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Finding the PSA-based screening stopping age using prostate cancer risk 利用前列腺癌风险确定基于 PSA 的筛查停止年龄。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100791
Azin Nahvijou , Mohammad Hadian , Naser Mohamadkhani

Background

Prostate Cancer screening was not rational for people who were suffered from other serious diseases and had a low quality of life. Biopsy and Prostate-Specific Antigen based screening also had imperfect information, pain, and costs. Finding the Prostate Cancer screening stopping age was important because after an age, Prostate-Specific Antigen test was not recommended and patients should not perform subsequent procedures. It could reduce the economic burden of Prostate Cancer. In this study, we modeled the effects of Prostate Cancer risk and comorbidities on the Prostate Cancer screening stopping age.

Methods

first, using a Markov model for PC progression, we provided a model for optimal Prostate Cancer screening stopping age. Second, we explored the relationship between comorbidities effects, Prostate Cancer risk and the stopping age.

Results

Our results suggest that the stopping age was an increasing function of PC risk and comorbidities effects. Screening should be stopped before 70 years. Finding showed that for men with diseases such as stroke or heart diseases, screening should not be performed at any age.

Conclusions

Personalizing PC screening through paying more attention to PC risk can improve efficiency of screening. The role of personal characteristics such as race, family history, and previous PSA in PC screening decision-making was highlighted by stratifying men in different PC risk groups to find their stopping age. Incorporating comorbidity effects shows that severity of comorbidity was a crucial factor in PC screening stopping age decision-making process.

背景:对于患有其他严重疾病且生活质量较低的人来说,前列腺癌筛查是不合理的。基于活组织检查和前列腺特异抗原的筛查也存在信息不完善、疼痛和成本等问题。找到前列腺癌筛查的终止年龄非常重要,因为超过了这个年龄,就不建议进行前列腺特异性抗原检测,患者也不应再进行后续治疗。这可以减轻前列腺癌的经济负担。在这项研究中,我们模拟了前列腺癌风险和并发症对前列腺癌筛查停止年龄的影响。方法:首先,我们利用 PC 进展的马尔可夫模型,为最佳前列腺癌筛查停止年龄提供了一个模型。其次,我们探讨了合并症影响、前列腺癌风险和停止年龄之间的关系:结果:我们的研究结果表明,停止筛查的年龄是前列腺癌风险和合并症影响的递增函数。筛查应在 70 岁之前停止。研究结果表明,对于患有中风或心脏病等疾病的男性,任何年龄段都不应进行筛查:结论:通过更多关注 PC 风险来进行个性化 PC 筛查可提高筛查效率。通过对不同PC风险群体的男性进行分层,找出他们的停筛年龄,突出了种族、家族史和既往PSA等个人特征在PC筛查决策中的作用。结合合并症的影响表明,合并症的严重程度是PC筛查终止年龄决策过程中的关键因素。
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引用次数: 0
Evaluation of treatment strategies for patients with stage IIIA non-small cell lung cancer in the immunotherapy era 免疫治疗时代IIIA期非小细胞肺癌治疗策略评价
Q3 Medicine Pub Date : 2024-01-01 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.
背景:IIIA期NSCLC患者的最佳治疗方案存在争议。越来越多的证据表明手术辅助或新辅助化疗(SC)可能优于非手术治疗。在IIIA期NSCLC患者中,自巩固免疫治疗被纳入治疗指南以来,尚未对SC和放化疗加免疫治疗(CRI)进行直接比较。方法:本回顾性研究比较了2017-2021年诊断为IIIA期NSCLC的成人手术和全身非手术治疗(靶向治疗除外)。数据来自ConcertAI精心策划的EHR Patient360™NSCLC真实世界护理产品。使用Kaplan-Meier和Cox比例风险法评估SC或CRI患者的真实无进展生存期(rwPFS)和总生存期(rwOS)。使用倾向得分衍生的逆概率处理权重(IPTW)平衡基线差异。结果:在1718例符合条件的患者中,两个主要比较组(SC和CRI)分别有431例(25%)和576例(34%)患者;711例患者接受了放化疗或单药治疗。在包括肿瘤诊所观察到广泛的治疗策略(例如,0-67%的诊所患者接受手术)。经iptw校正的分析显示,与CRI相比,SC组rwPFS (HR 0.78, 95% CI: 0.63-0.97)和rwOS (HR 0.63, 95% CI: 0.49-0.82)的风险降低。SC对不同淋巴结状态组的患者同样有益,对可切除的鳞状细胞肿瘤患者尤其有益。结论:IIIA期非小细胞肺癌的治疗变化很大。现实世界的研究可以提供有价值的证据来支持手术作为IIIA期患者的治疗选择,这些患者目前可能只接受放化疗和免疫治疗。
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引用次数: 0
Very first real-world data on zongertinib use in non-small cell lung cancer patients with HER2 mutations: A brief report
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2025.100875
Oliver Illini , Anna Sophie Lang-Stöberl , Hannah Fabikan , Christoph Weinlinger , Arschang Valipour , Maximilian J. Hochmair

