Asia, Eastern Europe, and South America. This comprehensive review synthesizes the latest epidemiological data and explores both modifiable and non-modifiable risk factors associated with gastric cancer, aiming to delineate the multifactorial etiology of this disease. Modifiable risk factors include Helicobacter pylori infection, obesity, dietary habits, smoking and alcohol consumption, whereas nonmodifiable factors comprise genetic predispositions, age, family history and male gender. The interplay of these factors significantly impacts the risk and progression of gastric cancer, suggesting potential preventive strategies. The challenges in treating gastric cancer are considerable, largely because of the late-stage diagnosis and the heterogeneity of the disease, which complicate effective treatment regimens. Current treatment strategies involve a combination of surgery, chemotherapy, radiotherapy, and targeted therapies. The FLOT regimen (5-FU, Leucovorin, Oxaliplatin and Docetaxel) is now a standard for resectable cases in Europe and the US, showing superior survival and response rates over ECF and ECX regimens. For HER2-positive gastric cancer, trastuzumab combined with chemotherapy improves overall survival, as demonstrated by the ToGA trial. Additionally, immune checkpoint inhibitors like pembrolizumab and nivolumab offer promising results. However, the five-year survival rate remains low, underscoring the urgency for improved therapeutic approaches. Recent advancements in molecular biology and cancer genomics have begun to pave the way for personalized medicine in gastric cancer care, focusing on molecular targeted therapies and immunotherapy. This review also highlights the critical need for better screening methods that could facilitate early detection and treatment, potentially improving the prognosis. By integrating epidemiological insights with new therapeutic strategies, this article aims to thoroughly understand of gastric cancer's dynamics and outline a framework for future research and clinical management, advocating for a multidisciplinary approach to tackle this formidable disease.
胃癌的死亡率和发病率都很高,尤其是在东亚、东欧和南美地区,是全球健康面临的重大挑战。这篇综合性综述综合了最新的流行病学数据,探讨了与胃癌相关的可改变和不可改变的风险因素,旨在阐明这种疾病的多因素病因。可改变的风险因素包括幽门螺杆菌感染、肥胖、饮食习惯、吸烟和饮酒,而不可改变的因素包括遗传倾向、年龄、家族史和男性性别。这些因素的相互作用对胃癌的风险和进展产生了重大影响,并提出了潜在的预防策略。胃癌的治疗面临巨大挑战,这主要是因为胃癌的诊断较晚,而且疾病具有异质性,这使得有效的治疗方案变得复杂。目前的治疗策略包括手术、化疗、放疗和靶向疗法的综合治疗。FLOT方案(5-FU、亮菌素、奥沙利铂和多西他赛)目前已成为欧美可切除病例的标准方案,其生存率和反应率均优于ECF和ECX方案。对于 HER2 阳性胃癌,曲妥珠单抗联合化疗可提高总生存率,ToGA 试验也证明了这一点。此外,pembrolizumab 和 nivolumab 等免疫检查点抑制剂也取得了可喜的成果。然而,五年生存率仍然很低,这凸显了改进治疗方法的紧迫性。分子生物学和癌症基因组学的最新进展已开始为胃癌治疗中的个性化医疗铺平道路,重点是分子靶向疗法和免疫疗法。这篇综述还强调了对更好的筛查方法的迫切需要,这些方法可促进早期检测和治疗,从而改善预后。通过将流行病学见解与新的治疗策略相结合,本文旨在深入了解胃癌的动态变化,并为未来的研究和临床管理勾勒出一个框架,倡导采用多学科方法来应对这一可怕的疾病。
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引用次数: 0
Liposomes for the treatment of prostate cancer therapy: A review 用于前列腺癌治疗的脂质体:综述
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100792
Chinmaya Keshari Sahoo , Nalini Kanta Sahoo , Madhusmita Sahu