Introduction

Treatment options for HER2-mutant patients with non-small cell lung cancer (NSCLC) are limited. New agents, including zongertinib, a HER2-selective tyrosine kinase inhibitor (TKI), are being investigated in clinical trials. However, published clinical data on the efficacy and safety of zongertinib are limited to data from a single phase I trial including only 36 patients with NSCLC.

Methods

We report real-world data on six consecutive patients with HER2-mutant NSCLC who received zongertinib through a named patient use program between December 2023 and June 2024. Radiological response evaluation and blood testing were routinely performed every two to three months, and adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.

Results

All patients were diagnosed with a metastatic adenocarcinoma, had previously progressed on at least one line of chemotherapy and had been previously treated with trastuzumab-deruxtecan (two had to stop treatment because of pneumonitis). Three patients (50%) presented with an Eastern Cooperative Oncology Group (ECOG) performance status of ≥2. A clinical and radiological benefit was achieved in all patients (complete response (1), partial response (4), and stable disease (1)). In one patient with brain metastases, a complete response was achieved. Treatment with zongertinib is ongoing in all patients. Adverse events were reported in one patient (elevated blood pressure (grade 1).

Conclusion

Zongertinib may be an effective and well-tolerated treatment option for HER2-mutant NSCLC patients even if they are heavily pretreated, have a reduced performance status or have a history of pneumonitis and brain metastases.
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引用次数: 0
Factors influencing smoking cessation in Lebanese patients with bladder cancer: A cross sectional study
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2025.100879
Georges Horkoss , Joey El Khoury , Rami Halabi , Anthony Kanbar , Serge Assaf , Anthony Mina , Sabine El Breidi , Charbel Dabal , Charbel El Hachem , Maher Abdessater , Rodrigue Saad , Antoine Kassis , Raghid El Khoury

Introduction

Bladder cancer (BCa) is a very common urological cancer. Literature showed smoking as a main risk factor for BCa however patients may not be well-informed about the relation between smoking and BCa. Urologists play a crucial role in educating patients about smoking risks and encouraging cessation. The objective is to discover sociodemographic factors that influence the success rate of smoking cessation and other behavioral changes in a sample of smoking Lebanese patients diagnosed with BCa.

Methods

A cross sectional study was conducted using a phone survey composed of 53 questions assessing the patients’ knowledge that they had or received from their treating physician about smoking as risk factor for BCa. A sample of patients diagnosed with BCa between 2015 and 2020 were contacted and data was collected between the months of September 2022 and May 2023. Inclusion criteria consisted of adult patients with a diagnosis of BCa and a history of smoking while exclusion criteria consisted of unreachable patients. 260 patients were chosen, 182 patients responded making the response rate 70 %

Results

Our sample size consisted of 182 patients was composed of 143 males (78.6 %) and 39 females (21.4 %), 97 (53.3 %) are currently smokers of which 50 (51.5 %) tried but failed, 41 (42.3 %) found no benefit in stopping and 6 (6.2 %) were not counseled. 145 patients (79.7 %) knew about smoking as a risk factor for BCa, with only 6 (3.3 %) knowing before their diagnosis. The multivariate analysis has shown that women (p = 0.010), patients with higher educational level (p = 0.004) tend to stop smoking after diagnosis with BCa more than men and people with lower educational level. Also there was a positive correlation between urologist counseling and smoking cessation (p = 0.03).

Conclusion

These findings showed that people had little knowledge about smoking as risk factor for BCa. A need for nationwide awareness campaigns about smoking risks specially targeting lower educational level patients and men or implicating stricter laws for smoking. Also a need of improving in smoking cessation counseling of urologists.
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引用次数: 0
Influence of histopathological changes after neoadjuvant chemotherapy on the survival of breast cancer patients
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2025.100886
Sabine Danzinger , Verena Heiss Spornberger , Hannes Vietzen , Kristina Tendl-Schulz , Georg Pfeiler , Christian F. Singer , Michael Seifert

Introduction

Neoadjuvant chemotherapy (NACT) is an established form of therapy for early breast cancer (BC). The aim of our study was to analyze histopathological parameters before and after receiving NACT and to determine the influence of these changes on prognosis of BC patients.

Material and methods

We retrospectively analyzed data of patients with primary early BC, diagnosed between January 2012 and December 2019, and NACT, followed by primary surgery. Patients achieving pathological complete response (pCR) were excluded. For the outcome analysis, disease-free survival (DFS) and overall survival (OS) were defined.

Results

A total of 237 tumors were analyzed in the study. The conversion rates of tumor grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67 status, and BC subtype were 34.6 %, 3.4 %, 14.3 %, 4.6 %, 30.0 %, and 28.7 %, respectively. After a median follow-up of 58.03 months, we found an association between consistently negative ER/PR with the worst prognosis (DFS and OS) (ER p < 0.0001 for both; PR p = 0.0003, p = 0.0004, respectively). The conversion from Ki67 ≥14 % to <14 % led to an improved outcome compared to a constant Ki67 ≥14 % (DFS p = 0.003, OS p = 0.001). Tumor residuals with a non-triple-negative (nTN) subtype (TN → nTN) showed a better prognosis than those with TN subtype (nTN → TN) (DFS and OS p < 0.0001).