One of the cancers that affect men, prostate cancer considerably raises mortality rates for males around the world. Patients with prostate cancer can have a localized or advanced form of the illness. Digital rectal examinations, prostate-specific antigen analyses, and prostate biopsies are all used to identify prostate cancer. The onset, development, and spread of cancer are all correlated with mutations in specific genes. Radical prostatectomy, ablative radiation, and active surveillance are all forms of treatment for localized prostate cancer. Androgen deprivation therapy (ADT), radiation, and chemotherapy are given to men who have metastatic prostate cancer or have experienced a relapse. When compared to traditional cancer chemotherapeutic methods, the liposome-based drug delivery technology offers less toxic, biodegradable, and biocompatible nanomedicine. Liposomes offer great advantages for use in nanomedicines by improving the sensitivity, specificity, and persistence of these anti-malignant cell agents in the body. Liposomal formulations are undergoing clinical trials of variety of cancers including prostate cancer. The present narrative review describes the composition and types of liposomes, its advantages, disadvantages, and the methods of preparation, research studies, clinical applications, drug repurposing and administration.

前列腺癌是影响男性的癌症之一,它大大提高了全球男性的死亡率。前列腺癌患者可能是局部病变,也可能是晚期病变。数字直肠检查、前列腺特异性抗原分析和前列腺活检都可用于鉴别前列腺癌。癌症的发病、发展和扩散都与特定基因的突变有关。根治性前列腺切除术、消融放射治疗和积极监测都是治疗局部前列腺癌的方法。雄激素剥夺疗法(ADT)、放疗和化疗适用于转移性前列腺癌或复发的男性。与传统的癌症化疗方法相比,基于脂质体的给药技术是一种毒性低、可生物降解、生物相容性好的纳米药物。脂质体可提高抗恶性细胞药物的敏感性、特异性和在体内的持久性,从而为纳米药物的使用提供了巨大优势。脂质体制剂正在对包括前列腺癌在内的多种癌症进行临床试验。本综述介绍了脂质体的组成和类型、优缺点、制备方法、研究、临床应用、药物再利用和给药。
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引用次数: 0
Tumor circulating biomarkers in colorectal cancer 结直肠癌中的肿瘤循环生物标记物
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2023.100787
Raana Bagheri , Mohsen Ghorbian , Saeid Ghorbian

CRC is a major global health concern and is responsible for a significant number of cancer-related deaths each year. The successful treatment of CRC becomes more difficult when it goes undetected until it has advanced to a later stage. Diagnostic biomarkers can play a critical role in the early detection of CRC, which leads to improved patient outcomes and increased survival rates. It is important to develop reliable biomarkers for the early detection of CRC to enable timely diagnosis and treatment. To date, CRC detection methods such as endoscopy, blood, and stool tests are imperfect and often only identify cases in the later stages of the disease. To overcome these limitations, researchers are turning to molecular biomarkers as a promising avenue for improving CRC detection. Diagnostic information can be provided more reliably through a noninvasive approach using biomarkers such as mRNA, circulating cell-free DNA, micro-RNA, long non-coding RNA, and proteins. These biomarkers can be found in blood, tissue, feces, and volatile organic compounds. The identification of molecular biomarkers with high sensitivity and specificity for early detection of CRC that are safe, cost-effective, and easily measurable remains a significant challenge for researchers. In this article, we will explore the latest advancements in blood-based diagnostic biomarkers for CRC and their potential impact on improving patient survival rates.

CRC 是全球关注的重大健康问题,每年造成大量癌症相关死亡。如果 CRC 在晚期才被发现,成功治疗就变得更加困难。诊断生物标志物在早期发现 CRC 方面可以发挥关键作用,从而改善患者的预后并提高存活率。开发用于早期检测 CRC 的可靠生物标志物以实现及时诊断和治疗非常重要。迄今为止,内窥镜检查、血液和粪便检测等 CRC 检测方法并不完善,往往只能发现疾病晚期的病例。为了克服这些局限性,研究人员正转向分子生物标记物,将其作为改进 CRC 检测的一个有前途的途径。通过使用 mRNA、循环无细胞 DNA、micro-RNA、长非编码 RNA 和蛋白质等生物标记物的无创方法,可以更可靠地提供诊断信息。这些生物标志物可在血液、组织、粪便和挥发性有机化合物中找到。如何鉴定具有高灵敏度和特异性的分子生物标记物,以安全、经济、易于测量地早期检测出 CRC,仍然是研究人员面临的重大挑战。本文将探讨基于血液的 CRC 诊断生物标记物的最新进展及其对提高患者生存率的潜在影响。
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Cancer treatment and research communications
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