Conclusions

After NACT, tumor grade and Ki67 showed the highest conversion rates between primary biopsy and tumor residual. Depending on changes in ER, PR, Ki67, and subtype, we found significant differences in the prognosis of the patients.
引言 新辅助化疗(NACT)是治疗早期乳腺癌(BC)的一种成熟疗法。我们的研究旨在分析接受NACT前后的组织病理学参数,并确定这些变化对BC患者预后的影响。获得病理完全反应(pCR)的患者除外。在结果分析中,定义了无病生存期(DFS)和总生存期(OS)。肿瘤分级、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)、Ki67状态和BC亚型的转换率分别为34.6%、3.4%、14.3%、4.6%、30.0%和28.7%。中位随访 58.03 个月后,我们发现 ER/PR 持续阴性与最差预后(DFS 和 OS)有关(ER p < 0.0001;PR p = 0.0003,p = 0.0004)。与Ki67≥14%的恒定值相比,Ki67≥14%转化为<14%可改善预后(DFS p = 0.003,OS p = 0.001)。结论NACT后,肿瘤分级和Ki67在原发活检和肿瘤残留之间的转换率最高。根据ER、PR、Ki67和亚型的变化,我们发现患者的预后存在显著差异。
{"title":"Influence of histopathological changes after neoadjuvant chemotherapy on the survival of breast cancer patients","authors":"Sabine Danzinger ,&nbsp;Verena Heiss Spornberger ,&nbsp;Hannes Vietzen ,&nbsp;Kristina Tendl-Schulz ,&nbsp;Georg Pfeiler ,&nbsp;Christian F. Singer ,&nbsp;Michael Seifert","doi":"10.1016/j.ctarc.2025.100886","DOIUrl":"10.1016/j.ctarc.2025.100886","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemotherapy (NACT) is an established form of therapy for early breast cancer (BC). The aim of our study was to analyze histopathological parameters before and after receiving NACT and to determine the influence of these changes on prognosis of BC patients.</div></div><div><h3>Material and methods</h3><div>We retrospectively analyzed data of patients with primary early BC, diagnosed between January 2012 and December 2019, and NACT, followed by primary surgery. Patients achieving pathological complete response (pCR) were excluded. For the outcome analysis, disease-free survival (DFS) and overall survival (OS) were defined.</div></div><div><h3>Results</h3><div>A total of 237 tumors were analyzed in the study. The conversion rates of tumor grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67 status, and BC subtype were 34.6 %, 3.4 %, 14.3 %, 4.6 %, 30.0 %, and 28.7 %, respectively. After a median follow-up of 58.03 months, we found an association between consistently negative ER/PR with the worst prognosis (DFS and OS) (ER <em>p</em> &lt; 0.0001 for both; PR <em>p</em> = 0.0003, <em>p</em> = 0.0004, respectively). The conversion from Ki67 ≥14 % to &lt;14 % led to an improved outcome compared to a constant Ki67 ≥14 % (DFS <em>p</em> = 0.003, OS <em>p</em> = 0.001). Tumor residuals with a non-triple-negative (nTN) subtype (TN → nTN) showed a better prognosis than those with TN subtype (nTN → TN) (DFS and OS <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>After NACT, tumor grade and Ki67 showed the highest conversion rates between primary biopsy and tumor residual. Depending on changes in ER, PR, Ki67, and subtype, we found significant differences in the prognosis of the patients.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"43 ","pages":"Article 100886"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526672","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
0,1,2,3D nanostructures, types of bulk nanostructured materials, and drug nanocrystals: An overview 0、1、2、3D 纳米结构、块状纳米结构材料类型以及药物纳米晶体:概述
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100834
Ali Assim Adul-Rasool , Duaa Mohammed Athair , Haider Kamil Zaidan , Ahmed Mahdi Rheima , Zainab T. Al-Sharify , Srwa Hashim Mohammed , Ehsan kianfar

Functional materials are required to meet the needs of society, such as environmental protection, energy storage and conversion, integrated product production, biological and medical processing. bulk nanostructured materials are a research concept that combines nanotechnology with other research fields such as supramolecular chemistry, materials science, and life science to develop logically functional materials from nanodevices. In this review article, nanostructures are synthetized by different methods based on the types and nature of the nanomaterials. In a broad sense “top-down” and “bottom-up” are the two foremost methods to synthesize nanomaterials. In top-down method bulk materials have been reduced to nanomaterials, and in case of bottom-up method, the nanomaterials are synthesized from elementary level. The different methods which are being used to synthesize nanomaterials are chemical vapor deposition method, thermal decomposition, hydrothermal synthesis, solvothermal method, pulsed laser ablation, templating method, combustion method, microwave synthesis, gas phase method, and conventional Sol-Gel method. We also briefly discuss the various physical and chemical methods for producing nanomaterials. We then discuss the applications of functional materials in many areas such as energy storage, supercapacitors, sensors, wastewater treatment, and other biological applications such as drug delivery and drug nanocrystals. Finally, future challenges in materials nanoarchitecture and concepts for further development of functional nanomaterials are briefly discussed.

大块纳米结构材料是将纳米技术与超分子化学、材料科学和生命科学等其他研究领域相结合,从纳米器件中开发出逻辑功能材料的一种研究理念。在这篇综述文章中,根据纳米材料的类型和性质,采用不同的方法合成纳米结构。从广义上讲,"自上而下 "和 "自下而上 "是合成纳米材料的两种主要方法。在 "自上而下 "的方法中,大块材料被还原成纳米材料;而在 "自下而上 "的方法中,纳米材料是从基本层面开始合成的。目前用于合成纳米材料的方法有化学气相沉积法、热分解法、水热合成法、溶热法、脉冲激光烧蚀法、模板法、燃烧法、微波合成法、气相法和传统的溶胶-凝胶法。我们还简要讨论了生产纳米材料的各种物理和化学方法。然后,我们讨论了功能材料在许多领域的应用,如能量存储、超级电容器、传感器、废水处理以及其他生物应用,如药物输送和药物纳米晶体。最后,我们简要讨论了材料纳米结构的未来挑战和进一步开发功能纳米材料的概念。
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引用次数: 0
Deleterious association between proton pump inhibitor and protein kinase inhibitor exposure and survival for patients with lung cancer: A nationwide cohort study 质子泵抑制剂和蛋白激酶抑制剂暴露与肺癌患者生存之间的畸变关系:一项全国性队列研究
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100801
Constance Bordet , Mahmoud Zureik , Yoann Zelmat , Margaux Lafaurie , Maryse Lapeyre-Mestre , Agnès Sommet , Julien Mazieres , Fabien Despas

Introduction

Previous studies have identified an interaction between protein kinase inhibitors (PKIs) and proton pump inhibitors (PPIs) in patients with lung cancer. This type of interaction may reduce the efficacy of PKIs. However, the effect of PKI-PPI interaction on patient mortality remains controversial. This study set out to determine the impact of PKI-PPI interaction on overall survival for lung cancer patients.

Materials and methods

This study was conducted using data from the French National Health Care Database from January 1, 2011 to December 31, 2021. We identified patients with: (i) an age equal to or greater than 18 years; (ii) lung cancer; and (iii) at least one reimbursement for one of the following drugs: erlotinib, gefitinib, afatinib and osimertinib. Patients were followed-up between the first date of PKI reimbursement and either December 31, 2021 or if they died, the date on which death occurred. The cumulative exposure to PPI duration during PKI treatment was calculated as the ratio between the number of concomitant exposure days to PKI and PPI and the number of exposure days to PKI. A survival analysis using a Cox proportional hazards model was then performed to assess the risk of death following exposure to a PKI-PPI interaction.

Results

34,048 patients received at least one reimbursement for PKIs of interest in our study: 26,133 (76.8 %) were exposed to erlotinib; 3,142 (9.2 %) to gefitinib; 1,417 (4.2 %) to afatinib; and 3,356 (9.9 %) to osimertinib. Patients with concomitant exposure to PKI-PPI interaction during 20 % or more of the PKI treatment period demonstrated an increased risk of death (HR, 1.60 [95 % CI, 1.57–1.64]) compared to other patients. When this cut-off varied from 10 % to 80 %, the estimated HR ranged from 1.46 [95 % CI, 1.43–1.50] to 2.19 [95 % CI, 2.12–2.25].

Discussion/Conclusion

In our study, an elevated risk of death was observed in patients exposed to PKI-PPI interaction. Finally, we were able to identify a dose-dependent effect for this interaction. This deleterious effect of osimertinib and PPI was revealed for the first time in real life conditions.

导言先前的研究发现,在肺癌患者中,蛋白激酶抑制剂(PKIs)与质子泵抑制剂(PPIs)之间存在相互作用。这种相互作用可能会降低 PKIs 的疗效。然而,PKI-PPI相互作用对患者死亡率的影响仍存在争议。本研究旨在确定 PKI-PPI 相互作用对肺癌患者总生存期的影响。材料与方法本研究使用了法国国家医疗保健数据库中 2011 年 1 月 1 日至 2021 年 12 月 31 日的数据。我们确定了以下患者(i) 年龄等于或大于 18 岁;(ii) 罹患肺癌;(iii) 至少报销过一次以下药物中的一种:厄洛替尼、吉非替尼、阿法替尼和奥西莫替尼。患者的随访时间为 PKI 首次报销日期至 2021 年 12 月 31 日,如果患者死亡,则以死亡日期为准。PKI治疗期间PPI的累积暴露时间按PKI和PPI同时暴露天数与PKI暴露天数之比计算。结果在我们的研究中,34,048 名患者至少接受了一次相关 PKI 的治疗:26,133 人(76.8%)接受了厄洛替尼;3,142 人(9.2%)接受了吉非替尼;1,417 人(4.2%)接受了阿法替尼;3,356 人(9.9%)接受了奥希替尼。与其他患者相比,在20%或更长的PKI治疗期间同时暴露于PKI-PPI相互作用的患者死亡风险更高(HR,1.60 [95 % CI,1.57-1.64])。讨论/结论在我们的研究中,观察到暴露于PKI-PPI相互作用的患者死亡风险升高。最后,我们确定了这种相互作用的剂量依赖效应。奥希替尼和PPI的这种有害效应首次在现实生活中被揭示出来。
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引用次数: 0
EGFR-mutation testing, treatment patterns and clinical outcomes in patients with stage IB–IIIA non-small cell lung cancer in Norway–a nationwide cohort study 挪威 IB-IIIA 期非小细胞肺癌患者的表皮生长因子受体突变检测、治疗模式和临床结果--一项全国性队列研究
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2023.100785
Åslaug Helland , Tor Åge Myklebust , Simona Conte , Line Elmerdahl Frederiksen , Jørgen Aarøe , Espen Enerly

Introduction

Testing for mutations of epidermal growth factor receptor (EGFR) is crucial to identify non-small cell lung cancer (NSCLC) patients eligible for treatment with EGFR tyrosine kinase inhibitors (EGFR-TKIs); This study aims to describe EGFR-mutation testing, treatment patterns, and overall survival (OS) in localized NSCLC patients.

Materials and Methods

Patients with localized (Stage IB–IIIA) NSCLC registered in the Norwegian Cancer Registry during 2010–2017 were followed from diagnosis until emigration, death, or end of study in 2018. The cohort was linked to data from the Norwegian Patient Registry, the Prescription Database, and the Cause of Death Registry.

Results

Of 2367 patients identified with localized NSCLC, 52 % were females and median age at diagnosis was 69 years. Most (66 %) were treated with surgery, while 16 % received curatively-intended radiotherapy (RT). EGFR-mutation testing increased significantly from 58 to 84 % during the study period. Testing frequencies varied across regions and comorbidity levels. Nine-percent of tested patients were EGFR-mutation positive (EGFRm+), of whom 27 % were treated with EGFR-TKIs. There was no correlation between initial treatment with either surgery or RT and EGFR-TKI use. The 3-year OS did not vary considerably by EGFR-mutation testing, but EGFRm+ patients had a higher 3-year OS (78.8 %) than wild-type EGFR (EGFRwt) patients (65.9 %).

Discussion

Although EGFR-mutation testing is increasingly being implemented in the early-stage setting in line with national recommendations, some patients are still not being tested for molecular markers as part of their diagnostic workup–a prerequisite for providing equal access to effective targeted treatments, such as EGFR-TKIs, to eligible patients.

导言:表皮生长因子受体(EGFR)突变检测对于确定有资格接受表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)治疗的非小细胞肺癌(NSCLC)患者至关重要;本研究旨在描述局部NSCLC患者的EGFR突变检测、治疗模式和总生存期(OS)。材料与方法对2010-2017年期间在挪威癌症登记处登记的局部性(IB-IIIA期)NSCLC患者进行了从诊断到2018年移民、死亡或研究结束的随访。该队列与挪威患者登记处、处方数据库和死因登记处的数据相关联。结果在2367名被确诊的局部NSCLC患者中,52%为女性,确诊时的中位年龄为69岁。大多数患者(66%)接受了手术治疗,16%接受了根治性放疗(RT)。在研究期间,表皮生长因子受体突变检测率从58%大幅上升至84%。检测频率因地区和合并症水平而异。9%的受检患者表皮生长因子受体突变呈阳性(EGFRm+),其中27%接受了EGFR-TKIs治疗。最初的手术或 RT 治疗与 EGFR-TKI 的使用没有相关性。讨论尽管根据国家建议,表皮生长因子受体突变检测正越来越多地应用于早期治疗,但仍有一些患者没有在诊断过程中接受分子标记物检测,而这是为符合条件的患者提供平等接受有效靶向治疗(如表皮生长因子受体-TKIs)机会的前提条件。
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引用次数: 0
Characterization of genomic profiling of Mexican women with breast cancer using EndoPredict 使用endopdict分析墨西哥乳腺癌妇女的基因组特征。
Q3 Medicine Pub Date : 2024-01-01 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.
目的:在墨西哥乳腺癌发病率和死亡率上升的背景下,我们的研究深入研究了被诊断为I-III期乳腺癌的墨西哥妇女的基因组景观。方法:采用endoppredict测试进行基因组分析,我们的回顾性横断面研究探讨了基因组表达与免疫组织化学(IHC)之间的相关性。结果:50例女性患者中,免疫组化风险分层显示50%为高危,50%为低危,两组临床及组织学差异显著。高危样本肿瘤较大,组织学分级较高,淋巴结阳性较多。免疫组化结果显示与endoppredict测试有中等程度的一致性(kappa Cohen’s 0.48),强调其临床可靠性优于免疫组化。结论:该研究提倡整合基因组工具,特别是endoppredict测试,用于墨西哥女性乳腺癌的管理,以提高治疗决策的准确性。我们的研究结果为墨西哥人群乳腺癌诊断和管理的发展前景提供了宝贵的见解。
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引用次数: 0
Personalized medicine: An alternative for cancer treatment 个性化医疗:癌症治疗的另一种选择。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ctarc.2024.100860
Devendra Singh , Vinay Kumar Dhiman , Minakshi Pandey , Vivek Kumar Dhiman , Avinash Sharma , Himanshu Pandey , Sunil Kumar Verma , Rajeev Pandey
The incidence of cancer continues to increase worldwide, resulting in significant physical, emotional, and financial challenges for individuals, families, communities, and healthcare systems. Cancer is projected to be responsible for approximately 10 million deaths in 2020, accounting for one in six deaths globally. Prostate, colon, lung, and breast cancers are the most common types of cancer. In India, it is estimated that there will be around 2.7 million cancer patients by 2020. Personalized medicine has the potential to offer an alternative approach to cancer treatment. Precision medicine, often known as personalized medicine, is a new cancer treatment technique that focuses on tailoring medication to each patient's specific genetic, biochemical, and lifestyle factors. The goal is to optimize tumor response while minimizing therapy side effects, resulting in improved patient care and quality of life. Personalized medicine allows for the creation of focused medicines that address specific gene mutations by leveraging knowledge about a patient's cancer, including its genetic makeup. Ongoing research seeks to detect gene modifications in diverse cancer types, produce novel diagnostic tools, and develop treatments that particularly target these genetic changes. In recent years, personalized medicine has achieved major advances in the treatment of solid tumors, with the promise to improve treatment precision, reduce side effects, as well as enhance outcomes for patients in cancer therapy. This review aims to objectively evaluate the transformation of cancer treatment, emphasizing the shift towards a more precise methodology.
全球癌症发病率持续上升,给个人、家庭、社区和卫生保健系统带来了重大的身体、情感和经济挑战。预计到2020年,癌症将导致约1000万人死亡,占全球死亡人数的六分之一。前列腺癌、结肠癌、肺癌和乳腺癌是最常见的癌症类型。据估计,到2020年,印度将有大约270万癌症患者。个性化医疗有可能为癌症治疗提供另一种方法。精准医疗,通常被称为个性化医疗,是一种新的癌症治疗技术,专注于根据每个患者特定的基因、生化和生活方式因素定制药物。目标是优化肿瘤反应,同时尽量减少治疗副作用,从而改善患者的护理和生活质量。个性化医疗允许通过利用对患者癌症的了解,包括其基因组成,来创造针对特定基因突变的针对性药物。正在进行的研究旨在检测不同癌症类型的基因修饰,产生新的诊断工具,并开发特别针对这些基因变化的治疗方法。近年来,个性化医疗在实体瘤治疗方面取得了重大进展,有望提高治疗精度,减少副作用,并提高癌症治疗患者的预后。这篇综述旨在客观地评价癌症治疗的转变,强调向更精确的方法的转变。
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引用次数: 0
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Cancer treatment and research communications
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